what type of patients are on an ortho/neuro floor? (re: senior practicum)

[MidnyteRaine]

Hi everyone (and happy holidays!)

I'm trying to decide where to do my senior practicum at and I was hoping some of you guys could help out. I'll be on a med/surg/tele floor when I graduate, and I'm trying to decide between a regular med/surg floor and an ortho/neuro floor for my senior practicum. The floor I'll be on after graduation gets its fair share of TKR's and THR's and since I'm not too comfortable w/ post surgical patients and I have no experience w/ traction I was thinking the ortho/neuro floor might be good for that. However I'm not sure if I'll get experience with other things on that floor such as NG tubes, tube feeding, TPN administration, decubitus ulcer dressings, etc. So, what kind of patients are on an ortho/neuro floor anyway? The Total Knee and Total Hip patients are sort of obvious, but what about on the neuro end? Will I get experience w/ skills there or is it too specialized? Should I stick w/ the regular med/surg instead? Any opinions would be great, I have about a week to make up my mind yet. Thanks!

Ashley

[purplemania, BSN, RN]

ortho is self-explanatory. Neuro is head injuries, strokes, and related disorders. So you could get all kinds of experiences. People may have aphasia, dysphasia, be aggressive or vegetative, need special equipment or need only to be monitored and medicated. Some will need artificial feeding and some will be able to eat unassisted. I predict that it will be unpredictable which makes nursing "fun".

[P_RN, ADN, RN]

However I'm not sure if I'll get experience with other things on that floor such as NG tubes, tube feeding, TPN administration, decubitus ulcer dressings, etc.

Never fear you will! And as far as traction it's hardly done any more except for multi-traumas and I'd say the majority of the MT's go to the unit first and then to an ORIF.

Ortho you'll get the elective totals who usually happen to be elderly (though not always), and there's always the LOL who fx her hip and fell....yes in that order. They can have some cx like ileus (ilei ?) with NG tubes.

Depending on the type hospital neuro might be crianiotomies for trauma and masses. MS, laminectomies, nerve resection, syrinx. I only set foot on neuro for the 4 weeks when my dad died from a brain tumor and two other times I got pulled there.

Believe me there is no such thing as just an ortho or just a neuro. It's usually at least as "exciting" as med/surg, but at least on ortho they hardly ever die. Our code cart had dust bunnies some months.

[ICUnowOHN]

I worked both neuro ICU, and progressive, and on the ortho floor. P_RN has it pretty much nailed. However, we were a regional Level 1 Trauma center, and most of them came to us in NICU. we had a Burn/Trauma ICU, but it was mostly an overflow ICU, if not many burns in the house. Anyhow, I would only add that you also see endart pts, and they are typically older. If the chopper took off out our windows we knew we were in for some extra fun. Due to the avg age of pt you tend to get various and sundry other unrelated issues to handle in Neuro.

Good Luck :)

see as much as you can, and ask every "dumb" question you can think of. You'll learn more that way :)

[Sadie04]

When I worked ortho/neuro/trauma recently we would get a wide variety of pts, from the TKAs, THAs and hip fxs to multitraumas (CTs, feeding tubes, anoxic brain injuries) to craniotomies, spinal fusions, BKAs, CVAs, closed head injuries and open skull fx. I learned a lot working on that unit, and would still be there if their staffing ratios weren't so horrendous!