What will I see on an ortho/neuro floor?

Daly City RN · Oct 7, 2009

Hello all, I was just contacted by a local hospital facility today asking if I can come in tomarrow for an interview. I was surprised to say the least as I have applied at numerous facilities without a boo from them and it was just the night before that I had applied online. Anyhooz, I honestly did not do much of any clinicals on an ortho or neuro floor and would like to know from those experienced nurses that do work on such a floor what this might involve. I have heard some say that an ortho floor is difficult. humm.

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I worked in a busy ortho floor in a busy trauma center about 15 years ago. Be prepared to give a lot of narcotic pain shots. Patient's will bug you because they are really in pain. Assess your patient's condition carefully and if they are stable and o.k. to give them pain medication, then go ahead give it to them rather hearing that non-stop call bell and the loud yelling (they're in pain!). Suggest to the doctor to start your patients on PCAs; these will free up a lot of your time.

It is of utmost importance that you monitor your patients closely especially those on narcotic medications. I heard one incident in which a patient was given a narcotic pain medication but the nurse failed to assess the patient after 30 minutes which is the protocol in our hospital. The patient was later found not breathing, a cobe blue was called but the patient did not survive. That nurse lost her job, don't know what happened to her license though.

Also ortho patients are at high risk for blood clots...and other problems.

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RNperdiem, RN · Oct 7, 2009

On a floor like that, you will depend heavily on your CNA's. If you and some good CNA's work well as a team, work will go well.

Most of the ortho patients cannot get around without help. Often, ortho patients are elderly and have other health issues to manage.

Jen2002 · Oct 7, 2009

Different shifts will have a different busy. Dayshift sends them to surgery, afternoons gets them back and discharges them, and midnights gets them from the ER. Most patients that come from surgery already come with a PCA or epidural. Monitor closely! They will also have autotransfusers or drains. You give a lot of blood on that floor also. And the neuro people, well good luck they usually need neuro checks every hour or two. Great place to learn and I actually found out I love orthopedics!

Daly City RN · Oct 7, 2009

Different shifts will have a different busy. Dayshift sends them to surgery, afternoons gets them back and discharges them, and midnights gets them from the ER. Most patients that come from surgery already come with a PCA or epidural. Monitor closely! They will also have autotransfusers or drains. You give a lot of blood on that floor also. And the neuro people, well good luck they usually need neuro checks every hour or two. Great place to learn and I actually found out I love orthopedics!

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The one good thing of being, well...an "older nurse", you have heard more than a few bad things that happened in your hospital that you remember them very well, and hope that they never happen to you or to your patients.

One nurse was supposed to check the neuro staus of one of her patients on a regular basis. She later said that her patient was "asleep", so she simply documented "asleep" instead of waking the patient up to do the q1 hour neuro check as per doctor's order.

When the day shift nurse came in and did her initial patient assessment she discovered that that patient had blown pupils and the patient was comatose rather than "asleep".

Hard lesson learned by that night shift nurse. Don't know whether that nurse is still practicing as a nurse though.

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