Working with Ortho Patients

[JustJen, BSN, RN]

Hello All-

I will be working with Ortho patients and I am a recent ADN graduate. I am a bit concerned about how ortho nurses "fit everything in" that needs to be done. I am hoping some of you experts (you know who you are) will give me some pearls of wisdom. I know on any Med/SUrg floor nurses are very busy with Assessments, Meds, Dsg Changes, etc.....so how do Ortho Nurses fit in the "out of bed/ambulate TID" order that all the ortho docs write?How do you handle getting patients to get out of bed? Most of my client population are elderly, and it seems if I tell them they need to get up, they tell me to stick it where the sun don't shine!

Advice......please.....pretty please????

Also, anyone know a good site for tips on Ortho patients, limitations, etc?

[truern]

Jen, I did two semesters of clinical on an ortho floor. Our first few times out of bed and ambulating were always with PT. Make friends with them...they'll be some of your greatest assets

[P_RN, ADN, RN]

The great thing we had was the PT department satellite room right on our unit. They got them up, showed them how to use the BR safely, ambulated and either sat up or put back to bed bid /7 d week. The very worst is those CPM machines-are they still used? They weigh a ton. The rest is just like med/surg with the addition of color sensation movement assessments.

GOOGLING got me several sites. Here is one

http://www.emedicine.com/pmr/topic221.htm

[meownsmile, BSN, RN]

We get our orthos up the night of surgery for 30 min unless they have had symptoms contraindicating they be up. After that, they work with PT twice a day and we get them up as needed for commode or to a chair for meals. Noone gets a bedpan past the first night unless they were bedfast prior to surgery and even then we may lift them to the commode.

Sometimes it is difficult to make someone understand they need to get out of bed. They tend to be content to lay in bed and let the nurses do everything. Impress on them how important being up in a chair and ambulating is for their lung expansion to prevent pneumonia, and their bowel function to keep them from getting a ilius or something after surgery with the pain medications. If nothing else works,, just tell them its something they will need to discuss with the doctor because its his order they be up. You have to educate at the same time you are helping. Teach them how to slide the affected leg out as they sit down (for comfort), tell them to take deep breaths while they are up and do their coughing and deep breathing excersises, make sure they have pain medication on board before they are supposed to get up.

Getting cooperation is part of the nursing process, utilize your knowledge its there you just have to think it through.