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1 yr nurse in med-surg, HELP!!!

Specializes in LTC. Has 11 years experience.

I've been at a new job in med-surg about 3 weeks and am completely freaked out! I worked a year in LTC, and it got boring so I decided to try something new. I have no idea what I'm doing! I know how to do assessments and such, but I have a tendency to freak out when a pt goes bad. In LTC, most folks would go bad slowly, and be a DNR. These guys tend to have the bottom drop out and are a code. I maintain composure on the outside, but inwardly I'm a wreck. Is this normal? Will I learn to just chill and think methodically, or will I spend countless nights wondering why I didn't see this or think of that? Fortunately, I'm still in orientation, and will be for awhile. I'm just wondering (on a daily, sometimes hourly basis) if I made the right choice. I read through most of the sticky for new med-surg nurses, and it did help some. Is there anyone else who feels/felt they were not qualified to work med-surg? I do like the fact I "get to be a nurse" more than I did in LTC, and I do like a little faster paced work environment, but I'm afraid my lack of knowledge will kill a pt. I really care about my pts, and don't want to be the cause of harm to someone. Please help!:bluecry1:

Hi bluegeegoo,

I understand what you feel. Codes are scary. I hate coding patients. Sucks when you thought a certain would be stable, and then all of sudden they crash and burn.

One course that is helpful in learning how to deal with a code blue in the hospital is Advanced Cardiac Life Support (ACLS). Typically, critical care RNs and telemetry RNs are required to be ACLS certified, but often med-surg nurses are not required. However, as we all know, med-surg patients do go into cardiac arrest, just like the rest of them, so I think taking an ACLS class and getting your ACLS certification would be very helpful.

In the ACLS training I received in the past, we were taught and memorized "algorithms" regarding the treatment protocols for such emergencies as ventricular fibrillation (v-fib), ventricular tachycardia (v-tach), pulseless electrical activity (PEA) and many others. Some ACLS classes expect you to already have a basic knowledge of EKGs. If you don't know what normal sinus rhythm versus arrhythmias looks like, then see if any facilities near you offers a Pre-ACLS class.

When I started out as a newbie in 2004 I worked in cardiac. My hospital required me to take their Basic Arrhythmia course first and then I had to look for an ACLS class. I found a company in the Tampa Bay area of Florida that offered both a 4 hour Pre-ACLS class and then the standard 8 hour ACLS class with certification exam. It was a big help. The training helped me to better understand what is happening during a code and what's the best way to deal with it. :nurse:

suni, BSN, RN

Specializes in med surg. Has 15 years experience.

Med-surg is the best field of nursing I think, we each have the field we like best and this is mine. It can be scary but remeber you are never alone, and you are a professional. Start to look for subtle clues that your patinet may be deterioralting, change in MS, restless, skin is cool, just doesn't feel right. Trust your instincts and of course monitor your VS, urianry output, any incisional drainage etc.

Continue to ask questions, I have been in nursing 20 years and everyday I have quesitons about one thing or another. Allow yourself the time to gros


athena55, BSN, RN

Specializes in critical care: trauma/oncology/burns. Has 38 years experience.

Hello Bluegeegoo2:

I can remember when I first graduated nursing school and worked on a med-surg floor for 4 months before going into ICU. I was so unsure of myself especially during code situations. Then when I transfered into the ICU my knees would literally knock together post-code. Life is a learning curve. Do you feel safe enough to ask your preceptor (if you have one) or perhaps head up to Nursing Administration where the Nursing Instructors are and ask their advice?

IMHO med-surg nurses need to know a lot about a lot, i.e., you never know when you will get an adolescent, teenager, an adult or an older citizen as part of your patient load plus the different disease processes that they are in for. Dealing with your patient load plus dealing with the different personalities that make up your floor and life, in general!

I am hopeful that things will feel and get better for you as you go along in your professional career. I also agree with Villanova about taking an ACLS class. Why don't you check out "ACLS Review made Incredibly Easy" Lippincott Williams & Wilkins ISBN: 1-58255-626-1. Try your medical library or www.amazon.com or www.bn.com

Hey, keep in touch and let us know how things are going for you from time-time. Good Luck. Don't give up on yourself. You've come too far and worked too hard to let self-doubt gain a stranglehold.


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