Med/surg how do you handle the pt load?

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Reply Mon 10 Apr, 2006 07:11 pm
Med/surg how do you handle the pt load?
I have always worked ICU/stepdown, with a pt load of 2-4. Everyone keeps saying I should still do a year of med/surg to gain those wonderful organziation skills. Like a dummy, I allowed myself to be pulled to medsurg a couple of weeks ago. It was a nightmare...and I later found out from the regular staff that it was a good day!! Between trying to halfway chart the legal required minimum, throw meds at my pts and hope they didn't need anything else, answering call lights for yet another juice, and trying to take off orders, I was dead!! There is no way to juggle the load and do what is right and safe for the pt. I keep feeling like maybe I do need to force myself to take more shifts for the experience, but I really just hated it. I would love any advice from seasoned med/surg nurses that would help me. Also, if it is so rough and an awful place to be, then why do so many nurses do it? It's not like there are no other areas in which to work!!!
Lory 1
Reply Mon 10 Apr, 2006 08:06 pm
I did med/surg for 18mths and it was the aweful ! I had days with 8 patients going to and from surgery, when one was d/c another admitted , orders out the wazoo, vitals to check every 15x2 then 30x2 and soo on. Even though you have and aide the patients are your responsibility. I do have to say that it was the best experience I have ever had! But would never in a million years go back ! I am a pediatric nurse now, and love it! i am gonna try to to the nicu stepdown unit in hopes of getting into nicu with some experience. gl to you
Reply Fri 14 Apr, 2006 11:43 pm
Med/Surg How do you handle the pt load?
I've done Med/Surg off and on for 13 yrs. The only thing I can tell you is YOU GET USED TO IT. You develop somewhat of a routine and deal with whatever happens as it happens. Some days are worse than others. Do the best you can with what you have.
Reply Sun 16 Apr, 2006 05:47 pm
I just had to reply to this post b/c I too have been baptized by fire into the med/surg world, it happened years ago when I first started nursing, It was wild and messy!! and then I learned how to stay away from M/S not b/c I didn't like it, but b/c like housework, if done properly it will kill you... :wink:
Now for some reason I thought I might "Moonlight" over at the rural hospital near to where I live, it seemed like a harmless idea, only 30 beds and a good way to pick up a lil $$ for my daughters up coming Graduation......The following is a true story:

My first day of orientation to M/S went like this : 7am til 1pm nothing unusual but then at 1:22pm the bottom fell out and 8 admits came from out of the woodwork (all either acute or critical) ...

The ER was full and they needed beds so...well you know... (the word on the street was the owner of this hospital was upset b/c we were not full)...

Anyway as I was "orienting" with this nice nurse lady and the bottom fell out I was no longer "orientating" but soon taking on patients, since she was tied up with a GI bleed that we were trying to transfuse but couldn't d/t antibodies from Hep C and he was on a bad trip from some street drug ...
then we got an insulin drip., (my sister who works there too helped us with that one) town drunk needing a bannana bag, which I had to mix up Smile and then a pt with chest pain and two with NG tubes ( and a partridge in a pare tree!! ) I had to keep running supplies to nice nurse lady with the GI bleed...finally EMS got there at 6pm and picked up insulin drip pt and GI bleed pt....we took a deep breath and finished up paper work and reported off at 6:45 pm and night shift took husband gets to hear all the war stories and his response was "Oh that was good for you, it keeps your skills up!!" he thinks I get off to wild messy days!!
Reply Sun 16 Apr, 2006 10:37 pm
OMG!! Med/surg from hell!!
2 NG tubes??? Poor pt!! Nurses having to mix banana bags?? Poor nurse!!

At least where I work they make the pharmacists mix most everything (hey, pay me like a pharmacist and I"ll be glad to mix my own!!) I found out that there is no such thing as orientation...its just another word for "feeding you to the wolves"!!! God bless you.
Reply Tue 25 Apr, 2006 12:58 am
my home hospital floor is a med/tele unit....we work in the "county" hospital which i lovingly call the ghetto hospital we cater to the mentally ill, the homeless, the jail and prisons and also fly patients in from 5 surrounding states. we are a teaching hospital so have to deal with med students on up to attendings...i guess because this is where i started out as a cna and then nurse i am just used to the craziness...of course we have clerks that take off the orders, meds are mixed in the pharmacy and we usually have aids to help with baths etc.all of our charting is done on computer with computer in every room, pt load is 3 on a good day 4 on a bad. im one of the few that loved it...and can't wait to go back home to my floor...but im on my first travel assignment in cali and i never leave work on time, the pt load is nothing compared to what im used to, in fact i often am a little bored with the pts, but its all the paperwork always late because of it...the clerks dont actually take your orders off, you have to fill out the same info on 3-4 different peices of paper and there is no delivery system if you need blood, go get it, if pharmacy didnt bring up a med you need, you go get it, etc etc, so im at the end of a contract and i just now feel like im getting a hang of this system. i guess my point is that you just have to figure out your own way of time management/ takes some time but you'll get it
but i do also know that when i go home i will be applying to one of our ICU's, we only have 9 of them to choose from!!!! good luck in the med/surg dept...
Ginger Snap
Reply Tue 25 Apr, 2006 02:00 pm
Bad as all this sounds, it's a good thing. You learn resilience, flexibility and adaptability and how to priroitize. Best experience you can get. After this, wherever you go, you'll work with confidence in your own abilities.
hawkeye 1
Reply Tue 30 May, 2006 06:58 pm
med surg
I have worked med surg for 10 years and it can be hell on wheels!! On a good night we have 5-6pts and a tech on a bad night we have 7 patients and no tech, and on nightmare nights 10 & 11 and no tech to be had--it's happened twice. I work at a county "ghetto" hospital where the "CEO" who used to be a hospital administrator keeps building and building on to our hospital BUT HELLO we can't even keep nurses !!!! We have the lowest paid salary in the area..It sucks.. Just 6 more months and I too will be leaving for greener pastures...... But yes MED-Surg gives you a strong backgroud Rolling Eyes
Reply Wed 14 Jun, 2006 06:42 pm
med surg floors

I started out as a new grad at our local hospital in a medium sized city. We regularly have 5 patients each and cover an LPN with eight patients(orders, doc calls, IV meds and their paperwork) Ususally, we will have a CNA to share among the thirteen. That is on regular day shift with all the usual coming and goings to and from surgery and tests.
From the descriptions of the others I have been reading, I work in a hell hole - and yet because we have established our routines, it all gets done with out to much confusion. We do have a secretary to do the orders but we have to verify and sign them all. We do have computer charting and the docs have to enter their orders in computer as well - cuts way back on the nurse conferences to decifer the hand writing. We also do the discharge planning with the entire ancilary teams - takes about an hour a shift, unless you stay very organized.
I would like to actually be able to talk to the patients more and would love to be able to do some teaching - never time for that. The hospital finally did hire some RN's just for teaching.
My only suggestion for you is that you need to work over in med/surg more often, that way you can get used to how they do things and establish a routine that works for you - incorporate pieces of the others routines but none will work completely for you - customize customize and prioritize!!! Good Luck.

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