Atmosphere
Certified nurse’s assistants assigned to medical/surgical floors will often be tasked with a variety of responsibilities. These floors are usually busy, and you will sometimes need to keep track of patients and their records as they come and go from the floor. This will help to inform the doctors and nursing staff regarding the patient’s location and condition. Consider yourself the eyes and ears of the floor.
Being able to multitask is an essential skill for the nurse’s assistant in this type of atmosphere. Unlike a nursing home environment, medical/surgical units will frequently see a wide variety of patients of various ages that may have a whole multitude of different conditions.
Surgical Care Concerns
The goal of the surgical healthcare team is to make the patient’s hospital stay comfortable, safe and as short as possible. Surgical patients are classified into both pre-operative and post-operative care. During pre-operative care, patients are prepped for surgery and all relevant notes regarding the require blood test and possible patient allergies are noted on the patient identification bracelets and in their file.
During post-operative care, patient’s vital signs are closely monitored for signs of shock or infection. The nursing staff also must tend to the patient’s wounds, surgical drains and any other postsurgical concerns.
In your role as a nurse’s aide, you will assist the nursing staff in the following surgical care procedures during this time:
Vital Signs
You will be responsible for measuring and documenting patient’s vital signs. The four basic signs are temperature, blood pressure, heart rate and respiratory rate. You should immediately inform the nursing staff of any abnormal findings.
Post- Operative Pain
Pain is common after surgery. If the patient is complaining of pain, let them know that you are there to help and notify the nursing staff of the patient’s pain level. Offer emotional support and do your best to keep the patient comfortable during this time of physical pain.
Moving the Patient
When the patient is ready, they will need to get up and move as soon as possible after surgery. This helps with circulation. You will be called to help the nursing staff move the patient in bed at least every two hours. This helps to prevent bed sores and also helps to keep the patient comfortable.
Prior to moving the patient, make sure that their pain is under control. If the patient seems to be in too much pain, inform the nurse and try again later after their pain is under control.
When dealing with surgical patients, they often have tubes/drains that need to be unhooked from the bed and moved with the patient. If this is overlooked, it can lead to a tube or drained being pulled out of the wound and may result in additional pain to the patient.
The patient will also be encouraged to perform leg exercises to assist with circulation. This will help prevent blood clots in the legs. Walking, leg exercises, compression stockings and movement are all preventative measures against clots.
Fluid Intake/Output
Patients are often on intravenous fluids after surgery. During this time, it is important to monitor the patients to make sure that their output is adequate and that they aren’t retaining fluid.
Once the patient begins oral fluids, you will need to document how much they consume during your shift. You will also be responsible for emptying the urine containers and documenting the output during your shift.
After the IV fluids stop, the patient needs to be monitored for signs of dehydration. If you notice any adverse signs in the patient, report them to the nursing staff.
The signs are often poor skin elasticity, dry mucous membranes, thirst, and small amounts of constant urine. After the IV fluids end, patients will start with small sips of water and gradually move onto additional fluids.
Daily Living
Patients under surgical care will often require assistance performing activities of daily living. Be prepared to help them eat, brush their teeth, comb their hair and dress if necessary.
Use caution when initially getting the patient out of bed. Have them sit on the side of the bed for a while, and then slowly get them up. If the patient appears pale or dizzy, check their blood pressure and pulse to make sure they are alright to move.
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