Agency Nurse

Med/Surg
Orientation
Packet
 Agency Nurse
Med/Surg Orientation Packet
Table of Contents

Welcome Letter

Policies and Handouts

1. Core measures

2. Blood Administration and Transfusion reactions

3. Medication Administration Policy

4. Hourly Rounding

5. Fall prevention

6. HUGS tags and Pediatric Patients

7. PCA
 Welcome

The Med/Surg Unit would like to welcome you to our department. We are
glad that you decided to work with us.

This letter outlines some of the most important aspects of the care model
that is used by the MS department.

Patient Care Issues and Routines

1. Report is given at the desk/lounge and then the patient is rounded on
by both nurses at the bedside to evaluate the following
a. Patient status
i. Is the patient clean
ii. Evaluate the patient’s skin
iii. Is fall alarm on, if it is indicated?
iv. Overview of plan of care
b. Patency of IV sites, an all other tubes
c. IVF is correct and rate is appropriate
d. You introduce your self using the AIDET format
2. During report the I&O form, MAR and nurse’s notes are assessed and
initialed on the bottom right hand corner to validate completeness by
BOTH nurses.
3. Patients are rounded on EVERY hour by the nurse. C.N.A’s and
other healthcare providers will also round on the patients, but the
nurse MUST round hourly. Green sheets are in the room for you to
sign during rounds
a. Key words are used such as
i. I am here for your hourly rounds
ii. Is there anything else I can do for you to make you
comfortable, I have the time ?
b. Rounding involves the following evaluations of the patient
i. Pain. Is the patient in pain? If so, do they need meds
repositioning or more?
ii. Potty. The patient is offered the toilet, Bedside commode
or bedpan depending on what is appropriate for the patient
iii. Position. Of the patient and his/her belongings. Is the
patient aligned? Patients are turned every 2 hours on the
even hour. Does the patient have all of their items-water,
Kleenex, telephone, trash can and other necessary items at
their bedside?
4. Nurse’s Aides are available during the day shift and will take vital
signs, help with baths and pass ice water. It is your responsibility to
make sure that your patients get their trays, get their baths
and are fed. Trays are everyone’s responsibility.
5. Nurses on the night shift are responsible for performing their own vital
signs.
6. Room set up for admissions. All patients will have their room ready
before they come to the floor, this includes the following:
a. bed pulled out from the wall
 b. bed linens pulled down
c. admission paperwork in room
d. personal care products in the room
e. ALL pediatrics 3 and under MUST have a crib in their room before
they arrive. IF the parent refuses to use the crib, have them sign
the refusal to use crib form and notify the charge nurse.
f. Parents of pediatrics must be educated on safe use of cribs and
this will be documented in the nurses notes and on the patient
education form.
7. All patients admitted through the ED must be transferred to the floor in
a timely manner. Please see the enclosed REPORT FORM. This form is
to be used as a guide to receive accurate report.
8. All IV tubing is to be labeled and changed every 72 hours, including
piggy backs.
9. Handwashing, “foam in” and “foam out” on all patients except those
who are in C-Diff isolation.
10. You are expected to open your notes before lunch and make sure that
all of your documentation is complete before you leave. This includes,
nurse’s notes, I&0 forms, care plans and patient education forms.
11. Patient’s with PCAs must be monitored frequently. This
information is enclosed.
12. HUGS is a system that is used to prevent kidnapping of pediatrics
from the hospital. A list of pediatrics, in the MS department are kept on
the white board by the nurse’s desk. You are expect to monitor your
pedis assigned to you if a Code pink or Adam are called and then
report to a stairway or the elevator on your hall to monitor activity. See
enclosed information.
13. The medication policy is enclosed. You are expected to sign
the MAR and document in the nurses notes all PRN drugs.
Routine drugs do not have to be documented in the nurse’s
notes.
14. Routine vital signs are 7am, 3pm, 11pm. All pediatrics and telemetry
patients require vital signs every 4 hours.
15. The national patient safety goals are standardized by JCAHO and
are posted on the unit.
16. Admissions are completed by the nurse assigned to the patient.
Pictures of wounds and any other rash, area of skin breakdown or
questionable skin area should be taken.
17. If the patient has significant changes in vital signs or
condition notify the charge nurse immediately! IF in doubt ask!
18. You are responsible for your patients wound care. The wound
care nurse is available during the daytime to assist you as needed.
19. The House Supervisor is responsible for signing your time sheet when
you are finished. If this is your first time here you will be given a
packet to complete. NO BREAKS must be approved by the charge
nurse and supervisor or they will not be paid. You are responsible for
communicating with your charge nurse if you are having a difficult
time taking your break.
20. Weights are performed daily on the following:
 a. CHF patients
b. Pediatric patients
c. any others that are ordered

This information is not inclusive. If you have any questions please

ask your charge nurse or the supervisor.