From Kati Kleber, MSN RN

Nurse educator, author, and owner of FreshRN®

Learning how to be a safe, effective, and efficient med-surg nurse is challenging. We created the ultimate resource for nurses new to this complex and dynamic acute care nursing specialty.

I was once completely overwhelmed as a new med-surg nurse too


Whether you are fresh out of nursing school or an experienced nurse starting out in med-surg for the first time, the learning curve is steep.

Back in 2010, when I was preparing for my first day on the floor was really important to me, but I didn't know what to look up, read, or study.

I spent hours scouring the internet for help, but it was full of the same tips and general advice. It was either geared towards nursing school, or highly technical and over my head.

This course is everything I wished I had when I was starting my first acute care nursing job - and more.

Introducing...



With Med-Surg Mindset, here's just a few things you'll learn:


  • What normal progress during orientation looks like so you can have realistic expectations for yourself and keep your morale high
  • The unwritten rules of a med-surg unit
  • How to be tactfully assertive
  • How to manage your time when your patients are stable - plus many time management and prioritization practice scenarios
  • How to give and take report like a highly-experienced nurse
  • How a normal shift should flow - from start to finish
  • How to perform an awesome med-surg level head-to-toe
  • A run down of the pathophysiology, unique assessment findings, patient pathways, and nursing considerations of the TOP disease processes in med surg + considerations for common accompanying conditions
  • Basics of the most common diagnostics, how to explain them to patients, and how to coordinate getting them done
  • Written by experienced nurses who genuinely want you to succeed
  • ... and so much more!
With enrollment, here's what you get:
  • 18 hours of audio files - listen to each module like a podcast!
  • Over 3 hours of video content
  • High-impact downloads that can use at work tomorrow! These include: Sample report sheets (and audio files to practice at home), an ideal shift timetable (for nights and days), assessment checklist, electrolyte disturbances, patient flow checklist, and a post-op checklist!
  • 18.0 contact hours* upon successful completion of modules and a post-test
  • 24/7 lifetime access - unlimited logins, video views, and audio plays
Plus enjoy these bonuses!

My exclusive coaching package ($97 value) that includes videos to get the most out of each section of modules and your orientation to med-surg!

A 290+ page PDF download of the text of the entire course ($77 value) so you can take notes and revisit topics offline.

*This continuing education activity was approved by the Ohio Nurses Association, an Ohio Board of Nursing approver. (OBN-001-91) A post-test must be completed, and a PDF is automatically generated for the learner as proof of participation.


Check out the full course curriculum below!


(And preview the Pneumonia module at no cost)



  Introduction
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  Get Your Game Face On
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  Starting Your Shift Right
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  Anatomy of a Shift - Game Time
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  Patient Care
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  Common Primary Disease Processes
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days after you enroll
  Common Accompanying Problems
Available in days
days after you enroll
  Common Procedures, Diagnostics, & Medications
Available in days
days after you enroll
  Serious Situations
Available in days
days after you enroll
  Conclusion
Available in days
days after you enroll

Meet your authors, coaches, and biggest cheerleaders

Kati Kleber, MSN RN



Kati has been a nurse since 2010 with experience in cardiac-med surg, stepdown, and neurocritical care. Now a full-time nurse educator, Kati is an award-winning nurse, published author with the American Nurses Association, national speaker, and owner of FreshRN®.


Crystal Griest, MSN RN CMSRN



Crystal is a highly experience med-surg nurse and unit educator. She was an integral part in her med-surg unit receiving the PRISM award, a designation provided by the Academy of Medical-Surgical Nurses (AMSN) and the Medical-Surgical Nursing Certification Board. Crystal regularly functions as a preceptor and charge nurse, and holds her MSN in Nursing Education.

Hannah Schlake, BSN RN CMSRN CCRN


Hannah graduated from nursing school in 2018 and worked on a surgical floor for three years. Since 2021 she has worked in the Surgical Intensive Care Unit of a Magnet-designated, level-one trauma center in downtown Chicago. She has been a charge nurse and frequently serves as a preceptor. Hannah is currently working on her DNP in Nurse Anesthesia and will graduate in 2026.


Enroll below!


🌱 Hey Med-Surg Nurse, Upgrade to All-Access Mastery!


Unlock the full potential of your nursing education journey.
Get exclusive access to all of our high-value courses with the All-Access Pass. For the price of a single course, you can now enjoy unlimited learning opportunities and stay ahead in your career. Don't miss out - seize this opportunity now!


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Hear what current learners have to say about Med-Surg Mindset:



Includes 18.0 Contact Hours

This continuing education activity was approved by the Ohio Nurses Association, an Ohio Board of Nursing approver. (OBN-001-91)

A post-test must be completed, and a PDF is automatically generated for the learner as proof of participation.

Try for 14 days - Risk Free



The last thing we would want is for you to be unhappy. My simple offer is if you don’t LOVE this course, I’ll give you 100% of your money back with no questions.

You can check out the course and if it’s not translating to a deeper understanding of med-surg, a smoother orientation process, and less stress - I will absolutely give you 100% of your money back. Provided you have completed less than 50% of the course and have not claimed any contact hours. The refund must be requested and issued within 14 days of original purchase (please allow 1-2 business days for processing).

All you need to do is send one email (listed in the course) and that’s it. No phone call. No awkward conversation requiring you to explain anything. No questions asked. One email.

Objectives

Section 1 - Get Your Game Face On

  • Describe characteristics of an overbearing preceptor 
  • Describe characteristics of a disengaged preceptor
  • Discuss professional ways to navigate when a preceptor-preceptee match is not ideal. 
  • Discuss how to advocate for yourself to maximize your orientation experience.
  • Describe how to delegate tasks to nursing assistants, navigate challenging responses, build rapport, and foster teamwork.
  • Explain the chain of command and hierarchy of a medical team and how to ensure effective and efficient communication between nurse and provider.
  • Define the three types of communication styles, and provide example responses of each type.

Section 2 - Start Your Shift Right

  • Discuss at least three important pieces of information to review from a patient’s chart prior to hand-off
  • Discuss strategies to maximize efficiency and ensure appropriate continuity of care during hand-off
  • Discuss why shift change is considered a critical transfer point

Section 3 - The Ideal Shift

  • Discuss the benefits of developing a shift routine
  • Identify important key topics to discuss during interdisciplinary rounds on a med-surg unit

Section 4 - Patient Care

  • Identify the steps of a medical-surgical head-to-toe patient assessment
  • Discuss the difference between pain management and pain elimination and the importance of managing expectations surrounding pain management
  • Verbalized at least 4 reasons why accurate and timely documentation is paramount to safe patient care

Section 5 - Common Primary Disease Processes

  • Describe pathophysiologic processes, unique nursing assessment, typical patient pathways (including common diagnostics, labs, medications) and important nursing considerations of the following disease processes: 
  • Congestive heart failure
  • Pneumonia
  • GI Bleed
  • Acute renal failure
  • Chronic obstructive pulmonary disease
  • Urinary tract infection
  • Sepsis
  • Pancreatitis
  • Venous thromboembolism
  • Bowel obstruction
  • Altered mental status
  • Describe nursing considerations for pre and post-op patients, and patients admitted to a medical-surgical unit for the purposes of a cardiac work-up

Section 6 - Common Accompanying Problems

  • Describe patient considerations for the following common accompanying medical problems often impacting medical-surgical patients:
  • Alcohol withdrawal
  • Diabetes
  • Chronic pain and substance use disorders
  • Dementia
  • Chronic kidney disease
  • Electrolyte disturbances
  • Fluid imbalances
  • Mental, social, and financial issues

Section 7 - Common Procedures, Diagnostics, and Medications

  • Differentiate between computed tomography and magnetic resonance imaging
  • Identify different insertion sites for central venous catheters, differentiate between a PICC line and a midline
  • Describe why a central venous catheter enables vesicant medications to be safely administered 
  • Describe appropriate patient positioning for central venous catheter discontinuation
  • Define CAUTI and describe at least two preventative nursing management techniques 
  • Differentiate between peritoneal dialysis and hemodialysis, verbalize complications of each, and the med-surg nurse’s role in facilitating each 

Section 8 - Serious Situations

  • Discuss tactful yet efficient ways to navigate when a provider is unable to be reached during an urgent situation
  • Describe the primary nurse’s role in a cardiac and/or respiratory arrest 
  • Differentiate between palliative care, hospice, and comfort care
  • Identify at least 3 nursing responsibilities after a patient passes away

References

  1. Agency for Healthcare Research and Quality. (2016). Hospital survey on patient safety culture: 2016 user comparative database report. Retrieved from ahrq.gov.
  2. Baron, R. (2018). No one is born alone, and no one should die alone: Volunteer program ensures that no one dies alone. In Intermountain Healthcare. Retrieved from https://intermountainhealthcare.org/blogs/topics/transforming-healthcare/2018/04/no-one-dies-alone/
  3. Benavente, V.G., Grinslade, M.S., Hill, K., Kilgore, S., et. al. (2004). Pharmacology for Nursing Practice (2.1 ed.) Assessment Technologies Institute, LLC. 
  4. Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier and Erbs Fundamentals of Nursing: Concepts, Process, and Practice (10th ed., pp. 997-1004). Boston, MA: Pearson.
  5. Brennan F., Carr D. B., Cousins M. (2007). Pain management: A fundamental human right. Anesthesia and Analgesia, 105, 205–221.
  6. Brooks, A. (2016). What healthcare workers need to know about radiation effects. In Rasmussen College. Retrieved from https://www.rasmussen.edu/degrees/health-sciences/blog/radiation-effects-on-healthcare-workers/ 
  7. Buczynski, R., et. al, (2019). Clinical applications of compassion: How compassion-oriented therapies work and what makes them so effective. [Video lecture]. Retrieved from nicbam.com.
  8. Buczynski, R., et. al, (2019). Clinical applications of compassion: The neurobiology of compassion. [Video lecture]. Retrieved from nicbam.com.
  9. Cai, C. (2018). No one dies alone program offers patients end-of-life care. In UCSF Medical Education. Retrieved from https://meded.ucsf.edu/news/no-one-dies-alone-program-offers-patients-end-life-care 
  10. Carle Foundation Hospital. (2018). Nurse Honor Guard gains popularity as families pause to remember. Retrieved from https://carle.org/Newsroom/Community/2018/05/Nurse-Honor-Guard-gains-popularity-as-families-pau 
  11. Cass, P.S., Reese, M.R., Nigro, C.G., Schlapman, N., et. al. (2004). Registered Nurse Medical-Surgical Review Module (5.2 ed., Vol.1 & 2). Assessment Technologies Institute, LLC.
  12. Centers for Disease Control and Prevention. (2010). Central line-associated bloodstream infections (CLABSI). In Healthcare-associated Infections. Retrieved from https://www.cdc.gov/hai/bsi/bsi.html 
  13. Center for Disease Control (CDC). (2020). Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter associated urinary tract infection[UTI]) events. In Disease-associated module: UTI. Retrieved January 20, 2020, from https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf
  14. Centers for Medicare and Medicaid Services. (2015). Palliative care vs. hospice care: Similar but different. Retrieved from https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/infograph-PalliativeCare-%5BJune-2015%5D.pdf 
  15. Chua, K. L., Legido-Quigley, H., Jones, D., Hassan, N. B., Tee, A., & Liaw, S. Y. (2020). A call for better doctor–nurse collaboration: A qualitative study of the experiences of junior doctors and nurses in escalating care for deteriorating ward patients. Australian Critical Care, 33(1), 54-61. doi:10.1016/j.aucc.2019.01.006 
  16. Cody, S., Sullivan-Bolyai, S., & Reid-Ponte, P. (2018). Making a connection: Family bedside rounds in the Intensive Care Unit. Critical Care Nurse, 38(3), 18-26.
  17. Compton, P., & Chang, Y. (2017). Substance abuse and addiction. Clinical Journal of Oncology Nursing, 21(2), 203-209. doi:10.1188/17.CJON.203-209.
  18. Consumer Reports. (2015). The surprising dangers of CT scans and X-rays. In Consumer Report. Retrieved from https://www.consumerreports.org/cro/magazine/2015/01/the-surprising-dangers-of-ct-sans-and-x-rays/index.htm 
  19. Dennison, R. D. (2013). Pass CCRN (4th ed., pp. 385-475). Maryland Heights, MO: Elsevier.
  20. Duarte J, Pinto-Gouveia J, Cruz B. (2016). Relationships between nurses’ empathy, self-compassion, and dimensions of professional quality of life: a cross-sectional study. Int j Nurs Stud. 2016; 60:1-11. doi: 10.1016/j.ijnurstu.2016.02.015. 
  21. Evanoff B, Potter P, Wolf L, et al. Can we talk? Priorities for patient care differed among health care providers. In: Henriksen K, Battles JB, Marks E, et al., editors. Advances in patient safety: From research to implementation Vol 1, Research findings. Rockville, MD: Agency for Healthcare Research and Quality; 2005. pp. 5–14. Publication No. 05-0021–1. https://www.elitecme.com/resource-center/nursing/honor-guard-for-deceased-nurses/ 
  22. Eum, D. H., Lee, S. H., Kim, H. W., Jung, M. J., & Lee, J. G. (2015). Cerebral air embolism following the removal of a central venous catheter in the absence of intracardiac right-to-left shunting. Medicine (Baltimore), 94(13). doi:10.1097/MD.0000000000000630 
  23. Friesen, M., White, S. V., & Beyer, J. F. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality (US), chapter 34. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK2649/ 
  24. Gauer, R., Forbes, D., & Boyer, N. (2020). Sepsis: Diagnosis and management. American Family Physician, 101(7), 409-418. Retrieved May 4, 2023, from Sepsis: Diagnosis and Management | AAFP
  25. Gilbert, B. W., Reichert, M., & Fletcher, S. (2019). Strategies for the management of sepsis. Advanced Critical Care, 30(1), 5-11.
  26. Gracia-Gracia, P., & Oliv ́an-Blazquez, B. (2017). Burnout and mindfulness self-compassion in nurses of intensive care units. Holistic Nursing Practice, 31(4), 225-233. doi:10.1097/HNP.0000000000000215
  27. Harvard Health Publishing. (2013). Do CT scans cause cancer?. In Harvard Men's Health Watch. Retrieved from https://www.health.harvard.edu/staying-healthy/do-ct-scans-cause-cancer 
  28. Hinkle, J.L., & Cheever, K.H. (2014). Brunner & Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Wolters, Kluwer Health/Lippincott Williams & Wilkins.
  29. The Joint Commission on Accreditation of Healthcare Organizations. (2012). Joint Commission Center for transforming healthcare releases targeted solutions tool for hand-off communications. In Joint Commission Perspectives. Retrieved from https://www.jointcommission.org/assets/1/6/CLABSI_Toolkit_Tool_3-21_Scrub_the_Hub.pdf  
  30. Kee. J.L. (2001). Handbook of Laboratory and Diagnostic Tests (4th ed.). Prentice Hall. 
  31. Klimecki OM, Leiberg S, Ricard M, Singer T. Differential pattern of functional brain plasticity after compassion and empathy training. Soc Cogn Affect Neurosci. 2014; 9(6): 873-9. doi:10.1093/scan/nst060
  32. Klochkov, A., Kudaravalli, P., & Sun, Y. (2010, April 23). Alcoholic pancreatitis. StatPearls. 
  33. Kraft, L., Wiechula, R., & Conroy, T. (2015). The effectiveness of acute pain management for opioid tolerance or opioid-dependent patients: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 13(9), 120-135. Retrieved from Ovid (01938924-201513090-00013).
  34. Lewis, S.M., Heitkemper, M.M., & Dirksen, S.R. (2000). Medical Surgical Nursing Assessment and Management of Clinical Problems (5th ed., Vol. 1 & 2). Mosby.
  35. Lip, G. Y., & Watson, T. (2008). Atrial fibrillation (acute onset). BMJ clinical evidence, 2008, 0210.
  36. Lovenox® (enoxaparin) prescribing information. (2013). Retrieved August 13, 2015, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/020164s102lbl.pdf
  37. Marschall, J., Mermel, L., Fakih, M., Hadaway, L., Kallen, A., O’Grady, N., . . . Yokoe, D. (2014). Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute Care Hospitals: 2014 Update. Infection Control and Hospital Epidemiology, 35(7), 753-771. doi:10.1086/676533
  38. Moore, C., & Nichols-Willey, J. Enhancing patient outcomes with sequential compression device therapy. American Nurse Today. Retrieved from https://www.americannursetoday.com/enhancing-patient-outcomes-with-sequential-compression-device-therapy/
  39. National Center for Education Statistics. (2019). Adult Literacy in the United States. In Institute of Education Sciences. Retrieved from https://nces.ed.gov/datapoints/2019179 
  40. National Institute of Health. (2017). Palliative Care in Cancer. In National Cancer Institute. Retrieved from https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet#what-is-palliative-care 
  41. National Institute of Mental Health. (2021). Mental Illness. Retrieved from Carle . (2018). Nurse Honor Guard gains popularity as families pause to remember. Retrieved from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#:~:text=Mental%20illnesses%20are%20common%20in,(46.6%20million%20in%202017). 
  42. O'Leary, K. J., Wayne, D. B., Haviley, C., Slade, M. E., Lee, J., & Williams, M. V. (2010). Improving teamwork: Impact of structure interdisciplinary rounds on a medical teaching unit. Society of General Internal Medicine, 25(8), 826-832. doi:10.1007/s11606-010-1345-6 
  43. Osten, C. (2016). Are you really listening, or just waiting to talk?. In Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/the-right-balance/201610/are-you-really-listening-or-just-waiting-talk 
  44. Porth, C.M. (2014). Essentials of pathophysiology: Concepts of altered health states (4th ed.). Philadelphia: Lippincott Williams & Wilkins.
  45. Ruangkriengsin, D., & Phisalprapa, P. (2014). Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 97 Suppl 3, S206–S215. 
  46. Sardar, S. (2019) No one should die alone: volunteer support for patients dying in hospital. Nursing Times [online]; 15: 11, 34-36.
  47. Saskatoon Health Region Nursing Practice Committee. (2017). Central venous catheters - short term, tunneled, implanted - care of. In SHR Policies and Procedures. Retrieved from https://www.saskatoonhealthregion.ca/about/NursingManual/1086.pdf 
  48. Slatore, C. G., Hansen, L., Ganzini, L., Press, N., Osborne, M. L., Chesnutt, M. S., & Mularski, R. A. (2012). Communication by nurses in the intensive care unit: qualitative analysis of domains of patient-centered care. American Journal of Critical Care, 21(6), 410-418. doi:10.4037/ajcc2012124
  49. Sole, M.L., Lamborn, M.L., & Hartshorn, J.C. (2001). Introduction to Critical Care Nursing (3rd ed.) W.B. Saunders Company. 
  50. Stanhope, M. and Lancaster, J. (2010). Foundations of Nursing in the Community (3rd ed.) Mosby, Inc.
  51. UnityPoint Health. (2021). Des Moines Nursing Honor Guard. Retrieved from https://www.unitypoint.org/desmoines/nursinghonorguard.aspx 
  52. US Department of Health & Human Services. (2017). What are palliative care and hospice care?. In National Institute on Aging. Retrieved from https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care 
  53. Waterworth, S. (2003), Time management strategies in nursing practice. Journal of Advanced Nursing, 43: 432-440. https://doi.org/10.1046/j.1365-2648.2003.02740.x
  54. WebMD Medical Reference. (2020). How to prevent deep vein thrombosis (DVT). In WebMD. Retrieved from https://www.webmd.com/dvt/deep-vein-thrombosis-prevent-dvt
  55. Willis, L. M. (Ed.). (2018). Lippincott's review for medical-surgical nursing certification (6th ed.). Philadelphia: Lippincott Williams & Wilkins.
  56. Wisemen, T. (1996). A concept analysis of empathy. Journal of Advanced Nursing, 12(6), 1162-1167. doi:10.1046/j.1365-2648.1996.12213.x