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...


Set yourself apart and learn all of the insider med-surg nursing info before your first day


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

  • What normal progress during orientation looks like, so you can gauge your expectations accordingly and keep your morale high
  • The unwritten rules of med-surg nursing
  • How to be tactfully assertive
  • How to make a good impression on your new coworkers
  • 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 patient assessment
  • How to practically care for the actively dying patient
  • A run down of the pathophysiology, unique assessment findings, patient pathways, and nursing considerations of the TOP disease processes in med surg
  • Considerations for alcohol withdrawal patients, diabetics, patients with substance use disorder, mental status issues, renal issues, and more
  • Basics of the most common diagnostics, how to explain them to patients, and how to physically get them all done promptly
  • And so much more!

... Written by three experienced bedside nurses!

The course also comes with 10.0 contact hours.



Time management, assertiveness, and prioritization tips


Learn not only what to do, but how to effectively manage your time in a realistic way on a busy med-surg unit.


Common disease processes and accompanying problems


We outline only the must-know information: Abbreviated pathophysiology, unique assessment findings, typical patient pathway, treatments, complications, and nursing considerations for the top disease processes impacting your patients.

Videos, audio files, downloads, and more!


Each module has both a text and audio option to accommodate different learning preferences. Many modules have videos and downloads to print and bring to the unit!

Med-Surg Mindset

Curriculum Preview


  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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  Common Accompanying Problems
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  Common Procedures, Diagnostics, & Medications
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  Serious Situations
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  Conclusion
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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 current 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 is currently pursuing her MSN in Nursing Education.

Hannah Schlake, BSN RN CMSRN CCRN



Hannah Schlake graduated from nursing school in 2018 and worked on a surgical floor for three years. In 2021 she began working in the Surgical Intensive Care Unit at a Magnet designated, level-one trauma center in downtown Chicago. Hannah enjoys working with surgical patients because with high-quality nursing care, patients can make huge strides toward recovery in just a matter of days. She is passionate about helping new nurses develop confidence and positive self-talk, keen critical thinking skills, and sustainable work-life balance.


Enroll below!


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


"I recently was asked by a patient's daughter to explain her mom's sepsis.  I've always been confused by the topic, but I had just listened to the Med-Surg Mindset course on sepsis. I felt confident in giving a specific, yet patient friendly response. She told me that after talking to other nurses and doctors, it was the first response that made sense to her. In fact, she was so grateful that she told the charge nurse and gave me a present the next when when her mom discharged."

Heather, RN BSN


"I purchased the med-surg course to help me prep for my new grad residency on a med surg unit! I start next week but I’ve had a month between hiring and start date so your course has helped me feel much more confident stepping into my first day and having a grasp on what an actual shift will look like. 

Your course is just the right amount of detailed. I also listened to your podcast about interviews before getting my job and didn’t even realize you also made the course until after I purchased it! Thank you for all the time you put into helping nurses. 😊 "

Alicia Capotosto


"I loved the program. You're helping fill in the holes I missed due to COVID."

Jenni


"I earned my CMSRN because I felt like I was stagnating in my specialized field of the elective post-op ortho world. However, despite passing that certification exam (and for some reason this class is advertised as *not* being a prep course for cert exams, but it *totally* would have helped!), I felt like I had just memorized ideas & facts for it, and I knew I'd forget much of the material afterward. However, working my way through the Med-Surg Mindset course afterward really help me better conceptualize and internalize what I had studied previously, and I was able to float to med-surg units with much less anxiety than I had in the past."

Yvonne BSN, RN, ONC, CMSRN - Ortho / Med Surg (now newly SICU)


"In the weeks leading up to my first bedside job, I was very excited, but also nervous about the steep learning curve and how few practice hours on the floor I had gotten in schools. FreshRN kept me feeling excited about this new chapter in my learning and my career, and gave me both the skills that I needed as a trainee and as a new nurse, as well as the confidence that I could and would be able to do the job. I highly recommend!"

S. W., BSN - high acuity medicine


Includes 10.0 nursing contact hours


As with many FreshRN® courses, this comes with continuing education credits. A post-test must be completed, and a PDF is automatically generated for the learner as proof of participation.

Continuing education credits are provided in conjuction with Skills on Point LLC, an ANCC approved accreditor.

A total of 10.0 contact hours are included with purchase of this course.


Try for 30 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 30 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 and identify 

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. Brennan F., Carr D. B., Cousins M. (2007). Pain management: A fundamental human right. Anesthesia and Analgesia, 105, 205–221.
  5. 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/ 
  6. 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.
  7. Buczynski, R., et. al, (2019). Clinical applications of compassion: The neurobiology of compassion. [Video lecture]. Retrieved from nicbam.com.
  8. 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 
  9. 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 
  10. 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.
  11. 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 
  12. 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
  13. 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 
  14. 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 Care33(1), 54-61. doi:10.1016/j.aucc.2019.01.006 
  15. Cody, S., Sullivan-Bolyai, S., & Reid-Ponte, P. (2018). Making a connection: Family bedside rounds in the Intensive Care Unit. Critical Care Nurse38(3), 18-26.
  16. 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.
  17. 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 
  18. Dennison, R. D. (2013). Pass CCRN (4th ed., pp. 385-475). Maryland Heights, MO: Elsevier.
  19. 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. 
  20. 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/ 
  21. 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 
  22. 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/ 
  23. Gilbert, B. W., Reichert, M., & Fletcher, S. (2019). Strategies for the management of sepsis. Advanced Critical Care30(1), 5-11.
  24. Gracia-Gracia, P., & Oliv ́an-Blazquez, B. (2017). Burnout and mindfulness self-compassion in nurses of intensive care units. Holistic Nursing Practice31(4), 225-233. doi:10.1097/HNP.0000000000000215
  25. Hawkes, B. (2017). How to cope with patients who have a substance use disorder. In Nurse Code. Retrieved June 6, 2019, from http://nursecode.com/2014/10/addicted-patient/
  26. 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 
  27. 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.
  28. The Joint Commision 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  
  29. Kee. J.L. (2001). Handbook of Laboratory and Diagnostic Tests (4th ed.). Prentice Hall. 
  30. 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
  31. Klochkov, A., Kudaravalli, P., & Sun, Y. (2010, April 23). Alcoholic pancreatitis. StatPearls
  32. 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).
  33. 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.
  34. Lip, G. Y., & Watson, T. (2008). Atrial fibrillation (acute onset). BMJ clinical evidence, 2008, 0210.
  35. Lovenox® (enoxaparin) prescribing information. (2013). Retrieved August 13, 2015, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/020164s102lbl.pdf
  36. 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
  37. 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/
  38. 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 
  39. 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 
  40. 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). 
  41. 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 Medicine25(8), 826-832. doi:10.1007/s11606-010-1345-6 
  42. 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 
  43. Porth, C.M. (2014). Essentials of pathophysiology: Concepts of altered health states (4th ed.). Philadelphia: Lippincott Williams & Wilkins.
  44. 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 thangphaet97 Suppl 3, S206–S215. 
  45. Sardar, S. (2019) No one should die alone: volunteer support for patients dying in hospital. Nursing Times [online]; 15: 11, 34-36.
  46. 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 
  47. 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 Care21(6), 410-418. doi:10.4037/ajcc2012124
  48. Sole, M.L., Lamborn, M.L., & Hartshorn, J.C. (2001). Introduction to Critical Care Nursing (3rd ed.) W.B. Saunders Company. 
  49. Stanhope, M. and Lancaster, J. (2010). Foundations of Nursing in the Community (3rd ed.) Mosby, Inc.
  50. UnityPoint Health. (2021). Des Moines Nursing Honor Guard. Retrieved from https://www.unitypoint.org/desmoines/nursinghonorguard.aspx 
  51. 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 
  52. 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
  53. 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
  54. Willis, L. M. (Ed.). (2018). Lippincott's review for medical-surgical nursing certification (6th ed.). Philadelphia: Lippincott Williams & Wilkins.
  55. Wisemen, T. (1996). A concept analysis of empathy. Journal of Advanced Nursing12(6), 1162-1167. doi:10.1046/j.1365-2648.1996.12213.x