How to Survive as a New Nurse & Not Get "Eaten" By Senior Nurses
My start as a nurse was a little bit different than many nurses. I struggled to find a job and ended up giving flu shots and then volunteering as a nurse on a Navy hospital ship. I wanted to show that even though I couldn't find a hospital job that I was still motivated to work as a nurse.
After getting back from volunteering, I started my first job in an adult medical ICU (which is where I still work) in October 2011. I was incredibly nervous and felt like a deer in headlights. Thank goodness that you have a preceptor with you to help you learn how to become an actual nurse! You often hear about how senior nurses sometimes "eat their young," meaning that they are horrible to new nurses.
There were some tips that I learned along the way that can apply to all new nurses as they find their place at their first nursing job.
1. Ask questions. There is so much to learn and the easiest way to learn it is by talking with more experienced nurses. Find a nurse that you trust and use them as a resource. I always worry if the new nurses on the unit are not asking questions! We have all been new nurses at one point and understand what it feels like. Always ask questions.
2. Figure out your flow. Being organized and figuring out an effective work flow will make your life so much easier. We do a bedside shift report where we meet each of our patients during shift change. This helps me to prioritize which patient I want to see first. After getting report, I do my assessments starting with the sickest patient first and then assess my other patients. Next, I pass my medications and look through the chart if I need clarification on different things to do with meds like lab values or past medical history. After passing medications, I start charting on my patients and looking at the history and physical. Once you figure out your flow, just run with it!
3. Make friends. Nursing friends will become your best friends at work. You can comfortably ask them questions and ask them for help. You cannot do your job as a nurse without getting help from other people on your unit. When things are stressful it's nice to have a friend that can truly relate to you.
4. Further your education. Keep learning even when you're not such a new nurse anymore. Look up the pathophysiology of your patient and check the labs to see if they correlate to the normal patho. Try to get national certifications that correlate with where you work. I started furthering my education by making the "Nursing Basics" section of From New to ICU. It's my easy-to-understand version of many different things that nurses see all the time in the hospital.
5. The NCLEX and real life are not the same. Nursing school is geared towards teaching students how to pass the NCLEX. There is the hypothetical situation and then there is the real life situation. When learning about how to prioritize patient care, it seems (on the NCLEX) that there is loads of time to perform interventions on a deteriorating patient; in reality, there are multiple nurses all performing the A, B, C, and D multiple choice answers all at once. Adjusting to real life as a nurse can be challenging. Recognizing that practicing as a nurse is different than the questions on the NCLEX will be highly beneficial.
6. Be efficient. When I am heading into a patient's room, I try to think of everything that I will need. Grab all of the medications, alcohol swabs, syringes, etc. that you need prior to entering the room. Think through the different interventions and all of the equipment that they require. When you are in the room, pass your medications and do your vital signs at the same time. This will save you lots of time (and stress)!
7. Find a mentor. As a new nurse, I would often look around at the beginning of each of my shifts to see who my nurse friends were that shift. Who would be my mentor when I had questions? I found that there was usually at least one person on the unit that I felt comfortable with enough to ask my "stupid" questions to and not feel dumb.
8. Avoid complaining. Have a good attitude even when you don't feel like it! Complaining about your new job will only cause division between you and the other staff members (especially those that have been there for extended amounts of time). Don't be a know-it-all and talk about how you only need a year's experience until you can get that dream nursing job. Try to enjoy where you are at and be the star employee while you are there.
9. Anticipate your patient's needs. One of the greatest tips that I have received is trying to figure out what your patient will need before they ask you for it. When you answer a call light, make sure to ask if there is anything else you can get for the patient before you leave. Check to make sure that the 3 P's are taken care of: pain, potty, and position. If you are proactive about your patients, they will be on the call lights less and be much happier.
10. Give it time. Most of all, give yourself a break. Learning all of these things takes time. I used to have nightmares about the ICU before going into work. I was so stressed about trying to learn everything and trying to not feel terribly nervous. Try and give yourself a break and enjoy the little victories as they come. You just successfully started your first IV? Give yourself a pat on the back.
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