7 Things You Weren’t Taught in Nursing School 7 Things You Weren’t Taught in Nursing School | allnurses

7 Things You Weren’t Taught in Nursing School

  1. 28

    All the things you were not taught in nursing school could probably fill a few volumes, but here are a few that I have collected from emails and conversations with colleagues over the years.

    7 Things You Weren’t Taught in Nursing School

    All the things you were not taught in nursing school could probably fill a few volumes, but here are a few that I have collected from emails and conversations with colleagues over the years.

    Importance of a Mentor

    New nurses orient with one or maybe a couple different nurses, but new nurses could also benefit greatly from having a nurse mentor for their career. Having someone to offer advice on the best career moves and discuss how the new nurse is experiencing nursing as a whole, can keep nurses satisfied in their nursing career by having a sounding board and a guide to help them grow in their careers. The rate of new graduate nurses who leave the profession in their first year of nursing is astronomically high and having a confidante within the profession can help the new nurse navigate the ups and downs of the first year or two and mitigate some of the stress.

    This is a service-based profession

    That means in service to other people, and that’s not always a cake walk. Being a nurse carries prestige, but it’s not just about that and the fairly decent paycheck. Sometimes it’s about the grunt work too. After a nurse friend of mine told a new nursing student about cleaning up a patient after a “brown” accident, the student said, “but nurses don’t do that, that’s an aide’s job.” After schooling the student on just what constitutes nursing care, the student changed her major the next week. She said no one told her she’d have to do those types of things, and she wasn’t about to do them for any amount of money.

    Patients will insult, kick, hit, bite and sometimes throw things at you

    Nurses see patients at a point of vulnerability. Some act out due to frustration. Some medications have side effects that include irritability and anxiety. Other patients are simply unhappy people or are mad at the world. As a nurse, you are the person in front of them and can bear the brunt of their reaction to their circumstances. A thorough report from the previous nurse can eliminate surprises when it comes to patient behavior. Never hesitate to ask for someone, an aide or another nurse, to accompany you into a patient’s room.

    Losing a patient is never easy… and there’s lots of paperwork to do when it happens

    Nurses work hard to keep patients alive, and whether a patient codes or passes away from a terminal illness, nurses give all of themselves to counsel loved ones through the beginning stages of grief. I have watched nurses with tears welling up in their eyes making phone calls to physicians, completing paperwork, and just managing the loss while still also caring for other patients. A patient’s death may not be a personal loss for the nurse, but sometimes the grief feels the same.

    All the nursing roles/jobs that are available to nurses

    Although nursing school does provide clinical rotations in several areas of nursing, there are far more than new grads can ever imagine. Nurses are found in every spectrum of the working world from corporations to engineering, industry, and government. The world is a nurse’s oyster when it comes to finding a path that interests them. Nurses can also carve out their own niche for a job that suits them to a “T.”

    Nurse to nurse bullying is real

    The old adage that “nurses eat their young” can feel very real, and it has the potential of turning off new grads and good nurses that the profession needs. Dealing with a nurse bully is tough, and if new nurses do not feel confident in standing up to a nurse bully, it is best to talk it over with a supervisor. No nurse should have to tolerate bullying from a co-worker, no matter if you’re a new grad or a seasoned professional. Everyone met the same requirements to become licensed. Everyone has a right to be there.

    Advocating for your patient when you disagree with the doctor is part of your job

    No. Matter. What. New nurses are not taught, at least not effectively enough, that there will be times when they have to challenge a doctor’s order. Questioning a doctor may not be comfortable, but remember, you are the last line of defense a patient has. If you don’t feel comfortable in carrying out a doctor’s order, talk it over with colleagues or a supervisor. You may get some insight on how to approach the doctor and feel more supported, if you’re concerned about the order.

    • One Extreme Example: One nurse I know that was still in training, questioned an order of insulin that had to be specially prepared by the pharmacy. She looked at the syringe and determined that it was simply far too big a dosage. She took her concerns to her preceptor. He advised her to call the pharmacy. The pharmacy confirmed that the dosage was correct. She still did not agree. Her gut told her the order was wrong. Her preceptor said that she could call the doctor, but warned that she would be waking him up. She pressed on and called the doctor. The doctor was fine with being questioned, but stated that the dosage was correct. She again felt that it was absolutely wrong. She called the pharmacist again and asked him to please redo his math. She went back to her preceptor and told him the doctor had confirmed the order and that the pharmacy also recalculated the dosage with her on the phone and that it was correct. The preceptor said she needed to give the insulin. She said she would if he would check to make certain there was enough D50 on the unit in case they needed to push it twice. He assured her there was. She gave the insulin. Within 15 minutes, patient’s blood sugar bottomed out and she and her preceptor ended up pushing D50 three times before getting the patient’s blood sugar stabilized. The next day when she had the same patient again, the dosage in the syringe was much smaller, and the patient thanked her for trying to look out for him in the face of all the opposition she encountered. This new grad nurse was not taught that she may face such a rough time in questioning an order, and she felt completely guilty about causing the patient distress. She thought she had done the best she could given the situation and three people telling her the order was correct, but she never again distrusted her gut when questioning an order.

    The bottom line to remember: you really are the patient’s last line of defense.

    As stated previously, the list for things you weren’t taught in nursing school could be endless. So, expect a part two, and possibly three, as future posts!
    Do you like this Article? Click Like?

  2. Visit ElizabethScala1 profile page

    About ElizabethScala1, BSN, MSN

    As a keynote speaker, bestselling author and Nurse's Week program host, Elizabeth partners with hospitals, organizations, associations, and nursing groups to help transform the field of nursing from the inside out. In her bestselling book, ‘Nursing from Within‘, Elizabeth supports nurses to make those inner shifts that are required to more fully enjoy our nursing careers. Find out more and connect with Elizabeth at www.elizabethscala.com.

    ElizabethScala1 has '11' year(s) of experience and specializes in 'psychiatry, community health, wellness'. From 'Jarrettsville, MD'; Joined Sep '11; Posts: 46; Likes: 93.

    Read My Articles

    25 Comments

  3. Visit  Ruby Vee profile page
    #1 15
    Nursing has seemingly infinite opportunities for growth, change, and redirecting a career. However, most of them require a solid background in bedside care. (Or SHOULD, if they don't.) They tell you about those wonderful opportunities out there while you're still in nursing school, but they fail to mention (or to emphasize adequately) that those opportunities are available to experienced nurses; not to new graduates. You will need to spend some time in the trenches in order to qualify. I wish I could adequately imprint that on our daughter's brain; her other parent (who should know better) has sold her on the bill of goods that she'll be a "nurse leader" the moment she obtains a BSN and a license. No, darlin'. You'll really have to take care of patients first to acquire some experience before you can be a "nurse leader."

    Nurse to nurse bullying, while real, is not as common as one might think from reading the various posts about it on this forum. I've seen two bullies in 40 years. If you're seeing bullies everywhere you look, perhaps you might want to take a good long look inward. Maybe it's not them; it's you. Nursing school does not adequately prepare you for the reality of workplace relationships. It's not all like those sitcoms you've been watching your whole life. You will have to work with people you don't like, don't respect and don't want to deal with. They'll have to work with YOU, too, even if they don't like or respect you. An unpleasant or uncomfortable interaction (despite what all those websites will tell you) is not bullying. Negative feed back is not only NOT bullying; it's necessary.

    Nursing school doesn't teach you how to accept criticism, yet it's one of the most important skills for a new nurse. You WILL make mistakes, and you want them to be brought up to you by the person who discovers them -- not taken to your manager and addressed when the list is so long she cannot avoid it any longer. Most criticism will be well-meaning, and most criticism will be delivered in a manner that you find unpleasant. No one likes to give negative feedback, and most of us never learn how to give it well. The fact that you don't like the delivery doesn't mean you're being bullied, that everyone hates or disrespects you or that the content is wrong. Invest some time NOW and learn to accept negative feedback and incorporate the necessary changes into your practice. It's a habit that will help you go far.
  4. Visit  Brenda F. Johnson profile page
    #2 2
    Well done article! I wonder though about the statement about new grads leaving the profession in large numbers. Is that true? They get through school, clinicals and then the testing only to quit? They don't see or experience enough to know they don't like it before that? Where did you get this information. Just curious. I see a lot of students and many seem uninterested in seeing or learning.
  5. Visit  Nurse Beth profile page
    #3 3
    This article hits the nail on the head with things that are so important to know but are not taught.
    I love "the world is nurse's oyster" when it comes to finding your niche. So true
  6. Visit  traumaRUs profile page
    #4 5
    Nursing has opened a lot of doors for me: as a volunteer pre-hospital RN, and as a prison activist. As others have alluded to: nursing might be a great gateway to something that is less than the traditional bedside nurse.

    However, like others, I too feel that a solid bedside experience makes for a more well-rounded nurse, no matter the occupation
  7. Visit  JadedCPN profile page
    #5 9
    Quote from Ruby Vee
    Nurse to nurse bullying, while real, is not as common as one might think from reading the various posts about it on this forum. I've seen two bullies in 40 years. If you're seeing bullies everywhere you look, perhaps you might want to take a good long look inward. Maybe it's not them; it's you. Nursing school does not adequately prepare you for the reality of workplace relationships. It's not all like those sitcoms you've been watching your whole life. You will have to work with people you don't like, don't respect and don't want to deal with. They'll have to work with YOU, too, even if they don't like or respect you. An unpleasant or uncomfortable interaction (despite what all those websites will tell you) is not bullying. Negative feed back is not only NOT bullying; it's necessary.
    Perfectly worded. Reading through this forum gives a totally different view than what I've been fortunate to experience in my decade of nursing. In this day and age I just think the word bully gets thrown around way too quickly and easily when someone doesn't like what another person says, and that's unfortunate for those that have experienced true bullying.
  8. Visit  ElizabethScala1 profile page
    #6 3
    Quote from Ruby Vee
    Nursing has seemingly infinite opportunities for growth, change, and redirecting a career. However, most of them require a solid background in bedside care. (Or SHOULD, if they don't.) They tell you about those wonderful opportunities out there while you're still in nursing school, but they fail to mention (or to emphasize adequately) that those opportunities are available to experienced nurses; not to new graduates. You will need to spend some time in the trenches in order to qualify. I wish I could adequately imprint that on our daughter's brain; her other parent (who should know better) has sold her on the bill of goods that she'll be a "nurse leader" the moment she obtains a BSN and a license. No, darlin'. You'll really have to take care of patients first to acquire some experience before you can be a "nurse leader."

    Nurse to nurse bullying, while real, is not as common as one might think from reading the various posts about it on this forum. I've seen two bullies in 40 years. If you're seeing bullies everywhere you look, perhaps you might want to take a good long look inward. Maybe it's not them; it's you. Nursing school does not adequately prepare you for the reality of workplace relationships. It's not all like those sitcoms you've been watching your whole life. You will have to work with people you don't like, don't respect and don't want to deal with. They'll have to work with YOU, too, even if they don't like or respect you. An unpleasant or uncomfortable interaction (despite what all those websites will tell you) is not bullying. Negative feed back is not only NOT bullying; it's necessary.

    Nursing school doesn't teach you how to accept criticism, yet it's one of the most important skills for a new nurse. You WILL make mistakes, and you want them to be brought up to you by the person who discovers them -- not taken to your manager and addressed when the list is so long she cannot avoid it any longer. Most criticism will be well-meaning, and most criticism will be delivered in a manner that you find unpleasant. No one likes to give negative feedback, and most of us never learn how to give it well. The fact that you don't like the delivery doesn't mean you're being bullied, that everyone hates or disrespects you or that the content is wrong. Invest some time NOW and learn to accept negative feedback and incorporate the necessary changes into your practice. It's a habit that will help you go far.
    Thank you for your thoughtful comments. I do agree that if we look for a bully all of the time... you are likely to find one. I so appreciate your thoughts on this. Thank you so much for reading and taking the time to share your comments!
  9. Visit  ElizabethScala1 profile page
    #7 2
    Quote from Brenda F. Johnson
    Well done article! I wonder though about the statement about new grads leaving the profession in large numbers. Is that true? They get through school, clinicals and then the testing only to quit? They don't see or experience enough to know they don't like it before that? Where did you get this information. Just curious. I see a lot of students and many seem uninterested in seeing or learning.
    Thanks for asking further about this. I meant it in that once a nurse gets into their initial nursing job, they tend to leave within the first 2-4 years. Appreciate you asking for clarification though! Thanks for reading!!
  10. Visit  ElizabethScala1 profile page
    #8 3
    Quote from traumaRUs
    Nursing has opened a lot of doors for me: as a volunteer pre-hospital RN, and as a prison activist. As others have alluded to: nursing might be a great gateway to something that is less than the traditional bedside nurse.

    However, like others, I too feel that a solid bedside experience makes for a more well-rounded nurse, no matter the occupation
    Right on about the opportunities in nursing! I actually "fell" into nursing myself... therefore did not want to go the traditional route of getting med-surg experience and all that I was told.

    I have found a love and great appreciation for nursing. Because I have viewed the career as an opportunity to do so much more!
  11. Visit  ElizabethScala1 profile page
    #9 2
    Quote from Nurse Beth
    This article hits the nail on the head with things that are so important to know but are not taught.
    I love "the world is nurse's oyster" when it comes to finding your niche. So true
    Thanks, Beth!
  12. Visit  ElizabethScala1 profile page
    #10 3
    Quote from JadedCPN
    Perfectly worded. Reading through this forum gives a totally different view than what I've been fortunate to experience in my decade of nursing. In this day and age I just think the word bully gets thrown around way too quickly and easily when someone doesn't like what another person says, and that's unfortunate for those that have experienced true bullying.
    I do agree with you. I think that those who have experienced bullying are more vocal than those who have not. Maybe if all of the nurses who have NOT experienced a bully spoke up about this blessing... then we would have less focus on the bully and more on the greatness of nursing!

    Thanks for your comment.
  13. Visit  sevensonnets profile page
    #11 6
    Well, those of us who have never seen or experienced bullying do speak up but we get drowned out by (usually newer) nurses who see it everywhere they look. We tend to be those who are actually satisfied with our jobs and don't consider the look on someone's face or the tone of their voice to be bullying.
  14. Visit  la_chica_suerte85 profile page
    #12 4
    Quote from Ruby Vee
    Nursing has seemingly infinite opportunities for growth, change, and redirecting a career. However, most of them require a solid background in bedside care. (Or SHOULD, if they don't.) They tell you about those wonderful opportunities out there while you're still in nursing school, but they fail to mention (or to emphasize adequately) that those opportunities are available to experienced nurses; not to new graduates. You will need to spend some time in the trenches in order to qualify. I wish I could adequately imprint that on our daughter's brain; her other parent (who should know better) has sold her on the bill of goods that she'll be a "nurse leader" the moment she obtains a BSN and a license. No, darlin'. You'll really have to take care of patients first to acquire some experience before you can be a "nurse leader."
    I think what people also fail to realize when they aspire to get themselves removed from bedside care into a "nurse leader" role ASAP is that management has it's own horrors. I was a manager prior to going into nursing school and management is not for everyone. I had many instructors telling me that I would be an excellent "nurse leader" one day and I always said, "Oh heck nooooo!" That is just not me.

    While some days it seems like it would be cool if I could be doing more "leader-ish" stuff as opposed to fighting with residents dealing with another actively dying patient, I think about what managers are accountable to and how dull (i.e. sending emails about obvious/mundane things adult people should/shouldn't be doing, writing schedules, listening to conflicts between staff, ugh!) and unnecessarily stressful that can be.

    The struggle between knowing what nurses need to do to in order to provide their best care and between saving money for the hospital is daunting and I want no part of that. People who think they want to jump right into that have no idea what a meat grinder the business of hospital administration can be. They're out of their minds (or, they're tragically naive).

close