Something I wrote right after i finished school

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There are many new Nursing graduates hitting the market every May and December. They all work very hard to attain that goal and the right to take the state board licensure exam. Nursing school is grueling work with long days and hard nights studying and preparing. You may have a test the following day, or a clinical and either one is a trial of your skill and knowledge. Finally you have been to all the classes, passed all the tests and pleased your instructors, your clients, and yourself. Now the most important examination of your life at least of your scholastic career to date. State Board for licensure. The exam is terrifying but you pass. Finally it is over. You are a nurse. You don't have to study or take tests or go to classes anymore. Unfortunately this simply is not true.

I am not trying to discourage anyone from the field of nursing; in fact I love every minute of the work. I enjoy it even when the job is messy, smelly, unpleasant, and thankless. I am however, attempting to shed a little sunshine on the fact that when you take your first job, the real learning has only just begun. If you go to work for a major hospital you will probably begin an eight to twelve week orientation. The first two weeks of which are usually (yep you guessed it) learning, studying, and testing. You will need to learn specific hospital orientation rules and regulations, policies and procedures, rights and wrongs. This is just the general hospital orientation that everyone who will work in the facility will go through. Then, as a nurse, you will begin nursing orientation that will include medication tests, training on equipment such as glucometers, pumps, restraints, and much more. Then, if you are going to work in a specialty unit such as ICU, CCU, NICU, Labor and Delivery there will be many things that you will need to learn before actually beginning your career as a staff nurse.

I for example have gone to work in a Critical Care Unit. In the first year of nursing the new graduate that enters critical care nursing will have to learn many things. Including operation of intra-aortic balloon pump (IABP), continuous vasovenous hemo-dialysis (CVVHD), operation of ventilators and various pumps, how to use electronic defibrillators, pacemakers, EKG machines, and many other types of equipment. All the while caring for and administering to the patient attached to the equipment and their families and the physicians. The nurse will also be learning many procedures during this time, recovery of coronary artery bypass graft (CABG) patients, removal of arterial and venous sheaths after coronary arteriogram, removing arterial lines, management of swan-ganz catheters, central venous lines and placing peripheral IVs and nasogastric-tubes.

Nurses will also be assisting in bedside procedures such as placement of central venous catheters, bronchoscopy, esophagogastroduodenoscopy (EGD). Nurses will do all of this on top of the expected duties of patient care, administering medication orally, intravenously, rectally, subcutaneously, and intramuscularly. Safe administration of blood and blood products such as packed red blood cells and fresh frozen plasma. Then as if all this is not enough the nurse must also find time to chart and record everything done in the care of the patient. These are just the things a critical care nurse must learn. There are other specialties for other areas.

The nurse must have at least a basic knowledge of every medication administered and understand it's action, dose, side effects, expected effects, and be aware of allergic reactions. Critical care nurses need to be familiar with many various medications beyond the usual medications patients will be on daily. Cardiac medications such as dopamine, dobutamine, amiodorone, nitroprusside, nitroglycerin, epinephrine, lidocaine and cardizem just to begin the list. Last and absolutely not least for their importance the nurse must be aware of laboratory values of many different kinds and know what is normal or out of range or dangerous. The nurse will be responsible for reporting all pertinent information to the physician, teaching the patient and their family about every aspect of care, and all the things mentioned above.

The point I am attempting to make is that the education of good nurses never ends. There will always be more to learn and new interventions and improvements in procedures and processes. I invite every new Graduate to accept the challenge with healthy goals toward overall improvement. Strive to excel, Be a Nurse!

9/16/03 Larry Leeds RN

LisaRN2B

366 Posts

Thank you, Larry.

And I was hoping that would be the case! (Call me crazy, but I love this nursing stuff! ;) )

Love-A-Nurse

3,932 Posts

Specializes in LTC, ER, ICU,.

how kind to take the time to share the reality we should expect; thank you.

AmyLiz

952 Posts

Awesome post, Larry! I'm looking forward to it all, myself!

WanttobeRNinNC

16 Posts

What a GREAT post! Alot of great information. Thanks so much for the insite, and I am looking forward to having a career in Nursing.:kiss

Specializes in ICU, CM, Geriatrics, Management.

Thanks for caring and sharing, LL.

Super!

CCU NRS

1,245 Posts

Hey thanks everyone for all of the wonderful comments. I was an LPN for eight years and just finished my ADN last may and took boards in July and have been working as an RN every since.

Good Luck to all of you!!!

NurseDixie

419 Posts

Thanks so much for taking the time to let us soon to be RNs what we will be facing when we get out into the "real world". I have one more test, then a final...then graduation on Dec. 12. A lot of the nurses in our clinical settings have told us that our learning really begins when we start working as a nurse. I can't wait.

Dixie

RNIAM, BSN, RN

1,214 Posts

I have been very lucky to have spent a great deal of time in a teaching hospital and have already participated of watched most of the procedures you have mentioned. I am sure there is alot you haven't mentioned that a nurse is required to do. The part I love about nursing is that if you don't have the answer there are dozens of different resources available to find the answer. It is a great profession and I look forward to graduation in MAY!:)

Andrea-Jean

4 Posts

I am a single mother of a very active 9year old. Ive learned that going through nursing school(graduating in May) means making (sometimes) extreme sacrifices. One of them being able to spend the quality time with your children. I think, also, that to be in a nursing program you have to love learning and you need a certain amount of passion for the job to be successful. I can only hope that I am passing on my passion for learning and my determination to my daughter. Thank you again for the post it was very informative..

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