Hello to all the New Grad Nurses!
I have noticed, as I read the posts, a lot of you are talking about being frustrated, overwhelmed and scared. Let me start by saying that it's normal to feel this way. I have been an LPN for 5 ½ years and guess what, I sometimes feel the same! I know Nurses, both RN & LPN, with many more years than I have that have days like that too. So, take a deep breath and relax for a minute.
The one thing that most Nursing schools don't tell you is that what you learn in class and what goes on in the "real" world are sometimes very different. Instructors never tell you about how many patients you will be assigned, the different levels of care each needs, the tons of paperwork needed to be done each shift (not counting the emergency, admission and discharge paperwork), the problems of giving meds to some pts (that can take forever to give) , the pts who call you constantly for little things they can actually do themselves, The pts who berate you, scream & threaten you, the ones who complain to management about everything you do (no matter how much you try to satisfy their needs). But, remember, they also do not tell you about the little wonders that happen each day. The confused pt who remembers who you are, the hugs you get from them for something so small you never even thought about it. The Thank You received from the pt & family for catching a problem before it got worse. Being singled out by a very difficult patient, only to have them thank you for your care and the time you gave to them despite their attitude towards staff. And last but not least, the feeling you get when you know you did your best & the patient is healing perfectly.
Yes, you are overwhelmed, stressed, frustrated, scared, you question your decision to become a Nurse. You just graduated, you are learning, you feel like you should be quicker, know everything, maybe scared to ask too many questions. It will take 5 years for a Nurse to feel fully confident in her decisions and assessments. Seriously, 5 years! And even then, you will have moments where you question yourself. I was very lucky, I had a fantastic mentor!! She taught me many things, the most important things she taught me I will try to give to you;
1. Never be afraid to ask questions - if you ask someone and they won't answer, ask someone else (I know that sometimes the experienced Nurse get irritated by your questioning and may snap at you, gently remind them that you are still learning and they have the knowledge you need and you appreciate their sharing it with you) And try to keep a notebook to jot down answers to questions, this gives you the ability to look something up and remind yourself of the answers.
2. There are no stupid questions, only unasked ones
3. Keep a "cheat sheet" on your assignment - jot down the little things you need to know about that pt
-DX, treatments & times due
- hard to give meds, crush meds & put in applesauce, jelly, a drink, ice cream, best time to give meds, wants juice, warm water or ice water with meds
-BS, VS, Neuros, fall risk, specimens needed
-DNR or Full Code
-Allergies
4. Trust your CNA's - they spend more time with the pts than you do, they know when something isn't quite right, let them know what you expect from them and what you will to do for them (help with a boost, answer a call bell, toilet pts) and it never hurts to thank them for the great job they did today (they are overworked & underpaid, appreciation goes a long way). Ask them to write down pt requests on a slip of paper & place it on your cart, you can then prioritize requests.
5. When in doubt, call the DR, explain what the problem is (I have called them and told them VS are perfect, but, something isn't right, they usually believed me and ordered tests or asked me to continue watching. Though I have to say if you call the on-call at 2AM they will not be real happy with you, so keep watching and let the next shift know your concerns, as long as it's not life threatening).
Remember the ABC's of Nursing, a Nurse once told me the following mantra (at least I use it as one): Air goes in & out, Blood stays in and goes round & round, any deviation from this is bad! Follow this simple pattern for your shift: Safety First, Meds second, Treatments third, everything else is last. When you leave work do not take it home with you, do not worry about whether you did something right or wrong, unless you put the pt in danger you'll be fine, again if in doubt about something ask someone. Take a moment to breath, clear your mind, and rely on the Family of Nurses to help you, each shift has their own jobs to do, but, in the end we are all working towards the same goal: healthy patients!
