A list written by me for me. Also a list for new nurses, or not so new nurses. We all have lots of advice stored up from all of our experiences. We should share them, if only for ourselves. If not for ourselves, maybe our advice can help others as they navigate this profession called nursing.
"This is what reality shock feels like," I thought to myself as I stared at the little confused old man sitting on the edge of his bed, covered in blood from the IV that he just pulled out. It was quarter to eleven at night and I still had two more people who needed medications, foley catheters to empty, charting to finish, and now, another IV to start with an antibiotic to hang before my shift was technically 'over' at eleven.
As I stared at the mess that I was going to have to clean up, as that poor man held his blood covered hands up at me while saying "It's sticky" I felt a feeling that I have felt before. Anxiety mixed with panic mixed with adrenaline mixed with sheer exhaustion. Thankfully, the adrenaline instead of the exhaustion kicked in, I asked for help from my co-workers and they (bless their hearts!) finished my other medications while I cleaned the man up, started a new IV and hung his antibiotic in ten minutes- just in time(well, maybe not quite in time) to give report to the next shift and then wrap up my charting.
I have been a nurse for a few years now. I truly feel like I have gotten over the majority of reality shock that I felt for most of my first year of being a nurse. But I still have nights where that feeling comes back and I am humbled and reminded of what it feels like to be new or even that feeling of being absolutely unable to do everything that I wanted to do on my shift.
I have realized over the last few years that I cannot do everything on my shift and that it is ok to leave some minor things for the next shift to do. I do, after all, work in a 24/7 environment and I am not superwoman.
But when I am reminded of that feeling: anxiety mixed with panic mixed with adrenaline mixed with sheer exhaustion-it reminds me of a list that I have for the "New me RN" also known as the "List of things that your older self wishes that your younger self had known." I especially start thinking of this list in May, when all of the new nurse graduates are coming out of school and into the workplace, freshly pressed and ready to change the world of the sick. (I was that way, anyhow. Perhaps not everyone has quite that idea upon graduation.)
I want to share this list with you. I hope that it can be of help to someone and if not, that's ok. When I get my feeling again of anxiety mixed with panic mixed with adrenaline mixed with sheer exhaustion-and trust me, I will feel it again- I will just read my own list to myself, burn a lovely smelling candle, drink a delicious cup of tea and try to re-orient myself to why I love this crazy profession so very much.
Advice to the younger nurse me
You can't do it all. You can't. Read me again. You CAN'T do it all.
Ask for help when you need it.
Don't ever be afraid of looking stupid. If you don't know something, ask.
Be very very afraid of anyone who A) Is afraid of looking stupid or B) Knows everything.
If you don't know how to do something, ask. See #1,2,3 and 4 for reference.
Always check your patient's code status.
Know what your patient's medical history is before you see them, if possible.
Know who your patient's healthcare provider (Dr.,PA, NP) is before your shift starts. There is nothing worse than hunting for whom to notify when something goes wrong.
Know why you are doing what you are doing. See #3.
Focus on priorities. Putting a band-aid on a skin tear is less important than a heart rate of 134 and respirations of 35. You might think this is common sense, but I am just saying.
Bleeding can generally be stopped.
IVs can generally be restarted. If you can't -someone else can. If no one can, there are always central lines and surgeons.
Do not run around focusing on paperwork if you have someone who needs a new IV. See #2. It will only cause you more problems later.
Chart. As. You. Go. As much as possible. Otherwise you will be in the building for hours and no one likes that.
This may sound harsh and anti-noble, but money matters. Use your companies' resources and your time wisely. This also ties in with number 14.
Doctors are not horrible people. They can be wonderful team members if you treat them like the humans that they are.
If something doesn't 'feel' right, trust your gut. The worst that can happen is that you are wrong and your pride gets hurt. If you don't know what to do, see #2.
Sometimes, the loudest, in charge sounding person is actually dead wrong.
You will make mistakes. Just learn from them and move on.
When you get that feeling of anxiety mixed with panic mixed with adrenaline mixed with sheer exhaustion, remember that it will go way. Remember that it doesn't last forever. Find your method of stress relief.
And if necessary, add more to your list of advice to the younger nurse you. I know that you have a lot of knowledge by now. You could even post your list on allnurses and receive input from other nurses, to help make an even longer list, for you the 'older nurse' and maybe another younger nurse you.
Then pour yourself that cup of tea and read your advice again. After all, experience is the best teacher!
And maybe, just maybe, that feeling of anxiety mixed with panic mixed with adrenaline mixed with sheer exhaustion will slip away, until you are ready for work and to do it all again tomorrow.
LOVE the original post - such a relatable story at the beginning too :-)
I also have a few things to add--
1) If you have time during your shift - even just a few minutes - offer to help other nurses and techs. Of course, you won't have time to do this every day, but it will build so much goodwill between you and your co workers and really help your "area" or the whole unit run more smoothly. It doesn't have to be huge stuff - just passing a colace or setting up another pt.'s breakfast tray can be a big help to someone.
2) If you work in any sort of hospital setting where you have to draw your own blood and start your own IVs, WORK ON THAT SKILL!! Certainly ask for help if you need assistance, but you will be much less stressed if you become decent at it (which, unfortunately, comes only by actually doing it.)
Specializes in LTC, Corrections, newbie to OB/GYN.
This is awesome. Thank you! I have been an LPN for 1 1/2 years in LTC and corrections. I remember the overwhelming feeling I had as I started my 1st job as an LPN. I have that same feeling as I have just finished my ADN program and face NCLEX as well as a new job. I had a wonderful LPN instructor that shared with me an article similar to this post. It serves as encouragement and I am very thankful.
Hi SarahLee, Well I have to say that is one of the most poignant pieces of writing I have read in a long time. Your list is not only for nurses, I think it applies to us all, especially 1-4. I was practically in tears reading it. I'm going to print it out and put it on the fridge for my children to see. Thank you for this, btw, you have a lovely gift for writing!
Specializes in Wilderness Medicine, ICU, Adult Ed..
In any emergency there is always only one thing to do: the next thing that is necessary. Do that one necessary thing and trust that the second, third, and so-on will come to mind as you need them to; not all at once. Trying to manage everything results in managing nothing.
I am currently waiting on my acceptance letter, hoping to begin the nursing program this fall. I loved reading this and am going to print it out and keep in a handy place - thank you!
20. When you get that feeling of anxiety mixed with panic mixed with adrenaline mixed with sheer exhaustion, remember that it will go way. Remember that it doesn't last forever. Find your method of stress relief.
Thank you for posting this, the last few shifts I've had my orifice handed to me. I've saved this, printed it and will tape it to the inside of my clipboard.
RNJill
135 Posts
LOVE the original post - such a relatable story at the beginning too :-)
I also have a few things to add--
1) If you have time during your shift - even just a few minutes - offer to help other nurses and techs. Of course, you won't have time to do this every day, but it will build so much goodwill between you and your co workers and really help your "area" or the whole unit run more smoothly. It doesn't have to be huge stuff - just passing a colace or setting up another pt.'s breakfast tray can be a big help to someone.
2) If you work in any sort of hospital setting where you have to draw your own blood and start your own IVs, WORK ON THAT SKILL!! Certainly ask for help if you need assistance, but you will be much less stressed if you become decent at it (which, unfortunately, comes only by actually doing it.)