A Word to New Nurses

[bluegeegoo2]

I have recently had several new nurses to orient not only to my facility, but to LTC and nursing in general. This obviously does not apply to all new nurses as some have done well but are some observations that I have made that will help you along with developing your practice:

1. Ask questions.

Please. Many times I have oriented new nurses who will not ask a single question or will only ask one or two the entire shift. How can I help you learn if you don't let me know where you need direction?

2. Don't tell me you're "fine" or "ok"

When I ask how you're doing when you're clearly not "fine" or "ok." I can tell by the look on you're face that you're struggling. I ask how you are doing because I see you struggling and I'm offering to help you. Please take me up on the offer.

3. Understand that I'm going to have you do complicated drsg changes, tube feedings, injections, etc.

I know you said you're not comfortable doing them. I will walk you through. I have you do them even though you're nervous because orientation time is limited, and I'm giving you the opportunity to learn with guidance before you're on your own. Even then, you can still come get me if nerves are getting the best of you. With time, you'll gain confidence.

4. You can not learn everything there is to know during orientation.

Learning to nurse is mostly on the job training, and is on-going. I learn new things nearly daily. Nursing skills develop over time. A long time. I'm not the same nurse as I was when I started, and will likely not be the same nurse a year from now. Nursing is truly an evolutionary process.

5. It's OK and perfectly normal to feel overwhelmed at times.

I have personally excused myself to a quiet place for a good cry in the middle of shift. Recently. Just know that while the duties of the job do not change much, you're ability to handle it does. In other words, the job doesn't get easier. You learning to manage your time more effectively makes it easier to handle.

6. There are no "stupid questions."

7. Be honest about what you need.

If you're supervisor or another nurse asks how it's going, be honest with your answer. "I'm feeling pretty good about A, B, and C, but I'm having some issues with 1, 2 and 3." That way, you avail yourself to many years of experience and guidance from others.

8. If you're a new RN learning from a seasoned (baked or fried? ) LVN, or a new LVN being taught something by a CNA, please don't let your title get in the way.

I have seen that happen first hand. Remember as a new nurse, titles mean nothing. Experience does. I have learned (and still learn) a lot from CNA's and others. Also listen to what everyone including housekeeping and dietary people have to say. These people likely know the residents as well as the culture of the facility, and you would be wise to pay attention to them.

I could go on and on, but I think you get the idea. Please feel free to add any other suggestions or observations.

[icuRNmaggie, BSN, RN]

So true.

My Father was in a home for many years. At meal times every single employee from the receptionist to management to the housekeeping and even the maintenance guys were required to be in the cafeteria to assist in anyway possible. It was the way it should be.

I could not get my Dad to eat. Some little woman who spoke with a lot of aints and more betters, who I really did not trust to safely feed him, was able, somehow, to get him to safely consume his meal when I could not. She said I love my people. When things are hard at home at least I can come here and take care of my people. I don't know what I would do if I couldn't come here every day and take care of my people. I don't think you can teach that level of kindness and compassion. There truly is a place for everybody in nursing.

[kiszi, RN]

8. If you're a new RN learning from a seasoned (baked or fried? ) LVN, or a new LVN being taught something by a CNA, please don't let your title get in the way. I have seen that happen first hand. Remember as a new nurse, titles mean nothing. Experience does. I have learned (and still learn) a lot from CNA's and others. Also listen to what everyone including housekeeping and dietary people have to say. These people likely know the residents as well as the culture of the facility, and you would be wise to pay attention to them.

Yes!! And please help the CNAs with patient care when possible. Not only will it help you earn respect and be seen as a team player, there is much you can learn just from observing how they do things. Especially if, like me, you weren't a CNA before becoming a nurse. There is a petite NA I work with that can change an occupied bed on a 400 lb patient in no time flat. I've been a nurse for 8 years but have still learned so much from her and others.

[missna4u]

Thank you! I needed this

[jc317]

It's so awesome to read this post and feel the support of a seasoned nurse, even just through the web. I'm about to start my first nursing position and I feel extremely nervous about everything. I'm excited to start with a residency program and have a little extra bridge to being on my own but I hope there are nurses like you in my new unit! :)Thanks for not eating your young!

[LadyFree28, BSN, LPN, RN]

I would hope to get someone like you to teach me while in orientation!

You will...and even with those challenges, you still have AN for a wealth of information and support.

[spiderslap]

if only i had nurses like you who actually ask how things are going and welcome questions.

[Haynes3]

Thanks for the information. I'm a nurse waiting to start my first job and I'm always wanting to know the dos and don't

[blank]

A very good article. Right to the point.

[anymeans2014]

Thank you for posting this! I start my first hospital job in January and needed this!

[jeanbeth, MSN, DNP, RN]

Suggestion #8 needs exclamation points!! I was a new RN when I oriented with two LPNs who advised me to listen to my CNAs because they had so much valuable information for me. It was so helpful to me to watch and learn the techniques all of these women had developed after years of experience. I'm a better nurse because of it.

[sallyrnrrt, ADN, RN]

i really am impressed at your development becoming a seasoned LTC nurse since we first communicated

[BoyNamedSue]

I can only wish that all administrators were like you. Thankfully, my higher-ups have been very supportive, as well as most of my coworkers. Anything less would certainly lead to a mass exodus.