Published Feb 13, 2018
What was the toughest obstacle that you faced your first year out of school.
Ruby Vee, BSN
My toughest obstacle was that my first job was two hours away from where my spouse was had a really well-paying job. I moved; he didn't. Long distance relationship for four months before he got a new job and started school in my new city. But I'm not sure that's what you're looking for.
Are you asking about finding a job? Passing NCLEX? The first year of nursing?
Sorry, I should have been more clear. But what was the biggest obstacle job wise, such as, (time management, job skills, learning their system for documentation...). Also what was the toughest part of getting your first job? I would like to start in the ICU (that is where I just finished precepting) but am slightly afraid of getting in over my head at first. Would it be smarter to go into something like med surf first?
When I graduated, there was such a nursing shortage that the state legislature was talking about solving the problem by forcing females on welfare to become nurses. Fortunately, that extremely ill-considered plan never came to fruition. I applied for three jobs in two different hospitals and got five offers within a week. I chose a smaller community hospital because I thought it would be eaasier to fit in. That may have been a mistake -- they had their own diploma program and I was a BSN grad. They'd never had a BSN grad before. They had no idea what to do with me. I think they thought I'd hit the floor running like their own grads, and that wasn't the case. I'd had eight hours of clinical a week compared to their grads' eight hours a day. It was a very hard transition for me. I HAD no job skills to speak of. Oh, I'd had lots of jobs, but none of them were in health care.
Time management was an issue, but the biggest problem for me was simply talking to people. I was afraid to talk to the patients, the physicians or even my colleagues. It took me a long time to get comfortable with that -- more than the usual one year.
The documentation was a nightmare -- all paper in those days, and designed for the convenience of disciplines other than nursing. It took a few weeks to learn that.
I learned my job from the bottom up, so to speak. The NAs took me under their wing and taught me basic skills like vital signs, clean-ups, weighing a patient, how to set up a meal tray, etc. The LPNs taught me about time management, passing meds, signing off orders, dressing changes, how to place an NG tube (and what to do with it once you've placed it), Foley care . . . the list goes on and on. The team leaders taught me how to hang blood, chemo, mix antibiotics . . .
Although mine is an unpopular opinion these days, I think most new grads are better served by NOT going into ICU right away. Med/Surg is a good option, but so is oncology or neuro or ortho or even a step down unit. Learn the basics -- how to talk to people, manage your time, think critically, drop an NG, place a Foley THEN transfer to the ICU and learn about invasive monitoring, rhythms, ventilators, etc. Some new grads do fine in ICU, but not as many as think they do.
Good luck with finding your first job. The learning curve is steep, but it's well worth it!
barcode120x, RN, NP
My toughest part was when I was officially on my own as a working nurse after the new grad program. I had so much anxiety before and after work, thinking about what kind of patients I could get, all the what if's, and worrying about if I forgot to do something. It was terrible and a horrible feeling, but it's kind of part of the learning process and being a new grad. I've NEVER experienced such anxiety. I had some in nursing school, but it was related to exams and grades. My anxiety gradually faded, but the first 6 months was rough. After a year, majority of my anxiety dissipated. 2, going on 3 years now I'm just chilling haha. I also had a LOT of call offs my first year on my own because many times I didn't want to work due to the anxiety and just being scared and not confident.
For me it's definitely time management. I work in an outpatient hemodialysis clinic, and even though I only care for four patients at a time, something can go wrong quickly. I had to learn how to do all the technical aspects of the job (cannulation, setting the machine, etc) as well as making time to do my own med pass. On the bright side there is only a handful of medications we are responsible for.
Sometimes after treatment when the needles are removed, a patient will still be bleeding longer than usual. I have been fortunate enough that the cure was simply to continue applying pressure and time. Unfortunately, sometimes this shortens the amount of time I have to clean the machine, set it up, and test it for the next patient. In the meantime I have three other patients who still have to be monitored. Luckily if I need help, my coworkers are willing if they're free.
Don't let those old ratchetty nurses tell you how you have to start on the floor. I started in the ICU and it can easily be done if thats where you want to go. One thing many have to realize though is nursing school really doesn't teach you to be an ICU nurse. Be proactive and learn what you can.
Create well-written care plans that meets your patient's health goals.
This study guide will help you focus your time on what's most important.
Choosing a specialty can be a daunting task and we made it easier.
By using the site you agree to our Privacy, Cookies, and Terms of Service Policies.