Advice for newbie RN

foggnm · Jan 15, 2017

Congrats on your new job. There are a lot of learning experiences in nursing whether you are new or seasoned. If anything, I'd say start thinking about what you see your career/future looking like in 5 to 10 years and keep working towards that goal. And it is completely ok in nursing to try different things to find what fits you best.

Ruby Vee, BSN · Jan 15, 2017

Congratulations on your license and your new job. Advice I wish I'd had when I started:

You don't have to like someone to work with them, but it is so much easier all around if they like you. I'm an introvert, and it was excruciatingly difficult for me to introduce myself to folks and chitchat; but when I eventually learned to do is, it paid off more than I could have imagined. Spend a few seconds to greet the housekeeper and find out how her grandkids are doing in school, chat with the cardiologist about his recent scuba certification and ask that senior nurse about her kitchen remodel even if you could not possibly care less about such things. It pays off in improved teamwork.

If your coworkers like you, a big error will get you in very little trouble. If they don't like you, a little error will get you into very big trouble.

You WILL make an error. Everyone does. When you do, recognize it, admit it it to yourself and anyone who needs to know and immediately set about mitigating the damage to the patient. Patients are surprisingly tough and can survive most med errors provided you don't try to hide it. Be the first one to tell your nurse manager about it. (There are threads on this -- do a search on them.)

The good nurse is the one who does the right thing after she makes an mistake. I'd trust her any day over the nurse who claims never to have made one.

The first year is rough. You'll cry, you'll lose sleep, you'll hate your job and your life. After you get through it, you'll be a real nurse. The only way to get through it is to GO through it -- changing jobs won't help. We have all been there, and most of us got through it. The ones who didn't get through it are the ones who gave up. Don't be one of those.

Someone will always have your back.

Nurses do not eat their young. Nursing is not full of bullies. No one is looking to stab you in the back. If you go looking for wonderful, knowledgable colleauges who will have your back, that is what you will find. If you go looking for bullies, that is what you will find. Why go looking for bullies?

Good luck, and PM me if you have questions. I know nothing about L & D or Psych, but I can answer questions about how to ask a question, how to impress your preceptor or any one of a thousand other questions you can come up with.

Chem101 · Jan 16, 2017

Thanks! I think working towards a goal will definitely be helpful. Who knows where I'll end up in 10 years? I just hope it's something I love doing.

Chem101 · Jan 16, 2017

Thank you very much for the specific input! Also, I really appreciate knowing I can pm you. Thankfully, I also already know my preceptors as I spent time doing clinicals there and they are both fantastic and willing to answer my zillions of questions :) So, between them and here I think I'll be just fine. Just gotta make it through my first year is what I keep hearing.

mmc51264, BSN, MSN, RN · Jan 16, 2017

Don't be afraid to ask questions or for help. We really want to help you. Volunteer to do any task that comes up! the more you do, the better you become. Foleys, ostomy changes, dressing changes, enemas, NG tubes. Anything! It gives you confidence and makes you feel like you are a "real" nurse. I know it sounds silly but it really helped me. I was the only one for a while that knew how to do naso pahryngeal swabs, the only one to de access ports (intermediate floor). pull a PICC. You will be surprised how much some nurses don't do. We have an IV team and phlebo, so I don't do those things (I am checked off on drawing blood off approved central lines). I plan on fixing those things.

A great attitude goes a long way. Learn from your aides too. They can be your best friend or worst enemy.

Jules A, MSN · Jan 16, 2017

Congratulations on your license and your new job. Advice I wish I'd had when I started:
You don't have to like someone to work with them, but it is so much easier all around if they like you. I'm an introvert, and it was excruciatingly difficult for me to introduce myself to folks and chitchat; but when I eventually learned to do is, it paid off more than I could have imagined. Spend a few seconds to greet the housekeeper and find out how her grandkids are doing in school, chat with the cardiologist about his recent scuba certification and ask that senior nurse about her kitchen remodel even if you could not possibly care less about such things. It pays off in improved teamwork.
If your coworkers like you, a big error will get you in very little trouble. If they don't like you, a little error will get you into very big trouble.
You WILL make an error. Everyone does. When you do, recognize it, admit it it to yourself and anyone who needs to know and immediately set about mitigating the damage to the patient. Patients are surprisingly tough and can survive most med errors provided you don't try to hide it. Be the first one to tell your nurse manager about it. (There are threads on this -- do a search on them.)
The good nurse is the one who does the right thing after she makes an mistake. I'd trust her any day over the nurse who claims never to have made one.
The first year is rough. You'll cry, you'll lose sleep, you'll hate your job and your life. After you get through it, you'll be a real nurse. The only way to get through it is to GO through it -- changing jobs won't help. We have all been there, and most of us got through it. The ones who didn't get through it are the ones who gave up. Don't be one of those.
Someone will always have your back.
Nurses do not eat their young. Nursing is not full of bullies. No one is looking to stab you in the back. If you go looking for wonderful, knowledgable colleauges who will have your back, that is what you will find. If you go looking for bullies, that is what you will find. Why go looking for bullies?
Good luck, and PM me if you have questions. I know nothing about L & D or Psych, but I can answer questions about how to ask a question, how to impress your preceptor or any one of a thousand other questions you can come up with.

What an excellent. excellent post. I can't like it enough and wish it could be made into a sticky or plaque we could give to our new RN colleagues.

OP smart thinking to get a job where you already know the routine and you have contacts. I wouldn't have gotten 1/2 of what I have without having fostered solid professional contacts. Being well connected truly has made a huge difference in my success. Best of luck to you and congratulations!

MA Nurse · Jan 16, 2017

Congratulations. I know for a fact some older nurses do, and will, eat their young. So just ignore them and go to someone who is helpful and willing to teach. Do not be afraid to ask questions, it isn't safe to keep quiet if you are unsure of a procedure, etc. You will be dealing with many different types of people and their emotions. Your patient's families are like another patient, it can be hard. Don't be afraid to set limits. You will need to develop a thick skin. Remember to take care of yourself. Also, remember you can't and won't know everything there is to know. You will learn as time goes by. Good luck!!

amoLucia · Jan 16, 2017

And start saving your money for that inevitable 'rainy day'.

datalore · Jan 16, 2017

1. I'm 8 months into my first year -- I'm JUST starting to feel like I know what I'm doing, even though I've been doing "great" all along. Don't feel like you're not meant to be a nurse because you feel like you have no idea what you're doing -- that is normal! It goes away eventually, because....

2. ....Lots of people will have to tell you things you've done incorrectly or things you can do better. This goes along with the point I made above -- it's because there's SO MUCH to learn in the first year. It's not because you suck, it's not because they don't like you. It's how you get over the "I have no idea what I'm doing" feeling: listening to and acting on that feedback from others.

3. You will make a med error. You will. Any instructor that ever told you, "I never made a med error" is either lying or hasn't worked at the bedside.... OR, doesn't realize they made errors. WHEN (not IF) you make an error, own it, learn from it, cry about it, feel terrible, but know you'll always be vigilant to never make that same mistake again. Good coworkers will share their own stories with you when you're feeling terrible about your own mistake. Everyone has stories.

4. Be a sponge for feedback and information. Be curious. Be open to criticism. Be willing to advocate for yourself if you're given a task that is inappropriate (e.g., you haven't seen it done, been signed off on it, no necessary supervision) while in orientation and when you're first off orientation.

5. My best advice: KEEP A JOURNAL! :) I've never been a diary/journal type person, but an instructor told me to jot things down occasionally, so I have and it's so fun to go back and re-read the nice/sad/scary/proud memories. In 20 or 50 years I'm sure it'll be even more fun to remember things about the journey. It's worth the occasional writing!

chacha82, ADN, BSN · Jan 16, 2017

Congrats and welcome :geek:

If you are a floor nurse, don't get overwhelmed by your admissions if possible. As a new nurse I used to get so sidetracked with them my 4 other patients got really behind. Get them settled and if they're stable, you can do an assessment and come back to them.

Be wary of people who try to get your opinion on things - you are new and may be flattered but they're trying to stir the pot. Smile and go about your business. In time you will know who to trust and they really will seek your opinion and value it.

Be 100% present when you're at work, be 100% off when you're off. Enjoy your time off and don't feel guilty if you don't switch with someone or pick up extra. You deserve to feel refreshed, relaxed and do your own thing so that you can be present for your patients when you return. You do your best work when you are rested and ready to come back. I spent a year of switching with other people, picking up extra, etc etc...when I needed a switch recently NO ONE helped me out, even though I did it for them.

Don't take it personally if family fusses at you or your patients don't do what you think they should - it's complicated and if someone says "I want an experienced nurse" don't feel bad, just smile, leave, and tell your charge. I've been there and it stings - but it's not worth trying to change their minds.

Start a retirement account and also put money away every month in a savings account that you can get to in an emergency if you need it. I have been scoffed at for having an emergency fund but it saved my booty just this past week when my otherwise very reliable car needed a repair of over $200. That is exactly what the emergency account is for.

Don't be afraid to delegate tasks to your CNAs AND prioritize. A request for the third ice cream can wait five minutes while you get that EKG (or someone else can always take them that ice cream). I had a preceptor once who said "It's a process" and I have found that immensely helpful.

As others have said as soon as you realize you made a mistake or something happened, tell your charge nurse! Give them as much information about the incident as possible and move forward.

TriciaJ, RN · Jan 16, 2017

Don't "ignore the bullies". Ask them for help; ask for feedback. Ask how their kids are doing. You don't know they're bullies until you've given them a chance. They might turn out to be your best friends and staunchest advocates. If not, well at least you tried. Better than writing people off out of hand.

Also, use your worksheet. Your unit might have a preprinted one that works. If not, develop your own. Use it for everything. Do not trust anything to your memory. Even the best memories fail when there are too many things going on.

You've gotten some great advice on this thread. Congratulations on your career.