Areas new nurses are often lacking

[desire1684]

I am a nursing student completing my last semester of nursing school and want to be prepared as possible when I get hired on as a new nurse. Are there any specific areas that new nurses tend to be the weakest in that I should start focusing on now? For example: medications, procedures, patient communication, theory, etc. Any input from experienced nurses or hiring nurses is greatly appreciated. Thanks!

[Esme12, ASN, BSN, RN]

thread moved for better exposure/response

[UnicornRN]

Skills. My biggest weakness as a new grad was skills, and remembering what to do and when to do it. Nursing school prepares you for NCLEX, not floor nursing.

[Ruby Vee, BSN]

Most new nurses are deficient in skills -- nursing schools aren't really teaching them anymore.

Here's my advice for a new grad:

Learn to take criticism well, even when you're sure the person delivering it is wrong and that it's poorly delivered. Your preceptors are going to deliver criticism, and some never learned to do it well. Which doesn't mean they don't actually mean well, or that they don't want to help you. Instead of dwelling on "my preceptor HATES me," consider each piece of criticism delivered and try to learn from it.

Develop a thick skin. It's not all about you, and if someone forgets to say good morning to you, it doesn't mean they hate you. Understand that as the new employee, you WILL be talked about. Most of it will be well-intentioned. Preceptors and charge nurses will talk about you to try to get you the best experiences possible, to try to get assignments for you that will address your weaknesses and play to your strengths. Your colleagues will talk about you as well -- if Hortense and Beatrice talk about the fact that you have a two year old, anyone in the room who also has a two year old will find something she has in common with you that you two can discuss during lunch. If Burt and Curt are discussing the fact that your BSN is from California, I might ask you where in California you're from and whether you live near my sister.

Expect to study in your time off. We all have to do it. If you have a TB patient and your knowledge of TB is spotty, go home and read up on it before tomorrow. If you know your patient is going to the OR for a Whipple tomorrow, read up on it tonight. If you don't study at home, you may not be able to catch up. There may not always be time to study at work.

Arrive at work half an hour early to look up your patients before the start of your shift. Know their histories, medications, lab values and plans for today.

Your time management will suck. Work on it -- whatever it takes. Find someone whose time management skills you admire and ask them for advice and criticism.

You will be stressed and feel stupid and incompetent. It comes with the territory. The only new grads who DON'T feel stupid and incompetent at times are the ones who ARE stupid and incompetent!

Good luck!

[HouTx, BSN, MSN, EdD]

Time management is very problematic for new grads because they tend to give equal priority to everything - the end result is a feeling that they are just overwhelmed with all the demands on their time. It takes a while to be able to be able to deal with all the 'unexpected' things that crop up in the normal course of the shift - to readjust their mental task list based on changing priorities.

Delegation can also be very challenging if you are not really confident in your decision-making ability.

[meanmaryjean, DNP, RN]

The biggest thing I notice in precepting new grads is time management. Schools do a POOR job of exposing students to an average work load. We have one school in our area which is famous for producing grads who have never cared for more than one patient at a time before - and seem resentful when transitioning to taking an equal assignment with the other staff.