Brand new nurse; need advice to get through my first year of work!

Ruby Vee, BSN · Feb 27, 2018

So I'm a brand new nurse hired on a medical cardiology floor. I have 6weeks of training/shadowing my preceptor but I'm really feeling anxious that I won't be able to adjust to all the duties as an RN being a brand new nurse. I feel like I don't remember some stuff I learned in nursing school, I'm overwhelmed with the amount and different technology I have to learn especially the documentation computer(we use a program called sunrise clinical manager) and being fully knowledgeable of what to do/how to act when I will be on my own after 6weeks. My clinicals in school were different as they were all in underprivileged hospitals which didn't really follow a routine or protocols and no technology really. Now I have so much technology, plus certain stuff I gotta remember. Any tips to help me with my medical cardiology floor? Establishing routine?

Learning to document on Sunrise is difficult, even for those of us who already knew how to do our jobs! Assuming you're somewhat younger than me, you'll have an edge there as you grew up with computers. When I had to learn, no one had a computer at home or knew how to use them. I'm guessing the computer will quickly become the least of your worries. (I've never precepted an orientee who didn't teach me something about our computer charting that I didn't already know.) Most of the technology these days has a computer chip (or several hundred of them) and operates with menus -- you will catch on to that quicker than you think.

Adjusting to being "the nurse" instead of dealing with problems by going to GET the nurse is quite the adjustment. But we've all been there and most of us managed the transition, if we got some bumps and bruises along the way. No one remembers everything they learned in nursing school, and when the feces meets the rotary air flow device, no one remembers ANYTHING they learned in school. That's normal. You cannot expect to be fully knowledgeable of what to do in just six weeks. No one expects that of you. Honest.

Passing the boards gives you a license to learn, and no where do you learn as much as you do on your first job. In six weeks, you'll learn to handle a small fraction of things that come up. The more you learn, the more you'll be able to apply what you've learned in Situation A to Situation B. As you learn more, critical thinking will come more easily, and you'll be able to figure things out -- at first with a lot of help, and later more and more independently.

Here's the thing -- no experienced nurse trusts the newbie who seems too confident or who seems to think she already knows everything because she graduated from nursing school. The new nurse we trust is the one who's scared because THAT newbie is far less likely to screw up and kill someone. And here's the other thing -- patients (most of them, anyway) are surprisingly resilient. They can survive all sorts of screw ups as long as the person who screws up realizes that they've screwed up, admits it right away and immediately sets out to mitigate the potential damage to the patient.

Carry a little notebook with you, and jot down questions you have (so you can ask them at the appropriate time and of the appropriate person) along with the answers, frequently used phone numbers, your preceptor's email and/or cell number, medical terminology you're unsure of, correct spellings, how to pronounce some of those really big words and the disease you have to look up for tomorrow. Expect to study at home -- we all had to when we were new or when we switched specialties. I will NEVER forget my first year in CCU studying ECGs with another new nurse or the year I spent learning hematology and studying for hours after our shift with another new nurse.

AnnieNP, MSN, NP · Mar 6, 2018

Be honest with your preceptors and ask LOTS of questions.

RockinNurse2018 · Mar 23, 2018

Just making it through orientation will be an accomplishment, especially on a cardiac floor. Trust me on that.

If you or your preceptors are noticing any issues, ADDRESS THEM RIGHT AWAY. Ask for honest feedback right away. The LAST thing you want is to find out, towards the end of orientation, your preceptors were concerned all along, and now it is too late to improve upon any issues. Ask for feedback from both your preceptor and your manager. Trust me, preceptors report things to managers all the time that they don't necessarily address with their orientees. Although it is probably not true, it does seem that some preceptors are more interested in looking good, looking superior, getting rid of someone they don't care for, or have other negative motives and these motives keep them in constant with the nurse manager.

You probably will have to study outside of work. Although some of your coworkers and supervisors may recommend you take the night off to relax, that is probably not the best advice. STUDY as much as you need to in order to prove to them you have a basic idea of what you are doing and that you are trying to improve.

It may not be possible to have only one preceptor, but try and keep the number of preceptors to a limit. It is difficult to make progress when you have numerous preceptors who have different expectations. If one preceptor's style of coaching doesn't fit yours, ask if it is possible to switch to another. If there is another coworker that you feel that you would learn more from, ask if they could possibly be your preceptor.

Make sure your communication with your preceptors is up to par. Come to them with a plan of what you want to address that day, and see if your priorities coincide with yours. Although you may have different ways of organizing your workload, they're going to want to see that you are critically thinking. They will want to understand your reasoning for performing the way you have. Ask them how they want to be addressed. Do they want you to tell them everything before you make a move? Or would they rather that you perform what needs to be done, come back and report what you have done, and then discuss what else needs to be covered?

Lastly, if you get the inkling at all that the position may not be for you, which I really hope you do NOT experience, address them with your managers/supervisors and preceptors. See what their feedback is. If they have positive feedback, take that into account, and relax so you are more comfortable with your new role. But, if they are having any doubt about you being a fit as well, discuss the possibility of transferring to a different unit. Be proactive and take as much control over the situation again. There would be nothing wrong with deciding that you need a different unit, as long as it is a decision you are a part of. However, when the managers take the leap to decide the position is not the right fit before you do, you may find yourself without a position not only within that department, but within that facility itself. You may end up leaving to go to a nursing position that is not in your desired specialty. Not trying to scare you, just saying take as much control as you can. It is the absolute worst feeling in the world to be told that despite your efforts, the unit has decided you are no longer an asset.

With that said, good luck and best wishes to you! :)