Dear New Grad Nurse

Nurses General Nursing

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Hi, new nurse here. If you could go back in time what advise would you give new grad You? Advice for daily floor things, best career moves for starting out, ect. Is there anything you would've done differently? What would you do if you were a new grad nurse right now? I could use some wisdom!

Thanks!

Specializes in Emergency.
If you didn't get a job doing what you wanted right out of the gate it's okay. Plan your moves so that you gain more relevant acute skills (tele, progressive care, etc) and you can work your way there.

Make friends with everyone. You never know when the housekeeper is going to get you the secret stash of awesome boxes from OR that are perfect for moving, or the cafeteria people will give you free food when you left your wallet at home. Not to mention the potential for your career: your coworkers today might by nurse managers tomorrow.

Dogen - What great advice for *life* in general! I'm an older student (50!) and I have seen this play out so many times in so many ways over the years. Never miss the chance to be decent to anyone, the world is smaller than it seems :yes:

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Remember just because you are a BSN, RN, etc. basic patient care is not underneath you! Yes your education makes it less likely you should be wiping butts, changing bed pans, etc., but guess what you are there for the patients and we work as a team in healthcare.

Be nice to your CNA's and all support staff. Again we work as a team!

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Specializes in Hospice.

Be VERY nice to your CNAs. One of them might save your life some day.

The staff one evening shift was myself and one CNA. I had an anaphylactic reaction to a med I was mixing, and she literally had to bully the evening Supervisor into coming to the unit. I wound up in ICU, intubated.

When I returned to work, I thanked her for her quick response. She told me that if it had been either of the other two nurses who worked evenings (who both had a "Me nurse, you peon" attitude) she would have closed the door to the med room and kept going.

Yikes.

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Okay, since I am a new nurse and totally screwed up with my first job I feel perfectly qualified to give advice on what NOT to do and what *I* would do differently. (I have an interview coming up next week for a new job so writing this stuff down for myself as well!)

1. Watch how your preceptor does everything - especially assessments, med passes, and giving report. Guess what? How he/she does assessments and giving report is likely how they will expect YOU to do it.

2. To follow up with number 1, do a complete assessment! Even if you think other nurses are skipping things in their assessments don't YOU do it. First, they may really not be skipping things you just might not have noticed how they did it. Second, even if they are skipping things they will likely notice that YOU skipped something. They may think that they have enough experience to know what things can be skipped and you do not. And third, they may think you are incompetent if you left something out or if you go out of order. I didn't do my assessments literally head to toe because I got nervous and wound up jumping around too much. Don't do that!

3. Don't worry as much about IV starts, catheters, NG tubes and other "skills". You will be cut slack for not being as experienced with that, but you will be cut no slack for not doing a proper assessment or screwing up a med pass.

4. Be careful with your questions. I know lots of people say ask lots of questions, but that hasn't held completely true for me. Think hard on your question. Is it a question you can answer yourself? Instead of asking the answer ask for the resource to find the answer? If it's an pharmacology/physiology/etc question do you need to know the answer *right* now to do your job? Do you need to ask your preceptor? If the answer is no, write it down, and look it up later when you get home! You will likely be doing a lot of that!!!

5. Balance getting second opinions with being afraid to make decisions. This is probably the area I have struggled the most with. Your preceptor will find this super annoying if you can't make any decisions without him/her.

6. Don't start on a specialty floor! There are hospitals where this might not be a problem, but safer bet is not going there first. One, you really need time to build those basic skills. And two, others may not agree with me here, but there are definitely nurses on specialty floors that feel you have to earn the right to work there. Working with co-workers with that attitude is extremely difficult especially for a new nurse that is still working on building confidence. I absolutely would not do that one again!

7. Finally push yourself to keep trying even when it's really hard and you want to throw in the towel. The first year is hard and I'm barely getting started!

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Specializes in Surgery.

It gets easier. You're not expected to know it all and you shouldn't pretend to. Be patient with yourself!

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Okay, since I am a new nurse and totally screwed up with my first job I feel perfectly qualified to give advice on what NOT to do and what *I* would do differently. (I have an interview coming up next week for a new job so writing this stuff down for myself as well!)

1. Watch how your preceptor does everything - especially assessments, med passes, and giving report. Guess what? How he/she does assessments and giving report is likely how they will expect YOU to do it.

2. To follow up with number 1, do a complete assessment! Even if you think other nurses are skipping things in their assessments don't YOU do it. First, they may really not be skipping things you just might not have noticed how they did it. Second, even if they are skipping things they will likely notice that YOU skipped something. They may think that they have enough experience to know what things can be skipped and you do not. And third, they may think you are incompetent if you left something out or if you go out of order. I didn't do my assessments literally head to toe because I got nervous and wound up jumping around too much. Don't do that!

3. Don't worry as much about IV starts, catheters, NG tubes and other "skills". You will be cut slack for not being as experienced with that, but you will be cut no slack for not doing a proper assessment or screwing up a med pass.

4. Be careful with your questions. I know lots of people say ask lots of questions, but that hasn't held completely true for me. Think hard on your question. Is it a question you can answer yourself? Instead of asking the answer ask for the resource to find the answer? If it's an pharmacology/physiology/etc question do you need to know the answer *right* now to do your job? Do you need to ask your preceptor? If the answer is no, write it down, and look it up later when you get home! You will likely be doing a lot of that!!!

5. Balance getting second opinions with being afraid to make decisions. This is probably the area I have struggled the most with. Your preceptor will find this super annoying if you can't make any decisions without him/her.

6. Don't start on a specialty floor! There are hospitals where this might not be a problem, but safer bet is not going there first. One, you really need time to build those basic skills. And two, others may not agree with me here, but there are definitely nurses on specialty floors that feel you have to earn the right to work there. Working with co-workers with that attitude is extremely difficult especially for a new nurse that is still working on building confidence. I absolutely would not do that one again!

7. Finally push yourself to keep trying even when it's really hard and you want to throw in the towel. The first year is hard and I'm barely getting started!

This was a great list. I am a 4th level student set to graduate in December 2015 and I found this list valuable. One thing I do with each encounter with a new nurse, whether at my job as a tech in a pediatric ER or in clinical, I always ask advice as to whether new nurses should start on a med/surg floor or go towards a specialty. I've heard both sides with some saying definitely med/surg and some saying go where your heart leads you.

I used to say I did not want med/surg because of my clinical experiences and a previous job as a tech on a med/surg floor. I didn't find it interesting until this summer. I did an externship, ironically on one of the floors I did clinicals on, and I absolutely loved it. It really did change my view of med/surg. I performed more skills than I had ever done in clinicals and I had awesome nurses that imparted so much knowledge on me. One in particular made me work for my answers to questions. Lol! She rarely answered straight out, she made me think about it some more and prompted me when she saw me getting off track. I do know it will be different once I am on the floor, but I am actually excited about going towards a general floor over a specialty.

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Specializes in Cardiology, Cardiothoracic Surgical.

I've been in the game for about 2 years now, so I'll throw in my advice:

1) Don't worry about not ending up where you want to be right out of the gate. There is a thing called an 'internal transfer' for a reason.

2) Sometimes, the grass IS greener, and you should take opportunities as they arise if it's better for your life at the time. I was offered one of my 'bucket list' jobs last year with only a year of hospital experience under my belt, and guess what? I took it and have no regrets. I learned SO much in my 2nd year of nursing.

3) Don't burn your bridges, the nursing world is very, very SMALL.

4) Find more experienced nurses who will take you under their wing. This does not just apply to your nursing career.

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As a current new Grad Nurse and an older nurse (I am 59), notes to self if I was ever doing this again:

*Be physically fit

*Wherever you are in life, you are going to come across *******...just go with the flow and don't take things personally, most other nurses make constructive criticism.

*Don't be so nervous and overwhelmed, your skills are still there, even if you have changed roles.

*Make the most of the opportunities presented, to learn, even if it is that you "will never do that to a patient" the way the other nurse did.

You WILL get there in the end...perservere...

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Be VERY nice to your CNAs. One of them might save your life some day.

The staff one evening shift was myself and one CNA. I had an anaphylactic reaction to a med I was mixing, and she literally had to bully the evening Supervisor into coming to the unit. I wound up in ICU, intubated.

When I returned to work, I thanked her for her quick response. She told me that if it had been either of the other two nurses who worked evenings (who both had a "Me nurse, you peon" attitude) she would have closed the door to the med room and kept going.

Yikes.

This scared the crap out of me.

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Dear New Grad Nurse:

Leave things as you found them. Don't trash clean utility, PYXIS, or the Nurses' Station. If you take something OUT, put it BACK.

(I'm not touching the toilet seat debate!)

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Specializes in Hospice.
This scared the crap out of me.

Imagine how I felt-she wasn't kidding!!

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Specializes in Cardiac/Telemetry.

I'm coming up on my 1 year "anniversary" and I definitely agree with several previous posters. A couple of things to add: 1) If you know where you think you want to end up, give it a shot instead of starting out in med/surg. For me personally, I would be absolutely miserable if I chose to not specialize first and had to stick it out for a year or two in med/surg. I am already thinking of switching specialities because my current position on a tele floor is too med/surg-like for me. So, if you know you want to do, go for it. If you're undecided, there's no harm in starting in med/surg. Ultimately, it really comes down to personal preference. 2) Keep your patients and their rooms clean. I get really aggravated when I have to follow "dirty" nurses. Extra and/or used supplies, wrappers, dirty linens, old food trays, empty water glasses, old IV tubing, etc really gets in the way during the middle of a code!! Not to mention that it looks bad to family members (and the patient) if their rooms are cluttered. 3) Try out different routines for the start of the shift and see what works best. Some of my coworkers get bedside report and go right in to start assessments. I prefer to look at labs, meds, MD notes, orders etc before seeing the pts (if time allows) so I get a better picture of what's going on. You'll quickly learn who you like getting report from and who you would rather not follow. Sometimes the report from the off-going RN and what's actually going on with the pt is a night and day difference.

That's all I can think of for now. Good luck.

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