Dear New Nurse - what makes an average nurse great.

[snoopy29]

Dear New Nurse

Well you and I have just had a very difficult meeting haven't we? Over the years I have seen so many newly qualified nurses join our ranks - the shy, the quiet, the studious and ones like you - the confident. With care, teaching and nurturing many of these nurses have gone on to be great nurses but equally many have fallen by the wayside or become tired or burnt out. I believe the patterns that we form when we start nursing can continue throughout our career whether they are good, bad or indiffererent and that is why I feel so passionately from day one it is important to get it right. The meeting was difficult because you believed that you are doing a fantastic job and the failings if any are down to your colleagues and not you and I gently had to tell you otherwise......

You have so much potential - you are bright and quick and confident but there is still so much to learn. That is not a failing on your part in any way - I honestly believe that nurse training gives us the theory and a chance at testing the water but its only when qualified that the true learning begins. Enjoy the luxury of having the protection of time to learn and instead of seeing this as holding you back see it for the opportunity it is.

Having seen many nurses like you this is what I suggest.....

Learn to value all your patients - don't be known as a " first at a trauma last as a bedpan" nurse!!. I know that you like the exciting high profile patients but in truth we see far less of them than the everyday patients. They may just be "another abdo pain" but they are frightened in pain and deserve the best possible care we can give them. Learn the value and personal reward of doing the best you can for them without feeling the need to rush through their care in case you miss something "more exciting". The traumas still come and if you are a good solid nurse then you will be better placed to work with these traumas.

The elderly are our bread and butter - pretty much whichever field of nursing you go in you will care for a high number of elderly patients. I see how it frustrates you that they are slow and need extra care but I would implore you to see the bigger picture. These patients come with a lifetime of history and experience -see the whole picture and treat them with the respect they deserve and remember one day we will all be elderly and wanting our nurse to be gentle, patient and respectful.

Never ever cut corners - how good we are as a nurse is not measured on how quick we are. We can all wizz in and assess a patient in 5 minutes flat but that begs the question of are we giving our patient the best possible care we can? Learn to be thorough - ultimately if things are missed that will come back to you. Boring though it is documentation keeps us and our patients safe - treat it as your friend. Drug errors occur when complacency sets in and procedures aren't followed - to keep myself in check each shift I remind myself how I would feel if one of my patients got the wrong meds and trust me its a powerful motivator to do everything possible to get it right!

Learn to value and respect your colleagues. Trust me along your nursing journey you will meet every variety. I know that currently you have little time for the nurses you perceive as not as dynamic as you but the truth is that these nurses are the backbone of nursing care. Remember that nursing assistants are there to assist - and not do all your manual work. My rule is that I will never expect a nurse of nursing assistant to do anything I am not prepared to do myself !!!- in the time that it takes me to ask someone to get a bedpan usually I could have done it myself and beneffited from seeing the patient, checking pressure areas etc. If you think these tasks are beneath you then maybe, just maybe direct nursing is not for you. The respect for your colleagues extends to other areas - if you turn up late then they have to stay late - don't expect them not to be sizably fed up if this happens and you breeze in without an apology. Yes it might just be 5 minutes but it is 5 minutes of their time and your time is actually no more precious than theirs!!!

Believe me when I tell you that one day the penny will drop and you will see with utter clarity not how much you know but how little you know and trust me that day is very very scarey!! You are so confident at the moment and I have heard you say when other nurses have tried to guide you "I already know that". It is not about other nurses scoring points it is about them developing what you know and making it into something solid and meaningful.

The reason that I told you all the above was not to be mean or nasty and trust me I get absolutely no pleasure in upsetting you but firstly I have a duty to ensure our patients get the best possible care and secondly I believe that you have the potential to be a really great nurse but you honestly stand at a cross roads and of you carry down the other road you will become an arrogant, careless and cold. I know which nurse I would rather work with and more imprtantly which nurse I would want looking after me.

Good luck new nurse and prove to me that you truly have the potential that I see.

[CompleteUnknown]

What an amazing post. Much wisdom there.

[kevinbrown10]

Yes Snoopy, Thanks a lot for such nice information. I also do agree with you that a little amount of personal care and affection can make you stand above the others. Nursing is a well known profession which has an image among people. People think that nurses are very caring, supporting. Nurses are the persons who can fill your empty ness and can provide you better emotional support whenever you will require that.

[WillowNMe]

Thank you for the insight - great information and eloquently put!

[SpencerTwins2007]

Thank you so much! This is wonderful!

[+ energy]

As a person who graduates in May, thank you! This will stay in my thoughts as I start each day in my new position.

[NurseLoveJoy88, ASN, RN]

This is great for newgrads as well as seasoned nurses ! Thanks.

[Nurse SMS, MSN, RN]

I graduate in December and I am printing this out. Thank you for taking the time to write it and the time to mentor. I want to be you when I grow up. :)

[manicmom]

Snoopy -

Hopefully the new, future, and struggling nurses see this. With 20 years of nursing in all aspects, I can say that it is amazing how one little deed or a few short words can effect your patient/their family. Additionally, it is amazing how the exact same action can gain the trust and respect of the other nurses and other personnel. It is astounding how much of difference you are viewed in by your co-workers (and even the patient and family) when you are willing to take that little extra step for your patient. You actively are deciding how you are going to view and treat the patients for the rest of your career. I can't tell you how many times family have came back to me or my supervisors and stated what a big difference I made in a loved ones' stay. LITERALLY, an extra moment or two, handling the "bad job" because you are already there, making an attempt at a connection (whether it actually occurs or not)...are the things that will ultimately define you. I also would NEVER ask/tell someone to do something I was unwilling to do myself within my scope of practice. You can gain absolutely NO respect that route.

I know, and know of; nurses, aides, PCAs, physicians: "they have a good reputation", "they know what they are doing", but it doesn't mean nearly as much to the patient and family who has someone who is willing to give that little bit more and learn as they go to improve the experience/outcome of the current patient (and ultimately the next.). It doesn't mean as much as the person who says (and means), "This is not an area I'm familiar with or my area of expertise, but I am willing to learn it and will; because I want the best possible outcome for you." One of my very first cases was a gentleman with lung CA who hemorrhaged out in front of me. The family later told me I was a favorite because if I didn't know the answer to something, I said, "We'll find out together." and did so. They also said I was THE ONLY ONE who acknowledged to the (quite alert and oriented) patient that I was fully aware of his terminal diagnosis. ( He was in my first 3 months of nursing - we worked on IPs then, and I wasn't even licensed...) I was also very fortunate to have the patients who said, "Go ahead, you won't learn if you don't practice." And they knew that meant I was practicing on them. (Don't get me wrong - not all patients and family appreciate this "reality" approach, but in my experience, this is absolutely, the best/most direct method within to work.)

I firmly believe that these early interactions and feed back from the patients and their families formed the type of nurse I became. (I'm a great nurse by the way...LOL) The nurses who initially precept new grads need to realize their role in shaping these outcomes as well. Think about it...Your first preceptor (bad or good) was a definitinve map in your future role as a nurse. You KNEW you did or did not want to become that person. I was very fortunate to have great preceptors, mentors, and patients who allowed me to be what I am today.

Thanks again, Snoopy, for bringing this up...The ones of us who are established need to remind ourselves of the need to mentor the right attitude. Doesn't mean we won't mess up, but EVERY experience is a learning experience and if we make the patient and/or family happier and more comfortable with the situation they are in....well....that's the nurse we all want to have.

[CaitlinAnn]

Great post! I graduate in July, and I'm really glad I read this.

[cwhitebn]

Thank you for that letter. I have only been in nursing for a year. After reading this letter it makes me want to be a better nurse :)