Easy, dumb, common new grad mistakes

Nurses New Nurse

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I'm about to start my first real nursing job, and I know that I will forget things, and make some mistakes. I was hoping to start a thread where people could share some common mistakes they've noticed that new grads make. Or just things to remember, personal stores, etc.

I'd start, but I don't have a clue!

Mistakes are going to happen, so go easy on yourself when it happens. As a new grad myself I would suggest to ask questions! There is never a dumb question, especially when it comes to patient safety! Things may seem to be overwhelming at times so ask several nurses on your unit for tips on how they are able to handle different situations and how they are able manage their time. You can incorporate their different styles into your own as you start to get your groove and with time things flow a lot smoother. Hang in there!

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Remember to remove the tourniquet after starting an IV. "Gosh it looked so good....I just can't figure out why it isn't dripping better." OOPS!!

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When you hang a piggy back, remember to open the roller clamp!

That was my first dumb mistake. :)

And when you spike IV fluid, make sure your tubing is clamped, so it doesn't prime by gravity, then end up with air bubbles all throughout once you get to the pump and try to prime it again!

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Thanks for all the words of wisdom! I'm starting my first job next week and I'm suuuper nervous and excited! I just want to be a good nurse and I hope I can do it!

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Specializes in PDN; Burn; Phone triage.

Don't unspike a pressure bag while the bag is still inflated. !!!!

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If you need a surgical consent signed for a confused patient, and family is at the bedside, assume the family is leaving in 30 seconds. Grab them ASAP and ask them to wait a few minutes before you lose them and have to track them down by phone.

I also ask the ER nurse to ask the family to come to the floor for when I get an admit from ER. Families often take off when the patient transfers if not specifically asked to stay. A brief chat with family gives me a clarified understanding of the patient's baseline behavior. For example, I once had a confused but interactive patient suddenly stop eating, talking or even making eye contact. The family (after being contacted) was able to confirm that it was "normal" for him and occurred several times a month for a few days.

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Specializes in Cardiothoracic.

I just finished my first year and the things that help me most is after loading my pockets with alcohol swabs, flushes, pill splitter and white board marker and getting report is to review the charts, make a brain sheet of meds by time and check boxes next to my "to-do's that also includes finger sticks by time with a space to write the sugar and how much insulin they get next to it, its a great reminder of my to-do;s and i add to it throughout the shift as new orders get written, and i admit is feels great to see things checked off throughout the shift. I use similar strategies on my patient's white boards so they see their plan written out and things checked off, or the list updated. It helps me feel organized, and the patient informed. Once I have my brain sheet, I grab meds and my stethoscope, listen to my patients and do a quick assessment before rounding with the rest of their meds. That gives me a good feel for their status, mental and physical, immediate needs and organize their white boards. Good luck!

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Specializes in ED, Cardiac-step down, tele, med surg.

When you are hanging blood after you prime the tubing don't forget to clamp the tubing attached to the NS. You don't want to get blood in the bag of NS.

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Thanks for all the great advice, keep it coming! After my first couple weeks with my preceptor, I haven't made a (major) mistake, but right now I'm so paranoid I'm quadruple checking everything I do. I did incorrectly connect a syringe of morphine to my patient's IV and pushed it out all over him, but luckily he was nice and my preceptor is amazingly calm and patient.

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.... and my preceptor is amazingly calm and patient.

That's because we have all been there, done that, and no harm, no foul. :)

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Specializes in Pediatric Emergency.

Great thread! Applying to jobs now so will reply soon.

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Specializes in CPN.

Depending on how report is done on your unit, these things may/should already be givens... But these are a few things that I've come to find realllly important.

1) check the I/Os. First, see that they're appropriate (regarding mL/kg/hr for output) and second, that they were actually documented. My real life learning situation: RN giving report says "yea he's been eating and drinking well". But not until a few hrs later did I see intake for that shift was recorded as ZERO. Way easier to rectify when the off-going RN is still on the unit!!

2) check the most recent vital trends. Off-going RN says "yea she's been afebrile, signs stable". Until you go to chart and see that the HR has been stable, at 130s...for a 13yr old... (was he agitated? upset? in pain? tell me more so I can appropriately assess his next set of VS...)

3) check the meds. even if you can just eyeball them at this point. Find out why anything was held (off-going RN: he's been having diarrhea all day, so we're holding miralax) or see if anything was missed. Sometimes it wasn't charted correctly (we've had increasing problems with the computer either not saving or running out of power mid-med admin... problematic? yes!), or was accidentially skipped. If it's a fresh post-op, double check whether the off-going nurse has already retimed any meds (ie-the antibiotics)--if not, find out when it was given intraop. Easier to get this info from the RN who learned it in report than by sifting through the file yourself...

4) For peds, is the family there? Are they helpful/hands on?

Ugh-As much as I love giving this advice, I hate that it reminds me how report on my unit tends to be/IS way less organized than it should be!!! Mid-New years resolution = improving that. Stat.

Other advice not tied to report: Get a full set of signs EVERY TIME you call a doc for a concern or semi-concern. Not for a "your fluid orders are conflicting" kinda call, but then again, you might wish you had a fresh set of vitals then, too :)

PS- pretty much every shift I do, I learn something that changes the way I practice, even in just a tiny way! Good luck!

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