Essential Skills~Input from ALL Nurses!!!

[msnursealot]

Okay, so here goes..another "silly student" question. What was the hardest thing about transitioning from student nurse to NURSE? I will be starting my RN role transition this week. I will be graduating in 2 months!

My preceptor asked me to make a list of things that I really wanted to focus on or special that she can cover to make sure I get all I can from the experience. The problem is, I find myself sitting here making a list of all the "skills" that I feel I only performed on dummies (easy, you know what I mean).

I know I want to practice lots of IV starts, lab draws,etc..But I honestly don't know what to ask..Clinicals are truly unrealistic compared to actually being on the floor.

What do you wish you would have learned before graduating? What do you think all new grads need more practice with?? Any suggestions? Comments? Hints?

LPNs, RNs, seasoned & new---please throw me a bone. I know this is a golden opportunity to get a preceptor that is so giving---Thanks in advance!!!

[gwenith, BSN, RN]

Learning to wait 4 hours until you have time to go to the toilet!!!

[msnursealot]

Definitely a point well taken!!!

[UM Review RN, ASN, RN]

What was the hardest thing about transitioning from student nurse to NURSE?

Time management.

It's almost impossible to stay on top of things as a new grad. Take comfort in the fact that seasoned nurses also race against the clock each shift, and sometimes we can't do it all either.

[Town & Country]

Here is what I would tell you as you enter the workforce.

1. You are a new RN. Nobody in their right mind should expect you to be 'perfect'...they know that RNs get virtually NO clinical experience (I didn't.) So, if anyone says anything to you like "well you're an RN, you should know," they are just trying to push your buttons. Don't let them.

You don't have to defend yourself to people like that.

2. ASK QUESTIONS.

I have been a nurse a long time and I ask MORE questions than I ever did; because that is the ONLY way you will learn. Never pretend you know something you do not, and if you don't know how to do something, ask for help - don't try to do it anyway!

Trust your gut.

If you get a nagging feeling "maybe I shouldn't be doing this," stop and ask for assistance.

3. There is going to be professional jealousy and alot of other "issues" that you are going to have to learn how to deal with. Workplace bullying, gossiping, slander......I could go on. You have to be tough to be a nurse. Tough in the sense of knowing who you are, what you are about, and not getting defensive.

4. Now, as far as your question about the clinical side; I think you should focus on:

-insulin administration

-starting IVs

-primary and secondary IVs

-how to care for NGs and G-tubes

-post-surgical drains

-inserting Foley catheters in male and female

Those are the things that spring to mind.

Also: COMMUNICATION is the key! If you don't know how to do something, ask. If you want help, no one can read your mind - ask for help. If you want to watch a procedure, ask (I did this just the other night, myself.)

Be positive. "I want to learn how to............"

"I want experience in........"

The good nurses will help you.

Stay on good terms with your charge personnel and immediate supervisors - they are the ones who you will turn to for references later. Don't indulge in gossip and don't say anything you wouldn't want repeated, because believe me, it will be.

[JHUBRAIN]

I think it shows you are going in the right direction to be asking - keep asking. Be a sponge and absorb all you can during this time. Watch others during your clinical and learn from them. Time management (or lack therefore of) is the biggest problem most new nurses have. That and seeing a bigger picture.

Good Luck

[General E. Speaking, RN, RN]

Time management.

It's almost impossible to stay on top of things as a new grad. Take comfort in the fact that seasoned nurses also race against the clock each shift, and sometimes we can't do it all either.

I agree!!! Also, get some experience calling/speaking to the physician's yourself. Make sure you have all your facts in order before putting the call in...vitals signs, labs, etc...

And, yes, keep asking questions. I personally feel more comfortable with a new nurse who asks questions than with one who thinks they already know everything. They are dangerous!!

[purplemania, BSN, RN]

new grads tend to focus on skills, but that is really the easiest part of being a nurse. Managing your time and learning how to prioritize will save you legwork and grief. Ask people how they plan their shift. When someone makes a decision that differs from what you would have done ask about their rationales. The single best advice I can give is: when you go into the patient's room for the first time check out all lines and tubes and electrodes connected to the patient. Make sure all are properly connected and functioning. Check the IV pump to be sure there is enough of the RIGHT fluid and the pump does not need to be reset soon (or new bag hung). Ask right then if they need anything. Check the name on the ID band. I cannot tell you how many steps this will save you. Sometimes we forget the simple things.

[RNKPCE]

I also agree with time management. You can forget starting iv's, hanging other meds, dealing with ng's unless you can manage your time. You got to start a shift with a game plan in mind, and it will need to be adjusted along the way. Ask your preceptor who on the unit has the best time management and observe that person or better yet follow that person for one shift if able. I had some really great people to watch when I started. They could combine tasks, such as while doing bed bath, do your assessment. Or while getting patient to bathroom might want to take them on a walk in the hall( half the battle is getting them out of bed).

An instructor of mine once said " don't wait to do later what you have time to do now, cause you never know what crisis is around the corner that will get in the way of doing what you had planned" The exception to this advice is your lunch break. Don't put it off or you will rarely get one.

The other advice is never stop asking questions or opinions. Even after 15 years I still bounce ideas off of my peers, or see if they would have the same rationale for doing or not doing something.

[barefootlady, ADN, RN]

Learning to read exactly what is written is big on my list. Do not project, if there is a problem ask questions, but READ the orders/instructions first.

[Chaya, ASN, RN]

Learning to do a quick, focused assessment based on the pt's hx. but also keeping alert for anything else significant that jumps out at you.

[RNKITTY04]

I just graduated in August and the best advice I can give is: check check and check again your meds. When in a hurry its very easy to give the wrong med. I ALMOST gave insulin to the wrong pt once, if the daughter had not been in the room and said" hey my Moms not diabetic" she would have recieved it. (It was for her roommate) When 5 thousand things are happening at once and the pts are asking you questions you really have to keep your head screwed on right.

Good Luck to you!