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!!!
Specializes in Education, Acute, Med/Surg, Tele, etc.
I was able to pick my own patients (you had to get there early though), and I took on patients that challenged me. I took ones who had anything new to me, and hoped I had a friendly nurse that day..LOL!
I asked LOTS of questions, and had a clipboard to write down the info, and to organize my day (I still use a clipboard!!! I feel naked without it, and great for gotting down those little things you know you are going to forget. I put a box to check by each task, and for fun...I have different color highlighters and when I am done with a task...I mark the box first with a black pen, charting done equals a black line through it, and highlighter is reporting to another or any other item that needed to be done (like writing new orders on a MAR, awaiting a Doc call-back..etc)..the highlighter is my final 'okay done'..and I LOVE my highlighter time! LOL!!!! That helped to organize my day and not to forget all the other parts of a probelm I have to fix (like documentation and such).
My delema was that I wanted two things by the end of clinicals I never got...anyone with an ostomy so that I may practice the care and equipment (I couldn't believe it...two years and not a single one!!!!! Learned that once I got out), and a CODE, which I didn't get till way out of nursing school... I am a pro at both now!
Don't be shy and try to get some clinical practice in doing things like IV's, Caths, suction, ostomy care, complex dressing...that will pay off in the long run!
Think about what you like...and that is a great start! Self esteem is very important...so I started out with things I knew I felt confident in doing...once I showed myself I could do it...well the sky was the limit and I took on all sorts of challenges thinking...Hey..this is the best time to do it!!!!!
Good luck, and I know it is stressful but try to have fun! It was the fun parts that taught me more!!!!!
I think that for me, I was so busy with my new job, I didn't really hav time to think about it, I guess it just happens. I hav heard it becomes part of who u are as a person where ever u are or where ever u go!
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!!!
Just want to say THANK YOU, THANK YOU to all who responded...All the advice is pointing me in the right direction. I am so thankful for this forum & the great nurses that are in it!!!
I'll be sure to let everyone know how it goes! All the suggestions are great!
Assessment skills are so important. When I was in school I precepted in labor and delivery. It was a great experience but I didn't really work with sick people. When I started working in a surgical ICU I knew I really needed to work on assessment. I made a point of listening to lung sounds on every patient in the unit so I could learn to differentiate between different sounds. Just by spending a few moments talking with a patient you can see so many things- are they confused, SOB with activity or speaking, have they had a CVA and slur their words or have a facial droop. The advice about checking pumps and drips is great- I don't know how many times I've gone to assess a new patient and there is only 10cc left of a drip they're dependent on, or something has been labeled wrong. You always want to check for the things you may need- you don't want to be stuck if something happens- do you have suction, if your patient is on a monitor are all the alarms on, even if nothing is running through the IV can you flush it if you need it quickly. Skills like foleys and IV sticks will come with time (I'm still terrible at starting IV's) but having strong assessment skills and maintaining the safety of the patient are a great place to start.
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.
All VERY good ideas. And... don't piss off the unit secretary, she can make life very difficult ( i.e. orders, labs, tests etc processed ), or much easier, if you keep her happy, all you have to worry about are all of those other things :)
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I have not seen this yet:
learn the difference between assertion and aggression. You will HAVE to be assertive to survive in nursing.......so learn those skills sooner rather than later. Trust me on this, you will deal with MANY difficult, passive-aggressive and out and out hateful people in your career. Never be anyone's doormat.
Specializes in Cardiac, Step-Down, Psych, Recruiting.
I agree with the posters who brought up quick assessments, prioritizing and time management. Most new grads really struggle with these things, and if you don't have these skills, every shift you work will be miserable.
I advise doing a quick pop-in on each of your patients at the beginning of your shift before you do anything else. Check your patient, check your drips, decide what the priority for that patient will be -- ie: medicate for pain if that patient needs it so you're not interrupted for pain meds as soon as you don all your sterile gear for a dressing change, etc.
Learn to do a quick assessment based on patients dx, hx, age, etc. You can gain a lot of information in a brief conversation if you ask the right questions and listen carefully.
Ask several nurses to show you the tools they use for time management, report, and keeping track of their shift (usually a sheet of paper most nurses refer to as their "brain," as in "I lost my brain! Has anyone seen it?"):chuckle Different nurses use different methods, but finding one that works for you is invaluable!
Also, make it known to all the nurses working with you on your shift that you're up for new skills and experiences -- that you'd be happy to try to change outdated IVs, insert foleys, do dressing changes, etc. Most of us are glad to share!
I think that for me, I was so busy with my new job, I didn't really hav time to think about it, I guess it just happens. I hav heard it becomes part of who u are as a person where ever u are or where ever u go!
Jami
Antikigirl, ASN, RN
2,595 Posts
I was able to pick my own patients (you had to get there early though), and I took on patients that challenged me. I took ones who had anything new to me, and hoped I had a friendly nurse that day..LOL!
I asked LOTS of questions, and had a clipboard to write down the info, and to organize my day (I still use a clipboard!!! I feel naked without it, and great for gotting down those little things you know you are going to forget. I put a box to check by each task, and for fun...I have different color highlighters and when I am done with a task...I mark the box first with a black pen, charting done equals a black line through it, and highlighter is reporting to another or any other item that needed to be done (like writing new orders on a MAR, awaiting a Doc call-back..etc)..the highlighter is my final 'okay done'..and I LOVE my highlighter time! LOL!!!! That helped to organize my day and not to forget all the other parts of a probelm I have to fix (like documentation and such).
My delema was that I wanted two things by the end of clinicals I never got...anyone with an ostomy so that I may practice the care and equipment (I couldn't believe it...two years and not a single one!!!!! Learned that once I got out), and a CODE, which I didn't get till way out of nursing school... I am a pro at both now!
Don't be shy and try to get some clinical practice in doing things like IV's, Caths, suction, ostomy care, complex dressing...that will pay off in the long run!
Think about what you like...and that is a great start! Self esteem is very important...so I started out with things I knew I felt confident in doing...once I showed myself I could do it...well the sky was the limit and I took on all sorts of challenges thinking...Hey..this is the best time to do it!!!!!
Good luck, and I know it is stressful but try to have fun! It was the fun parts that taught me more!!!!!