First Day as RN

[c.kelly20]

Hello all!

I just passed my boards 3 weeks ago and today, I completed system orientation today of the hospital I will be working at. Luckily for me, the hospital I'll be working at is the one at which I did most of my clinical experiences. The floor I got hired on, I only did about 3-4 weeks (which is about 8 days) of clinical time there. It is an Acute Medical Inpatient unit -- like the 'medical' part of the medsurg type of floors (the floor above mine is the surgical portion).

Anyway, in school, we are only ever given one patient on clinical. Then, you enter your internship - I chose to do mine in our ER so everything there is really different than that of a typical unit (patient load, charting, patient turnover, etc.). I went to visit my new unit today, and counted that there were only 2-3 nurses, each having 7-8 patients. This makes me really nervous because, like I said, I've never had that many patients. Even during my internship, the most patients we had at a time was 4-5, and the pace is very quick, so there were times I would lose track of who was there for what and who was discharged, etc.

I'm really nervous to be entering this environment. My orientation will be 6 weeks long, and while I'm sure that's sufficient, I'm still nervous. I'll be rotating between 2 different preceptors also (nights/days).

Does anyone have any advice on how to 'prepare' for the first day? Is there anything in particular that I should take (aside from lunch, pens, stethoscope, etc.)? And do you have any words of wisdom as to how to handle a patient load like that? I've never been exposed to that many, so I'm kind of freaking out and afraid I won't be able to handle it. My confidence level in my knowledge has always been low which just adds to my anxiousness. I passed my boards, so, surely I can handle this, right?!

[HouTx, BSN, MSN, EdD]

I think that a lot of your anxiety can be relieved by simply having a clearer idea of what is expected of you. The unknown is always scary. So, job one is to get some clarity.

Make sure you have copies of all the 'stuff' you are expected to accomplish during orientation. This will probably include skills checklists & (hopefully) a list of goals you have to meet in order to complete orientation. Each goal should have an underlying set of criteria that will be used to determine 'success'. For example - what are the workload goals for each week? When are you expected to be able to handle a full assignment? What criteria will be used to determine whether you successfully managed the assignment?-- getting out on time? accurate documentation? meds on time? How many admissions, discharges & transfers are you expected to complete during orientation?

Then - be pro-active about maintaining your own paperwork. Keep everything very organized in a folder or binder. When you have completed a checklist item or goal, have your preceptor sign off on it. You will be dealing with multiple preceptors; they need to know what has already been completed in order to avoid duplication of efforts and major frustration.

You'll be fine - don't forget to breath.