A message to new grads: NEVER....

[UM Review RN]

* un-spike the old IVF's with 100 mls left in the bag while it's still hanging

* say the word "quiet" in reference to your hopes for the shift

* say you've never had a patient ________ before

* take your stethoscope off till you're in your car and on the way home

* plan on going to that inservice/staff meeting/whatever during your shift

Experienced nurses, share your wisdom. What are some other things that new grads should NEVER do?

[BETSRN]

Along the lines of "always"..........

Always open your charts as you do your assessments. That way you dont forget to chart something that you noticed or have done.

Always be the patient advocate.

Always remember that the patient you are taking care of is someones mother, sister, daughter, brother, or father, Not just the GI Bleed in rm 2 or the MI in rm 1

ALWAYS "think outside the box." We are nurses with critical thinking skills: NOT robots who just follow orders. Each patient is an individual and you need to adjust your care and actions based lon your assessment.

[renerian, BSN, RN]

Never think you know it all and don't act like you do. None of us know it all.

renerian

[Marvie]

Are you NA? I am curious because I am and I do not find many nurses who are. Would like to chat with you sometime.

Never forget that pain can be expressed in myriad of ways

Never say you are sorry for being "only an LPN" to an RN or "only an RN" to a doc or "only a nurse" to a patient

Never forget to wash your hands before and after seeing a patient

Never leave IVs dry for the next shift...they will hunt you down

Never gossip...it reflects on you

Never take an assignment that is beyond your skills...ask for help or reassignment

Never stop asking questions

Never stop building your knowledge base or stop critical thinking

Never let small kids sit or lay on the floor while visiting

Never assume

Never give a new patient a tray without checking the orders first

Never plant yourself at the desk all the time...get out and help

--------

Always say thank you when someone helps you

Always knock before entering into a patient's room

Always be mindful that you reflect your profession on the floor

Always ask who that strange person is looking at a patient's chart that you are not familiar with...it could be someone's lawyer...know your docs!

Always remember that you are human and can only do so much by yourself

Always look at your paycheck, comparing what it says and what you actually worked

Always be prepared for something to go wrong

Always count on another ER admit

[DNS]

Never.... assume (we all know what that means). Get your own info, don't always rely on the nurse who worked the shift prior to you. She may or may not have done as thorough an assessment as you would.

Never... treat insubordinates as grunts. Without them, you cannot begin to do your job well.

Never... fail to ask your supervisor, if in doubt. Don't go by what everyone else says. Follow the policy, & always do what's in the best interest of the patient. Too many 'old timers' have utilized short cuts that eventually landed a facility in litigation.

Never... fail to ask for help if you are in over your head, whether it be a shift that went crazy or performing treatments that you've never practiced.

Never...forget that the patient is the real reason you are there. AFter 17 years, I have days I wonder why on earth I'm still a nurse. Then I have a "God moment" with a patient & my doubts are resolved.

Never.. forget to take care of yourself. Without YOU, nursing cannot go on. It takes all of us.

DNS

[dpipes44]

If your a male nurse never offer free lap dances to other nurses to do your work for you. Lap dances are hard work.:balloons:

[TD]

Im not sure if this has been posted or not,,

but,, under no circumstances do you stand at the end of the bed to watch someone do trach care!!!!

And always remember to stand above the waist line of a person you are helping roll off the bed pan! "Projectile feces spackeling" is something you will always remember!

[Ruby Vee, BSN]

never brag to the next shift that you were so bored you never got out of your chair all night!

never leave the bedside cart unstocked, the ivs dry or the meds not ordered.

never lie about what you did or didn't do, gave or didn't give. patients can survive a lot of mistakes, but only of you own up to it and then work at fixing the problem you caused.

never leave the messy dressing change, bath, whatever for the next shift.

if you drew the labs, check for the results and deal with them yourself.

never forget to take care of yourself first!

[babynurseapril]

Always take time to get to know your pt's family or visitors. You never know you might find out valuable info.

Always be an advocate for sedation on ventilated pt's. This means something for pain AND something for agitation. Dr's hate this topic for some reason.!!!!!!:) :rotfl:

Always talk to your "intubated and sedated" pt's OR "brain Dead" pt's YOU NEVER KNOW! Tell them what you are doing to their bodies.

[RN TiggerGirll ER]

Always:

- do your own assessment, don't count on someone elses. Things can change or be missed by previous shift

-check your equipment. make sure your suction is ready, your ambu bag and resuss. stuff is available. It never fails that the one room that is improperly stocked is the one that will have the code/seizure/unresponsive pt.

- make friends with the housekeeper- you would be amazed at the resources they have!!!

- give your best.

- find a mentor on your shift that is willing to be there as a resource for backup. Have had some new grads in the ER and I am more than happy to back them up or be there for a question. We encourage our new grads to approach a resource nurse each shift and say "Will you be my resource person for tonight"

- chart any change in pt condition and what you did to address it. I am amazed at simple things like "pt. c/o slight dyspnea" but never charting that you informed the doc/gave a med/ check a pulse ox. You always need to be aware that your charting reflects your care and trying to explain 5 years later that "Yes, I checked a pulse ox" in court when you have no recollection and no evidence of a recorded pulse ox is an eye opening experience. Always chart like you are on the stand and always make sure that whoever reading it can see the full picture.

Never

- delagate a nasty job just because you can

- dump on your CNA/PCA/ floor tech while you sit on the phone (see this done all the time)

- say the word "QUIET" in any form or sentence- you will be smacked!

- sit on your butt while your co-workers are drowning and try and make yourself look busy with nothing

- be a lazy nurse.

- put down the floor, other nurses, the hospital. if you are unhappy do your best to make it better, if you can't find another job. Nothing is worse than working with a nurse who is miserable and complains all the time but continues to stay and make others miserable with her constant banter and bad attitude.

- put down a policy/procedure without following it with a solution to fix it. You will be respected by your nurse manager/director if you offer to help fix it.

- talk behind a co-workers back, they will find out eventually. don't get sucked into gossip by chiming in.

- accept rude/condesending behavior from a doctor. they are no better than you. You are both professionals and you deseve to be treated as such.

- apoligize for calling a doctor with a change in pt. condition- it is your duty to act.

- stop learning. keep up to date with lectures and obtain certifications in you area of specility.

[Forcemaster]

and as a new grad, NEVER act like a know-it-all.

i've seen too many new grads that challlenge the seasoned nurses, thinking they know it all from their recent education.

This one sounds familliar :chuckle!!!

I am a self confessed smart-guy but I would actually encourage new staff to challange the practices of more experienced staff... How else will outdated practices change or new staff learn?

Now in my case, even though ive only been qualified since September 04, I know a great deal more about a great many subjects than a lot of the other staff I work with (it's what comes of having a 1.5hour commute each way to my hospital and using the time constructivley in my 'commuti-versity' ) so I have often found that when i ask questions, i often need to supply an answer.

I would point out its not the challange that often irk's the more experienced staff... its the way they get challanged... Telling them "Well i was show to do it this way..." or "Your doing it wrong..." Is a surefire way to annoy the heck out of them... Asking questions about WHY they do something this way is much better :)

[acutecarenp]

What a great thread!

And I dunno, but I figured marinated meant seasoned, been in it awhile, etc.

What is a "seasoned" nurse???

Like... one with pepper on her/him?

[acutecarenp]

As a new nurse, what you have to hear is a whole lot more important than what you have to say.

Don't talk when you should be listening.