HELP! How do I learn what I need to know?

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I am a recent nursing graduate having just obtained my RN license in October. I got a job as a mom/babe nurse at a local hospital. My orientation was a crash course due to it being a very busy time delivering babies like crazy and at the time I began we were short staffed. I got a 4 week orientation and my first week off had a baby on oxygen which I had never had during my orientation. I handled everything okay but I am wondering if I screwed myself by taking too much initiative and jumping right in to be helpful. I think I made myself seem too capable and now no one seems to remember how new I am and that I am pretty clueless. I handle all the routine stuff okay, but I know when something out of the ordinary comes up it is going to eventually bite me in the butt. How do I continue to learn what I need to know since no one seems to want to play teacher? I am taking NRP this month so that will help some, but I need to learn way more than that. I had a baby the other night who had one arm turn blue repeatedly during my shift. He was 6 hours old and had lasting acrocyanosis in all extremeties but his right arm would turn BLUE from fingers to elbow with no obvious reason. FREAKED me out. Called doc who came to see him but we never did figure out what was causing it. Oxygen sats were good, though we did supplement him later. He initially turned beautifully pink under the radiant warmer so we thought it was temperature related, but then he did it again under the warmer. No murmer, blood sugar 80. I was puzzled. Any thoughts on this or how I can continue to grow as a nurse. I don't want my learning to be at the expense of a patient's well- being. I don't think it is fair that they be my lab rats. I also am now being cross trained to med-surg which will probably be another joke. They send me there to "orientate" whenever OB has low census and they don't need me because I'm not a labor/delivery nurse. I should learn a lot that way (NOT!) HELP!!!!:o

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Specializes in Nursing Professional Development.

One of the best thing a new nurse can do for herself is to make friends with the senior staff nurses on her unit. They may seem intimidating ... and/or you might not feel you have a lot in common with them ... but, it is well-worth your time to make friends with them. Listen to them, get to know them on a personal level, find out about their families, etc.

Once you have established good relationships with them, it will be easier for you to tell them exactly what you have just us -- a group of strangers on the internet. It will also be easier for you to go to them for advice throughout the shift as you need it. Nursing is not (should not) be a solo activity: it should be a team activity. The older nurses and the younger/newer nurses should be working together on a regular basis to support each other. Get to know them and let them help you with the specifics.

I would also suggest a similar strategy with your unit's educator. You might never get as chummy with her, but make sure you have a good relationship with her. Then you can feel comfortable asking her for help.

In other words, locate your resources and do what you need to do to use them to your best advantage.

Professional journals, books, and conferences can be a big help ... but the best help on a daily basis is your coworkers.

Good luck,

llg

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Specializes in med/surg, telemetry, IV therapy, mgmt.

sweetcheekers (love that screen name!). . .you ask, "How do I continue to learn what I need to know since no one seems to want to play teacher?" Guess what? You have to play teacher to yourself! So, whether you want that role or not, you are going to have to force yourself into it or as you say, "when something out of the ordinary comes up it is going to eventually bite me in the butt."

I can just imagine that fear and dread you must feel at times. What you have to do (that you didn't mention in your post) is to hit your books when you get home. You should have a good OB textbook and also invest in a textbook on neonatal nursing. When a situation comes up at work like the baby with acrocyanosis, you should search out everything about it in your textbooks, a medical dictionary or encyclopedia and on line. Did you do that? You didn't say. You cannot depend on your co-workers to always supply this information to you. Something that should have been focused on when you were a nursing student was how to find information on your own. Ultimately, you are the person responsible for your learning now that you are a working professional. Not the hospital, not your co-workers. You!

I appologize if I am going to sound too stern, but I have been a nurse a long time and done a good share of precepting of new grads. Time to live up to professional expectations and hit the books. If you thought school was out when you graduated, you were in error. School is just beginning for you. I commend you for stepping forward and jumping in to your job responsibilities. But, take a little walk here down memory lane. Did your instructors put you in situations before you had a chance to research and learn something about them first? Your performance on the job is not that much different. If you are going to jump into the fire, you need to also do your homework. Those questions that burn in your mind after a busy work shift should send you to your books looking for answers. Nursing school just gave you the starter kit. What you do with the knowledge and wisdom you gained in nursing school is now totally up to you--teacher. Will you add to it, reinforce what you learned, or stagnate? Can you meet this challenge? Or will you sink and drown? The answers to these questions are totally within your power, and your power alone.

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Specializes in Geriatrics, Cardiac, ICU.
sweetcheekers (love that screen name!). . .you ask, "How do I continue to learn what I need to know since no one seems to want to play teacher?" Guess what? You have to play teacher to yourself! So, whether you want that role or not, you are going to have to force yourself into it or as you say, "when something out of the ordinary comes up it is going to eventually bite me in the butt."

I can just imagine that fear and dread you must feel at times. What you have to do (that you didn't mention in your post) is to hit your books when you get home. You should have a good OB textbook and also invest in a textbook on neonatal nursing. When a situation comes up at work like the baby with acrocyanosis, you should search out everything about it in your textbooks, a medical dictionary or encyclopedia and on line. Did you do that? You didn't say. You cannot depend on your co-workers to always supply this information to you. Something that should have been focused on when you were a nursing student was how to find information on your own. Ultimately, you are the person responsible for your learning now that you are a working professional. Not the hospital, not your co-workers. You!

I appologize if I am going to sound too stern, but I have been a nurse a long time and done a good share of precepting of new grads. Time to live up to professional expectations and hit the books. If you thought school was out when you graduated, you were in error. School is just beginning for you. I commend you for stepping forward and jumping in to your job responsibilities. But, take a little walk here down memory lane. Did your instructors put you in situations before you had a chance to research and learn something about them first? Your performance on the job is not that much different. If you are going to jump into the fire, you need to also do your homework. Those questions that burn in your mind after a busy work shift should send you to your books looking for answers. Nursing school just gave you the starter kit. What you do with the knowledge and wisdom you gained in nursing school is now totally up to you--teacher. Will you add to it, reinforce what you learned, or stagnate? Can you meet this challenge? Or will you sink and drown? The answers to these questions are totally within your power, and your power alone.

Very good answer! I'm inspired. :yelclap: :yelclap: :yelclap: :yelclap: :yelclap: :yeah: :yeah: :yeah: :yeahthat:

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Thank you for your replies. I have spent time looking online, in books, and collaborating with other nurses regarding the baby who had the right arm turning blue off and on during my shift. Still, no answers. I sure there are going to be many times when the answers to my questions are not cut and dried. Anyway, I spoke with several nurses about my concerns regarding continuing to learn and expand my knowledge base. I already was signed up for NRP which will give me much more security in feeling prepared to handle bad situations. I also asked for my supervisor's recommendation on a text that would be helpful on assessment of neonates and common complications in newborns, (as well as appropriate interventions.) She had several so I brought one home today. I am definately a self-motivated person. I always seek out answers to anything I am unsure of. I personally cannot stand those who just go through the motions and never seek explanations for why things occur or knowledge of proper response. You know, the people who are just satisfied with the status quo and who are happy if everyone's still alive at the end of shift. I think some of my nervousness is also because I am being cross trained on med-surg now. This will be a great thing for expanding my knowledge and giving me a broader and more diverse base, however, it is a big undertaking to have obtained your RN two months ago and feel you must conquer everything at once because it is a race against the clock. I feel I must hurry and learn all I can before something goes wrong that I am not prepared for. I'm sure it will be fine. I graduated at the top of a class of over 100, I had many complements from top notch instructors and I have good judgement. I think knowing when you are in over your head is the crucial piece of knowledge to have when you are as green as I am. I just tend to be very independent and take the world on my shoulders. I know I need to be responsible and accountable for whatever care my patients require. Right now I certainly am not capable of doing everything independently without guidance. Hopefully, this will change quickly as I apply myself and try to get the most out of my experiences. Thanks so much for the advice. I'll keep you posted on my progress.

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Specializes in ICU, telemetry, LTAC.

I would suggest, in order to not add to your frustration etc. that you actually schedule times to do this at-home research thing. I have questions - about one or two a week- that can't be answered on the spot by my coworkers. I DO NOT look it up anytime during the 3 days when I'm scheduled (nights). I've gotten fond of bringing a book or two when I do laundry which is usually a day and a half or so after my 3rd night shift.

This helps me to be more clearheaded and a bit distanced emotionally from whatever situation prompted me to go hit the books in the first place. Sometimes it's hard; I'll never forget the first person I saw go into pulmonary edema while having a heart attack and boy is it eerie to go back to the book and read the descriptions, after having seen it. Couple that with the fact that I was bored out of my skull in school when it came to acid/base balance... and contrast that to the ABG's of this particular patient and suddenly acid/base is very, very interesting.

If there is anything that stands out specifically, I might mention it to a mentor or two the next time I see that person. They may say "oh yeah, everybody knows that," or they may be surprised to be reminded of it. If there's a drug nobody could find info on, when I do find it, I share.

Seriously, you may find if you pick the brains of your charge nurses, and more experienced nurses, that you'll find not only a mentor but a lifelong friend. At the very least, acting like you're part of a team will promote some teamwork and all nurses need that.

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