How do I succeed as a new nurse?

[NursePumpkin, BSN, RN]

Hi everyone! I took the NCLEX-RN yesterday and received my license number this morning (yay!) I have a job lined up on the cardiac floor and I'm starting in two weeks. I'm excited, but I'm also nervous. Unfortunately while in nursing school, I had limited opportunities in clinicals. Too many students were assigned to one clinical instructor, which created an issue as well. I also had an instructor who only allowed one student to pass a single med per day (She no longer works for the school after this). I have only ever passed PO meds, given a few IV push meds, and two IM injections. I've only ever touched an IV pump in our sim lab and whenever I'd go to skills lab to practice. I've never given insulin, done wound care, inserted a foley, etc. I didn't get to do my senior preceptorship because hospitals weren't allowing students due to a lack of PPE. All of this makes me very nervous because I feel so unprepared. I've been reviewing cardiac A&P, common cardiac meds, and even watching Youtube nursing skill videos. Fortunately, my new manager has expressed that she understands that I'm at a disadvantage here. I will be on orientation for twelve weeks before I am on my own. I'm determined to learn how to work effectively (and safely) though, and would like some advice on how I can be a better orientee. Thank you!

[Katie82, RN]

A twelve-week orientation sounds good, as long as they are orientating you as a new grad and not just to the floor. Don't be shy about asking for additional help if you need it. Don't let them "turn you loose" if you feel you're not ready. Don't let anyone make you feel like you don't work fast enough, know enough, or lack organizational skills. You are a new grad, and that's what orientation is for.

[DextersDisciple, BSN, RN]

I wouldn’t worry about it because this sounds about right in regards to what you can actually DO in clinical. My school did not allow us to do anything IV or even accucheks. I hesitantly asked a nurse if I could straight cath her pt (very pregnant mom waiting to go into labor with an epidural on board) and was shocked when she said “sure!”

Everything else was basically med scanning, bed baths and toileting. You’re going to learn basically all of your skills on the job regardless of your clinical experience. Best of luck to you!

[NursePumpkin, BSN, RN]

15 hours ago, Katie82 said:

A twelve-week orientation sounds good, as long as they are orientating you as a new grad and not just to the floor. Don't be shy about asking for additional help if you need it. Don't let them "turn you loose" if you feel you're not ready. Don't let anyone make you feel like you don't work fast enough, know enough, or lack organizational skills. You are a new grad, and that's what orientation is for.

Yes, I'll be getting new grad orientation thank goodness. Thank you for the reply! ?

13 hours ago, DextersDisciple said:

I wouldn’t worry about it because this sounds about right in regards to what you can actually DO in clinical. My school did not allow us to do anything IV or even accucheks. I hesitantly asked a nurse if I could straight cath her pt (very pregnant mom waiting to go into labor with an epidural on board) and was shocked when she said “sure!”

Everything else was basically med scanning, bed baths and toileting. You’re going to learn basically all of your skills on the job regardless of your clinical experience. Best of luck to you!

This is reassuring, thank you! ?

[toomuchbaloney]

Good luck as you now start practicing what you've learned!

[SilverBells, BSN]

It sounds as if you are on the right track to success by reviewing nursing skills and knowledge ahead of time! As others have said, nursing school clinicals greatly limit what students can actually practice outside simulation lab, so it would not be surprising that you do not have experience with certain skills. Even if nursing school and hospitals were a bit more flexible, there is only so much time a person has in nursing school, making it impossible to expose each and every student to each and every skill he or she might encounter on the job. With that said, if you don't feel comfortable with any new skill you need to perform, always ask for help even if the person you are asking seems inconvenienced. Seems simple enough, but could be easy enough to forget if you are trying to demonstrate confidence and competency. Don't worry about that initially; focus on patient safety regardless of whether or not your request seems "silly." Starting on a cardiac floor, these patients can get sick, or are already sick, quite quickly, so the pace can be fast at times (based on my observations during clinical). Even once you get more comfortable with your surroundings, you may want to continue researching and reviewing new material after work, including after orientation. Also, if it turns out that the acuity of the cardiac floor is higher than you were expecting or hoping for at this time in your nursing career, don't be afraid to ask to transfer to another floor which could provide you experience with lower acuity patients. With that said, there are many new grads that succeed on cardiac floors with the right determination, attitude, and willingness to learn from others. Good luck to you!

[CharleeFoxtrot, BSN, RN]

17 hours ago, NursePumpkin said:

...I'm determined to learn how to work effectively (and safely) though, and would like some advice on how I can be a better orientee. Thank you!

Eyes, ears and mind open...mouth shut ? . Well not all the time, just use these first few weeks to absorb as much information and practice as many procedures as you are able to. Good luck to you!