How to not make patients nervous as an orientee

Lev, MSN, RN, NP · Dec 3, 2014

That's why sometimes demented or lethargic patients are helpful as a newish nurse. That being said...it's a tough balance. As a new nurse, I was so focused on the task, that I paid little attention to the patient...so I didn't really care that they may have thought I was incompetent. Can you let your preceptor guide you quietly in the room and then ask the burning question(s) once you step out? Tasks come with practice...get a spare pump, some small IV fluid bags, and start piggybacking!

anh06005, MSN, APRN, NP · Dec 3, 2014

Also think about how you word things.

"I've never used this brand of pump so can you show me how to do this?"

Don't let patients see your nerves if you can help it. Ask your preceptor to run through how to do something BEFORE going in the room if you know you've had limited experience. Regardless of if you've done it before act like you've done it a million times. Confidence goes a long way.

There are certain things in home health I don't do very often and HATE doing anymore. When these tasks do come up, though, I act like it's nothing. I may say "well this isn't something I do every day so I may not be as quick as your primary nurse but I'll get it done!" Things like wound vacs come to mind that I use this excuse for lol.

dah doh, BSN, RN · Dec 3, 2014

Work on earning your patient's trust by starting with stuff you know how to do. Show confidence in your abilities.

Think about what you say when you ask questions about something you don't know how to do or why we're doing it this way versus that so it doesn't come across badly in front if the patient or family. Try reviewing policy & procedures and the actual process prior to entering the patient room.

PCnurse88 · Dec 3, 2014

Sometimes there's nothing you can do, especially if you're still on orientation. Your preceptor is in the room with you, right? If the patient is with it enough to give you "the look" for asking questions, he/she must be with it enough to realize that you're still training and that there is a skilled, experienced nurse standing right next to you. It's not like your preceptor is going to let you do something seriously wrong to a patient! I used to tell people I was brand new right from the beginning and say "but don't worry, [preceptor] has me on a tight leash!" and usually they would laugh about it.

scaredsilly, BSN, RN · Dec 4, 2014

Honesty works best. I always told the patient that I was learning how the equipment on this unit worked and that my preceptor was experienced enough for both of us and that we are BOTH taking care of him/her and then I would say something like "you get two nurses at no extra charge". The patients laughed, the preceptor thought it showed great people skills and I never let on how nervous I was.

NightBloomCereus · Dec 4, 2014

I find the first impression is important in a patient establishing trust in you. As a new grad I get patients to trust me by being very confident in my assessment, and also having a clear understanding of any issues I know they have, before I walk in the room. A head to toe is something that every new grad can do confidently and fluidly, and doing so immediately establishes trust, I believe.

If I'm doing something by myself, like changing a bag of saline, I might say, "Your primary nurse X has asked me to change your saline bag for you." This helps them to know that the experienced nurse is aware of what I'm doing and trusts me to do it on my own.

I think the patients just want to know that they'll be safe with you, that you're not going to do something that will hurt them. Sometimes asking my preceptor questions helps them to establish their trust in me rather than having the opposite effect. It's the way you ask that matters. Like if my preceptor tells me to get supplies for an IV med, I will bring the needle and syringe into the room where she is waiting and say in a confident nurse-y tone, "Before we give this, can you double check to make sure these are correct?" if I'm not sure. This helps them to know that I'm not going to administer something unless I know it's safe.

Just holding your head up, smiling and speaking in a confident tone does a lot to keep a patient from being nervous.

crj96 · Dec 7, 2014

I would hide my nervousness with explanations like, "I'm new to this unit" or "She's helping me learn how to use this equipment", etc.

thinwildmercury · Dec 7, 2014

I never noticed any problem with patients being anxious about a new orientee! They have always been very gracious and understanding to me. My precepter would introduce me as "new to this hospital" instead of just "new nurse" however I am very young looking so they would (and still do) always ask "how long have you been a nurse" or something along those lines and I'd have to tell them the truth haha But even as a student nurse, I never had patients refuse a student or distrust one of us or anything like that. It seems patients generally trust nurses unless we do something to thwart that.

If I have to ask how to do something, I always explain to my patients I just want to double check with someone more experienced because I care about their safety and two heads are better than one! If it's something you don't see everyday (on my floor we rarely see chest tubes) I tell the patient we don't get pts with CTs in often so I am reviewing our policy and double checking with another nurse, etc. Patients have always been understanding to me. They don't expect us to know everything =)

TeflonNurse · Dec 17, 2014

You know I realized this when I was going through orientation (only a few months ago.) In school they make a big stink about "never tell the pt this is your first time doing anything!" This all goes out the window when you walk into the room with your preceptor in tow. When a pt has had 1 nurse every previous shift and then they suddenly have TWO, gee do you think they'll notice? We would just joke about it saying they were so important they get to have two nurses that day.

I expected people to give me the scared look once they realized I was new but I think a few things helped so I never really experienced it: lots of orientees on the floor at the same time so pts were used to new nurses asking questions and all that. My preceptor was old school and wore the white cap and I noticed this gave us immediate "street cred":D People were often so fascinated by it they focused on asking her stuff and I was free to concentrate on what I was doing. It really helps to watch your phrasing. Speak with confidence and if you explain what your doing as your doing it people feel you must really be knowledgeable.