If You Could Only Give ONE Piece of Advice to New RNs

Between what to study, what to prioritize, how to handle patients, coworkers, stressful situations... if you limited yourself to one piece of advice, what do you think would make a new nurse's transition to the job a successful one? An important strategy might not be a clinical consideration, but a personal relations one. Nurses New Nurse Article

Having precepted some new graduates on the floor and in ICU, and having recently been one myself, if I could only give one piece of advice to any new graduate nurse, it would be this: accept criticism with grace and gratitude. Even if you suspect the person giving it to you is a bully, even if you disagree with them, even if someone else has given you literally the exact opposite advice--give them a smile, as genuine of one as you can manage. Then, even if you'd like nothing more than to punch them in the face, thank them for taking the time to explain the situation to you (or ask them to, if they haven't). Lastly, assure them you'll try harder to be better about whatever it was they were addressing with you. Again, be as genuine as you can and don't be facetious (even if you don't feel justly judged: fake it 'til you make it!) We've all been there. Hearing criticism is never pleasant, but here in this field, nine times out of ten, it isn't because someone is trying to make you miserable, it's for the patient, it's for the unit, and it might even be for your own future success.

Perhaps, you're wondering why this is so important that it would trump what to study, what to prioritize, patient care advice, and a plethora of other things. Of all the things you could tell a new nurse trying to balance many worlds of conflict, why this?

A French professor--one of those existential ponderers whose lectures and metaphorical references went far beyond what our novice undergraduate eyes had read--once said to me, "Of course, we all know the seven deadliest sins. But which is the worst? Pride." Interestingly, he never bothered to explain why, despite the few students who dared to ask, but merely gave a shrewd look from over his reading classes before switching subjects. It's been years since this lecture, and his words still haunt me. We were, at the time, discussing Madame Bovary and not anything relating directly to nursing, but I find the lesson of pride so applicable in this field. To new graduates in particular, why is pride so damning?

The first step is acceptance. (How many self-help books have crooned this one line?) You can't fix the problem if you don't see a problem. And perhaps you really don't see a problem. The problem with pride is that it's the ultimate barrier to change---more so than laziness or fear. Being confronted with something that someone has found you did wrong is uncomfortable at the very least. Perhaps you'll feel the need to defend yourself--don't. To people more experienced than you, a defensive explanation, however polite, is generally unnecessary unless you are doing so in an attempt to figure out together what went wrong in your thinking. Being able to take criticism well (as in: quickly, easily, without a wounded ego) shows your ability to grow. It shows that you're willing to fix whatever might be wrong. Senior nurses find that this is a safe behavior and therefore appreciate it.

But wait--maybe they're wrong. Maybe you have realized that you've struck the unfortunate luck of landing in a hostile work environment and you know this advice-giver is just antagonizing you to be a heartless soul-sucking bully. Even if this is the case, you get nothing by being defensive. This shows that they got under your skin enough to make you feel like you have to defend yourself. Instead, ask them to explain their reasoning. Ask what you can do better. And after all is said and done--very important--smile cheerfully and assure them that you'll do your best to follow their sound advice. If you feed into their ego without letting them bring down yours, they might just start leaving you alone. Wouldn't that be a win-win?

Specializes in Emergency Nursing.

I completely agree with the OP that this is probably the most important piece of advice for new nurses.

I work as a clinical instructor and tell my students that we as faculty try to teach them nursing theory, evidence-based practices, and how to THINK like a nurse but once they graduate and find jobs they will learn how to BE a nurse. Having been precepted and served as a preceptor in multiple healthcare facilities I can say that it definitely requires humility and accepting criticism professionally "with grace and gratitude" (to quote the OP) on both parts.

I also tell my students that during the orientation time they will likely work with experienced nurses who practice and perform certain tasks in a way that is different from how was taught to them. To increase their odds of being successful in a position and being recognized as a good team member it is in your best interest to keep an open mind and follow your preceptor's lead while on orientation. Unless what your preceptor is doing is completely disregarding institutional policy or is dangerous and likely to cause harm to the patient then you should carry out your assessments, documentation, nursing interventions, and workflow as they suggest while you are working with them. If you are working with multiple preceptors it's not wise to say "But Soandso does it this way..." because it can be perceived as staff splitting and comes across as making excuses. If you are offered a suggestion or correction in practice you should (1) listen, (2) thank the person for their suggestion honestly, and (3) verbalize that you will work on incorporating their suggestion into your practice for the future (even if you don't agree with the feedback). At the very least, you should listen to the feedback that is provided to you and reflect on it, you may not agree with it but there is a reason that it was said and it should not be dismissed without consideration.

After you have finished orienting then you can adjust your practices as you see fit (as long as they are within institutional guidelines and are supported) but being a new nurse and starting a position with a mindset that you have nothing to learn is dangerous and doesn't settle well with your peers.

!Chris :specs:

I completely agree with the OP that this is probably the most important piece of advice for new nurses.

I work as a clinical instructor and tell my students that we as faculty try to teach them nursing theory, evidence-based practices, and how to THINK like a nurse but once they graduate and find jobs they will learn how to BE a nurse. Having been precepted and served as a preceptor in multiple healthcare facilities I can say that it definitely requires humility and accepting criticism professionally "with grace and gratitude" (to quote the OP) on both parts.

I also tell my students that during the orientation time they will likely work with experienced nurses who practice and perform certain tasks in a way that is different from how was taught to them. To increase their odds of being successful in a position and being recognized as a good team member it is in your best interest to keep an open mind and follow your preceptor's lead while on orientation. Unless what your preceptor is doing is completely disregarding institutional policy or is dangerous and likely to cause harm to the patient then you should carry out your assessments, documentation, nursing interventions, and workflow as they suggest while you are working with them. If you are working with multiple preceptors it's not wise to say "But Soandso does it this way..." because it can be perceived as staff splitting and comes across as making excuses. If you are offered a suggestion or correction in practice you should (1) listen, (2) thank the person for their suggestion honestly, and (3) verbalize that you will work on incorporating their suggestion into your practice for the future (even if you don't agree with the feedback). At the very least, you should listen to the feedback that is provided to you and reflect on it, you may not agree with it but there is a reason that it was said and it should not be dismissed without consideration.

After you have finished orienting then you can adjust your practices as you see fit (as long as they are within institutional guidelines and are supported) but being a new nurse and starting a position with a mindset that you have nothing to learn is dangerous and doesn't settle well with your peers.

!Chris :specs:

Thanks for these tips! The job that I've had for the last ten years is a specialty that is independent and autonomous, so I literally have not dealt with seniority, management, or coworkers for a decade. I definitely work around other people, but it's a client relationship rather than a hierarchy. Even though I work for a company, they are not my boss.

The right way to interact with preceptors and coworkers is an area that I've contemplated a lot because I figure it's better to hash it out now than make a bunch of missteps and potentially damage actual relationships and make my work life harder than it needs to be, so this is kind of my simulator!

Specializes in Float Pool - A Little Bit of Everything.
Run away.

....Quickly.

Listen to the patient.

I lied - I have two pieces of advice. But this is such a good question I can't help myself. :)

Remember the NCLEX? Use it to you advantage. The next time you are struggling with what to say, what to delegate, or what to do first, reframe your situation into an NCLEX question. It will help you see what the safest/most therapeutic response or action will be. Sometimes you have to just remove yourself from the situation a little. Because you know the answer is not "throw your hands up in the air and give up." Even after 15+ years, I still use this strategy from time to time.

I have oriented many new nurses over the last 13 years. My steadfast rule for all of my orientees is to ask questions. No question is silly.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I have oriented many new nurses over the last 13 years. My steadfast rule for all of my orientees is to ask questions. No question is silly.

"Um,what is the phone number here?" Asked and answered seven times in two hours.

"What's the phone number for Pharmacy?" Asked and answered almost hourly for three days straight -- even AFTER I advised her to write it down so she wouldn't forget it again. If I told her to look it up -- and where and HOW to look it up -- invariably, someone else would either just rattle off the number or even dial it for her.

"Where does the bedpan go again?" No, it wasn't a question about where to store an empty bedpan. The patient was hoping to USE it.

"Help! How do I do a Foley?" (Alternatively, I'd suggest "Mrs. P has an order for a Foley. I've checked the procedure and I think I've got everything I need, but I've never done this before. Could we go over the procedure before we go into the room?")

There are questions, and there are questions. There IS such a thing as a silly question. I'm all for new nurses asking lots of questions but I'd prefer that they be halfway intelligent questions. Questions like "Can I use your password?" Are silly after the first time it's been explained that you need to use your own password, complete with the "why" explanation. A better question would be "Can you tell me where to find the phone numbers we use most frequently? I need to call IT again to see if they can help me with my password."

Specializes in Ambulatory Care, Rheumatology.

I would advise to set up your network of Professional support outside of your facility. The grass is not always "greener" at the other facility.

Specializes in Medical/Surgical/Telemetry RN.

Great advice thank you! I will use this especially when I am in clinical.

I am frequently asked this question. Here it is: Take a pen and highlighter to work with you and don't be late.

Specializes in Psych ICU, addictions.

My one piece of advice?

Constructive criticism is NOT nurses eating their young in action. It's a potential learning opportunity that, if you are wise, you will wring every last bit of knowledge out of.