Just passed NCLEX PN

TheCommuter, BSN, RN · Mar 29, 2016

So I'm asking for any advise you might have for me prior to beginning my first nursing job

1. Fake it until you make it. Act confident regardless of how frightened you might be. Some patients and coworkers take your confidence for weakness, unfortunately.

2. Ask questions when unsure.

3. Develop a to-do list to keep you organized.

Cactus Nurse · Mar 30, 2016

exactly what The Commuter said!

My first job was Home Health! Imagine the terror! What if something happened, I had no one to turn to. I have to chart manually!? It was so much easier thatn I thought!

Tips:

Have either a small notebook like you did in school or a folded paper and take notes on your training days. Take all notes you think you will forget. Then on your first day have a cheat sheet for yourself.

Ask lots of questions and have your charge nurses phone numbers so you can text them if they aren't around.

Read charts when you have any down time so you know what goes on, and how the patients are.

Look up any meds you aren't sure of- just look at the name and reason for usage.

charting- chart every 2 hours, or according to facility policy (like end of shift). I have my notepad or sheet of paper in my pocket and write down everything and chart was is only important...

example- Sara took PRN dose because could not sleep, pt. slept thru the night... OR pt. c/o abdominal pains at 1345, gave PRN, checked on 1hr later felt fine and sisn't complain rest of shift... I just write a lot for myself and chart the stuff the nurses need to know later.

Remeber you don't need to chart- changed patient brief, gave pt. water for meds, only actual nursing.

It's your time to shine! remember everything you learned in school and apply it! If you over do it, that will just make you look better than your co-workers. If it's too much, your CN will tell you, but at least you don't forget anything.

Checklist is the biggest thing, that will help you a lot!!

Goodluck

I'm a new nurse having worked only 4 months and at first I was scared, but now I work in 2 different fields and I feel totally comfortable now with just my notes and asking questions.

You know more than you think !

Tinkers33 · Mar 30, 2016

Thank you! I start next Wednesday! I am working where I did my practicum so that's pretty awesome!!

MedChica · Mar 30, 2016

Congrats!

Minus a bad shift, you're not going to be missing breaks often unless you're new, work a lot of new facilities or the pt ratio is just that huge and the care, that involved. The shift also. It's generally easy to take hour long breaks on weekends and nights. Although on a nasty weekend (7a to 11p), I once didn't eat until 8p. In most places Ive worked, nurses do take a lunch. They may not taste the food. They may take lunch late. The 7a to 7p weekend nurses where I work tend to eat AND chart but they do eat. I tend to take late in shift lunches, anyway. Food makes me sleepy and I prefer to take breaks when 75% to 90% of my work is done. On 7t3, Ill take lunch at 1330. 3t11, I take lunch at 2130.

It's okay to be scared. It may not take long for you to feel comfortable depending on how much you work and how much rigorous the floor is but, yeah, youll be nervous. I was.

You wont know the feeling of being lost at sea until you find yourself standing in the nurses station by yourself at 1030 in the morning. Phone's ringing off the hook, providers all over asking a million questions about the residents I know little about, etc... Answer the phone. Pharms on the phone for me. Okay, I clarified the order successfully. Yay. Answer again. Visitor wants to be transferred to mothers room. Okay. One moment, please. Now...to fumble around the nurses station looking for the 'book o' pertinent info' to teach me how to do that. Hmm.

You see the a/don heading in your direction. Thank god. She comes over smiling and tells you to hold out your hand. You do. She slaps a bunch of TOs in it, laughing.

"Are you, okay?"

Me? "Uh...Im okay. few quick questions. How do I -- ".

First day on the floor by myself. First job.

- Write things down. You will not remember everything.

Write down the facility phone number and fax numbers, too. Write down the name of your unit, too. Northside, Southside, 300, 400, MCU, SCU, etc....

- During orientation on the floor, bring your notebook. You will very likely be working that hall. If there's no assignment list, just write notes as you're being introduced to each pt Ex:

200a. Frankel, a. DM. C. Take b/p. Peg. Fall risk.

200b. Watkins, J. Iv ABT/Cdiff. Behavior. Sacral wnd. Takes med c juice. A/Ox2. Fall risk.

201a. Sanchez, R. Nectar. C DM. Blind. HOH. Abt/uti.

202b. Hardaway, M. Peg. Dm. Vitals. Fall prec. Seizure. A/Ox1. Prnq4

DM=diabetic

C= meds crushed

PEG = gtube/peg tube

HOH = Hard of hearing

ABT= Pt on antibiotics for uti. (You must take vitals and assess for adverse reactions to ABT therapy).

Youre not going to remember everything about every pt when you hit the floor by yourself.

Knowing your pts is half the battle in ltc/snf.

- When i was new, Id take a blank copy of a TO or new admit paperwork and make notes on that. That way, Id always have something to refer to if I forgot how to do something or how to fill out a form properly or what orders to write.

'How To Do new admit."

'How to order lab...xray..."

"Death Procedures"

"How to dc pt."

"How to pull" this and that report....

- Bring your equipment and try to get as independent as you can as quickly as you can. Do some sticks the first day. Do some PEGs. Try to handle the cart on Day 2. Your supv will be there. Dont worry. Most facilities don't give more than 3 days of orientation. That's why it's best to be proactive. Youve seen those wildlife shows where newborn calves are birthed during migration and have to be up, walking 30minutes later, running within the hour and able to follow the mother/herd? Same difference.

You'll do fine.