any late 20s new grad RNs out there?

[badtz143]

I graduated in May this year from an accelerated BSN program out-of-state. I'm now back in my home state working on a medical/oncology unit. People have been nice but I've had 3 different preceptors so far. Some of them good and some not so good. This is a career I didn't want when I first entered college but my mom desperately wanted it for me. Still I followed my own desire and spent 4 years to get a BS in Psychology. To make a long story short, I realized years later that this is what my calling is, aside from the job security it has to offer. So here I am in my late 20s, a new grad and had just finished my first week as an RN. Why do I feel like this was a mistake? I don't particularly enjoying cleaning feces and wiping behinds. Although I do enjoy all the other things we do as nurses such as talking to patients, giving out meds, and other stuff. I always feel like a chicken running around with its head cut off during work. Also delegation doesn't come naturally to me. I hate to make people feel like I'm bossing them around, yet if I don't ask for their help, they carelessly and lazily do nothing to help out, CNAs and LPNs alike. Yet I don't want to be called "one of the lazy RNs." Having been in nursing school only for 1 year, I also don't feel like I had enough clinical experience. There are still many little equipments I don't know the names of, and medications I don't know what for, and bunch of acronyms nurses like to use when giving shift reports. I always find myself asking what the heck they stand for, but they talk so fast I don't want to interrupt......besides I'm an orientee and i'm following my preceptor. Any tips on how to start a day as a new grad nurse? Do I do a full systems assessment when I see them first day in the morning, like we did in nursing school? how do i delegate AM care so that I can do other things? More like, how do I approach the UAP and LPNs professionally without them thinking I'm being lazy that I can't do these myself? ANY THOUGHTS at all?

[Altra, BSN, RN]

Having been in nursing school only for 1 year, I also don't feel like I had enough clinical experience. There are still many little equipments I don't know the names of, and medications I don't know what for, and bunch of acronyms nurses like to use when giving shift reports. I always find myself asking what the heck they stand for, but they talk so fast I don't want to interrupt......besides I'm an orientee and i'm following my preceptor.

This is where your preceptor can help you. Off the top of your head, can you list 5-10 acronyms, procedures or pieces of equipment that you need to know more about? Probably. Use your orientation manual and hospital/departmental P&P manuals to see what you can learn on your own and then ask your preceptor to help you fill in the blanks. Meds: look these up, ASAP. Make yourself an abbreviated version of the dreaded drug cards we all did in school so that you can keep them with you, if it helps. If you find yourself about to pass meds with your preceptor and there's a med that you're totally unfamiliar with, ask your preceptor to either give you a brief run down on the med, side effects, etc. so that you can safely give it and assure him/her that you'll be looking it up yourself later as soon as there's time.

Any tips on how to start a day as a new grad nurse? Do I do a full systems assessment when I see them first day in the morning, like we did in nursing school? how do i delegate AM care so that I can do other things? More like, how do I approach the UAP and LPNs professionally without them thinking I'm being lazy that I can't do these myself? ANY THOUGHTS at all?

A lot of how you start your day depends on your unit. Ask your preceptor for input. Observe how other nurses organize their day. The info you get in report should also clue you in about which patient probably needs your attention first, any potential "fires" that need to be put out immediately, etc. As far as delegating AM care ... you may not necessarily have to "delegate" this because it may be part of the UAPs job description. Do you find that AM care isn't being done, or are you unsure of what exactly the UAPs and LPNs do? These are questions for your preceptor.

Good luck to you! Let us know how you're doing. :)

[GrnHonu99, RN]

Hi!!

I am a new grad and I just turned 26. I also have a BA in Psychology and went back into an accelerated MN program. My program was also just a little over a year.

LOL, well as a new grad I cant give wonderful advice but i'll try:)

I love nursing too but I wonder at times if it was a mistake, I think a lot of people do. I actually went to a conference at OSU for new nursing students and there was a keynote speaker that was talking about this study on first year nurses (sorry I cant remember the name). It was a longitudinal study and basically it said that feeling overwhelmed is completely normal and that most want to quit by the end of the first three months, then after six they started to see the light and after the first year the students were beginning to feel comfortable. I willl look for this study.

I don't know anyone who LOVES cleaning behinds. I just try to think of it in an objective way such as: the skin will break down it it gets urine or feces on it and to prevent bed sores and skin breakdown I need to keep them clean and dry. Also I think of how I would feel if that were me..so I feel like i'm really helping that pt. in a personal way.

In the way of clinical experience, well I don't think ANYONE in ANY program ever gets enough!:) The real learning takes place outside of school. I look at it like this: school gave me a start, gave me an idea so i'm not totally clueless, gave me the tools to be a nurse and my critical thinking skills will take me the rest of the way. Its a process and i'm never going to know close to everything so I try to just go with the flow and keep taking in everything I can. Experience is something you can't learn in school even with tons of clincal hours. Did nursing school teach you to insert a foley? Yes, but think of the first time you did it, it still took a couple times before you were good at it and thats how I see this whole new grad thing. I know how things are supposed to be done according to the books and now im learning how to do them in the real world, using those skills, developing my own style.

At this point I try not to be soo hard on myself. I work it the neuro ICU and how I see it at this point is: a) i have nowhere near the amt of experience as most of the nurses on my floor and I can see how their experience is what really makes them the great nurses. It really is the experience, I know two nurses on my floor BOTH excellent nurses and have close the same amt of years under their belt. However bookwise one is great and the other is mediocre but both are wonderful wonderful nurses. So, while we might have the book smart thing going for us, we really just need experience and there isnt anything we can do about it (except work like crazy:)).

At this point in my career I know that i'm not going to know certain things so at my level of expertise, I need to know my patients baseline and know when something has changed, Im not going to know why something has changed necc and that comes with time. From there I need to document it and report the change. I know WHY somethings happen but I dont know why alot happens, for example, my pt. the other day came in neurologically intact and his LOC changed. I know that there was a change but I did not know why, so I reported it and charted it and he was taken care of. At this point, I wont know why, im too new, but it will come with time and I learned from this experience, little by little these experiences will build and someday I will have a clue:) hopefully.

LOL I have just accepted the fact that I am going to feel clueless for a long time. Thats ok, I would say the greater portion of new grads (if not all of them) feel that way, its normal. I just keep that in the back of my mind and keep truckin through, learning as much as I can. :):):):) My best advice? Remember your basics and the rest will come:P (at least thats what im telling myself:))

Erica

New grad-one month out