My take on my new career as I get ready to close out my first year

[BabyLady, BSN, RN]

Being an RN has been the most challenging experience so far of my life. From school, to graduation, to boards and oh yeah, starting that first job IF you are lucky to find one in this market.

I figured I would post a few thoughts on my first year of nursing.

1. Time Management...they didn't teach this in school, but has continued to be my number one challenge. Learning to prioritize between patients, procedures, medication while being interrupted with lost IV's, transporting patients to procedures or surgery, managing the high-maintenance family member, etc. If I live to be 100, I will always be continuing to improve on this.

2. The learning never stops....they aren't going to teach you everything you need to know in the hospital training program. I kept a notebook, correction, KEEP a notebook, where I write down procedures, tests, medications, diseases, conditions that I come across so that I am more familiar the next time I come across them. I look these up and find a time to ask the physician's or NP's questions when time is appropriate.

3. Be professional...this is what I feel has really set me apart from some that I was hired with. I come to work every day with a clean uniform that is pressed, neat hair, make-up, clean shoes. I speak professionally and tell everyone that helps me with advice or assistance how much I appreciate it. It makes them feel good.

4. You cannot use "I'm new" as a crutch...granted, you can't start by knowing everything, but I worked with one girl that you could see that she was doing a half you-know-what job taking care of her patients and it resulted in one medication error after another until she finally lost her job. I work with another that constantly takes patients that is well outside of her skill level and a patient almost lost it's life about three months ago because of it...there is a first time for everything but at the same time, take baby steps and don't be afraid to tell the charge nurse that you are uncomfortable taking care of certain critical care cases...it's your license if you mess it up.

5. Don't be bullied...you need the senior nurses to help guide you and teach you and they will be the source of the answers when you need it. However, don't be afraid to stand up for yourself. If a senior nurse belittles you in front of a physician or patient or snaps at you....calm down...and find a time to talk to that individual in private (where they can preserve some dignity) and professionally tell them that you value their expertise and help, but such-and-such was uncalled for and tell them why...and find a way to end it on a positive note. Yes, there will always be that ONE that insists on being a witch...and I work with one of those...and when kindness and passively standing up for myself didn't work, the next time she did it I said firmly, "When you can speak to me professionally, let me know, otherwise, route your concerns through the charge nurse or the manager." That nipped it in the bud.

6. Pharmacy isn't perfect....I read all the time on Allnurses on how some nurses never commit an error while some get fired from multiple jobs in their first year for medication errors...I catch Pharmacy in mistakes at least once per week...some errors are insignificant..some are life threatening. It is up to you to check and double check and when in doubt, ask. When working long shifts, anyone can become sleep deprived and this can affect your judgment...I have asked other nurses (and they in turn have asked me) to double check something seemingly simple that when tired, seems odd...you can never be too careful.

7. Get a buddy...you had one in school, right? Get one at work to help you get through that first year. I have two....I have a new hire and one senior nuse...I never would have made it through without them. The new one helps me remember all of these crazy requirements that we have to keep up with...the senior nurse answers all of my endless questions as my skills increase...all of those questions that you may not feel comfortable asking someone else.

So far, so good. Just keep a positive attitude. It has served me very, very well and has allowed me to earn the respect of my managers as well as the physicians...I am by far, not the most skilled nurse in my unit, however, when I have needed something from the management or staff or the physicians, I am rarely told no...because I have worked to earn that level of professionalism and willingness to learn AND I take constructive criticism well.

[Trina0606]

Wow...thank you for posting that . I have one year left of nursing school (i graduate May 2011) and I am already nervous about having to be that "new nurse" on a floor. I appreciate you sharing your experiences because it reinforces what many nurses I have spoken with during my clinical rotations have told me about how to survive the first year. Congrats on making it through and having such a positive attitude I hope to be like you one day !

[cncplus3]

This is a great post thank you so much, I am just about done with my orientation and feeling overwhelmed at times. I keep telling myself one day at a time and hope it gets better as time goes by. I know I will always have good and bad days but I am continueously learning every day.

[fiveofpeep]

thanks so much for the advice. I start my first night on my own (off orientation) this week and the advice was much appreciated :)

[Zookeeper3]

Ahhhh, you my wonderful nursing friend have got it:yeah:

Please save this, and write one each year, 15 years in you'll look back and be very proud of your professional growth. Now get out there and mentor our new nurses, you look like just the right person to do so:D