Nervous new grad

Double-Helix, BSN, RN · Apr 23, 2011

Your nerves are normal and healthy. You are NOT the only one. There is no way that you can learn to be totally comfortable with all nursing skills and meds during school. You will continue to develop your skills in your first years of practice (and probably forever). In fact, many people will tell you that most of your learning comes after graduation. Have you passed boards yet? If you have, congratulations! You've proven you know your stuff!

A big part of nursing is knowing how and where to access needed information. You never have to guess at or remember everything. If you forget how to do a skill, your hospital will have policies and procedures you can access to find out the steps. You will also be working with a team of other nurses who can answer your questions or demonstrate skills if needed.

Finally, your biggest resource- a drug book. There should be one on your floor, but you can also get your own and bring it to work with you. The drug book will tell you push times, drip rates, compatability, dosage limits, indications, side effects and more. Consult this whenever you have a question. Many hospitals also have online drug guides or software that you can access right from your computer.

As for juggling patient loads- that is a skill you will develop for years. Some days, your day will go great. Others, your patients will have complications and you feel like there is no way you can get everything done. That's okay. Flexibility as a nurse is very important. Again, use your resources and ask for help. (Remember to be willing to help others when you can!)

Orientations vary based on the hospital and the unit. For a new grad, your orientation is usually longer. For specialty units, the orientation may be longer too. (ICU can be 3-6 months, OR can be up to 12 months.) Typically, you are assigned a preceptor (an experienced nurse) for your orientation. The first few days are spent with her/him, becoming familiar with the layout of the unit, the supplies, the typical patients, the procedures, and the documentation system. You might also have lecture-type classes or spend some time with the nurse educator. Then, you slowly build up to taking a full assignment. You'll start with one or two patients, and work up to the typical patient load for the floor (4-6 patients for a general floor, less for ICU). During that time, your preceptor usually does not have patients and is available to help you.

You're going to be fine! Just remember that it is okay to ask questions or need help. Get to know other nurses on the unit, make friends, and find a few who are good mentors. Don't ever guess at something because you don't want to/feel to busy to look it up or ask. That's how mistakes get made. Remember that just because you graduated nursing school doesn't mean you are supposed to know everything. Your development as a nurse is a process. You are still learning and growing!

Ashley

birdie22 · Apr 25, 2011

I just landed a job as a new grad, so I, too, worry about the exact things you mentioned.

Every hospital is different re: orientation - but in general, you are paired with a preceptor for X amount of weeks - and just as Ashley. During that time, its your job to watch, learn, and listen to what they tell you to do.

Don't be afraid to ask for help. Also, try not to sweat the small stuff. It's not reasonable to remember how fast to push every IV med. I remember my clinical instructor asked me that question once, I simply told her that I had absolutely no idea, but I push everything slow (generally speaking), and will go and look up the answer. You arent expected to know everything - but rather, show people that you are willing to learn.