New Grad, New Job, New Role - Advice?

[86711lh]

Hi all, I am a new grad recently graduated in December, passed my boards in Jan and will now be starting a job on a surgical/trauma unit come February. I am extremely nervous, anxious and excited all at the same time! I have been a PCA(nursing assistant) for about 7 years now so I have hospital experience. The transition from PCA to a RN is frightening! I was wondering if anyone had any advice for me about things I should know, what to expect, or even experiences as new grads etc etc. Thanks for any input!

[CrazyCatLadyRN, BSN, RN]

Ask lots of questions! My preceptor always told me if you aren't asking questions I get worried. I graduated last spring with my bsn and have been on a surgical telemtetry unit since June. It's challenging, but you learn a lot with surg pts. There are so many body systems affected by surgery and there are also a lot of things that can go wrong. Last night I had 2 post op hemmrhoidectomy pts which seems like a simple procedure and one went into acute resp failure with respirations of 4 and high co2 and wound up on a bipap. The other have awful urinary retention and we had issues getting a catheter in. Once we got it in he drained 2400 cc! And those were just 2 of 6 pts. You'll learn a lot! Good luck.

[awheat]

An issue I found with change from PCA-to-RN status is that the nurse is too hard on herself. You say "so I have hospital experience", and you do, and it is valuable. But, it is completely different when you are the one the PCA is coming to, reporting an abnormal situation that needs to be addressed immediately, and you are trying to get report on your other 4 patients, and a physician is on the phone, and your charge nurse just gave you an admit. It is overwhelming at first, and you think to yourself that you have experience, and know what it is like, and why can't you do this like the super-nurse you have always thought you would be? You need to be gentle with yourself. Realize you are new to this. Like CrazyCatLady says, ask, ask, ask! Stay enthusiastic and idealistic, and do the best you can, but know there are days that will be overwhelming, and that is OK. Your shift will end, someone else will take over the patients, and you will get to clock out and go home (and cry if you need to). Best of Luck!!!

[alwayskatiek]

I agree ask questions. But I would also say learn to delegate! I was an ED tech in school but a lot of my classmates worked on the floors. They seemed to have a harder time letting things that could be delegated, like changing a patient, be done by a tech when there are things that only a nurse can do that need to be done at the same time. I always keep in the back of my mind when I have multiple things to do, who else could be doing this task for me. At the same time, you have to remember that the techs are your eyes and ears, as I'm sure you know, so helping them out when you have the time, makes for a better relationship. Another person to make a good friendship with is the unit secretary. They know a lot, how to get some thing, and who to ask a particular question. Good luck!