Old Grad/New Nurse

Seaofclouds, BSN, RN · May 2, 2015

First off, congratulations on the new position! The first year is the roughest, but you can get through it. I always go in early so I have an opportunity to prepare myself. I review my charts (orders, H&P, progress notes), write down recent labs and make note of any labs pending, and write down what times I will have meds to give, vitals to complete, and any other treatments I'll have to do. There are a lot of ways to organize a report sheet to include all of these things. As you are just beginning, it will take some time to know what works best for you. Don't be afraid to ask questions. Take some time to get to know where everything is, even if that means coming in a little early one day just to familiarize yourself with the supply room. Be proactive as much as you can about your learning. Find out where you can see all of the policies and procedures (probably on the computers somewhere). That way you know where to find information should you have questions later. Good luck!

_firefly, BSN, RN, EMT-B · May 2, 2015

Your first tasks will be to just learn the environment (computer system and charting, phones and phone numbers, where to find supplies and equipment). A huge part of nursing is just getting people what they need which includes making a lot of phone calls and doing a lot of walking.

The next tasks will be developing an efficient workflow. Once you have computer access, come in 30 minutes early, find out which patients you will have, review their history, the task list, orders, and scheduled medications. What diet do they have? Will they need regular neuro checks or blood sugar checks? The trick is to cluster tasks and care so you aren't making 35 trips in and out of each room. Consider hourly rounding and each time checking the five Ps (pain, potty, position, possessions, and any iv pumps to change bags early as needed). Stock up on alcohol wipes and flushes early and often. You want to keep those IVs clean and well flushed. You will get a ton of calls and interruptions throughout the shift so keep writing down what needs to get done and crossing off what is done. Chart early and often so you're not stuck doing it all after shift.

You'll have time to ease into all of this. Just breathe and realize you will often not have time for everything and so you just prioritize, multitask, cluster, delegate, and ask for help. Always ask questions. Ask lots of questions so you don't make mistakes. And use your resource and supervisor if you need something whether that be witnessing, starting an IV, or taking a discharge. Find volunteers and involve them. There are a lot of resources. You are never alone. If a patient looks like they are starting to be in real distress or becoming inconsolably hostile, you just call the appropriate code. Nursing is all about teamwork. You'll be just fine as long as you focus on communication.

strive2Bbetter · May 2, 2015

thank you sooo much. it helped relief some anxiety. and will definitely take your advice!

strive2Bbetter · May 2, 2015

thank you! I'm just as excited as I am nervous. but you helped me ease some of my nerves. I will take everything you've said and try to make the most of it. I just feel so much better.

RNKPCE · May 2, 2015

Get a paper brain and use it, if it isn't working try another one or tweak it so it works.

Try to combine tasks when you can. If your patient has to use the restroom use that time to walk them, half the battle is getting out of bed. As a new grad I saw one nurse washing her patients back and listening to their lungs at the same time.

Seek out organized people on your unit and ask them for tips.

Don't be too hard on yourself. Even experienced nurses get behind some days.

If you have to call a doctor make a list of things to ask so you don't forget an item. Anticipate what orders you might get from the doctor.

strive2Bbetter · May 2, 2015

Thanks! I got an email from my educator with a paper brain. do you have a template or know where I can find one? maybe on Pinterest. that idea of washing the back and listening to the lungs is a great idea!