Questions for a new nurse

ANH_RN · Mar 23, 2009

1. RN and I work in a busy med-surg/tele/oncology unit

2. Since August of 2008

3. Assess patients, implement plan of care, administer medications, monitor conditions.

4. Graduation from a certified nursing school. Ohio nursing license.

5. Being a nwe nurse myself I have learned its best to ask tons of questions and ask for help when you need it.

6. The hardest adjustment had to be dealing with time issues. I rarely had more than one patient in school and starting out with 4-5 patients was very difficult to adhere to. Still is.

7. People that are willing to help me, communicating with others about my fears and anxieties (just like getting on allnurses).

abanks9 · Mar 23, 2009

Thanks for the quick reply ANH RN. I worry about time management all the time. In clinicals I only have one patient at a time which I can do no problem. I watch the nurses on the floor juggle 4-5 and think, how will I ever be able to do that? It seems like time management training is really missing in nursing school. I"m hoping they'll cover it in our Leadership class in the last semester. Thanks for your answers.

Anyone else want to chime in?

MB37 · Mar 23, 2009

1. What is your title and what kind of unit do you work in?

Clinical Nurse, Cardiac ICU

2. How long have you worked in this unit/department?

Since November '08

3. What are your nursing responsibilities?

Provide total care for 2 critically ill pts per shift - we only occasionally have one tech for the entire unit. Some pts are on ventilators, many have Swan-Ganz catheters for hemodynamic monitoring, others have central and arterial lines. We titrate vasoactive drips regularly, and have to be proactive about calling MDs at the slightest change in a pt's condition. We also take care of pts pre and post cath lab interventions, and many return with sheaths still in place.

4. What continuing education and/or certification are required for your position?

We took a critical care course provided by the hospital before we started, and must get ACLS within 1 year of hire.

5. What advice would you give a new graduating nurse?

Ask tons of questions and be proactive about your learning on the floor/unit. Your coworkers are much more likely to help you adjust if it really seems like you care.

6. What was the most difficult adjustment you had to make from nursing student to graduate nurse?

Not having anyone to hold my hand anymore - I can and do ask my coworkers questions, but they're busy too. I have to think for myself, whereas in school I ran pretty much everything by the nurse I was working with that day.

7. What has helped you the most in making the transition from student to graduate nurse?

A very good orientation program, and coworkers who as a rule do NOT eat their young.

mcknis · Mar 23, 2009

1. What is your title and what kind of unit do you work in?

RN - Med Surg

2. How long have you worked in this unit/department?

3 yrs but only about 8 months as a new RN

3. What are your nursing responsibilities?

assessment,implement doctors orders, monitor acute changes (changes in VS, appearance, clinical condition, etc)

4. What continuing education and/or certification are required for your position?

24 hours of CEUs every 2 years; CPR, AED, ACLS (if desired)

5. What advice would you give a new graduating nurse?

Take your time to get to know what you are doing. Ask as many questions as you can in this short time and get to know your preceptor and rely upon him/her in this juvenile time. Take time to learn your meds/doctors/orders/procedures/labs/etc.

6. What was the most difficult adjustment you had to make from nursing student to graduate nurse?

Getting in the rhythm of the big change from one to another. The biggest problem for me was juggling the many problematic pts at the same time and going from 2-3 pts a student and being with them for about 5-7 hours, then going to at least 6 pts and having them for 12-14 hrs (while being in charge of everything for them in that time). Staying organized, functional, and beneficial to all is very important. Ever heard of Press Ganey's? You will within the first 2 weeks of being on the floor and how much we love about them!

7. What has helped you the most in making the transition from student to graduate nurse?

Going to my preceptor on many issues and not relying on myself for everything! Go to the nurses who have been doing this for 20-30 years and get hard core, great advice from them!

abanks9 · Mar 23, 2009

Thanks everyone for the great answers! It is great to get a feel for what lies ahead. I know I always cope better when I least have some idea of what to expect.

sin11899 · Mar 23, 2009

I am new to telemetry(6:1 ratio). Been a nurse for 2years on a sub-acute unit prior to this. Now I have this tele job and i'm scared to death, I don't think I can do it and I'm rethinking my whole career. I'm so scared to go to work, anxiety is sky high. Paranoid about making a wrong decision that may cost me my license. What can I do? Does it get better? Is this normal and will it pass?

PDXSammy · Mar 24, 2009

1. What is your title and what kind of unit do you work in? RN and Community Health Nurse, working at a county health clinic

2. How long have you worked in this unit/department? 2 months

3. What are your nursing responsibilities? advice nurse calls, walk in adult imms, triage provider paperwork

4. What continuing education and/or certification are required for your position? none

5. What advice would you give a new graduating nurse? Nursing school is for the true basics...real life is very different

6. What was the most difficult adjustment you had to make from nursing student to graduate nurse? Accepting the realization of the responsibility involved with being an RN

7. What has helped you the most in making the transition from student to graduate nurse? The awesome nurses I work with and my supervisor. They encourage me to ask questions and want me to be involved in their procedures. They're complimentary but don't sugar coat anything. As a new hire/new RN, I'm required to have tasks witnessed and 'checked off' before I'm given a provider schedule. Because the MA's do most of the walk in IM's and the lab does the draws, my supervisor volunteers to let me do injections and phlebotomy on her to get the tasks done and approved. I couldn't ask for a better first RN job! :yeah: :offtopic::Crash:

emtb2rn, BSN, RN, EMT-B · Mar 26, 2009

1. What is your title and what kind of unit do you work in?

RN. Emergency. 50 beds.

2. How long have you worked in this unit/department?

Started orientation in 1st week in August '08. Came off orientation Thanksgiving week '08.

3. What are your nursing responsibilities?

Assess, tx pts per MD/PA direct orders & standing orders (IV, meds, labs, etc) reassess to ensure tx are effective, intervene as necessary, educate pts & families as needed, d/c pts including education, perform admission assessments whenever possible for those pts being held for the floor/unit, code team for med floors above ER & the main lobby, take orders from admitting MDs and/or surgeons, give report to floor/unit RNs and get the pt outta the ER. And oh yeah, chart everything. That's kind of the overall gig.

4. What continuing education and/or certification are required for your position?

Beside's the state's requirements for all RNs, we took a critical care course (ENA) during orientation as well as a telemetry course. We need 4 stroke specific CEU's per year, BLS, ACLS, PALS, plus we get a least 1 CE handout with a test to handed in per month (i.e., Feb was conscious sedation, this month was our in-house triage & acuity model). And while CEN is not required, it is strongly recommended and encouraged.

5. What advice would you give a new graduating nurse?

Ask questions, be flexible, have fun with the job.

6. What was the most difficult adjustment you had to make from nursing student to graduate nurse?

Getting organized. That is, time management. I'm much more efficient after 6 months and expect to continue to improve as I gain experience.

7. What has helped you the most in making the transition from student to graduate nurse?

My preceptor did a great job teaching me the ropes of the ER and then the on-going support and patience of my co-workers (RNs, MDs & PAs) in answering my questions and understanding that I'm a newbie and learning the job.

Hope this helps.

abanks9 · Mar 26, 2009

Thanks everyone for the great responses.

PDXSammy-I really appreciate the input from a nurse who decided to do something different than the hospital setting. I see myself in a community health setting at some point in the future.

emtb2rn-I've really wondered about Emergency since I spent the night in one recently with my grandma. I was so impressed by her nurses's skill level. Thanks for the input.

KalipsoRed · Mar 26, 2009

1. What is your title and what kind of unit do you work in?

RN, BSN - Telemetry/Cardiac Stepdown

2. How long have you worked in this unit/department?

Since June 2008

3. What are your nursing responsibilities?

Reading EKG strips, med passes, wound care, chest tube management, foley's, rectal tubes, IV therapy, check labs, call physicians.... Basically I take care of patients after they've been in the ICU for a day of post op. My patients are usually open hearts, thoracotomies, and such. I have an interesting combination of respiratory and cardiac issues. I have a lot of patients with diabetes issues, cancer, post heart attacks, COPD, and so forth. While we do get patients with other issues not related to pulmonary/cardiac on occasion, this is the majority of our population. The one great thing about my floor is that we try to keep it "clean" because so many of our patients are post op, thus I don't have to deal with as many isolation rooms.

4. What continuing education and/or certification are required for your position?

I had to take and EKG course and an Essentials of critical care course. I have to do 12 hours of continuing education a year and I will have to take ACLS next year.

5. What advice would you give a new graduating nurse?

Just because you may want to be a critical care nurse doesn't mean it is such a great idea to start in that area as soon as you get out of school. The difference between school and reality is vast. Imagine school as a child...an infant really. Imagine school being that time where you learn to roll over and start crawling on all floors, then you get in to the real world and they expect that you are already capable of running a mile. It pretty much is a crappy deal. Make sure you go to a hospital with a long orientation, hopefully a fellowship if possible. Ask your manager how she plans to help you in your first year and what experience she/he has with new grads on their floor. Accept bonuses, but DO NOT use them. Put them in a savings account so that if you absolutly hate your job or situation you feel like you have the freedom to leave. Be prepared to hate your job for 6 - 9 months after starting.

6. What was the most difficult adjustment you had to make from nursing student to graduate nurse? Time management, the responsibility of people's lives totally in my hands, getting walked on by others because I was trying to be helpful. Only help others if you have the time unless it is a true emergency, otherwise do your stuff first.

7. What has helped you the most in making the transition from student to graduate nurse? I got a psychotherapist.

JazzyNursie87 · Mar 27, 2009

1. I'm a newly Registered Nurse, and I work in a Medical/Cardiac ICU in a teaching/university hospital.

2. 2 months

3. In general, to keep the patient safe and do what I can to aide them in returning to wellness. I deal with patients on ventilators a lot. We have to have special training to deal with CABG patients, but we have alot of post-MIs. There is a trauma/surgical/burn ICU..who deals with people that are broken and have cuts, etc..but are usually pretty healthy otherwise. There is a neuroscience ICU who deals with head injuries...and there's us...we are the ones that pretty much get everything else.

4. I think I have to have 30 CNE's in two years...or something like that.

5. Be assertive with your new nursing career. There is a good chance that a career won't be handed to you on a silver platter, even though nurses are in high-demand. I had to call the director and ask for an interview...and I'm more than happy that I did. Also, realize that it's okay to be scared and feel like you don't know everything. The learning starts when you get on your unit...nursing school just gave us a good foundation for the future.

6. The NCLEX was incredibly stressful. There is so much pressure.

7. Honestly, family and friends have been there throughout. That has been the best help for me.