REAL World Of Nursing!

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Hello,

I am 28 days and counting from graduation. I am in my preceptorship senior experience in clinicals and I am still learning a lot of tips of success that you cannot get out of a textbook. Some stuff I picked up from my preceptor, others just from clinicals at different hospitals. I have some, but I was wondering if others could chime in with other things learned. I don't want to learn these things the hard way. Some tips learned are:

A unit secretary is very knowledgeable about the unit and can either be a blessing or your worst enemy.

Never talk about a patient in the hall. A relative may be right there. (Learned from preceptor)

I still don't know doctor etiquette. If there is such a thing. But my preceptor says that there are consequences behind standing up to a physician. Didn't mention what they were.

Nursing is 50% patient care and 50% documentation.

If you scratch another nurses back, they'll return the favor.

Lastly, I learned that I want a job with a supportive staff as a new nurses. I don't want to be afraid to ask questions or get help when I need it.

Thanks everybody!:wink2:

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Specializes in ICU/Critical Care.

I still don't know doctor etiquette. If there is such a thing. But my preceptor says that there are consequences behind standing up to a physician. Didn't mention what they were.

Consequences for standing up to the doctor? Are you serious? We are advocates for our patients. If I feel that I need to question a doctor, I do it. The patient's best interests are at hand. There is nothing wrong with standing up to a doctor. I have many times and have suffered no ill "consequences".

The problem is, is that doctors are put high on a pedestal because they are "doctors". Doctors and nurses should work collaboratively together.

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Specializes in Home Care, Hospice, OB.
the problem is, is that doctors are put high on a pedestal because they are "doctors". doctors and nurses should work collaboratively together.

when i was a new night nurse, we had one physician who didn't want any "just-a-nurse" having input on patient treatment. he wanted to decide, independently, on all care.

so...we would wait until he had just enough time to fall asleep after a delivery, and then page him for tylenol orders, call with "panic" labs like a hct of 33, or to request another bag of pitocin.

after a week, he got the message, left standing orders, and got a lot more interested in collaboration!:rolleyes:

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so...we would wait until he had just enough time to fall asleep after a delivery, and then page him for tylenol orders, call with "panic" labs like a hct of 33, or to request another bag of pitocin.

after a week, he got the message, left standing orders, and got a lot more interested in collaboration!:rolleyes:

:chuckle:chuckle:chuckle

that's creative!

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Specializes in ER, Infusion therapy, Oncology.

Don't ever be afraid to stand up to a physician if you are right.

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Don't ever be afraid to stand up to a physician if you are right.

Thing is, when you're new and inexperienced, you not really sure if you are right... unless there's a blatant, obvious error, a newbie will often not be sure if something is normal or not... yes, a newbie should stand up to a physician even if they just need clarification... but I think it's useful to acknowledge the difficulty of this when chances are that there is no problem (but you as a newbie don't know that for sure and so seek more information) and the physician (or other colleagues) may castigate the newbie for not knowing that something or for bothering them over 'nothing' and may even question the newbie's basic competency as a nurse... Sigh...

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I used to work with a doctor like that. If a newbie would ask him to repeat the order or have too many questions, he would make comments to other nurses that he found that person to be incompetent even after we explained that she was new. It really took a long time for him to respect new nurses.

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Sometimes it seems to be more than 50% documentation, unfortunately.

Also, scratch the backs of your aides. When the incredible day comes that all your work is caught up, of course try to help the other nurses but also, the aides. Helping an aide can really pay you back in spades.

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Specializes in Cardiac Telemetry, ED.

Lastly, I learned that I want a job with a supportive staff as a new nurses. I don't want to be afraid to ask questions or get help when I need it.

YES! If you are unsure, just ask!!!! New grads who DON'T ask questions are the ones to worry about!

Just to add to this train of thought, when you ask a question, never ask "What should I do?". Take the time to think it through, using the nursing process, and present your question as "This is the situation, here are the facts, this is what I think I should do, what do you think of that?". This will get you either a "BINGO! You're on the right track!", or "What about this (other thing you might want to think about)?". This approach of question asking will earn you the respect of your colleagues because it shows that you are *thinking* and developing your own clinical judgment rather than relying on others to do your thinking for you.

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Specializes in Medical/Surgical Unit.

Although I'm not yet a nurse, i work with many during the day on my surgical unit, but from what I see: it's better to ask a question and know than not know, help out the aides and don't assume we do all the hands on work (only from expierence, If i'm the only aid for 20patients, I won't be in all your rooms every hour), check in on your patient hourly(some nurses check only every 2-3 hours), be a team player! :)

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Specializes in Peds HH, LTC.

I agree with the other poster regarding the aides. Treat your aides well. They can either make your job a thousand times easier, or make your job hell. My girls know that they can ask me for anything, and when I need something they will help with no questions or attitude. This is especially helpful in LTC.

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Hello,

I am 28 days and counting from graduation. I am in my preceptorship senior experience in clinicals and I am still learning a lot of tips of success that you cannot get out of a textbook. Some stuff I picked up from my preceptor, others just from clinicals at different hospitals. I have some, but I was wondering if others could chime in with other things learned. I don't want to learn these things the hard way. Some tips learned are:

A unit secretary is very knowledgeable about the unit and can either be a blessing or your worst enemy.

Never talk about a patient in the hall. A relative may be right there. (Learned from preceptor)

I still don't know doctor etiquette. If there is such a thing. But my preceptor says that there are consequences behind standing up to a physician. Didn't mention what they were.

Nursing is 50% patient care and 50% documentation.

If you scratch another nurses back, they'll return the favor.

Lastly, I learned that I want a job with a supportive staff as a new nurses. I don't want to be afraid to ask questions or get help when I need it.

Thanks everybody!:wink2:

Can't say I agree entirely with these lessons. Never had nor seen a secretary being an nurse's worst enemy.

The reason you do not talk about a patient is not because a relative might be there it is because it is illegal period. What you are saying is comparable to "don't steal because you might get caught."

l

Discussing a pt in a public area where you could be over heard violates HIPPA laws.

As far as consequences of standing up to a doctor. It depends on what you call standing up. Many people confuse (simply because they never learned) assertiveness with aggression. Aggression will backfire as will passiveness or passive aggression. Learn to be assertive. Take a course on it while you are in school. It is a real eye opener.

Another lesson learn to evaluate lessons from others including this one.

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