role transition...student to RN

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Specializes in LTC, Medical/Surgical.

I am a student and will graduate this December. My question is "what are common struggles that new graduates face on the floor?" I am excited and after precepting, I feel much more confident; however, I would love to hear about things to watch for, things to hold on tight too, situations to run from...all comments welcomed:)

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Specializes in Jack of all trades, and still learning.

Heck, there is so much! But...there are usually so many ppl that are willing to help. I'm not sure about the US, but many doctors here are helpful as well. Show you are willing, most ppl are appreciative of that. And read!

My problems?

  1. developing efficient time management skills - I am always conscious that I may be letting the side down (everyone laughs at me but that is me I guess)
  2. ensuring that I know my drugs, when to administer them, and when not to. Different hospitals have different policies as well
  3. learning about the whole process of nursing, from admission to discharge - working out when to involve allied health workers and ensuring that a patient has all possible requirements in place on discharge, especially if they are a dependent / confused person
  4. learning to cope with the different personalities I work with ie the less than friendly ones. Don't
  5. developing communication skills to both support your patients and their families. Communication also needs to be efficient, ie your time is money and you need to prioritise. Also, communication with doctors and allied health workers - what is the necessary information and knowledge to convey?
  6. prioritisation
  7. asking questions!!! It gets easier
  8. recognising that I am not expected to know everything especially at the beginning.

I wish you the best of luck, and really hope you will find it a great experience. What is a great feeling is suddenly realising that hey I am a registered nurse. But along with that feeling goes the responsibility, but we are all aware of that...

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Specializes in Med-Surg.

Great post above. I agree that prioritizing and time management are tough at first, as are critical thinking.

New grads also tend to be very sensitive, and when they come across a bad experience or person tend to be extremely hard on themselves, thinking they are stupid and incompetent, or hard on the nurses (judging the entire profession thinking we eat our young purposefully and with joy).

Asking questions is very important.

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Specializes in med/surg, telemetry.

Besides clashing with a few co-workers personalities, the hardest thing so far for me is being hard on myself. I can sometimes get frustrated with myself for not knowing something. Time management can be an issue as well. Seems no matter how I organize things, I seem to run out of time for certain things. I'm not sure if that's me or if it's my workload with still being so new. Even when we do screw up, so to speak, if you can walk away with having learned from the experience, that's a huge plus. Be proud when you do something well and give yourself a little pat on the back...sometimes those moments can come few and far between depending on the night (just do it on the run so you don't get behind in work...lol). Don't be afraid to ask questions. Most of my co-workers do understand that I'm not expected to know everything....and neither do they. Most are very helpful in answering your questions. The doctors that I have run across so far have not been that understanding, except for one in particular. With all the arrogant type doctors I ran into, the one that was actually nice and friendly that conversed with me was quite refreshing. Another thing I had to adjust to was a new schedule/routine because I took a night shift position (11pm to 7am). My body still hasn't fully adjusted to that change. Not to mention the change that has to take place within my household. I've had to release some of my parental duties that I handled off to my husband, which isn't really a bad thing, just difficult when you were the one used to doing everything. (I was a stay-at-home mom prior to starting college and now getting to work.) That's about all I can think of at the moment. Make to-do lists for what you normally have to get done during your shift and mark it off as you go. That way you don't go home wondering if you forgot to do something.

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Specializes in Med/Surg.

Remember that, dependant on where you work, skills/procedures might be done slightly different from how you were taught in school. Therefore, please, please, please check and actually read the facilities policy & procedures(P&P) BEFORE you do any skill/procedure/test/etc and then carry out the taks exactly how the P&P states to. Here's a non life-threatening example to explain what I'm talking about:

I am training a new LPN on my unit right now and last week he placed a foley cath in a patient for the very first time. Before we even entered the patient's room, I pulled up the hospital's policy on inserting a cath and was reviewing it with the orientee. It(policy) states that you must check the patency of the balloon BEFORE doing anything with the patient. When the orientee read that, he right away said "That's not how we were taught in school. The instructors told us that is not done anymore because of the risk for leaving the balloon partially inflated". Well, that might make sense & may be true as far as what's being taught in school(and it is at this specific school because I confirmed it with an instructor from there who had a clinical group on my floor; ironically, I also went there and was NEVER taught or told this), but it's not how the hospital expects the skill to be done.

Therefore, my point is that once you are employed somewhere, you are expected to do things according to that facilities policies & procedures. And if you don't, and something goes wrong &/or it ever comes up in questioning or an investigation on whether you did or did not follow P&P, using the excuse "I did it how I was taught in school" or "My instructor said xxx isn't done anymore even though this facility's P&P says it is" will not give you a leg to stand on. So CYA and do things right the 1st and every time!!!

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Specializes in LTC, Medical/Surgical.

I just want to thank everyone for the well thought and useful information. I was lucky enough to get a job where I precepted, same shift and everything. I love the staff and most are real helpful...perhaps this will take some edge off. I will review policies in detail before performing skills like central line d/c'ing, foley insertion, and blood drawns from central lines. I have heard how each facility varies. I too have problems with prioritization already and have never really had a real bad shift...I am sure it is coming though. In addition, I am the hardest on myself because all along, if I set high goals...I achieve them.

Again, thanks so much...this site is great and so very helpful!:balloons:

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