SHOCK of reality nursing vs Nursing School

Valerie Salva, BSN, RN · Jan 25, 2008

I am in my 18th year of nursing and still going through reality shock!

Best of luck with your project.

PurrRN · Jan 25, 2008

:hehe:

Okay now, I'm not looking to scare the heck out of myself before I even graduate!!

:rotfl::plsebeg::rotfl:

mh356, BSN, RN, EMT-B · Jan 25, 2008

I think it really depends on the type of clinicals you had in nursing school. My critical care clinical was on a tele floor so I was totally unprepared for a trauma stepdown unit with 3-4 high acuity patients. In our clinicals we had 2 or 3 patients at the most. As a nurse I have 4 or 5. You never get a chance to research your patient the night before or spend hours reading their chart.

Getting organized is the biggest challenge, which I never realized as a student. I wasn't aware of all the small things nurses had to do all day long. And also learning all the skills, because its one thing to practice on a plastic person but its another to actually do it on a real live person. And then they expect you to do it like you were born doing it!

I hope that helps.

shellsgogreen · Jan 25, 2008

i think my school prepared me as well as they could - when i was a student, i was consumed with testing and grasping procedures and spending loads of time with a single patient, so i suppose the biggest adjustment would be the full patient load, and figuring out a routine that works - almost like a juggling act :bugeyes:

some days are so stressful, my head spins and then there are good days.

good luck w/ your project

:up:

NurseRatched67 · Jan 26, 2008

What has been the hardest thing for you to adjust to in your role as a new nurse vs. what you thought as a nursing student?

A few things. 1. The physical and mental exhaustion at the beginning of your career in nursing. The toll on your legs, back and feet will surprise you, not to metion the varicose veins if your not careful. Mental exhaustion comes from always feeling like you are in over your head for the first 6 months at least. This is normal. Confidence will come with experience and that takes time. 2.) Time managment- nursing schools give you book smarts, but not a realistic idea of how to actually be a nurse from 7a-3p, 3-11 or 11-7a. Experienced RN's would love nothing more to sit down and actually spend more time with our patients and asking them all of those "open ended questions" we are taught in school. The unfortunate reality is that I usually don't have alot of time to sit and ask a patient "How does that make you feel?". You have to learn to manage multiple patients with sometimes great time needs, computers and charts that are confusing at best, medication needs, phone calls, family questions, covering other patients for lunches & breaks, dealing with MD's, residents, CNA's questions and concerns etc. 3) The dreaded "jaded" feeling. Every student comes out of school full of pep and ideas and thinks "I'm going to be the best nurse I can be and change the world if it's wrong!". I applaud that attitude, however it must be tempered with a bit more reality. For instance, if I don't like the way something is done on the floor at my hospital, then I must go through no less then 9 different people/departments to get heard. You will run into more politics and protocol then you can ever imagine. Be prepared to make change, but know it's going to take alot more then just a good idea...it will take persistance.

Was there indeed a "shock" moment where you thought "this isn't what I thought it would be"? And Why.

Sure, we all have had at least one. Mine was when I was a new nurse and working on an L&D floor. No matter how much you've been told that L&D won't always have "good" outcomes with patients, you never really never know until you experience the death of a pregnant patient or baby. There is nothing harder then seeing a newborn die and realizing that no matter how much you know, how much you do, how much doctors know and can do...some things in life are just downright unfair,cruel and out of your control.

How difficult has the adjustment been for you?

I've been a nurse for over 14 years, so my responses are based on how I felt my first year out. The adjustment was difficult for the first 6 months. After that it became familiar and more comfortable. There are big personalities everywhere to deal with, that was the hardest road to navigate. I kept my mouth shut pretty tight for the first few months. I gave everything and everyone a fair shot and always had a timetable in my head to leave just in case I figured this was not for me. I didn't leave and worked there for 3 years before I became interested in a different field.

Do you think nursing school did enough to prepare you for the role transition you were faced with in the very beginning of your new career?

Sorry to say this to all educators, but no. I'm not sure if the problem lies squarely with them alone though. For example: Probably 8 out of 10 nursing students will go into first time jobs that require a certain skill set. One skill being IV starting. This was something that we were not taught, nor allowed to do during any of our clinicals. During my schooling we spent one whole semester learning how to make beds and how to talk to patients. I think most students can learn how to make a bed and give a bed bath in a few days, rather then a semester. Also, having assignements like sitting with a patient for an hour or two is so far from reality that I feel like teachers are "setting" students up for the shock of real nursing.

Clincals should be focused on improving the day to day skill set needed for new nurses to feel more confident. Talking to a patient is great, but I feel schools are missing the boat on assessment skills. It's important that I know about a patients anxiety level, but in reality I have to be even more worried that they are not allergic to the medication ordered, or if their blood type is correct during a transfusion.

Today's real world needs nurese who are organized, skillful and confident. Give the nursing students correct instruction and experience on skills they will be using everyday and you will give them confidence.

Nothing more exciting then a new grad on the floor who comes in with an "I CAN DO THIS" attitude. That comes from confidence.

cubby1969 · Jan 6, 2011

Hi I'm in my last quarter of nursing school and need to

"Talk with at least 2 nursing graduates who have been working as nurses for anywhere from 3 months to 3 years. Ask them about their socialization to nursing after graduation. Did either of them experience reality shock? How long did it last? Did they recover from the shock? If so, how?

I would appreciate any responses that you might have.

Thanks in advance!!