Ten things I learned the first month on the job.

[ticklemenita]

1. Learning begins on the job. Keep reading and refreshing yourself with common diseases, medications, and procedures in your specialty. If you don't use it you loose it! So learn as much as you can from you preceptor and be sure to avoid at all cost the saying "But in nursing school, we did things this way." If you have a problem there has to be another way to say it. I personally have not said it but I have seen first hand how it puts a wedge between the preceptor and the new grad.

2. Always have a pen and paper ready if you put out a call to a doctor and try not to be too far away from the chart of computer. Likewise always get the first and last name of the MD and or ARNP calling with orders, and the time they called. I am sure you have better things to do to call the answering service back again and ask the name of the MD who just called =(

3. I try not to be jaded about pain but in two instances when I thought the patient was being a "drama queen" I was proven wrong. One ended up being septic with an absess of the hip and the other c/o pain at site of the lumber puncture and ended up being an absess there as well. So best advice notify MD of patient complaints of pain if unrelieved with medication, and cover yourself and note on the chart that the MD has been notified.

4. Round your charts as often as possible nothing worse than giving a med at 1100 and at 1000 the MD wrote orders to d/c that same drug. I like to check my charts often especially before giving medication. Pay attention to which doctors are looking at the chart and visiting the patient. This will save you the trouble of having to put out a call to them later. Now you can notify them of any concerns or ask questions. DON'T BE AFRAID TO ASK QUESTIONS.

5. You WILL make mistakes so try to have a thick skin about it. My silly mistake was telling the cardiologist that the patient has a UTI and his response was SO? If you don't know the doctors specialty ask. Not all white coats are created equal.

6. Be on time or ahead of time coming to work. I always get there early so I can absorb everything and get a feel of how my day is going to be. I find that my mornings are great but something always happens around lunch that throws me off wack. I am still not sure how to fix that yet. ANY SUGGESTIONS?

7. Ask for help. We don't have techs on our floor as a given sometimes we have one but they are busy. If I have 2 total patients I have to have a buddy help me move them sometimes or an extra set of hands while cleaning the hard to reach places. I do the same for them as well.

8. Be thorough but respect time. I started to realize I was getting sucked into the black hole. Thats when you get into a room and you can't get out. What is worse is... you do get out and five minutes later they call you back in. Sad thing is before I leave the room I ask them if they need anything and they say NO I AM FINE. I noticed this happens most often when the patient's family is not there. Sometimes patients will scream,yell, cry, and sob as if someone is killing them. I go in they are fine. I leave then it happens again. When the family stays NOTHING not a WORD. I think some are scared or lonely. So I just give them the phone and tell them call up their friends or family =)

9. A warm bath, clean linens, and a fresh gown can be a better sedative than medication.

10. Being a nurse is hard work, and often you won't get as much appreciation as you deserve. Don't let that stop you from being the best nurse you can be. Work hard and play harder. Do something nice for yourself. Now more than ever enjoy your friends and family who helped you through nursing school.

[quietpatty]

Thanks for sharing your experience. I haven't found a job yet, but it's always helpful to hear what other new grads learn during their first year of nursing. :)

[Nurse201007]

Great post!! Very informative, thanks for taking te time to write it!

[medicnurse68]

I have found it very irritating that I can't get a full time RN position, but yet see all the adds for nurses. Most places are not offering to train new nurses (that's what I have found) they want you to already have AT LEAST 6 months experience.

To add: make sure you cover yourself especially if you are in the "charge nurse" position because it will all come back on you - if someone you told to do something and they don't get it done for example.

[ticklemenita]

Thank for the feedback

[lioness1977]

In my first month of being on my own in Renal Medsurg I have learned.

1. Never believe when someone says: All the labs have been done or are ordered, they rarely are

2. Double check on all of your patients no more than 20 minutes prior to handing them off to the next shift they will inevitably be poopy

3. Sing a silly song when getting overwhelmed with 6 pts and a new admit during med pass time it keeps the crazy from driving you insane.

The good thing is I have also learned how to

Do complete Trach dressing on brand new trach alone &/ c CNA assist

Do Bladder & Zazzi irrigation

Wound care - big time

Smile when I go home and know I did the best I possibly could for 12 hrs.

By the way I love my job and wouldn't trade bedside care for the world

[hopefulwhoop]

The single most important thing I have learned since I started working last year is: DOCUMENT!

[elljayo]

fabulous post, thanks so much for sharing your experience.

re your question in #6: I find that my mornings are great but something always happens around lunch that throws me off wack. I am still not sure how to fix that yet. ANY SUGGESTIONS?

Sounds to me like it might be a food choice. A lot of time lunch makes me sleepy. I find more protein and fats, and fewer carbs, make a big difference in my energy levels. Also keeping myself hydrated. NO SUGAR!!!! some people do better with less protein, more complex carbs - so not saying i've got the answer for everyone - but that's what works for me. also, you may be eating something you have a food allergy or sensitivity toward. wheat gluten can be a real trigger for some, dairy for others. you see what i mean. Good luck with working it out. You might need to eat and take a short walk or something outside in the sunlight (see how little i know about real life work in hospitals? :) i assume you can actually take ten minutes for yourself and go out for a walk!)

[AzRnNeWgRaD]

Great post.

[volunteerpioneer]

I found this post VERY helpful. I'm finishing up my first month on the floor, dealing with 5 pts and I feel like I'm DROWNING.. Ontop of that I've been the only "new grad" on the floor for months, so everyone has mixed expecations.

It's always comforting to know I'm not alone, and to know others out there are going throught the same thing :)

[llg, PhD, RN]

Great post. As an old nurse who has helped to orient many new grads, it seems to me that you have learned A LOT of important stuff in your first month. Keep up the good work!

[koulett]

What a great post. This really is wonderful advice:nurse: