Ten things I learned the first month on the job.

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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.

Specializes in med surg, ICU.

Very interesting and real facts u described.

Specializes in Geriatrics.

thanks for posting this!! I am on week 2 and feel so swamped. I have noticed that making check lists and post it notes have helped me A LOT. I feel like I always go home thinking about "what did I forget"

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