The thing that has surprised you the most about nursing...

[er.mere]

I am about to graduate from nursing school and look forward to getting my first nursing job (fingers crossed). In preparation, I was curious about what the most surprising thing has been for others when starting their nursing career and how to best prepare to start a job. Any thoughts or advice?

[mmc51264, BSN, MSN, RN]

I was surprised by the lack of "lifelong learning" by more veteran nurses. I have been on my unit for a little more than 2 years and I am checking people off on skills that they should have already been doing and a nurse of >20 years. Stupid stuff like deaccessing a portacath or the proper way to do a naso-pharyngeal swab.

Rare, but it happens.

[Ayvah, RN]

I never realized how much of a "safety net" nurses were. Its hard for a lay person (before nursing school) or even a nursing student to understand.

We are the last step before a treatment or med reaches the patient. Policing orders between several consultants and monitoring trends/labs - requires a lot of skill.

Agreed. Coordinating care and babysitting every single department to make sure they do their job is a huge part of nursing. For example, I got a talking-to when my patient went down to xray and xray didn't do the image because the patient was moaning, but xray never called me to tell me they weren't going to do the image, they just simply didn't take the image. The patient was moaning due to dementia, not due to pain.

One other thing that surprised me, probably due to being young and naive, was that hospitals are all about the money, and patient care is far down on the list. They will do things like frivolous write ups to get rid of older, more expensive nurses. They will cut staffing to bare-bones, unsafe levels. They have no problems putting nearly new grads in charge. If you have broken equipment, they won't replace it and expect you to get by. They will cut funds from training and put it to PR instead. Etc, etc. Look out for yourself because your hospital won't.

[Farawyn]

That Pain is DEEP. Soul suckingly so. I never knew people could be in such pain.

[Libby1987]

I was pretty well prepared in nursing school and with the extern program. My surprises came later in my career..

The level of acuity we would later see in the home setting and the changes in the nurse/provider relationship. There has been some switch that has been flipped there, for the better but never expected to be given as much credence. Nor the willingness to get on the phone to discuss HH patients. The frequency of providers that call me directly on my cell (without palpable annoyance) is something I never thought in my earlier years. Good thing though with the increased acuity.

[BrandonLPN, LPN]

That Pain is DEEP. Soul suckingly so. I never knew people could be in such pain.

Which pain?

[brownbook]

I was shocked when veteran nurses would say....."I don't know that either." (Usually, hopefully, followed by let's find out, or ask Nurse Nancy, she has used it before.)

I thought veteran floor nurses were supposed to have magical power, super brains, and know every drug, every dose, how every piece of equipment worked, what every terminology meant, etc. I thought I was the dummy new grad who didn't know anything.

I missed out on a lot of learning because I was embarrassed to say...."That is new to me, I don't know about it, can you tell me what you are doing." Most co-workers, technicians, Dr's. love to teach, are proud to show off their knowledge. You cannot learn it all in nursing school!

If you are getting someone to help you ask the patient if it is okay with them if you have Nurse Nancy help, or watch Nurse Nancy do it so you can do it next time.