Orientation is meant to get a nurse ready for life on the floor, but it can be a gut check that nursing school is not. It is a culture shock and hits everyone differently. If you are going through this, will go through this, or remember going through this, then you should read this article.
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I can't stress enough the use of a brain sheet and getting down a way YOU like to organize your information. I had a brain sheet and would make notes on it then highlight things as I charted it. Then I knew what was and wasn't charted yet.
Also the not getting intimidated by cranky people. There are some doctors who just don't....get it. They are cranky and can be mean and may make you cry. The other nurses know what they're like so just do what you can.
AND take some time if you need after your first death. I still remember mine. I had to go spend some time in the bathroom. It was very unexpected but she was a DNR. I had just given her Lasix about 30 minutes before (and she was talking and visiting) and one of the docs had just seen her right before the Lasix. He was baffled along with me. I started tearing up in the patient's room and I had family comforting ME. You can't save everyone. Unexpected things will happen. Just take the time to deal with it.
One of the things I fear as a new grad is communicating with and calling doctors. That's not a skill they teach you in nursing school. Does your preceptor address this skill? Or are we expected to figure it out? The newer and younger docs coming out of med school seem to be more friendly and cooperative than some of the older ones (there are some nice older ones too though), so maybe the whole "mean doc" thing is dying more these days...
H4ywii said:One of the things I fear as a new grad is communicating with and calling doctors. That's not a skill they teach you in nursing school. Does your preceptor address this skill? Or are we expected to figure it out? The newer and younger docs coming out of med school seem to be more friendly and cooperative than some of the older ones (there are some nice older ones too though), so maybe the whole "mean doc" thing is dying more these days...
Learn how to communicate using SBAR when talking to anyone and everyone; being straight to the point has helped with ANY doctor.
Sticking to SBAR gives the message, even if the person reviving the message is receptive, snarky, whatever.
Even in the Ed where there are multiple docs to go to, I have learned to always go with a recommendation. Sometimes the doc discounts it, and gives/doesn't give another order. We are really team oriented so I can always ask why. I usually receive a great teaching moment.
When I don't I bounce it off another more experienced nurse. At that point I either get a teaching moment or we go back to the doc, and they get a teaching moment. I work in a teaching hospital so nobody really looks down their nose at people asking questions, unless it's the same question for the third time tonight...
BSN GCU 2014. ED Residency
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Don't accuse the preceptor of not following nursing practice unless it's super flagrant and you are sure you are correct. Even though you think you learned everything in school, do not treat your preceptor like she's done something illegal because you didn't know the real life application.
Don't tell the orientor that she doesn't know what she's doing. Just say ok and approach a manager or DON later about your querie in a non accusational manner.
H4ywii said:Thanks! I'll check those out and start practicing from the get go so I'll have SBAR communication down pat as a habit!
Another bit of advice I have when contacting doctors is check a recent set of vitals before you call, because they will probably ask. And don't just check heart rate or blood pressure- "check one, check 'em all."
Be kind to your feet, you are going to need them! Compression stockings are not just for patients, buy a few pair, and wear them. Never go to work a 12 hour shift with only one pair of shoes! Changing shoes half way through a shift gives your feet a break and feels really really good!!
This article and the below comments are very helpful. I've been nursing for about 7 months but I haven't had time or proper orientation. So I'm trying to use the current facility and learn as much as I can although it's not a great place to learn honestly. This will definitely help me a lot and future new grads, preceptors, and job changing nurses.
Thankyou for this article I am a new grad just finished my second day, on a busy acute ward. And honestly I feel useless, I had 5 pts and needed help to get get everything done, when i was a student everyone used a shift planner which beame my little mini bible for the shift but here no one does and they look at my strangly when I go back to look at it. DOnt get me wrong I am thrilled to get this grad yr, but I feel like I have more spent more time the last few days worrying about things i need to do than doing it, any tips would be great!!
Lil_chicken said:Thankyou for this article I am a new grad just finished my second day, on a busy acute ward. And honestly I feel useless, I had 5 pts and needed help to get get everything done, when I was a student everyone used a shift planner which beame my little mini bible for the shift but here no one does and they look at my strangly when I go back to look at it. don't get me wrong I am thrilled to get this grad yr, but I feel like I have more spent more time the last few days worrying about things I need to do than doing it, any tips would be great!!
So WHAT they look at you strangely; have the confidence to use it for YOUR benefit; so continue using your brain sheet and if you get everything done, great...remember it your practice on the line; no one else can do YOUR nursing practice for you.
New nurse orientation is one of the most eye opening experiences in becoming a nurse. You shift from being coddled to experiencing what the real world is like. Even nurses who change jobs have difficulty with orientation because nursing is so detail oriented. If you are a new nurse or a nurse changing jobs, here are some tips for making it a little easier.
Does anyone else have orientation horror stories or tips for new grads? Every bit of encouragement helps, so if you can think of something this list failed to mention, please post it in the comments. It may help a nurse adjust to their new surroundings.
About Lynda Lampert, RN
Freelance Medical Writer
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