50 Things New Nurses Need to Know about Orientation

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. Nurses New Nurse Article

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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.

  1. You will be overwhelmed. Expect it.
  2. Nursing school taught you the basics, but orientation teaches you how to be a nurse.
  3. Always be honest with your preceptor.
  4. Don't be afraid to jump in and help if you are sure you know what you're doing.
  5. Answer bells. Always.
  6. Study the policies and procedures manual. They will come up at some point.
  7. Don't be afraid to admit you don't get something.
  8. Follow the watch, do, teach model of learning a new skill.
  9. Be brave when trying new things that are asked of you.
  10. You will have far more patients than in school, and this can be scary.
  11. Get a brain sheet that works for you, not just for your preceptor.
  12. Talk to your manager about how things are going in your orientation.
  13. Don't compare yourself to other new grads because people learn differently.
  14. Try to observe as much nursing care as possible, even if it isn't your patient.
  15. Rotate to other departments that impact your own to get a feel for the other side.
  16. You don't need to know everything the first day.
  17. Chart as you go.
  18. Let your preceptor look over your charting to ensure you are doing it right.
  19. Get to know your floor's education specialist.
  20. Take every opportunity to do mock codes or use simulators.
  21. Don't do everything yourself. Learn the nuances of delegation.
  22. Make friends with your fellow nurses and CNAs. You will need them.
  23. Your charge nurse is your friend. You will turn to them when you are alone and confused.
  24. Learn the most common drugs on your floor: generic name, actions, side effects, and so on.
  25. Take any classes or seminars you are offered.
  26. Be sure to go through your skills checkoff sheet, and ensure you are comfortable with the skills.
  27. If someone needs an IV started, volunteer to try.
  28. Spend a half shift with the same day surgery pre-op nurse to learn how to start a ton of IVs in a short period of time.
  29. Get to know your crash cart, how to work the equipment, and what is on it.
  30. Don't be afraid to ask for a new preceptor if you aren't gelling with your current one.
  31. Use your nursing textbooks to brush up on skills you are using on the floor.
  32. Take your NCLEX. NOW.
  33. Find a nurse that you admire and befriend them. Ask them to become your mentor.
  34. Learn the ins and outs of different shifts on your floor. You will be working them.
  35. Don't stay after every shift for hours on end.
  36. When you go home, spend some time studying, but mostly just rest.
  37. It's okay to cry in your car on the way home.
  38. Be prepared to hate nursing for a little while. This is normal and will pass.
  39. Learn how to use all the equipment on your floor: O2 nozzles, IV pumps, the bed, suction, lights, and anything else you use frequently.
  40. Don't increase your patient load until you and your preceptor feel you are ready.
  41. Get to know the doctors as well as you can so you can work with them.
  42. Don't be intimidated by cranky people: patients, doctors, coworkers, or supervisors.
  43. Try to memorize the most common extensions you use, like the lab, the pharmacy, other departments, and the most called doctors.
  44. Spend some time looking through the medical record online to keep track of recent orders, doctor's notes, and radiology results.
  45. Shadow the unit clerk for a day to understand how the medical data is inputted and processed for admissions, orders, and discharges.
  46. Get into the habit of reading the bulletin board in the breakroom for policy changes.
  47. Learn how to lift safely and always use correct lifting procedures.
  48. Decompress with other nurses to get your fears and triumphs off your chest.
  49. Don't freak out if you have an emergency on orientation. Your preceptor is there to guide you through and other nurses will almost always help.
  50. Take lunch, go to the bathroom, get off your feet, and allow yourself to breathe every now and again. We've all gone through orientation and survived. So will you.

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.

"But after 3 months of those, my preceptor said NO MORE, and we only took patients with lots of comorbidities, on multiple drips, etc., which are less familiar in PACU and require a lot more prioritization, critical thinking, and communication with the team".... @wannabecnl.....How long was your orientation? I will be starting med surg floor next week, and my orientation will be 6 weeks. Is that normal?

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Wonderfully awesome research work and putting it all on place here. Thank you for sharing. Really appreciable effort and knowledge.

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