Tips for nurses in their first year of nursing

michellebsn · Mar 30, 2006

Thank you for your very wise advice! :nurse:

Yira · Mar 31, 2006

What are the major challenges for a foreign nurse in her first year in the U.S.?

Yira · Mar 31, 2006

I have at the front of the book acronyms which I find useful to assess patients, or which help me in my nursing practice.

THIS ADVICE IS GREAT

Yira · Mar 31, 2006

Never be afraid to ask questions, remember that nursing is forever a learning field.

transducen, BSN, RN · Apr 25, 2006

This Is Very Helpful, Would Like To Post It At My School.

NRSINGED KAREN, BSN, RN · Apr 26, 2006

I have a little advice also. I made a hugh mistake when I started my first job at a hospital as an RN. I went in with a professional, friendly attitude. I was treated like a doormat and had to repeatedly stand up for myself and prove myself. A little piece of advice is to go in with a very serious attitude, don't be too friendly until you figure out the underlying politics of the unit, and take notes as you are training so you don't have to ask questions over and over. I was trained by a preceptor who had never precepted before. Request that you have an experienced nurse train you who has had plenty of experience precepting. Don't let others get to you. You will become emotionally exhaused. Try not to become overly emotional and instead try to problem-solve. Hope that helps.

"That which does not kill me only makes me stronger." Wilhelm Nietzsche

rnsrgr8t · Apr 26, 2006

Greetings all!

I have been a pediatric nurse for 8 years and am now a PNP.

Here is some advice that I have:

1) Document, document document. If you did not write it down you did not do it. Don't worry if your nursing notes are long. There will come a time you will be glad that you wrote a "book".

2) Always ask if you do not know.

3) Read whatever you can get your hands on. Reference books, patient charts etc.

4) Keep attention to detail.

5) Always do the 5 Patient Rights every time you give a med. The one time I didn't, I made my one and only medication error.

6) Make a cheat sheet of the common drugs/lab norms/vital signs etc that you use every day and laminate it and keep it in your pocket.

7) Find yourself a good pair of hemstats and hang onto them. They are fabolous tools for all sorts of things.

8) Trust your gut. If your patient does not look right keep a close eye on them. Good physicians trust nurses who say, "I don't know what it is but they are just not right".

9) In pediatrics, always trust parents. They know their children better than you ever will. If they think something is wrong (even if they seem ok) they are probably right.

10) On the same note, if you have a child with a complex medical history (Spina Bifida/Cancer/Cystic Fibrosis etc) listen to the parents about their child's care. When I worked in Oncology, some of the parents I worked with new more about their child's disease than I did.

11) Be an advocate for your patients, always. You are often the only one they have.

12) Know who your friends are. Make sure you will have someone to back you up, especially if you have a run in with a physician. This is crucial, even if you are right, if your coworkers won't stick up for you it will not matter.

13) You should always have a little bit of anxiety. It will keep you on your toes.

14) You can do this job for 40 years and you will learn something new almost every day. The day you stop learning is the day you need to quit.

15) In a crisis/code, take one second and take a deep breath.

16) Be a team player, if you have a down moment, always look around and see who needs help, someone always will.

17) When you are learning to priortize and multi-task, whenever you have down time (even if it is 5 minutes) ask yourself, "What could I be doing rightnow?".

18) Whenever you are about to do a procedure (cath/dressing change etc). Bring two of everything.

19) Protect your back and your feet.

20) Take time to pee. I once went 14 hours without peeing, not good if you are prone to UTI's.

21) If you work nights, wear a digital watch that has a lighted face, makes it easier to do vitals in the dark in the middle of the night. A penlight is a must.

22) Until you learn the correct med dosages, always double check them before you give them. Doctors and pharmacists make mistakes too.

23) Don't forget to constantly reassess pain.

24) When asking a Doctor about a patient (especially in the middle of the night) get to the bottom line and ask your question. Have the patient's chart, weight, allergies and current meds ready. Also have a pen ready so you can take orders. I cannot tell you how many times, as a PNP, I go to give a nurse orders in response to their call and they do not have the information I need to help them.

25) Constantly monitor your IV sites. An IV can infiltrate quickly and it is very painful.

26) Learn from your coworkers example. Learn what you do want to do and learn what you don't want to do.

27) Let yourself laugh, cry, get angry etc. Just watch yourself around families and patients.

28) Learn to fake being calm and relaxed, even if you are screaming and freaking out on the inside.

Sorry for being so long! Hope this helps! Good Luck!

IttyBittyCritty · May 21, 2006

Can someone answer this... If a nurse makes a mistake, why do doctors get so upset. I understand the most important reason is the clients health. But, when we make a mistake isn't the nurses license in jeopardy and not the Doc's? Some things Just weren't explained in school. What are the possible consequences to frequent non critical errors made by a nurse ( besides being yelled at by a doctor?) What exactly is the rational for thier behavoir anyway?

Indy, LPN, LVN · May 23, 2006

My tips are probably more technical. I've noticed that things get stuck, and some nifty ways I've found to get things unstuck are as follows:

1. Vinyl or latex, doesn't matter. Gloves are fabulous for unsticking luer-lock connections that won't turn loose. This is most common after infusing prevacid or IV antibiotics. Those are nice sticky solutions and gum up the works, and you don't want to yank IV's out of someone's arm trying to get the line loose. Gloves are nice, kinda like the rubber pickle jar openers in kitchens.

2. When infusing IV antibiotics, say several times a day, I know the IV line is good for two days but I use a new line with a new bag. It's mostly because the stuff is all sticky and doesn't flush well, plus the connectors are probably gummed shut.

3. Central lines give me heck sometimes. When trying to change the needleless valves on the port ends, some of 'em feel like they were put on with an air wrench. Hemostat in one hand, gloves on. Gloves anyway, but see #1, and the hemostat is a lovely wrench. Works every time. I just try to use the hemostat for the end that's gonna be thrown away and not touch the port with it; plus I clean mine every shift.

4. New or almost new Tylenol bottles. Hemostats work for those too; I like to keep the ends of my fingers intact. Downside to this is that I've bent my hemostats; I'll probably keep this pair just for the tylenol bottles when I get new ones.

5. Opening ampules: yes, I wrap the top in an unopened alcohol pad to grip it with. Gloves would probably work but I haven't tried that yet. If I'm having trouble snapping them, getting slightly angry works.

6. For nights, always keep the penlight clipped to the pocket, not just floating in the bottom of whatever's in there. That way when you can't find something in the pocket, you don't have to turn on the room lights to find it.

sheba123 · May 24, 2006

Yes! that is what I needed to hear. I'm just browsing through, but when I read your thread I had to reply to it.

I'm not a nurse yet. I'm doing Pre-Clinicals, but you made me feel so different just by reading your words.

you're such a good motivator

Thank you!

sheba123:yeah:

justmanda · Jun 8, 2006

Please share any tips you might have for our new nurses. Hopefully, this will become a great resource of nursing tips from all of our experienced nurses from around the globe.

always wear a mask and goggles when doing trach care....the stuff that flies out of there during a cough is high powered. "Now here's spit in your eye"

justmanda · Jun 8, 2006

Don't forget to DRINK and PEE....you could throw a rock in a crowd and hit at least 10 nurses who have had a kidney stone.