Tips for nurses in their first year of nursing

Nurses New Nurse

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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.

Specializes in ICU, telemetry, LTAC.

A few things I thought would help besides whatever I posted a while back:

Bag/line sets for feeding tubes: read the package. No, really. Then you avoid nearly losing your sanity when you try to fix it. Also, if it has a thing where you "set dose"- set the dose at either the amount that will infuse before your next residual check, or less than the amount in a can of whatever you put in the bag.

NG tubes, sump tubes, whatever you call them- there exists a little plug doololly to go in the blue end, if you hook it to suction, to let air out/in and keep the green crap from getting all in the patient's bed. I just don't know what it's called. It's blue and white, two prongs on one end and one on the other, about 3 inches long. It's a good invention! Lacking this, you could tie the blue end of the NG to something attached to the ceiling or the top of an IV pole, but only if you wanna flustrate the next nurse.

Dobhoff tubes. God those things are the devil. It's not entirely necessary to leave the stylet in for the xray to confirm placement, if they are weighted. The weighted end has metal in it and will show up.

Removing the stylet while the patient has a coughing fit, after you know it's in the right place, can cause the entire thing to be coughed up into the patient's mouth. Ugh. Again with these things, read the package insert as it has advice on what to put in there. Don't use the stylet to unclog the tube unless you have a very tranquil patient and you've already put warm juice and/or soda in it, and can feel it wanting to unclog, just not quite there- if you have to put the stylet in more than oh, 8 inches on an adult, just don't go any further, you ain't gonna get that clog out, not that way anyhow.

Pushing meds through a dobhoff using a syringe- for god's sake put your thumb of the hand that is holding the tube, on the little alternate port cover or you'll spray yourself in whatever you've got in the syringe. Potassium orange liquid stains wall paint. Jevity makes an excellent thing to dissolve meds in by the way, as long as it's warm.

Do not leave unused ports of a central line unclamped or suffer the wrath of the night nurse who needs to draw AM labs and the thing doesn't work. (Not only that, if the cap on the end breaks, the patient could bleed out.) Do not assume that infusing fluids into any line is enough to keep it patent, especially do not assume that if the fluids are sticky. Patients and their docs get a little upset if they have to put in new central lines for what isn't a very good reason.

With your thoroughly demented LOL's, try and figure out just exactly what they want and if it's not harmful to them or others, try to make it look like they're getting what they want. If possible. It'll save you time, aggravation and if you can arrange it, they get their meds and such. (It isn't always possible. But it's fun when it is!)

If your facility supplies things like ensure in the patient's kitchen... don't underestimate the power of a few calories on some of your elderly patients. Also, if your refrig has ice cream - ice cream, a fork, and some ensure makes a nice milkshake. Add a PRN tylenol and some LOL's sleep nicely. OH. If you have someone who's NPO except for ice chips and they're not at risk for aspirating, and they just happen to be tired of the flavor of ice: a half teaspoon of grape juice in that cup of ice and voila! flavored slushie. If they don't get it in their lungs and have no stitches in their GI tract, it's not gonna hurt.

More later....

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Specializes in NICU, PICU, PCVICU and peds oncology.

NG tubes, sump tubes, whatever you call them- there exists a little plug doololly to go in the blue end, if you hook it to suction, to let air out/in and keep the green crap from getting all in the patient's bed. I just don't know what it's called. It's blue and white, two prongs on one end and one on the other, about 3 inches long. It's a good invention! Lacking this, you could tie the blue end of the NG to something attached to the ceiling or the top of an IV pole, but only if you wanna flustrate the next nurse.

Those little plugs are called anti-reflux valves and they're great work-savers! The blue end has a hole in the plug part and the white end has a lot of tiny holes (vents) around the collar that connects the two parts together but a solid plug part. If you want to let air out but keep everything else in, the blue end goes into the tube (like for the salem sump). If you want to completely close the port then put the white end in (on sump chest tubes when ready to change to closed suction). Another little use I have for these is when I have a tiny peds patient with an NG for gastric decompression. We let gravity take care of any drainage and most of the people I work with put a specimen trap on the end of the tube using the silicon tubing to collect any green goo that might come up with the air. That's all well and good, but if the kid is prolifically pumping out green goo, it's going to leak out the other port of the trap eventually unless it's a sealed set-up. I cut off a piece of the silicone tubing about 1 1/2 inches long and put the blue end of the antireflux valve into one end then push the other end of my little piece of tubing down over the open specimen port. Voila, air comes out, fluid stays in!

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Specializes in Utilization Management.

If you borrow someone's penlight to do a neuro check, make sure you return it.

It's probably attached to her key ring. Her car key ring. Without which, she cannot go home.:omy:

'Nuff said.

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Peroxide removes blood (especially if you wear whites, not so sure it you want to try it on colors)

Keep in mind--Instructors do not hate you, they have to hold you to standards or else they are setting you up to fail in the professional world

Yes, you will find on clinicals that some staff nurses "eat their young", just let it roll off your back. In some ways it is a right of passage we all endure and it makes you tougher.

Put 100% into every single assignment, test, etc... Shoot for the top grades on everything. Not only will it make it easier on you come time to graduate, but if you ever decide to purse advanced practice your past nursing school GPAs are used as part of selection criteria.

YOU WILL SURVIVE!!!!!!!!!

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Don't correct your assistant nursing manager! Just bite that tongue off if you have too, let someone more seasoned correct her. There is nothing like a PO ANM!:angryfire Oh, she's shoving a foley catheter in an old guy's urethra, he's screaming and bleeding, SHUT UP! It will only end badly for YOU!

unemployed RN

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Specializes in Geriatrics,Primary Care,Cardiology.

Is the VA Hospital a good place to work, for a 1st year nurse?

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Specializes in Management, Endocrine, ER, Corrections.

Thanks for all the tips! I appreciate the time everyone took to type them up!

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As a recent graduate, I can assure you that asking questions not only enhances our knowledge as new nurses, but earns respect from other more experienced nurses that can and will be valuable allies and sources of support and info.

Hopping on the defensive or hiding a lack of knowledge will always come back to bite you.

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I well remember five years ago when I began my first year as a nurse on a Med-Surg unit with the patient ratio of 1:8. It was a frightening realization that I would be responsible for the care of these patients.

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Document EVERYTHING accurately, well and thoroughly. Stay late if you have to. Fill out every possible form. In my career I have had several incidences now of people trying to get me in trouble for no appearant reason, in some cases with flat out lies. What always saves my butt is documentation. Always do the right thing but more importantly, write it down after.

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I am also a student and we got the chance to attend a Board of Registered Nursing Meeting today. I think every srudent should be given this opportunity. One thing they stressed upon us was know and always follow your Nursing Pratice act, you are accountable for every decision you make as a nurse. If there is something you are uncomfortable doing get help:specs: . Never ever falsify documents NEVER!!:nono: Problems with substances get help don't risk losing your liscensure. Diversion programs can help you prevent that and they are in place to help those who may need it.

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:wtosts:Hi, I've just started a nursing job in a heart unit after qualifying a few months ago and to be honest I'm finding it a struggle to understand and remember procedures , how to read ecg's as well as handling cardiac arrest calls and also provide 100% effective and effecient patient care. I'm now questioning myself if this is the right career as I dread handing over reports due to my lack of knowledge and feel very intimidated and embarassed when more experienced staff have a go about something not done right. I know its a very busy ward but could someone please tell me it has to get better! I would appreciate and be thankful if anyone could advice me on how to deal with this overload of information and in particular the criticism I receive as I do find it stressful and my confidence is getting real low.

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