Transition from new grad to RN: What did you wish you knew?

[Florence NightinFAIL, BSN, RN]

When you were first hired into a unit...what surprised you about your job and responsibilities, especially pertaining to scheduling, union contracts, sick/vacation time etc. I'm not speaking about the nursing/patient care aspects but about your actual work as a whole?

What did you wish school taught you beyond diseases and nursing care?

[carebearsRN]

i wished that they taught us how to delegate

[LeaRNed]

I went from being a medical assistant to becoming a nurse. I really wish I had known that the charting and documentation was going to be more time consuming than the actual bedside care. One-on-one care is what I decided to become a nurse for. In the facility I work at right now it feels like documention is the most important. I am saddened by this.

[RNperdiem, RN]

I wish I had known more about doctors.

I didn't know an intern from an attending, didn't know much about their role beyond as the person to call with abnormal results.

I called too much at first until the nurses gave me some guidelines about what warrants an immediate call, a note on the chart, or a mention on rounds.

Secondly, I came to understood the importance of a good breakfast, since the next meal might be a long way off.

[K+MgSO4, BSN]

how hard or easy a family can make your job.

The neurotic family who won't leave and ask waaaaaaay to many questions and never let you get to do anything with your other patients, yet will not help their family member in anyway buzz to tell you they need the toilet and did not "want to do it as that is your job nurse" The helpful family who come in and translate for their family member, wash them and walk them to promote mobility and work with you not against you.

[SoundofMusic]

That honestly, my education wasn't going to go all that far. I was going to just have to put the time in and learn on the job. So much of it I just had to learn through DOING, through SEEING, through feeling, and through experience. I was so pressured as a new grad, feeling like I had to know it all -- this just isn't possible.

I also wish I'd known about how much nurses have to rely on each other. This didn't come naturally to me as I've always been independent, and in a corporate setting, you are more on your own. Teamwork is how you DO nursing. That just wasn't stressed all that much in school.

Come to think of it ...school really didn't teach much. I mean -- not about dealing w/ docs, about thinking critically, about the nature of nursing, families, patients and what is important to them. Had to learn it all on the job! Had to learn a lot about nurses in general, also -- the good and bad. Had a LOT to learn about time management -- how much you are actually expected to get done in a 12 hours period -- had I know all of that?? Hmmmmm, not sure I would have continued my nursing education.

I feel nurses really should start their training AT the hospital, on the job. Start them as techs in school -- teach them those clinical skills on the floor. Expose them to patients, not theories in books. Expose them to the hospital -- how it operates, all its functions and departments. This is a HUGE missing piece and as a new grad, you have such a steep learning curve to catch up on all of this. Why hire techs when they truly could just use nursing students to do the job??

And all of that work on the plastic dummies?? Worthless.

[emtb2rn, BSN, RN, EMT-B]

Interesting. All of the areas mentioned above were covered in my nursing school. Not only in class but in clinical as well. Guess I was lucky to go there....

Nursing school really gives you just a very basic foundation. That is, a glimmer of a clue. The job is truly learned by, well, doing the job.

[labdad1234RN]

I would say that the most interesting thing that I did not really prepare for is the impact of this new career on the family. Given the schedules, hours, and responsibilities, it was a difficult transition for my loved ones who were used to me me @ home in the old 9 to 5 world.

[wound warrier]

Just remember that you will never get paid as much as you think you should, and that nothing on the unit will go the way you think it should. If you remember these 2 things, then everything will be quite positive!!

[BellaInBlueScrubsRN]

I second all of the above.

Dealing with doctors. Know WHAT you want when you call with change in status, abnormal results. Have everything ready, because they will ask you any and every question.

Coworkers. Before graduating, I only considered my "peers" to be people my own age. I hung out with only people my own age. No one above 25. :) Every one I guess seemed "old". (Sorry! I never thought about it.) It was hard to think of someone in 30s, 40s, 50s as a peer to work with. I was 22! I'm used to it now.

Juggling all my patients. In school you have 1 or 2. On the floor you have 5. I knew it would be like that, they told us, but I wasn't prepared enough.

[sassy_cassie]

I needed to easy up on my expectations of myself and others. I still struggle with the fact that I can not always get everything I would like to done. My coworkers don't always do everything how I think they should either. In school everything has to be done to the instructors expectations, in reality things ae a little looser.