Transition from School to Real Working World

Virgo_RN, BSN, RN · Nov 24, 2008

Your feelings of insecurity are completely normal. My advice is, don't put the cart before the horse. Just focus on your schooling right now, and don't worry so much about the future.

RedhairedNurse, BSN, RN · Nov 24, 2008

You just learn from experience, that's all I can say really. I forget things, but I also work with stable pts. I also learn things from reading this website. Just today I read a post about giving O2 to a COPD pt. I remember learning about it in school, but I totally forgot about assessment regarding this situation. I think it's good to start out in medsurg with stable pts instead of an ICU.

You'll be fine. It's amazing how much you learn while on orientation. If if you work on a hospital floor, there will always be experienced nurses to ask when you're unsure of something. I still ask and probably will continue to ask for years to come.

kcalohagirl · Nov 24, 2008

I've been working for 2 and a half years now. But believe me, I still remember what it felt like to be a "newbie"!!

I also came out of a BSN program, tho not an accellerated one. I think you will come out of your program with a whole lot of knowledge, but one of the weaknesses of the accelerated programs (as I have been told by my unit educator) is that a lot of times, the students lack clinical hours, and do not feel as confident in a clinical setting.

My advice would be to seek out an internship in an area that interests you. My senior year of NS, I worked on a floor as a tech. Not only did I become more confident at skills (phlebotomy, foleys) but I also became more confident interacting with patients.

I understand that picking up a job can be very challenging with the courseload you are carrying in an accellerated program, but it may just help you land that dream job when you graduate. I didn't want to work on the floor I interned on, but my Nurse Manager gave me a very good recommendation to the floor I ended up on.

Just keep your head up, your mind open, and don't be afraid to write everything down! When I have a night that I know is going to be busy, with multiple meds for multiple patients at all hours of the night, I write a timeline on the back of my report sheet with what needs to be done at every hour.

Occasionally you will get flustered, and things will happen that will get you off your "schedule." But if you start the shift with a good idea of what needs to be done, even when the unexpected occurs, you can adapt, overcome, and make sure that everything either gets done, or if it doesn't, you can hand off to the next shift in a responsible manner.

nursey2008 · Nov 24, 2008

see the fact of being a new nurse as your advantage. ok you might need to practice your clinical skills, but on the other hand you have a vast knowledge now at this point. Later in your life you will work probably in just 1 or 2 nursing areas and you will be very skilled and experienced in those. However you have the broadest knowledge now.

When you work make sure you always ask if you feel insecure. Dont feel shy to ask because it will be much worse to do a mistake than to ask a question. The nurses working with you should be able to remember what they felt like when they had their first job as a nurse.

Very soon you will have gained a basic experience and will feel more secure.

all the best!

nursey2008 · Nov 24, 2008

P.S. if you have a bad memory make sure u carry a piece of paper with u at all times with ur patients names and whenever something comes up u make a note. like this you wont forget anything

beautifulblair · Nov 24, 2008

thank you so much for posting this..I also feelthe same

It's such a relief for find answers on way wiser and experienced nurses like yourselves..

I admire all of you

thanks again

Flare, ASN, BSN · Nov 24, 2008

Your orientation on the floor should give you enough that you will start to feel confident. Though the advice given above of getting a job as a nurse's assistant or applying for an internship are great pieces of advice.

You'll find that time management and organizational skills are key. I made up a form of my own - though some units have their own version readily available - that listed my patient assignments for the day with spaces for all things that i'd have to remember like name, age, allergies, diagnosis, pertinent history, iv, foley, diet, meds etc. There was also room to make any notes, space to add meds in, space to write times in and so on. I would refer to my sheet all day long and jot down notes on it then cross them out once charted and/or addressed. You'll quickly learn what will work for you and what won't.

IcanHealYou · Nov 24, 2008

Thanks very much for everyone's responses. I'm a very organized person and I was already thinking of ways to chart all the things I'll have to do as a nurse.

I just don't want to be totally incompetent when I start working =/.

Reno1978, BSN, RN · Nov 24, 2008

School gives you a great foundation to begin practicing as a nurse. However, I think learning is exponentially greater once you're in the real world and really doing it all yourself.

If you work somewhere that supports your learning and growth, you will get plenty of feedback about what you can do better and how you can do it better.

Scrubby · Nov 24, 2008

My advice is to try and find out what areas are supportive to new grads and what places should be avoided.

Also work out a cheat sheet system where you write down what needs to be hourly on each patient like meds, obs, ADL's, feeds, dressings etc and cross them off as you do them. This helps with time management and organisation.

twistedpupchaser · Nov 25, 2008

When I first left school and started on my first ward I was worried that I knew nothing that would help me in the real world of nursing. Sure I had years of training and education but felt I needed more time, I wasn't ready. I thought that my knowledge consisted of passing exams and not much else. Once on the floor my knowledge consolidated as I saw the practical uses, I realised that I remembered and knew more than I thought.

Once on the floor I found my greatest tool was not the flash stethescope that I spent lots of money on or the gucci pants with lots of pockets, (though they helped a lot) it was a piece of paper with my daily plan broken into hourly tasks. This plan made sure I mised none of my jobs for the day and gave me somewhere to write my obs, BSL's and any other points I needed for handover and doing notes. Only problem is that I focused a little too much on that and didn't view the Pt's as a whole. While a great tool it is just an aide, try to look at your Pt's as a whole.

I also had a reputation for being a neat freak, by organising my bay I found that I knew where my stuff was and what I needed to get from the store room. Less time looking during the shift = more time trying to get everything done. 10/60 at the beginning of the shift saves a lot more than that during.

I also made it a point to not trust my Pt's to do something dumb, I eyeballed each of them as often as I could, expecting each of them to get worse every time my back was turned, this led toi the game of "what if?", What do I do if X's sats drop, etc. After a while you will know which Pt's to watch more carefully and the habits you create will ensure that your future in nursing will get easier.

Good Luck.