What is expected of a new nurse?

tanthalas · Apr 5, 2008

Ooooh good thread! Great for us newbies.

Wendy_RN · Apr 5, 2008

No one expects new nurse to begin their career with skills perfected. You get the basics in school but your orientation is when you will have the opportunity to begin to focus more on nursing in the real world and to start putting the pieces of the puzzle together. The best advice I can give you is to first of all go to work somewhere that will give you a good orientation. Learn all you can from your preceptor. Let your preceptor know what you need help with. The key is to ASK QUESTIONS. Never be afraid to admit when you don't know something. I cannot stress that enough. I would much rather spend my time explaining something, show a new nurse how to do a procedure, etc., than to see them make a mistake at a patient's expense because they did not ask for help. Nursing is a continual learning process and you are just beginning the journey. Good luck in your new career!

hikernurse · Apr 5, 2008

Well put, Wendy. Another thing I'd suggest is to be pro-active. Don't just hang back and wait until your preceptor tells you what to do. Most preceptors are great at giving new RNs a broad experience; if another nurse's patients are doing something interesting, they're usually more than happy to let you participate in those patient's care, too.

Read some journals before you start, too. Nursing is a good well-rounded one, and specific areas also have their own. Even if you don't understand everything--and you won't at first, at least things will start to sound familiar.

Also expect that it will take months before you feel like you have a handle on things. Don't be afraid to ask! Even experienced nurses run into new things or things they don't do often.

Ask for suggestions about time management for your particular area; that's a skill that takes time to develop.

Get some sleep and start off with a good breakfast :).

Michael076 · Apr 5, 2008

I am 25 days away from graduation and I was curious of what skills are expected of a new nurse? I feel in my particular school we did not get alot of hands on experience as far as Injections and IV's This really worries me because I don't want to start a new job and not be prepared. Are these things that your preceptor will help you with? I understand that IV's take time, but the thing that I am concerned about is the injections. I have done a few, but I do not feel confident in this area.

Believe me I am a few weeks in as a new nurse and injections and iv's are easy now. Just take your time my school had bad clinicals as well but my teacher always said you can teach a monkey those skills and they focused on critical thinking. She was right. Do not be worried it gets easier and you become more efficient with each iv/im....What I would worry about is the organizational skills and writing everything down....The hardest part of the job to me is being bombarded with information plus always check id bands on patients for me i'll confuse patients often because I can not conceptulize yet who is who and some names sound similar so checking id bands is tantamount..I could see clearly now how mistakes happen...Good luck you will do great....

MIA-RN · Apr 5, 2008

Show up on time.

Dress appropriately.

Bring your own steth and pen.

Don't complain how tired you are.

Don't be afraid to ask questions but remember that you have the skills/knowledge to look things up yourself too.

Stay with your preceptor but allow her/him some space too. Don't haunt them. Don't be overbearing.

Don't do anything that you are uncomfortable with.

If for some reason you are directed to do something that rings alarm bells in your head, look it up and find out why.

Remember that you really can do the job, even when your nerves get the best of you.

Learn from your mistakes (yeah, there will be some) and be accountable for what you do.

Don't expect the techs to be your slaves. No one works for you; you all work for the patients.

Take some time to poke around in cabinets etc so you have a basic idea of where supplies are.

Don't spend your time sitting at the nurse's station reading Star magazine or gabbing. Limit personal calls to none or to just on your break.

Advocate for your lunch break but don't ask when it will be the first thing in the morning.

Don't start all your sentences "But in school we learned it this way..." or some variant. Each unit has its own way of doing things and as long as its safe, do it the way they do it. You will work out your own way later when you are more comfortable on your own. A much better statement is "Can you show me how you do it?"

**

As a new nurse, you will not only still be learning how to be a nurse but your first job will also come with lots of orientation, classroom activities and the stress of just plain doing the job.

This all will combine to make you very task-oriented at the ouset--you'll be thinking along the lines of things you have to accomplish and do. That can cause a lot of stress sometimes. Relax and understand that its normal. Get up each morning and tell yourself its going to be a good day. Sure you will have stresses but understand that we all do...they just seem a lot worse to the new grad because of all the other stuff you have to do and with the NCLEX looming...well, be nice to yourself and don't beat yourself up. Try to learn something from everyone and take what works to incorporate into your own nursing practice.

No one expects you to be perfect; they all know you are new at this and they were all new once too (although some might not remember it).

Mostly though, just go to work, be alert and learn everything you can.

kiki_me · Apr 5, 2008

NEVER EVER HESITATE to ask questions about things (procedures, medications, etc.) that you are not 200% sure of coz you're dealing with the lives of people.. you can never be too careful.. ^^ :nurse:

imanedrn · Apr 5, 2008

No one expects new nurse to begin their career with skills perfected.

This totally depends on the nurses with whom you work! I've encountered one night charge (thank goodness I work days!) who DOES expect me to know everything! When I tell her I didn't know I had to do something, she literally will scold me in front of my co-workers, within range of patients hearing. It's nasty.

The other scenarios I encounter are when my co-workers / charges assume that I should know something. When I say I never learned that while training, they say it should be common sense. My rebuttal is that, if my preceptor made these same errors and didn't do what you're expecting of me, then why should it be common sense? Haven't heard reasonable response to this yet.

Unfortunately, there will ALWAYS be seasoned nurses who expect new nurses to know everything. Sadly, I haven't found a good defense yet

kiki_me · Apr 5, 2008

Unfortunately, there will ALWAYS be seasoned nurses who expect new nurses to know everything. Sadly, I haven't found a good defense yet

Yeah, some seasoned nurses expect you to be up to par with them even if you are still new.. they forget that they too once were new nurses and were not yet that adept nor that knowledgeable on a LOT of things.. But anyway, just better take this as a opportunity to prove yourself. Rise up to the challenge, you can do it. :wink2: (Although the scolding in front of co-workers and patients thing is out of line.. :down: )

ilstu99 · Apr 5, 2008

I am 25 days away from graduation and I was curious of what skills are expected of a new nurse? I feel in my particular school we did not get alot of hands on experience as far as Injections and IV's This really worries me because I don't want to start a new job and not be prepared. Are these things that your preceptor will help you with? I understand that IV's take time, but the thing that I am concerned about is the injections. I have done a few, but I do not feel confident in this area.

My first reaction was: Mind-reading. :chuckle Anyway.....

Don't worry about the needle stuff. It will come with practice. Be upfront with your preceptor, and explain your limited exposure. I would ask for as many opportunities as he/she can give you for practice. Some new RN's will just hide from the things they are uncomfortable doing. You lose a lot of respect that way, and it doesn't help you any....not to mention how much it doesn't help your future patients. :)

But...MIA-RN's list is pretty awesome, and very accurate. A lot of your orientation depends on how things are done in your hospital. One of the first things I did was print the protocols I really, really needed to know (since they're all online, and not accessible from my home), and took them home and studied them.

ALWAYS be on time, and prepared. Take more than you think you'll need, rather than less...pens, steth (if you need one), scissors, penlight, Sharpie....and any personal things you might need.

Don't think you're the only person who has ever broken out in a sweat when trying some new/unpracticed skills.

ALWAYS follow ALL of the rules, even if other people don't. Many of them may be "guidelines," rather than "rules," but you haven't earned the right/ability to hedge them.

Don't use your cell phone during working times. Make sure anyone who might need to call you during your shift understands that it's for *emergencies ONLY,* and to call the unit rather than your cell.

Don't EVER tell your preceptor that they're "doing it wrong," or that another preceptor did it a different way, or that your instructors told you something else. Just smile and say "okay," and ask for clarification if you need it.

Take notes when you have a minute! I did everything from drawing a diagram of the unit (ours is a whacko maze), to listing the things I could remember in the Pyxis and Omnicell, and writing down the most common meds. It might sound silly, but learning the basics of the unit along with the RN responsibilities is SO much. Trying to start IV's is hard...but not knowing where to even find the IV stuff can make you feel like a total dork.

Basically, you're expected to be honest, curious, intelligent, focused and accountable. Have a good time, and congratulations!!! :nurse:

Virgo_RN, BSN, RN · Apr 5, 2008

As others have mentioned, the skills will come. It's the critical thinking that will be a bear for the first year or so. Never be afraid to ask!!!!!

husker_rn, RN · Apr 6, 2008

Agree with everyone else. Remember you're just getting started so you will be expected to do basic nursing care; ask questions, ask questions, ask questions. We would all rather answer questions than have a fellow nurse mess up because they were afraid of sounding dumb.....only dumb question is the one not asked. Good luck !!