What is it really like to be a new graduate nurse????

[profjanmc]

We as nurse eduators want to make nursing school better.

New grads have told me,we thought we knew what we are "getting into" ...

Now that several months have passed since graduation, does reality compare with what you thought it would be like?

How could your nursing program/hospital better prepared you?

If you had to give one piece of advice to new grads, what would it be?

Any other pearls of wisdom?

Thanks

[profjanmc]

I really apprecaite all the input from new nurses in this thread. I understand the passion around what you are saying. Sounds like most are in med-surg. I am a maternal-child (L&D) instructor looking to change things, but it is difficult to buck the tradition. You all have good suggestions, keep it up, it gives me encouragement to keep trying to innovate and change.

[danu3]

It is interesting that psych and community health nursing is mentioned. Guess I am one of the minority who are actually in these areas. Guess it would be idea if we can rotate through all the areas on a minimum basis to get a feel. Then have the choice to spend extra time in a few potential areas we are interested in and get lots of good experience in them.

This thread has been very very informative. Thanks.

-Dan

[pgrsctrn2be]

I think stress the careplans less and the verbal interactions with the doctors, and other departments in the hospital setting would have helped me more. Also I would like to see the students teamed with nurses on the floor working a patient load instead of just one or two patients per student. The shock of taking 5-7 or more patients is pretty overwhelming to a new grad. I have the chance to see my clinical intructor often now (working in the same hospital now) and after talking to her last week about this same topic, she is working with the school to try and change her clinical for the fall. Hope this will work out, I really think next years grads will not be as stuned when they go to work if it can be changed.

[PaedsNurs&LovinIt]

I look back at what college was like and there's many things I would change about it. For one thing, when it came to clinical rotations, we had to choose between doing paeds or obs, and yet it was required that we complete a community rotation. I think the psych rotation was important, that's how I learned I don't make a great psych nurse. But I think it was important to do both obs and paeds because they are very different, and community could have been done in one week really, because in the community we really weren't doing much, mostly observing.

Before graduating from college, we had to complete a pregrad rotation, which was four months fulltime, no classes, just real work one on one with an experienced nurse. I liked that because we were able to put our focus on the specific area of nursing that we hoped to work in upon graduating.

Nursing school seemed to emphasize this fantasy land we were going to be working in instead of focusing on the reality of it all. They're teaching us to be honest professionals, while they're lying to us about what it's really like out there. It's just not right.

[RN92]

Im not a new nurse, but I do remember my first year out of school. I wish I had been given a class on legal aspects of nursing. Lawsuits are such a BIG part of healthcare today. Ive just picked up bits and pieces along the way.

Also, I think every nursing student should be required to work in a health care setting pryor to graduation. We werent required to- but they strongly encouraged us to get a job our last year of nursing school. There are certain thing that you're only going to learn on the job.

[Toby's mum]

moia, I think your comments are excellent and right on the mark!

[Toby's mum]

JacelRN, you made a great suggestion and I see significant value in your proposed approach. It makes so much sense and would be far more interesting to the student.

[oldiebutgoodie, RN]

Thanks for asking!

Although I am not a new grad (I'm halfway through a program). here's what I can say so far:

1. Lose the weeks and weeks of bed baths. After 3 or 4 weeks of baths and bedmaking, I think we can move on. My program gave us a whole term of this, which I think was a waste of time. Their rationale was that we can do a thorough assessment. That sounds good, except that we didn't have the Health Assessment class until the following term.

2. Start giving meds and injections as soon as possible.

3. Don't yell at students who are doing sterile procedures. It doesn't help our learning, and frankly, I doubt the patient will die if my hand happens to move over the sterile field. (not touching it, just above it). Remember how hard it is to grow bacteria in Microbiology class?

4. Let us do more procedures, less care plans. The care plan is overused and every nurse I know says they are totally unhelpful.

Thanks for listening!

Oldiebutgoodie

[RN4NICU, LPN, LVN]

So many people have slammed the care plan, but I think it is necessary for the nursing student who is not yet familiar with critical thinking. They are simply writing down what we already know and do automatically. It introduces them to the fact that nursing is not just about following doctors' orders. It is about looking at the entire patient and thinking outside the box:

What is wrong with this patient?

How does it affect areas outside the medical diagnosis?

What complications does it put the patient at risk of?

What can I do/recommend to decrease these risks?

Will this patient be able to care for him/herself after discharge? (you wouldn't believe how many docs don't even think about this one)

Then - you decide what you are going to do, do it, and see if it worked. It is similar to the scientific method.

We don't need to write it down because we have been there and done that so many times it is second nature. We think of these things naturally, but the nursing student needs to be taught to think this way - so lets not be so quick to chuck the care plan.

[profjanmc]

How many of you have standardized/computerized care plans in your facility? Do you think having standardized care plans in nursing school would work as well as developing your own?

Could we replace it with developing some sort of critical thinking exercise, case study etc.....?

[leslie :-D]

for the sake of time constraints, standardized plans are ok but should be individualized to each pt's needs.

also, i'm wondering if this will benefit new nurses as it really doesn't teach you to think independently and/or critically.

i wish i had been exposed to more of the ethical dilemmas in nursing school as i've experienced in my career.

and definitely, wish i had been forewarned about all the backstabbing and disparity amongst nurses.

leslie

[twarlik]

As much as it pains me to admit, writing care plans has helped me tremendously. The first couple took hours to complete, but I've gotten pretty good at them now. They force me to really examine what's going on with my patients and to think about what sort of things I can do for them. I think the key to care plans is to make them as short as possible. Cut out all the repetition and unnecessary information.