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

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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

There is a ridiculous overemphasis on "cool skills" in student nursing...I know giving an efficient bath to 5 people in 40 minutes is boring,repetitive and well really boring but..guess what? that is what a nursing career is all about...I work CVICU...I still have to bath my patient and turn them and sit them up and dangle...every shift..for years and years and years.

Get really good at it and do it as the first thing you do..get them naked and move them around ...that"s the assessment...what do they look like and how hard is it for them to move?,,,what else will tell you all you really need to know?

You don't need a 35 page care plan to explain and treat my patient that has bruises everywhere and purple heels and can't turn because they get so short of breath they turn as blue as their heels. A good patho class EVERY term means students will know why this is happening....how about a 35 page paper on what happens to an elderly patient who doesn't get turned and mobilized while in hospital...forget the careplan..make them include pictures and diagrams....make things REAL.

take them to a long term care facility first term and have them pack the holes left behind from when people "forgot" to turn patients regularily.

No care plan and no in class ethics lesson will teach as much as the moment a new student sees a hole the size of their fist to the bone and they are responsible for packing and dressing it and making sure it never happens again.

Nursing students need to be challenged over and over again with real world tests..not in class tests.

Dump the endless nursing philosophy...all those nuns and the like are great for Masters programs but for the rest of us? we don't need someone trying explain what nurses are or what nursing means or how nursing is a "real profession"..nurses know what they do and have no problem considering themselves professionals...all that nursing theory for me is a little like.... sorry to say it..academic masturbation....it's what people in academia like to sit and around and kvetch about... a little like college students playing with existentialism....useless in the real world but pleasant to fight about after a few drinks.

It can be mentioned in passing as a slightly amusing academic exercise for one hour of the program but don't waste real time for teaching. The questions have already been answered..we are a profession governed by law and policed by a supervisory board...we are a profession already, we have societies and lobbyists for goodness sake.

For those worried about skills...once you realize a catheter needs to go in a certain hole...well..the mystery is over...the only thing that changes is level of difficulty..bring a flashlight. Removing an IV...well it doesn't get anymore exciting than that first time...wash your hands..bring a piece of gauze and a bandaid..hold pressure till it stops bleeding..apply bandaid....

All the technical skills we do? Rarely change...all the rules remain the same..follow the rules.....now when you have a fantastically explosively incontinent patient?...well thats the time for your creativity to shine..and that one will never stop being really really surprising and different. thats why knowing how to give a complete bed bath in less than 15 minutes is a truly invaluable skill...because you really don't want to be in that room any longer than that or the smell will render you helpless.

Nursing school also needs a sense of humour and some foul language every once in awhile...lighten up occassionally...sometimes this stuff is really funny.

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moia:

You have obviously been a nurse for a while.....you can tell by your reflective nature about your experiences, it shows that real life can be a valuable learning experience, pass it to the new nurses, keep it all in perspective and laugh a lot! It helps the bad times..... :chuckle

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There is a ridiculous overemphasis on "cool skills" in student nursing...I know giving an efficient bath to 5 people in 40 minutes is boring,repetitive and well really boring but..guess what? that is what a nursing career is all about...
It's not what EVERY nursing career is all about. I agree that students need not be so concerned about getting experience with procedures - that will come, but bulk bathing is not the core of every nurse's career. I have never bathed 5 adults in a single shift and I have been a nurse for over 8 years. (Most I have ever bathed is one and that was when I was in adult ICU).

I would be much more concerned if a new grad were unable to understand principles of pathophysiology and pharmacology than if he/she was unable to assembly-line their baths. That is another skill that becomes more efficient the more you do it. Experienced nurses often have time to give new nurses "hints" or "tricks of the trade" that will help them make their shifts easier, but they most certainly don't have time to review with them what they SHOULD have learned in school.

The knowledge of A&P, assessment, pharm, patho, etc. in addition to how to give a bath is what separates the RN from the CNA or the med tech. The bath is not the be-all-end-all of nursing. I rarely give one, unless it is a "fresh delivery" and I don't want to have to wear gloves every time I touch my patient - doesn't make me any less of a nurse. There are many, MANY nurses that only touch a washcloth once in a blue moon, if EVER, in the course of their practice. Not every nurse works in a hospital, after all.

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whether you give baths or not, you should certainly be able to give one head to toe, just like a pro.

however seemingly small, it is very important as part of the nsg experience.

it is also a great opportunity to teach your cna's, if they are present with you.

it is a perfect way to assess your patient from head to toe.

and although nsg assts do adls, i would never make a patient wait if the cna was busy.

to me, if someone is at risk for impaired skin integrity, i don't want reports; i don't want to just read their medical hx to see what puts them at risk....i need to see and treat the patient.

if a cna tells me a pt is crying, i am going to see that pt myself rather than give report that pt was distressed.

being a hands on and involved nurse is one of the most helpful interventions you can give to your patients.

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