Your Help Needed: Give A Tip To A New Grad Nurse

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Here are 9 tips for new grad nurses. Asking experienced nurses to share their best advice.

by Nurse Beth Nurse Beth, MSN (Columnist)

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

What tips do you have for a new grad nurse?

Your Help Needed:  Give A Tip To A New Grad Nurse

9 Tips for New Grads

1. It’s OK to speak up.

Even though you are new and don’t really know the culture of the organisation, if something is bothering you, speak up. For example, what if you were promised 2 preceptors, a primary preceptor, and a backup preceptor?  Instead of 2 preceptors, maybe you’ve had 6! In fact, perhaps you’ve never had the same preceptor twice. Definitely have a talk with your manager so they can have an opportunity to make it better. Chances are that with everything on their plate, they may not be aware that you are being bumped from preceptor to preceptor.

2. Ask questions.

Preceptors see this as an indicator of a good nurse. Did you know that experienced nurses are concerned about new nurses who don’t ask questions? We believe that new nurses who don’t ask questions are not as safe as new nurses who do ask. You’ve heard it before, but there are no dumb questions:) So ask away.

3. What you can expect.

You should expect that your preceptor is friendly, welcoming and knowledgeable. You do not have to tolerate bullying or being humiliated. An example of being humiliated is if your preceptor embarrasses you in front of a patient. If this happens, talk to your preceptor yourself. You can also go to your educator or your manager with your concerns. Do not go to HR as it may backfire.

4. Don’t expect to have "nursing instinct" yet.

It takes time to develop a “gut instinct”. Nursing instinct comes from pattern recognition after years of practice. It only creates frustration to be told “Go with your gut” as a new grad. What does that mean? What does that feel like? What you most likely feel is fear and anxiety, not to be confused with instinct. 

5. Find out who is credible on your unit.

You will be needing and asking for a lot of information. Certain colleagues will give you an answer, and it may be correct. Or it may be incorrect.

Some people just like to give answers. Generally your Educator is a credible source, and so are people who are known to say “Let’s look that up.” If someone tells you “That’s our protocol (or procedure)” it’s perfectly acceptable to ask “Can I get a copy of that?”. After all, you are held accountable to policy and procedure. You cannot blame another nurse’s memory, opinion, best guess, or practice drift when asked to explain your practice rationale.

6. Learn how to look up policies and procedures.

They are the source of truth, and basing your practice on organizational policies and procedures protects your license. You may get conflicting information from different preceptors and colleagues. For example, one preceptor may tell you “You should hold long-acting insulin such as Lantus when your patient is NPO for a procedure”. The next morning a different preceptor may tell you “Don’t automatically hold Lantus when your patient is NPO, it is given for metabolic function, not for caloric intake”. Meanwhile, if you look up the policy, it says to call the doctor before holding meds if he/she has not specified parameters.

7. Accept constructive feedback.

It is possible for your preceptor to be wrong in their delivery and right in their message. If your preceptor gives you feedback, take it to heart. 

8. It’s pretty common to feel overwhelmed and it’s helpful to talk about it.

Aside from your preceptor, you have a manager and an educator on your side who want you to succeed. Talk to them and talk to nurses who graduated one or 2 semesters ahead of you. They will help give you perspective.

9. Give yourself grace.

Look at how far you’ve come since your first day in nursing school. You have earned your right to be here. Look down the hall on a day when nursing students are on your floor and you’ll realize how much you've grown. You are a nurse, not a nursing student.

That’s only 9 tips 🙂...

What tips do you have for new grad nurses? Share your wisdom.

Best wishes,

Nurse Beth

For more tips, read:

When You Receive a Warning at Work

Overwhelmed International Nurse - Preceptor is Condescending

Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger and author.

145 Articles   2,535 Posts

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32 Comment(s)

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 41 years experience. 4,291 Posts

I have a couple of others:  1.  Do not take anything personally, even if it was meant that way.  If you ask a question of someone who rolls her eyes at you, that's someone who likes to roll her eyes.  No reflection on you.

2.  When getting unpleasant feedback, ask for more information.  If the feedback is legit, the extra information will be helpful.  If someone is power-tripping, they will have trouble being specific.  That's how you will learn the best people to take your questions to.

3.  Make friends with your worksheet.  If your unit has preprinted ones, great.  If after a week or two it just doesn't work for you, then develop your own.  But have a visual system to keep track of information and your running to-do list.

4. Try to be mindful of the nurse who inherits the patient from you.  You don't like to come on shift to find bone-dry IV bags or the room looking like a nurse-generated landfill, so try to have things squared away for the next person.  If you're swamped and have to pass things along, acknowledge that in report.

5.  Don't forget to keep breathing.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 25 years experience. 20,878 Posts

Be on time; matter of fact be there early  (not too early, just a few minutes). Form good habits of attendance and being punctual from the start. Nothing will ruin your reputation faster than inconsistent attendance and punctuality.Arrive on time, ready to work.

JBMmom, MSN, NP

Specializes in Long term care; med-surg; critical care. Has 10 years experience. 4 Articles; 1,944 Posts

I would recommend being there for your patients. Don't sit at the nurses station and chart while lights are going off because it's the "tech's job". Help your patients to the bathroom, don't tell them you'll get someone else. How would you feel if it was your grandma that had to go to the bathroom and she was made to wait? Now, if you're far behind and have to ask for help that's another issue. The more time you can spend with your patients, it will help you develop your instincts to recognize a change in condition. It may all seem overwhelming at first, you'll find your groove, give yourself time. 

Daisy4RN

Specializes in Travel, Home Health, Med-Surg. Has 20 years experience. 1 Article; 2,041 Posts

Try to keep a low profile (at least at first) and stay completely out of unit/hospital politics. When assessing who the credible nurses are to ask questions don't just assume it will always be the charge. There are probably more experienced staff nurses.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 25 years experience. 20,878 Posts

Stay out of the gossip trap too. If they talk about others to  you, they talk about YOU behind your back. Just say no to gossip. Smile and change the subject or walk away.  They will test you as a new nurse in this regard, trust me. Don't fall for it.

Have a life outside work. You are a nurse but that does not define WHO YOU ARE. Have a clear identity that has nothing to do with being a nurse. Trust me, many make this simple mistake.

Learn to say "no" when you mean "no". If you don't want to or cannot work extra, say "no".

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 25 years experience. 20,878 Posts

If something does not feel right, it's not. Learn to work with others, asking questions and don't be afraid to get an experienced nurse to weigh in on something. Don't ignore that "bad feeling" you get when something is wrong; act on it!

JKL33

6,090 Posts

12 hours ago, TriciaJ said:

1.  Do not take anything personally, even if it was meant that way.  If you ask a question of someone who rolls her eyes at you, that's someone who likes to roll her eyes.  No reflection on you.

@TriciaJ beat me to it.  This is so important; I think it is right up there with learning nursing-specific things. Figuring out how not to absorb negativity, how not to feel provoked, how not to react...is crucial.

MelEpiRN

171 Posts

You're not going to please everybody, learn to let it go and move on.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience. 67 Articles; 14,000 Posts

Contrary to popular wisdom, there IS such a  thing as a dumb question.  If you ask a question without any attempt to find the answer on your own, it's a dumb question.  (Unless you're asking where the procedure manual is kept, where is the employee bathroom or if the drug reference that used to be on top of the Pyxis has another home.)  If you ask the SAME question over and over again, it's a dumb question.  For instance, you can ask (for the 47th time this week), "what's the number for the blood bank again?" or you can ask, "Where  do we keep the list of most frequently-called numbers?"  And then find it  yourself next time.  

You can ask, "Mr. Furosemide is supposed to get a Foley -- what do I do?"  Or you can ask, "I've read the procedure and have gathered all of the supplies I think I need, but I've never done this before.  Can we talk about it before we go to do the catheterization?"  

Nurse Beth, MSN

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience. 145 Articles; 2,535 Posts

13 hours ago, Ruby Vee said:

Contrary to popular wisdom, there IS such a  thing as a dumb question.  If you ask a question without any attempt to find the answer on your own, it's a dumb question.  (Unless you're asking where the procedure manual is kept, where is the employee bathroom or if the drug reference that used to be on top of the Pyxis has another home.)  If you ask the SAME question over and over again, it's a dumb question.  For instance, you can ask (for the 47th time this week), "what's the number for the blood bank again?" or you can ask, "Where  do we keep the list of most frequently-called numbers?"  And then find it  yourself next time.  

You can ask, "Mr. Furosemide is supposed to get a Foley -- what do I do?"  Or you can ask, "I've read the procedure and have gathered all of the supplies I think I need, but I've never done this before.  Can we talk about it before we go to do the catheterization?"  

Thanks, Ruby Vee! I love "Mr. Furosemide" 🙂 and your example of the preceptee asking about catheterization is perfect.

I was just talking with this the other day during a Preceptor training class. It's helpful to try and find out the reason for the preceptee asking the same question repeatedly. I think you're referring to not just an expected lack of recall and information overload situation but one where the preceptee is overly dependent and not secure about stepping out on their own. It can be a coping mechanism, albeit not a productive one.

The preceptor needs to move their preceptee forward and one thing they can do is to basically not answer the question, but instead push the preceptee to recall information. "So the other day you asked me how to look up a policy in the computer. Show me what you remember".

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 25 years experience. 20,878 Posts

19 hours ago, Ruby Vee said:

Contrary to popular wisdom, there IS such a  thing as a dumb question.  If you ask a question without any attempt to find the answer on your own, it's a dumb question.  (Unless you're asking where the procedure manual is kept, where is the employee bathroom or if the drug reference that used to be on top of the Pyxis has another home.)  If you ask the SAME question over and over again, it's a dumb question.  For instance, you can ask (for the 47th time this week), "what's the number for the blood bank again?" or you can ask, "Where  do we keep the list of most frequently-called numbers?"  And then find it  yourself next time.  

You can ask, "Mr. Furosemide is supposed to get a Foley -- what do I do?"  Or you can ask, "I've read the procedure and have gathered all of the supplies I think I need, but I've never done this before.  Can we talk about it before we go to do the catheterization?"  

RUBY VEE   gurrrrrrl I am glad to see you here! OK carry on w/the thread everyone (sorry).