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.
Who said I didn’t listen respectfully? Seeing as how I was the third preceptor this new grad had and then they went on to have two more after me that had the same issues, I’m guessing it wasn’t due to me not listening respectfully. This particular orientee came in thinking she knew everything, and would not listen to a word any of us had to say. We tried to work with her and give chances, which resulted in 5 preceptors.
So yes, respect your preceptor.
LovingLife - did that orientee make it past orientation? Or did you 5 bullies just 'eat up' that young one?!? ;)) (Being sarcastic here.)
LovingLife - did that orientee make it past orientation? Or did you 5 bullies just 'eat up' that young one?!? ;)) (Being sarcastic here.)
No, she did not. She ended up walking out. I’m never, ever mean to my new grads. I’m a huge advocate for my new grads as I know it takes time. But the constant arguing with me drove me crazy. Especially if you are pausing critical gtts such as pressors to draw a CBC. When I explain the first time how that can be deadly but you continue to do it, at some point, critical care is not for you. And when 5 people have the exact same problem with the arguing, and not open to listening, that an issue.
I didn't, but I think respect is earned. Just my .02
This is a what Camry first, the chicken or the egg mentality. You can go back and forth on who should earn that respect first. If you are a new grad orientee, you start by respecting your preceptor until they show you otherwise. That’s how it works.
This is a what Camry first, the chicken or the egg mentality. You can go back and forth on who should earn that respect first. If you are a new grad orientee, you start by respecting your preceptor until they show you otherwise. That’s how it works.
Specializes in Neurosciences, stepdown, acute rehab, LTC.
Anticipate pt. needs. Lots of new grads get flustered and leave the room without having the patient totally comfortable and with unanswered questions and then the pt. will ring the call bell a lot more. Do the 4 Ps (potty, pain, position, posessions) each time. Using the phrase "we round each hour" as Opposed to "we will check on you" is proven to reduce call bell use. For me, I will say "myself or my CNA try to round each hour so if we haven't heard from you you will see us anyway. If we are tied up we may take a bit longer to come back, but your call bell is here if you don't see us and you need something sooner." If I am expected to be tied up with a long admission or procedure I will often let them know so we can address their 4 Ps. For me, being ultra proactive reduces call bell use a ton, with some patients NEVER ringing the callbell and they give you a lot of grace if you do get busy and take longer to get back. By afternoon these people often just will say stuff like "im completely fine dear! Look after your other patients! " or "I just want a long nap now!" This ultra proactive approach gives me a lot of control over prioritization and time management, makes the nursing care strong, makes everyone very happy, and gives me time to get breaks. Obviously, there are patients and situations where this doesnt work at all, but I usually have at least 1-2 patients in my 3-4 patient load who are zero trouble at all with this method. This of course only works well if you have a reasonable patient load (I usually do). I do have slightly different "scripts" for busy days which still help a lot though.
Anticipate pt. needs. Lots of new grads get flustered and leave the room without having the patient totally comfortable and with unanswered questions and then the pt. will ring the call bell a lot more. Do the 4 Ps (potty, pain, position, posessions) each time. Using the phrase "we round each hour" as Opposed to "we will check on you" is proven to reduce call bell use. For me, I will say "myself or my CNA try to round each hour so if we haven't heard from you you will see us anyway. If we are tied up we may take a bit longer to come back, but your call bell is here if you don't see us and you need something sooner." If I am expected to be tied up with a long admission or procedure I will often let them know so we can address their 4 Ps. For me, being ultra proactive reduces call bell use a ton, with some patients NEVER ringing the callbell and they give you a lot of grace if you do get busy and take longer to get back. By afternoon these people often just will say stuff like "im completely fine dear! Look after your other patients! " or "I just want a long nap now!" This ultra proactive approach gives me a lot of control over prioritization and time management, makes the nursing care strong, makes everyone very happy, and gives me time to get breaks. Obviously, there are patients and situations where this doesnt work at all, but I usually have at least 1-2 patients in my 3-4 patient load who are zero trouble at all with this method. This of course only works well if you have a reasonable patient load (I usually do). I do have slightly different "scripts" for busy days which still help a lot though.
This is so helpful- thank you! I am a new nurse and just started on a telemetry floor in July. Time management is one of my biggest challenges so far. Some nights we have 5-6 patients, so I would love to hear about your alternate scripts for busier shifts if you are willing to share. Thanks again!
Document document document! If a patient comes to your facility from a long term care facility or home make sure you document a complete wound assessment if they have one upon admission. That way the hospital/facility where you work isn’t liable for a pressure ulcer that was there upon admission to your facility.
If you call a physician after hours, document it! Keep calling until you get a call back. Go above by following the chain of command. Tell the charge RN, the house supervisor that you’ve done XYZ. I have been told several times that my documentation has saved the facility from a lawsuit by a patient/family! Always CYA!!
Don’t be afraid to call the provider in the middle of the night. If you have a concern, bounce it off a more experienced nurse first. But if your gut says you need to escalate it, do it. Even if the provider is mean, crabby and always yells at everyone. (I swear some of them do it just to get the nurses to NOT page).
Specializes in LTC, assisted living, med-surg, psych.
Don’t panic. Ever. It’s the surest way to make the patient and/or family freak out. Even if it’s your confused elderly fellow who just yanked out his central line and is wandering around the floor bleeding, take a deep breath (or several) to center yourself, then ask for help. No new nurse should have to deal with a situation like that on her/his own. But even if for some reason your co-workers aren’t available, try to avoid tackling your patient and slapping an occlusive dressing over the insertion site … he may not react well and then you’ve got another problem to handle! Bottom line is, keep calm while you’re in the thick of it, and you get to fall apart (in private) after it’s over.
amoLucia
7,736 Posts
LovingLife - did that orientee make it past orientation? Or did you 5 bullies just 'eat up' that young one?!? ;)) (Being sarcastic here.)