Nursing is hard. So hard, in fact, that I failed miserably at it. Here’s an irreverent video I created with some helpful tips for new nurse graduates who DO want to succeed.
I created a script that I was reading off of during the making of the video placed at the end of this post. Here’s the script.
This goes out to all of you nurse graduates. Congratulations! You are entering into a challenging and rewarding career in which you are providing competent and compassionate care. Keep that positive mindset no matter what happens. I mean, you don’t need a PhD to hold someone’s hand, offer a warm blanket, or bring someone ice water or help someone to the bathroom. You are there to help your preceptor, other staff members, and most importantly every single patient.
You’ve finally finished nursing school and passed your NCLEX which is super hard. You’re tired of studying, writing papers, attending lectures, and not having seen the sun or felt the wind on your face or made contact with any of your friends or family for 4 years. You are now a social outcast and you are barely holding it together. But press on! You are caring for other people now, so don’t let extended periods of solitary confinement slow you down! You’ll have plenty of time to rest when you’re dead!
Take as few personal items as humanly possible. There won’t be lockers for the students rarely for new grads. There won’t be chairs that you can sit on or walls you can lean on. Basically, you will be in perpetual motion. If you are completely broke, and I know you are. You’re going to be bringing your own cheese sandwiches and last night’s leftovers in overused Tupperware containers. Shove your lunch, your coat, scarf, mittens, and purse into a large black garbage bag. Put it into a cardboard box and kick it into an inconspicuous location like the soiled utility room.
Wear scrubs that are loose-fitting and comfortable. Good luck with that. You’ve spent the last 4 years sitting on your arse studying and are now 20 pounds heavier. See if the emergency department has extra scrubs. You can’t afford frivolous things such as new uniforms. You will also need adult diapers. Since you will not be sitting, standing, leaning on walls, or using the toilet (if you can find it), you will not be urinating for 12 hours. Holding urine in your bladder for too long can cause discomfort and UTIs. Feel comfortable and confident with an incontinent product that won’t slow you down. Make sure your bowels are completely evacuated the night before your first shift. Use an enema or a laxative. Whatever it takes to get the job done.
If your ear canals go the wrong way, try out every stethoscope you can. Ask staff members or friends (oops sorry you don’t have any) if you can try theirs. Nobody will mind. Everyone will be super forgiving that somehow you managed to get through 4 years of training without obtaining your own stethoscope. Remember, there is no “I” in team! Then go out and get the most expensive stethoscope you can find. I would recommend a $325 cardiology stethoscope. You might have to pawn some jewelry but it’s a worthwhile investment and you will be using it for the rest of your career. If by some chance nursing does not work out, it will make a great Christmas gift for your 3-year-old nephew.
Get your own fucking bandage scissors. There are no scissors on the unit and you will be torn a new asshole if you ask to borrow someone else’s scissors.
Penlight – especially useful for looking to see if your patient is still alive. You aren’t going to be able to check your patients every 15 minutes on the night shift to ensure they are still breathing.
Pens. Have your own. Bring about 10 of them with you. Shove some in your bra, some in your pockets, and jam a few into your hair if you have a ponytail or bun and hope nobody notices.
Report sheet templates. If you can’t multitask, you should give up right now. In fact, multitasking is an important part of many jobs. If you can’t multitask don’t expect anyone to hire you. Ever. Move back in with your parents.
Energy snacks. OK so your food is still back in that cardboard box and you didn’t have the time to go get your lunch. Maybe you wasted your break two blocks away from the hospital so you could have a cigarette. So, you will need to have some items on your person to keep up your energy.
- glucose tablets
- 2 small cans of red bull or other energy drink
- a ziploc bag full of instant coffee
- labeled bottles of prescription amph…. that you convinced your doctor to prescribe for you
MAKE THE MOST OUT OF YOUR ORIENTATION PERIOD
Make sure you’re with a preceptor who can teach.
You will have no choice in terms of which preceptor/nurse you will be paired with.
Direct your own learning. No one is going to do this for you.
There are some excellent nurses out there. Sad, sad for you, many of these nurses are not excellent teachers. Suck it up, buttercup. You’re not the only one with problems. That nurse probably had a rotten teacher too. Have a bit of empathy.
You might be paired with more than one nurse. This gives you an opportunity to learn how 2-3 other nurses manage their workload while trying to figure out a system that works for you. This will serve to confuse you further. It might even slow you down or stop you altogether. Don’t be discouraged.
You can ask to switch preceptors, tactfully, if your situation is untenable. This will give you practice in terms of conflict management.
Make sure everyone knows that you need to jump in at every opportunity to practice needed skills. You are expected to know how to do all skills correctly and competently the first time with your preceptor and 10 family members watching you since you practiced for hours on non-human plastic subjects in the lab setting.
Practice calling the doctor. With your preceptor. With role-playing. Because every nurse has half an hour to sit down and role play with you. You will be expected to call the doctor, sound professional, and will have plenty of practice stitching up the strip of skin that he or she tore off of you for calling at 3a.m. because a patient’s blood glucose fell one point below the insulin sliding scale that was ordered. Not only will you have practice with suturing, but those bandage scissors will come in handy when it is time to remove your stitches.
After about 5 days you should have a full patient load. During this time, your preceptor will sit and chat with other nurses and will only jump in if you screw up. So don’t screw up. God is watching you from a distance.
Sink or swim. It is important, even though you have a cement block tied to your ankle and haven’t yet learned to tread water, to let yourself drown, and allow the water to enter your lungs. If you do survive, and many of you will, you may vomit and acquire aspiration pneumonia. The family you haven’t seen for 4 years will help you out. You will have a new appreciation of the importance of social support systems and finally, you understand Maslow’s Hierarchy and how it applies to you. It will take several years for you to reach “self-actualization.”
Be careful with medications: carry a nursing drug guide in a back pocket or shove it down the back of your pants. Be ready to cite the TEN rights of medication administration at any moment. If you are unfamiliar with a medication, grab that drug book out of your ass and make sure you know how the drug will affect your patient. You will need to assess the patient prior to giving a high-alert medication, and also after. You will not have time to do these assessments but then again, you really don’t need a break if you don’t know how to cluster care. This is where the red bull, raw instant coffee, and your prescription amph… will come in handy. Be quick about it and make sure no one sees you. In 15 minutes you’ll be like the guy from Limitless.
Participate in receiving report and giving report. This can be challenging as many of your patients have already been discharged halfway through your shift and some admitted closer to the end of your shift.
You will feel slightly overwhelmed. This is normal. Every other new grad is freaked out. Do not, under any circumstances, ask the same question twice. Don’t ask or request more orientation time. This will raise alarm bells and red flags. Even though you want to hear or see a procedure repeated, DON’T DO IT. Go home and stay up all night if you have to. Read about it. Watch videos. Direct your own learning.
You will likely experience incidents of drowning, having to suture your fragile outer shell back together, PTSD, and many other forms of abject terror – for 6 months to a year. Don’t worry! It’s normal!
Good luck and good for you for entering into such a selfless, caring occupation. You’ll be just fine.