I’m really excited about the blog post today! As I’ve mentioned before, I’m a full time nurse on an oncology/hematology/bone marrow transplant/palliative care unit. Being that it is Nurses Week, I thought it would be a great time to share this post (+ I received the responses from all of the awesome contributors). Don’t you worry, I will be sharing how my run through with my trainer Nick went on Monday (spoiler: awesome + I’m so excited to start the program that he wrote for me).
As graduation day approaches for many college students, I wanted to do a blog giving tips for new nurslings about to start their first job! It’s a very exciting, but nerve-racking time for many.
Some of these tips could translate to any profession + if you are a reader you can get more of a peak into my job.
I still consider myself new. I started working at UW in February 2014. I’ve learned so much since that time, and still continue to learn with each shift. What I decided to do was to reach out to a few of my colleagues that I respect and look up to. I thought it would be great to introduce them first + give you an idea of why I picked them to contribute.
Amy P: Amy was my preceptor! She saw me on my first day of my nursing career + now I get to hand patients off to her in the morning. Amy was always so patient with all of my questions. As a new nurse, you need information and skills repeated…and it was SO amazing to have someone that didn’t make me feel bad about it. She is an incredible nurse and a very kind soul. She always has a smile on her face and has an ability to connect with each patient. As my friend Sarah put it, “I hope to be as nice and happy as Amy one day”.
Courtney K: I tell Courtney this all the time, but she has a great ability to stay calm + is so kind to her co-workers and patients. She is great at prioritizing the needs of the floor above her own needs making her an appreciable charge nurse. She is always ready and willing to help and I love asking her questions because she has loads of knowledge about the population we work with.
Ali: One of the funniest nurses on the unit making her a pleasure to work with. She is also great at her job. The other week I listened as she gave report to another nurse when she had to transfer a critical patient off the floor. Her mind worked like a freakin computer just rattling off information and giving a detailed and orderly synopsis of what happened. I also love that when she is busy she doesn’t take it out on others or let her stress show visibly. She just does her job a + delegates what she can.
Kaitlin: Kaitlin loves the population we work with. She is one of those nurses that knew exactly what type of unit she wanted to be on and continues to gain experience and knowledge to improve and serve those patients. She is easy to ask questions to and is great at either walking you through what you need to do or finding a resource to answer your question. She also has a really good perspective on life/death, which is important on our unit.
Carrie: You might recognize her as my running partner! Carrie came to our unit as an experienced nurse and quickly acclimated. I look up to her because she is very helpful to other nurses, especially the newbees. She has a great skill set and is really good at teaching others + making people feel comfortable asking her questions. She also has a great attitude/outlook on life, and that is just one reason I love to spend time with her.
There are plenty of other nurses on the unit that I respect + love, but I knew these gals would be up for answering the questions. I asked them all to try to remember back to being new themselves. One actually keeps a journal, so it was easy for her to go back and see how she was feeling early on.
It’s unbelievable how fast you will grow as a new nurse, so if you are just about to start your nursing career or new and feeling like you are never going to get it…you will. Just be ready to learn each day and be really humble. Nobody knows it all, and nobody likes a know it all 😉
Ames: Here we go…What was the hardest thing about transitioning from nursing school to your first nursing job?
Amy P: I think the hardest thing for me starting my first nursing job was the crazy schedule. I worked PM and night shift 40 hours a week. I also still had my nurse residency classes, chemo classes, etc. during the day. There were some weeks where I would have days, PMs and night shifts all in one week. It was exhausting.
Ali: The hardest part for me was trying to figure out my identity and my place on the unit. I transitioned quickly from being a college/carefree student, to a nursing grad on the unit (keyword, *grad, because I did not feel like a true nurse, I did not yet have my license), and then soon after that into a registered nurse. Holding this title at first was both scary and empowering, I felt like I had to really play the part and mold myself into this new professional position. After that, it was all about mentality! I needed to modify my college kid life/mind set into that of a professional/full-time working woman!
Courtney: One of the biggest challenges I had was putting together all of the knowledge I had from school and residency classes with my skills I was using during my shift. It definitely takes time (I am still working on this) to be able to explain why you are doing a nursing process the way you are or why you are giving a certain medication and how it works for that patient or diagnosis. At first all I could do was focus on getting my tasks done in a timely manner and now gradually I have a deeper understanding of the reasoning behind these tasks. This definitely helps in patient education and boosts your confidence of your skills when you have reasoning/knowledge behind them. Another challenge I faced was having a completely different lifestyle and routine than that of nursing school. Which brings me to the next challenge I faced…exhaustion. Maybe I’m alone in this, but I was extremely tired when I first began my nursing job. Learning new things, trying to get all of my work done (and done right) on time, and handling how emotional our unit can be really made me tired. Eventually you learn how to be more efficient, bundle tasks, and learn new ways to cope. Ames: Definitely not alone! Drew was getting frustrated because I always wanted to go to bed at 9pm, even on Fridays on my weekends off. Starting your first nursing job is definitely overwhelming and stressful, so it takes a lot out of you mentally and physically.
Kaitlin: Nursing school does a great job preparing you for “perfect world” situations. (ie. you have all the time that you need, all the supplies that you need, people are always right there when you need them, etc.) However, real-world nursing is quite different. I think the most difficult thing for me was learning how to make split-second decisions. From prioritizing 10+ tasks in my head to dealing with unexpected situations and yet still finding the time to comfort my patients and families, it’s a little overwhelming. For example, in nursing school I had the time to do an assessment and then chart it right away, however, I quickly learned that that is nearly impossible in the real world.
Carrie: I think the hardest thing about transitioning into my first nursing job was just being patient with the learning process. I got so frustrated with myself because it just felt like day after day, even month after month, there was just SO much to know and learn, and I just wanted to know it all right away. I couldn’t get over that “I’m stupid” feeling, and I guess that it still happens from time to time, but I no longer beat myself up when those moments happen and just ask for help.
Ames: What are your very best tips for brand new nurses?
Amy P: One of the best tips I can think of is do your best to maintain a good work-life balance. If you can afford it, cut back to working 80 or 90%. Ames: see, 80% Drew…Amy says 😉 As a brand new nurse, you are still learning and that makes the job even more stressful. Plan fun things to do on your days off and try not to bring work home with you. Many new nurses have a problem not letting go when they punch out at the end of a day. I often would call my mom on the way home after a bad night and vent to her. Then, I would try to put it behind me. Reading a book before bed or going out to breakfast with friends after a night shift also helped.
Ali: Learn that it is OKAY to not know the answers to everything. I learned early on that it was perfectly okay to say to patients, “I don’t know the answer to that, let me find out for you” rather than talking yourself in circles trying to figure out an answer. Ames: love this. Also, know that in nursing you will be in a perpetual state of LEARNING. Take lessons from your peers and patients and accept that you will never know everything and that is just fine. I think as a new grad, a lot of us are used to the college way of learning: read the required books, memorize, study and work for an A. In nursing, there is no way to master everything like we may have out of a textbook and flashcards
Courtney: Find a passion outside of work. When I first started, work consumed me. Even when I left work, I felt like I couldn’t stop thinking about it. I would ponder if I did everything right, forgot to do something, or would wonder how a particular patient was doing. I would even dream about work. I felt like I never left our unit, even on my days off. I found that it is best to have something you are passionate about outside of work to de-stress and take your mind off of your day. Whether it be a hobby, exercise, or a relationship, I think it is important to have something to look forward to outside of work. Along these same lines, I think it is important to have someone to talk to about work related experiences. While I had/have quite a few people to talk to, including my parents, friends, boyfriend, and other family members, I felt like other nurses truly understood what I was/am going through the most. No matter how much I tell my mom about my day, I feel like she just doesn’t have the same deep understanding of what I am talking about as my friends who are nurses, which can be okay too! I think it is great to have a wide variety of people to vent to. Our jobs can be emotionally heavy and I find it therapeutic to be able to discuss these situations with those around you (while still upholding patient confidentiality of course!). Take care of yourself. I know I have already mentioned how trying our job can be as nurses, but remember in order to do your job best; you have to be in good condition yourself. Eat right, be in good shape (our job can be pretty physically demanding at times), and sleep the right amount that is best for you. Emotionally take care of yourself as well. Journal, talk with friends, and de-stress.
Kaitlin: Ask questions! You are never going to know everything so it’s perfectly okay to admit that you don’t know something. It’s good to be a little nervous. If you’re nervous about something, it means that you care. Whether it be hanging your first IV medication or taking care of the sickest patient on the floor, nerves are a good thing. Go with your gut. If you feel like something isn’t right, it probably isn’t. Talk with your co-workers. Nursing is a very unique career and we see and do things that most people wouldn’t understand, however, other nurses GET IT. They know what you’re feeling because, chances are, they’ve been there before. It’s good to debrief about difficult situations and talk about your feelings. Oncology nursing in particular is mentally, emotionally and physically exhausting. Don’t keep all of your thoughts and feelings bottled up because you’ll get burned out in no time. Find balance (Right, Amy??). Find activities that help you de-stress and forget about work. Ames: Yes Kaitlin!
Carrie: Ask question, ask questions ask questions, but also be confident with your own nursing judgment. If someone else tells you that a situation is totally fine, but deep down you feel that it truly is not, ask someone else and follow your gut. Be patient with yourself and the learning curve. This profession is hard, and just when you think you are starting to feel comfortable you may have a patient throw a curve ball at you, with a certain diagnosis or situation that you have never even heard of before and you will feel like a brand new nurse all over again. Use your peers for support. When you are feeling frustrated about a situation or maybe need shoulder to cry on, use them, because they have probably been in your shoes one time or another. Ames: Yes, this is one of the many reasons I love therapeutic runs with Carrie!
Ames: I’ve heard (aka experienced) that it was really hard to transition from when you were training (had your preceptor right there for questions) to really being on your own. What are your best tips for this period?
Amy P: Realize that even though you don’t have a preceptor anymore, you are not alone! I was lucky to have my first nursing job on a very supportive unit and there was always a more experienced nurse close by. Always ask questions when you aren’t sure about something. Much better to ask a question you may think is silly, than potentially make an error and harm your patient! That being said, you know much more than you may think you know. You build on your experience every day. Trust your intuition. Each day gets a little easier and your confidence improves. Don’t beat yourself up about those bad days. Every nurse has those days when they feel inadequate. It doesn’t matter how much experience you have. Then you will have those really great days that remind you why you became a nurse in the first place. Remember those days when you have the not-so-great ones.
Ali: Try not to have the mindset that you are your preceptor’s “assistant.” When I first started I sometimes convinced myself that I was just “helping out” my preceptor and she was the real/true nurse. I would recommend trying to set your mind as a nurse as early as possible and allow yourself to take the lead when you can. Your preceptor is there to guide you (not to have you follow behind them)! Ames: Really great point!
Courtney: While it can be very intimidating to no longer have a preceptor by your side, remember that you are never really “on your own”. Nursing is a team effort and I feel our night shift is a great example of this. If there is a problem going on, most nurses know about it and are helping the situation as best as they can, or at least giving their feedback. The charge nurse should always be there for you and do not be afraid to continue to ask questions. I find that it is most helpful when new nurses use their resources to find the answer to their question and then consult someone with more experience with what they found. This shows that as a new nurse you are trying your best to be independent, expand your knowledge base by using available resources, and making sure you are correct before going ahead with a task. I also found it comforting to know that my assignment always looked worse on paper. I would get really overwhelmed reading notes and getting report at the beginning of my shift, and then once I met all my patients I would realize that it was not that bad (I still do this!). I have to remind myself not to be so anxious, look at what has to be done right away, and take on one thing at a time. Overtime I have really learned to prioritize. While keeping the big picture of your assignment in mind, you learn to focus on one thing at a time and before you know it, everything is handled and under control. Another thing I have learned is to delegate appropriately, although I can still work on this. At first, being an NA prior to a nurse, I did not like to delegate much to my NA, knowing that when I was an NA I found it annoying when a nurse took more time to find me to do a task instead of just taking care of it themselves. I have learned appropriate times to ask for help and to help others when I can. I also find it easier to ask for help when I have supplies ready for that person to help me.I continue to remind myself that I am truly not “alone” in my job and that I have very supportive coworkers available to help whenever/wherever I need them.
- Ask Questions even when you “think” you know the answer.
- Don’t be afraid of the doctors.
- Utilize your coworkers as a support system
- Talk through the tough situations, but also the awesome experiences you have
- Praise yourself when you feel like you did a good job and legit tell yourself someday that “You Rocked it” Ames: I love these Carrie!
Amy P: Hang in there! There is always turnover on nursing units and you will be surprised at how fast you move up in seniority. Then you can snag those better shifts. In the meantime, do your best to maintain that work-life balance like I mentioned above. Get plenty of sleep, exercise, and eat right. Hang out with your new nursing co-workers after those odd shifts. They are on the same schedule and can empathize. They also have great tips on how they manage the crazy schedule. I always enjoyed going out for a drink after a PM shift or breakfast after a night shift with my co-workers. It was a great way to unwind and also vent, if needed. I always got the questions “when do you sleep when you are working nights?” and “when do you sleep on your days off?” What worked best for me was going to bed as soon as I got home from night shift. Ames: Me too! The less exposure to sunshine the better for me! I wore dark sunglasses on the drive home. I would generally get to bed by 8:30 or 9 AM and sleep until 5. Then I would get up and go about my day. On my days off I would usually get up by noon or 1 if I worked the night before. Ames: again, me too! I would try to stay as active as possible that day so I wouldn’t be tempted to nap. That way I would sleep better that night and be on a more “normal” schedule for the next day off. If I only had one day off I wouldn’t usually try to flip my schedule too much. The main thing is to find a schedule that works for you and that will give you enough sleep.
Courtney: My best advice for getting through having a tough schedule would be to stick to a routine. If you are working a stretch and only have one day off, I find it easiest to keep the same sleep pattern and routine. Having a routine makes for the most productive weeks for me. I know that I felt a lot of pressure to work 40 hours a week when I first started. My dad especially did not understand why I struggled so much and was so exhausted with working 5 days a week. He was not experiencing the physical and emotional exhaustion I was having working that much, working off hours (PMs/NOCs), and working rotating shifts at the time. I would advise new nurses who are having a difficult time with long stretches and odd hours to drop the percentage they work so that they do not get burned out from the start. I also know that at first, working off shifts, that I felt guilty sleeping during the day, or sleeping late in the morning after a PM shift. I learned that sleep was really important, no matter what time I was sleeping at, and that I had to be productive when I was awake, even if that meant late at night. Over time it does get better! You get used to what routine works best for you with sleeping/eating/exercising/being social and eventually different positions with different hours or weekend rotations will become available that may better suit you.