1. Nursing school is nothing like doing the job. I think that they make the schooling so ridiculously awful to maybe weed out the people that shouldn’t be in the profession.
2. Realize you have to pay your dues. We all have to start somewhere. Usually it’s med surg but not for everyone. Being a new grad is scary and hard, but you need this time to gain experience and develop your critical thinking skills to make you the best nurse that you can be.
3. Put a little water in the commode before you empty it! I learned that one the hard way when I emptied a giant BM in the toilet and a monster splash occurred. Man down. I was hit! Gross…… Almost quit right there.
4. Do not reposition a heavy patient yourself. I don’t care how young and strong that you think you are. All it takes is one wrong move and there goes your back and your livelihood.
5. If you cannot picture yourself in a court of law to testify to why you did something than don’t do it. I once had a Doc write an order for an obscene amount of Xanax to be administered PRN for a patient that I was caring for. And yes, the patient wanted it, all of it, although she could barely keep her eyes open. When I questioned the order his response was, “She takes this at home and she will get her hands on it anyway.” I went to my manager and refused to give it. It was enough to put down an elephant. Advocate for your patient but also yourself. It’s your license.
6 Don’t be afraid to ask for help or admit that you don’t know something. This is not the career to pretend that you know something that may get someone hurt or worse. Check your ego at the door. These are people’s lives you’re dealing with. You need to have some inkling of what you’re doing.
7. #6 Being said…. Know when to fake it. Sometimes you are going to have to appear confident and twist the truth a little. A patient who is getting an IV started doesn’t want to have a nurse do it who has never done it before. You need to exude confidence because believe me, they spot a newbie a mile away, and they will have no problem calling you out when they see that you’re nervous. In certain circumstances when the patient asks “Have you done this before?” your answer is always yes. They do not need to know it was a dummy in the lab or on an orange that you did it on. We all have to do these things a first time.
8. Realize that you cannot completely overhaul a patient and fix all of their issues. Rome was not built in a day. Some of your patients you will never make any progress with. I once got a CHF patient to stop eating Ramen Noodles but that was all she would agree to do. Hey, it was something…
9. Practice self-care. When you are not taking care of yourself it makes it extremely difficult to take care of others.
10. Realize that 99% of the population has a psychiatric diagnosis of some sort whether diagnosed or not. In this career, you are dealing with A LOT of people with A LOT of issues.
11. Treat home health aides and ancillary staff VERY VERY well or you are going to be VERY VERY sorry.
12. Be accepting of what type of nurse that you are. But also, realize you have to be a chameleon in this gig. I for one am not the most coddling and nurturing person by nature. I started out my career on a post-operative surgical floor and it was my job to get people’s pain controlled and then up and motivated when that was the last thing that they wanted to do. That is what I am good at. But also, you have to be flexible and realize when a tough love type of care giver is needed or when a softer more caring approach is called for such as the case with a terminal cancer or a hospice patient.
13. Invest in good shoes. You rarely will sit down…. Like ever.
14. Stop yelling! Just because a patient is old does not meant that they cannot hear. Don’t assume. I was speaking very loudly to my elderly patient once who then turned to me and nicely said, “Sweetie I know I am old but I can hear just fine.” I felt stupid.
15. Go with your gut! I cannot tell you how many times I have had a patient where I just knew something was wrong but in assessing them they were seemingly ok. After you’re in this career for a while you can spot something coming. Send them to the Doc or call the Doc to assess or make a suggestion.
16. The saying sadly is true. If you didn’t document it, it didn’t happen. Yes, documenting is AWFUL, but you need to cover your ass period.
17. Realize that medicine is a science created and managed by humans and guess what? Humans are flawed. You will make mistakes. We all do. Learn from them and move on.
18. Leave work at work. Or you will burn out very fast.
19. Patients get sick and die. Your patients may get sicker and some will die. That’s a fact, and there may have been nothing that you could have done differently. This is life.
20. Know when to move on. You can do so many things in this profession. I never understood why I would see a crabby miserable old nurse who has never left the med surg floor after starting their one-hundred years ago. It’s ok to try new things. You will probably need to maybe even many times over the length of your career.
21. Let the 99-year-old with CHF have the salt shaker. I mean….. C’mon.
22. Go to the bathroom and take your lunch. Patients can wait…
23. An extra five minutes will save you time. I was told this a long time ago as a HHA and it stuck with me. If you take an extra few minutes explaining what you are going to do with a patient and hearing their input on it, it will help you in the long run. No one likes to be pushed around and feel like they have no control over what’s about to happen to them. They are sick and in your care. They already have lost some control.
24. Double check and then check again and then have someone else check. If you do not know something (like a drug you are going to give for example) or are unsure of a dose prescribed or a procedure to be done… look it up, call to clarify and/or have another nurse double check with you. You can never be too sure.
25. Don’t forget to laugh. Some of the funniest things happen in the medical field that none of your non-medical friends will ever understand. Laugh and laugh some more at all of it and don’t forget to laugh at yourself.