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New Nurse Transitions

Hi all,

I have just begun my career as a full fledged registered nurse. I can hardly believe I have passed my exam and have a career, it is just a tad sureal. I am noticing now more than ever the gap between what we learn in school and what I need to know now, working out on my unit. Things take me 5 times longer because I do not know where a certain number is, how to communicate with a Dr or team member or even something small like how to take a poop sample!!

I am feeling defeated, tiered, and overworked when I get home. I know in my mind that once I begin to do these things over and over they will become second nature to me but in the mean time it is not easy being new-in an enviironment where you are unsure of your actions and your surroundings.


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11 Responses to “New Nurse Transitions”

  1. Doreen Says:

    It will get better and you will find yourself thinking you know nothing and then surprise yourself that you really do know something. I have just completed my first year as an RN and it was and is scary. If you are lucky enough to work with seasoned nurses that like to share their knowledge you are in luck. My first year I have worked with some amazing nurses and some real bi***es, those that are helpful and take time from their busy day to answer a question or assist you in a procedure are the best. I still feel like I know nothing lol. Best of luck.

  2. addie Says:

    It’s not easy I know. I as well just graduated this year and I know the feel of not “knowing anything” or at least feeling that way. But remember you’re always harder on yourself than what other’s are actually expecting from you.I repeatedly got told to ask for help, I tried to take on too much. Feeling that, I went to nursing school I should be able to do this. They will think I’m a failure if I don’t/can’t. And then when I started to ask for help I felt as if everyone else was too busy with their own pt load to really help me. Which was more often than not true. I even tried to call the hospital educator one time when I needed some back up as I was ordered to give Narcan stat. But as I had never done this and was not sure what to expect I wanted someone there with me. Unfortunately all she ended up doing was bringing me the policy and IV manual page. Which I had already looked up, so I never have called them since. HOWEVER it does get better… ish. I say ish as I come from an area where we are so over crowded they’ve put pts in the hospital coffee shop. Not to mention the acuity is through the roof to which the manager replies have been “you all have the same staffing levels that are across the province” Result I’ve left acute care for continuing care and psych and am much happier although still feel as though I wimped out/failed…. Yeah sorry maybe this is not that helpful but in effort to actually help here’s some sound advice-
    When talking to a Dr use SBAR
    S- situation
    B- background
    A- assessment
    R- Recommendations
    There’s lots of lit on it and everytime I’ve had to call a Dr and used it I’ve had great responses even other nurses commented that “wow that Dr is usually so rude and you can never get orders from them”
    Good luck and talk to your fellow grads cuz we all feel this way just most are afraid to admit it for fear no one else feels that way

  3. Jason R. Thrift, RN, BSN Says:

    Take heart, Alicia, this too shall pass. I’ve been right where you are now. It’s no fun knowing that after all of the time and effort you have spent for the last 2-4, maybe even 5-6 years that you come into the workforce of nurses and basically have the realization that you don’t know jack, but it’s the truth.

    I’m assuming your orientation is over with now, correct? That’s why I’ve been researching mentorship and residency programs while going for my master’s because this is a very, VERY weak point in the nursing world. The transition from a student to a full fledge nurse, as you say, is ridiculous. Some can handle it, a lot more cannot.

    A mentorship is not going to help you in your situation since you’re beyond your orientation, but from what I have read in your post you already have a good idea of what you need to do.

    One thing I would suggest is a very simple set of questions my mother used to ask me when I first started out as a nurse. She could tell I was ready to pack it in several times back then and didn’t want me to give up. So she asked me this:

    “Did you have a lot of patients? Did you have a lot of patience?”

    Now, it’s a neat way to ask this, but the questions are very good. You have to learn patience with yourself, your coworkers, and especially your patients. Once you get that down, everything else will follow suit. Don’t know how to help you with doctors, that one may never be solved until doomsday.

    When you feel the stress building, ask yourself these questions, then go ask questions. If you piss someone off, GOOD. They are there to help you as much as they are the patients. Nurses are literally in it together and none are more superior to another. Unless it’s by title only, but even that is very hollow when it comes to taking care of patients and each other. Any good manager, director, or CNO would tell you the same.

    So keep your chin up, use the knowledge you know you have, ask for more from those that have been there longer, and be not afraid! Just be conscientious, have some faith, and never forget patience.

  4. jparadisirn Says:

    My first six months as a new grad nurse were so painful, I almost quit. More than twenty years later, I can laugh about it enough to post them on my blog, I was lucky to find a great mentor, but don’t wait to see if that happens for you. Accelerate your knowledge base by looking up your patients’ diagnoses in textbooks at home to compare what happened on your shift, and look for information you may have missed in school.
    Trade work for work with your coworkers by offering to take vitals or other tasks to make up for the time they take to help you.
    And don’t forget your other non-nursing colleagues as resources: Pharmacists can provide medication administration advice and check your math. Respiratory therapists can offer advice on airway management and options.
    Buy coffee for the people who frequently help you and cover their patients when they need a break. Most of all, be patient with yourself. Becoming a nurse is a process, and it takes time. There are no short cuts.

  5. C.V. Compton Shaw, R.N., B.S. Biochemistry Says:

    First, you must “comprehend” the medical-nursing situation that you are in. Secondly, based upon this “comprehension”, you must make a “nursing” judgement based upon this “comprehension”. Lastly, based upon the aforementioned, you should utilized “reason” to adapt to this and future similar medical-nursing problems.
    In order to “comprehend” a particular “nursing-medical” problem, I suggest obtaining a PDA with appropriate medical-nursing software on the same. The same can be obtained on EBay extremely economically. My above theoretical statements are derived from a book by Kant called “Critique of Judgement.”

  6. Old dog new tricks Says:

    Breathe deep. Ask questions. Watch everything you can to learn. And say a prayer of thanks and guidance.

  7. Lois Says:

    Alicia, the well-kept secret is that we all felt that way at the beginning of our careers. If you are in a hospital that values new grads, then you should have a mentor to whom you can turn for help. Please, above all, don’t feel pressured into doing something more quickly than your skill-level currently allows. Protect yourself, your patients and your license. The rest will come over time, so be patient!

    Lois P2, PhDc, MSN-Ed, RN

  8. Leslie Says:

    Hang in there. It is a lot to take in in the beginning but move at a pace that is comfortable for you. I think we all were intimidated at first. I was in a daze for weeks after taking my boards not to mention getting over the shock of actually passing. My first job was on a pediatric med/surg unit where I worked in a surgical pod with patients who were undergoing a new procedure to correct pectus excavatum. I learned real quick how to deal with docs/residents/interns and bossy ER nurses (which I later became). I was a nurse 3 months and I transferred to a level 1 ER. Talk about feeling completely unprepared but I had a rockin preceptor who had been a nurse for 23 years and just walked me through those first couple months. Trust me, it is a learning experience every day but it does get better. Stick close to the nurses who want to help and support you.


  9. Veronique Says:

    Hello Alicia,
    Your feelings of gaps are so correct. Reality vs Idealogy. May I suggest that you stay true to the authenticity of nursing, that is the patient lead relationship. I suggest to try an not be overrun by the tasks and climate of a hospital that makes the nurse disappear int the walls. I suggest getting all the acute experience you can for a few years and then jump into the real world of patient phenomenal experience either out in the community or clinic. Nursing is standing beside the patient while they are living the illness. This cannot be done while they are staying in a hospital which is organized as a machine to escort only one profession The medical professionals. I suggest studying the carative factors by J Watson. Because in the long run you will be burntout when the workplace makes your efforts invisible. Good luck stay true.

  10. Gen’vieve Says:

    After a year as a brand new nurse, I went back to waitressing. I make more money waitressing and my stress level is markedly decreased. You have to have the guts to make hard decisions and I made the best one by leaving nursing. The hard questions are, “Am I on the right floor? Can I see myself doing this long term?”

    My preceptor was awful, my manager is more concerned with productivity numbers and not what it takes to get there and our attrition rate is horrible. I didn’t have a choice of jobs at graduation due to the economy and no one hiring new grads.

    If this doesn’t mean anything to you, then hang in there!!

  11. Brenda Sutter Says:

    Hi Alicia, I hope I can make you feel better, by telling you, we have all felt the same way in the beginning. Some of the best nurses I know, have said they “didn’t sleep for the first month” after finishing school and starting a new job. You are not alone or weird for feeling as you do. In fact, I kind of take it as a good sign, that you are concerned and worried. It shows how deeply you care about your patients and your profession. Congratulations on becoming a RN. You are on you’re way to becoming a great nurse.

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