When I worked at the bedside, especially in my later years, I started precepting new nurses and nursing students. Just like I will have a preceptor in my upcoming clinicals, I used to be on the other side of the equation! Basically, you’re paired one on one with a nurse to help build their skills, teach them the ins and outs of nursing, and eventually set them free to be independent. I always found it interesting to see nursing, patients, and the system through the eyes of someone new. It really made think about my practice and reminded me how much I learned over time.
Jenny recently started an accelerated BSN program (Go Jenny! You got this!), so I’ve been talking to her a lot about nursing school. It’s crazy to think back to what it was like as a student – we were all once beginners and didn’t gain experience overnight! I asked her if she had anything she’d like to see for Nurse’s Week, so thanks for the ideas! She asked if I had any words of wisdom for students (or new nurses) who are freaking out about lab checkouts or school or clinical in general. It’s pretty humorous because I’ve given her advice and then turned to nurse anesthesia students who are ahead of me to basically be told the same thing – freaking out about starting clinical and being prepared for the unknown. It’s mostly the same things I would try to instill in nurses I was precepting, so sometimes you have to learn to take your own advice!
So without further notice, my words of wisdom to those students or new nurses out there. (I will be reading this back to myself before my first clinical, that’s for sure!)
You may have heard that nurses eat their young. I personally think that this occurs because people forget what it’s like to be new and that there is a huge learning curve in nursing. That being said, be prepared! If you just learned how to take a blood pressure, great! We know you’ll have a first time for everything, just like the rest of us had a first time for everything. Know the drugs you’re giving, know what signs and symptoms your patient may have depending on their history and why they’re in the hospital.
…but you won’t know everything
And that’s okay! We weren’t born knowing how to be be a nurse, knowing which patient to assess first, how to effectively communicate with other members of the team. Be willing to learn and be teachable is so key. Always ask questions.
Skills Can be Learned
I’d rather have a nurse who knows that a patient with a low oxygen saturation needs attention rather than someone who successfully placed IVs from day one. Many of the hands on things are skills, and skills take practice, but can be learned. It’s much easier to measure success with drawing blood, but it’s harder to teach the idea of being able to walk into a room and realize something is wrong. (Experience can help with that, of course.)
You Will Make Mistakes
No one wants to make mistakes, especially since we’re dealing directly with people. However, as a new nurse, it’s going to happen – which is why you have someone watching out for you and hopefully preventing anything from reaching the patient. Use it as a learning experience and try not to beat yourself up about it. It can happen to even the most experienced practitioners.
Every Moment Isn’t a Learning Moment
One of the tricky things about being new in the health care world is that time doesn’t slow down. When you’re new, everything takes twice as long. Sometimes things just need to get done, so someone may step in to help catch up. Sometimes an emergency happens and that’s not the time to throw in the new person – observe and talk about it later, but not every moment is teaching moment. If a preceptor jumps in and takes over, look, listen, and learn, but again, don’t beat yourself up about it.
It’s Okay to Cry
Oh man. I cried so much in my first year as a nurse. I once found a resident crying in the supply room. The learning curve is high and it can be so frustrating to just want to get it and be able to do it, but always find yourself behind. Sometimes you cry because you’re behind, sometimes you cry because patients or staff aren’t always nice. Take a deep breath, drink some water, splash some water in your face, talk about it with someone you trust (preceptor, other students, etc), and remember you don’t become a nurse overnight and that you’re working with people who are going through a challenging time.
Always be ready and willing, and try to take initiative as best you can for the level that you’re at. If you help someone take a patient off a bedpan (this is nursing, it will happen!), they may be more likely to pull you in to see something cool. Keep your phone in your pocket! (Or backpack. Or locker.) Smart phones weren’t around when I was in school, and I know there are lots of apps you can use, but try to stay off your phone and if you do use it, ask or mention that you’re using it to look something up.
Develop a Routine
This is one thing I always told people I was precepting. There’s always a list of tasks that need to be done, and you’ll remember to do everything if you do it in the same order every time. (Sometimes it gets changed around when working with a patient, but you can at least run through the list in your mind.) Do your head to toe assessment the same way each time. I used to walk into a patient’s room, scan for the emergency equipment, say hello and ask how their day/night was while writing my name on the white board, took vital signs (oxygen sat on, BP cuff, temperature, listen to heart, lungs, bowel, ask about last bowel movement), rest of head to toe assessment, ask about pain, talk about plan for the day, refill water etc, done. Your routine can be whatever works best for you, but develop one that works for you and stick it it.
Stuff Your Pockets
Until you learn what you’ll need for what you’re doing in patient’s room, stuff your pockets! Saline flushes, alcohol swabs, red caps, 2×2 gauze, tape, scissors, clamp…it’ll cut down on having to run out of a room for the one thing you forgot until you get better at remembering what you need for everything.
Say Thank You
You may have a bad day. Your preceptor may have a bad day. (We’re all people, after all.) But always treat people how you would like to be treated, and thank your preceptor/other staff at the end of the day. Precepting a student or new nurse isn’t easy, and sometimes you have to do it even though you’re not really in the mood to. Even if your day didn’t go so well (and maybe you got some criticism), thank them for the learning opportunities and teaching – they may not go so hard on you next time, either!
Fake it Til you Make it
I feel like this one is a little controversial, but be confident in what you know and can do (and know what you don’t know!). Patients can sense when you’re hesitant, and you want them to be confident in your care even if you’re not totally sure. (If only I had a dollar for every time I said to a patient, “Let me go check on something, I’ll be right back!” then ran out of the room to ask a more experienced nurse.)
Know Where the Bathroom is
When you gotta go, you gotta go. It seems silly, but it can ease your mind knowing where the bathroom is.
Whew! That’s all I’ve got for now. I hope this helps anyone out there who is just starting out – I’ll be starting back as a student in the clinical setting too, so I have to remind myself of all of this. Some days will be great and others will be really, really tough, but no one is born knowing how to do this. The only way to get experience is to actually do it. Be confident, be prepared, and always, always ask questions.
Nurses – what are your best tips for students or new nurses? What helped you in the early days?