You've persevered through countless lectures, long clinical shifts and late night study sessions, and you're finally a registered nurse. Surely the real world won't be as difficult as nursing school, right? Brace yourself, brand new graduate, because your education is just beginning.
The biggest reality check you'll likely face in your first job is the higher patient ratios of working on a unit as opposed to nursing clinicals. While you may have only cared for one or two patients in hospital clinicals, you'll find yourself assigned to anywhere from four to eight patients in acute care settings, depending on the unit's acuity as well as the shift worked. Expect far more patients if you begin your career in long-term care. Developing an organizational system for completing your shift work becomes critical with this adjustment. You can ask your preceptors for some advice on their organization of shift responsibilities, and then adapt it to work for you. A key point is getting to assess each of your assigned patients early in the shift, and checking what medications are due at what times. Many nurses make a small checklist, noting med times and blood sugar checks to refer to on their clipboard.
While it is a nice idea that all your coworkers will be happy to help you without complaint, you probably already know from your clinicals that's not always a reality. Fortunately, it may be easy to figure out which nurses are happy to help. Start with your charge nurse, especially if he or she doesn't have a patient assignment. Find out who the other veteran nurses are on your unit and ask them for tips on everything from diagnoses to time-saving tips. The organizational tricks can be discussed during breaks, so you aren't pulling them away from patient care. And if other nurses help you with something, try to offer some help in return if possible, such as assisting with vital signs or blood sugar checks. That may be tough at first, but as you get more comfortable with your new patient workload, you may find some time to offer a hand to them as well.
For questions about how the unit runs, don't be afraid to utilize other personnel besides a registered nurse, such as unit secretaries and clerks. They are the hub of the nurses' station and can be a great resource.
Hang in There
All new nurses have felt overwhelmed at some point, and had moments in which they thought they couldn't cut it in the real world. We've all been there, and we've all worked through it. Also, recognize you'll never "know it all" in this profession, and that new things are learned every day.
So take a deep breath, ask for help when you need it, and realize that you can get through this and that things will get a easier. Before you know it, you'll be the wise veteran giving the new nurses advice.
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