10 Things I Learned In My First Year As A Nurse
They say you learn more on the job than you do in all 4 grueling years of nursing school and They. Are. Right. While you may have “made it” to graduation, there really is no end goal in nursing. You’re in a constant state of questioning and critical thinking and growing, and just when you think you know what you’re doing you’re faced with a tough situation that shows you just how much you don’t know. There’s a reason one of the roles of nursing is Lifelong Learner!
Quick background on my unit: I was a nursing technician on my floor for a year, then started as a nurse last July (2016) and was on my own sometime in October. I’m on a surgical cardiac unit and while we see a wide range of cases, our specialties are mostly heart and lung transplants, LVADs (left ventricular assist device – a machine for people with heart failure that pumps blood through their heart while they’re waiting for a transplant), thoracotomies (an intense surgery often used to remove lobes affected by lung cancer) and people who have had just open heart surgery, such as a valve repair or a Coronary Artery Bypass Graft. Or CABG for short, pronounced like the leafy green vegetable.
So let’s take one of these CABG patients, for example. They come up from surgery, still super painful, but we can’t just let them lay there. Oh no, we have to walk them at least four times a day. Oh yeah and they have like three tubes coming out of their chest attached to these big boxes plus a urinary catheter bag and oxygen and you have to find a place for all these accessories on their walker every time they get up. But wait! They just had their chest cracked open so they’re not allowed to use their arms. Oh and they probably need pain meds around the clock and they’re nauseas and they have fluids running and you have to get their blood sugar every hour and you have at least three other humans you’re trying to take care of *catches breath* What I’m trying to say is our floor is HEAVY! And this type of patient is often times the easiest heavy patient because we see them so often and can usually anticipate most complications.
A lot of what I’ve learned in this first year of nursing has been medically based and unit specific, like side effects of certain medications and what symptoms to look out for. But the list I’ve put together is more broad and can be helpful no matter what type of unit you work on, or even if you’re in a different profession!
- Ask questions. This may seem like a no-brainer because well, it is. A lot of your peers will have quite a few years of experience under their belts which may make them seem intimidating, but it also makes them really helpful! And most of the time people enjoy sharing their knowledge. While you may think google has your back, your fellow nurses are usually a better resource.
- Seek out learning opportunities. If your peers have a unique patient or have to do something you haven’t learned how to do yet, see if you can get involved! Ask if they need an extra hand, or if you miss the chance, just ask them a little bit about it so you can be more prepared if you ever run into a similar situation. If you come across something you’ve never heard of or could at least brush up on, ask around or look it up! If you don’t have time, write it down to remind you to look it up later. A lot of information was jam packed into the curriculum in nursing school, and a lot of it wasn’t specific to the type of unit I currently work on so there are a lot of concepts and terms that I find helpful to relearn.
- Build rapport with your patients. A lot of times when I meet my patients for the first time I like to make eye contact and give them a firm handshake. It sorta says hey, you’re in good hands and you are valued as a person. Then throughout my care I try to ask them about themselves and just get to know them a little bit more. It’s easy to see them as just another patient and harder to remember that they don’t normally wear a hospital gown in their everyday life. They have jobs and families and they’ve been on crazy adventures and seen some cool stuff. Or maybe they’ve had a rough go at things and that’s good to know too because maybe they could really use a listening ear or even just a kind smile.
- Be helpful. Helping your co-workers is a necessary contribution in creating a team atmosphere. Plus, when you help out a teammate they’re more likely to want to help you out too! Then everybody’s helping everybody. It also increases patient satisfaction and overall just creates a safer environment and a more enjoyable workplace. And that includes doing what you can to set the next shift up for success. While you may want to give milk of mag for the third day in a row sometimes you just have to suck it up and give them a suppository!
- Bundle care. This goes for night shifters especially! Nobody wants to fall asleep only to be woken up at midnight for vitals, 1 AM for a medication, 2:30 for a blood sugar and 4 AM for more vitals. Look at what you have for the night and make a plan with your tech so that your patients can get as much sleep as possible. We all know you don’t come to the hospital to sleep, but it’s nice if you can maximize your patients’ time to sleep as much as possible.
- Have a positive attitude. It’s often difficult to have a positive attitude in such a stressful work environment but it’s important in staying sane. I’ve had nights that have completely sucked solely because I was in a bad mood and I’ve had nights where my assignment was terrible but I made it to morning with a smile on my face because I made the conscious decision to change my perspective and stay positive. Sometimes you just have to laugh at the ridiculous things you might deal with during a shift and embrace the crazy nature of the job.
- Learn to prioritize, but don’t freak out. Most of the time it feels like you have at least a dozen things to do all at once and the panic soon sets in as you realize there’s only one of you. Maybe you need to take a patient downstairs for a test because transport is unavailable and you’re thinking about all the meds you have to pass when you get back to the floor and oh my gosh I was supposed to start those tube feeds an hour ago and then a family member calls while you’re trying to take a patient to the bathroom and of course you get a call letting you know you’re getting an admit. Yikes! Slow down, take a deep breath, and know that it’s all going to work out. Utilize your team and take one thing at a time. It’s all going to get done eventually! #stillworkingonthis
- Show gratitude towards your team. This is another thing that helps contribute to a positive work environment and team atmosphere. Let your coworkers know how much you appreciate them and all their help! We’re all working hard and it’s good to show each other recognition for our efforts. Some people might not hear it enough! Maybe people think they’re just doing what’s expected of them but everyone wants to feel appreciated and they usually work better when they are!
- Don’t keep it all inside. Nursing is a stressful career. We’re thrown into a lot of intense and frustrating situations and we also see a lot of heartbreaking things. I’m lucky to be married to a nurse who understands the nature of the job, but you can also talk to your coworkers or even just journal about it.
- Take care of yourself. I feel like this is really underrated in nursing. We’re so busy taking care of other people that we forget to take care of ourselves! You can’t pour from an empty cup and you’ll have so much more to offer if you take care of yourself first. This is something I still struggle with but I’ve definitely seen a difference at work in weeks where I’ve prioritized better self-care compared to when I don’t. Get some sleep, eat healthy, go for a walk, whatever it is that you need!
It’s crazy to think it’s been just over a year since I’ve been on my own. I still feel like I’m a brand new nurse at times! I often feel like I’m just trying to survive the shift ahead of me but I want to be more intentional but learning more and becoming a better nurse.
What lessons have you learned in your profession?