Many recent nursing school graduates have recently started orientation as new graduate nurses. Orientation is a time that can be stress-filled, overwhelming, and even nerve-wracking. Below, I’ve compiled some of my favorite tips for new graduates embarking on their bedside nursing journey.
1. Bond with your fellow new graduates and cohort.
I am still so close with the new graduates in my residency program. Befriending the nurses in your exact position is embracing a built-in group of nurses who know exactly what you’re going through, and they can offer comfort and share experiences and tips. Debriefing with fellow new graduates and discovering they feel the exact same way as you do can be very validating. Make time to talk with your cohort, and make an effort to be each other’s cheerleaders on the unit.
2. Figure out who your resources are.
Your preceptor or clinical coach is an obvious resource for you on the unit, but I guarantee you there are others—a charge nurse, a CNA, a tech, or even a transporter or other clinical associate. Resources are people who have worked in the unit for a long time and can answer your many frequently questions: It may be where to find something obscure, a unit or hospital policy on a certain issue, or how to perform a clinical task. Also, just because you’ve graduated from nursing school doesn’t mean that books, manuals, and Dr. Google are no longer available to you!
3. Grow a thick skin.
It might be a terse comment from a doctor, a rude comment from a fellow nurse, or a patient who is ungrateful or angry, but I guarantee that something will upset you. Try not to take it personally. Remember that stress runs high on hospital units, and patients in the hospital are by definition not at their best. Try to grow a thick skin and move on.
4. Write things down.
Search for “nurse brain sheets” and find some that apply to your unit, or make your own. All that great note-taking you learned in nursing school can really pay off when you write things down on the job. If there’s a highly detailed policy or procedure in your unit for transferring a patient, for example, or a series of numbers to call to page dietary, write them down on a clipboard. You won’t regret it.
5. Get as much sleep as you can, and pack good lunches.
You may not be in control of your own schedule for a while, and that is both difficult and frustrating. Try to do your best to make sure you’re getting enough sleep before and after your shifts. If you’re transitioning to night shift, be sure to ask other nurses for tips on how to prepare. You are learning so many new tasks, procedures, and thought processes that sleeping after a shift is essential to strengthening the memories you’ve formed that day.
Although you may be too tired to grab a healthy breakfast or to grocery shop and pack a solid lunch, it’s imperative that you are able to keep your blood sugar high and your body fueled for your never-ending shifts. It’s no secret that nurses rarely get lunch breaks, so focus on snacks that are portable and quick and easy to eat on the run.
6. Try not be afraid to speak to physicians.
Learn how to speak to physicians in the SBAR format: situation, background, assessment, and recommendations. Effective communication is key to being a member of a care team and is critical for patient safety. Try to master the SBAR technique when speaking with physicians (and it is OK to have to practice what you would like to say before you pick up the phone!).
7. Cluster your care.
Time management will be something you work on for many months. In the beginning, the best you can do is try to cluster your care and anticipate orders. I used to think about it as “saving steps” — how can I walk one fewer mile today? What tasks can I group together? How can I go into this room only once instead of four separate times?
8. Timely documentation is absolutely essential.
Staying late to catch up on charting is a bad habit, and if you can stop that from the beginning you’ll be in better shape when you’re on your own. Try to document things as soon after you do them as possible so that you’re not constantly playing catch up. This is easier said than done, so be sure to ask your preceptor for his or her best documentation tips for your particular unit. One of my favorite tips is that if you have to check to see whether it’s been too long since your previous set of vital signs, just grab them!
9. Don’t be afraid to mess up….but try to only make the same mistake one time.
At some point, you have to realize you can’t wade into the deep end, and you’ll have to just jump in and fly solo. In the beginning of my own nursing career I remember being so terrified of making a mistake that I was virtually paralyzed by fear. This was not helpful, most especially in a code or critical situation! If you do make a mistake, forgive yourself, but try not to ever make that one again. Rely on your preceptor to catch you before a mistake reaches a patient. Formulating a trusting relationship with your clinical coach is also very beneficial.
10. You’ll never feel ready.
There will come a day when your preceptor and unit manager feel you’re ready to be on your own. When that happens, although you may feel like you are nowhere near ready, remember your resources. The first shift will feel out of control to you, but that’s OK! This is just the beginning of a long journey, and you will be a novice nurse for years. One day you’ll have a shift when things just click, I promise. Take deep breaths, focus, and remember to be the safest nurse possible.
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