A Day in the Life of a Postpartum Nurse

A Day in the Life of a Postpartum Nurse

My name is Sarah and I have been a postpartum nurse for about a year. I work on a 36-bed labor, delivery, recovery, and postpartum unit in the Seattle area. We take care of a variety of postpartum patients and babies on our unit, and see gestational diabetes, preeclampsia, small- and large-for-gestational-age babies, late pre-term babies, etc. I work three 12-hour shifts per week, and I am currently working night shift.

Typically, I have three to four couplets each night, all needing vital signs, assessments, medications, 24-hour newborn screenings and much more. I am lucky enough to work at a baby-friendly hospital where we encourage breastfeeding, so I spend about 30% of my time as a postpartum nurse educating and assisting my patients with breastfeeding. The rest of my time is spent delivering hands on nursing care (about 40%) and charting (about 30%).

It would be nearly impossible to write about the many things I do during my 12-hour shift, but I will try to describe a typical day as a postpartum nurse:

17:00: My alarm goes off. I snooze for another 15 minutes while I cuddle with my cat.

17:30: Shower time. Once I am squeaky clean, I eat a bagel and cream cheese and drink my English breakfast tea. I always make time to sit down and eat before I go to work so that I can fuel my body and mind.

18:10: I braid my hair, do my makeup, and put on my scrubs.

18:45: I say goodbye to my cat and she meows in protest. I head to my car and listen to NPR during my 10 minute drive to the hospital.

19:00: I clock in, grab a work phone, drop off my bags in my locker, fill my pockets with my essential nursing supplies, and sit in the break room to hear the unit’s announcements and safety concerns.

19:10: Out on the floor I am greeted by the day shift nurses, who are extremely happy to see the night shift nurses. I have been assigned three couplets tonight. Two are vaginal deliveries and one is a caesarean section. One of them is an experienced mom, and the other two are first-time moms. All have chosen to breastfeed their babies (yay!).

19:15: I find the day shift nurse who has my patients and we go into their rooms to get SBAR report, introduce me to the patients, and write my work phone number on their white boards. As I congratulate each set of parents and ask about their baby’s name, I scan the room and patient to make sure all my emergency supplies are available, tubes and drains are functioning properly, and the bed and bassinet are locked and safe.

19:40: After getting report, I sit down at a computer to gather additional information on my patients and plan my night. For each patient, I look at their history, orders, medications, and labs, and chart a Braden skin assessment and Morse fall scale. I plan out when vital signs, medications, and other tasks need to be done during the night.

20:15: Feeling organized and ready to take on the night, I visit each of my patients to tell them their plan of care. While I’m in the room, I restock supplies, take out trash or dirty linens, and tidy up the room.

20:30: I get a call from one of the dads. Baby pooped for the first time and they need help with the diaper change. I enter the room to find a screaming baby and panicked dad. Dad hands me the baby and I proceed to change the diaper while I educate the parents on diaper basics. The parents look at me with wide eyes as they see the sticky black meconium. I reassure them that this is completely normal as I swaddle baby and hand him to dad.

21:00: It’s time to do the first set of vital signs on my cesarean section patient and her baby. I get blood pressure, temperature, and do a full assessment on mom. Her belly is distended from the c/s and she hasn’t passed gas yet, so I talk with her about taking a medication to help relieve the gas and other alternative therapies she can try. She agrees to take the medication and try walking the halls, so I grab the gas pill, simethicone, as well as her Advil and Tylenol that are due. I assess her pain and give her the medications. I then listen to baby’s heart and lungs and do a full assessment. Baby has a wet diaper, so I quickly change it and swaddle him.

21:30: Spotting my charge nurse in the hall, I stop to give her an update on my patients and ask a few questions. She tells me there are cookies in the break room from a thankful patient, so I make a mental note to grab one later in the night.

22:00: I take my 15-minute break and scarf down an apple with peanut butter, pretzels, and cheese. I drink some jasmine green tea on my way back to the unit.

23:00: More vitals and medication administration. While in one of the rooms, I notice that baby has managed to wiggle out of his swaddle, so I wrap him up and spend a few minutes cuddling and cooing at him until mom has returned from the bathroom.

00:00: I get a phone call from one of my dads and he expresses concern about baby being fussy. I go into the room to see if I can help soothe baby. I educate the parents about the many reasons baby might be crying: hunger, wet/poopy diaper, wanting to be held, etc. The parents soak up the information like a sponge and begin to discuss what baby might want. They decide that baby needs to be re-swaddled and might want to be held. I watch and give feedback as mom swaddles the baby. It takes her two tries, but she is thrilled to have done it by herself.

01:00: It is time for the 24-hour screening, so the tech and I gather our supplies and head into the patient’s room. The baby is sleeping, so we take advantage of the quiet time to do the CCHD heart screening and jaundice check. Baby passes the CCHD test, but the jaundice level is higher than average. I explain to the parents that while I do the metabolic screening, I will also be gathering a small tube of baby’s blood to test the serum bilirubin level. The parents are asking questions about why baby’s bilirubin is higher, so I sit down to explain and educate them about newborn jaundice. While I’m discussing this with the parents, the tech is weighing baby and warming baby’s foot for the heel poke. Once the baby’s foot is warmed up, the tech holds the baby in her arms while I clean, poke, and gather blood from the heel. The baby doesn’t cry during the whole procedure and the parents proudly state that they have a brave baby.

01:30: I run the bilirubin test to the lab. I then get a phone call. One of the moms is having difficulty feeding her sleepy baby and she would like me to come help.

01:40: I enter the patient’s room and baby is sound asleep on mom’s chest. It has been almost three hours since baby’s last feeding, so I pick up baby to try to wake him. As soon as I change the diaper, baby is awake and crying…success! I help mom with her positioning of the baby and latching. It takes several tries to get baby on the breast, but after about 15 minutes, we are finally able to get him actively sucking. Mom is so excited and profusely thanks me for helping. I leave the room feeling accomplished and sweaty. Helping with breastfeeding is one of the more physically taxing parts of my job.

02:30: I sit down at the computer to do some charting and look at the baby’s bilirubin lab result. While chugging my water I see that the baby’s bilirubin level came back normal. I go tell the parents and they are noticeably relieved.

03:00: Break time! I grab a warm blanket and settle into one of the large lounge chairs in the break area. I typically try to eat healthy while I am at work to avoid feeling sluggish. Today, I have a salad with a variety of exciting toppings, rice cakes, and a La Croix sparkling water. I watch TV on my phone as I munch on my food. During the last 15 minutes of my break, I lay my blanket on the floor and do some stretching while I drink peppermint green tea.

04:00: Feeling refreshed and ready for the last few hours of my shift, I head back to the unit. I give pain medications to a patient, grab a set of vital signs on another, and help with a breastfeeding.

04:30: I get my cesarean section patient up to the bathroom with the help of my tech. While I am in the bathroom with my patient helping her with peri care and Foley catheter removal, the tech is changing the bed linens. The patient stands up from the toilet and says she is feeling dizzy, so we quickly escort her back to bed to relax. She hasn’t slept in over 24 hours, so I encourage her to get a quick nap in before the next breastfeeding.

05:00: I check in on one of my patients I haven’t heard from in a few hours. She is resting in bed with baby skin-to-skin on her chest, and she excitedly tells me she was able to get baby to latch all by herself. I congratulate her and chart about the breastfeeding and a poopy diaper.

06:00: A worried grandmother comes out in the hall seeking help for her daughter’s baby who is spitting up. I hurry into the room and help baby work up the amniotic fluid. I educate the parents on how I helped baby, clean baby up, and put the baby skin-to-skin on dad’s chest.

06:30: My tummy grumbles and I remember about the cookies. I sneak into the break room hoping there are still some left. I snag the last one and hungrily snack on it as I review my charting for the night.

07:10: Feeling a bit delirious, I give report to the day shift nurses. I say goodbye to each of my patients and introduce them to their new nurse. One of my patients gives me a big hug and expresses how much I helped her survive the night. My heart swells as I walk out of the room thinking, “This is what makes it all worth it.”

07:35: I clock out, feeling excited and relieved to have survived another shift.

07:45: Finally home. I am greeted at the door by my very-happy-to-see-me cat. I quickly shower, put on my PJs, turn on relaxing music, and read my book while I snack on nuts and berries.

08:50: Snuggled in bed, I set my alarm for 17:00 and get some much-needed rest so I can wake up and do it all over again!

Surviving Your First Year as a Nurse

Surviving Your First Year as a Nurse

So you’ve graduated from nursing school, passed the NCLEX, and gotten your first nursing job. All the hard work is done, right? …Not quite. While the path to becoming a practicing nurse may not be the easiest, the reality is that the work is just beginning. Your first year of being a nurse will most likely be incredibly difficult. You are going to struggle as you learn the vast number of skills that it takes to be a nurse in your specialty area. Here are a few tips to help you survive and thrive during your first year as a nurse:

1. Ask questions.

One of the best ways to learn as a new nurse is to ask lots of questions. A lot of people might be afraid to ask questions because then they have to admit that they don’t know something. This is a natural feeling, but remember that you are not expected to know everything. Having the courage to speak up will help you be a more knowledgeable nurse. If you’re not able to ask questions in the moment, try making a list of all of your questions. Then when you have down time later, you can ask your questions.

2. Get to know your coworkers.

During your first few weeks as a new nurse, take some time to get to know your coworkers. Remember their names and say hello to them in the halls. Eventually, over time, you will be able to develop relationships and create a network of people you know and trust. This is not only important for your job satisfaction, but also for your survival as a nurse. Your fellow nurses are the ones who will be there to support you during difficult days, laugh with you after funny situations, and help you in emergencies.

3. Take time to relax.

When you get a day off from work, make the most of it! Don’t think about work, your patients, or your charting. Take time to relax and de-stress. If your mind is constantly thinking of work, then you may be at risk of burning out. Try to find an activity that gets your mind off of work like hiking, hanging out with friends, or reading.

4. Learn how to prioritize.

It is very easy to become overwhelmed as a new nurse. You may have several different patients to care for, or one high acuity patient. Either way, you will have a multitude of tasks to complete during your shift, some planned and some unexpected. Try breaking down your day into hourly increments of time. Within that hour, ask yourself, “What is the most important task I need to accomplish and what is the least important task?” With this method, you will not only be able to organize your tasks, but you will also be able to react appropriately when something unexpected happens.

5. Set realistic goals.

Being a new nurse is extremely difficult. Give yourself time to struggle and learn the ins and outs of nursing. You won’t be a super star on your first day. In fact, it could take you years to truly feel like an expert in your nursing field. With that in mind, set small and realistic goals. By setting goals that are easily achievable, you will build your confidence. Try setting a goal to learn something new every day. This will help you feel successful after learning a new task or fact, rather than feeling defeated and beating yourself up for not knowing something.

6. Stay positive.

Some days are going to be more difficult than others. On these days, remember to stay positive. Every nurse has bad days, even an experienced nurse. If you are having trouble staying positive, try making a list of the things that went well during your day, rather than focusing on the negatives. Your first year as a nurse will fly by, and before you know it, you’ll begin to feel more confident and on your way to becoming an expert nurse.

What Happens After You Graduate from Nursing School?

What Happens After You Graduate from Nursing School?

Graduation. It’s the moment that all nursing students look forward to, but what happens after this highly anticipated day? A lot of what happens next depends on how well you prepared during your last semester.

Here are a few tips to help guide you.

  1. Apply for licensure with your state’s Board of Nursing and register for the NCLEX exam with Pearson VUE.

In order to be eligible to take the NCLEX after you graduate from nursing school, you must apply for licensure/registration with your state’s Board of Nursing/regulatory body, as well as register to take the NCLEX exam with Pearson VUE. The cost of applying for licensure and Pearson VUE registration varies from state to state. Be sure to set aside several hundred dollars for this purpose. It also takes some time for your registration to process, so plan ahead and talk to your instructors about how far in advance they recommend applying for your specific state.

For more information on this process, visit the National Council of State Boards of Nursing website here.

  1. Start applying for jobs.

If you are hoping to have a job soon after graduation, you will need to start applying 3-4 months prior to graduating. It may seem counterintuitive to apply for a nursing job before you have your license, but it can take a while for your applications to be considered. Human Resource departments receive vast numbers of applications, and it can take them several weeks to work their way through them before deciding who to interview. Having a job lined up that is contingent upon passing the NCLEX helps relieve the stress of having to job hunt while you are studying. 

  1. Prepare for job interviews.

It is very important to prepare for your job interviews so that you can impress future employers and stand out from the crowd. You can do this by polishing up your resume and lining up your references during your last semester.  It’s also helpful to write a strong cover letter that can be tailored to each position you apply for. Take several copies of your resume, cover letter, and references to each interview.

Another major way to impress employers is by looking professional. Invest in a nice suit jacket and slacks or a skirt. This will help you feel confident going into the interview so you make a great first impression.

Be prepared for the questions that the interviewers will ask you by making a list of possible questions and having several detailed stories ready that you can use to illustrate your answers. Practice these with a friend beforehand so that you can become comfortable talking about yourself under pressure.

  1. Sign up for an NCLEX review course.

One of the best ways to begin studying for the NCLEX is to take a review course. There are several types of review courses. Some classes are purely online, while others are in-person, lecture-based classes. Think about your learning style and pick a class that fits with the way you like to study.

The focus of each class will also vary. Some classes will be strategy-based, meaning that they will teach you how to answer NCLEX-style questions. Other classes will be content-based, meaning that they will give you the basic foundation of knowledge that you will need to have in order to pass the NCLEX. To decide which one is right for you, think about why you typically miss a sample NCLEX question. Is it because you don’t know the information needed to answer the question? Or is it because you don’t understand what the question is asking and how to answer it with the best response? Think about the primary reason for your mistakes and choose the type of review class accordingly.

  1. Make a study plan.

Much of your time following graduation will be spent studying for the NCLEX. It is important to make a study plan so that you can use your time efficiently. Set aside a chunk of time each day to sit down and study. There isn’t a magic amount of studying that will help you pass the NCLEX, because each person is different. Some people will only need to study 1-2 hours a day, while others may need to study 4-5 hours a day.

It’s a good idea to pick a topic or focus for each day. One day you may work on memorizing lab values, while the next day you may focus on answering questions about psych patients. Picking a focus for the day will help to keep you from feeling overwhelmed.

  1. Celebrate!

Don’t forget that graduating from nursing school is a HUGE accomplishment, so be sure to celebrate! Give yourself a couple of days to relax and spend time with friends and family. It is really important not to jump right into studying for the NCLEX because you may burn out quickly.

Getting Involved with Student Nursing Associations

Getting Involved with Student Nursing Associations

Getting involved with student nursing associations (SNAs) while you are in school is one of the best decisions that you can make. SNAs are designed to assist you as you make your transition into the nursing profession. When you join, you will become a part of a community of nursing students who are going through the same experiences as you.

Never heard of SNAs? That’s okay! Here is the basic breakdown of how SNAs are organized:

The National Student Nurses Association (NSNA) is the nationwide SNA. Then, there are 50 state associations and several local school-run SNAs in each state. Think of NSNA as the SNA umbrella; the state and local associations are under the SNA umbrella.

When you join the NSNA, you will be getting a membership to your state association and school association as well. Prices vary by state, but in general, it is a very reasonable price that students will be able to afford. 

So you are probably asking yourself, “Why should I get involved with my SNAs? I don’t have time for that!”  Here are three reasons why you should get involved with your SNAs:

1. It looks good on your resume and will help you get a job.

Listing SNA involvement on your resume will instantly separate you from other candidates because it shows that you have leadership qualities. Employers are always looking for nurses who have qualities that will help them advance in the hospital system and become unit managers one day.

Tip: If you really want to impress your future employers, run for a board of directors position at the local, state, or national level.

2. It’s a great way to make friends and network.

SNAs have several meetings, community service events, and conventions each year that you can attend. This will help you interact with other nursing students and make friends.

Nursing faculty and practicing nurses attend these events as well. This creates a great networking opportunity. When you network with other nurses, you are making connections that could one day help you get a job or advance your career.

3. It will help you prepare for your transition into the nursing profession.

The main purpose of SNAs is to help you successfully transition from being a nursing student to a being nursing professional. SNAs do this by providing leadership opportunities, educational events, access to career advancement resources, and much more! Once you join your SNAs, you will be amazed at how many opportunities and resources are available to you.

So, you’re ready to start getting involved. Great! But how?

Start out by asking your nursing faculty if your school has an SNA. Find out when the next meeting is, and go! At the meeting, the leaders of the SNA should be able to guide you on how to become a member and get more involved.

If your school does not have an SNA, then try looking for your state association on the internet. There will be information on how you can join and get involved on their website. You can also go to the NSNA website and join at any time.

So what are you waiting for? Get involved today!

10 Tips for Successful Studying in Nursing School

10 Tips for Successful Studying in Nursing School

Nursing schoolwork can be incredibly overwhelming. Here are 10 tips to help you successfully study in nursing school.

1. Get organized.

During the first week of the semester, take some time to organize your school calendar with important dates. This will help you stay on top of your assignments each week and ensure that you will never be blindsided by an assignment or quiz that you didn’t know was due. Doing this will also help you plan out when you need to start studying for each exam.

2. Take detailed notes in class.

Always take detailed notes when you are in class. I cannot stress this enough. Often professors will emphasize topics that will be covered on the test, so listen carefully. If your professor has provided you with the PowerPoint slides before class, think of them as outlines for the exam. Your job is to fill in the details as your professor is talking.

Tip: If you are having a bad day, maybe you’re tired or not feeling well, record the lecture and then listen to it at another time. 

3. Make time to study every day.

It is important to make time to study every single day. Set a specific time to study each day and stick to it. Getting behind in a class in nursing school can be a disaster. Your class material can quickly become overwhelming if you procrastinate. Instead of letting this happen, just take it one day at a time.

4. You cannot memorize everything.

It will be nearly impossible for you to memorize everything that you need to know for your next exam. Nursing school is loaded with concepts that need to be understood and applied to questions. Memorization will only get you so far in school. If you really want to excel in your classes, it is important that you fully understand the material.

5. Know your learning style.

Everyone learns and studies differently. It is crucial to know what your learning style is in order to be successful in nursing school. Some people learn best while reading the book, while others find this unhelpful. If you do not know what your learning style is, think of a time when you got a really good grade an exam, and try to remember how you studied for it.

6. Take scheduled breaks.

It is important to take breaks when you are studying so that your time spent studying will be productive. Try using the 30-5 rule. This means that for every 30 minutes that you spend studying, take a 5-minute break. You do not have to take a break every 30 minutes, but don’t go longer than 90 minutes without giving your brain a chance to relax and refresh.

7. Mix it up.

Chances are that you will be spending a lot of time looking over your class material. Mix up your study methods in order to see the material from a different angle. If you are just flipping through your notes, then you may get to the exam and find that you don’t know the material as well you thought you did. This is because you are not challenging your brain to view the concepts in a different way. Try re-writing your notes, making flash cards, or even drawing pictures that will help you remember the information.

8. Form a small study group.

Forming a study group can be beneficial in many ways. The group can be used to discuss difficult concepts, swap notes that you might have missed in class, and quiz each other before an exam. Not all study groups are productive, so be sure to choose who is in your group carefully. It may not be the best idea to pick your closest friends, because you may spend more time socializing than studying. Keep the group small with 3-4 people.

9. Be flexible.

It may take some time to find a study method that works for you. If you try something new and it doesn’t end up working for you, that’s completely okay! Think about why it didn’t work. Maybe it was because you didn’t give it enough time to be successful? Or maybe it was just not the right way for you to study. Be flexible and keep trying different study methods until you find the perfect mix that helps you get the grades that you want.

10. Get plenty of sleep.

This may seem like an obvious thing to do, but the amount of sleep you get each night can dramatically affect your memory, ability to be productive, and your performance on exams. Your hard work studying will be wasted if you are not resting your brain for at least 7-8 hours each night. Make sleep a priority and you will be pleased by the results you see in your schoolwork.