You are a new graduate Registered Nurse starting out on your unit but let’s rewind six months ago when you went through some drastic changes that easily could have been a feature reality show on TLC or the Discovery channel: You’ve made it through your final year. You pass your pre-grad, you graduate from your program, you walk across that podium and smile like you are constipated shaking the hands of the Dean Chancellor and everyone else on the faculty as you get that degree in your hand. After celebrating that you are finally graduated, you go back studying like the world is going to end for that CRNE which seems to determine your fate no matter how you look at it. You write the CRNE not remembering how you got to the examination centre, writing it or even remembering some of the questions but you keep on thinking what would happen if you did not pass the CRNE. After six agonizing weeks of hell you get the best news of your life that you pass the CRNE so you are now an official Registered Nurse while at the same time landing a new graduate position in a hospital working as a nurse.
So far so good right?
But then reality hits. You are now responsible for everything you do and I mean EVERYTHING. You are now to trying to juggle what you learned in your four years of nursing plus squeezing in what your clinical teachers and what your pre-grad preceptor has taught you. You try to remember the right ways that your lab and clinical teacher taught you but you find out that the department you work in does things a bit differently which sometimes causes your mind and thinking to do a summersault. These are just a few things that as a new graduate nurse you are faced with and perhaps what many new grad nurses are faced with. When I got hired as a new graduate in the emergency department I was like a child opening his first toy on Christmas morning. I was happy, excited, contented, flabbergasted, the whole nine yards. I mean come on, this is the ER we’re talking about right? As with any job however, there are some challenges that you come across that over time you learn to overcome and adapt to.
One of my obstacles I faced was prior to me being a new graduate, I worked in the ER as a clinical extern therefore creating job role conflict. As a clinical extern, I was there to assist nurses and other staff members in the department with anything which included anywhere from helping changing a heavy patient to assisting in a code where I needed to help do chest compressions. Being an extern was great because I was able to be everywhere and was always be able to jump in and help when the time needed. Once I became a RN, the roles changed. I had my own specific area, my own patient assignments therefore, I was only able to help out in my area. I couldn’t just run off and help someone who needed help or I couldn’t simply stop what I was doing to go run off and do something; I had to prioritize. This was a challenge for some other staff in the department who forgot that I was now a RN and not a clinical extern and would sometimes grab me in the middle of the task and ask me to help them with something. This leads to my second challenge, the responsibility.
You now have complete responsibility on what you do which means that you have to triple check if not sometimes quadruple check your stuff to ensure that everything is done right. I would not call this a challenge but it becomes a challenge when the amount of time used to triple check everything might work against you. As a new graduate nurse, you will (and I still do) certain things slow because you are still learning. The last thing you want to do is rush something fast to only find out later on that you made a mistake. Though taking your time to do something is great, time as mentioned can work against you which leads me to another challenge that I personally face and continue to do so; time management.
This is perhaps my biggest struggle that I have as a new graduate and likely a skill many other new graduates face. It’s one thing when you have two or three patients or even four patients with your pre-grad instructor but when you are by yourself and have the responsibility of managing four patients in an environment where the turn over can potentially be fast (especially in the ER) it can be quite challenging. I personally still find this a challenge for me because throughout my clinical experiences the time management skills I had and were taught throughout school were based on if I was on a floor or a unit. When you are in a fast pace environment such as ER, you learn to adjust your time management skills to adapt to the fast pace environment. For someone who is used to working at a constant speed and having time on their hand, this can be quite challenging (which I found out quite easily.) Despite these challenges which I believe every new nurse will face, I will say that working in the ER has been a blessing. The staff here (and I mean entire staff from the physicians to the nurses to the unit clerks to the patient transport representatives to even the housekeeping staff) all make the department a great place to work.
So what advice do I have for upcoming new graduate nurses, pre-graduate students or current new graduates? First, believe in yourself (I know I sound like a 3am Anthony Robbins self help infomercial) but seriously trusting yourself and having self confidence is key. Everyone makes mistakes and if you don’t know the answer to something, ask. As a number of fellow experienced nurses in my department have told me “a nurse who asks few questions are the ones that you want to be careful of instead of the ones who ask a lot of questions.” Second, everyone has different learning patterns and ways on how you learn and do things. It does not mean you are stupid, or dumb or slow, it just means you learn things differently. This leads to my third advice, don’t feel discourage or better yet don’t let anyone make you feel discouraged. I will admit I have these feelings while working as a new graduate and sometimes like a stubborn cold sore they tend to flare up again. As a new graduate nurse it is very easy for you be discouraged. You are working with other staff members who have more experience than you, you might have some nurses who give you that “you should know this by now” look, you sometimes feel nervous when talking to a doctor about a situation and don’t want to appear as a “newbie”, and sometimes even a patient might even question your ability because they can sense that you are fresh young and new. As nurses, we are constantly learning everyday and our learning curve increases exponentially with our years of experience. Try not to let someone’s words of discouragement get to you and if it does, focus on something positive. A couple of weeks ago I was being attacked my own feelings of discouragement and began doubting myself as a good nurse. Half way through my shift I heard two comments that made my day. “You did an awesome job today.” and “You were a really great nurse today, thanks for taking care of me.” Though for some that might mean a little pat on the back, for me it transformed and transcended my feelings of self doubt to encouragement. You see, sometimes you worry over the biggest things when it’s the little things as a smile, and acknowledging someone that can make someone else’s day, and in turn yours.
New graduate nurses should remember that we are now the upcoming new nurses for our health care. We carry vast amount of knowledge as well as our new learnt experiences. We are definitely not perfect ( no one is) but as we continue our new path and career we will be absorbing vast knowledge. With time comes experience; don’t feel discouraged, mislead, and confused thinking that you are not a good nurse when you know deep down you are. Remember a good nurse isn’t just a nurse who can just read off an ECG flawlessly, insert a Foley catheter with ease, predict an illness before the doctor can, insert an IV after the first try or able to have all their tasks and meds done ahead of schedule and have time to relax. A good nurse is also one that is able to make their patient smile, laugh and have that patient remember who you were and what you did for them, even it was something little like giving them a warm blanket or asking them if their okay.
Let’s now fast forward six months ahead. You are no longer a “new graduate nurse.” You are now a nurse working on your unit. You are still learning new skills, tasks procedures but you now have learned to be confident. More importantly, you push away your discouraging feelings and continue to believe that you are a good competent nurse that will provide the best care you can for your patient that day. This is what passing that CRNE was for. This is what graduating from your nursing program was for. More importantly, this is what makes you stand out as a good nurse from others. Don’t give up……give in.
Dwight Barrett RN. BSc. BscN. aka medsoulbrother