You recently asked me a question. I must say I was pleasantly surprised. It’s always promising for us old, salty dogs to have a newbie seek out our counsel. To ask is wonderful, and to listen is even better. You asked me “what advice would you give to a new nurse?”
I started throwing a few suggestions out to you and you nodded appropriately at my comments. I gave this bit of advice in between bites of cafeteria food, a hurried lunch we were miraculously allowed during a timeframe that the rest of the working world calls “lunch time.” They had assured us we had “plenty of time” to eat before the patient arrived, but no sooner had I taken a bite of gravy soaked turkey and offered a morsel of counsel to you then we were cut short. The sound of a rolling stretcher, brisk voices, and the beeps, tings, and alarms that accompany a sick patient caused our heads to turn. Like Pavlov’s dogs we rose immediately, pulled a last gulp of life-giving soda, and rushed off to receive the new arrival.
Now that I’ve had some time to articulate I thought I’d finish our conversation. So here goes.
Don’t ever assume you know it all.
You just recently completed a major course of study, the beast that is called nursing school. Then you successfully passed a grueling licensure exam, the NCLEX. You brought it on home by nailing down a job straight out of school. If you managed to get a day shift position right away then you certainly have done better than I did once upon a time.
You did all this and I’m not so old that I’ve forgotten how hard all that was. So congratulations. You deserve a pat on the back. Your knowledge is extensive and that’s something to be proud of my dear. But not too proud. Ok? That’s where you’ll mess up.
You just had about 20 years of knowledge pushed into a two year time frame with about zero years of actual experience. That’s a lot of theory, but not much practice.
I don’t want you to misunderstand. I’m very happy with all that stuff you learned in school. I’m quite certain I have forgotten a lot of it! I appreciate your knowledge and the fresh approach you bring to the table. We old hats need that to keep us honest. But please don’t assume this plethora of book sense is all you need or superior to the real world of patient care.
You have so much to learn! But so do I. We can learn from each other. Never think you have nothing to gain from me, and I’ll repay the favor. We can do a lot for each other. Please remember that.
Never stop asking questions. The absolute worse thing you can do is not ask me a question. Please don’t be embarrassed. Please don’t assume you know. Please don’t assume it’s a stupid question. Hey, nine times out of ten, it probably is, but that’s ok. Do you realize how many stupid questions I asked to get where I am? Do you realize how many I asked just last weekend? Don’t stop!
Don’t stop asking questions. Don’t remain silent, or tell yourself you’ll Google it later. You won’t. You’ll just be glad to be able to sit down and pee when you want. In your joy over freedom of bladder release, you’ll forget.
When you stop asking questions you stop getting answers. Sounds simple, and it is. When you stop asking questions you cease to learn something new. That’s career death. You will grow stagnant and wither away in your lack of growing education. The field constantly changes anyway. You have to ask questions to keep up.
Don’t get defensive. This is a really hard one. The nursing field, especially certain areas such as critical care, are full of strong personalities. It’s how some people deal with stress. They use their commanding authority to gain control of an out of control situation. In doing this they might just step on your toes or hurt your feelings. Don’t take it personally.
If I got upset, and believe me I used to, over every harsh word slung my way in a code or critical situation I would be a blubbering mess carried away in the torrent of my own river of tears. Don’t get hurt, but don’t get defensive either. It’s not personal, so don’t take it that way. While you’re busy thinking up a witty comment for the overbearing nurse who offended your delicate sensitivities you are missing something important, some clue as to your patient’s decline, or perhaps some nugget of practical knowledge you can store away for the future.
I’ll be honest, I’m still working on this one myself. It’s easy to take offense, get hurt, get angry, etc., but don’t. Remember that it’s all about the patient when you’re at work. Not you. That knowledge will help you let it roll of your back. Plus remember, you don’t know everything, so try and use these circumstances as learning experiences. I sure do!
Don’t skip the small stuff! What do I mean by this? You know all that knowledge we were talking about earlier, all that stuff they teach you in school, all those crazy steps you take to get something done? Well, there’s a reason. Yes, I’ll admit real nursing is far different from nursing in books, but you need to hold on to those gems of nursing process
Don’t skip the small stuff. There’s steps you take in assessment. As you spend longer and longer at the bedside you’ll become more and more comfortable with the process of patient care. Somewhere along the way you’ll start to eliminate steps of the assessment process. You’ll discard them as useless and too time consuming. This will be a terrible mistake.
People may laugh at me for my thoroughness, my continued step-by-step methodical approach to patient care and assessment, but I don’t care. We are not in charge of keeping a cactus alive, it’s a human. The outcome of neglect or error is catastrophic. I take saving lives and preserving life seriously. If that means taking a few extra steps to ensure I don’t miss something, then I’m fine with that.
Don’t become too comfortable. Don’t become complacent. Don’t become lazy. People will die. Does that sound harsh? Good. I’m very serious.
Lastly, keep this is mind. You won’t be new forever. I know you probably hate it now, but one day, far sooner than you think, you will no longer be the “new nurse.” One day you will be minding your own business, taking care of your patient (thoroughly like I suggested), and someone will come to you with a question. Then you’ll be even more surprised to realize you know the answer.
I remember when this happened to me. I remember the first time I was asked for help, and I remember the first time I was called ma’am. It was horrible. It was wonderful. What I mean is it felt good to be considered “experienced” but it was frightening at the same time. Now people would come to me! What if I didn’t know what to do?!
You are in a magical time in your career. It may not feel like it, but you are. You have the opportunity to turn yourself into a sponge, soaking up every drop of knowledge and experience you can get your hands on. Don’t be that new nurse that acts like she already knows or is bored. No one will want to teach you then, and you will miss out on so much.
Take this time of orientation and even the time beyond that, your first few years, and revel in them, take advantage of them. You must. Because one day you will be considered the “old nurse” or the “most experienced” and you will be expected to take charge, to lead the next generation of new nurses. You won’t stop learning at that point, or growing. You never stop that. But you will never have the opportunity like you do now. Don’t let it pass unused. Enjoy it and learn from it.
Like I said before, you impressed me with your ability to ask for advice. Hold on to that attitude and you’ll go far. I’m proud of you. Please keep it up because one day you’ll probably be taking care of me.