*Original post released 11/25/19
Continued from “Things I Wish I had Known as a New Grad RN: Part 1”
As a new grad, I really wish I had known that the expectations are low. No one is expecting you to walk onto the unit day one and be able to set up a CVP line accurately and by yourself….much less will they be willing to trust your ability to do so if you try. The first couple of months working as a new grad nurse are spent learning skills specific to your unit and proving your competency. They likely will not release you to handle 2-3 patients on your own right out the door. What I like about the fact that expectations are low is that it leaves room for growth and improvement. It allows you to have room to shine! If you’re great at inserting NG or OG tubes after intubation and had a lot of practice doing this in clinicals, then take every opportunity to do it as a new grad to prove your competency to your coworkers and supervisors.
During your orientation phase, your unit will likely have a list of competency items that you are required to have visualized/performed/discussed/etc. and then signed off on. This is usually done prior to being released to work on the unit by yourself; however, in my residency program, it was not structured this way. We had a change in residency coordinator multiple times and this slipped through the cracks. I didn’t actually even receive my set of competencies until I was already off orientation. If they haven’t given a list to you within your first month, I’d ask about it. It can be a bear to try and complete after the fact.
Another thing I wish I had known is that things do get easier to handle. And by that, I don’t mean the caseload gets easier….you begin to develop a better routine and figure out your own way of doing things that works best for you. It will come with time and practice.
While working on the unit, both during orientation and afterwards, I wish I had known that it is extremely beneficial to have a few coworkers you trust to turn to when you have questions or are unsure of how to approach a situation. They can be an invaluable resource to you during this new grad time period. This person should be understanding, resilient, patient, knowledgeable, and non-judgmental. It helps to make sure you’re on good terms with your charge nurses, because they can make or break a shift at times. It’s unfortunate but true. Many times, these mentors are usually the nurses that precepted you during orientation. Another key note worth mentioning is that you’ll want to make sure this person is someone who follows rules, policies, and evidenced-based practices to protect your license as well. It’s best not to learn bad habits as a new grad, because they’ll be harder to break later.
Finally, find your niche. Units tend to be like their own “high school” of sorts. There are going to be pre-existing groups already established, and you’ll be the new kid. It can be difficult to find which nurses best align with you and your values/ideals. Trust me, you’ll need someone you can talk to about the stresses and successes of a hard day’s work who will understand what you’re saying without judgment or disgust. You need someone in your life that understands exactly what you’re going through so you can leave work at work and not take it all home. When you get home, find a routine to help you unwind and relax so you can rest and recharge — whether it’s to spend time with family or prepare for another shift.
The Study Nurse 