Wednesday, December 19, 2007

A LIttle Help for New Graduates

I certainly do not profess to be the expert here, but as a nurse for 23 years in med-surg, surgical progressive care, open heart, and ICU as well as a clinical nursing instructor and a graduate student (MSN), I think I have some general words of advice. So, for those of you who need it - here it is for what it is worth to you.

1. First - every time you sign your name as a RN - please remember how hard you worked for this accomplishment and the sacrifices of yourself and all those people in your life that helped you "make it!"
2. Remember, nursing is a hard job! It has always been a hard job and it will always be a hard job! (Florence Nightingale).
3. Learn as much as you can! Do NOT be afraid to ask questions. You might drive an experienced nurse crazy, but in the long run, any experienced nurse understands why you are asking the questions and will respect you for trying to build upon and grow your knowledge base. For those that don't - forget about 'em - they ain't worth the time of day and probably are burned out nasty nurses that need to get the hell out of the business.
4. Always remember - the only reason you are an RN is to care for that patient. They are the true reason our profession is here. Don't ever forget your compassion, honesty, love and integrity. Fight for that patient and the care they need - they are counting on you!
5. Never give a medication that you don't know how it works. Ask the "WHY" questions as many times as you need too until you feel you understand and are comfortable with WHY you are doing something. Too many nurses don't ask the "WHY" questions and that gets them into trouble.
6. Never let a physician intimidate you. Yes, they are more educated (in some cases) and have more experience than you do, but you are the person at the bedside that is best situated to see changes in condition. While in the beginning you might feel like you don't know enough - rely on other experienced nurses to review your assessment with. They will help you to determine what to say to the physician.
7. An employer will work you until you are dead! Live a balanced life and don't make excuses for having balance in your life. If they ask you to work extra and you know that your child has a play and you can't work - please know that NO can really mean NO! And, you don't need to feel guilty about it.
8. Don't get STUCK working in an area of nursing that you are not passionate about. It is the fastest way to burn out in this profession. Seek out learning opportunities that will grow your knowledge and skill in an area of nursing that you desire to work in. Nursing offers so much variety that there is really no reason to stay in a place that you are not happy working. And - don't let them tell you that you need a year of med-surg before you can go to a speciality area. While having a med-surg background offers you the opportunity to develop your skills and competencies - I have known many of nurses that went into a speciality areas right out of school and have been highly successful. It really all depends on your motivation and your commitment. You call the shots.
9. After you have finished your first year in nursing - pay it forward. Remember that poor new graduate that your manager just hired - help them, be friend them and mentor them. You owe it to them.
10. Remember that nursing is a life-long learning profession. No matter what happens in your life - keep learning and never forget the benefits of more education. And - finally, remember your days as a new graduate and be the experienced nurse that other new graduates can look too as a resource and a person to learn from.

Congratulations on passing your boards and becoming a nurse! We need you and we need you to stay around for a long time. Thank you for entering our noble profession and for making a REAL difference in the lives of patients that need your care and love. Thank you for caring.


  1. Patrick, that brought tears to my eyes reading it. I'm going to probably have to come back and read it often over the next few months. I have decided to start off in cardiac at a specialty hospital that I have been working at for several months. So far, I think it is the right move. We'll see how I feel a few months down the road. Keep up the good work with your students!! And thanks for the advice

  2. My pleasure and I hope it helps.

  3. That was wonderful. Thanks so much.

  4. I actually really like Telemetry.

    Hard to believe. I've done it seven years straight now, after "downgrading" from general ICU, which I also loved.

    It's all good. Nursing is a great job no matter what your area of practice.