The Anxious Nurse’s Survival Guide

Last Fall I wrote a post entitled The New Grad Nurse’s Survival Guide which has since become one of my most popular posts to date.  That post includes tips to help new nurses acclimate to the fascinating but often challenging & frustrating world of hospital nursing.  Today I thought it would be beneficial to create a survival guide for those nurses, like me, who struggle with anxiety issues.  You will notice a lot of overlap between the two posts, but nevertheless I hope that you will find this post helpful if you too struggle with anxiety both in your personal life & as a nurse.nurse pic

Disclaimer (because we live in a wildly litigious society these days): As you read this post, keep in mind that I have no official psychiatric credentials.  This list is based purely on MY OWN PERSONAL EXPERIENCE & is in no way meant to diagnose, treat, or cure any condition.

I struggle with anxiety, but I've found that this blog is a great way to tame the

I struggle with anxiety, but I’ve found that this blog is a great way to tame the “anxiety monster.”

  1. My first recommendation is to get to work as early as you’re allowed to clock in so that you can maximize the amount of time you have to read up on your patients before receiving report. This will allow you to already have a basic idea of what is going on with your patients & thus empower you to ask good questions in report.

    Yes, we nurses know what all of this means.

    Yes, we nurses know what all of this means.

  2. After finishing report, take time to look up more information on your patients before you start seeing them (provided no one has an urgent need of course). I’ve found that the more background information (labs, test results, etc) that I have on my patients, the better I feel about taking care of them.  This came into play recently when I had a patient who ended up in ICU not long after the start of my shift.  If I hadn’t taken the time to write down the patient’s history, labs, etc at the beginning of my shift, I would have been scrambling to look up that information during a very emergent situation . . . which is obviously less than ideal.  I’ve found that my anxiety is much better controlled if I start out my shift knowing as much as possible about my patients because I know that if an emergency occurs, I’ve already got my head in the game, so to speak.
    A very simplified explanation of anxiety . . . but it made me laugh.

    A very simplified explanation of anxiety . . . but it made me laugh.

    1. To be clear, I try, at minimum, to glance through all the current orders, the H&P, the most recent lab/test results & vital signs, & the most recent doctor’s note(s) on each patient before starting my rounds. Obviously this doesn’t ALWAYS happen, but I make it a priority to have it done ASAP no matter what because I’ve found it does help me so immensely.
    2. On a similar topic, find or create a good report sheet that will help you stay organized.  After several tries, this is the one I’ve come up with that I’ve found works best for me.  Feel free to use it or adjust it to make it work better for you.  DO NOT FEEL LIKE YOU HAVE TO WRITE EVERYTHING FOR EVERY PATIENT ON ONE PAGE!  I did that as a new grad, & I look back & want to slap myself because it only made me more anxious than I would have been if I’d just used a separate page for each person (duh!).bedside report
  3. Review all lines, drips, wounds, etc during report (preferably at the bedside). This way you can ask the off-going nurse about any discrepancies you find.  Doing so is an easy way to help prevent errors, so don’t skip this simple but important step which can save you a lot of anxiety later in your shift.
  4. Stock your pockets with the most commonly used items at the beginning of your shift (before or after report) & periodically throughout the shift as needed. The things I always carry are alcohol swabs, blue caps (for IV lines), saline flushes, my scissors & penlight, a pen & a highlighter, & a roll of tape.  I’m borderline OCD, so I’ve quickly learned that I feel naked without any of these things in my pockets.  I’ve also found that my shift flows a lot more smoothly when I carry these things around because I’m not constantly running up & down the halls for something as small as an alcohol swab.  Wasting time on little things that like, for me anyway, creates a lot of unnecessary anxiety that can be easily avoided by simply stocking my pockets on a regular basis.scrubs pockets
  5. Establish some kind of routine & stick to it as much as possible. You can read about my routine here under #6.
  6. Following closely on the heels of the above point, learn to group tasks as much as possible. On my unit we as nurses take our own vital signs, & I’ve learned that the vast majority of the time it is more efficient for me to do vital signs, assess, & medicate each patient before I move on to the next one, rather than doing vital signs & assessments on every patient & then going back to do meds on each one.  Do I have to break this practice sometimes when one patient has an urgent need or I get an admission at the beginning of the shift?  Of course.  But the point is that I’m making good use of my time rather than running in & out of my rooms constantly.  Does this sometimes mean I’m a little later seeing my last patient?  Sure.  But as long as I know that patient is stable, I don’t think that’s a big deal because I feel like I’m able to devote more time to each patient as I go along rather than constantly being rushed between rooms.  If your routine is different than mine, that’s ok.  JUST FIND WHAT WORKS FOR YOU!anxiety
  7. Write down your meds/tasks & the times associated with each, & scratch them off or highlight them as you complete them. For me doing this not only organizes my shift but also gives me a great sense of accomplishment as I highlight the meds & tasks I’ve accomplished.  I also write in important labs so that I don’t forget to check for those (e.g. coags on a patient with a heparin drip, Troponins on a chest pain patient, etc). to do list
  8. Don’t be afraid to ask for help when you start to feel overwhelmed, & be specific in your requests for assistance. I’ve found that people are a lot more likely to actually help me when I’m specific in my requests.  For example, if I know I have an admission coming but one of my other patients is unstable, I’m going to say something like this to the charge nurse, “Hey, as you know I’ve got this admission coming to room 5, but room 10 is having a lot of trouble breathing right now.  I’m going to need you get vital signs on the new patient & get them settled so that I can take care of this situation in 10.”
    1. On the converse, if you see someone else who is struggling, don’t just say “Do you need help?” Of course they need help!  Be specific in your offer to help them.  For example, “I know you’re really busy right now.  Whose meds can I give for you?”  Or “I know your new admission is really sick & I heard you say he needs a new IV site.  I’ll go try to get a new IV on him.”help
  9. Celebrate your strengths & recognize your weaknesses. Being a nurse who struggles with anxiety is definitely a challenge at times.  This job is difficult enough without being a perfectionist; trust me I know!  However, I also know that my meticulous nature is a great part of what makes me a good nurse.  I could describe dozens of situations in which I’ve made a significant difference in a patient’s life because of how obsessively I’ve watched their labs, respiratory status, vital signs, etc.  However, I also know that because of my “sensitive” nature, I’m prone to burn-out, & thus I can’t work much OT without feeling like I want to quit my job &/or lose my mind.  I recognize this & thus I don’t work much OT because I know it’s not in my best interests psychologically.  I’ve also had to learn (& believe me it’s a continual learning curve) that it’s ok to not know everything or be perfect at everything all the time.  No one is THAT good.strength quote
  10. On a similar note, find ways to manage your anxiety outside of work. I’ve found that seeing a therapist about once a month is a HUGE benefit to me.  I can’t tell you how much I wish I had started therapy years ago, before I even became a nurse.  Yes, friends & family are great, but there is something very unique about having an objective person who can listen to your struggles (both as a nurse & outside of work) & help you recognize methods to better manage your anxiety.  Going hand in hand with therapy, don’t be afraid to take medications for your anxiety if your medical provider recommends it (& don’t be afraid to ask for meds if you feel like that is needed).  I was very hesitant to take any psychiatric meds, but I started taking Prozac last summer, & there are no words to describe how much better I feel these days.  No, it’s not a magic “happy pill,” but I have found that it “takes the edge off” so to speaks & thus helps me to stay calm & better able to survive anxiety-provoking situations, whether at work or at home.  TAKING MEDICATION FOR ANXIETY IS NOT A WEAKNESS.  I still have to tell myself that sometimes, but the point is that I’m better able to function as a nurse, a wife, a friend, a daughter, a dog mommy, & just as a human being thanks to Prozac.  If that’s not a good enough reason to take a medication, I don’t know what is.  In addition to therapy & Prozac, I’ve also found that writing (hello, blog!), music, & exercise are great sources of stress relief for me, so making time for those is extremely important.  It is true what they told you in nursing school: YOU CANNOT TAKE CARE OF OTHERS IF YOU DON’T FIRST TAKE CARE OF YOURSELF.  Don’t forget that!anxiety meds

Fellow nurses, feel free to comment with any suggestions you have for how to navigate the healthcare world, as chaotic as it often is, while living with an anxiety condition.  It is definitely not easy, but it CAN be done.  Trust me, I still have shifts where I have to step into the break-room for a minute just to clear my head (or occasionally to wipe the tears of frustration from my eyes), but I’ve found that those times are much fewer now that I follow the tips outlined above.  As I stated at the beginning, these are just the things that I’ve found work for ME, but I’d like to believe they could be helpful to others as well.

I’ve said it before & I’ll say it again: learning to live with anxiety is a continual learning process.  Some days are better than others, & that’s the way it will always be.  We just have to learn not to let the bad days get us down forever.  We must keep fighting the good fight because as nurses our patients desperately need us.

8 Essential Characteristics of a Good Nurse

As this is Nurse’s Week, I’ve been thinking about a few different posts I’d like to write in honor of my profession & the many wonderful nurses I know.  While driving around town running errands today, I started thinking about what I consider to be some of the most essential components of a good nurse & decided this would be a good way to start off my blog posts in honor of this special week.nurse pic

*Disclaimer: Obviously, these are all MY OPINION, so feel free to take them with a grain of salt, so to speak.  But these are all based on my (almost) four years of nursing experience.  Also this list is most applicable to HOSPITAL nurses as that is the only type of nursing I have actually done thus far in my career.  (I was exposed to various other forms of nursing as a student, but as far as an actual job as an RN, I’ve only done inpatient nursing.)  I daresay many of these are applicable to all forms of nursing, but in general the list was written with inpatient hospital nursing in mind.

Furthermore, I am by no means 100% faithful to all of these points all the time.  I’m as human as everyone else, naturally.  But these are things I sincerely try to live up to as much as I can because I know they are (some of) the things that make a good nurse, & as with anything else I do, I want to be the best nurse I can be.

These are in no particular order.nursing humor

  1. Organized: Organization is key to being a competent nurse. The great thing is that everyone’s idea of organization can be quite different.  My report sheet & routine don’t look like everyone else’s, just as everyone else’s report sheet & routine don’t look like mine.  And that is just fine.  The point is that you find a system that works well for YOU.  I strongly encourage new grad nurses to get started on this very early in your career or otherwise you’ll always be a few steps behind.  As nurses we are responsible for monitoring vital signs, lab results, diagnostic test results, the mental status of our patients, & myriad other things, not to mention keeping up with & double-checking doctor’s orders, again among other things.  Obviously none of this can be done efficiently without a good organization system.  Show me a disorganized nurse & you’ll show me someone who is probably displeased with her job & who drives her coworkers (& quite possibly her patients) crazy . . . I’ll leave it at that.  P.S. Here’s my report sheet, in case you need something to help you out: Nursing Report Sheet
  2. Adaptable/flexible: One of the first things I learned about nursing, thankfully while still a student, is that being a nurse requires you to be extremely adaptable & flexible. Not only do patients’ conditions change constantly, but so do hospital policies, routines, & equipment.  Just when you think you’re getting up to speed, something will change.  Trust me.  It is just the nature of the healthcare field.  There is no question that the constant change in healthcare contributes to the high stress level nurses experience, so if you don’t handle change well, you will probably be a dissatisfied, easily burnt out nurse.change quote
  3. Willing to learn: Following right along with the above point, as nurses we are constantly asked to learn new things. Whether it’s new equipment, a new computer system, or a new medication, there is ALWAYS something new to learn.  While this can be frustrating at times, it’s also one of the things that (to me) makes nursing fun.  I for one could never be satisfied working in a stale, unchanging environment.  As someone who has always loved learning, the very dynamic nature of nursing is just one of the many things that I believe makes this such a fulfilling career for me.learning is work
  4. Assertive: This is one that hasn’t always come naturally to me but that I’m pleased to say I picked up on fairly quickly (I like to think so anyway). Being a nurse means you will inevitably deal with angry patients, disgruntled physicians, rude family members, inefficient hospital systems, & all manner of frustrating things.  Most nurses, I’ve found, are naturally kind people who long to please others & make others happy.  Considering the caring nature of this profession, that is logical.  However, we must strive to never allow our desire to help & please others to turn us in to doormats (partially because that inevitably leads to burn out).  As nurses, we have to advocate for our patients, many of whom cannot or will not speak for themselves.  I’ve found that being assertive with doctors, patients, families, management, etc is the best way to both advocate for my patients & retain my own mental sanity.  It’s not always easy, for sure, but clearly nursing ain’t a career for the faint of heart.  (Can I get an “Amen”?!)assertive
  5. Thick skin: Ooh, here’s another one that definitely didn’t come naturally to me. Trust me, I have more than once cried when a patient, family member, or doctor spoke harshly to me, usually in the bathroom or at the nurse’s station after the fact.  But slowly I am learning to be a bit more thick-skinned.  You have to or you will not survive in this profession.  If you’re a soft-hearted new grad like I once was & wondering how you’ll ever learn this skill, trust me, it will come with time & experience.  I imagine it’s kind of like being a parent: you can’t take every temper tantrum personally & you have to pick your battles or you’ll lose your mind.  Additionally I’ve found that if I make it obvious to “testy” patients & family members that I’m not really ruffled by their behavior, quite often they calm down very quickly.thick skin tender heart
  6. Empathetic: Not disregarding the above point, it pretty much goes without saying that an essential characteristic of a good nurse is empathy. There’s a fine line between having thick enough skin to survive in this field while also maintaining an empathetic heart.  And it’s not an easy line to walk sometimes, trust me.  But it can be done.  Perhaps one of the greatest things I learned in nursing school is that people who are hurting do NOT actually want you to provide them with a solution to their problems.  What they really want is someone to listen to their story & validate their pain & suffering.  This can be as simple as listening with an open mind & saying “I’m sorry, I know this has been difficult for you.”  (As I’ve found, this is a great skill to learn for your personal life as well.)  As nurses, we must also remember that our empathy needs to extend not only to our patients & their families but also to our coworkers & even ourselves.  None of us is perfect & we have to learn to forgive ourselves for not always being the perfect “angels of mercy” we strive to be.empathy
  7. Resilient: This is one I’ve come to appreciate more the longer I’ve been a nurse. Being resilient basically means you’re able to recover & bounce back from the hard times.  As nurses, we witness all kinds of terrifying events that inevitably leave some scars on our psyche.  Because of this it’s inevitable that we’re going to have some bad days/nights as nurses.  It just can’t be avoided.  In order to recover from the bad shifts, we have to have outlets that allow us to mentally recuperate.  For me this comes mostly in the form of music, writing, & of course venting with my fellow nurses.  I also volunteer with a local hospice group (not as a nurse, just as a regular volunteer) which I’ve also found brings me a lot of joy.  Additionally, I see a therapist once a month to work on my innate anxiety issues.  Even though much of my anxiety has very little, if anything, to do with my career, I still find it helpful in handling the inevitable stress of working in the healthcare field.resilient
  8. A warped sense of humor: When one patient is screaming for pain meds, another just pooped all over the floor, the monitor tech is calling to say your third patient had a run of V Tach, & your admission just arrived, you better have a warped sense of humor or you’re going to run out of the building in tears. I’m serious.  This is something I didn’t totally appreciate as a new grad, as most new grads probably don’t.  You just can’t know the insanity of being a nurse until you’ve done it.  The things we laugh at would probably make the average person cringe, but then again the average person isn’t a nurse. And if you don’t learn to find the humor in the crazy things we see & deal with on a daily basis, you won’t survive in this field.  It’s as simple as that.sense of humor nursing

If you’re reading this & you’re considering entering the nursing profession, I hope you’ll take this post seriously.  If you don’t feel that you possess any of the above characteristics, frankly I’d suggest going into another field.  Naturally none of us is born with all of these characteristics or possesses all of them 100% of the time because, as I said, we’re all human.  All I can say is I’m so thankful to have worked with so many wonderful nurses over the past four years who have demonstrated these characteristics to me & helped me develop them as well.  If you’re one of those nurses, or one of the many fabulous nursing professors & clinical instructors I was blessed to learn from, & you’re reading this, I thank you from the bottom of my heart.thank you

The New Grad Nurse’s Survival Guide

It’s hard to believe that it’s been three whole years since I was a new grad nurse.  What’s even more amazing is how much I have learned & grown as a nurse in what is really a very short amount of time.  I’d never have believed it if you’d told me I’d be a charge nurse or a preceptor starting at age 24!  There are several new grad nurses on my unit at work right now, & I also have several friends who are currently in nursing school, so I’ve been meaning to write a post like this for quite some time.  For one reason or another I have never gotten around to it, but tonight I feel motivated to give it a shot.  Please don’t think I’m identifying myself as some nursing expert or genius, but I do think I’ve gained a certain amount of wisdom over the past three years that’s worth sharing.  Here goes.nurse pic

  1. Find or create a good report sheet. I cannot tell you how important this is.  I created my own just a week or two into my first job & it made such a HUGE difference in how prepared & organized I was during those first few months as a nurse.  When I moved to NC a year later & got a new job I eventually created a new report sheet because I realized I needed something different.  Furthermore I realized that trying to cram all my information for 4-5 patients on one sheet of paper was just ludicrous.  As long as you have a clipboard, there is no need to fit everything for all of your patients on just one sheet of paper.  I now write all of my information for each patient on a different piece of paper (as in one paper for each patient).  I write meds & other scheduled procedures/tasks on the back of each sheet.  Then I can check them off (by highlighting them) as I go.  You just have to find something that works for you.  You can see my report sheet by clicking the link at the end of this paragraph, but of course your needs will vary depending on the type of unit/area in which you’re working. Nursing Report Sheet
  2. To extrapolate on that topic, invest in a good clipboard, the kind that you can store papers in. You can get them at Wal-Mart for about $8.  These things are genius because you can use them to store hospital policies, blank copies of your report sheet, & other such things that you want to have handy at all times but that you couldn’t possibly fold up & store in your pocket every shift.nurse clipboard
  3. Buy scrubs with plenty of pockets. I don’t care if they are the cutest scrubs in the world, if they don’t have lots of pockets (2-4 on the top & at least one cargo pocket on the pants), they are a waste of money.  Before you start your shift (either before or after report), stock your pockets with the most commonly needed items on your unit.  In my case, I always carry a roll of tape, scissors, a penlight, IV tubing dead-enders (“blue caps”), 10 mL saline flushes, alcohol swabs, a pen, a highlighter, & a miniature Sharpie.  Depending on where you work, of course, your needs may vary, but at a minimum you should always have alcohol swabs because nothing is more annoying than having to make extra trips up & down the hall just to obtain an alcohol swab that you could have easily had in your pocket.  (Additionally, penlights are awesome for night shift nurses because they make it easier to sneak into dark rooms without waking your patients OR tripping over equipment in the room.)scrubs pockets
  4. Don’t rely too much on information you receive in report. I’m by no means implying that you shouldn’t trust your coworkers, but I just know how hard this job is.  I know how easy it is to miss a lab value or to get one patient confused with the next.  ALWAYS take the time to verify orders in the computer (or God forbid the old-fashioned & horribly antiquated paper chart), research your patients’ lab values & test results, & read the doctor’s notes as much as possible.  Remember that if you’re ever involved in a court case, saying “Well, the day shift nurse told me such & such in report” is not going to cover you.  For example, if you’re giving blood, double-check that the patient has signed a consent form.  If you’re giving multiple IV medications at once, double-check that they’re all compatible.  Don’t just assume that if the last nurse gave them together it must be ok.  Really look at your IV & central line dressings & make sure they are dated appropriately.  Read over ALL the orders on the patient’s chart.  What I’m saying is it’s really easy to miss stuff & we all have to hold ourselves & each other accountable.  GO BACK TO THE SOURCE.  Read the orders.  If you’re uncertain, ask another nurse for help, then call the doctor for clarification.
  5. On that subject, before you page a doctor, have all of the information gathered that you might need. Get a set of vital signs, familiarize yourself with the patient’s medical history & test results, & try to have a plan in mind of what you want the doctor to order (SBAR really is brilliant, y’all).  If you don’t know what you should be asking for, consult another nurse.  As a new grad, sometimes it’s hard to know what to expect because you are new & inexperienced, but the more experienced nurses around you should be happy to help you (I know I always am).sbar
  6. Find a routine. I know this can be so challenging because every shift can be so different.  One of the hardest things about nursing is finding a balance between having a routine that keeps you sane & “on schedule” & having to be flexible & adapt that routine to the differing circumstances you face each shift.  Every nurse’s routine will be different & that is ok.  It’s all about finding what works for YOU.  Yes, this will take some time.  But really make an effort to analyze how your day went at the end of each shift.  Over time you will identify trends of what made one day better than the next.  Just as an example, I have detailed my basic routine below.  Obviously I have to shuffle things a bit sometimes based on various circumstances that occur during my shift, but in general this is the routine I try to follow because I have found it works best for me.
    1. After clocking in, I stock my pockets with all of the items I mentioned in point number three above.
    2. Then I look up my patients in the computer & start outlining my report sheets with as much information as I can. This allows me to know what questions to ask in report.  If I go into report blindly, it’s harder to anticipate what questions I need to ask.  I don’t always have time to look up everything I’d like, but even a little information is better than none.Abstract of Doctor Writing on Clipboard with Dramatic Lighting.
    3. Get report. I like to log into the computer in the room during bedside report so I can double-check orders, meds, etc with the previous nurse.  If the patient has a major wound/incision, a central line, a PCA, etc, I double-check that with the previous nurse during report.  If your hospital doesn’t participate in bedside report, I encourage you to do some research & suggest it to your manager.  A lot of nurses aren’t fond of bedside report, but I love it.  Here is why: It gives me a chance to meet my patients before actually doing their assessment & to ask them if there is anything I can bring for them when I come back to do their assessment.  I can then write down those requests & be more prepared when I next enter the room (in other words, it saves me time in the long run).  Furthermore it’s a huge safety measure that protects both patients & nurses.  And additionally if anything crazy happens during the first hour or two of my shift, I never have to worry that I haven’t even laid eyes on some of my patients yet because I’ve already at least seen them during bedside report.  As a new grad nurse in a facility that did not (at the time) participate in bedside report, one of my greatest anxieties was knowing that if anything slowed me down in the first hour or two of my shift, there were patients I literally hadn’t even seen yet (& there was no way I could guarantee when the last nurse had seen them either).  I no longer have that anxiety . . . Ok, I apologize for the tangent.bedside report
    4. After report, I get back on the computer & finish looking up lab/test results, orders, doctor’s notes (from the current day), & anything else that I feel is particularly relevant for my patients’ care. The only time I break this part of my routine is if I have a patient with a particularly urgent need.  Even then I make time to do this as soon as that urgent need has been addressed.  Yes, I do have a few OCD tendencies, but I really do think it’s important to have as much background on your patients as you can.
    5. Next I start on assessments & meds. As a new grad I usually tried to do all my assessments first & then do meds.  Eventually I realized this was taking me way too long & patients sometimes got annoyed if their 2100 meds weren’t given till 2200 or later (usually because they wanted to go to sleep earlier & didn’t want to be woken up for meds).  Nowadays I try to combine meds & assessments, usually starting with the “easiest” patients first (i.e. those with the fewest meds, those who are “walkie-talkies” & less likely to need 30 minutes of care in addition to everything else).  By starting with the easier patients, I can then devote more time to my more time-consuming patients without worrying that I’m late to see everyone else.  If you have a patient whose meds all have to be crushed or who is confused & likely to fight taking their pills, if at all possible, save them for last.  Exception being if they have some kind of truly urgent need of course, but that should go without saying.  It should also probably go without saying, but 99% of the time you can & should group your 8 & 9 o’clock meds, etc.  Just know what your hospital’s protocol is in regard to this.nurse giving meds
    6. Chart as you go as much as possible.  At the very beginning, this might not be possible because you might not yet be familiar with your hospital’s charting system.  But over time this is really one of the best ways to manage your time efficiently.  At the very minimum I try to chart safety checks, pain & IV assessments, & any relevant I&O since those things can all be charted relatively quickly anyway.  Then when I go back to finish up my charting later, all I have to do is add in my head-to-toe assessment, care plan, & patient education.  If I don’t have time to chart the head-to-toe assessment in the room, I’ll jot down notes & the time so I can remember it later.charting cartoon
    7. After I finish meds, assessments, & at least a little documenting, I’ll round on all of my patients again to ask about evening snacks, toileting, etc.
    8. At midnight (or noon, if you’re day shift) the cycle starts again at # 5 above.
  7. Get to know your fellow nurses, both as nurses & as human beings. I know I wouldn’t be the nurse I am today without the guidance, coaching, & support of so many great nurses with whom I’ve had the privilege of working over the past few years.  Nursing is absolutely a team effort & knowing you’ve got people to support you will go a long way in making your first year as a nurse more rewarding & less stressful.nursing teamwork
  8. On a similar note, build a good relationship with your NAs because your NAs will make you or break you. Show them that you’re committed to the unit & your patients by chipping in with vital signs & toileting when you can.  I’m not saying you shouldn’t ask them for help, especially when you’re feeling overwhelmed, but don’t be that nurse who leaves the room to find an NA to take the patient to the bathroom just because you don’t feel like doing it.  That is unacceptable (unless of course you have a true emergency with another patient).  A good NA is worth her weight in gold.  When you have one, show them how much you appreciate them.  I’m a much better nurse when I have good NAs to help me & I always strive to make sure they know that.  Remember, we’re all in this together.
  9. When you’re scared to try something, do it anyway; just find someone to help you. I was never one of those nursing students who was dying to learn to start IVs.  In fact I was terrified by the idea.  Unlike some, I didn’t become a nurse because I wanted to stick needles in people.  I really didn’t.  It took me a solid six months as a nurse to really get a handle on starting IVs because I was just so freaked out about it.  I would get so nervous that I was practically paralyzed with fear.  But I am so thankful for a few nurses who really took the time to help me, to even push me into rooms to start IVs, even when I really didn’t want to, because guess what: eventually I got it.  And after a few more months, I actually became pretty good at it.  Not great perhaps, but good enough that people occasionally asked me to try an IV for them.  Sometimes you will fail over & over again, but every time you fail you still learn something.  And it truly is all in your head.  Once you master the fear, you will be amazed at how quickly your skills improve.  On the same subject, don’t obsess too much about your hands-on skills.  You will master them with time.  Focus on time management & critical thinking because at the end of the day these things are what will really make you or break you as a nurse.  I’ve said it before & I’ll say it again: as a nurse your must important tool is not your hands; it’s your brain.  Use it!!nelson mandela quote
  10. Don’t beat yourself up for not being perfect. No one is ever perfect.  We’re all still learning, & that is part of what makes nursing so much fun.  And we all have days when we feel like we’re just barely keeping our head above the water.  It happens to the best of us.  It’s very easy to get burnt out in nursing between demanding patients (& family members) & unsympathetic/unrealistic upper management, not to mention the sickness & death we see on a regular basis.  Realize you will have times when you are not the angel of kindness you always dreamt of being.  Just be aware of it so you can temper it & not become a bitter, angry soul.  Go out with your nursing buddies & vent about your frustrations.  They really are the only ones who can truly understand what you’re going through.  Additionally, find outlets away from nursing that allow you to relax & rejuvenate.  For me that means listening to music, playing my flute, hiking, reading, & above all, writing.  It doesn’t matter what your outlet is, as long as it contributes positively to your mental health.
  11. If you’re working night shift, realize it does get easier with time.  I DREADED night shift.  I cannot tell you how paralyzed with fear I was about it because I have NEVER been a night owl.  Even in college, I never once stayed up all night.  But guess what: three years later I now love night shift (for a variety of reasons which you can read about here:  Everyone has to find what works for them in regards to adjusting to night shift life, but for me I’ve found that working three nights in a row is helpful so that I can have a more “normal” life on my days off.  Also black-out curtains are a MUST.  The Eclipse brand sold at Wal-Mart or on Amazon are fabulous.

night shift humor12. Perhaps the most important advice I can offer is also the simplest: ASK QUESTIONS.  If something doesn’t feel right, speak up.  Do not be afraid of “looking stupid” or “bothering” other nurses or even doctors.   Mistakes happen when people DON’T ask questions.

If you’re a new grad nurse or a nursing student who can’t wait to graduate, I hope you’ve found this post helpful.  Your first year as a nurse will be incredibly challenging & incredibly difficult at times, but please believe me when I say it really does get better & easier with time.  Take a deep breath, listen to some Five Finger Death Punch or Godsmack to get you all fired up, & go out there & be the rock star nurse you know you were meant to be!

If you’re an experienced nurse & would like to chip in with your ideas, please comment below.  I’d love to hear from you.  As I said, I’m always learning too.  Cheers!