27 Tips for New Nurses… From Experienced RNs

Every new nurse is eager to succeed. After years of study, clinical practicums, and finally passing the NCLEX-RN examination, it’s time to start your nursing career.

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Once you’re on the job, you’ll soon learn that organization is essential. There’s no time to run back and forth for supplies or to hunt down an extra pen. You’ll also notice that the experienced RNs seem to carry what they need most. And that they know how to anticipate common situations. They’ll be the first to admit that they didn’t always know these things.

Efficiency is key in helping your shifts go smoothly. Since every day is different, it’s smart to be as prepared as possible for whatever comes your way. Nursing school gives you the knowledge, and the working world gives you the reality. Now you’ll be able to combine them.

We’ve gathered tips and tricks from seasoned nurses to help you jump-start your new profession. No one is expected to know everything, especially as a graduate nurse. Here are 27 ways -- big and small -- that will give you confidence, save time, and let you feel like a savvy team member.

Basics: Before you begin your first shift

• Set your cell phone to military time. It’s how healthcare works, so get comfortable thinking in a 24-hour way.
• Be on time. This is non-negotiable, so if you’re a person who tends to scoot in at the last second or runs a “little” late, start to change that behavior. Hospitals have tardy policies, but you also don’t want to start your shift feeling frazzled and unorganized.
• Find really, really comfortable shoes. What brand or style that works for another nurse may not be right for you. First, check your new facility’s policy on footwear. Then, take time to do a little research, try some shoes on, and make sure your feet can stay happy for a 12-hour shift.
• Buy a tiny notebook. Keep it in a pocket and use it to write down checklists, priorities for your shift, things to look up, facts you learn, names of doctors, new policies… anything, really. Once you’ve jotted something down, you don’t have to remember it. Over time, you’ll probably give it up, but in the beginning, it’s super handy.

Just starting: Easy does it

• Be patient with yourself. This is a major leap and you’re not expected to be perfect. Everyone started where you are now. Everyone.
• Get to know your team members. Not just your nursing colleagues, but the respiratory therapist, the unit secretary, and the unlicensed professionals, whatever title your facility uses: CNA, NA, etc. Introduce yourself to the housekeeper, the pharmacist, the dietician, and the managers. You’ll be much more comfortable when you do.
• Introduce yourself to the physicians, residents, and fellows, as the opportunity arises. It helps them put your face and name together, which is handy when you call them later. Ask them questions, too. Their knowledge base is different, so you’ll learn a lot.
• Depending on your unit, become familiar with the common diagnoses, medications, treatments, and abbreviations. It’s less stressful to do this away from work, so make lists of things you can look up at home.
• Ask for help. You’ll have at least one preceptor, but don’t be shy about asking others if you get stuck or need an explanation. Build your own network of co-workers who are happy to help you learn. ASK!
• Be humble. You’ve already got a lot of knowledge, but be prudent about how to share it. No doubt you’ve learned things that longtime nurses aren’t aware of. Don’t be the smarty-pants newcomer. Remember the expression, “You don’t know what you don’t know.” Watch and listen. Ask questions. Lots of questions!
• Ask for feedback, too. You can’t improve if you don’t know that you could be doing something better. Be receptive and grateful when a colleague gives advice or offers a suggestion.

On the job: Getting the hang of it

• Adjust to your shift. No matter which shifts you’re on, there are pros and cons. Day shift? You can’t stay up too late. Afternoons? You learn to use time wisely. Nights? Figure out how to get quality sleep during the day. For any shift: Don’t overextend or overtire; you must be alert when you’re at work. Period.
• Develop a routine. Depending on your unit and shift, things happen at about the same time. There will always be distractions or emergencies, but you’ll soon be able to look at a clock and know what you should be doing at that point in the shift.
• Become efficient at charting. As soon as possible, learn the charting system. Know what must be recorded, how to do it, and when to do it. Time is valuable, so use it to provide care, not to sit at a computer.
• Accept mistakes. Any nurse who tells you they never made a mistake is lying. We’re humans and mistakes happen. Don’t let it get you down. Figure out what went wrong, learn from it, and move on.
• Take your breaks. It’s tempting to pass up breaks and meals in order to stay on task or show that you’re dedicated. But you’ll tire out quickly and won’t be able to give the care you want. There will be days when your unit is so busy that breaks aren’t an option. Benefits of breaks and meals are well-documented. Just a few minutes can make a big difference in your shift.
• CHEAT! Okay, this isn’t really cheating, but you no longer have to memorize everything for an exam. Carry a pocket reference guide. Use your small notebook to write down things like drip rates, normal lab values, drug calculations, anything that you might need to know or that’s specific to your specialty. Download apps. Your goal is patient care and safety, not passing a test.

About the patients: How you can help

• Learn the acronyms -- and how to explain them. Every industry acronyms, but medicine seems to have more: CBC, B/P, TURP, CSF… the list is endless. As health care professionals, we don’t think twice about saying them. But for patients, who are already anxious and scared, they are overwhelming. Talk to patients and their families in a way they can understand. “A CBC is a blood test… ” You already know enough to explain these in simple terms.
• Listen to your patients. No matter how much you know about a disease or condition, patients know their own bodies better than you ever will. Pay attention to what they tell you; they might be describing an important symptom.
• Don’t ignore them. The reality of being a nurse -- no matter where you work -- is that some clients are annoying. They constantly press their call light, they call the clinic every day, or they complain about seemingly everything. Try to understand the reason behind their behavior and always treat them with courtesy.
• Keep calm and carry on. When a situation escalates, it’s important to remain as calm as possible, so you can be helpful and make appropriate decisions. You’ll take part in codes and encounter emergencies. Even if you’re not sure what to do, steady yourself and be ready to do whatever you’re asked.
• Keep a straight face. If you didn’t already know this, nurses see and hear some unbelievable things. However, as professionals, we never show shock or judgment. Clients and families know they can trust nurses with things they’d never share with anyone else. Don’t let them down.

Take care of YOU, too!

• Hydrate, hydrate. You’ll be busy from start to finish of your shift. When an energy slump hits, it’s tempting to have another cup of coffee. But your brain and body need water, so drink plenty of water. By the time you feel thirsty, you’re already dehydrated.
• Nutrition matters. Some days you get a meal break, some days you don’t. Plan accordingly and carry healthy foods that you can eat on the go. Here are five good snacks. Remember, your clients need you at your best.
• Strive for balance. As you begin your new career, it can be easy to live and breathe nursing. When you’re not at work, you’re thinking about it. It’s fine to look up information and think about ways to become more organized, but be sure to add some fun, exercise, and social activity to your time off. You’ll always need to do this, to avoid burnout.
• Never stop learning. Every shift you’ll learn something new. As soon as you can, start to find workshops, seminars, and conferences that continue your personal and professional growth. There are online resources and inexpensive ways to keep learning. Subscribe to a nursing journal or join a nursing organization like the American Nurses Association, which has state-level activities, too.
• Once more: Be patient with yourself. Experts agree that it takes a full year to learn enough to be both proficient and comfortable at any job. For nurses, the challenge may be even greater: taking the knowledge from school and combining it with the reality of the working world can feel overwhelming. Don’t expect yourself to handle everything like a pro from Day One. You WILL, for sure… for now, take it all day-by-day.

It’s exciting to think of starting your professional career. With your nursing degree and license, you’re on your way. With advice from veteran peers, you can look back every month and see how far you’ve come. It won’t be long before you’re the experienced nurse, helping a new graduate learn and remembering how it was for you.

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