So you're done with school, ADN, BSN, you studied hard and passed the NCLEX, got your registered nurse license, feeling pretty good about yourself, quite an accomplishment, right? Right! You set up your resumé, applied for a few positions, get a couple interviews, most likely not your dream job, but you're just happy you now have a job. Than you start, general orientation, one million powerpoint presentations, guest speakers, rules and regulations, you can't keep up with all the details.
Most hospitals and health care facilities will have you orienting on the unit after a week or so. Then the real fun starts, which quickly you find out there's nothing fun about it. People coming at you from all sides, have you done this? Do you know about that? You can quickly, and I mean quickly become burnt out and frustrated with nursing and question your life's decision of becoming a nurse within the first month of orientation.
You will feel unprepared, lost, but at no point should you question your ability or intelligence as you proceed with your career. This is when nursing leaders and great preceptors are tested, a new nurse should not be allowed to feel this way, it will jeopardize their entire clinical preceptorship, and put their patient's lives at risk from pressure and intimidation from the new job they are learning and information overload. Truth is, no nursing school will properly prepare you for the real world, you will learn as you go.
Nursing leaders and management have to weigh proportionately the desire for productivity of their new hire, and the outcome they desire out of their preceptorship and orientation programs. Proper training of nurse preceptors are a must, and continuity of nurse preceptor and new hire should continue throughout the entire period. I have seen many new graduates starting in different units I have worked in and claim they feel completely lost due to the fact they are paired with a different preceptor everyday they come to work, each preceptor not knowing or failing to recognize where the new nurse stands in the orientation process.
If you are a new nurse starting out and feel completely lost, that's ok, what is not ok is if you feel lost and have no resource to follow up with and clear up doubts, properly trained preceptors that will know how to guide you and make sure you are ready and prepared to safely tackle the patient load on your own once you're done with orientation. Also, clinical educators should be assigned to follow new nurses throughout the orientation process and even after to make sure they are comfortable performing the tasks, and at no point in time feel as if they are being "thrown to the wolves." I personally feel there is also a need for clinical coordinators and nursing educators to pair up with physicians to allow an ease of mind for new nurses to communicate with the physicians participating in the patient care, this is also another big issue new nurses find, and some are frustrated when it comes to communicating with physicians, a team care approach should be established in all healthcare setting to allow all those involved to feel comfortable to discuss plan of care and raise any concerns if any come up.
To any new nurse reading this post, remember, it is a tough road until you become comfortable and know exactly what to do. But also remember, being too confident or too comfortable allows for mistakes to happen, always remain vigilant and aware of changes. But, feel comfortable asking questions, seek a mentor; whether it be your preceptor, manager, clinical educators, or any of your fellow colleagues. Verbalize to your superiors that you may feel like you're sinking before you hit the bottom.
When interviewing for your first job, ask the interviewer about their orientation process and education departments, ask whether you will be paired with a preceptor that has been trained on the transition of student nurse to registered nurse, one who will not judge a question as "stupid" or assume "you should know that if you became a nurse." Also ask if there are other resources they will provide in case you need more help. Needing more help is not a weakness and interviewers should not hold that against you, in the end, we all want to provide safe patient care, and it is crucial that you are instructed and given the proper training to do so.
I want to congratulate you in completing school and becoming a registered nurse. Wear that RN proudly, you deserve it. I hope you all find the job you want, and one that will train you to define your skills as a nurse, a job that will bring out the best in you. Now go save some lives!
The Dude Nurse
Klaus Campos, BSN-RN