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Saturday, August 1, 2015

My First Week as a New Graduate Nurse

Graduate Nurse, RN, new nurse, preceptor, hospital, patient, nursing school, new unit, LPN, CNA, new job

My First Week as a New Graduate Nurse

I finally did it. I graduated, landed a job, and passed NCLEX. It has been a whirlwind blur for the past several months during this process so I thought it would be helpful to share the experience with others. That way you know what to expect upon graduating from nursing school. Remember the Seven P's from the Marine Corps: "Proper planning and preparation prevents {piss} poor performance." My family is full of rough and gruff straight shooters that tell it like it is. Guess you could say the apple doesn't fall too far from the tree. So let me tell you about my experience so you know what to expect!

Day Numero Uno

I am the type of person that has to physically see or feel something before I believe it's real. When I was offered my job I didn't want to tell anyone other than the few that I am close with. First off, I was worried if I made a big announcement and then didn't pass boards (thus losing the job offer). I did not want to be faced with that humiliation. Fortunately, I passed. But I still had this gut feeling. Someone pinch me! Do I really have this job?

I'm so stoked to get started at this amazing place on such a bad ass unit. I was all smiles as I approached the check-in desk HR had set up at nursing orientation. Until they said I was removed from the list.


Que the most silent, polite meltdown that I've ever had all in my head as I waited over an hour for the HR/recruiters to figure out where the confusion occurred. Did I make the right choice? Did I choose the right organization? Did I have a job? Perhaps they didn't mean to offer me the position. Did I dream up all of those emails? What am I going to do with all of these student loans? I'm probably going crazy. Web MD says I have brain cancer. Oh, God!

I was having a very silent, stoic meltdown in the waiting room. Turned out to be a simple mistake. Something was misplaced. A folder was lost somewhere. I'm not sure. But I did in fact have a job. Yes, they did mean to hire me. I am not insane. 

Basically, if nursing school didn't already teach you to expect the unexpected, I'm telling you, "Expect the unexpected." I have yet to hear of anyone having a smooth process getting hired on at a hospital. It's not HR's fault the mixup happened in my case. It was a human error. (Truthfully, I never found out what had happened. I'm sure it was something silly.) This time of year is hectic in hospitals. You have all these new nurse graduates, new resident doctors, new fellows. The summer air is hot and accidents are a plenty. The hospital is full of trauma and bursting at capacity. 

Don't freak out. At least don't freak out, outwardly. It's stressful. You don't know where to park, what to wear, or if lunch is being provided. I have a lot of anxiety in new environments. Starting a new job, a new career, is one heck of a new environment. Especially in healthcare. Hospitals are their own little cities. Mine has two banks and a Barnes and Noble inside. Say what? Keep in mind I grew up on a farm and my closest neighbors were miles away. 

On the Unit

Once you make it through the first week or two of new employee/nurse orientation, you'll finally meet your preceptor and work on your new unit. 

Within the first half hour of work on my new unit, one of my patients was upset and was cussing the staff. Welcome to nursing! I definitely expect to run into this from time to time. Patients are mad. They're stressed. They're frustrated with the process of being sick in the hospital. I completely understand. I try to deliver the best and conscientious care as possible. It's horrible sticking people for labs at midnight or 3am as they sleep. I understand it's necessary so we can deliver proper healthcare but I definitely understand that the process may get you cussed at from time to time. I just thought I'd last longer than 30 minutes... 

My second day I was floated to a different unit. Luckily, my preceptor and the staff is super friendly. They're happy to have some new hires on the floor and not be so short staffed. 

The third day the computers crashed for the entire organization.

The fourth day a confused patient ripped out a g-tube.

As you can see, expect the unexpected. You truly never know what could possibly happen next. You'll feel very overwhelmed. Here are some suggestions:

How to Survive Week 1 on the Unit

  1. Always eat breakfast.
    I didn't on day one because it was being provided, but because of the mix up with my paperwork, I missed the breakfast that was served. I was starving. Lunch can be anywhere from 11-4 so eat a substantial breakfast and bring some quick snacks. Cliff Bars were a life saver for me when I waited tables. They'll fill you up quite a bit when you're running low on fumes and lunch is nowhere in sight.
  2. Pee before you start your shift.
    You just never know when you'll be able to pee again. Pee early. Pee often.
  3. Go with the Flo'.
    Again, if nursing school didn't prepare you to expect the unexpected, then this is your warning. It's not THAT bad, but I do feel like you need to have it in your head already so that you can be mellow when things change. Because things change constantly.
  4. Sleep.
    I am terrible at robbing myself of those precious hours of sleep by reading something silly. Why yes, I do want to know which Disney villain I am most like! A migraine from sleep deprivation will not make for a pleasant day.
  5. Eat when you can. Drink when you can.
    Just like tomorrow is never promised, neither is lunch or a water break. If you have a second, I think it's a good idea to take full advantage of it.
  6. Be positive! This is a bit of a pet peeve of mine. It's not that you can't have a bad day. Or that things in life don't suck. But when every day is a bad day, maybe you should reevaluate your life and see if there is anything you can change. A rotten attitude just brings the energy of a team down. I try to not contribute too often to negativity on a unit, but I am not always a bright ray of sunshine. I just find it hard to not feel absolutely blessed when I am surrounded by others that are sick and in need of our help. Supervisors will love the positivity and enthusiasm.
  7. Bring Tylenol
    or whatever over the counter (no narcs) you like to use to treat a headache, or aching feet/back/neck. That's a staple in my nursing bag.
  8. Don't be a know it all but don't be clueless either.
    Being a know it all will not make you many friends. However, you do need to show that you have some knowledge in your noggin or else the staff will not have confidence in your abilities. I try to walk my preceptor through my thoughts so that they can see where I am lacking knowledge or if I am getting something confused.
  9. Ask Questions!
    Most places I've been during school, and now after, welcomed questions. I found that the staff had more confidence in me if they knew I'd ask a question if I wasn't positive how to do something. I ask a ton of questions. I remember my very first clinical, I didn't ask that many questions. The thing was was that I didn't even know enough to know what questions I should've been asking. I still find myself sometimes in situations where I don't even know what questions to ask because I am that clueless. Expressing that to your preceptor is way more helpful than remaining silent. 

Chin up, buttercup. You'll survive this new transitioning period. It's a lot of stress at first. Hopefully these tips will help you out. This is just basic stuff. I haven't even touched the whole overwhelming process of time management. That's something that all new nurses struggle with. It is something that I am struggling with. Keep in mind, you'll probably be working with a different computer program than the ones you were exposed to in school. There is a learning curve. And chances are that there is someone you can turn to on your new unit for help in organizing your day. I would ask multiple nurses that you observe as having a good routine, your preceptor, managers, educators, and online there are a lot of tips. Whenever I feel more confident in my abilities to organize my day, I'll post some helpful tips. 

Perhaps you'd like 6 Tips to Become More Positive.

What are some tips you use to survive being new to a unit? What's in your locker/bag?




  1. Loved reading this! I'm in my last year of RN school and I really liked reading about your first week :)

  2. Thanks for reading, Jessica!! Good luck in nursing school and with NCLEX. You'll be great! The last half of the last semester and the month or two that follow graduation are CRAZY. At least they were for me. Good luck to you sister. Thanks again for reading. It's kind of scary putting my personal thoughts out there for others to read, but I always found reading posts from other nurses made me feel like I wasn't alone and that there was hope that some day I wouldn't feel so lost. However that day still hasn't come. haha. :)

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