I start back in September as an RN on the Mother/Baby unit which is really just postpartum and well newborn nursery combined into one unit. The hospital I work for is a large hospital that takes all the high risk patients from the region so we see everything from healthy pregnancies/deliveries to extremely high risk pregnancies and not so healthy newborns. The floor consists of 30 rooms and I think 35-40 newborn bassinets, we take on couplets as patients so a mom and a baby count as 2 patients for us, our expected nurse to patient ratio is 1 to 8 however I have had up to 12-13 patients as a single nurse. While this may sound fairly easy to some nurses and even others who have no idea what I'm taking about when I bring up nurse to patient ratios however I would like to mention that no I am not giving out a zillion medications every shift or constantly watching a monitor to make sure my patient stays alive one more night we have our own special kind of busy that many don't understand unless you work in the women and children's area. Working nights brings on a whole different set of challenges, being that we are the only ones on the floor we become the lactation nurses, the case workers, and so many other roles that just are not on the unit like they are during the day (yes some of those we do keep on call but it's not easy to find a case worker at 2 am). Being that we take care of high risk pregnant women those women then become high risk postpartum patients. I think a typical shift in my world is better saved for a different post however I do think it is important to give you some background information on my job and unit.
So 10 things I wish I would have known about being a nurse in my position or even a nurse in general before I signed that first RN after my name is a compilation of things I've learned over the last few months or things I have learned to most while being in my current position.
1. You are never going to stop learning. Yes I know it sounds super clique and that I am sure every nurse says this but it is true. Not only in class session (I have taken so many education classes I thought I was back in school) but on the floor. Even nurses who have been there for decades are still learning something new, take advantage of it, it may be a once in a lifetime learning opportunity and you may ever need that information again but if you have it if you need it. Who knew unborn babies could get gallstones while in the womb?!
2. You are not supposed to be best friends with all your co-workers and that is ok. This one was especially hard for me because moving to a brand new city I wanted so badly to make friends and have them be the people I spent the most time with, which is at work. I slowly learned you will make friends at work and you may have some really good close friends that you spend time with outside of work but for the most parts be friendly at work with your co-workers and look else where for those friends you tell everything to. I made some very good friends at work and sadly the one I felt I could talk to the most at work left the same day I hit my 6th month mark.
3. Ask for help and if no one wants to help keep asking. When I first got off orientation I was convinced I needed to prove myself to the rest of the unit, feeling like I needed to show that I could handle the patient load, take on the responsibility given to me as an RN but I found that I was always behind, eating lunch late, running around like I could find my own two feet even with them right under me. When I finally reached my breaking point I asked for help only to encounter rude remarks, that left me feeling like maybe I should be asking for help like I wasn't entitled to it, I eventually learned you just need to ask the right people. Sadly some people are not willing to help even when you desperately need it, thankfully this is fairly rare on my floor however there are a select few I still won't be bother asking for help.
4. Go at your own pace, it is ok! Getting off orientation I thought I had to keep with the same pace as everyone else, going home at the same time as everyone else. I always felt rushed and never felt like I was getting anything done, I was always way behind. Over the last three weeks or so I noticed I was getting faster, I was leaving with everyone and sometimes even before everyone. It took me several months to get good and quick at my charting and my assessments, to be able to time my rounds to get the most out of them while still leaving myself time to chart and get my paperwork done. Learning anything and becoming good at it just takes time, so give yourself some.
5. Find someone at work you can talk to you, you will need it. Sometimes you just need a person at work that you trust, either when a co-worker is giving you a hard time, you just don't understand something, you perform a med error, anything it helps to have someone who you can talk to and know they are not looking down on you or judging you for being new and not knowing or understanding. It really does make a difference when you feel uncomfortable asking for help or guidance.
6. It is ok when your job doesn't live up to your expectations. I had high high expectations for my first job, that is was going to be exactly what I really wanted (in reality I wanted to be a NICU nurse more than anything so I expected healthy babies to be a close second). However I was so wrong from the truth, yes it great caring for healthy happy newborns and families and even some not so healthy stable newborns, but its not the same as I was expecting, we do much more interacting with the moms and the families than we do with the babies. There are lots of things I like about my job, when we do get to interact with the babies it makes my shift, I've helped some families make some precious memories that have brought tears to their eyes, I've learned more about pregnancy, delivery, and after baby than I ever thought possible when in school but its not my dream job and I have felt disappointment in my job, every time I go to the NICU for something (drop off breast milk, pick up or drop off a baby) my disappointment aches a little harder. I've learned it is ok to feel that disappointment, you don't have to stay in your current job forever.
7. Find a way to make yourself happy in your current job if you are unhappy. While it is easy to say find another job in this economy that is not always possible especially if you are a nurse with hardly any experience. I was struggling to be happy working with a certain groups of people, I would usually end up leaving work in tears trying not to let anyone see. We self schedule so I started putting myself on the team that had more people on it that I worked well with so I could surround myself with more positive people during my shift. I also emailed the person responsible for finalizing the schedule so she would be aware of why I always wanted to work with the same team and asking her to avoid putting me on the other team for various reasons without placing blame on anyone.
8. Don't cry on the floor in front of your co-workers, find a time and a place for it. I found myself many nights wanting to break down in tears from the feelings of being over whelmed, not connecting with my co-workers, or feeling like I wasn't being a good nurse to any of my patients. I cried in front of maybe 5 co-workers before and before I knew it everyone knew about it. From then on I either held it in or went some place else for 5 minutes to give myself a break. We have a conference room at the end of the unit that no one used at night so if I need a minute I go in there (locked unit so you need the code to open any door on the unit) and sit for a few minutes and let myself cry there. I pick myself up fix, fix my make up and go on with my shift. Normally I don't care if I cry in front of people but I don't need my co-workers thinking less of me or differently of me because of it.
9. It is ok to not be a perfect nurse every shift, in fact it isn't possible! I tried to so hard to make all of my patients happy every single minute of every single shift. Guess what, not everyone is going to be happy and appreciative of every single thing you do. In my unit I expected everyone to be happy, they just welcomes a gorgeous new baby into the world. Sadly that is not always the case, no matter what I did for or offered them they weren't happy. Some shifts I have a wonderful patient who could want for nothing and appreciates everything I do for them and when they need something simple it takes me forever because my ungrateful patients are demanding and simply ungrateful. I have had shifts where I felt like a terrible nurse because I couldn't give my mom the 45 minutes of attention to help her breastfeed her child, she maybe got 10 minutes of my time that hour. Or my sweet NICU mom who spent my whole shift in the NICU visiting her baby only for me to see her twice during my shift, both times I could do nothing for her. Or the mom who didn't get to see her baby because the NICU was closed and I could only hug her not take her tears or pain away. Some nights I feel like a champ nurse I've accomplished tons and other nights I leave feeling like I couldn't name one thing I did for any of my patients that really stood out in my brain. It is ok, we are nurses, not perfect.
10. Take every moment as a nurse as a learning opportunity. Your first job (even second or third job) may not have been the position you had your eyes on, the hospital you really wanted, or the city of your dreams. But you can learn so much from every position and every day as a nurse. Take advantage of each moment and learn from it. You never know when your previous experiences and knowledge gained from other positions will come in handy and may help you in your dream position, at your ideal hospital, in the city you always wanted to be in.
I hope these tips will help someone somewhere. I know I haven't been a nurse for very long and have many more years before I can pass on any great deal of knowledge to a new nurse like my preceptors did for me. However I do hope these tips will come in handy to someone out there. Remember to be proud to be a nurse, I still smile every time I tell a patient I am their nurse for the evening or write RN after my name on the charts and forms. You earned those letters after your name, wear them proudly.
Thanks for reading everyone, I know this was a long one!
