Tips For Graduate Nurses

Every year (or more often) a new group of graduate nurses is unleashed upon the world. Some will have the safety net of a graduate program and others will be going it "alone" (although never really alone). Either way chances are if you are a new graduate you will have a lot of things going through your head about what you might see, hear, feel, experience and do in your graduate year. It can be overwhelming, exciting and sometimes anxiety-making! That is why we are here with some tips to help you survive your first year as a nurse.

This is up first because I believe it is so important. Regardless of how smoothly or not your graduate year is, no matter if you got your dream job straight away or not there will be times in this year when you are just completely overwhelmed and/or exhausted. When you feel this way just know that it is normal and the best thing you can do is take some time out for yourself. Whether that is getting time off or utilising your scheduled days off to do something you love or just simply getting more sleep. Do whatever it is that you need to do to replenish your cup, including taking all of your breaks. Particularly in Covid times I hear graduates talking about the guilt of saying no to overtime, the guilt of asking for leave or the guilt of taking a personal day when they feel like they can't take another step. Let me tell you that you are going to be so much more use to your team and so much more safe for your patients if you take that time to rest and refuel early rather than waiting until you fall in a heap and end up off sick for a week! It is not selfish to put yourself first. In fact to be able to care for anyone you must put yourself first so that you have energy to give out to those who need you.

This kind of goes along with point one but I have made it it's own point because even if you are cruising along, not a care in the world you still need to take time out. Taking annual leave in nursing is not as straight forward as it sounds. Managers have to balance rosters, skill mix, new staff coming in, staff leaving, training requests and about ten million other things when they are considering to approve leave. My best advice is to get in early and actually have a conversation with your manager about when would be a good time to take leave. Or if you have something planned that you need to take leave for again don't just submit that electronic form, go and talk to your manager and let them know what's happening and why it is important to you.

At the end of they day it is your registration that is on the line. Regardless of whether a doctor or senior nurse was the person who asked you to do it you need to be able to explain and rationalise anything that you do. You may feel uncomfortable because it is outside your scope, it is something you haven't done in practice or you feel that it is unnecessary or unsafe. Just explain to the person asking you. You can say something like "I haven't done that before, can I watch you do it this time and I can try the next one?" Or if you think something is unsafe you can say " I don't feel comfortable doing that do you mind explaining to me the reason we need to do this?" At times you might get allocated a patient load that you feel is unsafe for you whether that is because of the number of patients, the conditions they are experiencing or their acuity. Take a deep breath and explain calmly why you feel the situation is unsafe for you to manage. Sometimes decisions are made with certain things in mind and the fact that you are a new graduate is not considered so don't hesitate to remind or alert people to this. If you are still getting push back ask if you can chat to the doctor, team leader, graduate program, manager etc or whoever else you can escalate the situation to, to get some back up.

When I started nursing I had a young family and a great group of friends around me so I didn't put a lot of effort into attending work events or trying to make new nursing friends. A few years down the track and I regretted it and had to go back and do the work I should have done in the beginning. I still had an amazing support network of the same family and friends as when I started nursing but they are not nurses and they don't always understand the pressures that I experience. And with debriefing being such an important part of being a nurse I think it is important to have people to turn to when you've had a terrible shift or you're second guessing that wound dressing you attended or you think you should have done something better and you need someone that can listen and understand without you having to explain every second term.

Time management is not something that usually comes easily and it is not something that you can have every single shift no matter how long you have been nursing but there are some basics that will help your day run smoother. Firstly USE A PLANNER! Even if you're not on a ward, even if you are in ED you need some kind of plan of attack. Some places your plan might just look like a to do list whereas other's you might have a beautiful colour coded, time organised, a4 sheet. Whatever it is, you need something. Secondly, try to group tasks, especially if going into a precaution room. Does your patient have two things due at the same time such as meds and obs. Do them both at the same time. Check your fluid balance, drains, wounds, cannulas or catheters whilst you're in the room too. Will save you coming in and out and explaining yourself multiple times. It also reduces the risk of you going back to do something and your patient has gone for a walk or is on the toilet and you have to remember to come back. Don't wait around for anything. If you can start something early, do it. If you are waiting for a patient or sitting at the phone waiting for a return page; fill out some paperwork, update your planner, start some notes. Ask for help early and accept help when it's offered. Nursing is a team sport. As a grad you might be taking more help than you are offering this shift but trust me you'll get them back at some point. On the same topic though you don't have to say yes every time someone asks for help. Just like your colleagues might not say yes every time you ask them and that is ok. You need to know your limits. And if you are helping someone make sure your patients are sorted first. There's no point helping someone with a wound dressing whilst freaking out about all your late obs and meds or that you left a falls risk patient on the toilet alone! Nursing is 24/7.... I'll say it again NURSING IS 24/7! We all have stories of nurses who have made us feel bad for handing something over but that's their problem. If you have done your best that is all that can be asked of you. You prioritise your tasks and you get done what you can in the time that you have. Some days you will not stop all shift but at the end of the day have no idea what you did? You kept your patient's alive and safe! And at the end of the shift you have to shake it off and leave work at work.

Every person makes mistakes in every single profession in the world and so will you. The most important thing is knowing that as a professional you need to suck it up and admit it so that it can be dealt with and the harm prevented or hopefully at least minimised. Hopefully you will feel dreadful that you've made a mistake... Why do I say this? Because if you feel dreadful it means you care and there is nothing that scares me more than a nurse who doesn't care. So once you have done what you need to do for your patient it is ok to go and cry and have a moment and debrief with your manager or your trusted person. It's probably going to feel a bit crappy for a little while but each day that's going to fade a bit more, your confidence will return but most importantly you will remember and you will never make that mistake again.

This is such a big thing that I don't think our profession as a whole puts enough time and energy into. Communicate with your colleagues, with your manager and with your patients. When a patient asks you when they are having surgery you might be running around for the next 2 hours trying to get a hold of the team or the theatre whilst also doing other things and waiting for a call back. You are very busy doing exactly what your patient has asked but behind that curtain they don't know that and if they haven't heard from you for 2 hours they might think you have forgotten them. So maybe you don't have any new information for them but popping your head back in to say "hey I'm waiting on a call back from the doctor, I'll let you know as soon as I hear" is really going to put their mind at ease and possibly stop them getting agitated later on. I've heard the example in a training session that when an IV pump is beeping and whichever nurse is around might just pop in and silence the alarm and then walk out again without saying anything. To us it's obvious we've just stopped that annoying noise. But to the patient they might be thinking "I have this medication that's going into my veins and someone I don't know has just come in and fiddled with the machine!" It's not hard to say "Hi I'm Meg, your pump is alarming because the medication has finished now, I'm just going to turn off the alarm and let your nurse know". And if your patient asks you a question you don't know the answer to, tell them you will find out and then follow through.

I'm not going to say there's no silly questions because there probably is some but I am going to say I don't care if it's silly. When it comes to nursing and healthcare I want you to ask all the questions. I want you to know exactly what you are doing, how you are doing it and why you are doing it. Because that is the only way you can be safe. And this will extend well beyond your graduate year across your whole career because there are always more questions to ask, more things to learn and new things to see!