I officially finished my second week on my own as a new grad and finished my PCU new grad classes! My new grad cohort has monthly meetings until April after which I will officially go from a CN I to CN II! It’s been awhile since I’ve posted so I thought I would update you on what to expect your 1st 3 months in a new grad acute care setting.

The past 3 months have been exciting, terrifying, gratifying, frustrating, and a roller coaster ride of emotions to say the least. If you are a new grad or even a new nursing student, anxiety and imposter syndrome may be among some of the things you are feeling…. and that is NORMAL! Make sure to decompress, participate in self-care, and talk to a co-worker, friend, peer, or colleague. You will be surprised how many people you can relate to! Being new at anything in healthcare can feel a lot like you are trying to drink out of a fire hydrant. Let me tell you that you are exactly where you are supposed to be IN THIS VERY MOMENT! Breathe. Take it in. Appreciate everything you have the opportunity to learn. You weren’t hired/accepted because you are an experienced nurse. You were hired because the hiring staff believed you had the potential to become an amazing nurse with proper the training and experience. The skills and “nursing brain” will come, but what is absolutely essential for you to be the best new grad in the meantime?

1. ERROR ON THE SIDE OF CAUTION

The best new grad is a SAFE new grad. You aren’t expected to know how to do everything and anything yet! You are expected to know what is safe and what is not safe. If it feels wrong, don’t do it and verify that it is within your scope.

EX: The dermatology team asked me to remove sutures on a patient at bedside. I have never removed sutures before and wasn’t sure it was within my scope. I verbalized this to the MD. She was happy to show me how in case it was within my scope and then I went to go verify with my charge after. (Answer: it depends on your hospital and the type of incision the sutures are being removed from but make sure you have orders if you do)

2. KNOW HOW TO SAY I DON’T KNOW

This ties in with the first New Grad Commandment. Never GUESS in nursing… or any healthcare profession for that matter. GUESSING = MISTAKES = PATIENT HARM. Say… I don’t know BUT let me check/look it up/find out/etc. Never just leave it as I don’t know.

Guess what? This isn’t your nursing exam. You can use your resources! Look it up. Keep notes of things you need to remember but forget easily. For me, I am compiling a small binder I keep in my work bag of cheat sheets, guidelines, etc. that I know I will encounter but don’t have memorized yet (like how to get an IAP).

3. BE ABLE TO ASK FOR HELP

Healthcare is a team environment. You are never alone. There is always SOMEONE you can go to so don’t be afraid to ask for help. This isn’t about your ego or their opinion of you. This is about quality patient care. Are you drowning? Ask your resource RN, charge RN, or whoever is close by for help! Most will be glad to help, and just ignore the few who want to grumble along the way.

EX: Yesterday was the HARDEST shift I have had thus far. I am on a VERY BUSY tele PCU unit, which means I can take anywhere from 4 med/surg/tele patients to 3 IMU patients. I happened to have 4 med/surg/tele and I HAD 4 DISCHARGES. Well, one was an AMA, but ultimately I was running around like a crazy person for the ENTIRE shift. Discharging and admitting patients can be very time consuming because of the extra patient education and discharge/admit tasks required. The first thing I did when I found how I had 1 AMA and 3 discharges happening at the same time was tell my charge RN and resource RN. At this point in time, I didn’t need any help quite yet, but I knew I was about to get slammed. I did everything I could and delegated the smaller things that I couldn’t (like arranging transport, taking out peripheral IVs, doing glucose checks, etc.) Somehow, I finished everything, completed my documentation, AND clocked out on time. The point is… don’t ask for help when you’re drowning. Ask for help as soon as you know you might need it. A co-worker of mine was so slammed she didn’t even know what she needed help with so all she told the charge was, “I need help”, and went from there.

I hope this helps and am always available to hear out your questions, concerns, or fears! Stay well 🙂