What I Learned my First Year as a Nurse

    I've officially been a registered nurse for over a year now. Whoop, whoop! (I assure you, I am whooping in the most professional manner possible.)
    In that year, I can honestly say I've grown in ways I never thought I was capable of. I've done things I never thought I would do. Seen things I didn't think were possible. Felt things I never thought I would feel. And I've loved every minute of it.
    Well, almost every minute of it. The honest truth is, and be prepared to have your mind blown, nursing is freaking hard. I'm not naive to the rest of the working world either. Between the age of 14 to 21, I've had 7 separate tax-paying jobs. None of them held  candle in difficulty to the world of nursing. I don't say that to belittle any other occupation. I know they each have their own set of challenges. But nursing blends such a unique set of skills. Nurses have to be intelligent, critical thinkers with the ability to make decisions at a moment's notice that could save or kill someone. They must be well-versed in a 1,127 medications at any given time and be capable of completing complex calculations, recalling details of medical diagnoses, and anything else that may have been in the library of books we had to study and comprehend in nursing school and beyond. We also must be compassionate and gentle with everyone who comes through our hospital doors while balancing that compassion with the courage to tell patients and their families things they don't want to hear. And nurses must have a self-awareness and emotional stability that helps them be able to walk into situations that are frightening and heart-wrenching day after day.
    I was reflecting on some of the things I learned in the last year and thought, "Hey, why not make a blog post of it." So here's my list of twenty-one things I learned my first year as a nurse.


1) Invest in good shoes. Spend the money on a pair that are good quality and fit your feet well. Those twelve-plus hour shifts are long enough as it is. String them together into a row of six or more and you'll barely be able to stand in the end. And play around until you know what brand fits you well. It's worth every penny!

2) You know all those hours you spend crying, sweating, and pulling your hair out while studying in nursing school? Here's the kicker after graduation...you still know nothing! There is so much to learn in the world of nursing that can't be taught in a classroom or lab. So fake it till you make it. You'll walk into hundreds of situations you don't feel comfortable in. You have to develop what's called "nursing armor" and deal with things as they come. Don't let your patients see the confusion on your face as the doctor throws confusing orders at you. They're frightened enough already. Nod, smile, and go look it up. Make sure your patient feels they are in safe and competent hands. Don't stare at your IV tubing and say "Ummmm...." for ten minutes. Calmly excuse yourself and get help if you need it. But carry yourself in manner that belies your nervousness and assures your patient they truly are in competent hands. They are. You've got this! But they also must believe that.

4) On the other hand, you know more than you think. Own what you know. Don't be obnoxious about it. But you have the right to be confident and respectfully voice your concerns and thoughts even to senior staff. And don't second guess every move you make. Your gut instinct is a powerful voice that shouldn't be ignored.

5) Ask questions! All the time. Sometimes ask the same question more than once to different people. Everyone has their unique spin on how to handle situations. Take what works best for you from different sources, compile them in a way that is unique and effective for you, and voila! You'll never stop learning. So keep asking!

6) Health care professionals are always on a stage. I've heard people in my community say, "I saw ______, RN at the bar the other night. And she saves lives for a living?! If she walked into my room and said she was my nurse I'd walk right out the door." We represent our hospital, our profession, and our own abilities when we are out in the community. Don't forget there will be eyes watching your every move. Carry yourself in a way that lends credence to your strength and professionalism as a nurse.

7) Laugh or else you'll cry. Learn to find humor in frustrating situations.

8) Compassion is one of the heaviest crosses someone can carry. But it is essential to the work we do. However, it is also essential that you find a way to leave work at work. It doesn't cross the threshold of your home. Not only do you suffer as a result, but so do the lives of your loved ones. My specialty area is psychiatric nursing. For the first six months as a nurse, I would come home and agonize over whether a patient we had discharged would be safe or if they would go home and kill themselves. I would replay conversations I had had during the day and wonder if I had possibly said something wrong that would harm the patient's progress. Stop it! Give the best you have at work, but find a way to let it go at the end of the day.

9) It's not your fault. Sometimes something will go terribly wrong. Mistakes will be made. Not all outcomes are perfect. The first time I heard of the suicide of a patient I had cared for, I questioned everything I was doing at my job. When she discharged, she had been doing wonderfully! Had I missed all the signs? We have to find a way to protect our hearts from breaking. Learn lessons where lessons can be found, and grow from the experience. But you cannot accept blame for everything that doesn't have a perfect outcome.

10) Do everything you can to keep it from being your fault. Laziness will breed mistakes. Your education isn't over when you graduate. Keep learning. Also there is a distinct difference between "nursing armor" and just developing a calloused heart. This will harm your patient's ability to heal and your effectiveness as their nurse. Please, do frequent self-evaluations to determine where improvements can be made and how effective you are being in your specific role.

11) Take bathroom breaks and drink water. Take care of yourself. This is just practicing what we preach.

12) Organization is the key to success. Take ten extra minutes in the morning to get yourself organized and figure out a game plan. I promise the pay-off is worth it. And sometimes when you feel the most hectic, stop, look at that game plan, and adjust accordingly before you just keep plowing ahead and putting out fires. You might find that putting out the forest fire will stop the little bonfires you're been dealing with.

13) Everyone you know (and don't know) will call with questions about their kid's cough, their grandma's weird pill having a speck in it and is it supposed to be that way?, and their gold fish's rash.

14) It's easy to be addicted to busy-ness. Nursing school may be the culprit. For years, we slaved away in a dark cave of nursing school drowning in our tears and Ramen while our family and friends forgot our names. We were too busy to think past the next two hours. Immediately after graduating it's easy to feel like our lives come to a screeching halt so we try to get beck to that busy-ness we got used to. It can be easy to fall into a similar pattern of hectic chaos and keep the madness going. Being busy is all right to a certain extent. But we don't have to be involved in every committee and volunteering opportunity, our kids' soccer concessions, the church pie bake, the new drug trial for better bowel movements, and the local animal shelter. Learn to say no.

 15) Nursing teaches you fantastic life lessons that can be used at home as well. You can learn how to use humor to diffuse an argument, ways to cope with stress (deep breathing, everyone! All together now!), and DEFINITELY to have a deeper appreciation for your loved ones and their health.

16) You will see too much too soon. And have to learn to be okay with it.

17) You will develop the immune system of Captain America. And it's awesome.

18) Remember when you were a nursing student and thought, "I will never become so calloused and bitter as that RN"? I have some sad news. It happens more easily than you would think. Like I was saying, we can see things on a daily basis that most people never see in a lifetime. And a year from now, you will realize you aren't as touched by it as you once were. To some regard, it's okay to get to the point that we can better cope with those things. But we can't let this cross the line into bitterness or nonchalance. So fight that with everything in you. Find a couple nurses that have a sweet, loving spirit and tell yourself, "That's the kind of nurse I want to be." And hold onto that for as many years as it takes.

19) Don't kick yourself for not doing that one thing you learned about that one time in nursing school perfectly and efficiently in an emergency situation. Everything gets better with practice so how can we expect ourselves to do something perfectly the first time it's set before us? Do your best. You will do it better the next time...and the next time...and the next time until you can handle that crisis situation in your sleep.

20) Admit when you're wrong without excuse. Too many nurses like to make a thousand excuses as to why something went wrong or they made a mistake. By all means, do dissect the situation so you can figure out what went wrong and improve the next time around. But accept your responsibility in the situation. Never blame shift and NEVER cover up a mistake.

21) You're not just a nurse.
Find your niche in your personal life. Have pastimes and hobbies and leisure activities. Go out for coffee with friends that aren't nurses. Run a 5K. Get into knitting if that's your thing. Whatever.
But make sure you have a life outside of work or the pressures of that world will consume you.

22) You're not just a nurse.
I once had someone ask me what I do for a living and I proudly responded to her, "I'm a nurse." She responded, "Oh. I could never wipe butts all day for a living." I told her, "Me neither. That's why I went to school for four years to learn how to save them." Maybe that could be misconstrued as rude (that was not my intent), but we can never fail to be proud of our profession.

    Nurses have strength beyond imagination. Intellect. Wisdom. And stamina. Be proud of your profession. Defend its honor. Love what you do. The day you don't love it anymore, move on to another unit because you're in burn-out mode. And above all, never forget how absolutely essential the part we play every day is to the dear patients that walk through the door.

 Because like I said, it's freaking hard.
And amazing.

I know we have many people in the health care field that follow our blog. What would you add to this list? Let us know in the comments and I'll come back and edit it in! Or for the nursing students out there, what would you ask or add?
Let us know. And go!
-Corinna