The end of my grad year is fast approaching… like really fast… out of nowhere… and apart from wondering where this last year has gone and am I even ready to not ‘be a grad’, I felt like now was a good time to reflect on the year that was and share my final few thoughts, tips, pointers and major milestones. Let’s start at the beginning, since that’s usually the best place to start.
I have always felt pretty comfortable in the hospital setting (I have no idea why to be honest), so although I was nervous to be trusted alone with patients and be responsible for making potentially life-changing decisions multiple times a day, I wasn’t as nervous or scared as some of my fellow baby-grads. Having said that, the first few days and weeks you feel a bit like a baby animal finding their feet and looking hell clumsy as they do it. It’s messy, awkward and sometimes painful to witness – but if you watch it with a little sense of humour and faith that it will all be okay in the end and everyone goes through this phase, it’s totally okay.
It took me about a month or two to really feel comfortable and in all honesty, it was all the little things that made the most difference. Like, I used to get sooooo frustrated that I didn’t know the doctor’s names or faces or pager numbers or that I could never find anything in the equipment room in under 7 minutes. But once those little housekeeping things sorted themselves out, I could focus on the fun stuff – the nursing stuff.
I will never forget the day when I had my first ever (what I call) ‘proud nurse moment’. Basically, a patient that I had in the first few weeks of my grad year seemed clinically not well after a surgical procedure and it was handed over to me that it was just her anxiety. I did her obs and had a chat to her, then looked back through her folder to see what her obs were doing over the last few days – straight away I noticed a very clear trend (increasing tachycardia, increasing oxygen demands and increasing resp rate) and escalated my concerns to my preceptor – aka my grad mum. She listened to my concerns (she had a rough idea of what was happening with this patient as at this time she was still getting a handover on my patients) but said that she was pretty confident it was just anxiety. I gave her a bit of weird smile like I wanted to agree but I just knew something was up, so I said that to her. Being the epic grad mum that she was, she said ‘okay let’s go and assess her together’ so we did. My grad mum still felt like anxiety and pain could be the underlying explanation for her presentation, but I was adamant it was something else. Long story short, the doctors came, again tried to say it was anxiety and/or pain but with me being adamant it could be something else, they investigated further and worked out she had a blood clot in her lung (a very serious risk for patients, especially if the clot flicks off and goes to the heart or brain). My grad mum and I debriefed about it after and both she and I were very proud that I stuck to my gut feeling – even with more experienced people telling me not to worry – and recognised a trend (we’re all about trends in nursing), escalated and acted accordingly. I was and still am very proud of that day.
More recently I have had some super memorable moments – one being the day I wrote this post. I recently decided I will be leaving my current ward (cue tears because I seriously love my ward so damn much) to work in the cath lab back home in Cairns to save some money. I was thinking about a patient who I’ve looked after multiple times and grown very close to – hoping that she’d come by the ward one day before I left. I was also just hoping that I’d see her as an outpatient, because last time she was on my ward, let’s just say it wasn’t looking good. So today I was running around trying to organise all these things for my patients when I look down the corridor and see her – in plain clothes, looking healthy and happy. We gave each other the biggest hug and had a lovely catch up before she had an appointment to go to and I told her I had decided to leave to save money and go on my adventure (her and I had discussed my potential travel plans many times). On her way back through she came back past to say good bye. I almost cried. She almost cried. But we kept our heads up and no tears came out because that was her attitude about life – it’s all about appreciating the good things and keeping your head up in the tough times. I don’t think I’ll ever forget that moment and I truly hope to see her again, happy and healthy and not in our ugly hospital gowns.
Now enough of story time, I’ll share a couple of little tips I have for new grads before I wrap this little series up.
I know everyone will say this but it’s soooooo important and will make or break your grad year:
You are going to be nervous, make mistakes, not know the answer, be late to a shift, think you’re on a PM when you’re on an AM, make more mistakes – but you have to not be so hard on yourself. It’s easier said than done, yes. BUT! The more you just accept that everyone starts somewhere, and you basically are still a student for the first few weeks, you will have a much better time. I really struggled with this at the start – and was very hard on myself, but after a few weeks I realised I was learning a lot as I went, therefore, I knew more than I thought as every day went by, so it was totally okay.
A few rapid-fire tips:
And I think that’s about all! I still can’t believe my grad year is over – I still get those feelings/thoughts like I don’t know enough/what I’m doing/why anyone trusted me to have unwell patients… But at the end of the day, I finish each shift knowing that I made a difference in someone’s life and that’s what it’s all about.
I am genuinely so excited for you if you’re nearing the end of your nursing degree or about to start your grad year – this is such an exciting time for you!
As always, I’m always happy to answer questions so feel free to contact me here or through Instagram.
Endless love and appreciation,
Since I'm not here to sugar coat the truth and make you believe that I and any other grad has not been stressed (a lot), you have to accept the fact that you will be stressed as a grad (just like any new career). Actually, as a Registered Nurse for that matter; this is a pretty stressful job being responsible for other peoples lives. There are ways, however, to deal with this stress so that it doesn't consume you to the point where you don't want to go to work or you burnout completely. I think one of the most important things you can do to manage grad-year related stress is to first recognise when you're stressed.
You know those shifts when you're running around doing task after task after task after task and all of a sudden it's an hour before your shift is over and you're like 'ummmmmm where did the last 6 or so hours go?!'? Well in those hectic moments you should stop, take three deep breaths and just chill. Give yourself 30 seconds to be still, whether thats in the drug room, toilet or while you're waiting for the BP cuff to do its thing, just slow down. And if you're thinking 'I don't have time do that', it's 30 seconds of your life and I promise it won't impede on your time management since it's such a small amount of time. But, this small amount of time will do you a world of good because taking a few slow, controlled, mindful breaths will help your stress levels immensely!
Some people say that they can't remember to practice this mindfulness activity of slowing down and taking a few deep breaths and that's okay, I'm super forgetful sometimes so don't stress (no pun intended). Write it on your planner or try and do it at certain times (for example at midday on AM shifts or at 4pm on PM shifts) or in certain places (for example whenever you go into the med room and no one is in there or when you finally get to go to the loo). This way you will build up a habit and before you know it, you'll be doing some mindful, stress-busting breathing and you'll feel calmer before you know it.
Secondly, if you are stressed about one thing in particular, work out how you can not be stressed about that thing. Is it by asking your nurse in charge for help or by doing a bit of at home research about something so that when you come across it, you have more knowledge about it? Identifying what it is that stresses you will help you nip stress in the bud before it happens. An example of this is on my ward (cardiothoracics) we get day 1 post CABG's patients who have ICC's, pacing wires, catheters insitu plus are almost always in a lot of pain, have Sp02 issues and need very close monitoring. The first time I had a day 1 post CABG's patient I didn't even know I was stressed because my shift went by in about a minute (well, it felt like that) and it wasn't until the end of the shift that I thought 'wow I need to look into the care of these types of patients more for next time because today was f'ed'. It was one of those shifts where I felt like I did nothing but I actually did so much. Plus, I was super stressed all day because I didn't take the time to stop and breath, or to think that just by looking up exactly what to expect with the care of this patient I would have felt more in control of the day. One thing that I did to help myself was as soon as I got handover I paged my grad support nurses to be like 'hey, I'm 100% going to need help today but I don't know what with so can you pls see me at some point'. This was perfect because at one point in the day (I actually couldn't tell you when), one of them came up and did a few things for me, including being there when the doctors came around to flag things that I wouldn't have picked up on which made me feel better about the care I provided, even though it was kinda through someone else.
My third tip may sound a little contradictory but here goes anyway; prepare yourself by studying, but don't study too much. What I mean by this is do some study/research into things you feel you need to work on, but don't spend all of your waking moments studying because that will stress you out before you even get to work to put your new knowledge to work. I sometimes think I'm too good at this, where I don't study nearly enough, but I get past this by always asking questions if I don't understand something, or at work I'll quickly look something up to make sure I have a rough idea on what 'it' is (condition, medication, medical procedure) so that I can care for my patient appropriately and then later when I have time (and brain power) I'll look it up in more depth. If you're finding yourself getting home from work and hitting the books straight away for hours on end, you're putting yourself at such a high risk of burnout because you're bringing your work home and not giving yourself a break.
A few brief things you can do to help de-stress in the stressful times of your grad year can be things like journaling, exercising, yoga, debriefing (aka venting), getting together with other grads to talk about how you're all going (aka venting in a bigger group of people who actually understand the struggles of your life right now) or even just treating yourself on the regular with something like a spa day or a trip to the beach. I'd be lying if I said I haven't had those days where all I want to do to de-stress is have 700 glasses of wine, and trust me, I've used a glass or three to destress after some hectic shifts, but it's important to make your de-stressing/coping mechanisms/practices healthy and not self-destructive so don't turn to things like alcohol too often as a release.
My final words of wisdom on this matter is don't be too hard on yourself. Some days you'll be acing work and other days you won't. Some days you'll destress with some perfect mindful breathing and reflection and other days you'll come home and nap for four hours and eat ice-cream for dinner. That's all totally fine. This year will be full of ups and downs; it will be such a massive learning curve for all of us and it's okay to not have your sh*t together with this new career. Just do your best and remind yourself every day that your best is all that you can do. Everyday is a new day, a new opportunity and a new chance to try new de-stressing until you know what works best for you.
I'm not even sure what week I am up to with my grad year but I can tell you for certain that it's going fast.
It seriously feels like yesterday that I had no idea what I was doing, where things on my ward were or who's idea it was to give me three of my own patients to be 100% responsible for. But now, now I feel like it's all coming together; like maybe I do know enough to be a real nurse. I'd like to share with you some of my highlights and low-lights of being a new grad.
Having patients and their families appreciate you and the care you provide is definitely the greatest feeling. Being the person that your patient comes to with their concerns or questions gives me an amazing sense of pride, even though my first thought is usually 'ummmmmmmm please don't ask me questions I know NOTHING!' when in actual fact, I do know (some things, definitely not all things). Seeing patients walk out of hospital to return to their normal life partly due to what you have done is amazing and I think that being a new grad, these moments are what you should spend time enjoying and reflecting on as opposed to stressing all day everyday about being a new grad.
I have had quite a few patients and their family members pull me aside to personally thank me for everything I have done for them. It's so easy to treat nursing as 'just a job' but at the end of the day, we are involved in some of peoples most vulnerable moments; some of their highest highs and lowest of lows, so I really value those reminders that this (nursing) is so much more than 'just a job'. I treat these as my highlights so far.
Making an error or having a near miss error is as stressful as you think.
I am yet to make a medication error or have anything drastic go wrong, however, I have had one shift where, for the first time, I didn't want to leave because I felt like I could have done more for a patient or maybe had missed something and then when I finally did leave, I couldn't stop thinking about this patient and continually going over the day in my mind trying to work out if I missed anything. Side-note: If you follow me on Instagram this was something I talked about in my Insta story a week or two ago about advocating for patients and making sure your concerns are heard.
On my ward, the nurse to patient ratio is 1:3 on one side of the ward and 1:2 on the other side so (obviously) the more acutely unwell a patient is/whatever the reason they're in hospital for, will depend on what side of the ward they're on. I was told when I started that grad's rarely get put on the more acute side, however, my ward decided to change this so that there was more opportunity for experience to be gained and knowledge to be shared.
I've been allocated on the more acute side (1:2 ratio) a few times now (yes, I almost had a heart attack the first time I was allocated there, no pun intended since its a Cardiothoracic ward) and this time that I couldn't stop thinking about this patient was one this side. I didn't feel too overwhelmed throughout the few shifts I looked after this patient but once they were deteriorating consistently by the day and I had time to reflect, I couldn't help but think that maybe I was way out of my depth and I didn't even know it... this mind-frame and fairly constant stress that you're going to do something wrong and someones life is potentially on the line is definitely something that I think every new grad will struggle with.
For me, I really just focus on the positives and try not to let all this stress of 'what ifs' stay in my head too long. That's what leads to burnout and I don't want that to happen to this new grad at all if I can.
It's all much easier now than it was when I started, but being a new grad is still pretty stressful, intimidating and fumble-y all at the same time. I'm just glad that it's getting easier by the day.
How six weeks has passed already is beyond me, but yesterday I graduated officially from my degree and I'm kind of feeling like a real nurse already.
In these last few weeks I have really focused on getting into some sort of a routine with shift work, making sure I'm not getting too overwhelmed and trying to learn something new every shift (which isn't hard being a newbie). I have really enjoyed every shift (even the hectic ones) and I don't feel very overwhelmed at all. I asked on my Instagram what my readers wanted in this update and most people said tips for new grads, so I will share with you the things I have learnt in six weeks and the things that I think have made my time as an RN not as overwhelming as I thought it would be.
I could write for days about things to help you and I promise I will give you more tips to get through your rookie days, but for now, I think these seven things will help you immensely in your first few weeks. Oh, and don't forget to have fun! Laugh at yourself, smile and don't be too serious. I do this all the time, like the other night I accidentally pierced a TPN bag to prime the IV line and somehow pulled the tip out again and TPN started spraying all over me. I just started laughing and ran to my preceptor and told her what happened and we sorted it out. I smelt like TPN which smells like salt and vinegar (but gross) for the rest of the shift which wasn't ideal, but I wasn't stressed, worried or sad at all because it wasn't that big of a deal. It was a little mistake that was a bit messy, but that's it. Nothing to stress about.
Send me a message on Instagram (@happylittlehumanaus) and let me know what you want me to talk about in my next update.
Endless love and appreciation,
Four days of being a real nurse. Taking all the patients, having to make all the decisions and having all the responsibility.
This week was a massive learning curve for a number of reasons. I guess you don't realise how much you rely on your buddy nurse/preceptor when you're a student as they're always there to remember all the little things you forget to do. But being a grad and having to do everything has definitely made me realise this!
The main challenge this week for me has definitely been to not have such high expectations and not be so hard on myself. But also, not letting the 'little things' have such an impact on my day. Let me explain.
Myself and other grads I have spoken to have all said the same thing: the little things like not knowing who the right doctor to speak to is, not knowing the right paperwork for certain things or not knowing the paging system are all more frustrating than the actual nursing aspect of work. Don't get me wrong, having full responsibility for three very acute patients is stressful, but those little things definitely caused me more grief this week than anything.
My first two shifts were really good. I felt like I was pretty good with time management, medications and everything else new grads stress about, but then when my preceptor would explain more in depth about the pathophysiology of my patients illness' or their disease trajectory, I was back to feeling like a student. Like I didn't know enough and there was no way I could ever know that much. So it was at those times were I felt quite exhausted.
My third shift was not great. Not because I had bad patients or anything like that, but because I was in a not so good mood and was in a negative mind frame and my preceptor was trying to push me by constantly asking what I was doing, where I was up to, what I should be doing next and so on. The more my preceptor did this, the more annoyed I was getting that sometimes I didn't know the answer and that she was pushing anyway. She kept asking if I was okay because I wasn't my normal cheerful self and I kept saying yes, but inside I was just saying to myself 'don't cry, don't cry, don't cry' all day.
At the end of the shift, my preceptor and I sat down to reflect on the day and to choose goals for the next shift and she asked me what I thought I did well during the shift and my response was 'I didn't cry' because I didn't think I did anything well at all apart from that (dramatic, I know). She went into telling me again that this year (especially in the first few weeks/months) are so overwhelming and it's okay to be stressed and get upset because you're literally thrown into the deep end, in a completely new job, new environment with new stressors. No surprise that in that conversation I had a little tear or seven. I went home, had a shower, received the most beautiful, supportive message from my preceptor and went to bed.
With all that weighing on me, my fourth and final shift for the week was... amazing!!!
I woke up determined to have a good day because I knew that the previous day's result was no ones fault but my own. I was being grumpy, difficult, stubborn and just sulky so it's no wonder that my day wasn't good!
During my fourth shift, my preceptor left me alone. She didn't question me like she did the day before (I think maybe she realised that I don't respond positively to that) but I constantly checked in with her and she helped me whenever I asked for help. We even had time to sit down (twice actually) to go through a few questions that I had along the way.
I think I've found my groove much better now! I will definitely still need help and support, but I feel really good for next week which is when I don't have my preceptor working directly with me. Instead, we will work on the same shift but she will have three patients and so will I, making the time she has to help me much more limited. But don't stress, there are plenty of other people that I can turn to for help so I'm sure I'll be a-okay.
My main lesson from this week is: be adaptable! Accept what you can't change and work out how to work around it. Nursing is so diverse and if you want to succeed you need to accept that not everything is going to be/go/turn out exactly how you planned and that's okay. Don't let it get you down.
Wish me luck for next week, I think I'll need it!
I am on an absolute high right now as I am writing this (natural high obviously)!
I just got home from work (feels so weird to say work haha) and I've seriously had the best day and week for that matter. Today I took one patient and it was SO WEIRD being able to give meds on my own, plus everything else that comes with caring for a patient.
I found myself continuously checking in with my preceptor as if I was a student because honestly, it still doesn't feel like I'm an RN. I feel like a student playing dress ups in scrubs...
There has been so much support this week with regular education sessions and plenty of opportunity to share experiences with the other grads. Honestly, I could not be happier with my preceptor, ward and literally everyone I have worked with. I'm so excited about work and life right now it's hard to type because I'm so full of energy and happiness!
As of next week I am taking a full patient load with my preceptor still with me for a week or two then I'm solo! I'm so excited and not really that nervous because there is so much support and everyone is so friendly so I would be more than happy to clarify anything with my colleagues as I go. Wish me luck!
Three long years of study and all of a sudden it is the night before I start my grad year.
What. The. F**k.
I feel like I have waited so long for this but at the same time it feels like it's come out of no where and I'm not sure if I'm ready! Well, that's how I was feeling, but now I definitely feel more ready to smash my first week as a grad nurse after doing these few simple things. Here is what I have done to prepare for my grad year as best I can:
I hope my tips can help you in some way to help you feel as ready as you can be for this exciting time! I am so excited to start my career tomorrow and I can't wait to keep you guys posted on the amazing things I learn and experience.
Well hello and welcome my fellow nurses, student nurses and anyone else reading!
I will be updating this section of my website regularly with nursing stories and content from my grad year which I am starting January 2018.
If you have any questions, want to know anything specifically or want me to dedicate a post to a certain aspect of nursing or being a new graduate nurse, please feel free to contact me here or send me a DM on Instagram!