So you’ve landed your first nursing job, congratulations! The coming months will probably be the biggest learning curve you experience in the whole of your career. Read on for our guide to what to expect and how to ensure that your first few weeks on the job go smoothly.
Making the jump
Your employer and colleagues will not expect you to emerge from your training as a fully rounded nurse. To help you ease into the role, you may be placed under the supervision of another trained nurse.
‘Use this opportunity to learn about the ward and its workings: the documentation and processes within the Trust (patient admissions; what to do in the event of a patient dying), as well as key staff and team dynamics,’ suggests Cathy Taylor, careers advisor for the Royal College of Nursing.
‘You might also want to attend a few case conferences with another staff nurse to get an idea of what your future role will be in these kinds of meetings.’
Preceptorship is a more formal period of quality mentorship from a skilled mentor who will help you to meet the competencies required for your new role.
Cathy says: ‘Although employers are not required to offer preceptorship to new registrants, the NMC does strongly recommend this practice. You can learn more about the key competencies for a newly qualified nurse at the Dh Framework on preceptorship, Flying Start.’
It’s natural to feel nervous, especially during your first few shifts. Remember that you will not be expected to know everything and the best way to learn is to ask questions. Even nurses who have been qualified for 25 years don’t know everything.
‘It’s better to risk asking a silly question than to get something wrong or work under a false impression,’ says Cathy. ‘Make sure you know what’s expected of you and ask for clarification if you’re not sure.’
By the end of your first day, you should have a good idea of the hospital layout. If you’re not given a tour, ask a member of staff to show you around during a quiet moment. You’ll need to know where the main departments are, including: HR, A&E, X-ray, the hospital chapel, porters’ base, theatres, recovery area, ITU, high-dependency unit, medical records, pharmacy, pathology and outpatients.
You should also know where the emergency drug cupboard is, what the cardiac arrest procedures are (where the equipment is kept and how to summon the crash team) and fire evacuation and procedures.
Learning to delegate
Delegation is one area where newly qualified staff experience huge difficulties, according to Jackie Hole, author of The Newly Qualified Nurse’s Survival Guide.
‘Often they do not feel confident enough to ask someone else to do something for them. Consequently, they try to do all of the work themselves and end up leaving late or providing less than adequate standards of care.’
When delegating, ask yourself if you are genuinely busy, rather than trying to avoid the task; if the person is competent to carry out the task; and if you have explained clearly what it is you want them to do and why.
‘As long as you ask the other member of staff in a courteous manner and stick to these rules, there will be few problems,’ says Jackie. ‘That said, there may always be someone who has the potential to react in a negative way. These people are often known for this type of behaviour. Try discussing the matter with the member of staff, or if you do not feel confident enough to do this, talk to your manager.’
Your first ward round
You may have attended ward rounds as a student but it can feel very different in your staff-nurse’s uniform. Unless the hospital provides you with a special badge, doctors may not know that you are newly qualified. Other staff may also assume that you have been qualified for some time, especially if you were a mature student.
You will be expected to know the answers to certain questions, so look at the nurse’s notes before the round starts. The information that the doctors are likely to want will concern the patient’s social situation, what nursing care they currently require and how they have been in the last 24 hours, says Jackie.
Take the nursing notes with you – this will help you answers the doctor’s questions – and make notes as you go, to help you remember what was said. Attend as many rounds as you can and look in the medical notes. Things can change rapidly over the course of a shift, and doctors may forget to tell you things.
Making a mistake
You will probably feel overwhelmed at times, but with time and patience your confidence will grow. If you make mistakes, report it to your mentor or the nurse in charge.
‘It might be difficult but putting patient safety and honesty first is vital. Reflect on your practice and ask for help when you need it,’ says Cathy.
‘Make sure you pay attention to your stress levels and that you have time for you – to relax and switch off. Pay attention to healthy eating, exercise and making sure you take breaks,’ adds Cathy. ‘You’ll only be able to perform at your best if you look after your own health and wellbeing.’
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