Saturday, March 15, 2014

20 tips for nurse noobs by Sean Dent

20 tips for nurse noobs

szefei | iStock
szefei | iStock
Stepping out of your student nurse shoes is much tougher than your teachers lead you to believe. Upon completion of your nursing program and successfully passing your national certification exam, you would think things might get a littler easier? Nope. Sorry.
Starting that very first nursing job brings a whole new set of challenges. Here are 20 brief tips I think every nurse “noob” should read as they start their nursing journey:
  1. Get used to being scared; it’s your best ally.
  2. Ask more questions than you answer.
  3. Don’t ever fake it. If you don’t know something, tell someone. It’s OK.
  4. You have to earn respect; don’t just expect it.
  5. Avoid all gossip. If you want to gossip, go back to high school.
  6. If you’re not early, you’re late. Timeliness is next to godliness.
  7. Write everything down. You will forget 80 percent of what you hear. (“What you do not keep in your head, you will keep in your feet.”)
  8. When you want to run: Stop, walk and listen. If you hurry, you will make a mistake.
  9. Put your own mask on first. Take care of yourself before you take care of others.
  10. Learn how to say NO to overtime. Learning your job does not require living at your job.
  11. DO NOT rush orientation. Make your mistakes with your preceptor.
  12. It’s OK–in fact, it’s expected–that you make mistakes. Don’t dwell on them; learn from them and don’t repeat them.
  13. Find a mentor. Your mentor may NOT be your preceptor.
  14. Surround yourself with people who love your profession. Don’t let the naysayers ruin it for you.
  15. The grass is NOT greener on the other side. Don’t be too quick to play the job hopscotch game.
  16. Grow a thick set of skin, and do not back down when advocating for your patient.
  17. Become a premiere team player. You cannot and will not survive this job otherwise. Play nice in the sandbox.
  18. Thank all those who help you, including the transporter, the aide, the secretary and the housekeeper. Remember your TEAM.
  19. Never apologize for doing your job…and that includes calling a physician in the middle of the night.
  20. Never stop learning something new, ever. Seek it out. Pursue knowledge and career advancement. Contribute to the growth of our profession.

Wednesday, February 19, 2014

10 Ways You Know You're A Night Shift Nurse

http://scrubsmag.com/10-ways-you-know-youre-a-night-shift-nurse/?utm_source=Scrubs+Magazine+Newsletter&utm_campaign=a1e7ce8a29-2_18_Humor2_11_2014&utm_medium=email&utm_term=0_4a70cd7e21-a1e7ce8a29-245014081


10 ways you know you’re a night shift nurse



Not to say that night shift nurses are a totally different breed, but you do tend to relate to the werewolf thing!
10 ways you know you’re a night shift nurse
1. Caffeine is a basic food group.

2. Any light of any kind hurts!

3. You completely dread lawnmowers.

4. When a patient asks you why you’re still awake, you wonder the same thing.

5. You can say, “I’ll try to let you rest” to a patient while thinking, That’s really hard to do at night.

6. You completely get the werewolf thing.

7. You love that the traffic is so much less.

8. Breakfast specials…need I say more?

9. The sun comes up and you get restless.

10. The thought of leaving the best shift ever makes you feel like you’re going to die.

This list is by Christine Blair, Staff Nurse.

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Tuesday, February 4, 2014

Acute Physical Rehabilitation

Acute Physical Rehabilitation nursing is a branch of the nursing field which is focused on providing care to patients who have been incapacitated by injury or illness. The goal of the nurse is to participate in a treatment program which will allow the patient to regain as much normal function as possible, thereby improving quality of life for the patient. Rehabilitation or rehab nurses can be found working in hospitals, rehabilitation facilities, clinics, residential care facilities, and home health care environments, and compensation in this field is quite varied.
These nurses may perform many basic nursing tasks, like cleaning wounds, administering medications, assisting patients with bodily functions, charting, and coordinating with a medical team, but they also perform tasks which are specifically related to rehabilitation. For example, a rehabilitation nurse might help a patient learn to walk, eat, talk, write, or perform other tasks after an injury or illness which has impaired these skills.
Rehabilitation nursing also includes patient education and empowerment. If a patient appears to be permanently consigned to a wheelchair after an accident, for example, a rehabilitation nurse will help the patient learn to use the wheelchair, and provide the patient with education which helps him or her live as independently as possible. Rehabilitation nurses also assist patients as they grow accustomed to prosthetic limbs, ventilators, and other assistive devices which may be required.
As part of a patient's care team, rehabilitation nurses work with other rehabilitation professionals to address the patient's specific condition and issues, and to develop a treatment plan which is appropriate for the patient. Some rehabilitation nurses choose to focus on a specific aspect of rehabilitation nursing, such as helping patients regain motor skills or assisting patients who need adaptive devices. Others in the field of rehabilitation nursing practice more generally, working with an assortment of patients and on a variety of cases.

Tuesday, January 28, 2014

Technology That Helps Nurses Cut Down the Steps

Technology That Helps Nurses Cut Down the Steps

 

nursing technologyA study commissioned by Herman Miller Healthcare showed that nurses walk up to four miles a day on their shift. Much of this is due to supplies not being readily available and the need for better communication, like keeping tabs patient location. Technology is beginning to make the job of the nurse easier by giving them better information, leading to less steps.

Real Time Locating Systems

Real Time Locating Systems, also known as RTLS, uses small tags attached to devices, making them easier to find. For example, a typical scenario finds the nurse walking from room to room to locate a blood pressure machine for use in their rounds. With an RTLS tag, the nurse can locate the machine on a dashboard at the nurses station. They may still have to walk to the end of the unit to retrieve the machine, but it will be a direct route.

Patient Locators

Similar to RTLS are devices that patients can wear to indicate their location, according to Villanova University. Tracking down a patient can be time consuming on a busy nursing unit. A nursing aid that has taken a patient to physical therapy and radiology calls up for the patient to come down for a test. The locator tags can prevent the hunting down of people who know where Mr. Johnson is by indicating that he is in PT.
Another use suggested for these locator tags is in monitoring patients who may wander out of their rooms and be difficult to track. Mental health units, neurology units and Alzheimer's treatment centers benefit from these devices.

Tools in Your Pocket

With smartphones and tablets, you can have a number of tools in your pocket to help you get through your day easier.
The Pocket Pharmacist is available for your iPhone, and gives you a drug reference list with interactions. Calculate by QxMD uses current clinical decision trees to determine the best course of treatment.
Other tools to help you with your nursing career include a wage calculator by Intuit to help you precisely calculate your time and paycheck amount, which is handy for those extra shifts and holiday hours you're asked to work. ShiftPlanning is a nursing shift scheduling tool that the charge nurse will find useful for tracking time and adjusting schedules.

Mobile Devices and EHR

Electronic Health Records (EHR) became mandatory as of January 1, 2014, notes USF Health. Institutions must begin making patient records available online. A study by American EHR on more than 800 health practitioners showed that 33 percent with access to EHR used a tablet to access patient information.
As tablets and mobile charts become more available on nursing units, the constant walking back and forth between patient and their information is reduced. Devices such as the iPad EHR by drChrono allow bedside status updates to be made once vitals and other observations are completed.

Patient Workflow

Nursing Critical Care highlights a software system used in a Pennsylvania hospital that helps save steps during a patient's discharge. When the patient is ready to be released, the nurse uses a workflow panel to contact the transportation department to pick up the patient. Once they have arrived and are leaving with the patient, they use the panel to contact the cleaning crew. Once the room is clean, they use the panel to contact the admitting patient, to tell them the room is ready. This keeps the nurse from walking to the room to see the status, so they can report back to admitting that the room is ready for the next patient.

Wednesday, January 8, 2014

14 pieces of advice for a new nurse

by Jo, RN  


1. Always have an extra pair of scrubs in your locker.
2. Rubbing alcohol will get almost any odor out of fabric. Shaving cream will get almost any odor off of skin.
3. There is no getting tincture of Benzoin off of anything.
4. If the post-op nurse turns a patient over to you with the assurance that he will be “easy-peasey,” disaster lurks around the corner.
5. The proper response to your digital thermometer reading “HI” is not “Heeeeeyyyy!”
6. Blood is not the worst thing that can get on your scrubs.
7. The amount of poop a patient produces is inversely proportional to her level of consciousness.
8. Fire, code or disaster drills will never happen in the middle of a calm day.
9. The number of obscure drug allergies a patient has is inversely proportional to his grasp on reality.
10. Little old ladies in no acute distress are much stronger than you imagine. Be careful.
11. If it can be torn off, braided into knots, knocked over, pulled out, wrapped around something vital or otherwise jacked up, a sedated patient with a severe head injury will do it.
12. If your lunch is particularly delicious, you will have no chance to eat it.
13. Caffeine is a food group of its own.
14. And finally, the number one rule of nursing that I want to share with every new nurse:
If you have to jack with it, it’s wrong. Anything that requires immense amounts of skull sweat to figure out is wrong somewhere. Back off, get a second opinion and for God’s sake stop messing with it. The longer you fool with it, whatever it is (drug calculation, foot pump or IV bolus), the more messed up it’ll get. Stop immediately and figure out where it’s wrong, then proceed.

Saturday, January 4, 2014

15 ways nursing will change your life

15 ways nursing will change your life

by Sean Dent
Thinkstock | istockphoto
The nursing profession is changing. The average age of nurses and the average number of years of nursing experience both are decreasing. As a nurse with close to a decade of experience, I’m considered old.
I often wonder what the newer generations think they are getting into when they choose our profession. What do they think their job will be like? What do they think we actually do? How do they decide and say to themselves, “That’s what I want to do, that’s what I want to be”? I’ve recently discovered a lot of nurses are finding out the hard way what nursing is really like.
This is the REAL world of nursing:
1. Your feet will hurt.
2. Your back will ache.
3. You’ll start grinding your teeth in your sleep (if you didn’t already start in nursing school).
4. You’ll NEED to be in shape for this job.
5. This job will make you cry.
6. This job will scare you.
7. Many patients will not like you.
8. Most patients will test your limits.
9. Many patients are not nice. In fact, they’re downright mean.
10. You’ll rarely hear a “thank you.”
11. Your job is never done.
12. What you do directly affects others, ALL the time.
13. No one notices what you do–until you don’t do it.
14. You won’t get home on time. Hardly ever.
15. You’ll be the medical “go to” person for everyone on the block (sometimes at midnight on a Tuesday).
Sounds pretty bad, huh? This is why we constantly repeat the phrase, “Nursing is not for everyone.” You have to be tough in order to thrive in our world. The greatest thing about our profession, though, is that the benefits of our work GREATLY outweigh the risks.
But here are 15 ways nursing will change your life:
1. Your heart will grow 10 times its normal size.
2. Your compassion will exponentially expand.
3. You’ll develop strength where you once were afraid.
4. You’ll learn to push past your limits.
5. You’ll become resourceful.
6. You’ll develop keen decision-making skills.
7. You’ll become comfortable with being uncomfortable.
8. You’ll truly empathize and understand what loss really is.
9. You’ll impact human lives.
10. You’ll truly make a difference.
11. You’ll meet and befriend some amazing people.
12. You’ll find that the rare “thank you” and/or hug is worth it all.
13. You won’t do this job to be noticed.
14. You won’t do this job expecting to leave on time.
15. You’ll be proud to tell people you’re a nurse.
Sounds pretty good, huh? This is why we constantly repeat the phrase, “Nursing is not for everyone.”
The things that make our profession so tough are also the very same things that make this profession amazing. If it were easy, wouldn’t everybody be doing it?

Tuesday, December 17, 2013

Guest Blogger at MinorityNurse.com

Nurse Residency Program: The First Eight Weeks!
http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks

Nurse Residency Program: The First Eight Weeks

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.
- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Nurse Residency Program: The First Eight Weeks

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.
- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Nurse Residency Program: The First Eight Weeks

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.
- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Nurse Residency Program: The First Eight Weeks

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.
- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf