Many years ago, my nurse mentor told me, “You’re only new once, so make the most of it.”
She was right — it’s important to maximize the advantage found in those first few weeks or months on the job when no one expects you to function independently as a professional nurse. Most likely, you will be working alongside a preceptor, adding to your clinical knowledge and skills at a rapid pace during this period. This is the time to ask lots of questions and sponge up every ounce of information about your new job.
During your orientation period, your seasoned teammates will recognize that you are on a steep learning curve as a new clinician; however, from day one they will have certain expectations about you as a new co-worker. If you exhibit the behaviors of a responsible co-worker, you will increase the support from the experienced nurses and ease your transition onto the team.
What are those valued behaviors?
- Be punctual. In the world of health care, on time is late. If report starts at 0645, you should arrive at work by 0630. This gives you time to put your belongings away, get your assignment and prepare to receive report according to unit protocol. The off-going nurses are ready to finish their shift and go home. Nothing will ruin your reputation faster than delaying report due to tardiness.
- Be respectful. The experienced nurses on your team deserve your respect for their knowledge and skills. Your preceptor will be your main source of training during orientation and you should express appreciation frequently for her expertise, patience and time. Other nurses will be helpful and available to you both during and after the orientation period. But there may be some nurses who are not easily approachable or welcoming to novices. Your respectful attitude will be key in developing relationships with these folks. If you seek their expertise at the appropriate time and express your appreciation sincerely, you may open the door to mutual respect between novice and expert.
- Be a good listener. During orientation, your preceptor and others will help you build on the clinical knowledge and skills that you learned in school. As a general rule, the person who knows the most should do the most talking. Listen closely, take notes, review and study after work as needed. As a good listener, you should put your phone away during work hours, even if the experienced nurses do not.
- Be resourceful. Identify the people, their roles, and the hierarchy in your organization so that you know who to go to for questions and help. Locate the policies/procedures/standards of care so that you may refer to them and answer many of your questions yourself. Find the available resources for clinical and pharmacological information so you can access them as needed.
- Be organized. Each workplace will have its own daily routine and rhythm. The experts know how to manage their assigned work as well as planning for interruptions and circumstances that will occur throughout the shift. Follow your preceptor’s guidance for organizing her workload. You will share in her patient care responsibilities, so continual communication is essential. Review your work with your preceptor throughout the shift to make sure all patient care is completed correctly. Near the end of your shift, you should practice giving report. Shift report is the time when experienced nurses will “evaluate” your progress as a new nurse. They may give you feedback directly or provide it indirectly via your preceptor. Either way, be appreciative of correction, take action immediately to make improvements and continue to grow.
- Be a follower. There is no shame in being a follower instead of a leader. In fact, it is your duty to become an excellent follower when you are a novice. Watch, listen and learn from the best nurses on your team. Focus on achieving the goal of providing exceptional patient care and customer service. Become a dependable team member who is committed to excellence.
- Be positive. It takes courage to be the new person. At times, you may feel awkward or even overwhelmed. Expect to encounter “bumps” in the road because your new workplace will not be perfect and your orientation will not be completely smooth. You may run into Negative Nancy or Crabby Cathy along the way but don’t be disheartened. Stay focused on your development as a professional nurse and celebrate your achievements. Commit to maintaining a positive outlook by taking care of yourself so that you can provide first-rate care for your patients and their families.
- Be flexible. Most likely you will be on a pre-arranged schedule during orientation in order to work alongside your preceptor and attend all required classes. Attempting to make schedule changes for your personal needs will not be appreciated during this time. Your coworkers have made a commitment to get you “on board” and you should reciprocate by exhibiting flexibility and compliance with the orientation schedule.
- Be productive. Even though you will not have your own patient assignment for the first month or more, you can still contribute to the team effort in many ways. Perform all the tasks and skills that you are permitted to carry out. Seek ways to get “checked off” on competencies as soon as possible and practice new skills at every opportunity. Read and study about the common diagnoses and medications for your patient population.
- Be responsible. The success of your orientation and your continual development as a new nurse is ultimately your responsibility. Work along with your preceptor to assure that orientation checklists, documents, classes and other requirements are completed on time. Discuss your strengths and weaknesses and make a plan for improvement as needed. You are embarking on a lifetime of learning and growing as a professional nurse.
Congratulations to all of you on your upcoming graduation! It is my hope that these tips are helpful to you now as new nurses starting your careers, and in the future as experienced nurses helping the next wave of new grads who will be counting on you to show them the way.
About the author:
Peggy Adams received her BSN at The University of Texas at Austin School of Nursing in 1978 and her MSN at Texas Womens University in the Texas Medical Center in Houston in 1987.
She worked for 10 years in pediatrics at Hermann Hospital (now Memorial Hermann) in Houston. She currently has a consulting business (Adams Consulting) that specializes in individual and group training for those in nursing leadership and management positions. She also coaches new graduates who are seeking their first professional nursing position. Her interview preparation strategies are based on:
- firsthand experience interviewing and hiring nurses as a supervisor,
- personal knowledge of the professional nursing culture of many health care institutions, and
- carefully honed writing and speaking skills.