- Nurse Tori
55 New Grad Nurse Tips!
Updated: Nov 2
So, you are a new NICU Nurse! Congrats & welcome to
“The Real” Nursing World.
Nursing school was a great foundation to teach you the importance of SAFETY & the Medical Lingo, & to help you pass NCLEX of course!
Bedside Nursing (Especially in the NICU) can be different from your Nursing School experiences. Here is a list of TIPS I have compiled to help you transition into your nursing role. (NICU Style)
1. Never be afraid to ask questions.
Asking questions as a New Grad can be intimidating. For the safety of your patients, ALWAYS ASK. You might be surprised if you ask the question and your seasoned Nurse learns something too!
2. Learn to admit your mistakes.
We all make them. Don’t make a habit of covering up a mistake or trying to argue out of it. You colleagues will understand if you admit your mistake, and they will help you solve it.
3. Always clarify if you have doubts.
Never hesitate to clarify a detail regarding your patient’s care if you are unsure about it.
4. Always safety check your bedside after report.
(IV assessment, suction, oxygen, code sheet, ambu bag (or neo puff), IV fluid check etc.)
5. Know the SIZES of all Tubes & lines in your patient.
The NICU is a small & delicate population of patients. Attention to detail is vital. Examples of things to know: Nasogastric Tubes, IV gauge, ETT Tube, UVC/UAC, Foley Catheter, etc)
6. Keep up with your charting.
If you save it for later, there might not be enough time to complete it. (Staying over to chart is not fun). Remember that you cannot fully anticipate when you will be really busy.
7. Don’t be too hard on yourself.
If you need to pee, don’t hold it as it will just take few minutes of your time. If you need to hydrate yourself, drink before continuing with your tasks. Most nurses delay the little things they need because they focus on finishing a task but in reality, if you are too hard on yourself the work you do can be affected.
8. Before calling a doctor, always think about & make a list of the things you need to mention.
You can’t fully trust your memory when talking through a phone call especially when the doctor is always in a hurry.
9. Invest in your footwear.
You will walk a lot in your entire nursing career so wear appropriate nursing shoes that are made for ultimate comfort and durability. Check out my favorite! Sanita Clogs (Nurse Tori for 20% off your order.)
10. Learn to be assertive.
Learning your confidence takes time. Watch and learn from seasoned nurses on how they give report, ask questions, take phone calls etc.
11. Avoid being involved in workplace gossips.
It will do nothing good to your career as a nurse.
12. Always look up your Medications.
You are administering new medications you don’t know. Take the time to understand dosage, compatibility, reasons for treatment, side affects etc.
13. Read the Doctors Notes.
Often times nurses forget to pass things along in report. Make a habit of reading through the Doctors notes and plan of care. You may find extra information you didn’t know.
14. Make your statement short and precise when calling a doctor in the middle of the night.
These doctors are usually sleepy and you will need to relay your concern straight-to-the-point so they can quickly understand you.
15. Extend a helping hand to your colleagues when they need it.
You will soon realize how helpful it is to have caring co-workers.
16. When in DOUBT, take it OUT!
NICU IV’s only usually last 24-96 hours depending on the baby’s vasculature. If it looks puffy, red, a little swollen, difficult to flush, or blanches, take it out.
17. Don’t fully trust an IV pump or Equipment.
Manually check the rate and volume (and concentrations) of the IV fluid during your rounds.
18. When drawing up new medications or narcotics, always ask an experienced RN to watch you.
This will give you confidence and security that you have prepared the right medication. Also ask how they reconstitute and administer the medication. You can learn a thing or two!
19. Be careful with your charting.
Remember that if it is not charted, it was NEVER done. Your charting will be very significant in case a lawsuit is brought against you or the hospital.
20. Whenever you are about to do a procedure like dressing change or Foley catheter insertion, make a list of things so you don’t forget anything.
This will save you time and energy if something unexpected happens while doing the procedure.
21. Always get the right size of gloves for your hands.
Gloves work better when they fit your hands perfectly.
22. Be a nursing ambassador.
Just remember that wherever you go, you are representing the nursing profession. Your actions, hygiene and attitude should reflect the nursing profession you have worked hard for.
23. Always appear calm and try relaxed even though you are freaking out inside.
You will need this to calm down your patient’s relatives in times of critical conditions.
24. Treat yourself at the end of a tiring shift.
#TREATyoSELF This will give you the energy and motivation to continue the next day.
25. Wear compression stockings.
Nursing involves a lot of footwork and prolonged standing. Take care of your legs early so you can avoid developing varicose veins.
26. Be open to suggestions.
If your senior nurse suggests an easier way to do a task, try it. Experience is the best teacher and your senior nurses know it very well.
27. When you are working under a preceptor, ask all the questions you have in your mind.
This is the time to ask ANYTHING. You are new and they know that.
28. Time Management. Organize your shift and the things you need to do.
Writing them down in a piece of paper will help you remember them. Prioritize which needs to be done first. You can also use it as a guide in doing your shift report and charting.
29. Get to know everyone in your unit.
You don’t need to make friends with them even outside work but getting to know them will help you adjust to your assigned unit and feel more comfortable asking for help.
30. Your first year as a nurse is the toughest.
All nurses who are new in the profession undergo the same period of adjustment, so be patient.
31. Avoid complaining.
Complaining at work affects the mood of your co-workers. So, try to stay positive and minimize negativity.
32. Delegate tasks.
You can’t do all the work alone. Delegate simple tasks to others in a respectful manner and ask their opinions as well about patient care.
33. Develop your own support system.
It’s helpful to talk about your problems at work with someone who understands it well.
34. Set goals.
Where would you want to be in 5 years? Setting your career goals will help you maximize your profession as a nurse. You should make room for growth.
35. Find something you enjoy doing which has nothing to do with nursing.
A hobby will help you direct your attention away from nursing while at home.
36. While you are still under the orientation program, watch every procedure you will encounter in the unit.
The more seasoned nurses have their own tricks in doing certain procedures like Foley catheter insertion, dressing changes and Sterile line changes, Admissions, etc.
37. Be flexible.
If you are asked to float in another unit for extra help, accept it. You will learn a lot from floating to other units.
38. When you have experienced all the hardships of being a nurse, you will have nothing to fear for.
If you run three codes in a single shift, the next time you have a code you will know what to do very well. The same thing applies when inserting IV lines; when you have done IV insertion hundreds of times, you will feel that it is now easy to do venipunctures.
39. When talking with a doctor over the phone, read the order back & clarify.
There’s an old saying that we forget 80% of what we hear, so take down notes.
40. If you make mistakes, don’t dwell on them.
What’s important is you learn from your mistakes and move on.
41. Don’t apologize for doing your job.
If you need to call the attending physician at the middle of the night, do it.
42. No matter how tired or stressed out you are, always approach your patients with positivity and a gentle touch.
They are at the hospital because they have illnesses and they will thank you for being the bright part of their day.
43. Get to know your secretaries, respiratory therapists, UAPs, techs and housekeepers.
They make your tasks easier and can even teach you a couple of survival tricks to boot.
44. When you’re faced with a crisis and you don’t know what to do, always start with the basics.
Get the patient’s vital signs, perform head to toe assessment, visualize your lines, tubes. Etc.. The other important assessments will stem out from here.
45. . Listen to your “gut feeling”.
Trust your instinct. As you develop skills and an understanding of your patients, you will develop instincts that may help you along the way.
46. Leave your work at the hospital.
Go home with peace in your mind. It is unfair to think
about what you might have forgotten to do at work when you are already at home with your family.
47. When the more seasoned nurses grill you at your report, don’t take it personally.
Remember that they know more than you so take this opportunity to learn from them.
48. When giving medications, double check everything.
Remember the 6 rights – right medication, right patient, right time, right dose, right route right documentation.
49. If you are not really sure about something, ask and if you still aren’t sure continue to follow the chain of command.
For example, if you are not sure that the ordered dose is correct, ask the opinions of your senior nurses, then charge nurse, pharmacist, or even doctor.
50. Do physical assessment properly as it will serve as the foundation of your care.
Practice it over & over with a systematic approach. Soon it will become second nature with a speedy, detailed, accurate approach.
51. Use proper body mechanics all the time.
When pushing equipment, lifting objects, moving isolettes, and even charting, protect your body.
52. Always disinfect your bedside & stethoscope at the beginning of your shift.
Remember that the NICU population are very vulnerable and they already have weak immune systems, so don’t pass the infection to them.
53. Never forget the reason why you became a nurse.
Think about it whenever you are feeling tired, down or burnt-out from work. It will help you go through the rough times of being a nurse. (Burn out is a real thing)
54. Nurse with Compassion & Family Centered Care.
Remember you are caring for someone’s most precious gift. You care caring for a neonate/preemie or infant at their most vulnerable time in life. Provide a caring touch, families will never forget it.
55. Start your retirement!
More than likely your organization provides a retirement plan! Whether you are able to contribute 5% or 15%, start your retirement NOW! This always seems to be put on the back burner, however it should be one of the top things you prioritize for your future!
Tori's Tips on NICU NURSE 101:
Tori Meskin BSN RNC-NIC has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a nurse, blogger, podcaster, NICU & Pediatric Critical Care RN, MSN student, a Barco Uniforms Ambassador, and Brave beginnings affiliate. Find her at www.tipsfromtori.com or info@tipsfromtori.com
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