Tips Nurses Wish They’d Known When They Started Out

When you begin working in the nursing field, there’s a lot that you learn, no matter how much schooling you’ve had. As years pass, and you gain experience, you realize that there are many things that would have made your job easier or allowed you to see or do things differently if you had only known about them.

We’re helping new nurses get a little bit of a shortcut. If you’re more of a novice, you’ll still have to learn a lot on your own. But to give you some ideas ahead of time, we spoke with some nurses for tips on what they wish they had known when they started in the field.

A Failure to Communicate

“I wish someone could have shown me how to talk to families when it comes to dealing with grief and loss. I think as nurses, we deal with grief and loss in different forms each day. You learn about the stages of grief in school, but it’s different when you go through it with [patients and families],” says Josanna Lei Enriquez, MSN, RN-BC ,CNL, FACDONA, CDP, director of nursing services at Oak Trace, a Life Care Community in Downers Grove, Illinois. “If I had this knowledge before, I would have felt more confident and more capable of giving support to my patients and their families.”

Communication is especially key, says Stacy Strait, RN, MSN, nursing supervisor also at Oak Trace. “Communication failures are among the most common root causes leading to patient deaths, as reported by the Joint Commission. Consequently, communication skills are as important, if not more important, than clinical skills,” says Strait.

As part of what she wishes she had known about communication and collaboration with doctors and health care providers, Strait wishes she had been familiar with the SBAR (Situation, Background, Assessment, and Recommendation) tool. “This tool helps to structure and improve communication with primary care clinicians in a way that satisfies varying communication styles and needs,” explains Strait. “It has been proven to be effective in nurse-physician communication and ultimately promotes quality care and patient safety. Talking to doctors and health care providers is scary and stressful for new nurses. The SBAR tool would have made my job easier and given me more confidence when interacting with them.”

Ask, Ask, Ask

Oftentimes, new nurses may feel uncomfortable and intimidated, and, as a result, they won’t want to ask questions. But that’s exactly what you should do.

“Don’t be too hard on yourself, and ask questions. It’s better to acknowledge that you do not know something than make unsafe decisions,” states Enriquez. “I wish that I had someone who provided me with reassurance when I was starting and told me that it’s okay to ask questions.”

Strait agrees that asking questions is imperative. “Never hesitate or be afraid to ask a question, and never stop asking questions. The only silly question is the one that is never asked. It’s better to ask and learn than not to ask and potentially do something wrong and harm a patient,” says Strait. “Even after 26 years as a nurse, I still ask questions on a daily basis, either to learn something new or to question something I’m not sure of. There is no ‘typical’ day for a nurse, as every day—and every shift—is unique. The field of nursing is constantly changing, and there is always something new to learn. I’m still amazed that I continue to learn something new every day.”

The Sixth Sense

Intuition, your “sixth sense,” going with your gut—no matter what you call it, it’s definitely something you should do, as a nurse. “When in doubt, trust your instinct,” says Pam Colvin, MSN, RN, CEN, nurse manager for Legacy ER & Urgent Care in Coppell, Texas. “Don’t be afraid to challenge when appropriate and with the right intention and knowledge.”

Listening to this inner voice is crucial. “Nurses have instincts that they can trust if they suspect there is something wrong with the patient or if they suspect that a health care provider orders a questionable course of action. Don’t be afraid to be assertive and firm, and take your concerns up the chain of command. Nurses are the last safety check between health care provider orders and the patient.”

Tips, Tips, and More Tips

We leave you with more tips from Enriquez, Strait, and Colvin:

•   When calling a doctor, make sure you have everything ready in front of you because their time is precious, and they do not appreciate callbacks.
•   Realize that nursing is a comprehensive service to others: it’s about clinical care as well as bathing, feeding, cleaning, listening, supporting, advocating, encouraging, and more. It’s never “not your job” to care for patients in ways that impact their recovery.
•   Make patient and family engagement part of your daily interactions.
•   Keep a snack (granola bar, peanuts) in your purse or work bag in case you get busy.
•   Prioritize! Those A-B-Cs you learn in school will come in handy.
•   Keep learning: subscribe to free nursing magazines and journals (and read DailyNurse.com) because they offer continuing education on a variety of topics, including how to deal with the changing health care environment.
•   When you are feeling overwhelmed, walk away, go to your happy place, refocus, and come back with a smile.
•   Know that nurses are natural leaders and can make changes at the unit level as well as the organizational, state, and national levels.
•   Empower yourself: surround yourself with quotes or objects that motivate you.
•   Find joy in what you do, and celebrate the little things (when a shift ends and no patient fell or when you make a patient smile).