Tag Archives: nevergiveup

Lessons Without My Preceptor

I have been working without my preceptor since the beginning of August, or for about three weeks. I’m lucky to work in a place that values teamwork and helping one another because other nurses have helped or guided me on almost every shift since I’ve been off preceptorship. One of the biggest things I’ve learned and the best advice I’ve received as a new grad is to ASK FOR HELP.

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I have no problem asking for help or clarification when I am unsure how to do something. However, I get flustered when asking someone to do things for me when I think I can or should do such things for myself or my patient. At some point in my shifts, I may start falling behind, or the unexpected happens; if I want to stay on track or not be completely off-schedule, I must ask for and accept help and support. Other nurses have started IVs or completed bladder scans at the end of my shift for me, so I can finish passing meds or complete tasks for my other patients. While uncomfortable for me, I’ve learned to ask for help and accept the support and generosity of others. (Note to self: Never mess with a funky IV contraption that ED set up – it’s probably the only way they got it to work. Trying to “fix” it just before shift change can mess it up and cause you to lose IV access, requiring a new IV start as you scramble to do morning meds).

I’m on an exponential learning curve and make mistakes. Each week, I discover new ways of doing things inefficiently, incorrectly, or in ways that doctors, patients, or my manager do not prefer. [Un]fortunately, I am learning through experience and by doing. I make mistakes or feel so uncomfortable or irritated with my performance that I must consider various ways to improve or avoid making mistakes in the future to feel competent and more confident about my work.

Communication

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I’m still learning how various doctors want to communicate with nurses during the night shift. Some doctors prefer secure chat, while others only want phone calls. I’ve learned preference, of course, because I’ve utilized the opposite method of communication to what some doctors wish to use. Meanwhile, my manager advised only calling doctors in an email that I didn’t read until days after sending numerous notifications to doctors via secure chat. (I now try to be more diligent about checking my work email). Ultimately, if I need to urgently communicate with a doctor about a patient condition or issue, I will use whatever method allows me to get a hold of them. I’ve also learned that it’s better for a doctor to be upset because I communicated something they thought unimportant instead of not sharing a potential issue with a doctor. Also, I need to document every attempt at trying to reach a doctor. I had a doctor upset with me for contacting him so late in the evening, even though I called his answering service multiple times, hours earlier.

Compare and Despair


To be clear, my leadership or staff have not shamed me for my shortcomings. My leaders have been genuinely supportive and offer non-discriminatory methods of correction. I don’t feel singled out by my mistakes, and I know I’m not alone when I speak to others in my cohort. However, I measure my success by using others’ progress as my ruler. For example, one of my cohort-mates calmly activated and engaged in rapid response for one of his patients on only his fourth day without a preceptor. He received accolades from the leadership team, and our manager shared his praise with the rest of our cohort. I was so impressed and in awe by what my colleague faced and how he acted in crisis.

In comparison, during my second week, one of my patients fell. I was getting the patient’s medication in the med room when the fall occurred. Falls require an incident report and are a pretty big deal for hospitals. Thankfully, my patient did not get injured and was apologetic for the fall. I felt embarrassed and ashamed for having an incident and kept replaying the scenario and trying to understand what I could have done differently or how much worse it could have been. I have been vigilant with my patients’ bed alarms and documenting their fall education since that event.

Discovering What I Don’t Know


I have done things in less than ideal ways and made mistakes and will likely make more mistakes. However, instead of dwelling on my mistakes, I can focus on continual improvement. Am I learning from my past actions or others’ mistakes? Can I figure out how to minimize the chances for errors or prevent making the same mistakes again? Can I improve on my processes or methods? As a new nurse, I have so much room for improvement and growth. I don’t even know what I don’t know, and I keep discovering this each week.

I recently learned that I needed to administer or waste narcotics within a specific time from retrieving the medication(s) from our Omnicell. For the past three months, I dispensed and gave narcotic drugs while likely exceeding this time limit because I hadn’t known this guideline existed. I had no idea until a nurse on the floor mentioned it to me this month, and my manager emailed the team after his periodic department audit. Now that I know about this limit, I try to avoid other tasks after pulling a narcotic that may prevent me from immediately administering the medication to the patient.

From a poster in one of our break rooms

Moving Forward


As I’ve shared in previous posts, I’m still adjusting to working nights and have had difficulty sleeping. I think it’s also because I’ve developed stress-induced insomnia: I replay how my shifts went and how I could have done better. I can beat myself up about things I didn’t know or events I wished I had handled differently, or I can use these experiences as lessons and move forward.

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I write this blog to help others and because it allows me to process my experiences as a new nurse. It’s a way to release the ideas in my head so they don’t ruminate in my mind. My blog is also a reminder to focus on neutral or positive thoughts for self-encouragement and coaching. I consider how I would talk to a friend if they were experiencing what I was experiencing.

If you are a new nurse with anxiety before/during/after your shifts or beat yourself up over your mistakes, I am with you. Without realizing it, I survived the last night shift I had without caffeine; I think my stress response kicked in, and I was running on adrenaline. (Also, a unit secretary pointed out I was having hand tremors with the amount of caffeine I was consuming, so I’ve been trying to reduce my caffeine intake). I’m still figuring out the best ways to relieve my stress and practice self-care, just as I’m learning how to be the best nurse I can be. Besides lowering my caffeine intake, I try movement (yoga or hiking), meditating, blogging/journaling, or confiding in other nurses. It doesn’t matter how old, young, experienced, or inexperienced you are – there’s always room for growth and self-discovery.

This blog chronicles my nursing journey and serves as a journal of sorts, but I share my life to support and encourage others’ success and progress, too! I would love to hear from you: How do you give yourself grace while developing and growing? How do you move forward from mistakes? How do you practice self-care? For ideas, check out the past IG post I had about the Alphabet of Coping Mechanisms: https://www.instagram.com/p/B3uuR4ynB_9/

Never Give Up: My New Grad RN Job Search Experience

I am happy to announce that I got a job as an acute care RN and started my new grad program at a hospital! I did not post last week because I was in orientation all week and transitioning into my new role. I am thrilled to be part of my program since it is at my top choice hospital and provides comprehensive training. While I’m excited to share my good news, I wanted to discuss what led me to land a spot in my new grad program. I share my job search experience to offer encouragement, hope, and advice to future new grad nurses.

I applied to the same program after getting rejected the first time.

I got rejected the first time I applied to my program last Fall. The hospital did not even invite me to interview. I applied a second time to the new grad program in January, interviewed in March, and got an offer two weeks later. Some differences when I applied the second time:

  • I had gained several months of experience as an RN (COVID tester),
  • I had earned additional certifications to add to my resume,
  • I finally knew a couple of nurses working in the hospital, one of whom put in a good word for me to their manager,
  • I tweaked my application based on what I heard about the need and availability of positions; I emphasized wanting acute care experience instead of working in a specialty.

I applied to 74 RN positions before I got my offer at my hospital.

The new grad program at my hospital was the very first RN job to which I applied. I continued to apply to other positions, but I was narrow in my search. I focused on the specialty I was interested in and expressed this in my new grad program personal statements. After months of submitting applications and not getting any interviews, I expanded my job search to include Med-Surge/Telemetry positions. I finally landed my first acute care RN interview in a Telemetry unit. In the interview, I expressed strong interest in eventually transferring to a specialty unit within five years. I learned they were interested in me but concerned I wouldn’t be happy in the department and abandon them. They did not give me the job offer. 

As my search continued, I learned not to narrow my focus to a specialty unit when I had no hospital experience. Once hired, it’s much easier to switch positions internally than to be an external hire. I still have a strong interest in the specialty unit. However, my priority as a new grad is to gain acute care experience and develop my nursing practice in a supportive and safe environment. In my new grad program, no specialty unit positions were available where I initially focused my search. Still, I applied and was determined to have a spot in the program because of the training and development I knew it would provide me. So far, I’ve been happy with my choice and have been learning a lot!

I worked as a COVID tester and vaccinator while applying to new grad programs and acute RN positions.

One of the 74 positions I applied for was a contract RN supporting studios as a COVID tester. Thankfully, I got the job. It was a great way to get experience working as an RN while still having enough flexibility to apply to hospital RN jobs and interview. More recruiters were interested in me once I became a working RN. Also, after working several months, my employer wrote a lovely reference letter for me that I submitted with my applications and included in my portfolio. A handful of positions required an employer reference. It was nice to be able to provide an employer reference from the healthcare industry.

I interviewed at five hospitals before I accepted an offer to join my program.

I applied to many acute care RN positions, with numerous ones at the same hospital or same unit but day and night shift positions. After applying, working, and networking, I eventually got invited to interview for some hospitals. However, most of these interviews took place only because I knew someone internally who advocated for me. 

After unsuccessfully job searching on my own, I began to reach out to friends and family members in healthcare to let them know I was searching for hospital RN jobs. I also spoke with other nurses I met in my per diem job about their hospital jobs or connections. One of my coworkers got me an interview at her hospital! Most of the hospital interviews I had were because someone I knew convinced a hiring manager or director to interview me. 

If you don’t know someone, it’s not impossible to get an interview. One of the interviews I had where I knew no one in the organization resulted in an on-the-spot job offer. I eventually turned it down and accepted a spot in my current new grad program instead.

I persevered after rejections or no feedback.

I applied to many programs or positions where I received no feedback for months or not at all – I would be listed as “under consideration” several months after applying. The first time I applied to my program in September, I didn’t receive my official rejection until November, months after my application submission. I tried contacting and leaving messages with some of the recruiters for other job submissions but would still get little to no response.

It was frustrating to hear people’s surprise at my difficulty finding a job: “Isn’t there a shortage of nurses? We’re in a pandemic – don’t they need nurses?” I had to explain that organizations need experienced nurses, and I had no experience. 

My lack of experience working in healthcare was a disadvantage for me. I knew many of my classmates that quickly found jobs had prior healthcare experience working as surgical technicians, CNAs, Patient Care Associates (PCA), EMTs, or nurse extenders. The majority of my cohort completed their preceptorships at a hospital that used them after completing their clinical hours as nurse extenders or surge nurses in preparation for and during the COVID surge. I’ve learned if you can work in healthcare before you graduate, it’s much easier to find a job as a nurse.

Additionally, new grad programs were difficult to find or were highly competitive since many had been canceled or delayed. While I was disappointed at not getting accepted into programs earlier or not having acute care RN offers to consider sooner, I wonder if the rejections were God’s grace saving me from starting a job amid a COVID surge. A former classmate shared she cried before most of her shifts due to the deaths she witnessed. Another friend shared that many new grads in her unit were pulled off orientation less than two weeks into their training to help with the surge. In various ways, new and veteran nurses that worked during the surges were traumatized by the pandemic. If I had started working in a hospital sooner, COVID would have impacted my nursing experience in a much different way. In retrospect, I’m thankful for the rejections and disappointments in my life that led me to where I am today.

Never Give Up

I did not envision starting a job in a hospital almost nine months after graduating from nursing school. However, I trusted in my skills and abilities and knew that I had something to offer and had to keep trying. I was unsure of when or where I would work as an acute care RN, but I was confident in eventually getting a job somewhere and remained passionate about wanting to help people. 

If you have a calling, go for it. If it’s truly your calling, opportunities will present themselves to you to lead you to your vocation, no matter how much you try to ignore it. The road may not be easy and may come with disappointments and rejections, but it might be what you need to direct you to your ultimate calling. Good luck on your journey!