You’ve heard it plenty of times, from professors and older experienced nurses as they look at you with wide-eyed excitement “your first year as a nurse will be the hardest in your career.” They’ll smile wistfully and tell their story remembering their youthful days at bedside. The simple fact of your first year of nursing is this: you are going to screw up, however, the same fact holds true for your second year through your 28th year and beyond. Yay, so much to look forward to!  I no longer am filled with a growing sense of dread the closer I get to my hospital, I no longer quibble in fear at the thought of what I might encounter. Instead, I have a small, but sure belief that it will work out. Let’s not sugar coat it, nursing is hard. For twelve hours at a time, your world revolves around your patients, you live and breathe their every need or want. It is your job to fix it if they are hurting, scared, hungry, have to pee, haven’t peed, cold, hot, hypotensive, hypertensive, hypoglycemic, hyperglycemic, have an electrolyte imbalance, or shortness of breath. It is your job to coordinate every test, every consult be it with neurosurgery or physical therapy, you name it the responsibility and the call are on you and sometimes they are life and death. Aren’t you glad you chose nursing???
           So, you probably want to know to leave work not in tears everyday. The most crucial step is simple: make friends with the other nurses. Yes, one might be a bully, ignore them.  Endear yourself to these brilliant experienced people in some way and it will go miles. If people around you want you to succeed, you are that much closer. You need them; they are your greatest resource. You have to be able to ask them a question; they know the answer without thinking 9 times out of 10. You have to ask questions to keep your patients safe. You know that small, sure belief I mentioned earlier? It was and is built on the foundation that there is always someone to ask for help. Â
        Step two, and I already said this, but it bears repeating, ignore the bully nurse. The fact is you are a new nurse, you have enough going on finding your footing as a professional without fighting with someone. She will get hers one day and you can pine for the day and pray you’re around to see it. (Clearly the part about treating my coworkers kindly does not apply in this case). I read in a book about nursing once that “no one is harder on nurses than other nurses.” I have found this to be and true and to be frank it is bull. Sometimes the nurse before you will forget to do something or tell you something or any number of things. Remember that the leaving nurse will be you in twelve hours and you don’t want your successor to run your name through the mud. So, do not run your mouth listing what was not done or said. Everyone from the nurse to the doctor to the food service employee that delivers the tray should have the same goal in mind, get that patient better. So why, if we all have the same goal, do we have to tear each other down? There are mean people in life, I’m betting you already knew this. Ignore them. Do not emulate them. Treat everyone kindly, say thank you, and try to set a better tone. People will notice, you can be the change.
        Step three: take breaks both at work and in your schedule; use that PTO. Your mental and emotional health are as important as your physical health and this job drains it all.Â
        Step four closely relates to step three. Step four: sleep. You are probably going to be tired a lot at first, especially if you have the added physical stress of switching to night shift and let’s not forget you just came out of exhausting turmoil of nursing school.  Sleep can refresh your mind and change your perspective. When you leave work, after 13 hours and you are totally exhausted and struggling to remember where you parked your car, try not to think on all that went wrong and the horrible thing so and so said to you and how you have to come back in 10 hours. You will end up pulling the bookshelf over on yourself and spiral into a complete and total meltdown.  There is no way, to give your patients and coworkers your best, without being rested, so go home, take a hot bath, go to bed and do not let your mind dwell on every failure. Doing this job without sleep is the equivalent to climbing Everest backwards: dangerous, stupid, and unnecessary.
       Step five: try. You have to grow; you cannot stagnate at new-grad nurse level for the rest of your career. Learn when to wake the doctor up at 3 am and when it can wait till morning. Learn the policies and procedures of your hospital and let those serve as a guideline for your practice.  You will not meet every need, want or whim of all of your patients, but you have to learn which one must be addressed.
       Do you want me to make you feel better? Let me share some of my screw ups: I gave a patient going to PET CT insulin (fortunately the radiologist caught MY  mistake before it  ruined the test), it took a lot of failed IV starts to get good, I have sent a patient on AFB precautions to dialysis without calling ahead to tell them (although that was more a case of them needing to calm the heck down, realize we’re all on the same team and get on my level). Laugh at me, but more importantly, learn from me. Â
      One night in my very first months as a nurse, when I still worked on the floor, my patient went unresponsive. The bully nurse was there and her lover (scandalous) was charge nurse. I could not wake my patient up at 4 am, when only hours earlier she had fixed her hair before bed, because she was so excited about pending discharge. The bully and the lover, helped me, heck the patient transporter who was taking a patient to another room stood beside me to make sure I wasn’t alone while I waited for the emergency NP. My patient woke up eventually, around 10 am after two lactulose enemas that I stayed and gave with my manager so the day shift nurse could see her other patients. I went home after 15 hours and slept well knowing I had done the right thing. A week later when the patient was discharged I encountered her exiting the hospital in a wheelchair as I was walking into work. She stopped the person pushing her and reached up to hug me, while repeating the word “Thank you” over and over. That was a flicker of hope in the midst of a hard year. You’ll start to have those, grasp them, remember them, go back to them during miserable moments. I think you’ll have to do that throughout this career, the road you chose was not an easy one my darling new nurse, but some days it’s worth it, as a whole we all need to focus on those times.
       I have a couple of prayers for you, my darling new nurse. I pray you have a good preceptor, manager and unit that is gracious, kind, and want to see you succeed, while understanding that you are still growing into those brand new nurse shoes. I pray you are just a little bit afraid. Afraid enough to make you check the med three times, but not too afraid to push the D50 at 2 am when your patient is hypoglycemic and you don’t have the order for that just yet. I pray you use that brain full of NCLEX approved nursing knowledge to be the best you can for your patients. I pray you never lose sight of the fact that you can do this. - Jenna
