A Practical Guide For New Graduates

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Congratulations on securing a new graduate position and congratulations on graduating from University. For those who did not receive a grad position – Don’t give up hope on finding a job!

In this post I will be sharing small snippets of my new grad year and some useful tips for new nurses.

I graduated in December 2015, and it honestly feels like yesterday! I really struggled at University — I was reunited with my biological father then a short time later was watching him pass away. My nan was very sick and I remember juggling 2 jobs along with having a car that was very unreliable, making travel to Uni (40km away) very stressful. Graduation could not come soon enough.

I secured myself a new graduate position in a large central Emergency Department (I literally landed my dream job at my dream hospital) and boy was I on cloud 9 – Uni payed off! I remember being told “Don’t put this hospital as 1st preference, its way to competitive and you probably won’t get it” – I had an amazing mentor at the time who advised me to just do it and so I did.

My first day was in February 2016, I met four other girls who were also chosen for Emergency and we became very close, very quickly. We all decided to purchase cheap $30 navy blue scrubs from Ebay (we didn’t want to stand out from the crowd) for our first day on the floor while we waited for our ‘real’ uniforms to arrive.

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  • Get onto your managers details ASAP to order your uniform as it can take ages – think about the influx of orders the supplier is about to have, YIKES!
  • Invest in a decent pair of shoes – make sure you check the ward/hospital policy as some places are cracking down on shoes. I started off with black Asics gel kayanos, which were amazingly comfortable however they got pretty ratty, 6-7 months in. I have since purchased Asics all leather runners + Birkenstocks seen below. To be honest the Birks are pretty and comfy but took a while to break in. My all leather Asics are also comfortable, but let’s face it are ugly AF — leather runners, sweet Jesus I never thought I’d see the day of that purchase!
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    Birkenstock London shoe
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    Birkenstock London shoe
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    Asics leather runner

    Our first day was orientation and we were given 100,000 sheets of paper, booklets, passwords, codes, keys and a list as long as our arms of mandatory training!

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  •  Get a folder to keep in your backpack – pictured below is literally all the paperwork I received as a new grad compiled all together and kept in my bag. I hate bits of paper that get creased floating in my bag– typical ICU nurse, yeah yeah.
  • Buy a packet of red and black ink pens.
  • Buy a pocket diary for special dates – Trust me, your year will be busy.
  • Buy a small plain notebook to keep in your pocket. Handy for all the notes you will be jotting down, especially key staff member names/contact numbers.
  • Download a shift app – I personally started using a free one called “Shift Worker”. However I couldn’t stand the layout and codes – it made my monthly roster look hectic and chaotic.
    So I downloaded “Shift Work Days”, and it is SO much better for my organised OCD mind. It is simple, easy to navigate and you wont be restricted with how many shifts you can save. For example my work has an AM 8 hour, PM 8 hour, float 8 hour, night 10 hour, AM 12 hour, night 12 hour shift etc etc. From memory, I payed around $5. A shift app will be your life planner – keep track of all your shifts, study days and overtime + when a new roster is out, just type in all your shifts. When I am trying to plan things with family or friends, I screen shot my roster and say pick a day that is empty! 

     

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    Example of my roster

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    My paperwork folder during my new grad year

The first month or two, I had never cried and laughed so much in my life. I remember the 5 of us new grads finished ON TIME one afternoon, and walked out of the department word vomiting about our day. We decided to just sit down on the side of the road at the ambulance drop off and let it all out, crying and laughing with each other over how insane and overwhelming it all was. Our debriefs were often filled with crazy stories and lots of laughter either at the pub, outside work or in the staff change room.

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  • Make sure you find someone, whether it is a fellow new grad or just someone you get along with at your new workplace, to be able to vent and debrief with. This is SO important. You will unfortunately cross paths with unpleasant nurses who will bully. Please don’t let anyone shoot you down, remember you have a voice and are damn valuable to your team. These nurses will never change, so if you ask the wrong person for advise just breathe, keep your head held high and try your best to move on. These people are uncommon and their behaviour has most likely affected many other people. Seek out the good role models, teachers and friends who are always willing to help, educate, chat or laugh – these people will be your grounding and make your transition year smoother. I have met SO many beautiful souls as a nurse and I am forever grateful I crossed paths with them. You will find the good ones pretty quickly don’t worry!
  • Some of the most helpful people are the cleaners, ward clerks and wards-men – they know where most things are so make sure you say “hi” and introduce yourself as a newbie. They looked after me when I had no clue where to go for something! 

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I was buddied with various RN’s after orientation (I think it was for 4-5 shifts) before I was on my own. BAM! Four patients in emergency all mine to care for! I was petrified yet surrounded with support. A great idea from one of my first educators was “Go home and triage absolutely EVERYTHING you do this afternoon”. I did exactly that and still do it to this day, without noticing – I triage everything I do. House work, study, cooking, groceries and self care etc – What is the most urgent thing to do? What’s the most logical and practical way to do it? Prioritise and execute, a must in nursing.

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  • Whether you have really good days and really crappy days, please write about them in a personal diary for you to reflect on later (as a new graduate you will be required to complete written reflections, start early). My diary was useful to vent my emotions rather than arriving home and word vomiting to my partner, who would be like WHAT THE HECK :O My partner has since learnt to have open ears and allow me to talk about a crazy shift, but in the beginning it was a shock for him. So I turned to my diary instead, which worked just as well. As Elsa would say…. “Let it goooo” – whatever works for you! 

One morning not long ago, after a really long night shift in ICU. I was still feeling really down about a patient that I had looked after a few nights earlier. Thankfully on this particular morning I was handing over to one of my beautiful ICU preceptors. I mentioned I wanted to have a debrief about something and she was onto me like a hawk. We debriefed for about an hour and it felt so good getting it off my chest. I could leave work and actually enjoy my days off. During the debrief, my preceptor said something to me that really stuck with me “If your shift went absolutely haywire, what was one successful thing that you did?”.

I absolutely LOVE this because from that day on when I have crappy shifts I try to think of something I did for my patient that was successful, whether it be changing that massive dressing or just being present for a patient who doesn’t have family visiting – sit down and have a tea, or ask about what they used to do for work. Most people love this as you could imagine, it gets very lonely in that hospital bed. As my preceptor says, it can be the smallest achievement – Just walk away with one success, always!

 

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My first week as a new grad I remember the doctor asked me to give 1L on N.Saline STAT to my patient who came in with N & V (nausea and vomiting), 99% of my mind knew it was the entire bag to be given as fast as possible but the 1% of me thought, “Oh goodness, what if I give it to fast and something happens to my patient?” So I asked another RN, and we chuckled because I answered my own question but was praised for having the guts to ask anyway!

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  • When you start you will look like every other RN working, so it is important to introduce yourself to EVERYONE you have a conversation with. I found it useful to highlight being junior – others will appreciate this and help guide you when/if required, as they were also once junior.
“Heyy my name is Jami, I have just started working here fresh out of Uni, I am wondering if you wanted me to give this blood pressure medication for Mr Smith in Bed 7 his BP is…….?
“Heyy my name is Jami, I have just started working here fresh out of Uni, are you able to check out this ECG for me?” – I always get the doctor to sign/initial any ECG to highlight that it has been reviewed and then I add that into my notes.

I used to DREAD hand over time because I would always fumble and feel like I was never ‘doing it right’, or that I sounded and looked like I had no idea what the heck I was talking about. I used to freak out receiving handover, and even reading the patients notes – what the HECK does ICH mean or BPH?!?!?! ARGHHH. My list of things to Google would be so long, but please don’t stress yourself out if you don’t know every medical term or diagnosis – as long as you are aware of the important things and seek out the necessary information, you can save the big Google search for your own time. Obviously use your clinical judgement and seek help if you’re unsure of anything. I was and still am that nurse who asks loads of questions – we are always, always, always learning! 

To this day if I’m feeling overwhelmed and really busy before I have to handover, I literally grab a paper towel and jot down important info so I don’t miss anything. Then shove it in my pocket, so its ready for me to refer to when I have a small group of nurses all listening to my handover.
Yes it is nerve racking when you have to handover in front of others, but just be calm, breathe and have a conversation rather than a public speaking contest. Explain what is happening with your patient, even if you are not entirely sure what something means – I like to verbalise this even to this day. Sometimes my teammates will also say “oh yeah I’ve never heard of that before either”, OR someone does know and will gladly explain. Either way, just be truthful and open!
As I mentioned earlier I was and still am that nurse who asks SO MANY questions – I couldn’t care less if I annoy people asking questions, because my patient is always my priority and so is the way I deliver my care. I am a nurse who loves to be shown all the short cuts/tricks, and also the nurse who learns how to do things the right way. I strive to be a nurse who “knows her stuff”. 

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  • As a new grad if you are being shown how to do something that is a short cut, be sure you learn the proper way as well. 

Starting full time work will be a challenge, so get yourself into good habits now!
Join a gym close to work or home, or whatever would be the easiest way for you to actually attend. For me, my gym is next to work so that I can go before shifts. I make sure I am organised, having a workbag and a gym bag so that I can easily throw what I need into both. I ensure food is always readily available, so I eat well and stay fit. Have a read of Eating habits when the Ol night shift rolls around.

 

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When I food prep for work food, a go to meal I L O V E is this one – A go to meal that packs a punch and is full of goodness . I freeze whatever I don’t use for next time. Also keep checking the Instagram page for tips or advise. 

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  • Invest in glass tupperware – for some reason I find it a lot easier for food prepping + it doesn’t leave residual stains/smells from particular foods. Glass tupperware is easy to heat up, eat out of and clean up!

One of the most important things to keep in check of this year is your mental health! It is absolutely OK to feel like a failure, sad, overwhelmed, not good enough and the list seriously goes on and on! If you ever feel like this, please be aware of your emotions, write them down and talk to someone. It could be ANYONE you feel comfortable talking to. I would often talk to a close work mate or walk really fast to my new grad co-ordinators office on a morning tea or lunch break and cry/vent to her about something.

I have also taken the time to see the Employee Assistance Program (EAP) a few times. I would book an appointment to chat about feeling overwhelmed and traumatic things I had witnessed at work. Seeking help makes you a stronger person and a better nurse, because you are able to recognise and read your body to eventually find ways to move on. Please remember to look after yourself and fellow grads, who’ll likely be going through the same thing on different days. 

 

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The new grad year will be full of up’s and down’s and many challenges that will make you question why on earth you even chose to study nursing – rest assured I promise it gets better! You may love where you start or you may hate where you start, but that is the great advantage of nursing – CHOICE! You will find your groove in time just have fun along the way!

 

 

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