Let’s meet new nurse, Susie. Susie just graduated from nursing school and is excited about her first day as a Med/Surg RN. She makes it through her first day, first week, and then first month. Yay, Susie!
Yet, within a year of starting her long-awaited nursing job, Susie has not only quit, but has decided to leave the field of nursing all together. Sadly, statistics show that Susie is the poster girl for a growing trend in our field.
According to several different studies conducted between 2009 and 2016, new nurses are leaving the profession at a rate of 20-33% within the first year of employment. Note that. They are leaving the profession, not just a particular employer.
The Disconnect Between Textbook and Reality
Many of the new nurses I’ve precepted longed for time with patients, the ability to make a difference, and the time to thoughtfully plan. Often, they were surprised to encounter challenges to these ideals.
I heartily believe that in time, an experienced nurse can realize these ideals in her practice. However, many new grads are not making it to that reward. I fully realize there are a host of problems that contribute to this issue. However, if seasoned nurses would teach new grads how to self-prepare mentally, professionally and physically before and throughout each shift, I truly believe we can slow this mass exodus. While I support nursing advocacy, often policy initiatives and grand change take time.
Here are things every nurse can do every day.
Make sure that you arrive early enough to sit in your car and think for just two minutes about your expectations for the day. Make sure they aren’t unrealistic.
1. Set expectations regarding yourself.
After long talks with my mentors, the things I expect of myself are honesty, fairness, kindness, responsibility, positivity, and competency. Notice I didn’t say anything about getting every IV start the first time, finishing my charting by end of shift, performing every skill I ever learned flawlessly, or leaving on time.
2. Set expectations regarding your co-workers.
Expect that your co-workers, supervisor and physicians will both disappoint and inspire you. Don’t expect to be ridiculed daily, but know it will happen. Have a general response ready that allows you to maintain professional integrity while addressing the misbehavior.
3. Set expectations regarding your patients.
The previous expectations apply here also. In addition, make it a goal to have ten consecutive minutes of quality interaction with each patient each shift. (I know some of you are thinking of all the units that pose exceptions, but remember most new grads start in Med/Surg type units.) This seems small, but patient exit surveys show that short, meaningful interaction makes a bigger impact on care scores than longer, task-based interactions.
1. Always be in the seat of the learner.
Yes, I know. Nursing school is behind you, but learning is never over.
2. It’s okay to say “I don’t know.”
Many try to desperately avoid these words to the point of making up information or stalling, wasting everyone’s time. This will definitely lead to strained professional relationships and a distrust among your peers. Just be honest. Learn for next time and move on.
3. Arrive early and make a plan.
Give yourself 15 minutes to look at your assignment, prioritize tasks, and make a mental (if not written) plan. The nurses I know who do this are always less flustered and burned out by shift’s end, even if three new admits come in and change the plan.
4. Spend time refreshing your mind on new/infrequent skills the night before.
This applies to scheduled procedure units mainly, but some Med/Surg units have scheduled admits that can be reviewed the day before.
5. Upon arrival, identify your resource person for that shift.
This individual is not necessarily the most experienced RN present. Rather, look for a mentor who is approachable as well as knowledgeable.
6. Don’t go cheap on the tools of the trade.
When you pull out your bandage scissors, they better cut. Dollar-store pens don’t always write. And you can’t underestimate the importance of a quality stethoscope. If you use it everyday, buy quality.
If you are physically weakened by hunger, headache and muscle/joint aches, it will affect your performance and job satisfaction.
1. Eat a high-protein breakfast, snack and lunch. You many not get a lunch break every day. Bring quick snacks that do not require much prep in case you only have a few minutes to eat. Hard-boiled eggs, nuts, cheese, and yogurt are favorites.
2. Wear comfortable shoes and scrubs. There are some darling options for shoes, but “darling” is better for a night out. Go for comfy on shift.
3. Don’t let your hairstyle give you a headache. If you have to wear your hair up for 12+ hours, chances are you know about hair headaches. I recently found Flexi Clips and can go all day without even knowing I’m wearing it. They are durable and beautiful to wear after work if you have social plans.
4. Stretch out before, during and after shift. A mid-shift stretch is revitalizing during a challenging day. Take 60 seconds and stretch your calves, your arms, and your neck.
5. Watch your body posture. If you are lucky enough to sit while charting, be sure to keep your knees below your hips. If you stand, bring your abdominal muscles in towards your spine. This provides core support for your back and reduces muscle spasm and strain.
These are the things I share with new grads. Every single one of them thank me for being realistic, yet hopeful. Those who are seasoned need not paint too bleak a picture, but simply encourage our new Susies to prepare in this way.
About our Guest Nurse Writer:
Karie Bair received her BSN in 2002. She spent the early days of her career in Med/Surg and OB, then received Perioperative Certification to pursue surgical nursing practice. She has 10 years of OR experience and now enjoys community-based nursing, as well.