Top tips for our nursing graduands Paying it forward: wisdom of old for nursing colleagues new

Overall, nursing has given us so many opportunities and opened our eyes to so many new and wonderful things. Nurses change lives and that changes everything. As nursing educators, we wanted to give that opportunity to you, and feel privileged to have been a part of facilitating that change. Here is some nursing wisdom of old for our colleagues new.

Start as you mean to go on, create healthy coping habits now that stay with you throughout your career. Eat healthy, plan your meals for work and exercise regularly. Look after your mental health; as health care professionals we care for people who are suffering, who are in pain and sometimes even dying. We are not immune to the feelings that this ignites in us and we need a strategy to cope with them. Engage in regular debriefing activities with your colleagues. Reflect on the care you provide and get professional supports as needed.

However, try not to talk about work over lunch or break time. We all know nurses have got a strong constitution, but just don’t. Get to know your colleagues instead.  They are your nursing tribe.  Family and friends are great, but your colleagues understand exactly what you are going through.

Every senior nurse leader started out as a junior nurse, never forget what it was like to be a student or new to a unit. The person you take under your wing today may change the world tomorrow,  with a little kindness, wisdom, and lots of learning and encouragement from you. So let us build ourselves up as a profession and empower and support each other.

Speaking of wisdom, here’s another top tip to pass on. Before going into an isolation room or going to any patient. Stop and think, and gather everything you need for a task. Guaranteed once you pop out from behind the curtain to get something you forgot, at least 5  people will stop you along the way!

Another important one, double check or triple check, never ignore your gut feeling or your patients doubts, if you think something is wrong or not quite right, check it out, get supporting evidence and communicate with your peers or superiors. However, to make a mistake is only human; so when it happens, be honest, reach out and get help.

Learn from it, to avoid repeating it. Ask for support from family, friends, colleagues and your managers, and pay it back when they need it.

Be open to constructive criticism and learn from complaints. Reflect often. If you are called to give evidence or make a statement, get professional advice and support. Again help from family, friends, colleagues and your managers is important. 

So don’t cancel plans with your nursing friends if possible, they are an important support network. You will have probably noticed already that it takes military-like planning to arrange a date, even for a video call, and it may be another 6 months before your shifts line up again.

Please also remember your time of study at DCU School of Nursing, Psychotherapy and Community Health, you are not alone; you are part of a very special community now, so stay in touch and watch out for each other. Remember your programme chairs, lecturers and skills nurses too who helped you along the way. Stay connected on social media and when it’s safe do so again, pop in to say hello or have a cuppa when you can– we always love to hear from you.

You’ve got this far, be proud of where you are and what you have achieved. However, this is just the beginning; and you can achieve more if you want. Nurses are great leaders and you are one of them.  Innovate, and challenge the status quo. Use your voice, advocate for your patients and the profession. Try to think of ways to improve patient care or expand your skills. Maybe enroll as a student in one of our Masters’s programs.  Please check them out when you feel you are ready. Competence is a journey, so soak everything up, keep practicing, keep questioning, keep reflecting, and learning. We are always here. 

Look up each new medication you are about to give, over time it will get easier. We can’t know everything, but we must be willing to admit that, and we have to know where to go to get the information. It is okay to say to a patient I don’t know and tell them you will try to find an answer to their query. So get help, no question is dumb. Keep asking as it can help us stay safe and prevent potential mistakes.

Find a way that works for you in keeping up to date.  Utilise your clinical education units, that’s what they are there for, and take your study leave.

“Let us never consider ourselves as finished nurses…we must be learning all our lives” Florence Nightingale.

Often it’s the simple everyday tasks like regularly decontaminating your hands, that saves lives’ and makes a big difference, don’t underestimate this. So, never call patients by their condition, their surgery, or their room number (shockingly impersonal I know, but it can and does happen). Please use their name, smile, maintain eye contact, and give them your full attention when you are with them, no matter how busy or tired you are. They are scared and anxious, and our kindness and attention is vital.

Speak with respect to your patients; don’t condescend or use medical jargon, again we can get complacent. Speak clearly and remember communication is both verbal and non-verbal.

Respect, and be kind to our colleagues and ourselves also. Colleagues may be acting snappy etc. at times when things get stressful, and they could just be having a bad day.  Set lines in the sand, don’t accept bad behaviour but do check it’s not something else. We got into nursing to help people, let that include our colleagues.

Junior doctors are very similar to junior nurses; we are all nervous and a little afraid starting out.  Be careful, but at the same time show confidence with your patients, they need that to be confident in you. Think through everything step by step. Take a deep breath and keep calm, it’ll help both you and your patients.

Healthcare is a team effort; we can’t do it alone. Every member of the team is important, starting with the patient. 

You are professional, conduct yourself as such, always think twice before you post, social media won’t always be your friend. Use your voice with diligence.

We all have a responsibility to safeguard the profession and our patients, don’t let complacency, guilt or friendship get in the way of this.

Mind your feet, invest in safe comfortable shoes. Protect your back, raise the bed, sit down as appropriate for a procedure. Hydrate! Your output should not be less than your sickest patient. Don’t hold that bladder, the work will be still there when you get back. 

So take you designated breaks. It’s part of looking after yourself.

Find a way to process and decompress after work that allows you to let the day go, so you can sleep. For example, mindfulness or music can be helpful. 

As tempting as it is, don’t stay in bed after three long days. I know you are exhausted, but try to go for a walk and do things that help you relax and unwind. We must look after ourselves to be able to help others. 

Be yourself and preserve your integrity. Be the nurse you set out to be, but on the days you struggle, don’t be too hard on yourself. Be kind, and lean on your family and friends.  And on the really bad days, do indulge and take the creamy bun or chocolates a patient’s family brought in for the staff. Treat yourself!

Hope for the best but plan for the worst, check all your emergency equipment is working at the start of your shift. 

A pen touch and a nursing scissors are vital, you will use them so many times, but as they travel with you, please remember to decontaminate every time you use them.

Keep up with your documentation, if it’s not written, it’s not done.

Never forget the basics, no matter how advanced we get in our knowledge or skills, things like pressure area care, comfort, nutrition, hydration, hygiene, communication, pain relief and observational skills are fundamental. 

Listen to our patients; don’t let other opinions colour our judgements. Assess each admission or transfer with fresh eyes, so nothing is missed.

It’s never as bad as the handover sounds, check and greet all your patients first and then make a plan and list of priorities.

 

When calling the medical team, document same clearly. Prepare yourself mentally and have a list of everything you want to discuss. Gather everything necessary first, like a pen, and the patient’s charts and paperwork etc.

Assessment and observation is vital. Escalate when necessary, you can prevent deterioration. Count your patient’s respirations and palpate their pulse. I can’t emphasise this enough, don’t over-rely on machines.

Your colleagues want to leave on time, be on time and they will return the favour.

Don’t be afraid to leave a unit or a position to grow, sometimes we reach a plateau. So advance your career when you get a chance. Take the challenge and become a Nurse Manager, a Nurse Educator or an Advanced Practice Nurse-the choice is yours. You might have a set plan in your head already but there are so many paths and avenues in nursing, you’ll never know where you’ll end up. 

However, it’s your life, your job, make sure you enjoy it. Take time before specializing, your passion for the area will get you through the long hours of study.

Stay interested, but don’t be afraid to change your career if you and your interests change. We don’t have to fit into the same box for the rest of our lives. It may be a new adventure in nursing or a completely different avenue altogether, that’s okay.  

Just like us, our patients don’t always fit nicely into boxes or guidelines. Treat and assess them accordingly.

Enjoy your career, have fun along the way, it’s a journey so travel, travel, travel! (When we are allowed again of course).  It’s fun, it broadens the mind and allows us to see different healthcare systems and different ways to care for people.  Irish educated nurses are valued all over the world, be proud that you are one of those nurses.

 

Now pay attention, this is the big one you have been waiting for. Don’t lend your pen to a doctor, I repeat don’t lend your pen to a doctor, if you do, follow them to the ends of the earth, till they clean it and give it back to you.  Obviously, we are kidding.

This is the big one… Remember how you would like to be treated or how you would like your family to be treated. Healthcare can become routine for us, but it most certainly is not for our patients. Our professionalism is so important to their experience of healthcare. Our actions speak louder than words. They may not remember exactly what you said, but they will remember how you made them feel.

 

Author: Felix Toner – BSc, RPN.