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What All New Nurses Need to Know Before Their First Shift

The time has come. You’ve completed the requirements to get your nursing license, and you’ve scored your first job as a licensed nurse. Your first day on the job is fast approaching. What do you do now? Is there a way to prepare?

Like the first day of nursing school, the first day on the job as a bonafide nurse can be an intimidating prospect. Even though you’ve gone through countless clinical hours and may have worked in the field already under a previous job title, there are still many unknowns. 

As you prepare to take that significant step into the future you’ve worked hard for, here are some things to remember and keep in mind for your first shift. 

1. You Will Make Mistakes

Like anyone who is new to working at a job or in a career field, you will make mistakes. 

Those mistakes might be as serious as giving patients the wrong medication or as minor as misplacing your stethoscope when you need it to do an assessment. But for many of us, each mistake seems like a monumental failure.

But don’t let those mistakes drag you down. Yes, sometimes they will be serious, but you have to make many difficult decisions every day. You’re bound to make mistakes. You’ll learn more and more over time, and the number of mistakes you make will slowly go down.

Don’t let the feeling of failure or the pain of past mistakes stop you from finding joy in your job.

2. You Can Learn Something New Every Day

Every day brings a new patient, a new doctor, a new family member. Each shift runs a high chance you’ll see a condition you haven’t seen before, or maybe a common condition presenting unexpectedly. The staff you work with might be on rotation for shifts, or you might flat between floors.

Or you might work with the same people every day in the same unit with more or less the same patients. But even then, there is something new you can learn every day, whether it’s empathy from a patient or wisdom from a well-experienced colleague.

Look for those opportunities. Take advantage of them every chance you get. You learn the foundation of how to be a nurse in school, but you don’t become a nurse until you’ve worked as one.

3. Your Day Can Change Quickly

One moment, your floor is dead quiet. It might be empty, or all the patients might be resting. Then the next moment, you find yourself rushing from room to room, trying to keep up with the call lights, administer routine medication, and handle an influx of admits.

On another night, you might have a patient whose health has been steadily deteriorating. They might have a poor prognosis. Then one day, they start to feel better, until eventually they leave the hospital fully recovered. And vice versa.

In the medical field, we never really know what to expect every moment of every day. We might have an idea. We might even have a planned schedule of when patients will be arriving and for what. But health care never fails to throw a curveball when you least expect it.

Be ready for things to change quickly, sometimes for the better and sometimes for the worst. 

4. It’s a Stressful Job That’s Physically, Mentally, and Emotionally Demanding 

Nurse burnout is real. The job is stressful and oftentimes expects you to make many difficult decisions, some of which might have permanent consequences for your patients or yourself. 

Understand that it’s normal to feel stressed. It’s even normal if you find yourself crying in your car or in the shower at home or venting to your cat while you binge-watch Netflix. 

But don’t let those feelings go bottled up and unaddressed. They’re normal every once in a while, but if you find that you’re feeling more and more depressed and apathetic as the norm instead of the exception, then you need to take the time to stop and address the source of the burnout and the symptoms.

Take good care of yourself. Although we talk a lot about caring for other people and educating them on how to care for themselves, we’re pretty bad at practicing what we preach. 

So decide now to put your mental and physical health and wellbeing as a priority. After all, if you aren’t taking care of yourself, eventually, you won’t have the ability to best take care of other people. 

5. Nurses Can Be A Superstitious Lot

You might have already run into this in a previous health care job or during your clinicals, but we nurses can be superstitious sometimes. If you haven’t ever heard someone be quickly silenced after commenting on how “quiet” a shift is, then you’ve encountered this side of us.

Nursing superstitions vary widely, but it’s interesting to see how common some beliefs are. Some nurses tie a knot in the corner of the bedsheets of a patient to prevent them from dying on their shift. Others open the window of a dying patient to let the soul travel when they’ve passed.

If you work in emergency services, you’ll hear all about full moons and Friday the 13ths. You’ll probably get to know which doctor or fellow nurse is the harbinger of chaos — every time you work with them on the night shift, something goes terribly wrong. 

As your career develops, you might find that you have your lucky socks or your lucky parking spot. Every nurse is different, but most of us still adhere to some superstitions, even if we don’t believe in that sort of thing.

Nursing can be so unpredictable, so there’s a certain comfort in the feeling like we might have some sort of control or ability to predict the worst. If you’re not familiar with these superstitions yet, and you come across them in your first shift, don’t judge harshly. 

And never, ever say the word “quiet” out loud until you’re packed up and headed home.

6. Other Health Care Professionals Can Be Mean

Other health care professionals, particularly other nurses, can be mean to one another. There’s a saying you may have heard during nursing school, that “nurses eat their young.”

Some facilities will have it worse than others, and it’s certainly not the ideal or encouraged. But be aware of the potential for this to happen, so you can recognize it and be prepared if it happens.

Nurse bullying can be serious, whether it’s hateful gossip or refusing to help when asked just because they don’t like you. Know your work’s policies for reporting bullying to HR to protect yourself and your colleagues and patients.

In recent years, many schools and facilities have tried to foster a positive environment on units to eliminate bullying, and you’re an important part of helping that process. Avoid gossip, be positive and helpful, and don’t let instances of bullying of other staff members go by without speaking up.

As you start your nursing job for the first time, remember what it feels like to be the new nurse on the floor. Eventually, when you’ve become the experienced nurse, be ready and willing to help the next new nurse. Help make nursing a supportive field for all nurses.

7. The Schedule Is Just A Guideline Anyway

Sure, you might have been scheduled for a 12-hour shift from 6 a.m. to 6 p.m. But what they really meant when they scheduled you for that time frame was that you should show up half an hour before and plan to stay at least a half-hour later (or longer) than what’s printed. 

There’s the shift-change report to get from the outgoing nurse when you start your shift and the report to give to the incoming nurse when you’ve finished. 

You’ve got to make sure you’ve finished all your charting (which you most certainly did concurrently, and didn’t save until the end of the busy day). And, oh yeah, the patient in room 303 wanted you to give them their pain medication half an hour ago.

In a field as dynamic as nursing, our shifts are often as dynamic as our patients. In most nursing jobs, you can expect your schedule to be a rough guideline rather than a hard and fast rule.

8. Just Because It’s Not in Your Job Description Doesn’t Mean You Shouldn’t Do It

As you go through your nursing career, you’ll likely run into a nurse who feels as though there’s something a certified nursing assistant can do, then that duty is beneath them.

Please, don’t become that nurse. Although you may have other health care professionals to delegate jobs to, you are also a leader, and good leaders are willing to do anything they can delegate to someone else if the need arises.

If you’re already in the room when the patient asks you to help them to the bathroom, if you’ve got the time, help them. If they need help cleaning something up or putting on compression stockings, and taking a few minutes to do so won’t harm another patient, then do it. 

As a nurse, we can do many things. Be prepared to do what you are able to. It’s a part of providing quality care and being a good nurse. 

9. Don’t Forget to Care About The Little Things

As we settle in and become comfortable with many situations, it’s easy to become lax, to maybe forget the little things. A smile and greeting to a patient’s family member, remembering a name or life detail of a patient, or asking a colleague how their weekend went goes a long way in making someone feel comfortable and seen. 

Remembering these little things also reminds you to keep caring. It can be exhausting to expend that much emotional energy. But actions of empathy are what separate the good nurses from the best nurses. 

Don’t stop caring.

10. Remember, You’ve Already Gotten Through Difficult Times

Nurses are no strangers to difficult situations. We are no strangers to death or dismay. 

There will be patients who pass away under your care that you’ll still think about years down the road. You might not remember their names, but you’ll remember their faces. You’ll remember the time you first met or the last time they spoke to you.

You will have many difficult and emotional moments that will turn into difficult and emotional memories. And you will get through them, often as the pillar of strength that family members desperately need in a time of loss. 

Although you might not know it now, you have already gotten through many difficult things to get to this point in your life. That strength and determination will get you through the many difficult things to come. Remember why you decided to become a nurse in the first place when times get tough. You’ll be alright.

Nursing is an often difficult profession, but it can be engaging, informative, and incredibly rewarding. Congratulations on making it through nursing school and finding yourself your first job in a hopefully long and successful nursing career. 

Michelle Paul

Michelle Paul is an RN Content Specialist at Clipboard Health. She has worked with a variety of patient demographics, ranging from young adults in foreign countries, to elderly residents in skilled nursing facilities, to healthy blood donors in her community. Her experience in content creation gives her a unique perspective on communication within the healthcare field.

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