Nursing Survival Guide
Reviewed By Christine Contillo, RN, BSN, PHN Having graduated nearly 40 years ago, I can hardly call myself a new nurse, but since my job responsibilities in the past year included mentoring nurses new to our facility, I wondered if anyone had any words of wisdom for new RNs. Scrolling through the nursing books on Amazon, I found The New Nurse Survival Guide. Reading this book, I found myself thinking back to my first job in a large inner-city hospital. Back then, my more experienced RN colleagues were more interested in dumping their work on the new grads than in teaching us. The main lessons we learned were how to shift problem patients to another team — not exactly what a good internship should be teaching you!
Author Jon Haws has clearly spent some time thinking about what new nurses need to know and how he can teach it. Haws is a charge nurse on a neuromuscular intensive care unit in Dallas, where he’s also a preceptor for new graduates. (His coauthor and wife, Sandi Haws, is a registered dietician.) My big question was whether Haws and I agreed on what is important for new nurses to know. I was pleased to find that we do.
Nurse Managers: Are you struggling with the complexity of your role? Some nursing shifts it's all you can think about. However, with these 6 things in your nursing kit, life will suddenly get a whole lot easier. Survival Guide. You thought you were ready when you applied to nursing school and were thrilled when you were accepted--but now you may be wondering.
In fact, I wish I’d had this book when I first started nursing. Many of his suggestions fall squarely in the “be prepared” category.
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Nursing is not a “shoot from the hip” profession. You either know what you’re doing and are well-prepared or you should be asking for help and ready to accept both suggestions and criticism. Haws offers useful tips like lists of what tools you should always have with you and which phone numbers to keep close at hand. He talks about how best to stay on top of your patients’ labs, vital signs, medications and chronic problems during each shift and how to give a report.
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He also describes specific skills he believes all nurses should know, including everything from how to flush lines to how to manage your student debt to how to connect with patients, families, managers and physicians. He discusses the value of obtaining certifications and how to seek out new experience and practice opportunities. With each tip, Haws provides a clear rationale. You never feel like he’s admonishing you, just gently pointing you in the right direction.
Many of the tips also include links to additional resources such as media articles and TED talks. (A few of these links require subscriptions to services such as Medscape.) Shortly before I read this book, I changed jobs for the first time in 10 years, accepting a new part-time position closer to home. It’s been a positive change, giving me a chance to learn new skills without feeling overwhelmed and stressed. It would be great if new nurses could approach their first jobs with the same kind of confidence and positivity. A book like this could really help. This isn’t a long book — you could probably read the whole thing in an hour or two — but I wouldn’t hesitate to recommend it to any new graduate. It would also make a great gift for any nursing students or new nurses in your family or who are enrolled in your hospital’s residency program.
Christine Contillo, RN, BSN, PHN, is a public health nurse who suggests joining a book club as a reason to put down trashy magazines and look smart on the subway.
Manage the Unexpected Jennifer Nugent, RN, a critical-care nurse at Boston Medical Center since July 2005, was jolted by the unpredictable nature of nursing. 'There is a constant assortment of things that can come up, because I am dealing with really sick patients,' she says. Nugent previously worked for the American Red Cross for 10 years in a variety of roles, including HIV counselor, infectious-disease counselor and regulatory-affairs supervisor. One of Nugent's best survival techniques has been adopting an attitude of humility. 'It's important to acknowledge that there are always going to be things that happen that I haven't seen before,' she says. 'Once I have really settled with the fact that I can't know everything, it makes it easier to handle it.
I can confer with nurses with 30 years of experience who have seen everything. It's a group effort taking care of these patients.' A tactic Karin Huster, RN, an acute-care nurse at Harborview Medical Center since September 2005, picked up from her preceptor was to prepare for worst-case scenarios. 'When you start your job with your patients, you need to think about the worst thing that could go wrong, so that if it happens, you are prepared in your head,' says Huster, who was a program manager at Microsoft for 12 years before becoming a nurse. 'That helps a lot and is reassuring.' Another new-nurse challenge Huster and Nugent both faced was the switch from sedentary office jobs to 12-hour shifts on their feet - shifts that were physically, emotionally and mentally demanding.
These days, Nugent is careful to use her time off to rejuvenate with rest and yoga. Accept that You'll Have to Start Over Another source of angst for second-career nurses is realizing they're now low in the employee hierarchy. 'It's like starting at the bottom all over again,' Nugent says. 'Before, I could take my summer vacation anytime. In nursing, it's seniority-based. You have to give up that idea of control.'
Saunders Nursing Survival Guide
But forgoing that seniority is easy when it's in exchange for the chance to directly help people and learn new things every day, she says. Encountering some of the same frustrations they experienced in their first career can also be disappointing to second-career nurses. For Maritza Salazar-Abshire, RN, MEd, it was nursing's high volume of paperwork - an also-annoying aspect of her former job as a teacher. 'You just have to get into a routine of doing it,' says Salazar-Abshire, a nurse in the pediatric adolescent clinic at MD Anderson Cancer Center. 'I drew from my experience as a teacher and decided I needed to have a routine and be organized.' Adjust Your Attitude High expectations can also exacerbate transition pains.
'Many people would ask me why I was leaving Microsoft to do nursing, and this made me feel concerned,' says Huster, whose career change meant a 50 percent pay cut. 'What really worried me was whether I would be satisfied with nursing for a long time.' Huster's attitude has helped allay these fears.
Rather than just taking vital signs, she uses her extra minutes to read her patients' charts, learn about their psychiatric issues and ask doctors about diseases with which she is unfamiliar. 'You can learn a lot about why patients are here and their history,' she says.
'Then it's much more interesting when I give care to the patient.' As a nurse with a long-term dream of volunteering overseas, Huster knows that what she learns now could someday help people around the world. And for her, that's worth giving up an office with a window.