You passed NCLEX. You got the job. And now you're realizing that nursing school, as rigorous as it was, left some gaps. Here's what experienced nurses wish they'd known from day one.
Time Management Is Everything
In school, you had one or two patients. Now you have six. The difference isn't just quantity - it's learning to prioritize constantly. Tips from the trenches:
- Brain sheets are your lifeline - develop one that works for you
- Cluster your care - don't walk into a room empty-handed
- Document as you go - staying caught up saves you hours
- Learn to say "I'll be right back" without guilt
Communication With Physicians
SBAR (Situation, Background, Assessment, Recommendation) is great in theory. In practice:
- Have vitals, labs, and relevant info IN FRONT OF YOU before calling
- Know what you want - don't call just to "report" without a request
- Be concise - physicians are juggling multiple priorities too
- If they're dismissive but you're concerned, escalate appropriately
Dealing with Difficult Situations
Nursing school simulations don't prepare you for:
- Angry families - They're often scared. Stay calm, listen, and get help if needed.
- Workplace dynamics - Not every nurse will be supportive. Find your allies.
- Death - Your first patient death will hit hard. It's okay to feel it. Debrief with colleagues.
- Your own emotions - You can't pour from an empty cup. Self-care isn't optional.
The Learning Never Stops
Your first year, you'll feel like you know nothing. That's normal. You'll learn more in 6 months of practice than you did in all of nursing school. Be patient with yourself, ask questions, and never pretend to know something you don't.
Welcome to nursing. It's harder than they told you, and more rewarding than you can imagine.