Maxims for New Graduates

Courtesy of Will Hardy

Will Hardy over at Drawing on Experience wanted advice for new grads.  Here it is.

Learning never ends.

Learn by doing.

See one, do one, teach one.

[as amended by Leigh: “See several, do several supervised, and only once you are competent do several unsupervised, teach several.”]

Pay attention when a patient complains of imminent death.

Go to codes.

Never pass up the opportunity to see a procedure.

Not everything can be fixed.

Eat.

Pee.

Breathe.

Patients die unexpectedly for reasons unrelated to the quality of your care.

Don’t think you know more than you do. You don’t.

Ask for help.

Ask questions.

More importantly, know when you must ask questions.

If you still don’t understand, ask more questions.

Advocate. For your patients. For your profession. For yourself.

Be skeptical.

Critical thinking is not optional.

Bedbaths are an essential skill, even for RNs.

Chart. Then chart some more.

Read Notes on Nursing.

Walk before running. Basic nursing before Swan-Ganz catheters.

Listen. Carefully and mindfully. When someone offers you a piece of chewing gum, you’re not thinking your breath stinks, right?

ABCDs.

Wash your hands.

Foley catheters are not a substitute for good nursing.

Housekeepers and ward clerks are your best friends. Treat them as such.

Bring chocolate.

Your most recent assessment is the most important one.

Find a mentor.

Sixth sense counts. Ignore it at your peril.

Five rights. Three checks. Always and forever. No exceptions. Ever. Amen.

If you’re giving more than two of anything — tablets, capsules, vials — you’re giving too much.

If your colleague is drowning, throw her a life ring.

Specialize in a skill. Be the go-to guy for hard IV starts.

Make it your rule: take no shit from anyone.

Vern Dutton’s Addenda:

You will make errors. Learn from them.

When watching a patient for a colleague, watch them.

If the Nursing Assistant says something doesn’t look right, do go look — something is not right.

When the patient says,”I have never seen that pill before,” go check the MAR again. You almost certainly have the wrong medication.

Know what you are doing before you force anything.

When a colleague asks for your opinion, give it.

The clinician will not always order the dose intended. Check it.

Do not guess. Know.

When you tell the patient you will be back, go back.

When a colleague says “Come see this,” be prepared.

When you know a patient needs to be turned, go turn them.

If pharmacy questions an order, go check it.

If you think the clinician needs to be notified, notify them.

The day will come when you realize you are the most knowledgeable person in an emergency situation and decisions need to be made. Make them!

Feel free to add your own in the comments!

[Adapted from a post originally published 8/12/2010]