What to Expect in Your First Year as a Registered Nurse

If you’re a veteran nurse, by now you’re a “voice of experience” for yourself, associates, and most of all, your patients. If you’re a new nurse with so many questions, Monster has no-nonsense answers from your colleagues who’ve “been there, done that.”

An R.N. for more than 20 years, Barbara Arnoldussen of Los Altos, Calif., also writes self-help and career materials for nurses. She edited First Year Nurse: Wisdom, Warnings, and What I Wish I'd Known My First 100 Days on the Job. The 266-page pocket-sized book compiles frank, anonymous questionnaire answers from thousands of nurses nationwide.

“The messages for new nurses are of encouragement, support and resilience,” says Arnoldussen. “Challenges will be thrown at you that weren’t covered in school or clinical rotation, but know that you’ll make it, do meaningful work, and always be proud of your profession. This book allowed hundreds of nurses to give voices to help the next generation entering the practice.”

Embark on the Journey of a Lifetime

Some lessons that Arnoldussen has learned include:

• Walk Tall: “Make sure you have a nice comfy pair of shoes—there are many miles to be walked.”
• Mean Clean: “Nursing school definitely did not prepare me for all the poop I cleaned up in my first hundred days as a nurse.”
• Be Wise and Organize: “When the patients are buzzing with requests, the doctor’s on the phone, and new admits and your coworker are asking questions, you could easily forget your own name, let alone your next task.”
• Approach with Care: “Difficult patients, hostile patients, manipulative patients, depressed patients, patients with pain: Every patient requires a different approach.”
• Make Friends: “No one can understand a nurse like another nurse.”
• Lead the Troops: “Keep it democratic. Don’t play favorites.”
• Help Doctors Help Patients: “The relationship between nurses and doctors comes down to respecting each other’s roles and working together for the good of the patients.”

Benefit from Others’ Wisdom

These nurses work for RNnetwork, one of the largest travel nursing companies in the country, and a part of the CHG Healthcare family of staffing companies. They told Monster they’re passionate about their jobs and that they love what they do—who could ask for more in a career?

Prepare to Be Needed: “Being a nurse is harder than what you see on TV or learn in nursing school,” says Rachel Shafer of Boca Raton, Fla. “Hours are long, and a scheduled 12-hour shift can be 14 or 16 hours, with new nurses last in line for time off. Sometimes you’re the only one there when people need you most.”

Face Up to Challenges: Traveling Nurse Dorothy Grezik has amassed a 33-year career, and now covers Guam, St. Thomas, Virgin Islands, Hawaii, and the West Coast. “Understand that nursing is physically, emotionally, and mentally challenging,” she says, and offers these top tips:

• Work as a nurse’s aide prior to starting your nursing career to reduce “reality shock” of that first nursing job.
• Charting patients is important, but remember it’s hard to be a good nurse sitting behind a computer.
• Don’t be afraid to ask questions to keep learning new things at any stage.

“It’s not easy to see a family dealing with a loved one on life support,” she says. “It is incredibly rewarding when the care you give can mean life or death for a critically ill patient.”

Color Your Nursing Career: “I thought nursing would all be black and white,” says Brooke Tincher of Belfry, Ky. “I thought I would give meds at a certain time, turn patients every two hours on the dot, communicate with doctors efficiently and they would listen to me. Nursing consumed me—continuous learning, continuous education, constant questions to be better. I didn't go home and forget about my day. I wasn't able to. I spent many nights lying awake, thinking of my patients, their families, things I could have said, and things I could have done differently. Instead of delivering meds at 9 a.m., for example, some days I would be holding the hand of my dying patient at that time. The reality of nursing was much more intense than I ever expected.

Remember It’s Just the Beginning

And from an experienced nurse, who’s also an eldercare expert, author, speaker and consultant, this direction:

Manage Great Expectations: “Expect to work nights, weekends and holidays but not in the area you likely desire because most ‘desired’ areas want experienced nurses,” says Angil Tarach-Ritchey R.N., G.C.M, in Ann Arbor, Mich. “Expect to be flexible and open when it comes to finding your first job. Be open to areas of nursing you may not have considered, like long term care. You may find yourself loving an area you hadn't thought about. Expect to have employers and co-workers treat you like you should know everything when you are really just beginning to learn once school is over.”

Finally, from Arnoldussen’s book: “There’s nothing like eating popcorn from an unused bedpan.”

Don't forget to check out openings on Monster to find Registered Nurse jobs in your area.