15 Things I Wish I Knew as a New Grad Nurse

One year ago, I began as a baby nurse, every fiber of my being laden with trepidation and excitement. I pulled up my compression socks, laced up my promisingly supportive Brooke’s ghost shoes and stepped foot into the hardest year of my life. I didn’t think anything could be more challenging than nursing school, and I was in for a rude awakening. Everyone says the first year of nursing is the most challenging, but it’s hard to grasp until you are in the throws of the anxiety, incompetence, and fear that plague your every day. There are a few things I wish I had known or someone had told me before I began this year, and maybe, just maybe, this can help some new grad nurse out there on this emotional, wild, and spectacular rollercoaster.

  1. You will make mistakes. For some reason, I didn’t realize that as a new grad nurse, you make mistakes. No one ever said point-blank, buckle up, you’re gonna screw up…. a lot. Maybe people don’t talk about it because we have people’s lives in our hands, and we should strive for perfection. This is true, but I think it would have saved me much of the intense self- badgering if I realized mistakes were inevitable. Don’t get me wrong– always triple check your meds, doctors orders, operate in professionalism, always do your absolute best….. but every little mistake from having an overdue med due to mismanaged time (IT WILL HAPPEN) to forgetting to unclamp your piggyback antibiotic (everyone has done it) to not charting something correctly is an opportunity. Never try to cover it up, make sure your patient is safe first and foremost, and then… learn. Trust me.. you won’t make that mistake again. Do not beat yourself up. Repeat after me… Mistakes= Lessons, Lessons= Growth. You need the mistakes to grow, and each mistake is molding you into a strong, robust, competent nurse. The mistakes will become fewer and farther between, but they never will entirely cease. Neither will the lessons, and neither will the growth.
  2. You will experience a new level of anxiety, but it will get better. Every single day I stepped onto the floor, the anxiety overwhelmed me in a way I have never experienced before; it plagued the crevices of my mind and soul. I felt like I was operating in flight and fight at work AND at home. I couldn’t separate the two, and would often wake up in hot sweats- “Did I return that med?! Did I chart that?! Oh shoot, I forgot to get that patient ice chips!”… I had literal breaks with reality. One time I woke in the middle of the night panicked because I thought I had forgotten to give my husband insulin (he’s not diabetic). But somewhere along the line, I was able to turn the “work” brain off. It took a long time, but now a year later even though I still think about my shifts, it doesn’t carry the same anxiety provoking reflection it did at the beginning. I still shed plenty of tears for my patients on the way home or the next day after a hard stretch of days, but it’s out of mourning for and with them… not from anxiety.
  3. Those impossible skills…. become possible. One of the most frustrating parts of being is a new grad is the lack of agility and the constipated pace of your skills. Tasks that are super “easy” to most seasoned nurses still scare the code brown out of us. Even priming IV tubing seemed like a formidable obstacle when I began (air- in-line alerts sent me straight into cardiac arrest). By the end of the year you will be taking out central lines, hanging blood, straight cathing, and working with PEGs/trachs like it ain’t no thang. Hands on skills were my weakness, I didn’t think I’d ever get the hang of it. But somewhere along the way, I did. And trust me, if I can do it, you can do it.
  4. 12 hour shifts are long, but nursing is a 24-7 job. One thing that I didn’t quite get when I began is nursing is a 24-7 job. Yes, in those 12 hours that belong to you, the weight of people’s lives are in your hands. But always remember— it’s a 24-7 job. Do your best not to pass on any tasks, make sure you give all your shift meds, but if you don’t get around to changing the now expired IV tubing because your patient was physiologically unhinged and you were keeping them from grave, it’s ok. I used to think I literally would get fired if every single little protocol ridden task was not completed. Some days, all you can do it keep someone alive. It’s a 24-7 job. Just remember that.
  5. Yes, you can do another day. Countless times I thought to myself, I don’t know how I can do another day of this. Sometimes we have such a bad first shift in a stretch of three, and we don’t know how we can physically or emotionally handle the next two. But you do. You just do. After enough times of thinking this, and enough times of doing that “next” shift, you start to know that you can, in fact, do another day.
  6. Listen to your patients! Sometimes symptoms are not textbook clear. If a patient says they feel “off”, listen to them, closely. What is off? When did it start? Listen to their concerns, even if they seem unwarranted, because often times they are not. There are clues in conversation, history, and in chats with family that may not show up in vital signs.
  7. Patients listen to you, closely. Patients will ask you so. many. questions. Sure, you may know some, but there are plenty you will have no clue. Do not be afraid to say, “I don’t know, but let me find out!” or direct the question to the proper team. Something I have discovered is when you have those scrubs on, patients take you at your word. Even if you put a disclaimer- such as I’m not 100% sure- or, make sure that’s ok with your primary doctor, or “I think _____” but double check with your pharmacy….. they will only hear the answer part of your statement. Avoid saying those disclaimer statements, because as soon as it is out of your mouth, they will hear my nurse said ____ and take it as truth. It’s better to utilize your resources (call pharmacy, ask your charge, ask the MD) and give them the most informed answer possible.
  8. Listen to your gut. “What gut?” you may be thinking as you have only been a nurse for about a month. Ok, your gut will develop as time goes on (and I’m not just talking from break room potlucks and donuts). If you have that “bad” feeling… investigate why. There are so many times I wish I had just listened to my gut a bit more. Just last week I had a patient who I had a off feeling about. Nothing had changed in their baseline neuro exam or technically by physiological assessment. But I knew something wasn’t quite right. I told the MD, but he had no real basis to conduct any additional tests either. I told the next shift nurse about this feeling too… and the next day when I returned this man was in the ICU. Trust. your. gut.
  9. Nursing Assistants are vitally important. Y’all. I don’t think I understood just how important nursing assistants are before starting this gig. They are massively crucial to our success and the patients’ success. The nursing assistants on my floor are brilliant, many have been working for years and single-handedly keep me afloat some days. I learned (and continue to learn) a tremendous amount from them. Do not be afraid to ask them for their tips/tricks in patient care.
  10. “Thank you” goes a long way. This may seem elementary, but as a nurse, you begin to understand the weight and gravity of a thank you. Give thank-yous out like candy. They are free to give and priceless to receive. Thank your housekeeping staff, your charge nurse, your transporter, your nursing assistants, the previous nurse who tried her best to get loose ends tied up for you, doctor’s, PT/OT who helped your patient walk for the first time since surgery. We are a family in healthcare, and it’s so important to remind them they are all appreciated.
  11. Make recommendations, and happily accept constructive criticism in return. ISBAR- the “R” (for recommendation in communication) is especially hard for a new nurse, but do it anyways. You will get some MDs who will make you feel as if your idea is the worst possible idea they have ever heard. You will also have others who will kindly suggest an alternative. And EVEN some who will accept your recommendation. Regardless of the response, ask them to explain the reason behind the intervention/order/medication, and then thank them for taking the time to explain. It will go a long way in developing rapport among you and the provider.
  12. Go the extra mile. Cue the eye rolls from my nurses in the back. I get it, we already are given an impossible to-do list every day. There is no way to go the “extra mile”. Or is there? When I first began, I barely saw my patient. I only saw the to-do list. I barely had time to be with them, because I was just trying to get it all done. Yes, this is the way of nursing now it seems, but sometimes, just taking the tiny extra seconds to hold their hand and say, “How are you” at the beginning of a shift or offering an extra pillow can make all the difference. This one takes time to conquer, but you’ll get there. I am still learning how to do this, and it takes reminding myself daily to just look the patient in the eye and not just to examine their pupils.
  13. ASK ALL THE QUESTIONS. Not sure how I didn’t have this listed as number one… but ask every question. Do not assume ANYTHING. You will feel like you are grating the nerves of some other nurses, but you will learn who your best resources are. Remember, a little annoyance is nothing in comparison to someone’s life. Even the slightest bit of doubt, check it out!
  14. ‘You time’ is necessary time! “On the clock” for us is a fight of life vs. death. When you are off the clock embrace your life- do what you need to do to take care of you. Go for a walk outdoors, exercise, do yoga, pray, write a letter to your friend who lives far away, get a massage (get multiple massages), pedicures, go out for a nice dinner, nourish your body with healthy foods (and nourish your soul with dessert), travel, or do nothing at all. Find what helps you relax and disconnect. I didn’t want to be social at all for a good six months and found myself in a hole of isolation and depression. I didn’t think I had the energy to do anything. But once I started making plans, planning trips, etc. things started turning around quite a bit. Find what works for you!
  15. It’s worth it. Oh my sweet fellow baby nurse, you don’t know if you will survive, but you will. I know it’s hard to believe, but things will get better. People would say that, and I just didn’t believe them. Have faith. You are stronger than you think. This year, yes it is hard, it’s probably the hardest thing you have ever done, but it’s worth it. When you see your competence start blooming, so will your confidence. When a patient tells you that they will never forget you, it’s the most rewarding feeling in the world. Through this whole process you are impacting countless lives and countless lives will impact yours. Soon you will have forever-in-your-heart moments, unforgettable connections to patients, and “good” days under your belt, or stethoscope rather. Write them down and remember them. Because at the end of the long twelve hour shift day, there is no amount of fear, anxiety, or bad days that can overshadow the honor it is to save a life.

Go get em, Rockstar! You’ve got this!

Ohh, and never use the “Q” word. Never, ever, ever use the “Q” word.

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Napa & Sonoma Part Two… & Graduation Day!

Annnnd here we are! Round two!!! Welcome welcome to perhaps one of my favorite recaps of all time. I am going to conclude our incredible time in wine country (if you missed part one, peep it here) then recap the rest of last week. I’ve just caught up with my favorite Peet’s barista while holding up the line (apologies to my fellow coffee addicts), have a cup in hand, and am situated in my favorite spot looking out the rain sprinkled window for the next couple hours. I don’t have any studying, applications, projects, or any other big “must dos” on my to-do list for the first time in years. I feel like I am breathing, really truly breathing. And this oxygen is quite nice. Inhale, exhale, sip some cafe au lait, repeat. Join me?

After we finished up at the brilliant Castle, we headed over to Frog’s Leap winery. I would say if you only have limited time in Wine Country Rambauer and Frog’s leap are the two I would recommend. Also, Kalpana, a friend that lives in Los Gatos, shared some amazing tips as well in the comments of the last post, so definitely take time to read those over too if you are looking for suggestions!

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Frog’s Leap is what I would equivocate to heaven on Earth. It is a floral oasis with winding gardens in the middle of a quiet cozy valley. Reflecting on it almost feels like a dream, the warmth of the sun and the wine as we walked around the Switzerland remnant abode nearly left me half expecting Julie Andrews to start serenading the visitors with Sound of Music.

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Halfway through our exploration of the majestic vineyard, I remember telling my mom no amount of pictures could do this place justice. And now I will say it again! Darn, guess you’ll just have to visit it yourself!

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Maybe I should put those sunglasses to use? Just an idea?

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We reluctantly left this ethereal destination only to follow a path just as beautiful onto our next destination. At one point we had to stop just to take in the most stunning natural spring of flowers we have ever seen!

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Adoring God’s creation can really work up an appetite. We headed to Mustards Grill upon my Uncle Pat’s recommendation. Good thing I just had a snack because even looking at these pictures my stomach is growling again! O my lanta, if you need a place to eat in Wine Country, I’ll tell ya, your decision is made- GO here!

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We started with the BEST calamari dish ever… crispy calamari with curried slaw and fresno chili. Yumayumayummm.

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Deej had their half Pound niman Ranch Hamburger or Cheeseburger, house-made pickles, french fries. I love how everything has a little touch of Mustard too on their dishes.

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My mom and I of course split their special Halibut. And we also split a glass of their recommended pinot grigio for the halibut. I am not even kidding, this halibut was some of the best of all time. And for it being split, they gave us such a generous serving. We didn’t leave one nibble to be consumed. It was tremendous. It was so good that momma Jill decided to purchase a cookbook to take home. Her and Pete like to collect books from places as souvenirs. Such a fun idea!

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We then headed to our last stop for the day- Domaine Carneros.

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This chateau is the oldest sparkling wine house in all of Napa.

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It’s pristine winding staircases leading up to a mammoth mansion overlooking the miles of vineyards, mountains, and rolling hills was a picturesque site to behold..

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We tried their sampler of sparkling wines with some roasted almonds. Once again, hate to be the bearer of bad bubbly, but we all agreed we preferred our Almond sparkling wine from Trader Joe’s.. Maybe we just didn’t try the right ones?! Certainly worth the experience though!

DJ had to head back that evening to work the next day, but my mom, Pete, and I watched Fixer Upper and ate our leftover desserts. Pete was feeling much better by this point!

That evening my mom handed me a big thick envelope. I had no idea what it could be. Inside were pages on pages of prayers she has wrote out for me through this year . I have cried reading her cards in the past, but this just pulled the heart strings next level. This was one of the most special gifts I have ever, EVER received. I still haven’t finished them all yet, it may take a while, but I cry every single time I read one. She has always set such a great example for us of what it looks like to be in true relationship with Christ and how prayer is not just about requests or bringing struggles, it’s about the conversation. The prayers are so real, honest, and raw. I truly believe the only reason I made it through this year was because of her and others’ prayers. I did not make it through on my own strength, there is no way. Thank you again, Mom<3

In the morning of Monday the 12th, I headed back a bit before my mom and Pete did to get my speech finished up for the next day, to run a couple errands, and do a quick couple loads of laundry. I was just following my GPS and lo’ and behold, stumbled right on through the Golden Gate. Don’t you love it when that happens?

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In the evening, we all met at Willard Hicks in Campbell. DJ and I have wanted to try this place out for a while, but it’s near impossible to get a reservations.

Time to put this place to the test! DJ’s mom, Laura, who hasn’t been here in a YEAR (you may remember this epic weekend), was able to come for graduation! It meant the world that she wanted to come in the first place. She has been one of my main shoulders to lean on and always an ear to listen through this wild ride of a year <3

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So with the WH— LOVED the ambiance. I was expecting a pretty fancy steakhouse, based on the menu and wait, but it had a more casual sports bar feel, yet with a touch of pizzazz.

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We started with the exquisitely exotic willard hick’s baked brie. It came with phyllo wrapped baked brie with roasted veggies, whole roasted garlic (like still in the bulbs), dried fruit, chutney, and crostini. I probably do not need to even rave about how fantastic this was.

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We also had to try their iron skillet poblano cornbread. This may have been my favorite part of the whole meal. The sweet creamed corn was perfectly moist (sorry moist haters). We savored every single nibble.

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For entrees (everyone in my family is a saint for letting me be “That” person snapping pictures of their food)… anyway, Pete tried their awesome short ribs!

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Of course, my mom and I split the scallops with some of the most delectable mushroom risotto to ever grace our taste buds. The scallops were cooked to savory perfection and the small little critters carried the most divine flavor!

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Both DJ and my mom in law had the swordfish. Of course I snuck a nibble- it was mmm mmm mmm good!

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Sides- Butternut squash, Horseradish mashed potatoes, & Brussels. Can’t go wrong with those!

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I love these people more than words can say!

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The next day, March 13th, was graduation time!!!! I have yet to do a one year reflection post, and I will save most of my thoughts for that. But this was a HUGE day. HUGE. I honestly didn’t think I would make it to this point. I presented my research project that I have poured endless hours into, gave my speech (which went very well- thank you for your prayers & encouragement about that!), and lastly was given a certificate that I prize more than my high school or college diploma. This certificate states that I completed the Residency program, but to me, it symbolizes surviving the hardest year of my life.

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Also, I am so excited to share I was nominated Employee of the Month! When I saw the announcement in a staff e-mail I thought it was a mistake, or that there was perhaps another Mackenzie on our unit I was unaware of. Surely, it couldn’t be me?! This warmed my heart more than I can express. I feel like I fail and am incompetent on a daily basis, but it was beyond affirming that others think otherwise. I do not at all feel deserving, but it just motivates me to live up to the honor! Within a couple weeks I was accepted into my first choice for grad school, graduated from my residency program, had the most tremendous memories with my family, and then this?! Too much to handle. God is good and He is faithful. I was able to show my family the unit I work on, and of course my mom whipped out her phone for the picture below as I started blushing and quickly walking away. lol. It was great to finally show them where I work though after endless  conversations over this past year about it all!

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To celebrate, I was having a hankering for True Food kitchen which is nearby the hospital. Subconsciously, I think there is a reason I was craving this. After I took my NCLEX nearly a year and a half ago, DJ and I celebrated by going to True Food. I think it has officially become the place to go after super high stress events?!?

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I love that all the food is organic and wholesome, but it’s also annoyingly delicious (annoying meaning I crave it allll the time, but can’t get it enough to satisfy my craving).  Anyone else get that? All the girls tried the thai grapefruit martini… absolutely refreshing and not too terribly sweet.  Pete had their bloody! Can’t go wrong with a good bloody.

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Meals! Boy, can we eat. Us girls tried variations of their ancient grains bowl, which is my favorite thing I have had here yet (although their fall butternut squash and ricotta pizza is pretty flame- wood fired to be exact). This included miso glazed sweet potato, turmeric, charred onion, snow peas, grilled portobello, avocado, and hemp seed. Definitely something that could be recreated (although I probably could never make it taste quite as yummy). You can add shrimp, tofu, chicken, or steak too!

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DJ had their TLT again (tempeh, lettuce, and tomato). SO GOOD. You would never know the bacon wasn’t bacon.

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Pete had their spicy panang curry with organic potato, long bean, bok choy, carrot, thai basil, and coconut shrimp broth with chicken! I’m telling ya, their menu is super diverse- something for everyone!

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After the amazing lunch, DJ had to go to work, and Pete decided to take a little nap back at home. However, the ladies of the group were not about to turn down a stroll through a mall. We waltzed and frolicked (inside blog joke, anyone?) through the mall. It was a blast. Even the next day we were talking about how much fun it was to just peruse the mall together.

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Last, I just want to share something pretty special. When we were at Casillo Di Amorosa, my mom suggested we both get bracelets as a sweet way to remember our trip. We both picked out our own special color, and usually I would go for a neutral tone, but I couldn’t get over how pretty the periwinkle-like purple was. A couple days later I opened up a gift from my mother-in-law. I was blown away by the thoughtfulness of the gifts (I’m saving a couple for a Friday Faves), but I want to share one. This gorgeous necklace is Amethyst. She explained the amethyst represents healing powers and that this is what I give my patients. I cried when I read this. So beyond thoughtful, and something I will forever treasure <3

I also realized both the Castillo di Amorosa stone matched the amethyst and loved how well the two go together. Wearing this jewelry will always remind me of the strong, prayer warrior women that have been my rocks to stand on, my source of wisdom, and my encouragers.

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I have never been so emotionally, physically, and mentally exhausted as I have been this past year. And yet, in this moment I have never been so utterly fulfilled. Thank you for coming on this journey with us. Love to you all.

xo <3

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