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Lessons learned in my first year as a Registered Nurse – by Laurie Bickhoff


As my last shift in the graduate nurse transition to practice program approaches, I couldn’t help but reflect back on the last year.  It has certainly been challenging at times but also unbelievably rewarding.  There has been laughter and friendships formed.  There have been farewells and even tears shed.  Above all, and I think I speak for all graduate nurses, when I say there has been non-stop learning.

So I thought I would share some of the thing I have learnt during the program.

One of my first lessons was time management.  I quickly learnt this can make or break your shift.  Suddenly all those University assignments where we had to prioritise our care, became reality.  There were shifts when I struggled, when I felt overwhelmed and was eternally grateful for my iron clad bladder control.  But at the end of the day, I would leave the ward with a certain sense of satisfaction that I made it through and brainstorming new ideas and strategies on how to do better next time.

I learnt that no nurse is an island.  Nurses work as part of a number of different teams.  Even the hardest shift was made that much easier when surrounded by great people.  My teammates were there to lend a hand, give advice and even a provide shoulder to cry on.  They kept me going with their unique sense of humour and unwavering support. Often, they were the reason I came back, shift after shift.

I learnt that the cares nurses provide are anything but basic.  Ask any patient, and I’m sure they will all agree, the care we give is truly essential.  We are with our patients when they are at their most vulnerable and exposed.  To care for them during these times, maintaining their privacy, dignity and morale, whilst also mentally completing skin and mobility assessments and forward planning discharge requirements, is an often unrecognised skill of an RN.

I learnt there are some smells that you will never get used to or ever be able to forget. I was taught the importance of shallow mouth breathing and new uses for Vicks vapour rub.

I learnt chocolates don’t last long on a ward, so you have to get in quick. But they sure do come in handy at about 4am on night shifts to help you push through those last couple hours.

I learnt that advocating for my patients can take a number of different forms; from nicely asking their visitors to leave when I saw them getting tired, to tracking down the Resident Medical Officer to review their analgesia (pain medications) or ensuring the consultant has the end of life discussion they have been asking for.

I learnt a mile long list of new acronyms and just when I thought I had them all down pat, I was handed a brand new list to learn for my next rotation.  I am also well on my way to becoming an expert at deciphering doctors’ hand writing.

I learnt to listen to the patient who says “something doesn’t feel right” and began to trust my own instincts when they told me the same thing.

I learnt the importance of debriefing and reflecting.  I now know that not all shifts will be great, but hopefully the good ones will keep out numbering the bad.  I realised just how essential it is to have good friends and family around, especially when they have a steady supply of wine and chocolate.

I learnt just how much caffeine I needed to get through a morning and then doubled it whenever I was on a quick shift*.

I learnt there is a big difference between being a student nurse and an RN. The first time I had my own students to supervise, I was filled with a whole new level of appreciation for the patience of those nurses who supervised me.

I learnt documentation never ends and just when you think you’ve finished, you find another form you forgot to fill out.

I learnt there are all types of patients – from quiet and timid to loud and cheery, from positive and eager to grumpy and despondent. I soon realized each patient was going through their own unique journey, and I could play a large role in making that journey more enjoyable, or at least a little easier to bear.

I learnt we are not “just” nurses.  We are registered nurses with skills, training and education worthy of respect.

To those that taught me these lessons, I say thank you. Thank you to educators and NUMs (Nursing Unit Managers), to my mentors and every nurse who has helped along the way. Thank you to the medical teams who took the time to teach me rather than just brushing off questions. Thank you to the wards clerks who pointed me in the right direction when yet again I was struggling to find things. Thank you to everyone who made me feel welcome and a part of their team.

Most importantly, thank you to the patients.  Thank you for letting me practice my new skills on you.  Thank you for the tips and advice you shared and for the jokes you told when you saw I was having a bad day. I will never truly be able to tell you just how much I appreciated your understanding and encouragement.

Soon the next intake of graduate nurses will join our teams.  Many of them will look to those who have just finished the journey they are starting, for guidance and leadership.  I hope everyone working in positions to help mentor and teach our graduate and early career nurses, might remember this quote by Veronica Croome:-

“Challenges in leadership are to be strong (but not rude), kind (but not weak), bold (but not bullying), thoughtful (but not lazy), humble (but not timid), proud (but not arrogant) and have humour (without foolishness)”.

* A “quick shift” is when we work an evening (finishing at 10pm) followed by a morning (starting at 7am).

Laurie Bickhoff was chosen as one of the Australian College of Nursing’s five Emerging Nurse Leaders in 2012. You can read her previous article on My Health Career “Why I wanted to become a nurse.” Laurie can be contacted via email:





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