Practical Nurse (PACT)
Veterans Health Administration · Tampa, Florida
$61,000–$79,000/year
Ask the question, even if you asked it yesterday. Being embarrassed for a minute beats spending the whole shift unsure.
Coming off orientation doesn't mean you stop asking for help. Find out who you can go to before the shift gets busy.
You can be nervous and still have a good first clinical. Show up ready to listen, and tell your instructor when you need help.
Learn where the supplies are. Knowing which cupboard to open saves a surprising amount of stress.
Keep something in your week that has nothing to do with nursing. You still get to be a person when you take the scrubs off.
Get to know the techs and CNAs, and help when you can. A shift feels different when you know you're looking out for each other.
If you and your preceptor aren't clicking, talk to your manager. Ask for a different approach, or a different pairing.
Let your preceptor finish explaining, then ask why. Understanding the reason will help you remember the next time.
A feed full of bad shifts isn't the whole picture of nursing. Ask people about the ordinary days, too.
Make one plan for your day off that you actually want to keep. It helps to have something to look forward to besides being done with work.
At clinical, ask what you can help with instead of waiting in the hallway. Check with your instructor before trying an unfamiliar skill.
An experienced nurse still has questions. They've just had more practice knowing who to ask.
Call for help the minute your patient looks off to you, not once you are sure. Needing help is not a mark against you. It puts more eyes on the patient, sooner.
Thirty-four years in the ICU and there is still plenty I do not know. The nurse who keeps asking questions is the one giving good care.
“The most important practical lesson that can be given to nurses is to teach them what to observe.”
Some shifts end with you crying in your car because it all catches up at once. That is allowed. Just say out loud, to someone you trust, that it was a bad one.
Get certified in whatever you keep gravitating toward. After my wound care certification it was like new glasses: I saw what I had not known to look for.
“Willingly, had they accepted me, I would have worked for the wounded, in return for bread and water.”
When you are unsure and everyone else is slammed, try this: if another nurse walked up and put that exact question to you, what would you tell them to do?
Someone on clinicals may say something that has you wondering if you are cut out for this. Do not take it to heart. A couple of bad days are not the profession.
“The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest.”
Lean on the people who have been here longer than you, and never write off a good nursing assistant.
Three or four years went by before the overwhelmed feeling lifted, and close to six before I felt expert at the bedside. Measure this in years, not months.
“I do not see that I do much good to these wounded and dying; but I cannot leave them.”
If you and your preceptor are not clicking, ask your manager to switch you. People teach and learn at different speeds. You are allowed a better fit.
Confidence comes slowly. You will not feel ready for a long while. Then a nurse newer than you asks you something, and you hear yourself answer it.
“We tried to imagine how loved ones for whom we might be solicitous would react were they in the place of the patients whom we hoped to serve.”
Keep some distance from the chronic complainers on your unit. Of everything that spreads in a hospital, negativity spreads fastest.
Expect the unexpected every shift and at every hour of it. The part you can learn is flexibility: managing a bit of chaos, and finding something in it to enjoy.
“But time has helped to settle the question and a trained nurse’s position now is largely what she herself makes it.”
Most of what a dying person's family needs is to hear that nothing has gone wrong, that this is what dying looks like, and that they are caring for them well.
There will always be one more patient and one more paper. Your kid is only a toddler once. Do not give the people at home what is left at the end of the week.
“To do what nobody else can do, in a way that nobody else will do, despite all that we go through, that is to be a nurse.”
