20 Tips for New Nurses in the Hospital

As a new nurse you still have so much to learn, so plan to arrive about 30 minutes early to prep for your shift. Look through the chart for your assignment and write down admission diagnoses, the care team, when meds are due, and vital-sign trends. Note any upcoming procedures or tests. This keeps you organized and gives you context when you get report.

Get plenty of sleep and have the mental alertness to care for 4–6+ patients at once. Bring your must-have gear — a stethoscope, penlight, nursing shears, and pens. Whenever I forgot one of these, my shift was always worse for it.

New-nurse life is anxiety-provoking and stressful, but a negative attitude rubs off on patients and coworkers. Don't get into the habit of complaining — it can tarnish your reputation as a new grad. This doesn't mean you can't speak up for yourself or your patients. Even if everyone around you complains, stay positive.

Not to mandatory overtime — to learning opportunities. If someone offers to let you watch or assist with a procedure, say yes. There's still so much to learn and experience to gain, and you only get it by saying yes. It also gives a great impression, because new grads are expected to be eager to learn.

Humans are habitual; once you build a system, the rest falls into place. Write important information on your patient-care sheets so you have quick access. If you don't write it down, you most likely won't remember — especially juggling 4–6 patients. Keeping everyone straight takes time and experience, so until then, write it down. See How to Stay Organized as a New Nurse.

Getting comfortable with the charting system takes a while, so it'll be slower at first. Focus on patient care first, then the charting. Once you're proficient, I recommend real-time charting when possible to boost efficiency — but pressing patient care always comes first. See Top 6 Charting Tips for Newbie Nurses.

This isn't nursing school anymore — you're allowed to look everything up. Nursing is an open-book occupation! If you're not sure of something, either ask someone or look it up. There are so many valuable resources at your fingertips.

Don't just use Google or Wikipedia — use evidence-based resources. Most facilities offer an UpToDate subscription you can often log into from your phone after authenticating at work. Other solid options: Medscape, the Merck Manual, FP Notebook, and WikEM. For drug info, UpToDate or Epocrates. Also read your facility protocols — they're packed with how your facility expects you to handle specific situations.

Humility matters now. Even if you did great in nursing school, you have so much still to learn. Some people overcompensate when stressed by acting like they already know everything — one of the biggest mistakes a new nurse can make. Letting pride stand in the way of learning is dangerous to your patients. Even if someone teaches you something you already know, just say "thank you" instead of "I know."

If you're not comfortable with a procedure, ask for assistance — nobody expects you to be an expert. You're a new nurse and you're expected to speak up. Not doing so can harm your patient and means you won't learn for next time. And if you're drowning, ask another nurse or the charge nurse.

Sometimes you're unsure what to do but don't necessarily need the provider yet. Blood pressure high but not sure if it's high enough to worry? Ask another nurse, preferably one with more experience. This saves you from calling the doctor for every little thing. With time you'll learn what to simply document versus what truly needs a provider.

School being over doesn't mean studying is over. Use the resources above to read on your days off — not all day, but always be committed to learning. Make continued education a top priority. I attribute a large part of my success as a nurse, and later as a young NP, to this.

Learning to give a good report takes time, and not every report you hear is a model to follow. It becomes especially important relaying information by phone to a provider unfamiliar with the patient. Nursing school teaches SBAR, but I always felt it left gaps, so I modified it into the IMSBAR — adding the patient's information and relevant diagnoses before the SBAR. Read more in Calling the Doctor.

As a nurse you now have the responsibility of delegation — requesting tasks from CNAs, techs, LPN/LVNs, and sometimes other RNs. This doesn't mean they must do anything you say. Never have an elitist attitude. When you delegate, make sure the task is appropriate for their skill level and the patient is stable, and give clear instructions.

Don't delegate tasks you can easily do yourself. If you're slammed, of course delegate a bedpan or an EKG. But if you have the time, just do it yourself — your CNAs and techs are busy too, and you're a team. Always have a kind demeanor and never talk down to someone. If they refuse, delegate elsewhere or do it yourself, and bring concerns to your charge nurse.

Nursing is hard work and time flies in a tornado of stress. Your department should have a system entitling you to breaks — don't refuse them. Even with charting left, take your break, eat, and relax. Most facilities give one 30-minute and two 15-minute breaks for a 12-hour shift. And don't chart during your break — use it to recharge.

Take care of your body while you work. Use proper body mechanics when lifting patients, wear compression stockings and comfortable footwear, and don't hold your bladder all shift — your patients can spare the few minutes (outside a code). And drink plenty of water: if you "just don't have to pee," you're probably not drinking enough.

It's common to stay late as a new nurse to finish charting — a necessary evil. But don't let anyone guilt you into clocking out before you actually leave. If you're charting, you're still working. Clock out on your way out the door so you're paid for all your hard work.

On your days off, prioritize yourself and your mental health. Take a short trip, travel somewhere fun, read a non-medical book, or go swimming with your dog. Whatever it is, don't devote all your time off to nursing. Keep learning, sure — but protect plenty of non-nursing time too.

Once off orientation you'll be eligible for overtime, and management will take advantage of that. Extra money sounds fun, but is it always worth it? If you're being pressured to come in and don't want to, you don't owe management or your department your time off. They're responsible for staffing — the blame for short-staffing doesn't fall on you. If you want the OT and the extra money, go for it; just don't burn yourself out.