How to survive your first year of nurse training...

By the end of the first year, one thing is certain. Your year group at uni will not be the same size when you finish. For us 09/08 students, I think only about 60% survived the first year. I identify 3 critical stages: Early drop outs, after placement drop outs, and "I failed everything" throw outs.

After stumbling through my first year and comming out the other side here is my guide to surviving the first year of nurses training.

Rule 1

Attitude. Come to terms with the fact that you are not in fact Florence Nightingale. You are not the best thing to happen to nursing and your gonna muck up spectacularly one day. How you deal with that may be critical to your career, or possibly just hilarious to your co workers. (maybe indulge you with that story another day ;) Take criticism on the chin, and expect that you will be scrutinised and pulled apart left right and centre. This is usually by people in management, relatives, and your own worst enemy - Yourself. Quietly and thoughtfully reflect on these times, and learn from them. Change what you did wrong and be open to feedback from qualified staff. Remember that relatives, especially in child branch nursing, are experts of the child you are caring for. Not matter how high up the ladder you ever get, don't ever forget this. You are in a privileged position talking care of their loved one.

Rule 2

"I want to be a nurse because..." No matter how passionate you are about being the best nurse you can be, please do not be cringy. This counts from your first interview for uni till the day you retire. Come up with a intelligent and interesting reason for wanting to be a nurse. Don't just tell people "I'm a caring person, I want to help people." Your interviewers and lecturers will be secretly wanting to put their fingers down their throat's. Get a good enough answer and you'll even gain the respect of doctors! (Bowing also helps, as does making them tea, and doing their Ob charts before they get to their patient.)

Rule 3

Take time out. Doing well does not mean burying your head in text books and filling your spare time studying. Yes do extra reading, subscribe to nursing magazines, but keep a balance. If you read text books on the train home your on the wrong tracks. Forget who you are and you'll either become a text book nurse (which in my opinion is not ideal) or a burnt out drop out. Reflection is key to becoming a nurse. You wont do that with your head stuck in a textbook. Read a bit, think a bit, live a bit, and then apply that to your nursing. (Obviously if the living part includes a drink or two on a Friday night, please do not use that as anything influential to your carer!)

Rule 4

Be honest, and know your limitations. It is not nice to be a 1st year student. You are often treated like you know nothing, and are capable of only the simplest of tasks. Do not get so frustrated that you feel the need to prove you know more than you do. When you get to your first placement, ask this question "What am I not allowed to do?". You will be given a list of things such as not giving drugs without supervision, not taking a patient to theatre alone, neuro ob's, oxygen administration, etc etc. You then need to add to the list everything you do not confidently know how to do. Please be brutally honest with this. There may come a time on a busy day when somebody asks you to do something that could potentially be harmful to your patient. I cannot stress the importance of this, you are accountable for your own actions. Being just a student is not an excuse. If you are not sure if you can or are allowed to do it, don't. And whilst we are on the topic of honesty, be very very careful making promises. Much better to say "I'm gonna be here for you" than "everything is going to be OK".

Rule 5

Make the tea, and answer the phone. If you want to be respected this is key. You will be called "The student" You are a student. Shrug off being called one and make a decent cuppa for everybody. Later they will show you how to save lives and help to shape you into the nurse you want to become. If they don't their just a bully, take action on this if it's serious. (More on speaking up another time)

Rule 6

Confidentiality. Don't be tempted to gossip, and don't blog and include real situations. How would you like to have an enema then have the nurse discuss it on her way home on the bus? This is serious stuff, having a facebook status like "Had a bad day today, had to shave bed 5's pubic region and he hadn't washed for days" just isn't fair. And for all you know, Bed 5's aunts friend is your friends sister, who See's it and gets you thrown out of nursing. On that note this description bares no resemblance to any real person or situation, and confidentiality has been abided to in accordance the The NMC Code (2008) Yes, referencing is also something you gotta learn too.

Rule 7

Every patient has a name, and don't ever do what I did above and refer to people by their bed numbers or condition. Get to know your patient as best you possibly can and you'll be a better nurse to them. I say this because I think you can always so this to some extent, even if it is just a short introductory chat when you come onto shift.

Rule 8

Make health care support workers your first friends when you get to a ward. They will show you how to make a bed on your first day. They will show you the machines and what buttons to press. They know where everything is kept. They keep the ward chugging along. They are as valuable as sister or matron. Work with them and they will support you. Work as if you are above them and you'll lose the respect of possibly the whole ward staff.

Rule 9

Cry, not on the wards but in the privacy of your own bedroom. Preferably in the arms of your chosen loved one if possible. Not gonna lie, its an emotional journey. Don't feel immune at uni either. I remember one lecture on lung conditions, several students walked out during a video about lung cancer. A couple were smokers who did not like being shown what smoking can cause. The majority of walkers had endured painful experiences brought back to mind through the teaching. If you can, sit through it calmly and collectively. Its good practice for the wards. You shouldn't walk out on your patient when you find out that he has what your cousin had. Yes you need to deal with it, but put them feelings into a filing cabinet to deal with safely later that day. Just don't forget you filed them, which is worse than just walking out...

Rule 10

Hold onto the people who make your journey to becoming a nurse that much easier or enjoyable. That means everyone from your parents, to your partner, your friends, and even your new found work colleagues (if you make them enough tea). Make time for them, keep their numbers and email addresses safe.

In addition to these rules, here are a few other words of wisdom.

-Buy some really unattractive but comfy shoes for the wards.

-Keep two small notebooks in your pockets, One scrap one for writing observations and messages down, and the other to jot down things learnt on the ward. Scissors, numerous pens, and a fob watch are also essential.

-Don't tell your patient you are recording their respiration rate, ever been told someone is counting your breaths? You don't breath normally. Do this sneakily while you wait for the B.P to puff up. It can be hard to see with young children, I always ask them if i can put my hand on their tummy so i can feel instead if I'm unsure.

-Try where you can to go back to basics. Take observations manually because you never know when your equipment wont be to hand or will be on the blink. Remember that observations aren't just sticking on the machines on patients and recording the results. A child's colour will tell you more about whether he is getting enough oxygen than the saturation monitor on his finger.

-Communication is the back bone of nursing. Practice it from your very first day, at every opportunity possible. You wont get it right every time however. Learn the art of non-verbal communication. The understanding smile. The "I'm listening" pose. The encouraging pat on the back...

-And what ever your do, be professional. That means how you act, how you look, what you say, and how you behave.

I hope I can get better at all of this and everything else I learn during this next year.