| So now you are close to graduating from nursing | | | | aide. One thing that you must strive for is to use an |
| school or you have graduated recently. Whichever | | | | even tone of voice, and fairness when delegating. |
| the case, you will be in for a reality shock when you | | | | You must also remember the rights of delegation, |
| begin your career as a Registered Nurse. What do | | | | which are as follows,a. the right task,b. the right |
| we mean by the term, "reality shock"? Well, like the | | | | person,c. the right communication, (must be clear and |
| term says, it is the reality that shocks us. The | | | | concise),d. the right feedback, (the person who is |
| question you may ask is, "so there is a difference in | | | | delegated the task must comprehend what it is that |
| the reality of being a student or graduate nurse"? | | | | is asked of them and let the nurse know that they |
| The answer is an emphatic, YES! | | | | comprehend). By doing this you are ensuring that |
| First of all, as a student nurse you were given | | | | patient care will not suffer do to a personality glitch, |
| assignments that were not beyond the scope of | | | | which could have been avoided. |
| your practice or ability. In addition to that, you were | | | | 4. Know, know and KNOW where the Policy and |
| working under your instructor's license and whether | | | | Procedure manual is located on the floor. Part of your |
| or not you were aware, they kept a very close | | | | hospital in-service will include the introduction of the |
| watch on you. Therefore, there was a safety net | | | | Policy and Procedure Manual. This is the manual that |
| that always hovered beneath you in case you were | | | | you will have to refer to many times for protocol |
| to fall. This is not the case as you take on the title, | | | | from everything from changing out a Foley Catheter |
| Registered Nurse. There is no safety net. You are | | | | to transporting a patient to another floor. The final |
| out there by yourself, free to make decisions and | | | | analysis will be in any investigation, "did the nurse use |
| make mistakes. With those decisions and mistakes | | | | and follow the Policy and Procedure Manual?" You |
| you are also, FULLY ACCOUNTABLE. | | | | want to always be sure that you follow the rules and |
| Now imagine yourself with eight or more patients. | | | | protocols contained in your institutions manual. |
| You may be asking yourself, "What do you mean | | | | Therefore, you should know where it is located and |
| eight or MORE patients?" Most student nurses never | | | | be familiar with how to look up various procedures |
| have more than six or seven patients and that is only | | | | and policies. |
| at the very end of the program. Even then, the | | | | 5. the policy regarding medication errors. Most |
| student nurses can delegate tasks to assistive | | | | everyone makes them and it is crucial that you know |
| personnel thereby lessening their work load. | | | | what paperwork is required to be filled out. It will |
| However, there will be time that you will be on a | | | | come in handy. You cannot just, "wing it", when |
| floor, without any assistive personnel, with more than | | | | making a decision, you have to follow protocol. |
| eight patients and no one to rely on except yourself. | | | | 6. Use assertive communication when interacting with |
| To compound this scenario, there may be patients | | | | doctors'. Assertive communication indicates that you |
| that have very critical care pathways that you must | | | | are aware of yourself and your limitations as well as |
| follow, incoming calls from patient's families, doctor's, | | | | your liability to the patients that you care for. Using |
| operating room staff, and other collaborative care | | | | this form of communication with over assertive |
| departments requesting information. | | | | medical personnel will help you function to your |
| Now, let's stop this scenario in its tracks. You | | | | maximum capability and earn respect as an |
| probably feel the stress building by just reading the | | | | independent care professional. {For more information |
| previous passage. If so, don't worry, it is a perfectly | | | | on the uses and strategies concerning assertive |
| normal reaction. So, relax, and know that there are | | | | communication, please refer to the text entitled, |
| ways to ease this inevitable right of passage. Let's | | | | Nursing Today, Transition and Trends, by JoAnn |
| take a look at some of the ways to help ease and | | | | Zerwekh, Jo Carol Claborn, 5th edition, Co. 2006, |
| deal with reality shock. | | | | Saunders, Philadelphia.} |
| 1. First of all, it is important to understand that, | | | | 7. Ask questions. You will have time during your |
| "reality shock" does indeed exist and you will come | | | | in-service training to ask questions and get answers. |
| face to face with it. Knowing what you will face is | | | | It is your right to do so. Remember, not knowing is |
| most of the battle. The task at hand then becomes, | | | | not an excuse, and you do not want to be in a |
| knowing what steps to take and resources to use, | | | | situation where there will be no-one to ask. This is |
| and how to use them. | | | | not to say that you will know everything, but a least |
| 2. Learn as much as you can during your in-service | | | | you are giving yourself a head start and a good solid |
| training program, which usually lasts up to eight | | | | foundation by knowing what you can. So don't be |
| weeks or more. This means familiarizing yourself with | | | | afraid to ask. Also, know who your resources are, |
| every inch of your floor. Know where everything is | | | | for questions that you may have on the shift that |
| located, from safety pins to I.V. tubing. You may | | | | you will be working. |
| never know when you may need it, NOW, and the | | | | 8. Find a mentor with whom you can relate. Try to |
| worst thing that can happen is that you spend | | | | find someone not only on the shift during training, but |
| precious time looking for something as small as a | | | | also on the shift that you will be working. It is nice to |
| safety pin. | | | | find someone who has the experience and |
| 3. Know, who the assisted personnel are, and know | | | | understanding as well as someone that you can get |
| them by name and face. Find out who will be the | | | | along. There might be a time that you will want to |
| ones that you will be working with during your shift. | | | | call them in the middle of the night and vent your |
| What usually happens during in-service training is that | | | | concerns, or just to have them give you positive |
| graduate nurses train on the main shift, which is most | | | | input in your performance. Mentors are essential to |
| frequently days, before transferring to the shift that | | | | the growth of a new nurse. |
| they have been hired to work. Therefore it is very | | | | 9. Lastly, Know, Know and Know, what your State |
| important to know who you will be working with | | | | Nurse Practice Act states. This Act, is your guideline |
| during your shift. Try also to develop a working | | | | for most all that you do as a Registered Nurse. Know |
| relationship with the assistive personnel. Remember, it | | | | it well. |
| is not a popularity game, you are not out to make | | | | Hopefully these tips will help to ease the reality shock |
| best friends. Your goal is quality patient care, and the | | | | that you will face during your transition from student |
| patient comes first. | | | | nurse to full time graduate nurse. Remember, you |
| Let your intentions be known that your number one | | | | can't do it all. You are a welcome asset to your |
| goal is to give the best patient care that you have | | | | employer, but first and foremost an embodiment of |
| respect for the care team assistive personnel and | | | | all that Florence Nightingale stood for. Best wishes on |
| are a willing and helpful body to them as well. In doing | | | | your journey. |
| this, you will have disabled the invisible wall that exists | | | | Learn more about nursing education at The NET |
| between nurses and assistive personnel. That wall is | | | | Study Guide. |
| the one entitled, I am a NURSE and you are ONLY an | | | | |