What I Wish I’d Known About Nursing

  • Get a BSN. It isn’t necessarily fair, or even rational, but a Bachelors of Science in Nursing (BSN) is becoming the new standard in nursing education. Individuals with an Associates Degree in Nursing (ADN) are finding themselves increasingly disadvantaged, both in landing jobs and advancing within their organizations. While plenty of older, more experienced nurses have done well with Associates degrees, new graduates struggling to land that first job will find a BSN especially important. If you’re feeling upset or discouraged by this trend, consider that once you add in the time required to complete pre-requisite courses, many Associates degree programs are already about 3 years in length; the extra year required to obtain a Bachelors degree will serve you well throughout your career.
  • Getting a first job is harder and more time-consuming than you think. While it’s true that there is a projected long-term nursing shortage, due to the relatively weak economy many hospitals and other healthcare organizations have cut back or even temporarily eliminated their hiring of new nursing graduates, who are far more expensive to train and to retain than experienced RN’s. In short, those who entered nursing expecting employers to fight over them and compete to offer hiring bonuses are in for a rude awakening. This doesn’t mean that there isn’t a demand for nurses, and that healthcare continues to be a large and growing sector of the economy, but you may need to expand and lengthen your job search to be successful.

  • Nursing school is tough, and takes getting used to. Becoming a nurse isn’t just a matter of learning a great deal of information – it’s about learning a whole new vocabulary and way of thinking. Even the brightest and most-motivated students can find nursing school stressful, highly challenging, and frustrating at times. If you’re feeling this way in nursing school now, know you’re not alone, and trust that with ongoing commitment and dedication you’ll successfully complete your program. If you haven’t yet started nursing school, prepare yourself for a mental and emotional journey that will be tough at times; consider in advance how you’ll balance work, family and social commitments with the demands of your program. Have faith in yourself and your abilities, but be realistic about the time and effort you’ll need to be successful.
  • The gap between nursing school and actually being a nurse is very large. Nursing school will provide you the basic knowledge and clinical experience you need to be a safe nurse. But nursing school is just that – school. It can’t and won’t prepare you for the pace and responsibilities of working as an RN, which surprises many graduates. Another challenge some new nurses confront is the gap between the idealism and values that motivated them to pursue nursing, and the organizational constraints that confront them in the real world – haggling with pharmacy and physicians, negotiating shared responsibilities with testy co-workers, and placating patients who can sometimes be ungrateful or uncooperative. Nursing school will make you work hard, but like all forms of training and education it is nonetheless an imperfect preparation for doing the real thing. You can ease your work transition by being aware, up-front, that the learning curve you face as a new nurse is steep, and that feeling overwhelmed is normal.

  • When you start your career be pickier about who you work with than where you work. Many new nurses get hung up on which unit they start working on – ICU, cardiac, neuro, NICU, etc. Keep in mind, however, that this is only a first job, and where you begin your career is almost certainly not where you will end up; you may be on the unit or department you’re hired into for only a year (or even less). What does matter is that you are supported by helpful mentors and good managers, especially at the outset of your career. Working as a new nurse is challenging, and you want to have colleagues who will help you make the transition successfully. Later in your career you may find that who you work with remains your most important consideration too. Good colleagues, and friends, can make even the most challenging environments enjoyable, and unsupportive colleagues can turn what should be a dream job into a nightmare.
  • Always protect yourself and your license. When you begin working, you should have every reason to feel confident that your organization and your colleagues will work with you to deliver safe and effective care. If you ever feel, however, that you are being asked to do something unsafe or otherwise problematic, trust your instincts and speak up. Know your organization’s policies and procedures to address a potentially unsafe situation, and move up the chain of command as needed if you need to report something or someone. Always follow common sense guidelines such as minimizing distractions during medication administration, and always protect patient privacy and your own privacy by avoiding discussions of patients in public or semi-public locations, logging out of all computers or charting software, and the like. At the end of the day only you, not your organization or anyone else, is responsible for protecting the professional license you worked so hard to obtain.

  • If you’re at all uncertain about graduate school, get work experience first. For a minority of students who have a very clear idea about their professional goals, it can make sense to enroll in a masters-entry program without working along the way. For many (probably most) others, however, it’s a much better idea to get work experience as an RN before heading back to school, either full-time or part-time. While you may think you know the direction you’ll head you could easily change your mind, or learn about entirely new opportunities only once you begin working. Moreover, most employers highly value the work experience you’ll gain as an RN; even if you end up in an advanced practice nursing role, your experience as an RN will provide you valuable assessment and management skills too. Returning to school is usually time-consuming and expensive; before you make that substantial investment you want to be as experienced and as well informed about that choice as possible.
  • Don’t get into nursing for the money. This should be obvious, but if you’re considering becoming a nurse in large part because you’re attracted to the prospects of having a stable job with decent hours and decent pay, you need to think about this decision more deeply. While salaries for nurses have risen, most RN’s nationally make solid middle-class incomes but don’t earn a great deal of money. More importantly, nursing is hard work, and to be effective it requires that you genuinely care about your patients and their wellbeing. If you aren’t the kind of person who is naturally attracted to a helping profession like nursing, you’re at high risk of burning out. Nursing is not just a job; it’s a profession that demands its practitioners possess a deeply rooted set of values. Ultimately, your success as a nurse will depend on the extent to which you share those values, and the ongoing effort you make on behalf of your patients, every day.