Tricks of the trade

Your pockets are your very best friends when working a twelve and a half hour day (and especially when your are doing three on the trot). Put everything in there!

Get good shoes, therefore you need to go to Clarks and buy leather ones. Your feet will thank you! Cheapy shoes you have to replace every few weeks are pointless, and Crocs are demon shoes that make you fall on your face.

Ask questions! Yes, I am that person. If I don't understand, I will ask. It will benefit you and your patients if you find out as much as you can about everything. It doesn't mean you will forever retain that information, but you can always look things up.And don't be afraid to ask the consultants, because they quite like to show off all their knowledge and will (in theory) respect you for doing so.

Don't join in the ward bitching just to make friends. Keep your head down and get on with it. Especially if you're new.

Sign up for training. I've already done my IV course and have my sign off next week. You can't delay the inevitable, and the more independent you can be the more confident you will feel. Having said that, don't rush into things just because you feel you have to, or because you work in a busy area. Everyone works at their own pace, just because someone you trained with has completed all their mandatory competencies doesn't mean that you are a terrible nurse for not having done them yet.

The BNF is a wonderful thing, and befriend your friendly neighbourhood pharmacists! There are so many drugs out there, that sound the same but do different things, don't be the person to make a huge mistake or to omit something. Cos you will get hauled over the coals for both. The old culture of "if you're not sure then don't do it" doesn't stand anymore. Always, always check if you don't know.

It's never too early to work with a student. I had a student working with me on and off during my first two weeks and then a few weeks after my PIN came through. It really helped me realise how much I had learnt that I hadn't realised, and was a real confidence booster. It also helped that my university offered a Pre-Registration Mentorship course at the end of year 3.

Don't be afraid to change wards. I'm lucky enough to be on a rotation, so I change specialities every 6 months. Quite frankly, I haven't got a clue where I want to work. I just know that every experience I can get will be a valuable one, that makes me into a better and safer practitioner.

Be brave.
Be calm.
Go into the sluice/toilet/staffroom/wherever and scream or scry or laugh if you need to.
You will have days when you wonder what on earth compelled you to undertake such a career, and that Tesco is becoming ever more appealing. But then treat each day as a brand new start, having learnt from the fiasco that was yesterday.

Remember that relatives are concerned and grieving. They may be screaming or crying at you. But it is only because they love the person sat next to them. It is nothing against you, often you are just punch bag for their guilt, frustration and fears. Even if they say no, get them a cup of tea. It just shows that you care that bit more than the person they met yesterday who told them everything will be fine. It's the little things people remember the most.

Be on time. I get in to work at quarter to 0645, as much as I can.
And leave on time. Unless something has gone horribly wrong, then don't be that person scribbling in notes at 2000!

Speaking of notes - be accurate, be concise,  and if you end up writing 6 entries in someone's notes as thing happen throughout the day then so be it.

When in doubt, escalate. If your patient is poorly do a set of obs and tell the doctor (or whoever is in charge, or the bed manager etc) even if the obs are fine, but the person is looking dire they can order bloods, and other tests. It's better than thinking "oh, they will be alright", they might be, but unless you have developed the power of foresight don't even go there. ESCALATE, MY FRIENDS!

Don't be afraid to wean patients off oxygen.
So they've been on 2 litres for 4 days and have an SP02 of 100%? Turn that oxygen down, cos you can guarantee that's what the doctors will want, and that patient will not be going home with O2! Unless they have a specific aetiology and therefore require oxygen, of course :)

Take your breaks! You deserve them, and you need them.

Similarly, go and have fun.
You do an amazing job that many people just are not cut out to do. So enjoy your days off.

Finally, and not to end on a downer, but if you have made a mistake or an omission then admit to it. If appropriate complete an incident report. Other people may learn from this and systems that may be failing can be changed as a result. You might not be the only person to report this.