Tips For New Nurses: Advice on How to Succeed

0:00:01 - Intro

You are listening to the National University Podcast.

0:00:10 - Kimberly King

Hello, I'm Kimberly King. Welcome to the National University Podcast, where we offer a holistic approach to student support, well-being and success the whole human education. We put passion into practice by offering accessible, achievable higher education to lifelong learners. In today's episode, we're discussing how to succeed at your first nursing job. And we're fortunate to have two guests with us. Nancy Richmond has been active in the nursing field for over three decades And Khadija Hamisi has been a nurse for over 20 years. We are so happy that you're here. We welcome you both to the podcast. How are you?

0:00:48 - Khadija Hamisi, DNP

I'm good thank you.

0:00:50 - Kimberly King

So why don't you fill in our audience a little bit on your mission and your work before we get to today's episode?

0:00:57 - Khadija Hamisi, DNP

My mission is to provide the best care in nursing and also to provide the best teaching experience to my students at National University. I started my nursing journey over 20 years ago. I started working home health when I came to America. This is working in homes, taking care of people who have any kind of illnesses can be medical, it can be psychiatric. I went to become a CNA, a certified nursing assistant, during my school years. While I was going to school to become an RN, I transitioned to medical assistant. I became a registered nurse. I worked in ICU for three years While I was in ICU. I was both working in psychiatric, mental health. I went to become a nurse manager in a crisis hospital, psychiatric hospital. And from there I became a nurse practitioner, and I started teaching while working as a nurse practitioner.

0:02:08 - Kimberly King

Wonderful. And then tell me a little bit, Nancy. Tell me a little bit about your background. Thank you, Kim.

0:02:14 - Nancy Richmond, NP

I grew up in Philadelphia. I worked as a certified nursing assistant for 10 years. And then I was able to get the money together to be able to go back to school to work on my bachelor's degree as a registered nurse. And after I became a nurse, I worked for two years in an academic teaching hospital in Center City, Philadelphia. And because I had gotten a late start as a nurse, I wanted to try to play catch up. So I decided I would go back to school to get a master's degree.

And I got a master's degree as a psychiatric, mental health clinical nurse specialist and it was my hope that I would become a therapist and do therapy and put out my shingle and be independent in that way. But I decided to become a nurse practitioner so that I could write prescriptions in addition to doing therapy. So I became an adult nurse practitioner and began to practice. I worked in consultation liaison psychiatry in the academic teaching hospital, And then I went back to school again to become a psychiatric nurse practitioner. And I started to work in public mental health as a nurse practitioner. And I've done that for the last 15 years in the state of California. And now I'm also working full time as a professor at National University with graduate like NP students.

0:03:45 – Kimberly King

Wow, impressive. Both of you. And you can hear your passion And I believe you both have job security, especially in today's atmosphere, right? So thank you for sharing that. Today we are talking about how to succeed in your first nursing job and what tips you may have for new, newly graduated nurses. And so, Khadija, I wanted to ask you what tips would you provide for recent graduating nurses in hoping to succeed in their first job?

0:04:12 – Khadija Hamisi, DNP

Thank you, Kim, I would say the most important thing is to have long lasting relationships with your peers, the students or the students that you went to school with, where you find your first job is to make friends or relationships with other coworkers or other nurses, the management and everyone involved in patient care, because you will need all these people to help you succeed. Remember, you are a new grad. You really don't know a lot of things. You don't know how to really take care of patients because you just did clinical experience where it's minimal. You don't have the vast experience of what happens in real life. So the therapist good to talk to the therapist, to have a relationship with them, so they can teach you the best way or how to really help your patient, maybe get more mobile.

Other seasonal nurses that can help you do other things, let's say wound dressing, starting your first IV. I remember the first time I was employed after graduating school. I worked in ICU. I remember every single day when I'm driving to work my heart is pounding because I realized I really don't know how to start an IV that well, and it's all these drips, all these medications that I need to hook up. And I actually went to the oldest nurse that worked in the ICU with the longest years over there, A\and that became my best friend, And when she went to her room I would follow her, observe what she did, helped anywhere that I could, so that she in turn can help me with my patient, and four months, five months, six months, I became more comfortable and was able to provide care that I need. So I would say make relationships, always help other nurses and in turn you'll get someone to help you succeed.

0:06:16 - Kimberly King

Great advice and looking for those mentors, I think that's so important. Nancy, I wanted to ask you next- how crucial are effective interpersonal and communication skills in the nursing profession?

0:06:29 – Nancy Richmond, NP

Thank you, Kim. I think that effective interpersonal and communication skills are essential for nurses. First, for communicating with other nurses, because for me, when I first got started, I was very comfortable in the role as student. You know, I sat in the first row, I did all of the homework. You know, I really tried very hard to be successful. And then when I got hired as a nurse, I felt like I didn't know anything, like they asked me to help out with a patient and the patient needed to have an ice pack.

Well, I don't know, where do you get an ice pack from? Who do I ask, where do I get an ice pack from? You just, you know, I found myself wanting to cry before I got to work in the middle of the day, after I was, you know, at the end of the day. So it really became very important for me to find my mentors, to learn how to communicate with other nurses to help me, and I found it especially helpful with nurses that were relatively new- maybe they had been there about a year and they still could remember- and they knew that look in my eyes when I was like freaking out And they would help me. And you know, this is where you go to get the ice pack. This is where you go. Here's how you can get a Tylenol for your patient, and that was really helpful, and I learned how important communication was and, with the other team members, being able to communicate with the physician, you know respiratory therapy, everybody.

It's really essential for patient care, for successful patient outcomes, to be able to communicate what it is that you need and what the patient needs, as well as being able to communicate with your patient about, as I believe that the relationship that you have with your patient is really essential. They have to trust you, so you have to communicate openly with them and that's how you build trust. And then they'll share with you what they need and you can help them. So it really contributes to successful patient outcomes, but it also contributes to a sense of satisfaction and wellbeing for the nurse at the end of the day. For me, that was really essential.

0:08:44 – Kimberly King

And I loved your story about when they see that look in your eyes, because we've all been there, we've all started somewhere, so it's good to find those people that are gonna help lift you up and mentor you to the next phase. Khadija, how can nurses gain the confidence and expertise necessary to succeed in their role?

0:09:03 - Khadija Hamisi, DNP

Time and dedication. A new nurse should know that once you really, when you start in the field, you really don't know much, and you don't beat yourself down that I don't know I'm not gonna be able to succeed. You have to understand that everyone started somewhere. But with time, dedication, you will get there. You always have to keep yourself up to date, knowing the protocols, procedures, everything that you need to know about treatment. So before you go to work, depending on where you work let's say you work in mental health, you work in a medical unit what is the protocol, What are the procedures, What are the patients that you serve in that unit?

Go and read, learn about it, have confidence that you got this because you have already the foundation. You know 90%. It's only the 10% that you have to finance to finance yourself. So always read, familiarize yourself. Remember what you sew is what you reap, correct? So what you put in the efforts of you learning everything about the procedures, the protocols, the medication, is what you will become easier as the day goes on, as the month goes on, or the care that you provide to the patient.

0:10:34 – Kimberly King

Great, and that is so true, I think, in anything we do in life that time in dedication and your expertise will follow, right? What errors, Nancy, do novice nurses frequently make, and how may they be prevented?

0:10:49 – Nancy Richmond, NP

So, for me, one of the biggest errors that I made early on as a nurse was that I have a tendency- and it's not so much just early on- Just an hour ago, we were sitting in the car and I was having this conversation with my mentor, Khadija, talking about taking on too much responsibility. And how did I get down that path again? As nurses, we go into nursing often because we want to help people. So frequently, help is associated with “yes”. Yes, I can do that, yes, I’ll have more, oh, yes, you need this, you need that, and it's great to do that, but sometimes the outcome is not always as successful as you would like it to be. So one of the errors that I made is that I took on too much responsibility and, looking back, it would have worked out better for me and probably the other nurses and probably my patients, if I take it a little bit more slowly. Focus on reading about things, learning about my skills, asking questions, and that will help to avoid errors.

So that's what I would say is taking on too much responsibility, and that can be avoided by having a mentor that you can go to talk about what it is that you're doing with your time and what answers you're giving to these questions and they can say maybe you want to take a look at that and maybe you want to try to cut back a little bit.

0:12:25 - Kimberly King

That's so good. I love your advice there, and sometimes people don't see that by saying yes, you're actually overloading your schedule. So that is.

0:12:34 - Khadija Hamisi, DNP

I want to say to Kim you said before it's okay to say no, it's okay to be like, “This is too much. Let me take a step back,” because as nurses, we like pleasing, we like taking care, because that's our role is to take care. But at the end of the day, you have to understand if you have to take care of yourself first. And it's okay to say no sometimes so that you take care of yourself to be able to take care of your patients, to take care of your family.

0:13:11 - Kimberly King

And I hope everybody listening hears that, because we all wanna please, but especially nurses, and say yes and yeah, we have to be healthy too, right? That's great advice, Khadija. What do you think should be the major attribute of a new nurse?

0:13:19 - Khadija Hamisi, DNP

Empathy, compassion, and be able to communicate. And I can say this about myself. I'm from a different country, I’m a foreigner, and sometimes communication I may say something that is perceived differently. So never get offended or don't take it personal. If you talk to someone, you explain to your patient or to your colleague and they don't understand, or they perceive something different, the only way you can is go talk to them, right, because what you think you have said or what somebody perceived you have said can be different. So if there's any miscommunication, always go and ask and explain. Maybe this is not what I meant. So you don't put it in yourself and get offended, and everyone thinks okay, this is what you said, this is what I said. And then there's all this animosity in between everyone. So empathy, compassion, always put yourself into somebody else’s shoes.

Right, and I'll tell this. This is a big example that I always talk about. Actually, the other day I talked to a nurse. She works at a system living and I was trying to see this patient for a long time. And every time I talk to the system living, something is that they can't come to the phone, they can't come to the office, and in the end she's telling me this person cannot come because they don't smell good. Right, and I said that does should not stop the patient from coming. The reason I sit on this chair is because I can help that person smell good.

If I don't see that person, I will not be able to help the person. So the communication if there's no effective communication, things get lost. Empathy, put yourself in the other person's shoes. What if that was you? What if that was your mom? What if that was your brother, your sister? How would you want your own family member to be treated? That's what should come to the first thing in your mind, so that how you wanna be treated, how your family should be treated, is how you should treat your clients, your patients, and those are your family too, because they see you as somebody who can help them.

0:15:48 – Kimberly King

I love that too - and a lot of times and we hear it and we say it, but not everybody follows that -And it's that we don't always know what other people are going through. So when you say empathy and compassion, sometimes it's going to that next level and really probing. You know they admitted that they didn't smell good and we wouldn't know that typically unless you probed and you went to that next step. And again through compassion and empathy and communication. So that's great. Nancy, what is the biggest challenge new nurses face on the job?

0:16:23 - Nancy Richmond, NP

I think that part of that depends on the day and the situation, because there are so many challenges facing a new nurse. But one of the most important things is to be able to is prioritizing. You know what you see in the clinical setting, what you've learned in your textbook and the lab and your practicum sites is different than what you see when it's actually your assignment and your patient and your responsibility, and that can be overwhelming and there can be so many demands. You know patients want this. The phone is ringing. You know I have to take these orders off. A family member is here. You know my kids are at home.

You know you have to really work at learning how to prioritize things because and remember what's really important and being able to sometimes use effective communication to let people know that that's really important. But I can get back to that in a little bit. I think it's really important for new nurses when they're starting on the job that that takes some work and being again being able to communicate with patients and other members of your team, especially when you need help. And, as Khadija mentioned about, it's okay to not know everything and to be able to say no sometimes.

0:17:45 - Kimberly King

And that's being vulnerable, I suppose. But everybody's been in your shoes, right, and that's where I think that's where you find those ones that are going to come along and help you and also have compassion toward you being a new nurse. And Khadija, how can new nurses manage the psychological and emotional pressure of working in the healthcare profession, especially these days?

0:18:07 - Khadija Hamisi, DNP

Taking time for themselves. Sometimes you're stepping back, taking care of yourself, all right. So as nurses we take a lot of things. We take care. Like I said before, taking care of a patient, you take care of your own family. You take care of everybody else but yourself. So take time for yourself- yoga, exercise, especially for the nurses who work nox shift, night shift. You work all night, you come home you're tired, you can't do anything. Our bodies are not meant to be working every night, all night. When you come home, take a long nice shower for yourself, go to the gym, talk to friends. Just do everything to help yourself relax so that the next day you're okay, you're invigorated and you can take new challenges,

0:19:08 - Kimberly King

Great advice and again, yeah, we just don't think about that, but in what the work that you do and the hours that you put in? it's almost like leave that at work and come home and take care of yourself. Really interesting information.

0:19:18 - Nancy Richmond, NP

I just I wanted to piggyback on that a little bit, about, you know, having nurses having compassion and sort of looking out for each other and helping each other and just other members of the team. It reminded me of when I was first a nurse and I had an overwhelming assignment and I went into the patient's room and the patient had been incontinent everywhere, everywhere, everywhere, and I was alone in there and the patient was unconscious, not unconscious, but was not aware of what was going on at all. So he was in bed and I was there in the room with and I closed the door and I started to sob and I just walked in circles around the room thinking what am I going to do? I'm never going to make it. This isn't going to work out. What am I going to do with my student loans? I can't cut it.

And as I'm walking around, this housekeeper comes in. She doesn't say a word, she closes the door I'm still walking around and she begins to quietly clean up the room and I felt like I'm not in this alone. You know, I’m going to be able to do this. This will all work out. I'll learn how to do it. But there wasn't really anything said- she just I knew that she was there and she knew where I was at, and it really helped me a lot.

0:20:41 - Kimberly King

I love that a little angel that showed up and you have to say anything.

0:20:50 – Khadija Hamisi, DNP

And this I would say, culture, but relationships and the same thing is with everyone, because everyone makes a part of who you are. So the housekeeping, the therapist, anyone, family members, managers, everybody helps in their own way. So no one is too- no one does anything too little or too big. As long as you know, everyone helps and you don't put someone above the other person, you'll be you'll be amazed.

0:21:21 - Kimberly King

This is such key information and my daughter's friends are all graduating right now and there a lot of them are going into nursing field, so I can't wait to share this key information with them. So don't go anywhere. We're gonna have to take a quick break and more in just a moment. We'll be right back.

0:21:41 - Kimberly King

And now back to our interview with nursing experts Nancy Richmond and Khadija Hamisi. It's so interesting. We're discussing how to succeed in your first nursing job and perhaps what tips you have for newly graduated nurses. And Nancy, I wanted to ask what recommendations would you suggest to new nurses having trouble adjusting to the obligations of their roles?

0:21:58 - Nancy Richmond, NP

Okay, so the first thing that I would recommend is, keep in mind it gets better. Just stay with it. If you can do six months, you know, bonding with your peers and that type of thing, and I'm going to go through a couple little things that I have but it absolutely gets better. So a few of the things that I wanted to recommend is that we all get used to the idea of knowing everything pretty much in nursing school, so you just have to give yourself permission that you're not going to know everything when you first get started.

In the beginning it's a process you might feel overwhelmed, but you just keep studying your notes, talking with other people. You will get the hang of it. Don't be afraid to ask questions and ask for help whenever you need it. And talk to other nurses, especially the newer nurses. I mentioned this before because they that feeling that they have inside, that you have, is still fresh with them, but they're on the other side of that, and then you know, bond with your team members, the, the, the physicians, the respiratory therapy all those people, your aids that are helping you. And then work proactively, stay organized and practice patience in your career. Staying organized plays a really critical role because it helps you to avoid being overwhelmed. And you know, as we talked about taking on too much, you can really quickly get disorganized and feeling overwhelmed and that just is another obstacle for you. So, you know, staying organized, practicing patience with yourself and others, is really important and that's what I would recommend.

0:23:48 – Kimberly King

Great tips. I love them.

0:23:50 - Khadija Hamisi, DNP

And then, Nancy, I wanted to add to that when you say six months, that's exactly how long it took me to get comfortable. Every single day, I would get in my car and that was the last thing that I wanted to do. going to work every single day. Six months, I was okay. I didn't want to go to work because I felt like I didn't know, I felt like I was going to fail. but every single day became better and better and better.

So I agree with you. Six months is like the key, the magic word. Give yourself time.

0:24:19 - Nancy Richmond, NP

Well, that was actually a tip that I got from a mentor nurse, because I did the same thing. I cried so much in the beginning, before, during, after, and a nurse who had been there for a little while said to me don't quit today. Give yourself six months and then if you really still feel like this, then you should quit. And it was six months, that's what she said, and by six months I was feeling much better and I thought I could stay.

0:24:49 - Kimberly King

Boy, I feel like I just entered in on this secret conversation and that is the magic potion right there. I love that. We all need that cheerleader on the side there. Khadija, how can new nurses ensure that they give their patients the best care possible?

0:25:05 - Khadija Hamisi, DNP

Know your patient. Every patient is different. Every patient requires different care, different planning. Some patients I go basically in because I worked in ICU, I worked in crisis center, I worked in emergency room and private practice. Each patient is different. Each patient is from a different background. Each patient expects different things. Learn You have as a nurse. You have to be like a chameleon. You adapt to different things different times every single day. You know your patient. You cater the care best on the patient's needs, best on their cultural needs. That's how you provide the best care for that patient. Somebody likes to take coffee first thing at 8 am in the morning. Another one likes to take it when they go to bed. So know your patient, know their likes, know their dislikes and that's how you succeed in everything.

0:26:04 - Kimberly King

Great advice. Nancy, what are the main advantages of a nursing career that you would like to highlight to new nursing students?

0:26:12 - Nancy Richmond, NP

Okay, do you have at least an hour? (laughter)

0:26:15 - Kimberly King

Sure! Sitting back and we’re listening.

0:26:18 - Nancy Richmond, NP

I think that being a nurse is a wonderful thing, and some of the reasons that I believe that are, first of all, that you get to touch other lives And you get to be in that intimate position with another human being as they're on the journey to wellness, and for me that is certainly a privilege and something that I'm always grateful for. Also, I think that there are so many different jobs that you can have as a nurse. You can start out as a staff nurse on a med search floor. You can do that for a couple of years. You can move to OB. You can move to psychiatry. You can move to ICU. You can go to case management. You can go as a home care nurse. You can do wound care.

There are so many different jobs that you can do as a nurse. You know, if you like to sit behind a desk, you can do case management. You know, there are just a variety- school nursing, all of that. And then if you want to go on for your master's degree and do some advanced practice work, you can do that. You can go into teaching. I think that a nursing career is just bringing so much satisfaction because of your work with not just the one patient, which you can do, but you can do multiple patients. You can touch lives at a community level. You can touch students' lives. You can really do a lot of good work, and so that's very satisfying. So I think there are many advantages to going into nursing.

0:27:53 - Kimberly King

I love one thing with both of you is your passion, and literally I think nursing isn’t it one of the number one professions? And you're always in need of nursing, so I love that. You can go anywhere with it, you can do all kinds of things, but again you're touching people's lives on their journey to health. Wonderful.

0:28:19 - Khadija Hamisi, DNP

A lot. Things change every single day. There's new treatment. There's new evidence-based treatment that you don't know if you don't continue with your education. For example, right now. I was just talking to Nancy the other day, and this has been going on for a few years but I didn't know: neurofeedback. I called Nancy, I was so excited. Neurofeedback, where they take an EEG of your brain and it can actually have indicators of what is really going on in the patient's brain. Before in psychiatric, we go based on symptoms. Based on these symptoms you would call here, you have this. But now we have something- cutting-edge. Technology – that can indicate, this is probably where your patient is at right now, this is what you should focus on. And I had to take the class. And guess what?

It's very, very, very hard. I was like I don't even know all these things going on in the brain, right. But continuing education so many things. Now we have transgender care. That is different from when you went to school. Even now, most schools really don't have a lot of education on transgender care. So continuing education with that. We have substance use, substance abuse, we have eating disorders.

So, as a nurse, we only touch a little bit when you go to school about only a few things here that can help you. But now, when you go out, it's when now you have to distinguish yourself, to stand apart, to stand out. Continuing education. All these small things that don't make sense, they make sense because they make you an expert in that field, in that topic. So always continue with small certifications. I try to learn everything, like anything that you go, you'll find me there, anything. So I think it's very, very important for nurses to continuously enhance the education. Evidence based. Everything changes new technology, new treatment, that's all.

0:30:30 – Kimberly King

I can say, and I love that lifelong learning is the theme here and the end our world. We were just talking about this, how fast it's changing so that you're keeping up with all of these changes. So again, great advice. Nancy, what strategies can new nurses utilize to stay informed on the latest medical advances in trends for?

0:30:51 – Nancy Richmond, NP

me, one of the best ways that I can stay informed is I belong to my professional nursing organization and so that exposes me to the conferences that they have. Sometimes their annual conference sometimes focus specifically on certain areas that I'm interested in - adolescence or adults or children. They have, you know, on their websites they have different opportunities for CE use that they you know from the conferences. They'll you can watch the speakers that are recorded. They have journals that you can read, the journal articles about different things, that the research that's being done, new things that are happening in the field, that type of thing.

One of the things that I really liked working at an academic teaching hospital was they would have the continuing medical education at lunchtime, where you could have the speakers come, which was often about diagnosis and treatment. But you know, as a nurse you get to hear what, what's going on in the field and I, like Khadija, like to keep learning on what's going on, what's new, that's happening and that type of thing. So I found that the journals belonging to a professional organization I would network with other nurses, I would have the journal, I would have the conferences, the CE use, were all available to me. So that was a really valuable to me. Still is valuable.

0:32:19 – Kimberly King

Excellent. (to Khadija) Do you have anything you want to say on this?

0:32:21 - Khadija Hamisi, DNP

Yes, and when she said Nancy talks about, you know, joining organizations, organizations. This is very good, especially sometimes you have a question about a nursing practice. You can call an organization and if you belong to that organization, they can steer you towards the right directions. So that's very important.

0:32:41 - Nancy Richmond, NP

Right. Thank you, Khadija. They often have a blog.

0:32:46 - Khadija Hamisi, DNP

And sometimes they have a lawyer right that you can ask, yes.

0:32:49 – Kimberly King

That you have access to because you belong to that professional organization, and we kind of talked a little bit about this. but, Khadija, how can new nurses maintain a viable work-life balance, especially while ensuring they succeed in their nursing careers?

0:33:04 - Khadija Hamisi, DNP

I think sometimes you have to be selfish. Yes, and I don't mean that in a negative way is you have to put yourself fast. Like I said, if you don't put yourself first, you will not be able to help your patients. Nasty's, like we said, their mothers their fathers, their friends, their everything. So it's one person that takes all these other responsibilities. You will get a burnout if you don't take care of yourself.

Take time, go for vacation- a time that you don't pick up any phone calls. I need still need to make sure that Nancy does it, because she has her phone [on her] every time they're on night, so just take that time for yourself. Go to the gym, walk out. Before when I was younger, that's what I used to do. Straight from work, from ICU, I go straight to the gym, walk up for an hour go home, relax, sleep, so take care of yourself. Eat well, exercise time off, read, and then take care of your patients and yourself.

0:34:13 - Kimberly King

Excellent and again it's so true, especially as a new nurse. When you're right, I love that you say you’re mothers, you’re fathers, you’re everything, and you are caring for everyone. So it's okay to be selfish and think of yourself first. Anything else that you want to talk about and give the advice to these new nursing graduates?

0:34:35 - Nancy Richmond, NP

It's a wonderful Profession and it's difficult the first six months to a year, but it's absolutely 100% worth it.

0:34:44 - Khadija Hamisi, DNP

And it's a profession that you can be whatever you want. You can eat the pro. It's a profession within a profession and a profession. You can be a lawyer, you can be a dietician, you can be anything. Nothing is one profession that you can have so many different careers within the nothing field.

0:35:06 – Kimberly King

So it's awesome. Wonderful. Well, I’m very inspired. Thank you so much for both of you for your time today and discussing this such an important topic, and if you want more information, you can visit National University's website nu.edu and we look forward to having you on for our next visit. Thank you, you've been listening to the National University Podcast. For updates on future or past guests, visit us at nu.edu. You can also follow us on social media. Thanks for listening.