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Spinning Plates

Once again, NPR comes through with a really good story and quotes one of my mentors, Linda Aiken, at the University of Pennsylvania.  The story describes what nurses in the United States are managing in hospital roles.

If you're an experienced RN, the story probably sounds pretty familiar.  With Baby Boomers aging, hospital admissions are rising even though the state of the economy causes people to delay care to save money.  That means sicker patients.  But this isn't a new story.  Since health reform in the 1990s, patients who enter hospitals are sicker than ever before.  New evidence, technology, and modes of care ensure that more people survive conditions they wouldn't have even a decade ago.  But the price means busier nurses.

What does this mean for new graduates entering the field?  First, it means you can expect to feel totally overwhelmed for the first six months on the job.  Your practice becomes focused on task completion and trying to organize yourself.  You may wonder where all that critical thinking you started to develop went --possibly out the window?

In truth, it means you will work harder than ever before.  Nursing school, if the program was rigorous, will have prepared you very well for when you're out of school and working.  As you learned in school, the first thing to think about is what is "normal" in your patients.  Here's what to expect in your first year.  And yes, this comes from both evidence and experience, ensuring that you are working from the best form of evidence-based practice.

1) You may never feel caught up.  That's normal.

2) You will wake up in the middle of whenever you're sleeping convinced you missed something.  Sometimes that will be true, sometimes it will not.

3) There will be THAT nurse who calls you just before you're supposed to go to sleep to point out something you missed.

4) You're biggest challenges is organization.  Find ways to organize yourself and get a routine that provides some structure to your day.  It doesn't mean this routine is completing inflexible, but it helps to give you target points for what you should have done by certain times in the day.

At some point in your first year, you'll leave your unit and realize, "Wow, I got everything done.  I didn't forget anything or have to double check myself."  That's when you know you've passed a key point in your professional development.  You've got the role sorted out.  You may still feel like you're spinning plates, but you're getting good at it.

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