Victorian graduate nurse Tess Carr-Howard is on the cusp of completing her graduate year at Barwon Health’s University Hospital in Geelong.
She spent the first six months working on the Adult Acute Ward before moving to the hospital’s Special Care Nursery, a neonatal unit providing care for babies in the region.
The 36-year-old always had a passion for helping people and decided to go back to university and study nursing once her youngest of three children was almost five.
“Supporting people and their families through times that can be emotional, scary and overwhelming is so fulfilling – and being there for the great moments is fantastic too,” she says.
As she pushes ahead to the finishing line, Tess describes a typical day as a grad as much the same as any day for an RN.
“Get to work on time. Receive handover. Communicate with your patients and include them in their care,” she lists.
“Sort out shift planner for the day. Complete care plans. Read up on something you don’t know. Ask questions and take each and every opportunity to learn. Support your co-workers and ask for help if you need it.”
Tess says beginning her graduate year on a busy acute ward gave her a challenging introduction into her nursing career and the opportunity to hone her skills in a high-pressured environment.
“I could see it as a student nurse but now that I am an RN and actually working, I have a much bigger appreciation of just how much nurses do in a day.
“The importance of having sound leadership and a supportive team behind you to ensure that patients receive the best possible care has also been a great lesson early in my nursing career.”
Tess shared her top 7 tips with the ANMJ from what she has learnt throughout her graduate year.
1. You are not “just” a grad
I used to hear graduate nurses introduce themselves as ‘just the grad’.
You are not just a grad that does not know anything. Yes, we may not know all there is to know (no one does) but your opinion and care for your patients is important. Introduce yourself as a graduate nurse. It allows you to safely and confidently say – “I don’t know the answer to that but I will find out and get back to you”.
It gives you an opportunity to learn more and maybe take that little bit more time assessing a patient or asking them questions to establish what is happening for them.
Patients and their loved ones will appreciate your honesty and you will build rapport with them.
Introduce yourself to all the staff that you work with on a daily basis if you have not seen them before – with ever changing medical teams, allied health and assistant staff – it is a great way to meet people and let them know you are there to help and to learn.
2. When in doubt – ask
As graduate nurses we are keen to put all that we have learnt into practice – however we are not expected to know everything.
The beauty of the graduate year is that we are there to learn and consolidate.
If and when you do not know the answer to something – be honest.
There is nothing wrong with saying that you need to find out some more information.
You are being accountable and responsible in your nursing care and this is a great way to learn new things.
Communicate. Every single day.
Communicate with patients and their families. Be open and honest. Build rapport. Communicate with the multidisciplinary team. Be confident with speaking up and advocating for your patients.
Communicate with your NUM and NIC. Communicate with allied health and support workers within the hospital.
Our job and the health and safety of our patients is based on effective and timely communication of important information and knowing when to escalate care or when to pass on a bit of information you have observed or discussed with a patient – it can save lives!
4. “Nursing is 24/7”
You may hear this a lot during your graduate year.
We are eager to please and want to do our best, and sometimes that means trying to complete all tasks that were set at the beginning of the shift or handed over to us – and often wards get BUSY and you run out of time. Do not beat yourself up. Remember that there are nurses 24/7 providing care so you do not have to complete every single little thing.
Make sure you are getting the important stuff done – and prioritise your care provision.
Handover what has not been completed. You aren’t failing. You are being accountable for the care of your patients and ensuring that they receive the care that they need – even if it is not on your shift.
5. Time management is key
Time management and prioritising care is something that some graduate nurses really struggle with. If this is you, ask for help.
Know that you are not alone. Ask someone who you know handles a busy shift well to show you how they plan their day.
Get a shift planner that works for you. Make sure you include your breaks and any education sessions running on your ward for that day, so you do not miss out on learning opportunities.
Learn to say no. We want to help out our colleagues – but if it means you get behind in your own work it can get out of control.
Say no when you really cannot help. A time planner that keeps you on track on a busy ward is a lifesaver!
6. Make the most of every opportunity
Working within different areas of the hospital has given me the opportunity to discover areas of learning that I may never have.
Show initiative and put yourself out there to learn more each day. Even if it is one more medication that you have learnt, or a new way of completing a task that is more efficient or more patient focused – use your graduate year to learn and grow and discover areas of nursing that spark that passion to strive for excellence and provide the best care you can.
Go to the work catch up or social event. Go to the education days available. Use your study days to further your experience and upskill. Use each day as a new learning opportunity.
7. Reflective practice
I remember feeling a bit uncertain about the importance of reflective practice and the emphasis that was placed on it during my studies – but I quickly realised during my placements and certainly now that I am a practising RN that reflective practice is a very helpful way to work through some of the harder days and also a great way to see the growth that you have made during your graduate year.
Some people like to write it down, others just reflect with a friend – whatever works for you – but do not bottle it up!
Reflect on your day’s work and if something does not feel right touch base with your grad team or a supportive co-worker.
I am not at all surprised at Tess Carr-Howard’s successful completion of her graduate nurse year. Tess was the inaugural winner or the Shirley Anne Everett Nursing Excellence Award 2018. Even in her last year of study Tess stood out as being a most accomplished nurse who displays compassion, kindness and competence. Her nursing practice is informed by her exceptional qualities of humanity. Tess we are all very proud of you. You are exactly the kind of nurse Shirley Everett was.