What I learned from my first month as a graduate nurse

Melanie Challen

Registered nurse Melanie Challen finished her graduate year at Peninsula Health’s Frankston Hospital in Victoria in February.

She undertook three rotations throughout the year, working in gastroenterology and general medicine, the orthopaedic and plastics surgical ward and lastly in the emergency department.

Melanie followed in the footsteps of her mother to become a nurse.

She was attracted to the profession by the opportunity to care for people of all ages and with a variety of health issues, the ability to travel, the flexibility of shift work and the chance to work alongside like-minded health professionals with similar passions.

Looking ahead to the future, Melanie is setting her sights on undertaking post-graduate studies in Critical Care through the emergency department and completing a Diploma of Midwifery.

Her ultimate goal is to become a remote area nurse (RAN) and travel around Australia with her family while providing healthcare to rural and remote communities.

Melanie spoke to the ANMJ and reflected on her first month as a graduate nurse and the lessons she learned.

My first day on the job involved a supernumerary shift working alongside an experienced nurse, learning the routine for the day on the ward, exposure to the illnesses that I would work with over the coming months and discovering where to find the equipment I needed.

The first day on the job was a transition from student nurse to graduate registered nurse; similar because I was buddied with a nurse, but different because I was now allowed to administer medications and make clinical decisions.

In the back of my mind throughout the day also loomed the reality that the next day I would be by myself, although with support on hand.

That next day rolled around and I was extremely nervous, but I felt as though the supernumerary shift had me prepared for the shift and I felt extremely well supported by my peers, leaders and educators.

I found that from there, every shift had its challenges but I was better prepared to face them.

After I finished my first shift I felt a range of feelings from being overwhelmed to feeling completely empowered.

My mum has always described nursing as both a science and an art – nurses are expected to understand the science of anatomy, physiology and clinical skills – this is what we spend years learning at university.

But a compassionate nurse will also see nursing as an art; there is an art form behind making a patient and their loved ones feel safe, special and well cared for.

The art of nursing is something nurses are born with, but we also develop it throughout our careers.

At the beginning I found this balance quite overwhelming, whilst also trying to balance time management.

I also found my first shift extremely empowering. I loved what I was doing. I trusted my instinct/gut feeling and I knew I had made the right career choice.

I quickly learnt that asking for help was brave.

In the past, I have held extremely high standards of self, and this has seen me value my independence.

I quickly learnt that striving to achieve everything by myself, particularly at the beginning was unrealistic and I was only disappointing myself when I failed to achieve all the tasks of the day.

It soon became apparent that asking for help from other nurses, educators and my leaders was brave and was resulting in better outcomes for my patients.

This also meant learning that it was ok to handover tasks to the next shift.

To that end, I also learnt that if I expected help from my colleagues and I was going to handover tasks to the next shift, I also had to be an effective member of the team and help others when they required it.

The thing they don’t teach you at university is that the scenarios developed for our learning, whether it is a case study where a patient deteriorates, or a patient requiring an intervention, are likely to be only one of your many patients, and that those scenarios will not necessarily happen in the “real world”.

You will also be caring for other patients at the same time that will require other interventions, or you may have more than one patient deteriorate and you will need to balance your time to achieve the best outcomes for everyone.

At university, you are also split into groups and there may be four of you caring for a patient who is deteriorating, so university scenarios are the ‘perfect conditions’ and that probably will not be realistic once you start your career.

The biggest challenge was leaving my hometown.

Being born and raised in Mansfield, I had never really ventured away from my comfort zone.

When considering which hospitals would suit me to complete my graduate nursing year there was only really two options: Mansfield District Hospital or Peninsula Health. Both had their individual pros and cons, and both would challenge me, clinically and in my own personal growth.

Little old Mansfield held my family, the challenges of healthcare in a rural/remote setting and I would be working in the hospital that I was born in.

The Mornington Peninsula held my boyfriend, a new start and a major metropolitan hospital.

I landed myself a position at Peninsula Health, and I remember walking in the main entrance at Frankston Hospital on the first day and feeling lost by the sheer size of the hospital, I did not know anyone and I had moved my life here.

After a year, it is safe to say I made the right decision and I love living and working on the Mornington Peninsula with Peninsula Health, and I love returning home to Mansfield when I get a few days off.

My first mistake as a nurse was thinking that completing my university degree meant that I knew everything I needed to know about being a registered nurse.

I had spent years studying, watching lectures, attending practical sessions, performing skills on mannequins and I thought that all of this study would make me competent and confident with all the knowledge and skills I would require to effectively care for my patients.

I quickly found that my Graduation Certificate was in fact a ticket to start learning and that within a month of being a registered nurse I had learnt so much more than I did throughout my studies; and this learning has continued on throughout my graduate year, and I expect will continue for the entirety of my career.

The best piece of advice I got was catch people’s glitter, and then spread it yourself.

At the beginning of my career I found that I was working with a variety of different nurses; as with any occupation there were nurses that I enjoyed learning from, and there were nurses that I didn’t particularly agree with.

On debriefing with my mentors I mentioned this; and one of my mentors told me that throughout my career I will meet a variety of people that I don’t completely gel with; but she said the objective was to catch the glitter that I liked, and then spread that glitter amongst others.

What does all that mean? That on every meeting I have with people there will be things that I do and do not like, but the objective is to take the good parts and carry them on in my own practice; and to let go of the things I don’t like.

The thing I loved most was the variety.

Nursing is so full of variety on so many levels. The nature of shift work means that we are always working different days and different shifts throughout the day; sometimes we work weekends, sometimes we get a cluster of days off in a row.

The evolving roster means that we are always working with different members of the team and I enjoy the variety of working with different people; I see this as an opportunity to make new friends, to learn from different people and also to be an effective member of the team no matter who makes up the team that shift.

Most importantly, I have enjoyed the variety of caring for patients that come from different age groups, backgrounds and with distinct health issues.

I like that in the nursing world, no two shifts are ever the same and every day is a new challenge and a new adventure.

Something new I learnt about myself was that I CAN do it.

As I mentioned, I hold very high standards of self but this also means that I can be very self-critical and I doubt myself often.

Throughout the year I have worked towards being kinder to myself, whilst keeping my high standards and I believe, or at least I hope that this has been reflected through the work I have done.

Each day I have been exposed to new challenges and I continue to surprise myself by managing and doing the best I can; and the next time I am exposed to similar challenges I feel prepared to deal with it.

A memorable moment that sticks out is caring for an elderly lady with advanced Alzheimer’s who required surgery whilst I was working on the orthopaedic ward.

Prior to this, the patient was living at home with her husband. When the time came to escort the patient to theatre, the patient’s husband refused to leave her so he walked with his walking stick down to the theatre with us.

I handed over to the theatre nurse and invited the patient’s husband to walk with me back to the ward where I made him a cup of tea whilst he waited for his wife to return; but he refused and said that he would wait until she was sleeping, and when the procedure was complete, he would be there when she woke up.

I cried all the way back to the ward for a number of reasons;

  • I can only wish to be loved by someone as deeply as that gentleman loved his wife
  • The privilege of being a nurse, resulting in me being exposed to that kind of love
  • The trust that the patient’s husband had in me to care for his beloved
  • That to me, that patient was one of the four patients I cared for that day, and one of the many patients I will care for throughout my career. However, to that man, that patient was his whole world, which was a humbling reminder that every patient has a story and a family and we as nurses are just a small piece of that story.

My advice to new grad nurses is to be kind to yourself.

You can’t look after your patients and your colleagues if you don’t look after yourself. Find yourself a couple of mentors that inspire you both clinically and professionally; they will be the people that you debrief with so you can start fresh the next day.

After every shift I call my mum and tell her about my day and she tells me about hers; a problem shared is a problem halved.

Treat your patients as you would expect your loved ones to be treated; this is the golden standard for the care you will provide to your patients.

Be humble, be curious and try to learn something new every day. Help people, and they will help you. Catch a bit of glitter from every one you meet, and then spread that glitter on.

5 Responses

  1. About to start my first supernumerary shift next week and I needed to read this – thank you for sharing!

  2. Beautifully written and moving. Thanks for sharing this Melanie. I have bookmarked it so that I can refer back to it when I, hopefully, start my grad year next year.

  3. Hi Melanie, Beautifully written, thank you. I have shared this with my daughter in year 10 who wants to pursue a career in nursing – I will also share it with our career advisor at her school – your personality and pride in your work shines through, best wishes for a brilliant and fulfilling career in nursing.

  4. im just about to start applying for grad programs here in WA and thought this article was such a positive and beautifully written piece.

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