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Nursing Reality Shock: The New-Nurse Survival Guide

Nursing Reality Shock: The New-Nurse Survival Guide

For second-career nurses, the transition from nursing school to working with real patients can range from somewhat uncomfortable to highly shocking. These rookies often have given up secure, well-established careers, only to discover on-the-job demands never mentioned in the textbooks.

However, the right attitude can help you weather your first few months on the nursing unit. For those who overcome the challenges of transitioning to nursing, the rewards outweigh the costs of starting over.

Manage the Unexpected

Jennifer Nugent, RN, a critical-care nurse at Boston Medical Center since July 2005, was jolted by the unpredictable nature of nursing. "There is a constant assortment of things that can come up, because I am dealing with really sick patients," she says. Nugent previously worked for the American Red Cross for 10 years in a variety of roles, including HIV counselor, infectious-disease counselor and regulatory-affairs supervisor.

One of Nugent's best survival techniques has been adopting an attitude of humility. "It's important to acknowledge that there are always going to be things that happen that I haven't seen before," she says. "Once I have really settled with the fact that I can't know everything, it makes it easier to handle it. I can confer with nurses with 30 years of experience who have seen everything. It's a group effort taking care of these patients."

A tactic Karin Huster, RN, an acute-care nurse at Harborview Medical Center since September 2005, picked up from her preceptor was to prepare for worst-case scenarios.

"When you start your job with your patients, you need to think about the worst thing that could go wrong, so that if it happens, you are prepared in your head," says Huster, who was a program manager at Microsoft for 12 years before becoming a nurse. "That helps a lot and is reassuring."

Another new-nurse challenge Huster and Nugent both faced was the switch from sedentary office jobs to 12-hour shifts on their feet -- shifts that were physically, emotionally and mentally demanding. These days, Nugent is careful to use her time off to rejuvenate with rest and yoga.

Accept that You'll Have to Start Over

Another source of angst for second-career nurses is realizing they're now low in the employee hierarchy.

"It's like starting at the bottom all over again," Nugent says. "Before, I could take my summer vacation anytime. In nursing, it's seniority-based. You have to give up that idea of control."

But forgoing that seniority is easy when it's in exchange for the chance to directly help people and learn new things every day, she says.

Encountering some of the same frustrations they experienced in their first career can also be disappointing to second-career nurses. For Maritza Salazar-Abshire, RN, MEd, it was nursing's high volume of paperwork -- an also-annoying aspect of her former job as a teacher.

"You just have to get into a routine of doing it," says Salazar-Abshire, a nurse in the pediatric adolescent clinic at MD Anderson Cancer Center. "I drew from my experience as a teacher and decided I needed to have a routine and be organized."

Adjust Your Attitude

High expectations can also exacerbate transition pains.

"Many people would ask me why I was leaving Microsoft to do nursing, and this made me feel concerned," says Huster, whose career change meant a 50 percent pay cut. "What really worried me was whether I would be satisfied with nursing for a long time."

Huster's attitude has helped allay these fears. Rather than just taking vital signs, she uses her extra minutes to read her patients' charts, learn about their psychiatric issues and ask doctors about diseases with which she is unfamiliar. "You can learn a lot about why [patients] are here and their history," she says. "Then it's much more interesting when I give care to the patient."

As a nurse with a long-term dream of volunteering overseas, Huster knows that what she learns now could someday help people around the world. And for her, that's worth giving up an office with a window.

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