I am finally finished. After three years of taking classes, starting with A&P I because my pre-requisite courses from my first time in college were taken too long ago to be valid, through my final clinicals of nursing school, then taking the state boards, and finally navigating the "new grad" training program at my job, I am being turned loose to go to work. No more classes. No more safety nets. No more excuses. My first shift, on my own. For realz, with a pocketful of needles.
There are things I wish I had known when I started this process. Some things need to be learned on your own, but I will try to share my thoughts, to shed some light on the process perhaps for you, Dear Reader, who may be thinking about turning your life upside down and giving nursing school a shot as well. Ha. "Shot." Get it? Nursing humor.
1) There are nursing degrees, and there are nursing degrees. Once upon a time, nurses were trained at little career colleges, where young ladies learned how to bandage wounds and mix salt into water for 0.9% saline solution, and they walked away with an Associate's Degree and a nifty white hat (and, if they're lucky, eventually a wedding ring from a doctor). Those little nursing colleges are still around and they kick ass. Seriously, go to one of them and you'll be a really good nurse. But times change, the healthcare industry is changing, and hospitals don't seem to be hiring from those little colleges as much. What happened? Universities have created nursing programs on the Bachelor's Degree level.
Associate's or Bachelor's, you're still a Registered Nurse, an R.N. You don't get paid more when you have a Bachelor's. It's just a title by your name, because you took some additional classes in leadership, community health, and nursing theory. It's a weird loophole — both degrees have the same license, so why bother getting the Bachelor's? Because hospitals get preferred treatment by Medicare if they have a certain percentage of their nurses with Bachelor's degrees, which means those nurses often get hired first.
Every hospital is different. Lots of hospitals prefer to hire people that they like, not just people with good degrees. But there will undoubtedly come a time, probably soon, when the Associate's Degree programs are simply phased out.
2) Check your school's accredidation. Anyone can start an accrediting agency. It doesn't mean that accredidation is worth anything. Most legit nursing programs are either NLNAC or CCNE. For example, those are the only two accredidation agencies accepted if you want to be a nurse in the U.S. military.
3) If you want to see what working as a nurse is like, get a job waiting tables at TGI Friday's. You run constantly, you have to remember a million things, people yell at you for no reason, your coworkers tell you things you need to remember while you are in the middle of doing something else and they make you lose your train of thought, there will always be people you can't please no matter what you do, and you have to clean up stuff off the floor. It can be chaos. If you can't handle remembering drink orders for a table of eight, you do not have the stamina to be a nurse. And getting two new patient admits at the same time feels EXACLY like being double-seated.
4) Compression socks. My God, they will change your life.
5) When you are looking for a nursing job, apply for jobs advertised as "New Grad." It is a specific job intended for people who just finished nursing school and don't have experience yet. Many hospitals refuse to hire below R.N. II, which is a nurse with 6 months or 1 year of experience. But other hospitals like hiring new nurses, because those new nurses can be moulded into the type of employee the hospital wants. The hospital will pair you with a preceptor for 6-12 weeks and basically put you through nursing school again.
6) Before you enter nursing school, or even while you are a student, if you can get a job as a Medical Assistant, or a Unit Secretary, or anything in a hospital where you have interaction with patients — not just a volunteer who delivers flowers — that will help you a lot in your job search. Work PRN while you are going to school. PRN means "pro re nata," which is Latin for "as needed," as little as a shift or two each week. Although Medical Assistants and Unit Secretaries are still specialized positions with skills involved, but that's another story.
7) It's okay if stuff about nursing grosses you out. You just have to fix your face for a few minutes while you're with a patient. You can hold your game face for three minutes. And the first time a patient, who is also someone's grandmother, looks at you with shame in her eyes because she couldn't make it to the bathroom in time, you will learn what it feels like to put aside your own worries and give another person some help.
8) ...and there are people who help you with some of that stuff anyway.
9) If a person asks you for Dilaudid, he/she is in pain. If a person asks for Benadryl after Dilaudid, he/she is having a problem with itching from the Dilaudid, which is a common side effect of the drug. If a person asks you for Dilaudid, and Benadryl, and Phenergan, the Benadryl and Phenergan together increase the high of the Dilaudid, and he/she is quite possibly a drug addict looking for a fix. How you handle it is your dilemma. You will have to make these decisions. If you cannot handle these decisions without passing judgement, you do not have the stamina to be a nurse.
10) I mean it about the compression socks.