Nursing Lyfe 101

Navigating Your First Year as a Nurse: Thriving as a Clin 1

• Nursing Lyfe 101 • Season 1 • Episode 8

Share episode

💡 Episode 8: “Navigating Your First Year as a Nurse: Thriving as a Clin 1”

Welcome to another episode of Nursing Lyfe 101! Today, Christopher and Colby dive into the realities of being a Clin 1, or a brand-new nurse. From managing nerves and mastering medications to handling tough shifts and advocating for yourself, we’re giving you the real talk on how to not just survive, but thrive in your first year.


🔥 What You’ll Learn in This Episode:

âś… The top 3 things every Clin 1 should focus on

âś… How to handle overwhelming shifts and tough assignments

✅ The truth about asking questions (spoiler: it’s ALWAYS better to ask)

âś… Managing time, stress, and self-doubt in your first year

âś… Why biohacking and self-care matter for nursing longevity


👂 Listen now and take away practical strategies to make your transition from student nurse to professional RN a little smoother. Don’t forget to share this episode with your fellow new grads!

Send us a text

Support the show

✨ Follow & Support Us ✨

Stay connected and never miss an episode:

• Twitter: @NurseLyfe101

• Facebook: Nursing Lyfe 101

• Patreon: NL 101: Office Hours


đź’¬ Join the Conversation:

We want to hear from YOU! Share your thoughts, questions, and nursing stories on social media using #NursingLyfe101.


🎧 Don’t forget to subscribe, leave a review, and share Nursing Lyfe 101 with your friends in scrubs. Your support keeps us going! 🩺

Christopher:

Welcome to Nursing Lyfe 101, the most important nursing class you never got to take in nursing school. We will be traversing different objectives, like interviewing what to do in nursing school, boundaries, burnout and so much more, if this interests you. I hope you are taking good notes because class is now in session. Hello and welcome to Nursing Lyfe 101. We're so excited to have you here with us as we dive into the world of nursing, sharing our experiences, insights and a little bit of fun along the way. I'm Christopher and I couldn't be happier to introduce my co-host.

Colby:

Hey guys, it's Colby. Together, we'll be bringing you real stories, practical tips and discussions about all things nursing, whether you're a fellow nurse or just curious about life behind the scrubs. We're thrilled to have you join us.

Christopher:

We are experienced nurses. We have been experienced nurses, I guess, if you want to say anything over the year. I have been for four, you have been for nine, and there are still times where we have precepted people, we've hired people, we run across people who have come to our unit and they are completely new and you're like, oh boy, this is different. So we wanted to take a little bit of time and recognize the newbies in nursing career and I guess really and truly, this could also reflect a little bit on newbies in any career. But obviously we're going to focus on those that are in ours, because we know more about that and we see it all the time. So at our healthcare system we do a kind of like step-based approach in terms of nursing, where there are levels to what nurse you can be.

Colby:

In relation to your experience.

Christopher:

Right, right, right. And so the newbies are called Clin 1s. Those that who have survived their first year and are still at the health system are called Clin 2s.

Colby:

Survived and still there.

Colby:

Yeah, after your first year you automatically move up to Clin 2. Or this is and Clin is short for clinician.

Christopher:

Oh, yeah, yeah.

Colby:

Yeah, just in case someone's like Clin. Yeah, what does that mean?

Christopher:

Yeah, I probably should have said that. Then in clin 3 you have to do a portfolio and an interview. Actually, I don't think you have to do the portfolio anymore, you just have to do the interview.

Christopher:

It used to be very extensive to get clin

Colby:

I'm be totally honest, I'm not totally up to speed on what the clinical ladder entails because in my role they took the clinical ladder out of the like question.

Colby:

Like they kind of took it away from charge nurses because we're in quote unquote leadership instead. So I kind of lost sight. But a lot of hospitals do a similar thing which I've moved up on the clinical ladder and it may or may not entail some form of portfolio or, um, what's the other word for resume? It's not resume, but like uh, do you know I see your brain working. Like you know what the word is.

Christopher:

I do know, I do.

Colby:

Uh this is frustrating. But its like a document similar to a resume where it gives you an exemplar of the work that you are doing to kinda prove that you are appropriate to move up to the next step in Y clinical ladder. You prove that you have a certification. Um, these are the hours of CEUs you've done. These are, um, the, the sub committees and committees that you're involved with in the hospital. Um, I really wish I could. You're looking it up.

Christopher:

Yeah, I am.

Christopher:

Uh, so you have the cv, which is...

Colby:

yes, the cv.

Christopher:

But that's an actual word and I just can't think of curriculum vitae.

Colby:

Yes, yeah, so you. Sometimes it's a curriculum vitae or cv, which again is similar to a resume. Sometimes it's more involved, like a portfolio. I mean I have a from my first job, um, as a nurse. I stayed there for two years and I was a clin 3 when I left it was was super involved,

Christopher:

holy cow,

Colby:

yeah.

Colby:

Yeah, in two years. So like, I went Clin 2 after my first year and then in that year I worked and applied and got approved for Clin 3. So like, and I worked maybe like another three months yeah, isn't that crazy.

Christopher:

That's wild.

Colby:

Yeah, but I was, I was like really involved in like getting the hospital like magnet certified.

Christopher:

Oh my God, really?

Colby:

I got kind of thrown into it because they needed someone from a like graduate nurse perspective.

Christopher:

Okay.

Colby:

And then I guess, yeah, I don't know, I just like I was in the right place, right time?

Colby:

I guess, and I got I was on part of all these other subcommittees. I actually got to go to the magnet convention that year too, which was really cool in Atlanta. It was a blast. What? Yeah, and I'm in the. I'm actually. What year would this be? 2015? Maybe I'm in the book from the magnet convention that year. Yeah, there's a picture of me in the actual book. So the so the magnet convention the year following 2016 had pictures from the year before and I'm in the 2016 book.

Christopher:

That is wild yeah.

Colby:

So that's why I was like clin 3 baby.

Christopher:

That is insane.

Colby:

Yeah, but anyways, not to toot my own horn.

Christopher:

Well, you sure enough did.

Colby:

But anyways, yes, you can, I mean, and not every hospital you're able to do that so soon. I think it some like require years of experience to also move up the ladder.

Christopher:

Yea, that is the case here in our healthcare system. I also just wanna say you talk about me doing all the stuff, I'm not in a magnet book, but you went through the process and clin 4s, clin 3s and clin 4s have to do interviewing and then I'm pretty sure clin 4 has had a master's degree. But you have all these things and you get a lot of the time's extra pay. You have more responsibilities, you are looked at as more of a leader on the floor and can kind of really embrace the whole like I know what I'm doing. This is me now teaching someone else what they need to do.

Colby:

Being a great resource, that sort of thing, explain it.

Christopher:

But you know we did all of that to really just focus back on the Clin 1s. And oh, and to Colby's point, inpatient charge nurses designated inpatient charge nurses are outside of that because they are a different set of leaders that are looked higher than the Clin 3s or Clin 4s. And so, going back to Clin 1s, there are a lot of things that you have to like experience as a Clin 1. And I would like for us to kind of start and just kind of explain kind of what the expectations of Clin 1s are.

Colby:

I think so I'll give my perspective and then I because this will be interesting from a charge nurse and then from like actual someone that's like manager, because you're going to have the more defined, like actually define what it is. And I will give a perception first and you can tell me if I am right or wrong.

Christopher:

Like I am actually going to be able to tell you

Colby:

that job description more than a hundred times this month.

Christopher:

Yes.

Colby:

Because you have to go over with new hires. Okay, so your expectation as a new grad, your first year, you really have a lot of leniency and grace, like you are really just expected to learn what your role is Like. You're learning how to be a nurse and how to perform and how to do your job and do your job correctly and provide good patient care. So the bar is high, obviously, because you want to provide great patient care and safe patient care. But just know that like every other year, the bar gets a little bit higher. So for me the bar looks low from where I'm at and so, to put myself in the shoes, like the bar is high for someone who's coming out of school and learning exactly what being a nurse is.

Colby:

It's your expectation in our health system. We have something that's like a nurse residency program. So your expectation is that you're taking a part of, you're required to take part in that and there's also like a project that you do while you're on. It's kind of like school extended. It's a good transition point for I think for new grad nurses it kind of helps again with like the puzzle piece analogy, like it's giving you more tools for your toolbox. It's helping you make connections into, like what you learned in school to what you're seeing on the floor in real practice. What else, what do you think on your side of things?

Christopher:

yeah, I mean I agree everything you said. The perception is right and really and truly you, as a Clin 1, when you are coming to a unit, are just supposed to be safe.

Colby:

Mm-hmm Right, that's the number. One thing is safe patient care.

Christopher:

Right, safe patient care. You be safe and you learn.

Colby:

Mm-hmm.

Christopher:

That's it,

Colby:

mm-hmm

Christopher:

, like, yes, you can get involved into activities and like committees and all that stuff, because that's a part of learning.

Colby:

Yeah, and we love that. We love to see people with like new energy coming in, because it's new ideas and outside perspectives that people who necessarily, who haven't necessarily been around that group, so you can kind of like come up with, you know, like a fresh perspective on something and really make a good change on the floor early on. But just know that, like no pressure, you don't have to do that immediately if you're not ready.

Christopher:

Right and, and more than likely, you're not gonna feel ready

Colby:

no, you're gonna be overwhelmed,

Christopher:

yeah and

Colby:

that's and that's okay, that's normal.

Christopher:

Yeah, and it's not your expectation to be at least in our health system and you know I'm saying this as a big brother or your crazy uncle, you know whatever you want to call me but you are not expected to precept. You're not expected to do charge nurse, you're not expected to be any type of leader on the unit. Now you may have amazing leadership qualities and you come in with those leadership qualities, which is great. Continue to cultivate those leadership qualities in something outside of nursing and then, when you get to the point where you're actually in a more knowledgeable state in nursing role, then you start to facilitate that leadership quality outward into the nursing field. But don't think about doing it and it's okay. You know I'm not saying don't think about it like it's a terrible idea, but like you're here to learn, like it's a total receiving clinician role.

Colby:

If you have like a natural-born instinct to be a leader, like think about other ways that you can use those skills. Like, for instance, like one example of that would be like you started six months ago and then another new grad or like a nurse's aide of tech starts. Like you can take them under your wing and show them like friendship, being a good colleague, that sort of thing like making other people confident and comfortable in the unit too. There's nothing wrong with like having those skills naturally. Just know, don't get in under like don't get in over your head is what I'm saying like too soon, like just really concentrate, like we said, on safe patient care and making sure that, like you're everything's clicking for you, you're feeling like good doing the work that you're doing, your patients are healthy and responding well.

Christopher:

Yeah, because I mean that that's the main goal for a clin 1. You have way too much stuff being overwhelmed and kind of going to those like being things that you're overwhelmed with. You have a lot of problems as a clin 1 and it's expected for you to have these problems, honestly, because you don't know anything.

Colby:

Yeah, it's a big problem solving year.

Colby:

It's when your critical thinking skills come into. Like fruition it's. It's like a big. This is so cheesy and corny, but like it's a big, like blossoming year, like you're starting off as like a little bud in the spring and then, like, by the end of it, you're a full-blown flower. That's so corny, they're the analogy, but it it is.

Christopher:

The eye rolls I'm giving the camera.

Colby:

But it works. It's a big problem solving year. I mean you are learning time management. You're learning medications that you went over for one unit in pharmacology class.

Christopher:

And you know, you dumped those after that class.

Colby:

Yeah, it's like rote memorization. Then all of a sudden you have to apply and you're like wait, I think metoprolol sounds familiar. What does that do again? And then all of a sudden you're giving this med every single day to multiple patients, like you know it, all of a sudden, like the back of your hand, but it takes time, you're going to start and just be like I don't know, and that's okay and that's why you are getting precepted and you're on orientation and this is a great opportunity and time for you to ask questions.

Christopher:

And please do Like there was a preceptor that was precepting someone else and they had told this person. There are no stupid questions, except for the ones you don't ask that lead to a patient's death.

Colby:

I love that there are no stupid questions, except for the ones that you don't ask. Say it again louder for the people in the back. I always say that to people. I love the new graduate nurses on my unit and I feel they always come up to me and they're like I'm so sorry, I'm asking you so many questions. I always say don't apologize, I'd rather you ask me a hundred questions than you go do something you're not sure about and you mess it up and the patient pays for it.

Colby:

Like, ultimately, ask your question. If you're right. I'll tell you. You're right, yeah, you got it. Like, thanks for asking. You totally know what you're doing, though, in this situation, and if it turns out that you didn't know, it's a good thing. You asked because now I'm here as your resource to tell you or give you advice or, you know, help you form your thoughts, to send a page to a doctor. Like, I would rather you ask me every single question that you think might be so annoying, because it's not annoying to me, trust me. Like, when it comes down to it, it's about safe patient care. So you ask your, ask your elders and I hate to refer to myself as an elder, but ask your elders on the floor, people with experience any question, and that's part of the learning process.

Christopher:

All right, y'all, it's time for our segment break, and today we're diving into something that could literally change how you perform, recover and last in your nursing career. Welcome to Biohacking for Nurses.

Colby:

So this is one that's like near and dear to our hearts.

Christopher:

It really is.

Colby:

It really is so. Biohacking isn't just for elite athletes or Silicon Valley tech bros. It's all about understanding and optimizing your own body, and, as nurses, that's crucial, right. All right, we push our limits every shift, but what if we could work smarter, not harder, by tracking our own biometrics?

Christopher:

So let's break it down. There are key biometrics we can track that directly affect our performance, recovery and overall health. Here are some of the most important ones your heart rate variability, which is also known as HRV, tracks stress and recovery. A low HRV might mean you've overworked or not recovering well. Resting heart rate, also known as RHR, is a great indicator of overall cardiovascular health and fitness. You know those patients that turn on the cardiac alarm because they're sleeping and they're dropping into the 40s because they're 20 years old and run marathons. They have a low.

Christopher:

RHR, yeah, rhr and yep and probably HRV, and probably also Sleep quality and REM cycles, one I don't do very well. Poor sleep is the number one way to burn out faster. Tracking sleep can reveal patterns affecting performance Blood glucose levels monitoring. This can prevent energy crashes during your shifts. Hydration and electrolytes many nurses don't drink enough water on shift.

Colby:

Facts.

Christopher:

I drink a gallon so

Colby:

You're actively doing 75 hard right now. That's why you're drinking a gallon.

Christopher:

Yeah, that's a little bit different.

Colby:

Right Previously you were slacking off.

Christopher:

It's true, but I also have a scale that shows me my hydration and electrolytes Did I tell you that?

Colby:

No, yes, yes, on what?

Christopher:

Huh,

Colby:

we'll get into it,

Christopher:

okay. Hydration levels impact cognitive function and fatigue. Body temperature trends can indicate early signs of illness or stress-related burnout.

Colby:

And the best part is that you don't even need labs to track this. Wearables like the Oura Ring Whoop Band, apple Watch and CGMs, which are continuous glucose monitors, can give you real-time insights. And let me tell you, Christopher and I have all of the above. We are enthusiastic about biohacking ourselves and we've done tons of extracurricular research on how to live healthier and longer.

Christopher:

Yeah, I said it briefly in one of the other episodes. It's important to keep a vegan in your life.

Colby:

That is one of the suggestions that we've come across. It is, and that's why I keep Christopher around.

Christopher:

Only for that reason, just that, that's it. Okay, so why does this matter? Nursing is physically and mentally demanding, and if we're not paying attention to these biometrics, we're setting ourselves up for burnout, exhaustion and even long-term health problems.

Colby:

Right. So let's say that your HRV is super low for weeks and you might be overstressed. You might be not sleeping enough. Your body isn't recovering between shifts. If you track that and make small adjustments like better hydration, getting a couple hours extra sleep, stress management, you're preventing future exhaustion. This is biohacking 101.

Christopher:

It is it really is, and same goes for sleep tracking. If you're constantly getting poor REM sleep, it might be affecting your reaction time, your mood and even patient safety. Imagine being able to fine-tune your routine to show up sharper and more alert on your shift.

Colby:

This is why we're obsessed with it.

Christopher:

It's true, it's so true, and I mean like, literally, I look at my Whoop data in the mornings and I am constantly sleep. I have a constant sleep debt, which is bad.

Colby:

It is bad.

Christopher:

It's not good.

Colby:

But is it? Is it making you want to fix it? Because it would me? It would motivate me to like be, like, okay, what can I get done? And like, how can I squeeze in an extra hour?

Christopher:

yeah,

Colby:

Of sleep.

Christopher:

I mean, I'm trying

Colby:

disappointment.

Colby:

I'm trying well, we both. You recently just got the whoop and you have the Apple Watch and Oura ring which is cool.

Colby:

I have been on a long journey of finally breaking down to get the Oura ring and I am currently wearing this the sizing kit to determine what would be the best size for me, because I have officially broken down, have an apple watch and I think, while it's, it does basic need for your biomet, like keeping track of your biometrics. There's technology out there that's so much better. So that's why I'm like, okay, I need more information, I need better battery life, I'm gonna get the Oura ring. But then something we both just did together recently was get the cgms, the continuous glucose monitors, because they're new, like newer, easily easily accessible over the counter technology. And not that I had any fear that I might be like a diabetic or have high blood sugars, but I just like wanted to use that as another tool to figure out how my body is reacting to things.

Christopher:

It's wild.

Colby:

And it's been so fun it is.

Christopher:

And I mean, you know there was. There was one day I had eaten something. I had eaten Utz pretzels.

Colby:

Gotta be careful with the pretzels.

Christopher:

I went from between 75 and 85 to 150.

Colby:

Yeah Off of like one serving of pretzels.

Christopher:

Like a slight handful of pretzels. Yeah, I was like there's no way I'm eating these ever again.

Colby:

Well, you can just in moderation, I think, I think something is moderation. How long did it take you? So for me, so not pretzels, but fruit.

Christopher:

Yeah.

Colby:

I had an orange and I went up to like 169 in orange and then like blueberries. But I think it's the amount of time I think also we need to take in consideration and I personally need to do even more research about endocrine system but like, how long you're in that spike for? Like how long are you above one? Like the? You know, quote unquote normal gold. Gold star values would be 70 to 140. Range you are within recommend quote-unquote recommended range. So when I do have these little spikes spikes after eating fruit or like like for breakfast, I like to have like overnight oats and like fresh fruit in it yeah, I spike up to like 150, but usually within an hour, if not sooner, I'm back within the normal range. So I think, while it's super distressing because us as health caregivers are like, oh my god, we're not normal, like our sugar is not within that normal range all the time, I think also we need to take in factor like how long we're above the green.

Christopher:

Yeah, yeah, that's true, I mean, and even our CGM tells us that we should be, as healthy individuals should be, within the 70 to 140, about 96% of the time.

Colby:

We are

Christopher:

no.

Colby:

Oh,

Christopher:

last week,

Colby:

what?

Christopher:

Last week? I was only 81% of the time. I know

Colby:

what were you eating,

Christopher:

I don't know. But it also was like the last couple of days of the CGM and there were, like I had multiple, like under 70 moments.

Christopher:

But then just two nights ago yeah, that sounds right to just two nights ago I had the worst sleep of my life by the way and I was like you're constantly high weird.

Colby:

Yeah, what did you eat before you went to bed?

Christopher:

I can't remember. I would have to. I have to go back and look yeah, I would have to look. Which is cool with the CGM, you can track what you actually ate.

Colby:

Yeah, what might have?

Colby:

I've just been like fascinated, absolutely fascinated by it.

Colby:

So yeah, and then I'll continue with my journey of fascination when my Oura ring comes in the mail and I get to dabble in the app for that. So I highly suggest everyone get it.

Christopher:

Yeah, no, like at least one thing Right, and

Colby:

yeah, you don't need to be all of them Not like us.

Colby:

We're just crazy.

Christopher:

But the cool thing is, majority of them you can use your HSA or FSA to get it.

Colby:

That's very true. Yeah, so like that's free money. That's not true, but that's how I think of my HSA.

Christopher:

That's girl math.

Colby:

And that's what I use to pay for my Oura Ring. So you know, and for me, like to spend 500, you know, a couple hundred dollars on a biometric tool. I feel like to gain that insight and get that information on myself and have like a baseline of health for myself is worth it in the long run, instead of a lot of the time your patient comes to the hospital when their body is like at the end of the line, like I am, like I. They are in so much distress, their body is like alarm, alarm. But they probably have been living with, for example, heart failure, with like small signs of heart failure for months to years, years. And if they had a biometric device where they were tracking it, they might have noticed like, oh, my heart rate variability is changed, or my resting heart rate is changed, or, you know, there's like the VCO2, like all of these things that track. If you're cognizant and you're looking at those things, you're going to notice an acute change sooner than if you didn't have access to that data.

Christopher:

Yeah, and you know it's just a cool way. I remember Dang Colby. It's Colby's Dang fault she has. I've had my Oura ring since for two years now, I guess.

Colby:

Yeah, it's probably been. It's definitely been over a year. It's probably close to two years.

Christopher:

Yeah, and it's because this one and I'm pointing at it decides to be like Christopher, can you take me to get my wisdom teeth removed? And I'm like, yeah, I could do that. So I go take her to get her wisdom teeth removed. And as we're driving there, she's like hey, have you heard about this Oura ring? Blah, blah, blah, blah, blah. It takes HSA. Blah, blah, blah, blah, blah. I can't spend my HSA because I'm about to spend it with this.

Colby:

Get my teeth pulled.

Christopher:

Get my teeth pulled, blah, blah, blah, blah, blah. But you should get it, Christopher. Blah, blah, blah, blah, blah. And I'm just as gullible after they've walked off to take Colby to get her teeth, and I'm like well, might as well go ahead and get this.

Colby:

But not only Christopher.

Colby:

I like convinced probably like five people that year to get the Oura ring and people were like, wait, you don't have one. And I was like, no,

Christopher:

not at all.

Colby:

So the fact that I'm getting one now is really funny to a lot of people, because they're like you convinced us to spend like a couple hundred dollars on a device that you didn't even have and I was like I should get a cut. Is what you're saying like? What you're saying is Oura should send me this, this podcast is not sponsored.

Colby:

But if they want to and give me my ring for free and upgrade christopher's, the new gen 4,

Christopher:

I'll take that too.

Colby:

Yeah, we are. I'm here, I'm advocating for you guys, but yeah, they're just, I'm just. We have a fascination with, like blue zones, just living healthy, like I said, living healthier and for longer, and I just love that. I have tangible data that I can see every day and like see what I can do to biohack myself into feeling better, performing better.

Colby:

Everything just enhanced

Christopher:

And it's really and truly like I've noticed, and even if you pay attention to your apple watch when you set it to like do a workout, like if you just you don't, you don't need all these other things, you don't. If you, I mean I, I suggest you get it. I have the Whoop and the Apple Watch, one on each wrist but, and the Whoop does just as much as the Oura Ring, and so I'm like I have all this information. But even I know I was supposed to write Colby, a two-page double-spaced report I was looking at over the differences between honestly like whoops ability to show, like strain

Colby:

OK

Christopher:

During your workouts.

Colby:

Yeah.

Christopher:

The Oura Ring doesn't really do that, but like it puts a perspective, puts a number out there to show like how hard you actually went in your workout. And you know, obviously if you go out, go all out all the time, then you're going to get closer to injury possibly. But there's like a balance in you being able to like strain your body enough to just like, man, I need to stop on this whole working out and muscles and stretching and building muscles, but you work it out just enough to strain it, just enough to build that muscle for the next time.

Colby:

Yeah.

Christopher:

Yeah.

Colby:

It's just fascinating.

Christopher:

It is.

Colby:

All right guys. So I'm going to present you all with a challenge. So if you have a smartwatch fitness tracker or even a good old fashioned notepad, start tracking one of these metrics for the next two weeks. Maybe it's sleep, hydration or your heart rate variability. Write down what you noticed. Do you even feel more energized? Do you feel less fatigued?

Christopher:

And if you find something interesting, hit us up on social media, at Nursing Lyfe 101 or Nurse Lyfe 101. And let's talk about it. The more we learn about our bodies, the longer and stronger we can stay in this career.

Colby:

Nursing is a marathon, not a sprint everyone. So let's start playing the long game. That's it for biohacking for nurses. Now back to our episode.

Christopher:

You know, in those moments I want to ask you another question, but because we were talking about this you had mentioned, you know, I'm never annoyed by those questions or frustrated or like you know why are they asking me all this? There are some people that either look like that and don't feel that way I actually don't actually feel that way but look that way and actually feel that way. How do you, how do you navigate that as a Clin 1? Because you're like I really don't know, like what do I do?

Colby:

Yeah, right, yeah, I feel like, and I feel like you'll always even not in nursing specifically you'll always have like that mean person. That it's just inevitable, that's life. And so let's say you know what? You still gotta ask. If they're the only person around, it's a safe. Again, it comes down to safe patient care. You got to ask, even if they're annoyed, at least you didn't kill a person. You know what I mean. But also, if there are more people around, you know that person's not the friendliest Ask someone else, like just don't be afraid. You just you got to get the question out. You got to ask.

Christopher:

You really do. You know it goes back to we just had a couple of episodes ago about interviews and like asking about the culture of the unit these are. That's a question you need to like. Experience in itself you can't ask that question. That's why you shadow.

Colby:

Yeah, yeah, you can't say do you have anybody mean on the unit? They're going to be like, um, no, but they don't know. Even your managers probably don't know that someone's mean. I mean they probably do, let's be honest. But I mean they're also not gonna be like no, everyone's so nice, like that.

Colby:

of course that's gonna be their answer everyone's so nice

Christopher:

right, I mean we have interviewing skills just as much as you do, right, like I mean we. We've done it quite a few times now, yeah, and I've asked the questions and have answered the questions that we've been asked. But you know, you going to shadow that person and having to see the shadow and kind of asking them while they're doing their work, but also asking other people, you start to figure out are these people actually going to be really nice if I have all these questions? Because I'm asking questions now?

Colby:

Yeah, you're getting a lot of information up front, Right right, you know.

Colby:

Yeah, that goes back to an earlier podcast episode about interviewing and it's so true. Yeah, you've just got to be ready to ask questions, and also keep in mind that, like, as the new person whether you're coming in with experience or not, like just new to the unit, like the people who are there with experience, like we also are like anticipating being asked questions. So like, yeah, there's going to be someone that's grumpy and like doesn't really seem like they have the time for you. There's going to be somebody else around. Ask anybody else. We're anticipating that you're going to have questions. Like that's we're here. We on my unit and I know on Christopher's unit really try to cultivate a culture that is welcoming to others that are not like normally working with us or new to working with us, because we want to keep you like. We want to keep you here, we want to build our team and we want to provide good patient care to everyone together.

Christopher:

Right, so we talk about asking these questions as a Clin 1. What do you say they should focus on, Like, what is the in your eyes? What is the top? We'll just say the top three things. They should focus on learning because, you're right, they have medications that they have to learn.

Christopher:

They have they have.

Christopher:

um, how did how to communicate to a provider, how to communicate to their techs, how to communicate to their co-workers, their other nurses that they're kind of working alongside? They've got how to survive a night shift and not fall asleep and make it home safely, depending on how far they drive. How much of the pathophysiology should they learn? They have so much things that they have to learn as a Clin 1.

Christopher:

How do you use

Colby:

Very overwhelming, I think, the top three. For me personally, number one would be familiarize yourself with the most common medications given on your unit. Now, that could be hard if you're on, like, a general medicine floor, but if you're in a specific specialty, like myself with cardiology, there's going to be like meds, like I said, like metoprolol is one that we give to almost every single patient, like every single day that you have like familiarize yourself with medications that you're going to be giving commonly or

Christopher:

sodolol or ticacin.

Christopher:

Where you have to give

Colby:

important to make sure you know what you're giving and I say that there are still medicines today that I have. I will look up before I give the patient the medication, because I'm like I've never even heard of this. What the heck kind of med is this? And a lot of times for me it's like someone who's on my floor and is, coincidentally, like on a random chemo med and I'm like I don't know anything about chemo. I'm like what is this one? Let me look this up, because if you're giving a medication and you don't know what you're giving it for, what it does to the body and the patient and I'll use metoprolol again as an example it's a beta blocker. It's going to lower blood pressure and heart rate.

Colby:

If you get the patient like, if you know that that does those things, you're going to want to get a baseline blood pressure and heart rate before you give the medication. So if you get a blood pressure and it's 90 over 50 and the heart rate is 55, that should put a little red flag and say I need to check with the physician and make sure that they still want this med, given they're already brady, their heart rate's 55 and their blood pressure is soft. Sometimes a physician will say go ahead and give that med. That's okay, we're expecting that. We want the blood pressure low. We'll watch the heart rate and sometimes they say, you know what Good catch, let's hold that dose and we'll reevaluate at the next dose that as a new grad to make those connections, you could, you know you could have potentially made someone decompensate further very quickly, whether that their blood pressure tanks or their heart rate, you know, comes down even further.

Christopher:

Um, these, it's just, that's like my number one yeah, and I mean you did that with the best intentions. Right were like. I know that this person needs metoprolol yeah,

Colby:

and it's on their med list and this is the time and.

Colby:

I did my five rights and you think, like I did all the things, I scanned all the meds, I did all you know, everything matched. So I went ahead and gave it, like without knowing what some of the medications do to the body. It's just not, it's not safe, that's not safe patient care.

Christopher:

It's not.

Colby:

Like you just have to look it up and that's going to take more time. So as a Clin 1 or a new graduate nurse, everything takes more time. So my second, my second, is time management. Okay, so familiarize yourself with medications and then follow up with time management. That's my number two. I'm going to sit here and think about number three while I'm talking about this.

Colby:

But it's like in your new days, like you may have to do a little extracurricular work outside of work to get yourself prepared while you're at work, like otherwise you're just going to be bogged down by looking up 12 medications at nine o'clock in the morning times. Four, five, six, depending on what your ratios are. I mean that means MedPass won't be finished until 11 o'clock noon and you still haven't charted anything. So time management really can get away from you in your first year, in your first weeks, in your first months, some people really kind of get a hold of things pretty quickly and some people, for their whole careers, struggle with it.

Colby:

Um, I've seen like nurses that come in and they they don't clock out until like nine o'clock in the morning because they're still charting, which is like unacceptable, but like I've seen it happen. So you want to do your best to figure out like how to prioritize tasks and like acuity, so that you're not one of those nurses that are staying so late after your shift to catch up. Now, once in a while you're having like the shift from hell. That'll happen to you. I it's been a long time since I've had one, but oh knock on that I know I better knock on wood.

Colby:

I do work the next two days but like once in a while that will happen and that's inevitable and that's okay, but like when it's a consistent issue for you red flags going down the line further in your career. So it's really important to kind of get a hold of your time management skills and that kind of goes to my third. One is organization, and it's going to help you with both of the other two, so maybe that one should be. First is to be organized. You want to use your report sheet. It organizes your thoughts about what's going on with each individual patient. You're going to be able to see when medications are due.

Colby:

If you're organized, you can map out your whole day. I mean you have to be flexible, of course, because there's always going to be a wrench thrown into your plan. But I mean, if you have like a general outline because you were organized at the start of your shift, it's going to be okay to be bendy and flexy and make moves, because you know you can anticipate what is going to happen. So you can, you know, make adjustments where you need to. So I think those are my three.

Christopher:

Yeah, I think those are good. I think all of those sound great. I also would agree that the unit-specific medications is a very important thing to do and you know I was in a unit that was the same as Colby's, but it wasn't until I transitioned to transplant that I had to learn antithymocyte globulin. I had to learn what Celcept or mycophenolate was, or tacrolimus or Prograf, or Bella or Similac, like, like Belatacept excuse me, bella is Belatacept and Similac, like all of these are all transplant specific medications but they also have very unique side effects, like. You really need to know that and as a nurse, we have said this before you educate your patient. So when I give tacrolimus and we talked about this you know Prograf is good for your kidney but tacrolimus is also the quote-unquote nerve drug. You get tremors. If you have a high dose of tacrolimus you can have headaches, you can have all these things that kind of happen. And then Cellcept is more of your GI medication where you're thinking nausea, diarrhea.

Colby:

So as a Clin 1, you're gathering all this information. Eventually you'll get used because you're giving again. These are like unit-specific meds. If you're on the transplant floor you're going to get used to giving these meds. You're going to know it like the back of your hand. But it's like Christopher said, part of our responsibility and our job role is to educate the patient.

Colby:

So if someone came in and they got a transplant you know on this admission, and they have a new organ and now they're getting all these new meds and like of course they probably had pre-op education and been told that they were going to start these meds. But it's a very overwhelming time before and after surgery and so we are all working together to kind of try and solidify this. And so we are all working together to kind of try and solidify this new information with our patients so they might say, like what is the TAC drug again? And like while we're giving these meds, we said this is tacrolimus, this is an anti-rejection med for your new organ. Blah, blah, blah. Like it is our responsibility to do that education. We actually have to document that we do that education their ability to have conversation.

Christopher:

Communication is a class given in a lot of different colleges. There are different ways to communicate to people, there are different books about communication, and it is something that you will need not only in nursing. You will need communication everywhere. And I will be the first one to say I am not the great at my communication skills. I'm not. I am very introverted. I'd much rather just talk to myself and have all my thoughts in my head and never say them out loud. But I am on multiple occasions confused as an extrovert, because I have learned how to come off as this person who knows how to have communication with other people, but I don't. I really don't. It's a struggle for me and I encourage you to embrace that struggle and go through that struggle, the last thing being willing to struggle.

Colby:

Yeah.

Christopher:

Because,

Colby:

it's uncomfortable,

Christopher:

it's uncomfortable, and I am one who also absolutely hates to be last. I am very competitive. I hate. I just hate it. I hate being the struggle bus of an anything. But you as a clin 1 are going to struggle and that's ok. It is. It is totally fine, when you struggle you learn you allow your muscles to just like lifting weights. I don't know why I hate lifting weights, like genuinely. I am more of a calisthenic No-transcript workout person. So I don't know why I keep referring to lifting of weights as analogies. But as you lift weights, your body strains. That strain, that struggle builds more muscles and that more muscles makes you able to lift and strain more. And so when you are in the trenches struggling, know that this is going to be hard. It is not easy. This is not an easy job. This will not always be sunshine and rainbows, with wonderful daisies and sunflowers. You will have days where you go home and you cry yourself to sleep. That's going to happen.

Christopher:

is your ability to be resilient that is going to get you through your Clin 1. It is, and you have the ability to reach out to those that you have mentors. Your manager is a great resource and does not want you to struggle alone. So reach out to them when you're struggling and talk to them, because it's important. It really is your charge nurses.

Christopher:

Though they might not be as available on the floor, I'm sure would love to grab coffee with you. I'm sure would love to grab a bite to eat, would like to do things outside of work so that they can ensure you are taken care of, because this is your big person job. And you are like, I just jumped in I'm drowning because I have never known this amount of acuity, because I was just a nursing student and I only took care of that one patient, or I was with the nurse, but I really didn't do it because the nurse was the one that was actually doing the work and doing the assessment. I just kind of lackadaisically did an assessment on my own computer or paper or whatever, and then you're, you're thrown in and you're like hope you float.

Colby:

It does feel like that, at least the hope you float, sink or swim situation. But but no, that that's how it feels, but it's not reality.

Christopher:

It's not.

Colby:

And don't be afraid to ask for a life preserver, because there are people that want to help you.

Christopher:

And we really do.

Colby:

But if we don't know, then we can't. So you do, you know you got to be you have to ask for help. Sometimes, I mean as charge, I do keep a close eye on my graduate nurses who are freshly off orientation, keep a close eye on my graduate nurses who are freshly off orientation. And you know we're also making assignments for you know the next shift and there's graduate nurses on every shift. So we want to make sure we're setting you guys up for success and giving you an appropriate assignment so that you don't feel like you're drowning.

Colby:

But there's always, you know, unexpected, unexpected outcomes and, like a patient that was super stable all day can suddenly start circling the drain. And so sometimes those difficult shifts happen and, like Christopher said, like you may feel like you're just gonna like burst into tears. And I've done it. I've cried at work, I've cried on my way home, um, because just the shift, overwhelming. And this is not even like in my new grad year. I'm talking like I have, not too recently, but I have, in the last year at least, have had a bad enough shift. On the way home I'm crying. So it is an unfortunate byproduct of our job, but know that, like you are not alone, and when it all feels so overwhelming, know that there's somebody else on the unit that has been in your shoes in that moment as well, and we are comrades

Christopher:

yeah yeah you're never alone.

Christopher:

And to colby's point, when charge nurses makes an assignment, 9.879% of the time they are not doing a bad assignment to be malicious.

Colby:

Oh yeah, no,

Christopher:

Like if you... We as humans do not have the ability to have a crystal ball and say, oh yeah, this patient is going to decompensate at to 0200 and

Colby:

yeah, and they're gonna have a shit night

Christopher:

like yes, it doesn't happen that way.

Colby:

Yeah,

Christopher:

so you know, just just know that it's not intentional, but you can this. Those are, if you feel that way, that's something that you should

Colby:

Speak up about

Colby:

for sure,

Christopher:

yeah, approach about.

Christopher:

And it's okay to be like hey, I just realized that, you know, my assignment was a little harder than I anticipated it for it to be. Is there any reason why, like is there any way that I can, and maybe it is something that you yourself can improve on?

Christopher:

right, like, maybe you have to have something to improve on, but maybe it's just that you know

Colby:

also a note while we're talking, and I think it's super important to empower um graduate nurses like if you do have a shift and like one of the patients on your in your group was just kicking your ass like you just like are you were just beat down at the end of the shift, like that patient was so heavy and like whether it was like emotionally heavy, like they were a patient that was just like mean or crude, or like if it was like actually like medically heavy and you need a break. Like I empower a any nurse, not just a graduate nurse, but because we're speaking on being clin 1s today um to talk to your charge nurse and say, hey, I'm back, you know tomorrow, or I'm back tonight, but depending on what shift you are and I don't think I can take 13 back like I need, a break from that that patient. It was a hard night and that's totally acceptable. Yeah, like we can. If, if you want to hold just, you just have to use your words and explain and explain like just that patient. Or you're like just start me over with a whole new group.

Colby:

Like you can ask for that at the end of your shift you're like hey, this, this was not it like this group should not, or you know, or if you're like I'm fine with taking, like, some of these patients back, but and maybe you just didn't realize that they're very heavy all together and maybe we need to like just you know, make don't put these two patients together for your next, for your next shift, like if you're leaving and whatever.

Colby:

Like that insight like while we are in charge, like charge nurse roles, and we have we do know a little bit about everyone, or we know a lot about every patient on the floor, like we don't know everything. So it could be just that you feel like you're, maybe you feel like you're getting beat down in your assignments as a Clin 1, the charge nurse might not realize the acuity of the patient. Hopefully you know it has happened in the past. It's just like you know human error. So like, definitely, I want to empower you all to like speak up and talk to your charge nurses and let them know, because they are the ones making the assignments.

Christopher:

And really and truly, it really could just be the layout of the unit, because your unit, even its little adjunct, is actually pretty close together yeah and my unit is,

Colby:

yeah, I twice as big

Christopher:

yeah, I could go the entire day and never know someone else is working.

Colby:

Yeah, that's true

Christopher:

and that's you know. The charge nurse is a resource and does that's you know. They truly are amazing because they do know a decent amount about every patient.

Colby:

Something else about assignment making But you know you just geographic. Like I have a patient in one end of the hallway in room 20 and another patient at the other end of the hallway in room one. Like that's kind of far. I would like my patients to be close together. Can we consider that? It's always fine to ask and maybe it could be changed to make it easier. But just know that sometimes when the chargers is making assignment, the front of the hallway one through six might be super heavy patients, so you can't give a nurse including yourself as a new graduate nurse this. You know the front of the heavy patient.

Colby:

Yeah, because then you're like what the heck? So it's, you've got to split it up. But again, I empower you to ask questions and bring up your observations, because if you don't, then you just one you, you don't, you don't share the information the charge nurse doesn't know, and if you don't ask the question, then you don't know about the acuity of the whole floor. So I think it's just something to keep in mind.

Christopher:

Yeah, so you know. To recap all of this, you know, in terms of learning, one unit-specific medications.

Colby:

Yes.

Christopher:

Colby's number two.

Colby:

Time management.

Christopher:

And Colby's number three.

Colby:

Organization.

Christopher:

Okay, christopher's number two is is, you know, being able to communicate?

Colby:

yes, it's important.

Christopher:

And then number three number three christopher's number three is being willing to struggle, yes, and so you know all of that is important and I think when you combine all of those things you really, as a clin 1, will start to blossom and find your rhythm. You really will.

Colby:

Yeah, for sure.

Christopher:

All right, class dismissed.

Colby:

Let's wrap it up.

Christopher:

That's a wrap for today's session of Nursing Lyfe 101. We hope you found some useful takeaways to bring back to the floor. Remember, nursing is a lifelong learning journey and we're here with you.

Colby:

If you want to connect, find us on Twitter at NurseLyfe101, or on Facebook at NursingLyfe101. And don't forget to subscribe and share with fellow nurses. Until next time, take care of yourselves and keep making a difference out there.

People on this episode

Contributor

Christopher Henderson

Co-host
Contributor

Colby Daniel

Co-host