The rites of passage in a nursing career

Becoming a nurse is a lot like growing up: As the years go by, a nurse hits certain milestones and rites of passage that mark your years of experience. We all have been through the trials of nursing school: anatomy and physiology, clinicals and studying for tests.

The fun doesn’t stop there, though! Once you actually begin practicing, you’ll have a whole new set of milestones to look forward to! This is a list of merely five of them, but many more exist for working nurses.

First Day on the Job
Your first day on the job might make you feel nauseous. It’s just like clinicals—except it isn’t. This time, they are paying you to put your skills to good use and take care of patients. Of course, you have your preceptor beside you, but not many nurses will forget their first day. If you’re lucky, it won’t involve any other earth-shattering milestones. You will remember it simply as the first day you stepped on the floor, were called “nurse” by patients and coworkers alike, and were a part of a medical team.

First Call to the Doctor
The doctor can be the boogey man in the life of a nurse, and never is he more feared than when you are new. You wonder if you will have everything you need to talk to him. You think long and hard, attempting to anticipate his every question. You gather the chart, lab work and vital signs around you. You take a deep breath and call, hands sweaty and shaking on the phone receiver.

Really, it doesn’t have to be fraught with so much stress, but when it’s your first time, it’s actually helpful to be a little scared. It will allow you to gather the information you need and be concise. Remember, doctors are people, too, and they want to help the patient just as much as you do. Sometimes it may not seem that way, but deep down, it’s true.

First Day Without Your Preceptor
This is where the rubber really meets the road. When your manager and preceptor agree that you are qualified enough to operate on your own, you’ve really hit the big time. You will likely spend that entire shift double and triple checking everything you do, but most of the time, everything will go off without a hitch.

Remember, you are never truly alone. That’s why there are charge nurses: to help poor, struggling new grads. Don’t be afraid to ask for help or to pull from the resources around you. Many nurses still turn to each other and ask if they are doing the right thing. This is not only expected of a new nurse—it is necessary. Nurses don’t trust new grads who think they know everything and don’t need help. Ask your coworkers to help you, and have no regrets about it.

First Code
Hopefully, this milestone comes not too terribly close to your first day on the job! Getting experience under your belt before your first code is essential, but it doesn’t always work out that way. Sometimes, you have to jump into the deep end feet first and manage a code when you’re new. Codes are always stressful, regardless of your experience level. You will remember your first one like it was yesterday, in painstaking detail.

When you have your first code, it will be the first time you have to put to use all of those skills they taught you in school. You will have to perform compressions, push medications and give a bullet assessment to the doctor running the code. Take a deep breath and calm down. You don’t have to be perfect, and it will all come back to you. Trust yourself and your skills.

First Death
Nobody forgets their first patient death. With luck, it won’t happen to you until you’ve been nursing for a while, but it will still feel like a kick to the stomach. You can watch someone else’s patient die, and that’s difficult enough to take. It’s even worse when it’s the patient you’ve been caring for during your shift. Even after the first death, other deaths seem to linger because they’re always emotionally charged and they happen so rarely.

Know first that you are good enough. It’s common for nurses to question themselves mercilessly, thinking that there was something they could have done. The truth of the matter is you likely couldn’t have done anything more. Everyone dies, and no matter how good a nurse you are, you can’t avoid that. Of course, do your very best, but realize that even if everything goes right, you may not be successful in saving a life. Sometimes this is tragic, and sometimes it’s for the best. You will remember it, though, and it will ultimately make you a better nurse.

What are some other milestones that belong on this list?