Traits to Develop as a New Grad Nurse – An Interview with Nurse Mo

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Who You’ll Hear

Kati Kleber, MSN RN– Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, and speaker.

Maureen aka Nurse Mo, MSN, RN, CCRN runs the Straight A Nursing website and podcast. She is the author of the Nursing School Thrive Guide and the creator of Crucial Concepts Bootcamp, a nursing school prep course that teaches students core concepts and HOW to be successful. Nurse Mo has been a nurse for the past 10 years, with experience in ICU and PACU, and has precepted many students and new nurses in the critical care environment.

What You’ll Learn:

Join Kati and Nurse Mo as they discuss helpful traits to develop as a new grad nurse. These traits will help you as a new nurse and beyond.

Traits to Develop as a New Grad Nurse

Reactive vs. Proactive

You’ve mentioned before the importance of being proactive versus reactive. Can you outline what that actually looks like on a practical level?

Time management is KEY to having a smooth shift.

Reactive

• This leads to stress, and overwhelm
• Chasing your tail
• Never feel like you’re “caught up”
• Problems happen one after the other, can’t get ahead
• Things can spiral and you feel out of control.

 Proactive

• Anticipate needs and plan ahead
• Anticipate problems and take steps to avoid them
  • Ex: Patient who is fluid volume overloaded
    • Plan ahead, see I/O, see the weight, see their IV fluid orders: take steps to DC IV fluids. Easy.
    • Don’t plan ahead. Don’t notice the I/O, don’t get IV fluids DCd, now it’s 1730 and you’re calling RRT b/c pt has pulmonary edema and needs IV furosemide and BiPAP.
• Easy ways to be PROACTIVE

• Jot down pt problems after report…make a short list of things you’ll do to address them (care planning on the fly!)
• Discuss a plan of care with the patient…set goals together
• STAY present, NOTICE what’s going on with your patient.
• Plan how you will maximize your time in the room…can you do 5 things?
• When you leave, ask the patient what you can do/bring/address NEXT time you come in…anticipate their needs ahead of time
• Another great example is mobility…the proactive nurse mobilizes her patients knowing that increasing mobility is one of the best ways to prevent acute delirium…and it takes 10-15 minutes. Whereas dealing with a patient with acute delirium can easily take over all of your attention for your entire shift.

Hypervigilance and Situational Awareness

Something experienced nurses are great at is having this level of awareness surrounding subtle changes that on the outside looks effortless. As a newbie, it can be frustrating to see an experienced nurse walk into a patient’s room, take one look at them, ask all the right questions and immediately know what’s going on. Can you talk us through this a bit and how new grads can begin to build this skill?

• Noticing
• Awareness of sights, sounds, smells, moods…all vital components of hypervigilance.
• Probably the sense that gets the biggest workout in the clinical setting is sound…you can HEAR so much more than you can see.
• O2 sat tones…I can tell when my pt’s o2 sat is dropping without even looking at the monitor…b/c the tone changes. The QRS elicits a beep with every beat…I can tell if my pt becomes bradycardic or tachycardic…without even seeing the monitor.
• When I step away from the bedside I check that I’m clear of any tubing, the restraints are in place, the NG tube is still taped to the nose, etc… notice this all the time.
• A story about RYAN and the rain
• Takes an enormous amount of energy to maintain that level of awareness but it’s really key.
  • 5 things to assess with every interaction

How to Learn from Past Experience and then Apply that to Future Situations

Do you have any tips or “hacks” to help new nurses truly get the most out of each shift?

• This is huge! It means you are teachable. This is how you 10X your clinical competency.
• Tanner Model
  • Example: NGT that was pulled TWICE!
• As you encounter episodes, situations, clinical scenarios, disease conditions, complications…NOTICE what is done (or not done) and file that way. Use that when similar situations come up.

Where we can find Maureen and take advantage of her amazing resources

• Nurse Mo’s website: https://straightanursingstudent.com/
• Nurse Mo’s podcasts: https://straightanursingstudent.com/podcast-2/
• Nurse Mo’s courses for students: https://straightanursing.mykajabi.com/store