Transitions: from senior practice to Registered Nurse

June 10, 2015

RRC Nursing Graduates, Chantal Fortney, and April Graham talked with RRC Nursing students who were about to enter their senior practicum. They told their stories and shared the information that “they wish someone had told them” as they were embarking on the transition to senior practicum and then Registered Nurse.DSCN0293

From classes to Senior Practicum

They spoke of how “building a relationship with your preceptor” is fundamental and takes effort. One tip was to have a five minute debriefing at the end of each practicum shift to help define and work towards a positive working relationship. It is important to set your expectations, boundaries, and have the preceptor assess your skills. An integral piece of advice was to know your facility’s policies and standards. Learn the routines on the unit. “Think of yourself still as a student and try to absorb as much as you can. The practicum RN is there to support you.” April reflected on the first days of senior practicum, when she was still getting used to three twelve hours shifts in a row in her rural hospital setting. She said it’s a good idea to do a few “shadow” shifts and even spend some time shadowing the unit clerk to truly understand how to be efficient in the specific setting. She said in those first shifts, you are learning and transitioning into “who you are as a nurse”.

Chantal shared an experience from one of her first days on her acute medical unit, observing an overwhelming wound dressing change. Her reflection was: “I don’t know if I can do this”. Through perseverance, she later commented that during the last weeks of her 3 month practicum, she had learned to trust her gut instincts. She observed an acute situation and anticipated all of the actions the interdisciplinary team should have been taking to help the client. She found herself “thinking like a nurse”, and proud of her ability to critically analyze, and anticipate nursing implications and interventions.

A strong message to the current students was “90% of what we get tested on in the BN program, we should still do”. For example, when administering medications, don’t take them out of the packages until you get to the bedside. Safety checks are extremely important, every time you give medications.

Although you may only be at your practicum site for three months, it may be a place that you would like to work after the experience. Chantal and April emphasized taking time to build connections. They told the students to make an effort to get to know the staff and the unit manager.

They discovered more about the other disciplines on the units as well. They spoke of consulting with these disciplines to advocate for clients, and how important it was to know your scope. For example, the practicum student cannot sign off on doctor’s orders. Taking time to learn about the paper work and charting involved, was essential to becoming proficient with care.

Through sharing of stories and humour, the RRC graduates talked about adjusting to twelve hour night shifts. Their bodies had to adjust to being functional through the night, and then attempting to sleep in the day. When one works long night shifts and has children at home, those days must be organized ahead of time. Some tips when beginning a stretch of night shifts might be to stay up very late the night before, and sleep in for as long as you can, or another strategy might be to take a very long nap in the afternoon before you go into work. When sleeping after the night shift, make sure your phone is turned off, and you have no distractions.

From Senior Practicum to working as a grad nurse

As the required shifts for senior practicum come to an end, the entry to practice Registered Nurse can prepare to take the RN licensure exam. April and Chantal both agreed it is best to take your time to study for this exam. They advised buying the books, and practicing writing NCLEX style questions.

Before completing your practicum shifts, ask your manager if they could be a reference for you if needed in the future. They spoke of preparing for interview questions that that might arise during the job search process.

Having experience with twelve hour shift work, the former RRC students fully understand the importance of self care. They recommended going through your MARRs at the end of each shift to ensure everything is documented, and how it’s often important to separate work and personal life.

They said once you are hired somewhere, even if it’s the same place as your practicum experience, take a full orientation. It is important to learn the role in which you will be working from the perspective of new employee and not only a student.

April and Chantal shared some challenges, such as learning to delegate as a nurse, and consulting with doctors to advocate for your patients. They shared how important it is to continually develop tools to maintain organization such as worksheets and having the equipment you need in the pockets of your uniforms.

The Students entering their senior practicum valued the information provided by Chantal and April. Thank you to these two graduates of the RRC BN Nursing program for taking the time to share their experiences, and advice.