Jayme Maley

    When you graduate from Nursing School, you think you have learned all the skills you need to be prepared for working in the real world. Whether you’re working in a hospital, nursing home, or doctor’s office you know all your hard work, all the classes, clinicals, late-night study groups, and tests have prepared you for what’s ahead.

    Then you learn one more lesson: you were wrong. Sure, you can successfully triage patients, administer medications, measure and monitor vital signs, insert IVs, and administer fluids, no problem. But what about all the things they didn’t teach you in class and information that can’t be found in one of your books? You are suddenly faced with lessons in the real world.

    Working with nurses daily, and being friends with and family to many nurses, I have gotten to hear numerous stories of the things they wished they would have known before graduating from nursing school.

    For example, Pocket Nurse Corporate Nurse Educator Beth Telesz, MSN, RN, says she wishes she had had a “Code Class”. “Not one class,” she says, “but an entire course or mini-course on what actually happens in an emergency situation.” Ideally, it would include the textbook component, the real-life component, and no less than five simulation scenarios on getting educated, confident, and comfortable with emergencies and how to expect and respond to what is always unexpected.


    Telesz also says she wishes she had been taught how to communicate with different members of the care team. “In nursing school, many years ago now for me, we learned how to give shift reports and perform hand offs and what information to include. As a new RN, I’m pretty certain I gave the same level of information to the nurse following me as I did the cardiologist -- which was ‘TMI’ for the physician. As a brand new, novice nurse, I would’ve benefited greatly from a class on what information to provide to each different member of the care team."

    This is echoed by E. Murphy, RN: “A class called Nursing Communications that taught you how to deal with so many different people. Doctors, other nurses, administrators, patients, their family members and all their personalities! While providing the best care possible to your patients, of course.”

    On-the-Job Survival

    Time Management/Disaster Recovery – “In clinicals I had four patients. I wish we had been taught to juggle seven, eight patients with IVs beeping, demanding families, post ops with staff out sick and no assistant, when the computer system is down.” -- S. Andochik, BSN

    Shoes and Snacks – “I would have liked to have known to purchase the most comfortable pair of shoes you can find, no matter how ugly and how expensive. You are on your feet and running all day. And make sure you have plenty of snacks in your locker for you and your fellow nurses. Who has time to sit for lunch?” – J. Barber, BSN

    In the Trenches

    Anthony Battaglia, MS, BSN, RN and President of Pocket Nurse has a list of things he would communicate to future nurses:

    • How to complete a bed bath… on a ventilated patient with an arterial line, two central lines, tracheostomy, all while the patient is on a sedation vacation (which is when the IV drip is interrupted to wean a patient off a ventilator).
    • Bladder control
    • How to eat on the go
    • “Patients will claim allergies they don’t have,” Battglia warns. “Sometimes an allergy is something they just don’t want to take.” Be sure to read the chart thoroughly.
    • “It’s a smelly job,” Battaglia says. “Nothing can prepare you for the stench.”
    • NEVER assume who family members are (i.e. spouse, girlfriend, mom). You’re bound to make a big mistake.

    Graduating is only the beginning. As a nurse you will continue to learn and hone new skills through the rest of your career. But having an opportunity to share what you wish you knew is a great gift to your fellow and future nurses.

    Please leave a comment to tell us what you wish someone would have told you before graduation, or a course you wish you had had access to in school. Tips of the trade welcome!