Notes to Myself as a Novice Nurse Protection Status
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by Diana L. Gallagher MS, RN, CWOCN, CFCN

Recently, I have been intrigued by a variety of celebrities offering us a glimpse of their inner selves as they share what they wish they had known when they were young. These "Notes to a Younger Self" are fascinating to me. Wouldn't it be wonderful if we knew what we know now when we were first beginning? Would knowing have altered our decisions or the paths that we have taken? I don't know but I have to wonder.

It certainly would have been nice to know what I know now when I first started my career as a nurse. I was blessed with great mentors and preceptors; and, I was exposed to leaders who inspired me. I still remember the name of my very first charge nurse and preceptor. Cathy and Libby set the bar very high as they freely shared knowledge, experience and support.

During the time between taking boards and getting results, new nurses were in limbo. You were no longer a student, but you were also not a registered nurse. The solution, at least in Texas, was that you were a "graduate nurse". I began my career as a Graduate Nurse on an intense Med/Surg unit that served as the precursor for an ICU step down unit. The predominant focus was GI and GU. As a student, I detested Med/Surg rotations. I did not like my nursing instructor and lived every shift in fear of some unforeseen disaster.

As a Graduate Nurse, life was different. My preceptor, Libby taught me so much more than I had learned as a student and made me look forward to every shift. Successes were celebrated and with each skill mastered, new challenges appeared.

My memory of one of my very first patients is as clear today as it was so many years ago. We used to joke that if you did not have 7 lines, you did not belong on our unit, 7East. My patient clearly belonged and had lines everywhere including multiple IV sites, and both central and peripheral lines. He was terminal and was surrounded by a loving, protective family.

During my morning assessment, I identified that the peripheral line had infiltrated and needed to be replaced. I immediately went to find Libby because this man had been through enough and deserved the best in care as opposed to a novice attempting a difficult IV stick. Libby came in and agreed with my assessment and together we began the process of removing the existing catheter and preparing to restart the IV in a new location.

I was literally stopped in my tracks when my patient's loving wife, kindly asked if it would be ok if I started the IV as opposed to Libby. Libby assessed the situation and asked if there was a reason. The wife's perception, however wrong, was that a Graduate Nurse was more experienced than a Registered Nurse and her husband deserved the very best. Libby did not correct the misperception and agreed. Every patient does deserve the best. With a look that clearly told me that titles were not an issue to debate, Libby assisted me with that extra pair of hands and emotional support that is sometimes needed.

I was successful on the first attempt and learned several important lessons that I carry with me every day. Good enough isn't good enough; we all deserve the best. When facing a challenge that may be scary, take a deep breath, review what you have learned, and proceed with confidence. Finally, have the confidence in yourself that others have in you.

Because of Libby and the team of nurses I was privileged to work with, I built a solid foundation of nursing skills. I learned how to prioritize and I became a good nurse. Little did I know that my time on 7East would impact my career choices. It was on 7East that I met my first ET nurses and cared for my first wound and ostomy patients.

I have enjoyed a good career that I hope to continue for years to come. However, could things have been even better if only I had made different choices? What counsel could I have been given; what counsel would I have accepted? It is an interesting question to ask. If we had the luxury of hindsight, what would you wish you had known when you were first beginning your journey?

My "Notes to a Younger Self" would include the following advice:

-Work is never just a job when you love what you are doing. Always look for jobs that you love. All the others are going to be just work.

-Dream big but live even bigger. Don't be afraid to set grand goals for yourself. They will be reachable if you believe in yourself. When necessary, remember to break big goals into manageable pieces. By doing this, you will be able to complete those goals and make your dreams a reality. Establish your plans and set goals for yourself that will place you on the right path to make your dreams real. Avoid taking detours, no matter how inviting, that will take you off the path that you are trying to travel.

-What you learn and, in turn, what you teach will change lives. Be generous with your knowledge. Remember that you are teaching by example and pattern behaviors that you will be proud of.

-Seek those opportunities that allow you to continue to learn and grow. They may be formal or informal and sometimes you will learn valuable lessons from unlikely teachers. Everyone you encounter has something to teach you and it is your job to learn. Not all lessons will be positive. You can learn from your mistakes and failures, as well as from others' mistakes and failures. These lessons are ones that you do not need to repeat. It is hard to imagine being old, but age should never become a reason to stop learning. Embrace education in all forms and develop a pattern and a passion for life-long learning.

-As you gain the skills and credentials that will help you advance along your career path, remember what your specialized knowledge is based on. Never become so specialized that you are unwilling to deliver the basic care that a patient needs.

-Remember all that you have been given and be determined to repay those debts. Remember to say "Thank You." Seek opportunities to inspire others the way you have been inspired. Reach out to those who are beginning their own journey and inspire them to grow and reach incredible goals.

-Life is going to be busy. Slow down and take the time to listen. Patients will normally tell you what their problem is but only if you take the time to hear them. Husbands, children, friends and family will seek your counsel. Listen carefully before speaking. Hear their stories while making some of your own.

-Don't be afraid to push yourself. Your life is not supposed to be easy. Take reasonable risks and be willing to go on new adventures. Doing something that scares you is not necessarily bad and may help you grow.

-Remember the value of human contact. Sometimes words will fail you and in times of tragedy seem so inadequate. A simple pat on the hand or hug may provide more comfort than you will realize. Touch patients and allow them to touch your heart.

-Begin a journal and use it to capture the adventures and the stories that will come your way. It will be a challenge to find the time to write, but make the time. You may think that there will be time later to write something important down or believe that it is so important that you could never forget. Details will be lost and these adventures are worth capturing. Someday, you will look back on them and be glad that you took the time.

-Everyone has a story to tell and when you are struggling to make your way, it may be hard to know how your story will develop. Know that your story, like everyone's will be filled with adventures, triumphs and tragedies. Yours will not be an easy path and you should not expect your life to be fairy tale. Even in fairy tales, every main character has to overcome challenges and adversities before ending up with their "happily ever after." Even with the challenges that you will face, your journey will be worth the trip. Make it memorable.

What advice or lessons would you share if given the opportunity? We clearly can not go back and impact our own careers, but is our career path so unique that these lessons would not benefit others?

About the Author
Diana Gallagher has over 30 years of nursing experience with a strong focus in wound, ostomy, continence, and foot care nursing. As one of the early leaders driving certification in foot care nursing, she embraces a holistic nursing model. A comprehensive, head to toe assessment is key in developing an individualized plan of care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

WoundSource ENEWS


Love the content of your blog. You are such a good writer and a great mentor! I love your pearls of wisdom and always feel recharged when I am lucky enough to get one :D
Write On!!

I loved reading your blog, It gave me inspiration and hope. Specifically, it made me think that there is hope for many of the "new grads" per se that are unable to find jobs, due to lack of experience yet no facility is will to hire and /or train ,which or course entails allowing them to have that preceptor, or someone to learn that wisdom from. I have had my license for a year and still cannot find that job I want or even aspire to get. I am not trying to take away from your amazing and inspirational blog entry but I am hoping the nursing industry will somehow go (back) to a place that you described; an amazing learning experience. Again I thank you for sharing. L

I am so sorry to hear that you are having such a challenge finding that "right" first position. There is a trend among facilities over the past few years to begin just this sort of mentoring program. They come under a variety of names but are grouped under the general term "nurse residency programs". They essentially offer special attention and additional education to new grads. These programs range from a few weeks to months and a few continue through the first year of practice.

These programs are truly a WIN- WIN. If they did not benefit the employer, they would not be so popular. They are a tremendous plus for both the new hire and the employee. Everyone realizes that nursing education is not able to prepare students with everything that they need to know. The result has been that the retention rate among new nurses is very low. There are those nurses who accept a job while waiting on their "dream" job to open and when it does open for them, it is goodbye to that first position. Others leave for a variety of reasons, including disillusionment.

Good luck finding that first job. While you are looking, explore other options that will build your resume. If you would like, please contact me directly and we can chat about other ideas.

Diana Gallagher, MS, RN, CWOCN, CFCN

Your comments about nurse mentors is so spot on! Not having any, or having a bad one, can make or break a career sometimes. I'm lucky for the 1 or 2 (like yourself) that made up for the one(s) that made my career so much harder.

Thank you so much,


Nurse residency programs are a wonderful start for a new nurse. Unfortunately, one may experience age related partiality in this type of program. I was not young when I graduated from nursing school (48). Although I graduated with honors and an award for the most caring nurse in my class, I was never accepted for these type of residencies. I applied for several. I went through 11 interviews before being hired by a county hospital 9 months later. Working hard for 2 1/2 years on night shift, my medsurg director would tell me she wished there were more young ones with my determination and work ethics. Medsurg is not my favorite form of nursing, but I still work there and got certification in wound care which I paid for myself because I really love it. No one offered me tuition reimbursement for this. It led to me being offered a position in the wound care clinic. By the way, I took a 10 week phlebotomy class while looking for a nursing job in order to show my work ethics in my phlebotomy clinicals to the hospital that hired me. As the saying goes, sometimes you just have to make lemonade when life hands you lemons. I also worked a month free in the wound clinic during clinicals and they decided they wanted me to come permanently. Do not wait for someone to hand you your dream nursing job, work towards that goal. It will happen. I am still working on it. I am 53 now.

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