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First Day as a Nurse on the Job

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First day as a nurse on the job

Excited. And nervous. Excited and nervous. Mostly nervous.

First Day as a Nurse on the Job

Dear Journal,

Today was my first day as a nurse on the job. I’m an RN! I worked one whole shift as an RN!! I’m so tired..but here’s how my first day as a nurse on the job went…

I slept terribly all night. I woke up several times, at 0100, 03:30…but then was sound asleep at 0530 when the alarm went off.

First Day as a Nurse on the Job

I showered, pulled my hair back, put on a skinny blue headband and my new Danskos.  I changed my blue headband out for a pink headband, then back to the blue. Blue is more professional, right?

I wanted to pack a lunch, leftovers from takeout last night…but… maybe they don’t have a microwave. I stuck $10.00 in my pocket. Surely that would be enough for lunch in the cafeteria?

Driving to work, I rehearsed everything I knew about telemetry patients. I’m not very good on  heart blocks. What if my preceptor asks me things I don’t know? On the floor (I got there 20 minutes early), at 0700, the staff all gathered at the desk for huddle. No familiar faces. No fellow students…wait, I’m not a student any more.

The Charge Nurse looked up from her clipboard. “Jessica? New resident?” I nodded. “You’re with Danielle.” Danielle looked at me briefly, and half-nodded. “Come on. I’ll show you where to put your purse. And phone. No cell phone on the floor.”

In the staff lounge she asked “Where’s your lunch? Mark it and put it in the fridge.”

“Umm…I didn’t bring my lunch,” I answered.

Danielle said “I always bring my own food. No one eats in the cafeteria.” Oh. Ok. “Just follow me for now.”

Feeling awkward, I shadowed her. Danielle was always doing three or four things at a time- answering her phone, assessing patients, peeking under covers, pulling meds. It was dizzying. And she seemed so confident. Nothing rattled her. Such a pro.

Mid-morning, she got a call that 2116 was coming back from surgery. A post-op total knee. “Let’s go.” We both helped pull him over from the guerney onto the bed, and then Danielle left to answer another call. Left alone, I adjusted his covers and pillow. He was grimacing in pain. “Hi, I’m Jessica. I’ll be your nurse. Can you tell me your what your pain level is on a scale of 1-10?” It was a 6. I showed him how to use the morphine PCA. It was amazing. I felt so …helpful. Knowledgable. And competent. A real nurse. Taking care of a real post-op patient. I checked his dressing, took his vitals and coiled his drainage tubing nicely on the bed. Performed neuro checks on his foot. Wow. I think I got this, I thought, leaving the room. “I’ll be back soon to see how you are doing,” I reassured him.

In under 2 minutes Danielle called me. “Jessica- go into 2116 right now. And put the bed down.” I had left the bed up in high position. Omg!!! He could have fallen out and hurt himself. Would she write me up? Did she think I was utterly incompetent? How could I do that??

Soon afterwards Danielle asked me “Want to hang your first antibiotic? I’ll watch you.” Yay! Maybe she thinks I’m competent, after all. I pulled the Cefazolin, went in the room and told the patient I would be giving her an antibiotic for her infection. She was to let us know if she experienced any rashes, itching, or nausea. I was thinking I was coming across very professionally when she squinted and said “Are you old enough to be an RN?”

“Um..yes” I said (feeling like I was 16). I proceeded to identify her with two identifiers, check for allergies, scan the medication, spike and prime the antibiotic, remove the antiseptic cap on the proximal primary infusion hub, insert the antibiotic tubing into the primary, and program the infusion pump for the antibiotic infusion. Fingers trembling, I pushed “Run.” Triumphant, I gazed up at my preceptor. Danielle just stood there, stone-faced, clearly not approving.

Confused, I reviewed everything I had just done in my head. What had I missed? I glanced at her but she just raised her eyebrow and tilted her head towards the machine. Ohhhh….I forgot to release the rollerball clamp! It never would have infused! I felt my neck turn red. I hate my genes.

Sometime later in the afternoon, past lunchtime  (but lunch had not yet been mentioned), I went into the bathroom just to be alone. Sitting there in the quiet, I  tried to re- group. Outside there was chaos. Continuous alarms (which mostly seem to be ignored), phones ringing, call lights going off. People pushing huge meal carts and noisy Xray machines. Everyone looking as if they know what they’re doing. Not me. I was totally lost, and tired, and hungry. I would have given anything to have my Clinical Instructor with me. For a post clinical debriefing. But I’d better leave the bathroom and go check on our post-op knee.

This time his wife was in the room. She smiled gratefully “Are you Jessica? My husband said you are such a nice nurse and really helped him. Thank you.”

“You’re welcome,” I replied, surprised at how good it made me feel. Wow. I had made a difference! I could see the relief on her face, and suddenly I didn’t feel hungry or tired any longer. I looked at his face- he was so much more comfortable. Good. I wanted to bring him a warm blanket, or fresh cold water.

Much, much more happened today. But at the end of the shift Danielle  said “You did good, Jessica. I’ll see you tomorrow, OK?”. And now to bed, dear journal. 0530 comes early.


Jessica, RN

P.S. I am reading:

Avoid These Newbie Blunders

First Day off Orientation


Until next time friend,

Nurse Beth

Come visit me at Ask Nurse Beth career column at for all kinds of  entertaining and informative career questions and answers, and to submit your own question :)


About Beth Hawkes (146 Articles)
Nice to meet you! I'm a Nursing Professional Development Specialist in acute care, a writer, speaker and career columnist.

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