Last assignment handed in, last prac attended so it's time to start on the next learning phase. Your first job will be a steep learning curve which many nurses find very difficult. It's different to be responsible for the care of a patient on your own and it's often daunting to have to make important calls on patient care on your own.
When you consider your first position as a Registered Nurse, look closely at the support you can draw on in the hospital or healthcare area you choose. Is there a Graduate Nursing Programme which will help ease you into the new environment? Have you thought about the type of nursing you prefer? Are there mentors available so you can talk through unfamiliar ground?
Next, prepare for the interview. Learn all you can about the hospital you want to spend a large portion of your day in. Find out about speciality surgery or research undertaken at the hospital. It's a good idea to write out a few questions which you can ask at interview. Make it obvious that you have done your background check on the hospital.
Make sure you stay up-to-date with your practice including medication calculations. You will be asked to sit a short drug calculation test which must be passed at 100%. Practise before and ask for help if you are still unsure of calculations. remember that you may be nervous on the day so the calculations should seem like second nature!
If English is not your first language, be ready to show that you can function safely in English. Keep up your studies by accessing online materials or buy an English for Nursing book and work your way through it. Most hospitals have a glossary of acceptable terms on their website. These are the abbreviations which can be used when writing patient notes. It's a useful learning resource.
Finally, do a practice run of the interview with a friend. Practise from the moment you walk through the door and see the interview panel of maybe three or four people. Practise how you will sit and how you will maintain eye contact with all of the interviewers. Practise 'small talk' which is often used at the beginning of the interview to 'break the ice'.
It's always wise to work out which area of nursing you really like. You'll be spending a lot of time at work so better to choose an area you know you like. Think of the placement wards you went to. Did you prefer surgical to medical wards? Or is there a specialty area you would like to move to?
Sometimes it pays to start in a general medical or surgical ward before specialising, but let your interviewers know that your long-term plan is to move into a specialty area. At the same time, try not to close your mind to the possibilities of the ward area you start in. Many nurses have been sure that they would only like surgical nursing,for example, but found that a chance placement in a medical ward such as renal dialysis ward opened their eyes to a different area of expertise.
Put some research into finding hospitals which offer your area of interest. Consider moving to an area which seems to have the type of nursing or nursing philosophy you like. You can progress your career much faster if you are willing to be a bit flexible so you can gain experience in a particular specialty area. If there is only one hospital in the country which has a dedicated unit in one of your areas of interest, then think about relocating. It always looks good on a CV to see that a nurse has moved out of his/her comfort zone in order to learn more or specialise.
Most interviews for a hospital placement include a short maths calculation test to assess your probable level of safe practice in this area. The pass mark is 100 per cent, however, hospitals have to provide you with remedial tuition if you do not reach the pass mark.
You will have studied the maths during your course and then probably forgotten most of it! Get out the books and check online for free maths calculation resources and start practising. The test will typically have 10 questions. You will be given a calculator to use but you will need to know what to punch into the calculator. Revise formulae for drug calculation (Strength Required (SR) over Stock Strength (SS) times Volume over 1) and IV drip rates (for all the drip rates and for pumps) . Revise the common medications which crop up in medication calculations e.g antibiotics, digoxin,warfarin. Revise the formula for administering medication to children.
The sort of questions you may be asked are about:
IV drip rates: A bag of IV fluid (one litre) is half full and running at 250ml per hour. How long will it take to run through?
Tablet administration: You have to give Penicillin 500mg to a patient. The capsules come as 250mg capsules. How many do you give?
Digoxin: what must you do before giving Digoxin? (take the pulse and withhold if less than 60).
Metric conversions: How many mils in one litre?
Fluid loss: If a patient loses x mils per kg of body weight hour in fluid loss, how much needs to be replaced?
Warfarin: A patient is prescribed 8mg of warfarin. How will you give this (you have 1mg,2mg and 5mg tablets in stock) ?
Take some time to consider what you will wear to the interview. Remember that an impression of you is made within a minute or so of you walking into a room. A few years ago, I taught student nurses who would often complain that they didn't feel that nurses were taken seriously. My reply was to ask them to think about the image some nurses project. Nurses should project an image of cleanliness (after all we talk a lot about Infection Control) and professionalism. Look like a professional and you will be treated like a professional.
Showing that you understand the concept of appropriate dress during an interview will project an image of professionalism. Select an outfit which is understated and flattering. Go with one main colour with a small amount of accent colour. This allows the interviewer to focus on you rather than your busy-looking outfit. If you wear a blouse or shirt, make sure it is not low-cut. You need to send the message that you know how to dress appropriately.
Wear shoes with sensible heels and make sure they are clean. Some interviewers take prospective employees on a tour around the hospital. You need to be able to keep up the pace without breaking any Workplace, Health and Safety regs on the way! Minimise the jewellery you wear. Hospitals have a strict policy of no jewellery apart from a wedding ring - you are sending a message to the interviewer that you don't overdo jewellery out of work so are more likely to comply with hospital Infection Control policies when you are an employee.
Pay scrupulous attention to your hands and fingernails. Hand hygiene is a top priority in hospitals. Cut your fingernails so they do not show over your fingertips and don't wear coloured nail polish especially if it is clear and unchipped. Clean looking hands confirm the image of a healthcare worker who understands the principles of hospital hygiene.
Think about the sort of questions which you may be asked during the interview. It's possible to predict some of the questions which you may be asked, for example
Data Protection - You are asked to give out information to a person who claims to be a good friend of the patient, what should you say?
Open Disclosure - You make an error, what is the first thing you should do?
Gifts and Bribes - A patient offers you a gift of money, what do you do?
Safeguarding - You feel that an elderly patient may be at risk of abuse at home, what should you do?
Scope of Practice - You are asked to do a procedure which you have not been trained to do,what should you do?
Rehearse or role play these questions with a friend to increase your confidence.
Work out how you will get to the job if you succeed at interview. Some employers ask whether you have your own transport or not.
If you have your own transport and are not moving from where you live, research the route to the hospital by car. Google maps are useful in this regard. Do a practice run to the hospital and time it. You should also do this to cut down on nerves on interview day. Spend time checking out parking and parking costs. It may be that you are forced to park in a hospital car park and pay for the privilege. The parking meters are often run by a different company rather than the hospital. Make sure you have enough change to use in the pay-and-display meter unless you are sure you can use a debit card. Having parked the car, time the journey from car park to ward.
If you are going to be catching the bus to get to work, do some research on bus times. There will be no point interviewing for a job you can't get to.
It's a nice touch to be able to assure the interviewer that you can easily get to work - interviewers like reliable workers.
Many nurses use social media sites regularly. There are numerous stories about the consequences of chance postings which happen to have been seen by a nurse's employer or even the friend or relative of the employer. There has to be a clear disctinction between work life and social life and an understanding of how to manage any blurring of the edges.
Social media sites such as face book are generally used personally to stay in touch with friends and family. There is an increasing use of face book by businesses including hospitals as an information area. Much the same way that hospital newsletters are used.
The essential point of social media use is to respect the privacy and dignity of patients and colleagues and to remain professional at all times. Nurses who feel that they need to be able to 'let their hair down' in private sometimes feel that criticism of their private persona is unfair. Although it seems as though face book has been a part of our lives for a long time, it is a relatively new form of communication and conservative viewpoints take longer to catch up with the medium and some nurses have suffered serious consequences after their face book page is viewed. Be safe; check out your new employer's policy on social media use and stick to it. Ensure that any friends who are added to your network are not connected with anyone you may not want to view your page.
Other social media such as Linkedin is used for professional development and networking. This can be very useful as a way of advertising your expertise and testing the waters regarding new opportunities. Update your profile regularly as you develop new skills or attend courses.
Start a reflective journal about your experience of job-seeking. You will have used guided reflection during your studies to develop critical thinking skills and to reflect on your practice. Reflective practice is an important part of your ongoing education and can be a great help in focussing attention on areas which may need a bit more polish. After each interview, and remember that there may be many before you land the position you want, think about what worked and what didn't work during the interview. Consider how you can change the less effective parts of your interview technique and get ready for the next interview opportunity.
Join online nursing journals such as Nursing Times and Continuing Education sites such as Medscape. You can register for free.Take advantage of the up-to-date information and forum topics. Not only is this required for your ongoing registration but it also indicates that you are interested in your work and keen to keep learning.Think about writing an article yourself - articles from student nurses or recent graduates are always of interest and in demand. As your articles are published add them to your CV!
Finally and very importantly, join your professional union immediately.
Overseas nurses starting to work in an English-speaking country or communicating in English with patients in their own country (as a common language) can find it very challenging. Getting used to a different system as well as speaking a different language is very difficult. Nurses use a lot of jargon which can be different from place to place. I am an Australian nurse working in the UK and found that when I first started working in a UK hospital there were many terms which we didn't use. And, there were many terms which we use but are unfamiliar in the UK. For example, during a handover, I explained that a patient had an 'IVC in the left hand' . 'IVC??' they asked. They say 'Venflon' which is the brand name of IV cannulas.
A good way to keep up with your Nursing English language skills is to access online EMP materials or look at some of the online English language magazines which are available . Examples of online magazines are Infermiers.com and Business Spotlight .