Nursing Blogs>Nicole Lehr

26 lessons I’ve learned as a nurse


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I clocked in this week and was surprised to hear the little computer voice wish me a happy anniversary. No way, it can’t be. I’ve been working in Atlanta as a nurse for four years. The old adage about time flying is most certainly ringing true in my opinion.

In light of my four year anniversary as an RN, I began reminiscing about nursing school, and the feelings of being a new graduate, and about how much I’ve learned since then. I’m close to committing both mentally and financially to graduate school, and hearing that I have four years of experience behind me gives me that added bit of confidence. But I have my concerns that even after two years of graduate school, I still won’t know what I’m doing and won’t be ready for the responsibility of assessing and diagnosing my own patients as an advanced practice nurse. While discussing these concerns with a coworker of mine who will be a nurse practitioner herself in one more semester, she brought up a very valid point. “Nicole, did you know what you were doing when you graduated nursing school?” And that answer is clearly a big NO. Although nursing school gives us the framework for how to assess a patient, gives us the step-by-step instructions on how to start an IV, and drills in our heads how to participate in therapeutic communication with our patients, the bulk of the knowledge is gathered from on-the-job training and the experience of actually working at the hospital as a nurse.

So I started to think, as appreciative as I am for my University of Florida nursing education (I did get a nice diploma out of it), I’m especially thankful for the experience that I’ve gained on the unit, the experience and the confidence that you just can’t get while being a nursing student. And my hope is that once I decide to pursue my advanced degree, the same will apply in the future. Experience is everything.

Hopefully, years from now I can also write an article relating to what they don’t teach you in graduate school. But for now, I’ll stick to what I know…

Here are 26 lessons I’ve learned as a nurse…

1. Those nursing school textbooks that are taking up room in your closet and making your husband mad? You will probably never look at them again.

2. You don’t need to know every medication in your pharmacology book. Nor do you need to carry your pharmacology book around with you in your pocket. The internet is a beautiful tool.

3. That nursing diagnosis handbook that you carried around during clinicals? Pitch it. Sorry nursing school instructors.

4. Nurses rely on three essential things: a stethoscope, a good pen, and a pair of scissors. Anything else is flare that can be picked up on a case by case basis.

5. No two patients are alike, just because one patient acted or reacted a certain way doesn’t mean the next one will.

6. Your patients may die, and unless there is some extenuating circumstance, it’s not your fault.

7. Invest in good work shoes. Your back won’t like you if you wear your running shoes to work every day.

8. Patients trust you, do everything in your power to respect and build that trust.

9. You are the doctor’s eyes and ears at the bedside, which is sometimes more important than calling the shots.

10. Make a conscious effort to drink water while at work. Back to back twelve hour days of no water quickly leads to dehydration.

11. Nobody teaches you in nursing school how you are going to act and how you are going to feel when you are a part of your first code, most especially when the patient was yours.

12. Keep up with continuing education or else you will have a mad dash in December to finish what you didn’t do.

13. Join a journal club, or start one up on your floor, one with articles specific to your area of specialty. Nursing and medicine are quickly changing fields, keeping up with the latest research will make you a more competent, more informed nurse.

14. Starting IVs on humans is much more difficult than starting IVs on oranges.

15. Performing medication calculations without somebody looking over your shoulder suddenly is a lot easier.

16. Keeping your patient clean and your bedspace organized is looked at highly by the incoming nurse.

17. Twelve hour shifts are a nurse’s best friend and sometimes a social life’s worst nightmare.

18. Nobody is perfect, especially you. You will make mistakes, owning up to them is safer than the alternative.

19. Love your scheduling manager.

20. Be your patient’s advocate, they need you.

21. Never take for granted going to the bank, having a dentist appointment, and getting your haircut on your week days off. Sometimes normal business hour work days are not better.

22. All of your friends will call you when their neighbor, daughter, friend of a friend, great grandmother, and even dog get sick. And you will be expected to provide expert advice.

23. The lawn people will come, the UPS delivery man will need a signature, and your neighbor just got their kids a drum set… all on the day you are sleeping in between night shifts.

24. All nurses have a sweet tooth (even if they come out of school without one) because of the influx of treats always found at the nurse’s station.

25. Eat breakfast! There’s no telling when lunchtime will arrive.

26. Nurses are the heartbeat of the hospital- be proud to be a part of that.

Any other words of wisdom from experienced nurses?

Nicole Lehr
Nicole Lehr is a pediatric nurse. She can be described in three adjectives: content, thankful and fortunate. All credit for the aforementioned description can be given to the love she has for her profession as an RN. She graduated from University of Florida with her Bachelor’s in Nursing and moved to Atlanta to work at the Cardiac Stepdown Unit at Children’s — her dream job.

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