If I knew then what I know now: things I wish I’d known my first month on the job


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Now that I’ve been a nurse for mrmphyears, there are a few things that, looking back, I wish somebody had told me all of these tips right off the bat.

Not that I didn’t get good training, you understand, but there are some things that experienced nurses take for granted and don’t even think to pass on.

Lesson the First: Know where every bathroom in your building is.
This is actually both easier and more necessary than it sounds. Most modern hospitals have plumbing that’s centralized around a few points. Learn where those points are and you’ll never be without a biffy, even if you have to go down to the locked psych ward and beg to use one of theirs. I learned this early when, six weeks into my very first job, all of the bathrooms on my floor were being remodeled. Simultaneously. Nurses have big bladders, yes, but not that big.

Lesson the Second: Good pens are rarely cheap, and cheap pens are rarely good.
Does anybody even use pens anymore, what with all the computer charting? Let me tell you something, children: Back when I was first getting started, we had to walk 16 miles uphill to the office supply store to….oh, wait. Sorry. The lesson here is that the cheapo permanent markers and highlighters and stick pens that the hospital provides are rarely worth messing with. Buy your own. For a small outlay, you, too, can have one of those nifty Sharpies that hangs off of your ID tag along with all the other stuff you carry with you. And, speaking of carrying stuff…

Lesson the Third: You don’t really need all that impedimentia.
Calipers are nice to have if you’re working on a telemetry floor. A reflex hammer is nice, and a penlight is essential, if you’re doing neuro. I’ll bet you dollars to doghair, though, that somebody’s stashed at least one of whatever you need in a drawer somewhere. The only really critical things you need to have on your person at all times are coffee money and a stethoscope. The index cards, measuring tapes, quick-reference guides and so on can stay on your carefully staked-out turf where nobody will mess with it.

Lesson the Fourth: Learn where everybody’s “spots” are and stake out your own.
Each unit has its weirdo—the guy who gets really upset if you sit in “his” chair. Likewise, each unit has its own system of territory-staking. For my current unit, home is wherever your coffee cup is. In my previous unit, because we had only one nurses’ station, we all just sort of figured out where to dump our stuff and left everybody else’s alone. If you’re new on the job, your spot might be in the back, where the med students are, but eventually you’ll move up to the front of the station.

Lesson the Fifth: Not only are respiratory therapists great at getting nurses’ butts out of slings, but they also have the best coffee.
If you’re starting on night shift, this is vital to know.

Lesson the Sixth: Anything that’s good in the cafeteria or in the vending machines will be discontinued.
Once, many years ago, I saw some White Castle sliders in the big vending machine in the basement. I bought all of them and stashed them in a paper sack in the fridge. At the time, White Castles weren’t even available in the freezer section of your local grocery store and thus were like gold. Our vending machines haven’t had anything close to that good ever since, but I used those tiny, delicious burgers as currency with residents and attending physicians for a good month. Likewise, our cafeteria used to offer a tasty, healthy, low-fat grilled veggie buffet on Fridays. They don’t anymore. The takeaway? If you see something good, grab it, and don’t be surprised when they replace it with vaguely plasticky hot dogs and stale Ho Hos.

The Final Lesson: Nothing is as bad as it seems the first month (or six months) on the job.
I always tell the students I precept that it’s waaaay easier to be a nurse than it is to be a student. While this is true, it’s also true that for the first three months or so, being a nurse really sucks. You’re constantly overwhelmed and terrified, worried about what you’ll have to do next, and you never actually have time to do something thoroughly enough. This will change, I promise. Most of what you do as a nurse becomes routine after a while, so you can spend more time on actually nursing. Fear not, Chickadees. As your hip measurement increases with your time on the job, so do your confidence and efficiency.

Even without those oh-so-tasty little sliders.

Agatha Lellis
Agatha Lellis is a nurse whose coffee is brought to her every morning by a chipmunk. Bluebirds help her to dress, and small woodland creatures sing her to sleep each night. She writes a monthly advice column, "Ask Aunt Agatha," here on Scrubs; you can send her questions to be answered at

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