Table of Contents
Letter from the Author xi
Chapter 1 You've Arrived 1
Inspiring 1
What They Expect From You 3
Transition to Practice 5
Reality Shock 5
Novice to Expert 9
Poser Anxiety 11
Accept Ambivalence 13
Give Yourself One Year 14
Scrubs and Shoes 15
It's a Small World 15
Chapter 2 Orientation Expectations 17
Prepare for Your First Day 17
Nurse Residency Programs 18
Preceptor 23
Feedback 27
Your Part 29
Time Management 30
Find your Hidden Resources 35
Delegating 35
Reflective Journaling 36
Caring Practices 38
Deviancy and Moral Distress 38
Coming Off Orientation 39
Chapter 3 Shift Work and Work-Life Balance 41
Working Night Shift: Love It or Hate It 42
Working Holidays 48
Meal Prepping 49
Working Overtime 50
Work-Life Balance 51
Prevent Sickness 52
Chapter 4 Practice Environments 54
Unhealthy Practice Environments 54
Toxic Environment 63
Healthy Practice Environment 64
Manage Yourself 65
Just Culture 66
Success Stories 66
Chapter 5 Doctors 67
Nurses and Doctors 67
Respect is Earned 68
How Doctors Think 69
The Doctor-Nurse Game 69
Clinical Knowledge and Scientific Knowledge 70
Importance of Subtle Changes in Condition 71
Calling Doctors 72
Anticipating Orders 76
When a Doctor Snaps at You 78
Gender 78
Disillusionment 79
Chapter 6 Pro Tips from A-Z 80
Assessment 80
Assumptions 81
Back Care 81
Blood Cultures 81
Blood Transfusions 81
Bowel Obstruction 83
Chain of Command 83
Chest Tubes 84
Charting 87
C. difficile 87
Codes 87
Conflict 89
Death, What to do When Your Patient Dies 89
Emotions, Managing 90
Femoral Sheaths 90
Foleys 91
Insulins 93
IVs 94
Manipulative Patients 96
Medications 102
Nasogastric Tubes (NGTs) 102
Opioid-Induced Respiratory Depression 103
Oxygen Delivery Devices 104
PCTs and CNAs 105
Phone Numbers, Key 106
Potassium Replacement 107
Sepsis 107
Service Recovery 107
Supply Room 108
Tap Water Enemas 109
Visitors 110
Chapter 7 Safe Practitioner 111
Causes of Mistakes 112
Patient Falls 122
Know your Politics 123
Just Culture 124
Floating to Other Units 124
Getting Your Own Insurance 125
Defensive Charting and Red Flags 125
Chapter 8 Critical Thinking 127
Critical Thinking 127
Controlling Anxiety 128
Prioritizing 129
Recognizing Abnormal 129
A Note on Intuition 133
Anticipate 134
Preventing Codes 136
Respiratory Assessment 137
Context: Treat the Patient, not the Machine 138
Problem Solving 139
Pattern Recognition 140
Journaling 141
Chapter 9 Myths of Nursing Practice 143
Evidence-Based Practice 143
Practice-Based Evidence 144
Inflating Foley Balloon to Test Prior to Insertion 145
NPO Before Surgery 146
Protective Isolation 147
Sandbags Applied to Femoral Artery Site After Sheath Pull to Control Bleeding 148
Stat Glucose to Verify Hypoglycemia 149
Trendelenburg for Shock and Hypotension 150
Tube Feedings and Checking Gastric Residual Volumes 150
Patient Abandonment 152
Overtime 154
Two Doctors Signing Emergency Consent 155
Vaseline or Occlusive Dressing for Dislodged Chest Tube 155
Wet to Dry Dressing Changes 156
Chapter 10 Disciplinary Process 157
Signs of Trouble 157
When You Are Blindsided 159
SMART Goals 160
Close the Loop 161
Preceptor Feedback 161
Transfer to Another Unit 161
Chapter 11 Professional Development 163
Proper Title 163
Academic Degrees 164
Certificates and Certifications 166
Resume 168
Pro-Nursing Language 168
Continuing Education 169
Difference Between CEUs, Contact Hours, and CEs 170
Licensing Renewal and Continuing Education Requirements by State 171
Compact Licensure 176
Conclusion 179
List of Nurse Certifications 180
Chapter 12 Just for Fun 181
Bibliography 185
