Nursing Students

How do you stand up for yourself in a new environment as a new grad?

Anything that boosts your confidence will allow you to take a stand when needed – whether that is for you, for another person, or for your patient. Initially, many new graduates are focused on being accepted rather than ‘standing out’ – this is natural and normal. Try not to feel guilty about not standing up when you just arrive – it takes time to trust those you work with in a way that allows you to share your feelings and thoughts. If you have a mentor or someone you think you can trust when you arrive (perhaps there is a preceptor you worked with when you were a student there, or maybe there is another new graduate in the same position as you), utilize them to bounce ideas off of or ask their opinion on something you have seen or experienced. That will offer you ‘perspective’ that you might not have if you are anxious about being ridiculed or rejected if you decide to say something.

Can you explain if there are any loan forgiveness positions in rural communities and how to access them?

Student loan forgiveness programs can help ease some stress over your outstanding balance over time. Nurses with access to this program have their student loans forgiven, cancelled, or discharged which means they are no longer required to repay some or all of their loans. To learn more about the type of forgiveness available and whether you qualify, contract your loan servicer for more information. Doesn’t hurt to apply!

Any advice on how to manage test anxiety?

Almost all students experience some level of test anxiety. It is impossible to learn and retain every detail. Focus on the most important concepts as this will help you tease out pieces of questions that connect with those concepts. Here are some tips:

  • Develop a mantra. This is something you tell yourself before and during the test. For instance, you may simply remind yourself of past successes;
  • Don't give a test the power to define you. One test does not determine your intelligence;
  • Utilize practice tests – use them to work on your test-taking and to practice controlling your anxiety level;
  • Get a good rest before the exam;
  • You should get to the test site a little early, but try to avoid talking with other students right before (listen to music you enjoy) – their anxieties may increase your own;
  • Consider wearing earplugs during the test to limit distractions;
  • If you start to feel overwhelmed, take slow, deep breathes – it REALLY does help;
  • Resist the temptation to change your answers when you go back to review – unless you are ABSOLUTELY sure of the change, the evidence is clear – the first response is the better response;
  • Check the time periodically, but avoid checking too frequently. Your professors will do a countdown throughout the exam and will let you know when the time is coming to an end.

What do you recommend we do when we start to lose hope in school or feel like we didn’t do enough?

When you’re doing your best and working through building on your strengths and the strengths in others, it builds a sense of hope. It’s easy to get pulled into self-doubt when you are a student. Whether it’s in clinical practice, labs or theory courses there are times when everyone feels overwhelmed or questions whether they have done enough - the only person that can answer that question is you. Do your best to improve your knowledge and skills that will build your strength and ultimately your confidence. When you’ve done your best - that is simply enough.

How can I reflectively journal during my nursing clinical placements?

The purpose of reflective journals is to promote nurses' critical thinking, autonomy, open-mindedness, and attentiveness. Here are some ways to really REFLECT on your experience.

HEART - what touched you, moved you, inspired you about a care situation or workplace interaction during that week;

HANDS - what did you 'do' that you learned something about this week - perhaps it was a skill you performed or something you did (taught a patient or participated in a diagnostic observation);

HEAD - what did you 'learn' this week?  It might be about something pathology related, or perhaps a new approach to dealing with conflict, etc.;

Go DEEP and BROAD as you articulate the above.  Remember, your GOAL is to anticipate your instructor’s questions, answering them before they ask. They want you to be more aware of what is behind your actions: they want you to be considering WHY you are doing something, WHY 'something' is happening to your patient, HOW you should be responding, WHAT that response would be and WHY....DO NOT BE SATISFIED until you understand what is UNDERNEATH whatever it is you are reading, thinking, doing.

Can you share any study tips for online nursing students?

Online learning requires students to be independent, self-directed learners. However, for some without personal interaction between peers or instructors, students may fall behind. Here are some tips:

  • Create a working space to help get organized
    • Have a space in your home specifically designated for your studies, if possible;
    • Have a print or digital calendar to write down assignment and test dates;
    • Have separate desktop folders or binders for each class;
    • Review the orientation material provided by your instructors;
    • Back up your devices to an external hard drive;
    • Take regular breaks – what you do with each break can matter, too. It’s important to choose the right type of activity (ie. walk, stretch, tidy up, phone a friend, cook a meal, meditate). This ensures you can return back refreshed and focused, ready to get back to your books.
  • Connect with fellow students
    • Create/join a study group with other classmates so you can ask each other questions or quiz each other.
  • Let’s remember
    • Focus on critical thinking and UNDERSTANDING not simply memorizing;
    • Read the material out loud – ‘pretend’ you are teaching it to someone;
    • Write some of your studying notes by hand, with a paper and pen, to help enhance long-term memory.

As a student/nurse entering an Indigenous community, how can I respectfully learn to be culturally appropriate and sensitive of the Indigenouspeoples?

As a student or staff member, your orientation to the unit will include a manager or clinical coordinator that you can ask questions of prior to entering the area, including finding out which cultural communities are served by the area you are working in. Alternatively, you can speak to the staff you work with and ask questions about embedding respectful cultural knowledge (including local language) in your practice. For some areas, there will be staff orientation material created for the purpose of increasing cultural safety for communities who you are about to engage with. It is worth spending some time researching the area you are entering, noting the peoples and history whose traditional lands you are working on. As well, humbling yourself when working with Indigenous cultures (or any culture) is always appropriate – ask THEM to ‘teach’ you some words that would help you help them. Keep a book of culturally appropriate language phonetics to assist you to remember. Ask anyone with whom you are culturally unfamiliar if there are traditions or practices that you could include in their care.

 

Can I refuse to care for a patient who makes racialized comments? What are my options and resources if I encounter this?

All nurses in Canada are protected under the Canadian Human Rights Act (the Act). Within the Act, harassment is defined as “improper conduct by an individual, that is directed at and offensive to another individual in the workplace.” Offensive conduct includes discriminatory acts, comments, and displays. As such, a patient/client making racialized comments towards a nurse is considered harassment.

The Act states that the conduct must be repetitive in order to be considered harassment. This means that the patient/client makes a racialized comment more than once. If you have asked a patient/client to NOT make racialized comments and they continue to do so, it is your right to refuse care. That being said, a single act of racism can be considered harassment if it is so severe that the nurse is significantly impacted for a longer period.

In addition to the Act, nurses in Canada are covered under the Work Place Harassment and Violence Prevention Regulations. These regulations protect workers by outlining what is considered a “work place,” further defining acts of harassment, and your employer’s obligations to ensuring a psychologically safe work place.

If you encounter a patient making racialized comments, the first step is to approach your nursing supervisor to discuss changing your patient/client assignment. Other people that you can reach out to as resources include your local nursing union and regulatory body.

References:

Canadian Human Rights Act
Is it Harassment? A Tool to Guide Employees
Work Place Harassment and Violence Prevention Regulations

What skills should I cultivate for rural/remote practice?

Overall, a broad spectrum of skills should be your main focus. You want to solidify the basics of a holistic assessment and physical examination along with lab interpretation. You may not have much more to go on, depending on how remote a setting you are working in. Self-sufficiency is PRIZED in rural/remote settings, so consider additional competency training opportunities. Here are some examples: wilderness first aid, prehospital training, basic engine repair, basic outdoor skills. It is useful to be able to change a tire, jumpstart an engine, drive a standard, etc., but by no means required.

What should I study, focus my papers on, or request for practicum experiences if I want to specialize in rural and remote nursing as a career?

Choose a rural/remote focus for papers/projects when you have a choice of topic; choose generalist, primary care, or emergency options when available (these settings take all incoming patients which is great practice for rural/remote settings). Additionally, when given the option you can ask for a rural/remote placement for practicum if available. Share your goals with your Faculty of Nursing as they may be able to guide you further. In the moments where you are able to ‘shadow,’ meaning spend a day following alongside other interdisciplinary team members, you may be able to spend time in the Emergency Department (ED), Home Care, and Emergency Medical Services (EMS) to see how closely they work together as a team in these settings.

If I want to do my practicum in a rural or remote area, where can I get support in the community to find a place to live (e.g. a place to billet)?

Here are some options that may be helpful in your search for a safe living arrangement. Contact the manager of the unit you're going to complete your practicum on as they may have some connections to share with you. Become a new member of the Canadian Association for Rural & Remote Nurses (CARRN) or search the association linked to your area and reap the benefits the page has to offer. Finally, consider any community group connections you or your family may have (Church, Legion, Rotary, etc.).

Have any other nursing students expressed disappointment from the lack of graduation celebrations due to COVID?

First of all, CONGRATULATIONS to all the 2020-2021 Nursing Graduates out there! We would like to acknowledge all you have achieved and welcome you into this diverse and accomplished discipline. Since that eventful moment when COVID-19 rocked our world, things have changed more than we could have imagined. In compliance with national public health restrictions, events such as graduations/convocations were cancelled. The announcement hit nursing students especially hard due to the hands-on nature of their courses and clinical work. Some attended virtual ceremonies, some hosted backyard ceremonies and others could not celebrate. In some instances, plans were initiated for ‘future’ celebrations so connect with your school to find out what they are doing. The reality is that milestones like this are important stepping stones to ‘moving on’ – officially moving from being a student to being a GRADUATE! But you don’t need your school for that – take steps in your own circle to celebrate the achievement you worked so hard for – include friends, family or other graduates and create your own ceremony. We will be right there with flags waving!

What would be some great transition tips for nursing students preparing for transition in their final practicum?

- Get adequate rest and sleep (easier said than done but sleep-deprived brain simply doesn’t reason, learn or recall as efficiently);
- Learn the names of your unit staff members so you can greet them properly throughout your shift;
- When your work is done, HELP OUT! Ask the nurses around you what you can do to assist THEM – this ingratiates you to the nurses and they will be more interested in helping you;
- Ask for help when you need it, but respect others’ time - come prepared with some information or ideas on how to approach the issue;
- Show interest, eagerness, and respect for nurses’ thoughts and guidance in the clinical setting;
- Never do something if you are uncertain but be willing to put yourself ‘out there’ for all the experiences you possibly can while still a student;
- Work your way TOWARD the goal of taking a FULL (graduate nurse) workload by the end of your practicum;
- Try to take on some complex patients so you can learn to balance your workload, delegate and prioritize as needed, and understand how to deal with the decompensating patient;
- Practice the psychomotor skills you will need to do ‘with your eyes closed’ once a graduate nurse – this will allow you to reduce the energy consumed by figuring out how to perform basic skills once you graduate.

Why should I ask questions at the end of my nursing interview?

You got called into an interview for a nursing job – CONGRATS! It may come as a surprise that at the end of your interview, you will be asked something along the lines of “What questions do you have for me now?” Employers rarely want to hear: “I have nothing to ask”….they want to know you have seriously thought about this job, what it means to you and what your expectations are. Responding to this opportunity allows you to explore your nurse managers, the unit’s and maybe even the institutions expectations of you as a new hire. Bring your top 3 questions with you - here are some examples:
• What does orientation include and how long does it last?
• What is the patients:nurse ratio from shift to shift?
• What professional development opportunities are available to nurses?
• How do you provide feedback to your staff when they make a mistake or have an opportunity to improve?
• Do you have a mentorship program in the hospital? If not, do you have a vision for mentorship?

How do I write a nursing student resume?

Since a resume’s main purpose is to get you a job, you need to make sure that you market yourself well by highlighting your skills, accomplishments, and knowledge. This is a 1-3-page summary document. Before writing out your resume (or your cover letter), do some research on your potential employer by going to the facility’s website and reviewing the posting you are applying for. Use the headings, wording or listed job descriptions within the job posting itself to craft the cover letter. Remember, you need to target the skills they are LOOKING FOR, not just what you are proud of. You can seek support from your schools Career Counsellor or Student Services; these departments provide resources to help students build resumes, cover letters and employment portfolios. Start here, this will allow you to gain skills, prepare your required documents, and have the confidence to APPLY! Remember that this is your first impression on an employer, so make it a good one. Finally, keep your resume updated as your skills and opportunities evolve – make it a point to add to your resume each month that you are in school, adding copies of assignments or projects you did particularly well to a folder that can be accessed as ‘examples’ of your work.

How do you deal with a difficult clinical instructor?

Although we hope this doesn't happen, the reality is that it may. The first approach is to speak with the instructor; this can be difficult to do as there is a power difference between student and teacher, so bring a support person with you. Addressing the issue head on, in a respectful and objective manner, usually results in constructive plans for dealing with the concerns. The goal is for everybody to win! The more often you can stay with how YOU are perceiving the situation (versus talking about what the other person DID), the less chance for ‘reactions’. It is often a great learning opportunity for the clinical instructor as well. If approaching this individual directly is not an option, then the next step is to ask to meet with the Chair/Coordinator/Director/Associate Dean of the nursing program.

What can student nurses do to have a say in patient care?

It’s important for the faculty member to support the student in communicating concerns and recommendations for client-centred care to the health care team with or on behalf of the student. This can occur through the faculty member role modelling and supporting the student in direct communication with the healthcare team working with the patient, as well as during team meetings where the interprofessional team meets to plan patient care and discharge planning. Further, on more than a few occasions, the astuteness and comprehensive approach students take to their patient research and care planning results in those same students informing staff about challenges or solutions (i.e., discovered medication interactions or abnormal clinical findings that have been overlooked) that even they did not pick up. Remember, student’s voices are critical to having ‘new eyes’ on patient situations!

Is it helpful for students to self-organize their ‘brain sheets’ during clinicals?

If you don’t know what a brain sheet is please view the photo shared for examples. This is a way for a new nurse to plan their patient load. You can create a similar template and change it as you find what works for you.

Can you work full-time and go to nursing school?

Between attending class, completing clinicals and studying for exams, a full-time works chedule may not be feasible for many nursing students. However, do not let this discourage you. Perhaps consider a job position that may be flexible around a student schedule (ie. student research assistant, teaching assistant).

How long is nursing school?

There are several options as nursing programs can range anywhere from six months to four years, depending on the scope of practice for which you are preparing (Practical Nursing, Registered Psychiatric or Registered Nursing) and the prior education you have received.

Will I get paid for my nursing practicum(s)

In most cases, practicums don't pay because they are considered part of your education and supervised by instructors and nurses. The ‘focus’ of a practicum is not ‘work’ but ‘learning’.

How long will my practicums last?

The number of hours required to ‘pass’ or complete a nursing practicum varies depending on the type of program and degree level you are pursuing. Each practicum has its own individual requirements, so students should review their course and program requirements – you can approach the Program Coordinator or Director/Dean or Associate Dean for this information.

Am I able to work during my final practicum?

Some nursing students have anxiety about working 12 hours shifts and want to gain experience with this. Overall, you need to maintain your fitness to practice by not over-exerting yourself, so be patient and understand that you will adjust to the expectations of work when it is time – until then, try to focus on learning as much as you can while you are still in the student role.

What is the interview process like when you get hired?

The manager will connect with you via email or phone to set up an interview time. There could be an interview panel or sometimes you just meet with one manager. Often questions begin with “Tell me about a time..” or “Give me an example of..”. Many interviews will want to understand how you would ‘behave’ or actually deal with particular situations such as interpersonal conflict, workload challenges, patient decompensation or family crisis situations – remember that as a new graduate you need to demonstrate ‘safe’ behavior. Appropriate responses would always include asking for help, understanding policies and procedures, and knowing your scope of practice as a new nurse.

How long on average does it take a new graduate to obtain a job position?

It depends on the needs of the unit. For example, how many casuals do they have, do they have any vacant lines? Sometimes you are able to obtain a position the day after finishing school and sometimes it can take a few months. It really depends on the needs of the particular units you are interested in.

Can we work on specialty floors right away?

It depends on what the manager is able to support. Areas requiring specialty courses will hire new grads only based on need and often in conjunction with education funding that can support the costs of a specialized course. This is based primarily on manager discretion, regional capacity and workforce need.

What is different about getting hired as a new grad versus a provisional nurse?

You are usually hired on as a casual nurse when you are under provisional registration/license (not yet passed your national registration exam). You pay to receive this license. Normally, a provisional license is valid for one year, during which time you function as a Graduate Nurse. Some regions have particular stipulations around WHAT a provisionally license nurse can do so check with your hiring institution. It is usually during that provisional year that you write your Registered Nurse licensing exam. After that you receive a “practicing” registration/license and work as a Registered Nurse.

How will my senior nursing practicum help me?

Practicums provide first-hand experience into nursing practice. This is a time where you can ask questions, take skills learned from theory and lab practice and perform them alongside an instructor or preceptor. There is evidence that completing your practicum in the area you want to transition into as a professional nurse is very helpful.

Should I choose my final placement in a specialty area or somewhere I feel I am guaranteed to be hired?

While it is tempting to gain yet another experience while you are still ‘learning’, and equally tempting to take an opportunity to work in an area you might not see for a while (i.e., emergency, intensive care, remote nursing), you are wisest to use the time just before you enter practice to adjust to what you will most likely be doing immediately after you graduate. Doing so allows you to get to know the patient population, the staff you will ultimately be working with, and gives you a sense of the routines (WHO, WHAT, WHERE) – this will be very beneficial to you as you transition.

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Nursing The Future™ acknowledges that nurses across this country live, work and play on the lands of our Indigenous Ancestors and we join our members in expressing respectful gratitude for this privilege.
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