10+ Tips For New Grad Medical-Surgical Nurses

Are you about to start in Med-Surg as a new nurse?

As one of the largest nursing specialties and one of the most recommended starting points for new grad nurses, it’s no surprise that nurses just like you choose to begin their careers in Med-Surg.

Med-Surg can absolutely be a great starting point for a new nurse, but it does come with its challenges.

To help you in your first few months, maybe even that first year as a Med-Surg nurse, I have some tips based on my experience that will hopefully make your start smoother and more manageable.

Tips For New Med-Surg Nurses

Now, there are obviously a lot of tips out there, and different nurses will recommend different things.

If there’s something you’ve heard that isn’t mentioned here, feel free to share it in the comments section below.

1. Try to Get Along with Your Nurse Preceptor

Let’s go ahead and get started with my first tip, which is to really try to get along with your nurse preceptor.

Forming a good working relationship, if at all possible, can make a significant positive difference in your time on that first department.

Now, I am well aware that, for the most part, you really can’t control this. Typically, your preceptor is assigned to you before you even get there.

Before you even sign the paperwork, the nurse manager might already have an idea of who is going to precept you.

This could be because there’s a specific nurse who precepts all new nurses, or your preceptor might be the only one willing to do it.

Heck, maybe they didn’t want to do it and were “voluntold” to precept the new nurse.

Regardless of what the situation is, I think it is very important to try to form a good relationship with the person precepting you.

Many people underestimate the value that the first preceptor has for a new nurse.

On top of shaping and building the foundation on which you will build the rest of your nursing career, your first preceptor could potentially be an invaluable nurse mentor for you.

Typically, your preceptor has been a nurse for a while, on top of having been at that hospital system or department for a while.

They will have a lot of nursing experience and knowledge that would potentially be beneficial to you during your orientation and maybe even your time in that department if a good working relationship is formed.

Now, I understand that if things are going really bad, you should consider talking to your nurse manager about it and potentially getting a new preceptor.

But I’m also not naïve to the fact that in some situations, you’re probably going to feel weird about doing that.

You might feel like you’re starting off on the wrong foot with someone who could potentially be an informal leader in that unit or department.

So, it’s reasonable to be hesitant about talking to the nurse manager if there are ongoing issues.

While the nitty-gritty of dealing with and navigating that preceptee-preceptor relationship is a topic for another day, what I do want to stress in this particular segment is that you should try to have a good relationship with your nursing preceptor.

2. Learn the Mechanics of Starting an IV

My next tip is to start learning the mechanics of starting an IV as much as you can as soon as you can.

When I first got out of nursing school, I struggled a lot with starting IVs.

Over the years, I have improved significantly, and part of the reason for that improvement was that I asked questions from the people I worked with who were experts at starting IVs.

I watched videos on it and never shied away from attempting to start my own IVs.

I’m not saying you need to be an expert at it. There are nurses in departments who are known to be IV experts for a reason.

What I am saying is that it’s important for you to get at least comfortable with starting IVs.

You don’t want to be one of those nurses who always rely on other people to start an IV. It’s going to get old really quickly. First of all, it’s going to slow you down.

Whether it’s for medication or a procedure, constantly trying to track someone down to start an IV for you can be time-consuming.

Furthermore, even if other nurses are good at starting IVs, they may eventually get tired of always doing it for you. It can feel like you’re putting your work off on them.

If, for some reason, you need to ask someone to start an IV for you, be judicious about it.

If a patient is a hard stick, see if your department has a vein finder and, ideally, make an attempt first.

This approach tends to go a lot better with other nurses.

When they come in and see that you’ve tried and were unsuccessful, they’re more likely to appreciate your effort rather than feel like you’re shirking your responsibilities.

3. Be Teachable

So, I mentioned earlier how your preceptor is going to have a significant impact on your nursing career and the foundation you’re building as a new grad.

Another crucial factor that will shape your career is you.

You need to show up to work, especially while you’re on orientation, with a teachable mentality.

If you come to work as an arrogant know-it-all and are not open to being taught, you’re going to have a hard time succeeding.

Show up with an open mind and be willing to learn from your preceptor and other experienced nurses.

Now, I’m not saying that your preceptor or experienced nurses are always going to be right, nor that you should blindly follow everything they say.

There are experienced nurses who may not practice good nursing.

However, as a new nurse, you need to be perceived as someone who is teachable, willing to ask good questions, and willing to listen.

In many ways, I guess what I’m trying to say is to also show respect for the experience of nurses who may have been nurses longer than you’ve been alive.

This attitude will make your time in the department easier. You’ll learn a lot more and more likely gain the respect of your coworkers.

4. Ask Good, Well-Thought-Out Questions

My next point is related to the last one, but it’s important enough to pull out into its own separate tip: make sure you show up and ask good questions.

Let me emphasize this again—you do not want to show up to work with a know-it-all attitude.

Don’t act like you know everything because, as a new nurse, it’s obvious you don’t. Other nurses are going to expect you to ask questions. Honestly, it would be kind of weird if you didn’t.

Many of you watching this might feel nervous about asking questions.

You might think to yourself, “I don’t want to look dumb because I don’t know this,” or “I should know this.”

You might want to put on an air of knowing everything. The truth is, your nurse coworkers are probably not going to think you’re dumb because you’re asking questions.

On the contrary, many of them will probably think you’re being smart because you’re asking questions, especially if they’re well-thought-out questions. This shows you’re eager to learn.

Research, such as articles from the Harvard Business Review, has shown that when people ask questions, particularly well-thought-out ones, it makes them appear smarter and causes people to like them more.

If you think about it, the person you ask a question to will likely think, “Oh, this person is smart because they’re seeking wisdom and advice.”

Additionally, many people feel flattered when you come to them for advice.

You know the type of people I’m talking about—not necessarily bad people, maybe very pleasant and helpful, but who enjoy listening to themselves talk or helping others.

There are plenty of opportunities to leverage this dynamic to provide better care and improve your standing within your department.

Asking good, well-thought-out questions demonstrates your willingness to learn and grow. It can enhance your relationships with colleagues and contribute to a supportive work environment.

5. Start Learning How to Prioritize

In Med-Surg, depending on where you’re working, you’re probably going to be assigned a large number of patients, which can be overwhelming.

With a big patient panel, you’ll have a lot of tasks to manage for each individual patient. Some patients will be more demanding than others.

Throughout all of that, you’re going to have to keep your cool and remember that while everything in nursing is important, not everything has the same level of importance, and not everything needs to be done right this very second.

Prioritization is key to a successful nursing career, and this is especially important as a Med-Surg nurse.

For example, a patient pressing the call button because they want their pillow fluffed doesn’t take precedence over a decompensating patient or a post-op patient.

When you first start as a new nurse, take the time, especially during orientation, to observe how your preceptor and other nurses on the unit prioritize their patients and the tasks within those patients.

Ask good questions to your preceptor and other nurses to understand why they prioritize certain tasks over others.

6. Start Learning How to Delegate Effectively

Tip number five has to do with delegation.

Managing a large patient panel means you’ll have numerous tasks to handle, and part of prioritizing those tasks is knowing what you can and cannot delegate.

This will vary depending on where you are, your state nurse practice act, and the setup of your unit.

For example, are you in a scenario where it’s just nurses and techs? In such cases, nurses take their own panel of patients and have techs to help.

Alternatively, do you have another setup such as where there are techs, a med nurse (typically an LPN), and a lead nurse (typically an RN)?

Depending on your role—whether you’re the LPN or the RN responsible for all patients—you need to figure out which tasks you must do yourself and which tasks you can delegate to another nurse or an unlicensed assistive personnel (UAP).

Knowing the scope of practice for each role on your team is crucial.

You should be aware of the tasks that only you, as an RN or LPN, can perform and those that can be delegated.

For example, you might handle medication administration and complex wound care, while delegating vital sign checks and basic patient care tasks to a UAP.

Appropriate delegation becomes important because it helps ensure that all tasks are completed efficiently and that you can focus on the most critical aspects of patient care.

It also fosters teamwork and helps you manage your workload more effectively.

7. Be Helpful to Other Nurses

My next point is to be the kind of person who is known for being helpful to other nurses.

This means if you’re not busy, if you’ve caught up on your charting, and you have some downtime—not saying you shouldn’t take a breather—but if it’s a relatively light day for you, try to look around and see which of your coworkers are struggling and how you can assist them.

Little things can make a big difference.

For example, if you have a minute and notice that a coworker needs an IV started, offer to help.

You could say, “Hey Susie, do you need help? While you’re doing XYZ with the patient in room five, I can start the IV in room four.”

This small act might not take much of your time but could make a world of difference to someone who is overwhelmed.

Aside from being a good coworker and a good human being, there’s a practical benefit to being helpful.

You are going to struggle at some point—I can pretty much guarantee that.

When you’re known as the person who helps others, it’s more likely that others will help you when roles are reversed.

If you’re someone who pitches in to help others, they’re going to be more inclined to want to help you when you need it.

Ideally, it would be great if units had a culture of mutual help among nurses, but that’s not always the case.

Even if it’s not the culture on your unit, you can establish a reputation for being that helpful person. By human nature, people tend to reciprocate kindness.

So, even if helping others isn’t in someone’s nature, your willingness to help them might make them feel like they owe you, prompting them to go above and beyond to help you in return.

8. Be Your Own Advocate

My next point is to remember that you have to be your own advocate. Listen to me—you need to advocate for yourself.

If you think the company, your nurse manager, your preceptor, or another nurse will prioritize your health and well-being for you, you are going to be sadly mistaken and very disappointed.

You have to look out for your own best interests.

This could involve many things. For instance, don’t go crazy working a ton of shifts, even if your unit is severely understaffed.

At some point, working too many shifts will wear on your health and could lead to burnout.

Even if you really need the money, I generally recommend that new nurses avoid working excessive shifts in the first 6 to 12 months.

There’s so much you’re learning during this time, and it can get overwhelming. Taking breaks will do you a lot of good.

On top of advocating for yourself at work, you need to advocate for your own self-care.

Try to exercise, eat healthily, and take your vacations when possible. I’m not necessarily talking about going anywhere expensive like a beach resort.

I mean taking a break from work, putting in your PTO, going on a break, and not answering the phone when they call.

Being an advocate for yourself is crucial if you want to prolong your nursing career and ensure it has longevity.

Prioritize your health and well-being, and make sure you are taking the necessary steps to take care of yourself.

9. Take Care of Your Support Staff

My next point is to take care of your support staff. Don’t be that nurse who goes around mistreating the techs or other support staff.

Everybody plays a vital role. While the roles are different, they all come together to accomplish the mission of taking care of patients and providing good care.

Things will go a lot better for you if you adopt the mindset of being kind to your support staff—your aides, techs, etc.

Treat them well. Just as with helping other nurses, you want to ensure you’re helping your techs.

Being a registered nurse, licensed practical nurse, or vocational nurse doesn’t mean you can’t help with basic patient care tasks like turning patients, taking off food trays, or cleaning up.

Obviously, if there are more urgent tasks that only you can do, handle those first.

But if you’re constantly chilling on the phone with your feet kicked up while the techs are running around getting stuff done, that looks poorly on you.

In this scenario, you’ll likely find your support staff less willing to help you.

I understand that not all support staff are great. I’ve worked with plenty of support staff I wish were better.

But you’ll also work with many who are exceptional and can make your life much easier.

If you focus on not being helpful or dwell on the techs who aren’t performing well, you risk driving away the good ones who are solid and can make your life easier.

Remember, treating your support staff with kindness and respect fosters a better working environment and ensures smoother operations for everyone involved.

10. Learn the Art of Documentation

My next point is to learn the art of documentation.

Actually, before we even get to the art of documentation, you need to grasp the importance of documentation itself.

You need to document, document, document.

I don’t know if your nursing school emphasized this, but mine did, and many others do too: if it’s not charted, it didn’t happen.

That statement is very true. You need to realize that even if not many people look at your actual chart daily, attorneys certainly will if a lawsuit arises.

These lawsuits can happen years down the road, long after you’ve forgotten who that patient was.

But your charting will be there, and it’s crucial to ensure it’s complete and accurate.

Start learning the art of documentation during your orientation.

When you’re taking care of patients, take some time really really look at the nurses’ notes of the pt’s you’re taking care of.

Pay attention to what those nurses are doing or not doing.

What is it that you noticed during your shift of taking care of the pt that the nurse didn’t document or documented in an unusual way.

Some hospital systems offer seminars on charting, and if yours does, make sure to attend and pay attention to those guidelines.

Ideally you want to develop good principles and practices for charting and documenting early on.

11. Remember to Breathe a Lot

My last point is to remember to breathe. It’s okay to have bad days.

It’s okay to cry—though you probably want to avoid doing that in front of your patients, but it could happen.

It’s okay to have moments where you’re very stressed, a little anxious, or feel somewhat overwhelmed. It’s also okay to have tough days and shifts.

This is going to happen, especially during the first few months after your orientation.

Many of you might have a three-month orientation period, and those months are tough, but you have your preceptor there as a safety net.

You’re still learning a lot during this time. However, the next couple of months after your orientation, when you no longer have your preceptor as a crutch, are going to be challenging.

It will push you, and you might honestly have days where you question why you chose this path.

Key Takeaways

My words of encouragement to you are to take a breath. Sometimes, take it not just one day at a time but 30 minutes at a time.

Just focus on getting through the next task or the next moment. Then, move on to the next one.

You can do it.

So many people, I assure you, who were much less capable, have managed to get through this and excelled. You can absolutely do it.