August 4, 2007, 5:03 pm

It Takes a Village…



I love this photo!

As you can see from the name on the side, this baby was photographed by Mr. Tom Arma, aka “The most published baby photographer in the world!”

Check out his website for the epitome of the word “cute”.

If I have grandkids, I’m going to photograph them in a nurse’s cap and stethoscope.

Not any grandsons, of course. They just get the stethoscope.


I may have just set a record. I’m sitting in my second Starbucks of the day. I’ve never done that before!

And the Police are playing – geeze, how annoying can Sting be? “A goo-goo-goo, A ga-ga-ga.” Warning: impending emesis if they don’t change this music…

Don’t stand so close to me…

Don’t worry!


The baby and I have a lot in common – and I don’t mean the rolls of fat!

You see I once was a “baby” nurse. A new graduate with virtually no confidence, petrified at the thought of actually being a nurse.

To tell my head from a hole in the ground required a topographical map.

What happened to me that first year would never happen today, it just isn’t done.

Let’s just say I lucked out.


I’ve always found it funny that I ended up in critical care. After all, it was my ICU rotation in school that had me leaving mid-shift so I could go to the college and quit – with only six weeks to go!

I was convinced I was going to kill somebody.

Med-surg was not my thing, so when a small community hospital advertised for their 10-bed cardiac step-down/education unit, I applied and was interviewed.

For some reason, they gave me the job. I had zero cardiac training. The deal? They would pay for me to go through a cardiac course if I agreed to stay on the job one year.

I said yes.


They promptly closed the unit, an ostensibly temporary situation. That meant that my preceptor and me, a non-cardiac certified new grad would be working down in the Coronary Care unit.

This was in December. They weren’t able to put me in a cardiac class until April of the next year.

For four months, I came to work full-time and was never counted as staff!


I was able to work side-by-side with experienced nurses every day. They would answer my questions, taught me how to read a monitor and backed me up every single shift.

There were two cardiologists with offices in the hospital. When they found out I was new, they sat with me and explained preload and afterload and other tricks-of-the-trade, like hooking nitroprusside directly into the saline lock because it was safer than having it go through back up tubing, or how to troubleshoot a Swan-Ganz catheter if the wave form was poor.

They were always willing to answer questions and explain why something was ordered.

The unit nurses were just as supportive. Hours were spent discussing PVC-vs-aberrancy strips with my older colleagues. I was so green, the first time a patient went into bradycardia my preceptor threw a box of atropine into the room and yelled “push this”! I had to yell back “how much!!??”. “Half the syringe – point five!”

Hey! It worked!

Atropine rocked!


By the time I was enrolled in the cardiac course, I already knew how to read every rhythm and which ones to treat and why.

I knew I had “made it” when I called one of the cardiologists at 0200 for a patient who experienced a sudden, intense shortness of breath.

After I gave the rundown of symptoms, he said, “Kim, you know what you’re seeing. What do you think is happening?”

“She threw a pulmonary embolism.”


I was right!


I kept my end of the bargain. I stayed a full ten years at that facility.

The reason I stayed is the story behind the story.

You see, I had serious doubts about my ability to be a nurse after I graduated. I constantly wondered, “what the hell did I get myself into?”

By stumbling upon an experienced, enthusiastic and supportive group I was able to learn in a safe environment while growing confidence in my nursing ability.


You know the old saying “it takes a village to raise a child”?

Well, it takes a “village” to raise a new nurse. I know. I was mentored by a “village” of my colleagues.

Twenty-nine years later, I’m still nursing and I’m good at what I do.

I firmly believe I wouldn’t be where I am now had I not been supported in those scary first days.

How many new nurses are we losing to “culture shock” before their first year of practice is over?

How can we keep new nurses from finding the exit door?

Maybe the first step is not eating our young, but helping them find their strengths and mentoring them into confidence.

It worked for me.


Side note: Cardiac care was much different back then! Patients spent at least a week in the unit with commode privileges and then could get up to the bathroom using a “long cord” to keep them attached to the monitor. Later, when the unit was open, they would spend ten days or so in the cardiac step down unit getting “educated” on all matters cardiac.

We needed a doctor’s order to discuss sexual activity with the patients – there was a special booklet for that! There was no troponin, only CK, CKMB, LDH, SGOT and SGPT levels. You didn’t have to worry about running a patient to the cath lab, they did not exist. It was said a bypass was good for five years. Calcium channel blockers were experimental and we never heard of TPA!

We’ve come a long way, baby!



  • Jenn

    August 4, 2007 at 5:20 pm

    I feel like I lucked out too. I started at a community hospital as a tech and did my preceptorship on that unit and worked there as a new grad. The montior techs (we were lucky) liked to teach so by the time I got to any cardiac class I could read any rhythm.

  • NPs Save Lives

    August 4, 2007 at 6:49 pm

    So many new nurses hit the ground running and never get the support that they need. I feel like that again as a new FNP grad at my new job and I don’t like feeling like a novice again. I’m seeing on average 23 patients a day in a family practice. WHEW!

  • Kellie

    August 4, 2007 at 8:58 pm

    As a new nurse who just graduated with my BSN this June, I hope I am surrounded by a “village” when I start full time in a few weeks. I will be working in a high census, level 3 NICU at Children’s Hospital. As my start date nears, my anxiety is increasing even though I am incredibly familiar with the NICU and many of the procedures, drugs, and patients I will be handling (thanks to my two preemies, a 30 weeker and a 25 weeker). Here’s to a supportive environment!

  • Ali

    August 4, 2007 at 10:16 pm

    I also just graduated this spring and started working in June. My first month and a half have definitely had its ups and downs. There are days (or nights) when I feel supported and like I am part of the team, but there are other times when I feel as tho I am out there hanging in the wind. It might be related to the fact that there were a lot of new grads hired all at once this spring that it is hard to find good mentors for us all. But I shouldn’t be punished for that reason by getting a less supportive mentor. I have definitely had moments in this past month and a half where I question whether I am ready to do this job… and if it was the right choice for me. But there are other moments where I feel like I am in the groove. I just hope that the good outweigh the bad.

  • Grand Rounds at the Beach

    August 7, 2007 at 12:39 am

    […] at Emergiblog shares what it’s like to be a “baby” nurse raised by a village of other more experienced nurses and […]

  • mshkosh

    August 7, 2007 at 4:07 pm

    First off I don’t think we should routinely put new grads in ICUs… that can and should scare anyone away form nursing. I realize there aren’t lines of experienced nurses ready to take those jobs either, but I truly believe nurses should NOT start in critical care.

    The other problem is that nurses are too overworked to have the time to raise the new kids. Years ago there was all the time in the world ( when I got out of school), but now?…its not fair to either group, not to mention the patients.

  • Cinder

    August 8, 2007 at 12:01 pm

    Wow,that brought back memories.
    I,too,went into a challenging position as a new grad. I worked on a 45 bed surgical floor/mini unit in a large teaching hospital in which most of those Pt’s would be in ICU today.
    I had a great preceptor and there were so many other nurses. They appreciated me and taught me the ropes with humor and expertise. As I went from team leader to charge they continued to support me.
    I don’t remember any backstabbing,they were professionals who loved their work and did their job well. We had a difficult job to do and we all worked together to do it.
    I don’t think todays nursing environment is so supportive because there are so few nurses but I know I really appreciate GN’s because of their enthusiasm,it reminds me of why I went into nursing.And when I teach someone I learn it better myself.
    It’s much more difficult because of the politics and all the CYA paperwork,etc but those who will gently introduce a “baby nurse” to nursing are still there.

  • New Nurse Jane

    August 17, 2007 at 2:57 pm

    This is sweet! I could use some shelter. I am new and started on a telemetry floor. I feel as though I am always looking for someone to help me, and I rotate the experienced nurses. For example I do not ask the same nurse for help all day. Sometimes I feel as though I am asking questions about things I know the answer to but need that extra confidance. Some nurses just love to teach, and I can tell who likes teaching and who doesn’t. I just love to read these posts about experienced nurses who “rememeber” what it is like to so new! I feel like….”when did I miss this in nursing school?” I was super smart in school and aced all my tests…but now…I feel as though I do not know a thing!

  • kcalohagirl

    January 20, 2008 at 10:40 am

    I found this post over 6 months after it was written. Thanks for an insightful look at the way units sometimes function. On my floor (CTS stepdown) I am one nightshift nurse of 3 left after 18 months. There are 2 of 4 on the dayshift. I don’t even really want to think about the attrition of the more experienced staff.

    With your permission, could I copy this post and present it to our unit’s practice council?

    I think some of our new grad nurses are welcomed with ‘open arms’ yet others are, well, ‘hazed’ might be too dramatic a term, but I think you understand.

    I think your post might give a ‘nonthreatening’ insight into life as a new-grad, and what we can do, as the more experienced nurses to make orientation (and the first few weeks off) a better experience

  • […] Then the life changing realisation hit me… the next bunch of nursing students to leave school and start Uni where not even born when I started training.  The babies I saw being born on my midwifery placement, could soon be nurses!! (Thanks to Kim for the picture!) […]

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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