Ask for Help
In most cases, you will be assigned a preceptor who will be in charge of showing you the ropes and supervising you as you perform procedures for the first time. She will not be your personal tutor or always available to you as she will have her own assignment. Sometimes a preceptor has volunteered for the role and sometimes it has been assigned to her. Be sure you understand which way the situation is and how it can differ.
Dealing with Your PreceptorIn some instances, you may not like your preceptor and vice versa. Do look at the situation with an open mind and a genuine attempt before you go to your supervisor. If you do have to go to your supervisor, don't go in blaming and bad-mouthing the preceptor. Ask your supervisor for suggestions how you might work it out first. Maybe she has some insight into your differences and can give you some guidance. If all attempts fail, then take the burden for the failure yourself. Perhaps it's you who just can't seem to find a way to work with this person rather than blaming him for the failure, (even if it's obvious to everyone that the preceptor is the problem). This goes a long way in showing diplomacy and teamwork. It also shows that you have respect for your coworkers and the maturity to handle an impossible situation. Ask for another preceptor and allow your supervisor to handle the change in a diplomatic manner.
Ask your supervisor and preceptor who you should go to if you have questions and neither of them is available. If they say you can ask anyone else, just be sure to ask if there's someone they prefer you NOT ask. They may have very specific reasons for their answer.
In addition to your preceptor, you may find a mentor amongst your coworkers. This person differs from your preceptor because they aren't assigned to guide you, but she may have very similar philosophies about patient care, or a natural way of calming patients, an ease in performing her duties, or procedures that you admire and wish to learn. You may have many mentors throughout your career. You should aspire to be a mentor to others as well.
Don't Be Afraid to Ask QuestionsYou need to take your work seriously. You need to complete your assignments and to communicate clearly with your coworkers at all times. If you need to leave the floor, you report off to someone who will cover for you. If you have questions, you need to be sure to ask them. Don't be intimidated by the other nurses. They have more experience than you have right now, but you have worked just as hard to become a nurse. You will find that asking questions does not make you look stupid or ignorant, but rather shows a desire to learn and a respect for your coworkers' knowledge and ability. In health care, learning is an ongoing process for everyone.
Pharmacists are great resources. If you can't find a drug in your drug book or in the Physician's Desk Reference (PDR) on the unit, call the pharmacist before you give a drug that's new to you. If you question a dosage, ask the pharmacist. Perhaps the M.D. made an error or has a reason for the dose and it should be clarified. The pharmacist will usually be happy to assist you in this.
If you haven't done something or are uncomfortable with a procedure, ask for help. Be honest; don't try to bluff your way through something, even in the event that you find yourself alone with a physician who expects you to assist him.
Talk to the Whole TeamLook to the other resources around you for answers as well. Social workers and therapists (physical, occupational, respiratory, and speech) deal with the same patients. These other staff members may have an entirely different perspective on the care a patient needs. Sometimes patients respond to them in a different way, either positively or negatively, for various reasons. A patient may be combative with the nurse who is trying to administer medication or perform a procedure, but he may be totally cooperative with the physical therapist who's helping him to walk. The patient doesn't like the medicine or the procedure is invasive, but walking will get them out of there sooner. Maybe he doesn't understand the need for the medication or that it will help him just as much as the walking.
It is also helpful to learn the role that each discipline plays on the health care team. Nurses tend to believe that they have total responsibility for the patient and need to understand how and when to delegate. If you have a better understanding of the part each team member plays, you will also be less likely to overstep and interfere with the total plan of care.

