Initiation, Orientation and First Times


Published: 04 August 2016


Initiation. It’s not the time you got sent off to find the ‘left handed gloves’ on your first day at your ward. Initiation is a career-defining moment where you get to realise the weight of what you do as a nurse in helping and caring for others. When you have your license after graduating from university, you become part of a family that will stay with you the rest of your life. No matter if you stay at the bedside your whole career or decide to pursue something else, you will always be a nurse. That is the first step in initiation: the realisation that you are now part of something larger than yourself. You carry on a torch and can call yourself nurse.


In this critical time period you learn how to be a nurse. University only teaches you so much. When you are in orientation, you really understand what you are getting into. Fortunately you have a preceptor to rely on. Hopefully you will get a caring, supportive preceptor who will gently guide you through the hurdles of nursing in real life. However, it is going to be difficult regardless.

When you are in orientation, you finally see how hard nursing can be. Instead of taking one or two patients, you learn how to juggle four or five. You also learn what the blood tests and medications really mean. Instead of understanding them on an abstract level, you can appreciate what a high potassium or high blood pressure medication actually does to someone. This is part of the becoming process. You have to apply your learnt knowledge, and that isn’t easy. With the guidance of your preceptor, you can learn how different medicines interact and how they impact blood test results. By combining these and many more small details, a new recruit can become one of the team of nurses working on the ward.


First Time Alone

Your first time alone without a preceptor is one of the most difficult initiation events you will encounter. You are now responsible for the patients. The assignment is yours. When things go bad, you have to take care of them. You may live in constant fear that a patient will get sick or that you will do something wrong. Your only option is to trust your training and give it your all.

You should also remember that you are not alone. Not really, although it may feel like it. Your fellow nurses are watching to make sure you are ok. Don’t be afraid to ask the charge nurse for help. Even if you corner them four or five times per shift in the beginning – that is what they are there for. Your fellow nurses can help, too. Part of the initiation of becoming a nurse is taking a deep breath and learning to ask for help. The patients belong to everyone, and asking for help is something every nurse needs to quickly learn how to do.

First Year in Nursing

Your first year in nursing is the ultimate initiation. Along the way, you have probably had your first code, your first fall, your first critical decision and your first death. These are all very difficult to deal with, and they are part of becoming a nurse. They change you and shape you into the nurse you will be forever.

Just reaching your first year anniversary is a milestone in itself. You can reflect on what you’ve learned, but you can also realise that not everyone makes it through the first year. Some are so overwhelmed and they realise that the job is not for them. At this point you may consider the same thing. You may also decide to change specialties. The initiation that comes with the first year of nursing is the realisation that there is more to nursing than anything someone could have taught or shown you. Your next step is deciding how you will use your new skills, whether it be down a different avenue, or continuing in this special field of care.