10 Things You Should Know as a First Year

First year is strange. It is the year with the least pressure on paper and the most confusion in practice: new city, new cohort, a uniform that does not fit properly, and a timetable that seems to change every fortnight. It is also the year where a few small habits quietly decide how hard second and third year are going to be.

None of this is about being the best student on the ward. It is about the boring structural things that are easy to sort in September and horrible to fix in May.

OneAttend everything. Get as many hours as you can.

This is the one. If you take nothing else from this post, take this.

Attend everything. Get as many hours as you can.

A UK pre-registration nursing programme is built around a fixed number of hours — broadly 2,300 hours of practice learning and 2,300 hours of theory across the three years. Those are not a target you aim at. They are a requirement you have to evidence before you can register. Hours are counted, signed for, and audited.

Which means every shift you miss has to come back from somewhere. And there is nowhere for it to come back from except your annual leave, your reading weeks, or your third year — the year you least want to be making up hours in. I have watched people lose an entire summer to a handful of days they skipped in November because they were tired and it was raining and it felt like one shift could not possibly matter.

So: go in. Go in on the days you do not feel like it. Say yes to the extra long day if someone offers it and you are physically able. Say yes to the theatre list, the clinic, the community visit, the night shift you are nervous about. If the ward is quiet and another team will take you for a day, go. Get your hours banked early and get them signed off on the day, not from memory three weeks later.

Being ahead on hours is the single biggest bit of breathing room you can give future you. Being behind on hours is the thing that ends people’s courses.

TwoYour practice document is not a last-week job.

Whatever your university calls it — PAD, MyPAD, PARE, e-portfolio — it is the document that proves you can do the job. It is also the thing students most reliably leave until the final fortnight of a placement, at which point their practice assessor is on nights, on leave, or has simply not seen them do the thing they need signing.

Read it in week one. Highlight the proficiencies you need this placement. Then actively hunt for the opportunities rather than waiting for them to appear. “I need to be observed doing a set of manual obs and a fluid balance chart this week — can I do the next one with you?’’ is a completely normal sentence to say out loud.

ThreeYou are supernumerary. Use it.

Supernumerary means you are additional to the staffing numbers — you are there to learn, not to be counted as a pair of hands. In practice, a busy ward will absorb you into the work if you let it, and there is a real skill in being useful without becoming free labour for six weeks of bed-making.

Ask for the why. Why that antibiotic, why that catheter, why we escalated that NEWS2 score at 5 and not 6. Follow one patient properly rather than doing a little of everything for twelve. The students who get the most out of placement are not the ones who do the most tasks — they are the ones who ask the most questions.

FourDrug calculations start now and never stop.

Nobody fails drug calculations because the maths is hard. They fail because they have not touched it since the last exam, and the exam is usually pass-at-a-high- threshold, and there is a re-sit limit. Ten minutes a week from first year beats three panicked days before the paper, every single time.

Get comfortable with the same four shapes over and over: tablets and capsules, liquid doses, IV infusion rates, and dosage by body weight. Then keep them warm. Our core quiz and the drug calculations cheat sheet in the hub exist for exactly this.

FiveLearn to write in the notes properly.

Documentation feels like admin in first year and turns out to be one of the most professionally serious things you do. Notes are a legal record. They are read back in complaints, coroners’ inquests and NMC referrals, sometimes years later.

Learn the basics early: write contemporaneously, date and time everything, sign with your name and status, record what you observed rather than what you assumed, never document care you did not personally give, and never leave gaps for someone to fill in later. Get a registrant to countersign as your university requires.

SixReference from week one.

Referencing marks are the cheapest marks on the whole degree and first years throw them away constantly. Pick up your university’s referencing guide — usually a house version of Harvard or APA — and use it from the very first formative piece, when it does not count and the stakes are zero.

Keep a running document of every source as you read it, with the page number. Rebuilding a reference list at 1am from a browser history is a specific kind of misery you only need to experience once.

SevenSort the boring placement admin early.

The practical stuff eats far more energy than it should if you leave it late: your off-duty, travel routes for a 7am start, parking, uniform and spare uniform, ID badge, occupational health clearance, DBS, and how you are going to eat on a twelve-and-a-half hour shift.

Also claim what you are entitled to. In England that is the NHS Learning Support Fund, which covers a training grant plus travel and dual-accommodation expenses for placement; Scotland, Wales and Northern Ireland run their own separate schemes. Whichever nation you are in, find out what you can claim, keep the receipts, and claim within the deadline — students routinely lose hundreds of pounds simply by not filling the form in.

EightYou will see things that stay with you.

At some point in first year — usually earlier than you expect — you will be present for a death, an aggressive patient, a distressed family, or a piece of care that you cannot stop replaying on the bus home. That is not a sign you are not cut out for this. It is a sign you are paying attention.

Know your routes before you need them: your practice supervisor and practice assessor on the ward, your academic assessor or personal tutor at university, student support and counselling services, and the ward’s own debrief after a significant event. Ask for the debrief if nobody offers one. Do not build the habit of carrying it silently, because the habit is what burns people out in year three.

NineLook after the body doing the shifts.

Good shoes. Compression socks if you are on your feet for thirteen hours. Food you have actually prepped, because the canteen is shut at 3am and the vending machine is not a meal plan. Water. Sleep protected around night shifts rather than fitted in around everything else.

This sounds like the softest item on the list and it is the one that decides whether you can sustain the other nine. I wrote about how I managed this during a heavy haematology and oncology placement here.

TenMeasure yourself against last month, not against your cohort.

There is always someone in the group chat who has already done a cannulation, or who talks about their placement like they are running the ward. Some of it is real and some of it is performance, and either way it tells you nothing useful about your own progress.

The honest comparison is you in September versus you in January. Can you do a full set of obs without checking the order? Can you hand over a patient in three sentences? Can you walk into a bay and know who you are most worried about? That is the progress that counts, and it is invisible if you spend the year looking sideways.

And ask for help early — the week you notice you are struggling, not the week before the deadline. Every single person marking your work would rather have that conversation in October than write an extenuating circumstances form in May.

If you only do one thing

Go in. Get the hours. Get them signed. Everything else on this list is easier to fix later — attendance is the only one that quietly compounds until it becomes the whole problem.