Surviving the Real World of Nursing: 8 Tips for the New Grad

jeastridge, BSN, RN

"I did it! I finished! I passed my boards!" My friend, Kathy, shared her news in the hall at church and I hugged her back, grateful and proud. Having nursing as a second career, Kathy is older than most of her nursing school friends and especially thankful for the opportunity to head into the second half of her life with a completely new direction. She had always dreamed of being a nurse and after taking early retirement from an unrelated field (yes, I realize that no field is totally unrelated to nursing...), she enrolled in college, did the necessary prerequisites and finished strong.

Now, with eyes shining, she stood ready to take the next step: a real job. "Let's have coffee next week and you can give me the whole scoop on this new grad thing." After setting up a time and place, she went on her way, a new bounce of relief and pride in her step. I watched her go, and thought to myself, "What is the best advice I can give her?"

During the following week, I continued to give it some thought and even wrote down a few of my "Best Tips for a New Grad."

Relationships matter

Sometimes when we are training for a new position, we can become so nervous that we forget the most important thing: focusing on the patient. I can remember putting in my first Foley catheter with a preceptor. She was most helpful because she had the ability to talk with the patient and family and explain things, picking up easily the parts that I was struggling with. Also, taking time to learn all your co-workers names, including the people that work in dietary, the doctors and those in environmental service. In a hospital or office setting, we are all part of the team that makes patient care doable.

Expertise takes time, but pursuing knowledge is a lifelong calling

In Malcolm Gladwell's book, Outliers, Gladwell contended that it's "an extraordinarily consistent answer in an incredible number of fields ... you need to have practiced, to have apprenticed, for 10,000 hours before you get good." While it probably doesn't take 10,000 hours to become a competent nurse, the true experts have been in the field for a long time and they push themselves to continue to learn and hone their craft daily. Set goals for yourself and work toward them diligently.

Nursing is hard work

There I have said it. Nursing school is hard, and being a nurse is often just plain difficult. The rewards are endless, but to get to those rewards sometimes you have to endure a lot. Stick with it when the going gets rough. Sometimes co-workers can seem rude or short with new grads. But give them the benefit of the doubt. Everyone has bad days and with their experience, they often know that the thing you are asking about or focusing on, is not as important as you think it is, so they are answering you with that in mind. By trying to set your feelings aside-or just not front and center every day-you will open your mind to learn more and to be able to really hear what your co-workers are trying to teach.

When possible, stay with a position long enough to really understand the job

It may seem to the new grad that after a year everything is becoming more routine. A sense of restlessness can settle in, and the lure of other settings, a new challenge, a little better pay, can pull the new grad away from a job where they have just gotten comfortably competent. By staying the course, the new grad can allow himself to truly develop some of the aforementioned expertise. Also, given enough time, even co-workers that seem initially annoying can become more dear, their quirks less irritating.

Find a mentor

They can make all the difference. In searching for a new job, one of the determining factors is always what their training program looks like. If you happen to know someone or interview with a leader that you like, then chances are you will be happier working in that environment. Great leaders make even the zaniest work setting bearable. And remember, generally the culture of a unit, facility, or program comes from the top and trickles down.

Get a life

If you don't have a lot of family obligations, it's time to pursue joining that group or church or hobby that you have been putting off. Having a well-balanced outside life can restore your energy and enthusiasm for your work.

Stay physically fit

Work is exhausting but truly does not count as exercise. No matter what kind of nursing job you might have, you still need intentional exercise just about every day so that you stay healthy in mind, body and spirit. This is challenging but worth the effort.

Take a break

If these last three seem to be about NOT working, then you are reading correctly. Being a new grad can become so consuming that the rest of life suffers. In the end your patients will suffer too, as the effects of stress pass on. Taking a break means eating a meal during your shift and on a larger scale, taking a real vacation. Even if it's a "stay-cation" it can be a good time out and can help to re-energize you for your work. But true vacations don't just happen. They require budgeting and time-management. Taking a break also means keeping your spiritual self refueled and refilled.

What about you? If you were making out this list to give advice to new grads, what would you say? What experiences really helped you when you were starting out?