Why is it difficult to transition from nursing student to working Nurse?

[Beautiful_Beginnings]

As a nursing student, I have read numerous articles/blogs of new grad nurse experiences. I read many horror stories or tales of feeling overwhelmed incompetent and extremely nervous. Is the transition difficult from a student nurse to a RN? In your opinion from the different nurse specialilties and various experiences and background, why is it so difficult to be a new grad nurse?

[nursemike, ASN, RN]

Some very good points have already been made, but it occurs to me that, for me, the most difficult thing about my first year was that it was difficult. Now that I've been doing it for a while, a lot of times it's still pretty hard. Nursing school wasn't a picnic, either, come to think of it. Well meaning people, including me, will say you have a big challenge in front of you, but it's also fair to note that if you are a licensed RN, you have a pretty big challenge behind you. You can do this--but it is hard. Soon you, too, will have a list of things nursing school didn't teach you.

[Beautiful_Beginnings, ASN, RN]

Thank you everyone for your perspective. This site is truly amazing and I am blessed to be able to obtain real life answers from real nurses! I thank you. All the information allows me to see a greater picture and 1 be patient with myself when I too go through that and 2 possibly find ways to reduce the stress. Thank you you all! 😚

[brandy1017, ASN, RN]

Working conditions suck and are getting worse! I can't imagine starting out now with the high acuity, high patient ratios, computer charting and lack of resources. It was difficult for me when I first started over twenty years ago. School generally doesn't prepare you for bedside nursing. I had worked as a secretary in the ER so I had an idea what nurses did and I was amazed and impressed at all they did while the Dr's were on the sidelines.

I recommend getting hospital experience first as a CNA and then as a intern or extern to ease the transition. Generally, nurses with this background do better. That said I don't recommend nursing, so I recommend going on for your NP. If you stay at the bedside prepare to be overworked and overstressed.

[Ambersmom, BSN, RN]

As a nursing student, I have read numerous articles/blogs of new grad nurse experiences. I read many horror stories or tales of feeling overwhelmed incompetent and extremely nervous. Is the transition difficult from a student nurse to a RN? In your opinion from the different nurse specialilties and various experiences and background, why is it so difficult to be a new grad nurse?

partly because nursing school gives you the perfect world of black and white interventions, and you do not have to time manage, give meds, ambulate, do dressing changes and treatments.

The real world is a very pretty shade of gray, but all gray nonetheless.

[BBP42]

The RN program I attended had 6 classroom hours/16 clinical hours per week. So we had a lot of clinical time. I felt educated enough about diseases, medications, etc. but not procedures. I found that during clinicals we got very little real practice. The hospitals here do not allow students to perform certain tasks (i.e. IV push meds) at all, and most other skills can only be performed with the clinical instructor's supervision, and she would be watching eight nurses, meaning we only got about an hour each of her time max each day. The rest of the time, we were basically writing endless care plans for our assigned patients or performing CNA work, which is fine but not teaching us the real work of being a nurse. Skills labs are great places to practice, but I personally only inserted foleys in a couple of living breathing people during the whole nursing program. I did no dressing changes on live people, I only observed a lot of them. We didn't insert NG tubes on live people. Just to name a few skills that we have to learn really quick once we hit the real world.

[Nurse Beth, MSN]

As a nursing student, I have read numerous articles/blogs of new grad nurse experiences. I read many horror stories or tales of feeling overwhelmed incompetent and extremely nervous. Is the transition difficult from a student nurse to a RN? In your opinion from the different nurse specialilties and various experiences and background, why is it so difficult to be a new grad nurse?

Because there's a practice gap between nursing programs and nursing practice.

Theory and application are entirely different.

[Nurse SMS, MSN, RN]

Because nursing school exists in the realm of idealism and real life nursing exists in the reality of the world as it exists today.

[HalfBoiled, BSN, RN]

You transition from 1-2 patients to a full 5 patients.

[kbrn2002, ADN, RN]

Nursing school is a great place to learn how to learn to be a nurse. You'll learn the theory to better understand why we do what we do, you'll learn the bare bones basics of direct care. Then you are expected to take all the theory you now know and apply it yourself when you start working while using those basics of direct care you practiced in clinicals as a jumping off point.

Nursing is such a diverse career that the skills you need will vary greatly depending on the setting you work in, it's not practical or possible for nursing school to teach you everything you'll need to know for that first job. The hope is you've learned how to learn and can pick up those specific skills you'll need during orientation.

Some of the skills like time management and the ability to multitask should be addressed more in school though. It's a rude awakening for most new nurses when they find out how many balls they are expected to juggle in real world nursing. A little warning about this would be helpful.

[missmollie, ADN, BSN, RN]

One thing not mentioned in all the previous posts is the sheer mental exhaustion that is nursing. This was really difficult for me, because you are CONSTANTLY reorganizing your thoughts around what are the needs now, all the while making mental notes for later. When you first start, you are trying to remember everything, even if it is with a list or brain. It feels like everything is important, nothing is minor, and everything needs to be finished five minutes ago. Time flies and you flail, going home physically and mentally exhausted. Until one day, it just clicks, and suddenly you're like every other nurse on the unit and doing fine. That's right about the year mark.

[3ringnursing, BSN]

Although school is in the most basic sense work, there is a huge difference between being a full time student and being a full time employee. The differences are to numerous to list, however strictly speaking school is about learning and testing the waters - practice, whereas work is the real world with real consequences for errors.

The reason going from nursing student to new grad RN is so frightening is

because there is absolutely no way one can possibly learn everything necessary to know in school in order to be a confident, competent nurse immediately upon graduation. That means there is a lot of on the job training ahead for new grads, which gives one the sense of being a fish out of water. The very first preceptor one has in their first ever job can literally make or break one's self esteem.

Another thing to consider is working as a nurse bears no resemblance to the way clinical rotations are conducted. You won't get 1or 2 patients and thoroughly research all of the Rx meds, mechanisms of action, side effects, et al, and review their entire medical history in their chart. There may be shifts you run from room to room throwing meds at patients as you run by, and barely get the minimum charted.

There is a big discrepancy between what there is time to teach in nursing school and what we still need to know to be competent clinicians - sometimes it can take years to learn enough skills to feel comfortable. A new grad nurse is very vulnerable in this fragile stage, and needs all the support and kindness they can get.