New Grad Nurse: What I Didn't See Coming

As a new grad nurse, there were certain difficulties I expected: encountering incivility, imposter syndrome, getting used to a rotating schedule, etcetera. However, there was one thing I didn't anticipate being my biggest hurdle in my short 5 months as a new nurse.

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New Grad Nurse: What I Didn't See Coming

In May of 2022, I, along with numerous nursing students, walked across a graduation stage, signifying the end of being a nursing student and the beginning of (finally) being a nurse. Then, when I saw the RN license status go from pending to active signaling, I had passed the NCLEX, or as I refer to it - the ultimate nursing rite of passage, I was over the moon. The countless days spent studying, completing NCLEX questions until your brain turned to mush and waking up at the crack of dawn for clinicals had paid off. I was hired in my local hospital's NICU in a rotating position. I anticipated some growing pains but was eager to officially begin my career.

Throughout nursing school and via social media, I had heard that the first year of nursing is likely to be one of your toughest. From nurses eating their young, to feeling incompetent, having imposter syndrome, and managing multiple patients at once ... I expected these things to render difficult. However, the challenge I didn't see coming and what I have most struggled with since working is figuring out how to balance life and working 13-hour shifts. No one seemed to be talking about this, and I felt alone and confused. I questioned if this meant I couldn't handle nursing. I had no qualms about the job itself (in fact, I am lucky to say I absolutely love what I do); I was just struggling with being me along with it.

At work, online and in school, talk of self-care was abundant. But who has time for self-care when days off are filled with errands, cleaning, cooking, and time for friends and family when all I wanted was to shut the door to my room and enjoy blackout curtain heaven and sleep? Not to mention mandated extra shifts and text messages stating help is needed on the unit fogging up my brain on my days off. I had imagined myself being able to become invested in hobbies I had prior to nursing school, and yet I felt like I was back in school with not enough hours in the day. When I worked nights, I felt the tug of this struggle even more as one shift seemed to take up two days - one day of sleeping before the shift and one day of sleeping after. Add on top of that, barely getting outside, and my mental health became at an all-time low.

I was fortunate enough to connect with a coworker hired around the same time and found out she was feeling the same way. It may sound dramatic, but this revelation that I was not actually alone, that this feeling was normal, felt like finally getting a breath of fresh air. We later found out another one of the newly hired girls also felt this way, and she actually decided to go to a M-F job with weekends and holidays off. I can't help but wonder if there are others out there feeling this way too. I wish I had known about this earlier and that I hadn't spent so much time thinking it was just me doubting myself and the career I had chosen. So if there is anyone out there who has encountered this or currently is experiencing this, please know there are others on the struggle bus too. It might not be a struggle as apparent as a nurse bullying another nurse or getting yelled at by a doctor, but that doesn't make it any less valid.

Here are some things that have helped me balance the teeter-totter between work and everything else, although it is something I am definitely still working on:

  1. Don't feel guilty for sleeping. Seriously. The cleaning or whatever else feels like it needs to be done now can wait. Say no to plans if you need to. It's better than showing up all grumpy and sleep-deprived (trust me, I learned the hard way)
  2. Tell your friends and family how you're feeling. Explain that you may not be as available as you'd like as you adjust to your new schedule. (I know this isn't novel advice but it's something I wish I had done!)
  3. Get outside when you can. I don't mean take a 30-minute walk every day. I mean something as simple as when you walk to get the mail, just take an extra minute to soak in the sun, breathe in the fresh air, and just be outside. I have found this to be key to having good mental health.
  4. It can feel insurmountable when you think about a to-do list of what needs to be done on your days off - especially if you only have 1-2 days in between a block of shifts. There's likely something that is more important than another. For example, groceries definitely take priority over vacuuming ... Being hangry just isn't what we're going for here! So choose one thing on your to-do list and one self-care activity/hobby you want to focus on that day. This helps to ensure you don't become a slave to your to-do list while at the same time preventing you from feeling so overwhelmed you don't do anything and then just feel gross.
  5. Talk to your manager or staff scheduler if need be. I realized a large part of my feeling isolated from those around me is that I worked a lot of partial weekends in addition to my scheduled weekend shift. Don't be afraid to speak up, and don't feel guilty for doing so. You've got to care for yourself, so you can rightly care for your patients. 

In the meantime, I'll be working on the skill of napping as I am quickly realizing it is a necessity for survival. Also, I must give a shoutout to nurses that are also parents: in my short time as a nurse, I have learned your true title is superheroes - I am amazed at your ability to do all that you do.

If you have any tips, please share them!

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raven_h17

About raven_h17, BSN

Hi! My name is Raven Heuertz and I am a new grad nurse. I work in the NICU and am passionate about what I do. I love connecting with others and learning new things. You can find me curled up with a book on my days off. :)

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Specializes in Freelance Health Care Writer|End-of-Life Educator.

Oh, how I remember those days! Everyone who is NOT a nurse always seems to envy our schedules. But it can be super hard to work 2, off 1, work 1, off 3...etc. It leaves the body confused and our minds and spirit reeling! This is one reason I job-hopped a bit between shift work and home care positions (8-5,M-F). It allowed me to enjoy the 'pros' and when I could no longer find that enjoyment (and only saw the 'cons') I would switch it up.  Great article! And thank you for working NICU, a role outside of my personal comfort zone and so needed!

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Specializes in NICU.
8 hours ago, NurseDeltaInk said:

Oh, how I remember those days! Everyone who is NOT a nurse always seems to envy our schedules. But it can be super hard to work 2, off 1, work 1, off 3...etc. It leaves the body confused and our minds and spirit reeling! This is one reason I job-hopped a bit between shift work and home care positions (8-5,M-F). It allowed me to enjoy the 'pros' and when I could no longer find that enjoyment (and only saw the 'cons') I would switch it up.  Great article! And thank you for working NICU, a role outside of my personal comfort zone and so needed!

Thank you so much for your insight. Yes, I am the only one in healthcare in my family so it has been a big adjustment to say the least. I am glad you were able to find balance!

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Oh how I love NICU! Thank you for what you do there. I’ve had four premies myself; four of my seven came early. One of them at 25 weeks with severe IVH, etc., one at 35 with IUGR, another at ~37 with bicuspid aortic valve, and the last one at 36 due to eclampsia. I cherish what you do and thank you for taking on that role. I was in the NICU my final semester. My heart goes out to that and if I were younger, I would have applied to work there. 
 

What ultimately turned me away was the scheduling instability. Low census and you get floated to l&d or sitter, high census and you’re being mandated constantly. Absolutely take care of yourself. It is not an easy assignment, but I’ve never worked with a more rewarding patient population.

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Specializes in Family, Maternal-Child Health.

First congrats on passing the NCLEX and becoming a new RN.  Nursing school is a challenging major - no easy way through.  Your article interested me because I have many nursing years under my belt.  So I was curious what you would perceive as a major challenge.  I can understand why you say the long shifts and long hours are so disruptive in one's everyday existence and emotionally/physically depleting.  In my earlier years the eight hour shift was the norm then the profession moved into twelve hour shifts.  When twelve hour shifts were evolving many articles were written related to adverse responses on behalf of those engaging in twelve hour work days....fatigue, increased errors, physical and mental sense of imbalance....  Despite these warnings and due to demands of short-staffing twelve hour shifts became the norm.  And now the work day has even extended with doubles and overtimes.  So it doesn't seem surprising many nurses of today are expressing some of these same feelings you did in your article.  Not just new grads either - hope that helps to know your not alone.

I would just add one variable that I have heard many nurses doing twelve hour shifts complain about, particularly during Winter months when it gets darker outside earlier.  That is they can go days at a time without seeing light outside - and we all know how lack of sunshine can have both physical and mental effects on us.  They "go to work in the dark....and come home in the dark."  Doesn't even sound good!   

So this thought leaves me with one piece of advise I did not see mentioned in your terrific list of recommended self-care measures.  So I would add... make sure you leave the building during your shift and go for a walk even if you do so on your lunch or dinner time.  Take something you can eat while you walk or sit outside.  Don't think your department is going to fall apart if you leave the unit.  Don't convince yourself you are better off eating on the go in your department while you continue working or worse yet not even stop for breaks or to eat.  Those nurses who do take these short breaks away (and outside) feel somewhat more positive and refreshed when returning. 

Best wishes - you have some good self-care measures figured out.

 

  

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Specializes in NICU.
On 12/6/2022 at 1:09 AM, PositiveEnergy said:

First congrats on passing the NCLEX and becoming a new RN.  Nursing school is a challenging major - no easy way through.  Your article interested me because I have many nursing years under my belt.  So I was curious what you would perceive as a major challenge.  I can understand why you say the long shifts and long hours are so disruptive in one's everyday existence and emotionally/physically depleting.  In my earlier years the eight hour shift was the norm then the profession moved into twelve hour shifts.  When twelve hour shifts were evolving many articles were written related to adverse responses on behalf of those engaging in twelve hour work days....fatigue, increased errors, physical and mental sense of imbalance....  Despite these warnings and due to demands of short-staffing twelve hour shifts became the norm.  And now the work day has even extended with doubles and overtimes.  So it doesn't seem surprising many nurses of today are expressing some of these same feelings you did in your article.  Not just new grads either - hope that helps to know your not alone.

I would just add one variable that I have heard many nurses doing twelve hour shifts complain about, particularly during Winter months when it gets darker outside earlier.  That is they can go days at a time without seeing light outside - and we all know how lack of sunshine can have both physical and mental effects on us.  They "go to work in the dark....and come home in the dark."  Doesn't even sound good!   

So this thought leaves me with one piece of advise I did not see mentioned in your terrific list of recommended self-care measures.  So I would add... make sure you leave the building during your shift and go for a walk even if you do so on your lunch or dinner time.  Take something you can eat while you walk or sit outside.  Don't think your department is going to fall apart if you leave the unit.  Don't convince yourself you are better off eating on the go in your department while you continue working or worse yet not even stop for breaks or to eat.  Those nurses who do take these short breaks away (and outside) feel somewhat more positive and refreshed when returning. 

Best wishes - you have some good self-care measures figured out.

 

  

Thank you so much for adding in that piece of advice! I will definitely keep that in mind. You are so right that getting outside elevates your mood. I appreciate your comment - it brought me a lot of comfort :)

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Specializes in CRNA, Finally retired.

I started off on nights.  This is what I learned .  Put sunglasses on as early as you can on the way home.  Do your grocery shopping on your way home so you don't have to do it during the day.  Conversely, on the way home.  I remember a night when I got called in around midnight for a short case so stopped  on the way home in a big supermarket feeling sorry for myself having to listen to the horrible piped in music and the store was empty.  After a few minutes, I ran into the scrub tech and the surgeon (female) and we looked at each other with our carts facing each other and just cracked up.  We were the only customers in the store.   Sad and hilarious at the same time.  But back to sunglasses.  They will help you to produce some melatonin that is normally low in the morning. A BIG sleep mask and blackout shades with no light allowed in....not even a little peek.  A full spectrum light on your head when you have woken up for the stay.  And remind yourself how much more pleasant nights are without visitors and transporting patients for testing.  This will all pass. 

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