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

In this article, the author offers 8 tips for new grads. She invites the reader to add a few of their own.

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

"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?

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jeastridge

About jeastridge, BSN, RN

(Columnist)

Joy has been a nurse for 35 years, practicing in a variety of settings. Currently, she is a Faith Community Nurse. She enjoys her grandchildren, cooking for crowds and taking long walks.

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I am a new grad who has been on my own now for one month. I work on a busy med-surg floor. There are two things I've learned and strive to practice/remember at work.

1) One patient, one task at a time. It can be easy to become overwhelmed and lost in the endless to do list. I practice mindfulness by telling myself to be fully present in what I am doing at that very moment. Each patient and each task deserves my full attention and effort. Even so I am constantly interrupted. I jot down a quick note about the phone call or notification I was interrupted with and put it out of my mind temporarily while I go back to focusing on what I was doing. I find my day goes smoother when I'm able to fully focus on each individual patient and task at a time versus when I allow my mind to wander and panic over the overwhelming volume of things I need to accomplish.

2) Nursing is a 24 hr. Opperarion. I am one person with 12 .5 hours to accomplish as much as I can to keep my patients safe and hopefully leave them better than I found them. All I can do is my best and I can't beat myself up if I don't accomplish everything I set out to do. My friends who work at night and I are a team. If we work together remembering it's a 24-hour job, I need not feel bad if something gets left undone despite my best efforts. I always remember the same when I start my shift with things that were not accomplished at night. It's a 24-hour job and we need to work together.

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Specializes in Faith Community Nurse (FCN).
I am a new grad who has been on my own now for one month. I work on a busy med-surg floor. There are two things I've learned and strive to practice/remember at work.

1) One patient, one task at a time. It can be easy to become overwhelmed and lost in the endless to do list. I practice mindfulness by telling myself to be fully present in what I am doing at that very moment. Each patient and each task deserves my full attention and effort. Even so I am constantly interrupted. I jot down a quick note about the phone call or notification I was interrupted with and put it out of my mind temporarily while I go back to focusing on what I was doing. I find my day goes smoother when I'm able to fully focus on each individual patient and task at a time versus when I allow my mind to wander and panic over the overwhelming volume of things I need to accomplish.

2) Nursing is a 24 hr. Opperarion. I am one person with 12 .5 hours to accomplish as much as I can to keep my patients safe and hopefully leave them better than I found them. All I can do is my best and I can't beat myself up if I don't accomplish everything I set out to do. My friends who work at night and I are a team. If we work together remembering it's a 24-hour job, I need not feel bad if something gets left undone despite my best efforts. I always remember the same when I start my shift with things that were not accomplished at night. It's a 24-hour job and we need to work together.

Well said! And good job of synthesizing the essence of starting out and continuing to do well. Thank you for sharing your wisdom with all of us. Joy

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Thank you Kindly Joy!

I loved reading your article and it gave me a new goal to work on as a new grad. I will work on "get a life". I was also an older nursing student and now that I'm done with school, I'm trying to balance my new career along with being a wife & mom. Now I need to find some balance and find ways to just be me. I'm not sure what that is just yet but perhaps I can start to rediscover what I like and get my life back (haha).

Blessings!

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Specializes in Faith Community Nurse (FCN).
Thank you Kindly Joy!

I loved reading your article and it gave me a new goal to work on as a new grad. I will work on "get a life". I was also an older nursing student and now that I'm done with school, I'm trying to balance my new career along with being a wife & mom. Now I need to find some balance and find ways to just be me. I'm not sure what that is just yet but perhaps I can start to rediscover what I like and get my life back (haha).

Blessings!

Thank you for your comment. I can tell by your sense of humor that you will succeed. Blessings, Joy

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We have both single moms and childless new nurses, the burden is so much more difficult on the moms, I can't even imagine trying to learn a new trade such as nursing having dependents as well. Just being a working parent with work experience is hard enough.

Advice? Accept, prepare and focus on learning how to work in today's settings. Yes it is customer service oriented with too many interruptions and things coming in hot but that is the job. It's futile to waste emotional energy thinking about what it used to be like or how we think it should be, the skill set needs to be adapted to the challenges presented. There is no time to look up meds on the clock, that needs to be done prior to coming to work. The first 1-3 years needs to be a combo of practical as well as ongoing study with decent sleep, diet and hopefully some movement. Then comes the work life balance comes once you have the job nailed.

I think it would be beneficial for nursing students to plan and expect the first year on the job to be an extension of their education. Graduation comes after the first year on the job, don't even plan on that big sigh of relief until then.

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Specializes in Faith Community Nurse (FCN).
We have both single moms and childless new nurses, the burden is so much more difficult on the moms, I can't even imagine trying to learn a new trade such as nursing having dependents as well. Just being a working parent with work experience is hard enough.

Advice? Accept, prepare and focus on learning how to work in today's settings. Yes it is customer service oriented with too many interruptions and things coming in hot but that is the job. It's futile to waste emotional energy thinking about what it used to be like or how we think it should be, the skill set needs to be adapted to the challenges presented. There is no time to look up meds on the clock, that needs to be done prior to coming to work. The first 1-3 years needs to be a combo of practical as well as ongoing study with decent sleep, diet and hopefully some movement. Then comes the work life balance comes once you have the job nailed.

I think it would be beneficial for nursing students to plan and expect the first year on the job to be an extension of their education. Graduation comes after the first year on the job, don't even plan on that big sigh of relief until then.

Thank you for sharing your excellent insights! I love the last suggestion--about making the first year of work an extension of school. What a great way to put it. Joy

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