A Few Things I Wish I Knew As A New Grad Nurse
Firstly, congratulations on becoming a nurse and choosing the profession that serves our communities at one of the highest levels. Nursing is a career that is incredibly rewarding but also very challenging. I myself am a new graduate nurse and have been practicing since the end of June 2023, and I have been thinking of a few things I want to share that other new grads may find helpful before starting their first nursing job.
Introduction
During the final year of my nursing program there was a lot of excitement about who is applying for which hospital, what specialty, and what city or state they will be moving to. I remember hearing many in my program already accepting offers and signing contracts before graduation to begin work right after passing NCLEX post graduation. This was not the case for myself, and I did feel stressed not knowing where I was going to go after graduation once earning my license.
There is a lot to consider before applying or accepting your first nursing job. For example, what specialty and at which hospital, or maybe you’re considering outpatient, or not sure where to start looking. Don’t worry, it can be an overwhelming process and no decisions need to be made overnight. Here are a few tips when it comes to looking for your first nursing job I hope you find helpful.
Choosing Your First Job
Most units or hospitals that are hiring should offer a shadow opportunity to new RN’s and students that are interested in working in that field. A few things to think about during a shadow opportunity are, how is the workflow, what decisions will you have to make for patient care, and how steep the learning curve is. Ultimately, the goal is to try and find some opportunities in your area of interest to get a better understanding of the work environment. Most facilities should offer a shadow experience, and if there isn’t an opportunity this may be a red flag.
Something else is, what is the culture of the unit like. Will your fellow nurses help you if you have a question or they see you struggling in a small or intense situation. What is the turnover rate for the unit? This will be a tough question to ask and get answered, but it’s important because why nurses leave a unit says a lot about it. Finally, what resources will you have available to you? During high stakes situations are you able to consult the physician or other service within a reasonable timeframe when a patient’s condition changes.
Another thing to consider is how your training process/orientation will be to the unit. As a new nurse, you deserve to be trained as well as you can to be able to provide safe, high quality, and effective care. When interviewing for your first job ask about the orientation process and what it will look like. Depending on the specialty, the higher acuity you want a longer more in depth orientation to be properly adjusted. Do some research about what makes an orientation program strong, and ask the floor nurses how their experience was during your shadow experience.
You may be thinking what if I still don’t feel ready after orientation? This is a double edge sword. The truth is, as a new nurse you will most likely never feel ready, but as long as you can ask for help and ask plenty of questions this will help set you up for success. Don’t be afraid to ask your leadership if you can extend your orientation or what solutions may be available if you genuinely feel like you need more time. Don’t let this bother you because we all learn at different paces, and making sure you feel prepared is very important.
Another thing, will you be starting on days or nights. A common misconception is that new grad nurses cannot take a day position because you will need to gain knowledge and experience before switching to days. The thought process of this is that more patient care tasks happen on days adding to the complexity of patient care, and this is true in most cases but also depends on the specialty.
Finally, while working nights can you sleep well during the day or does staying up at night really challenge you and affect your ability to make decisions. Would you feel chronically exhausted and unable to go to the store or see friends and family? I hope to post an article about tips and tricks for adapting to night shift and what to expect from it in the future.
You don’t need to have it all figured out
Be prepared for a learning curve. Nursing school prepares you for the basics. How to assess and notice abnormal things, starting and giving medications, and how to continue to learn. Because as students we practice under an instructors license we’re not beholden to the responsibilities and liabilities of patient care. Students generally don’t have to worry about planning the flow of the day, speaking with the physicians, being in a code situation, or making care recommendations. The stress of those things are not there or as intense as a student and it can feel incredibly overwhelming when starting your first job depending on your specialty.
The first few months of my nursing career in pediatric critical care, I often felt I wasn’t a good nurse because of my lack of understanding. This generates a great deal of stress that can be difficult to work through, and on some days I was so stressed and exhausted I didn’t know if I wanted to be a nurse anymore. What I am grateful for is after my orientation my unit paired me with patients I would be more comfortable with, and orientation was a time where I could be exposed to high acuity cases rather than being thrown into one.
What I learned from this so far is there will be a huge learning curve in my first few years of practice. Unfortunately there isn’t really a way around this learning curve because you’ll be exposed to situations that didn’t happen in school, and how could I have been with the diverse patient encounters we deal with daily. What it also taught me was when you feel stressed and overwhelmed it’s important to have a support system to help you cope and process these emotions. I would talk with my closest friends, my family, or my fellow new grad cohort nurses who were experiencing the same things I was. Also during this time, I moved to a new city and had to adjust to its culture creating more stress. My solution to this was simple.
Find one thing you enjoy like exercise or art. When I moved to a new city to begin work I was away from family, and I’ve never been a social butterfly and making friends is difficult. I would go for a walk outside or sit at a restaurant bar and treat myself to dinner simply to be around people, and if I wasn’t feeling up to go out I would simply watch a movie and drink some coffee at home. The important thing is to find a healthy outlet because your mental health matters more than you know. If things are really overwhelming take it one day at a time, heck maybe even one minute at a time. I know many nurses who do that, and you have to take care of yourself to take care of others. Finally, if you need to cry, there is no shame, I’ve done my fair share and I don’t know a nurse who doesn’t. Journaling is also great and one of my favorites because it can show the timeline and progression of your career, and it’s also a place where you can get thoughts and feelings off your mind to have a sense of control.
Basic financial Info
Disclaimer, this is not financial advice. As a new nurse you will think you’re making a lot of money. Maybe you got offered a sign on bonus, have a shift differential, you’re on a rotating schedule, or weekend option. There are all sorts of incentives to fill scheduling gaps and you may earn a little extra money on top of your base pay. One thing I can say is don’t take a position to make more money, choose the medicine and if you get paid a little more that’s a bonus. There is a reason why some areas offer incentives, think about that.
Let’s say you’re making anywhere from 55k – 70k a year as a new grad. That will seem like a lot of money out of school, and it is, you should be able to support yourself and begin building a really good life for yourself. But something to prepare for is when you have kids, a mortgage, or car payment it can create financial stress.
First thing, create a budget and live comfortably off of the lower end of it and don’t spend your bonus, save every penny of it if you can. This way you can save money for a new car, house, and retirement. Once you’re able to get the first few paychecks under your belt you will be able to plan for your future. One thing that is guaranteed is that there will be money going out alot but it only comes in once or twice a month. There are plenty of financial resources on Youtube, and I personally like Dave Ramsey to handle getting started and student loans and how to set yourself up for success with your future.
Another thing to consider is your employer benefits. What sort of insurance will they offer, retirement 401k matches, paid time off, maternity leave, and what happens if you need to call in sick. Also, some facilities may offer tuition reimbursement or will pay for further education. This generally requires signing a contract for working an additional amount of time for tuition reimbursement/loan forgiveness.
All the serious stuff aside, definitely celebrate your achievement of becoming an RN with a little bit of your bonus or first few paychecks if you can afford it in your budget. I gave myself $200 combined from my first few paychecks and celebrated with a vintage watch. Yes nerdy I know, but something small and affordable I can appreciate and give to my kids one day. Don’t be ashamed in the slightest if this isn’t a possibility, everyone’s situation is different, some nurses may have families or loans to pay off. Definitely find a way to celebrate your accomplishment! A good night with my family and friends beats a two hundred dollar watch any day, possessions are never better!
Conclusion
Again congratulations, and take a breath. I know it can be very overwhelming trying to figure out what unit you want to work on, interviewing for the position, possibly moving, and learning the practice. I hope these things come in handy to consider before starting your nursing practice, or maybe even your first year into practice. Knowledge is truly power and you can make chess moves to give you the best chance possible at success in your career and life outside the healthcare setting. There are a few closing thoughts I want to emphasize.
The first few years of practice will be very hard, only those in healthcare or similar jobs understand because the stakes are so high. Please do everything in your power to take care of yourself! Spend time with friends and family, be outside, exercise, or if it’s too much, seek help. There is no shame in finding something else in nursing if in the first six months or year you’re not happy. Medicine can be traumatic for our patients, but no one talks about us and often it is, don’t hesitate to find help if you need it. Every emotion you’re experiencing is apart of the journey, the highs and lows are what make us human and we’re all in this together.
Be prepared for a steep learning curve. There are things in practice that school cannot prepare you for. If you’re fortunate to have been a tech or assistant and able to work independently you’re already at a huge advantage, but there is still plenty more to learn. Also, don’t be afraid to keep studying your specialty just like in nursing school outside of the hospital. I really like simplenursing.com with nurse Mike, the videos are put together well and provide a good foundation refresher. The unit should also have some education resources, if not there’re plenty of nursing resources available that are free online.
I’m really proud of you for making the decision and going through the process of becoming a nurse. The journey is an uphill climb and will continue to be for a while, but it shows your degree of character for wanting to help others and to persevere through a difficult career. Keep in mind, nursing is one of the most respected professions and you will make enormous changes in people’s lives that they will remember forever!
Best of luck and Godspeed! 🙂