The first year of nursing practice is the most difficult, especially within those first few months. Within the first 2 years of nursing practice, the profession can lose up to two thirds of new graduate nurses. This is a very high number. I failed the NCLEX exam which destroyed my confidence. I write more about that experience here. My first months of my new graduate practice were more stressful than I ever imagined. I tried my best to pull together my pathology knowledge with pharmacology, time management, and resiliency.
Only a few months into my practice I wanted to quit. I was working on a medical floor and I didn’t like the work. The medical floor is not where I was going to be forever but I just could not find the motivation to keep going. I knew I enjoyed Perinatal and decided early on I would specialize but I was really struggling mentally. When I reflect on this time I realize it was awful and I have some tips to survive your first year of nursing.
Does this sound like you? Are you a nurse in their first few months/years of practice? I can say that it does get easier and more enjoyable. These are actionable strategies and things you can do to help yourself early in your career. I have many perspectives when I write this post. The first is how I was a new nurse myself; the second, is from preceptoring new nurses, and the third is my nurse educator experience. Through these lenses I have found the following to be most impactful…
Know Who You Are
I put this first because it is so important for you to know who you are and what you bring to your nursing practice. What life experiences have you had? Do you have values that may conflict with a patient’s values? What do you do when your values don’t align with a patient’s? How do you cope with stress? What makes you a good nurse? What can you bring to your nursing practice that is unique to you? Knowing these things about yourself and having an awareness of them can allow you to identify them in practice and come in a more client-centered way.
Find a Friend
Find a friend that you can chat to about your experiences. Someone who understands the concept of confidentiality and whom you can safely debrief with is best. Nurses cannot discuss much of their workday with non-nursing friends; in my experience, non-nursing friends are unable to relate to and understand the difficulty of nursing. In another way… non-nursing buddies may not see the different intricacies and layers to a situation like nurses do.
Find a Nurse Mentor
Find an amazing nurse to look up to. This can help guide you as you navigate making critical decisions in your practice and with your career goals. There was a lovely nurse I worked with on a medical floor, her name was Linda. She was sweet and kind with her patients but also didn’t take shit. I also have a mentor that I think about when making career planning moves. She helped me navigate failing the NCLEX the first time and we have stayed connected through the years in a small way.
Ask Questions
The nurse who doesn’t ask questions is scary. The overconfident nurse is scary. These nurses are often not trusted by their peers which can lead to them feeling unsupported. Asking questions shows you’re thinking deeply about a concept and making sense of it. Asking questions helps fill the gap in your own knowledge.
Ask for Help
It is okay to ask for help. If you aren’t able to get that IV med up for patient X because another patient fell on the floor it is okay to ask someone to help you out. Patient safety comes first and that is something all nurses should understand and work collaboratively to achieve.
Invest in Meal-prepping Containers
You will become an excellent meal prepper. I remember first starting and thinking about how I would just grab things from the cafeteria and pack snacks. Well… the cafeteria was closed and I never again relied on that. 12 hours is a long time to not eat when you are caring for others. You need your brain and need to eat through the day to ensure you’re fit to practice. If you’re hangry and your own blood sugar is low you’re compromising your decision-making and the care of others. Prep your meals ahead of time for your set so you don’t end up in this position. If you feel like you can splurge, get some meal prepping containers and a decent sized lunch kit! I use 3 compartment bento-like containers similar to these.
Use Supports Available to you With the Health Authority or Union you Work for
Some health authorities offer an extended orientation for new grads. You can work alongside a staff member for a few weeks instead of 4 shifts. Unions often have educational workshops that help educate you on your rights as a new employee and support available for your nursing practice.
Manage Your Stress Appropriately
Depending on where you work, you may deal with emotionally draining situations. Birth, death, a difficult patient, an ethical dilemma that you can’t shake. If you’re going to make it as a nurse long-term you must take care of your stress and emotional well-being. Find strategies that work for you. Some examples are: going for walks, a hobby, meditating, therapy, counseling, and exercise.
Develop Excellent Time Management Skills
This is a skill that takes practice to develop but also requires skill with organization. If you’re going into a patient room, stop and take a minute to think of all the things you need to accomplish or further information you need to gather. Cluster your nursing care for yourself, and to allow your patient to have time to themselves if they don’t want to be bothered often. Make a quick list and bring it with you into the patient room to keep yourself organized. Being effective with your time management will help you develop an efficient nursing practice.
In my practice, I make a to-do list on a big post-it for each of my patients and stick it on the front of my working book. Also, I will write specific times that things are due like medications or vital signs. I keep track of any tasks that need to be completed with my patient, like dressing changes, patient teaching, weight, assisting with ambulation, or post-op washes.
Take Your Breaks
It is okay to delegate so you can take a break. Time your breaks with a partner or schedule them so you make a point to leave the unit or go to a break room. The in-charge nurse or nursing leadership can also relieve you for a break. If you cannot take your break for staffing reasons then this needs to be accounted for so you can be paid appropriately. Nurses work for free a lot and don’t start your practice out by making this a habit. Don’t expect that you’ll function like the nurses who have been doing this for 20 plus years!
I find doctors and other staff can occasionally interrupt you while you’re on break and this should be avoided. When it does happen, that time doesn’t count toward your break. The doctor can wait for you like you wait for them, you’re an equal and this hierarchy we practice in needs to be addressed. If I feel I need to, I will leave the unit and sit outside to have my snacks. I need to take my mental breaks and fuel my body for the stress of 12 hours shifts.
Prioritize Tasks
Some things are more important than others. Prioritize the tasks important for patient safety. If I have a stable and unstable patient I will be spending more time with the unstable patient. Use the resources from nursing school to support you in this. Talking ideas through with peers if you’re unsure or you think you’re missing something. Sometimes some validation about decision-making and critical thinking is supportive. Your co-workers may have information or experience to share that can support you. Find a way to organize yourself in your practice.
I hope that some of these tips to survive your first year of nursing can support you in your own nursing practice. Comment below if there is something that helped you that I didn’t mention!
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