So, the time has come for you to start working independently.

Your orientation time is done, and your preceptor is no more. The butterflies in your tummy are throwing a party, making you feel anxious and stressed.

Calm down. You’ve got this.

Although it might seem harder now without a preceptor, you need to trust your training and use the following strategies to help make that scary first shift successful.

How to Survive Your First Nursing Shift After Orientation

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To survive your first shift off nursing orientation, you need to continue asking questions. You also need to learn how to be a team player and show yourself some grace because you will make mistakes.

Below are some more of my top tips to get you through that first shift.

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Trusted by 430,000+ future nurses and new nurses everywhere. Check out the course that helps new nurses bridge the gap and transition smoothly to becoming nurses.

1. Don’t Be Afraid to Keep Asking Questions

Just because your orientation is over doesn’t mean that suddenly you’re not allowed to ask your colleagues any questions.

You are still new to the unit, and nobody expects you to know everything.

It’s far easier and more efficient to ask someone to help you with a task quickly or to give advice than to do it yourself, which turns out to be the wrong thing.

2. Don’t Be Afraid to Call the Doctor

Don’t ever feel like you can’t call the doctor. Doctors are a part of the multidisciplinary team, and you’re not the sole provider of patient care.

If you need to call the patient’s doctor, assess the situation first. You don’t want to be in a position where you call the physician before you’ve even laid eyes on the patient.


Some doctors may not like to be “disturbed” by new nurses, but don’t hesitate to call them anyway if needed.

They have a job to do that they signed up for.

On the other hand, be mindful when calling a physician for a non-emergency.

For instance, you probably don’t want to call a doc in the middle of the night for a stool softener.

You could. But the conversation probably won’t end too well.

3. Give Yourself Some Grace

Remind yourself that you’re fresh out of school, and it’s normal to feel a little scattered on the first day as you try to find your way of doing things.

As time goes by, you will feel more confident. Try to do your best, and don’t compare yourself to other nurses.

There will always be someone who seems smarter or catches on faster than you. It doesn’t mean that you’re an incompetent nurse. Everyone learns at their own pace.

4. Chart As You Go

Charting is one of those tasks that easily gets left till the end of the day. By then, you’re exhausted from running around to finish everything.

If you find it hard to find the time to chart during the day, keep a notebook with you. Use that notebook to jot down the patient care activities you’ve done as you work.

You can refer back to your notes at the end of the day when you finally sit in front of a computer to document everything.

This is very important because if you rely on memory alone, you may omit something important about patient care.


A nurse brain sheet is a good resource for this. We sell some nurse brain sheets you should consider buying.

As for learning how to chart, I have some great articles that walk you through the basics of nurse charting.

If you want in-depth teaching on nurse documentation, this is a great course you should check out.

5. Check Unfamiliar Medications With A Reference Guide

There is no shame in looking up a medication unfamiliar to you. No nurse knows every medication’s side effects in their head.

It takes a few seconds to quickly Google the medication name and side effects before giving it to the patient.

Try to keep the rule of never giving a drug to a patient if you don’t know what the drug is, let alone its side effects.

Lastly, consider whether the prescription fits in with the patient’s treatment before giving the drug. If you have any questions, call the doctor to clarify the order.

6. Be a Team Player

As a registered nurse, you will be in charge of a small team of unregistered personnel and aides who will work under your supervision.

Treat them like they are essential members of the team rather than inconveniences that are just there.

You will gain their cooperation if you treat them respectfully and are not too proud and stuck up to learn from their experiences.

Even if you’re the one with the license and not them, you WILL benefit and learn from their experiences. This is especially true for your techs who have been working in that department for many years before you.

Don’t be afraid to use their wisdom.

Making friends with everyone will ensure that not only will you meet some great people, but it will also make your work flow more smoothly.

New Nurse Academy

Trusted by 430,000+ future nurses and new nurses everywhere. Check out the course that helps new nurses bridge the gap and transition smoothly to becoming nurses.

What does it cover?

  • IV Insertion
  • EKG Reading
  • How to Chart
  • How to Prioritize
  • Nursing Interviews & Resume

Just to name a few.

7. Take Your Time With Patient Care

Remember that working with patients is not a race, and you don’t need to be the one who finishes all the day’s tasks first.

Work at your own pace, even though you may be slower than the experienced nurses at first.

Rather, focus on each patient’s needs so that you provide thorough quality care despite doing it a little slower. Your patients will thank you for that.

8. Listen Rather Than Talk

Remember, you cannot effectively listen when you’re always talking, and it’s hard to learn if you’re not listening.

Try to talk less and listen more during your first shift. For that matter, during your first year as a nurse.

Listening to patients about their concerns will help you provide effective care. It will also make you appear more caring and capable, especially if you act on the voiced concerns.


This is also true regarding your coworkers and developing a working relationship with them. There is a limit to this. Avoid getting drawn into a gossiping circle.

9. Draw Up A Plan To Finish Your Tasks

When you arrive at your unit on that first morning of working independently, check your assigned patient load, write down a plan for tackling the workload, and prioritize tasks according to urgency.

During the day, you can scratch off each task as it gets done. This way, you won’t forget to do anything, and your day should run smoothly.

Of course, not all days will go according to plan, and if chaos does break out, you’ll still have a checklist of all the tasks that need to be done once the fire is put out

10. Cluster Your Care

When planning your patient’s care, try to cluster similar patient tasks together to prevent unnecessary running around.

It will not only be beneficial to your patients by providing them with more rest periods but will also help you become less stressed.

Bonus Quick Tips

Remember to keep up with self-care. You won’t be any good to anyone if you get sick.

There is no shame in taking a toilet break when you need it. Holding off may lead to developing bladder problems as you get older.

You need to keep hydrated, so keep a water bottle somewhere you can get to it easily and take sips of water throughout the day.

YETI Tumbler
From my experience getting a Yeti cup is a great way to stay hydrated. Cold drinks stay cold and hot drinks stay hot for a long time.

The same goes for snacks. If you’re hungry, your brain won’t function well, and you may miss something important if you don’t keep some healthy snacks with you.

Most nurses find regular meal breaks difficult to fit into the daily routine.

With that said, there’s no law against finding a quiet, out-of-the-way corner where you can stuff some nuts into your mouth or quickly devour an apple to keep your body from starving.

Related: 10 Best Healthy Snacks For Nurses

Key Takeaways

The first day is never easy at any job. Don’t be discouraged if, despite your best efforts, things end up in chaos.

Remember, tomorrow is another day to start fresh; each day after that will become easier to deal with and less stressful.

Keep your chin up, and trust that you learn and become better at what you do every day.

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