New Grad Nurse- 26 Must Know Do's and Don'ts
Oh, those first few years as a new grad nurse! Seasoned nurses reading this.... remember those first years as a new grad nurse? We know those first years can be very nerve-racking. I remember those days well and like most of you, I don’t look back on those memories very fondly. We talk a lot about leadership but it is important to mention that like everything else leadership has a starting point. For nurses it is after you graduate from nursing school, pass the NCLEX and get a job. What you do from day one in your first year as a new grad nurse is important. You set the tone for your career during those first few years and lay the framework for becoming a leader. While it is true not all nurses will become formal leaders, I am convinced all nurses in some ways will become informal leaders.
Job-New Grad Nurse
1. DO keep learning
Just because nursing school is over, doesn’t mean you can put your brain on cruise control, or worse shut it off. As a new grad nurse, you hardly know enough to do your job safely. Even when you think you’re comfortable with the way things are; healthcare changes with new technology or new evidence-based practice (sound familiar).
2. DO get to know your coworkers
You’re going to be spending a lot of time with your co-workers. It’s important to get to know your co-workers and develop relationships. Especially with being a new grad nurse, some of those co-workers are going to save your butt A LOT!...Plus you never know when you might need someone to cover your shift :-).
3. DO ask questions
If you don’t know...do NOT guess, ask! We work in areas where choices can impact people’s lives. You want to avoid guessing! Plus everybody you work with knows you’re a new grad nurse. If your managers haven’t already told everyone they can probably see it in your nervous face. You’re expected to ask questions. You don’t know everything so don’t act like you do.
4. DO listen to advice
We encourage new grad nurses to ask questions. If you’re not going to listen that’s a problem. That’s not to say that you should do everything that you are advised to do, nor are we saying that every advice you get will be good. Listening to and evaluating the advice can help shape what you do and give you a different perspective you might have missed.
5. DO learn to prioritize.
Normally when new grad nurses or student nurses think of prioritizing tasks they usually think about med-surg nursing. Every field a nurse works requires some type of prioritizing skills, not just med-surge. Every nurse has opportunities for learning how to prioritize. You're going to be pulled in so many different directions. Each shift you will likely have objectives that you have to accomplish before the shift is over with. The questions won’t be which ones do I have to do and which ones can I choose not to do because you have to do all of them. The question will instead be which task needs to be done first.
6. DO stop and breath
As a new grad nurse, you are going to be stressed. You probably will reach a point when you will be thinking “why did I go to nursing school.” You might even start questioning everything you have ever done up till that point. First of all, let me say “it’s ok.” A lot of people go through the exact same thing. During your first moments as a new grad nurse, you will need to learn to breathe...breathe...and after you do that breath some more! Everything is going to be ok. You’re going to be stressed. The goal is to manage that stress well. Whether that’s pursuing a vacation or just venting about it, find ways to mitigate the damages of stress.
7. DO Remember there is no “I” in team.
Remember that saying there is no “I” in team… it is true. You better remember it takes a village. You will have a lot of shifts where it will literally take a “village” to get that shift done. When you receive that help don’t forget to say Thank You!
8. DON’T forget to chart.
Remember that saying in nursing school “if you didn’t chart it, it didn’t happen.” Well, that statement is more than true. In the real world, you might be asked to remember something that happened several months or years ago. Memories are going to be fuzzy, and even if it wasn’t it doesn’t really matter. What everyone is going to use to judge your actions is your documentation.
9. DON'T forget patient safety
When you chose to become a nurse, you chose to follow “you shall do no harm.” That slogan is fairly self-explanatory. Avoid doing things that jeopardizes the patient’s health. Always do what’s best for the patient!
10. DON’T be afraid of calling the doctor
Don’t be afraid to call the doctor. Just like you, they have a job to do also, which is to take call. On the same note, when you call be prepared. Have the patient chart open and any information you might need open and ready to go. For some doctors know what you want/need before you call them. This is compounded if you are calling the doctor in the middle of the night.
11. DON’T whine
“We’re too short-staffed”, “that family member is very difficult”, “that patient is difficult”...Nobody likes a whiner. You run the risk of looking bad and also you’re whining to the same people who have to deal with the exact same thing.
12. DON’T forget this is real life
In school exams and NCLEX world you get the perfect scenario. You didn’t have a dual diagnosis on a patient. The real world is a lot messier. Your patients are going to have multiple comorbidities. While we are on it this is also not a tv show. In hospital shows, everyone is sleeping around and there are affairs that are going on. While to a certain extent some of that may happen at the facility you work it's unlikely to be as drama filled… or as entertaining as the TV shows make it. Believe me there is nothing entertaining about baby daddy, or baby mama drama showing up at the place you work. KEEP GOOD BOUNDARIES!
Professional-New Grad Nurse
13. DO care about your personal nurse brand
As a new grad nurse remember the importance of your personal nurse brand. As mentioned in “Why Creating and Managing your Personal Brand is Important for your Nursing Career" a personal nurse brand is important and could be beneficial for moving up in your career. So strive to create and manage your personal nurse brand and avoid things detrimental to your brand such as gossiping.
14. DO find a mentor
Some facilities already have a mentoring program in place for new RNs and LPNs. If they don’t, try to find a more seasoned RN or LPN who is willing to take a new grad nurse under their wings and show them the ropes. Don’t be afraid to ask someone directly if they will mentor you, most will view this as a compliment!
15. DO Network
Networking is similar to getting to know your coworkers but this is for more professional matters. You never know where your nurse coworkers will be a year from now or who might end up being your new boss. Networking, if done right, might give you opportunities to connect with people that otherwise wouldn’t be readily available to you.
16. DO stay humble
Whether that shows up in thinking just because you graduated nursing school with a 4.0 or you passed your NCLEX with the minimum number of questions or because you are in the “prestigious” unit or area of healthcare. Your grades don’t matter and nobody cares how quickly it took you to pass boards as long as you passed...oh btw you’re new your going to ask for help. People love helping people who have humility...not so much with arrogance.
17. DON’T be defined by a bad shift
You might have a bad shift...actually I take that back you will have bad shifts and as a new grad nurse, you will have plenty of them. Ask any nurse, especially ones that have had a long tenure and see if they won’t tell you they have had so many bad shifts that they had lost count years ago. Try not to be defined by those bad shifts. A bad shift does not necessarily equal bad nurse, nor does it necessarily mean you provided bad care. Some days will just be better than others.
18. DON’T stick with a job you don’t like
Just because it’s your first job doesn’t mean you have to stick with it. If it’s turning out to not be what you want or if you find out that the unit’s culture doesn’t fit you, count your losses. Check and see what opportunities you have to transfer.
Resources for new grad nurses wanting to change jobs:
For the new grad nurse wanting to learn how to resign from a position check out 5 Important Tips For Quitting Your Nursing Job.
All need new grad nurses will at some point need to learn how to write a resignation letter. Check out Example of a Nurse Resignation Letter.
For the new grad nurse wanting to know how to start a new job the right way check out Starting a New Nurse Job
19. DON’T belittle your subordinates
That goes for your techs. A good tech is worth their weight in gold. A good tech can make your life so much easier. Take care of those techs. That also goes for housekeeping or anybody else you might think as a subordinate. Everybody has a job to do. Nobodies job is more important than the other, just different. We all play different, yet vital parts in carrying out our goal, which is to provide exceptional patient care.
20. DON’T lie
You are going to make mistakes. That’s to be expected. The worst possible thing you can do is to lie about it because the likelihood you are going to get away with the lie is slim to none. If it’s a big mistake you potentially put the patients life in danger. If it’s small mistake you just look dumb. The end result is a loss of credibility and especially for healthcare which demands a lot of trust. Nurses are voted regularly as some of the most trusted professions, and lying doesn’t look good. At that point the likelihood you will get fired is really high even if you weren’t going to in the first place.
Personal-New Grad Nurse
21. DON’T overcommit
Once you start getting comfortable with your nursing practice you are going to be tempted to join one committee after the other. You just got your freedom back after you graduated from nursing school. Don’t give it all away so quickly again!
22. DON'T forget your own self-care.
As a nurse, you will get pulled in a lot of directions. You will become overwhelmed. You will be tempted to ignore taking care of yourself. I would like to encourage you to not forget that before you can take care of other people, you have to take care of yourself.
23. DON”T ignore your personal finances
Money causes a lot of stress. Learn about personal finance and about budgeting. You should start thinking about retirement savings early. Oh and what about those student loans. How do you plan on tackling them? Student loans don’t go away just because you ignore that they are there. You will thank yourself later.
Business-New Grad Nurse
24. DO remember healthcare is a business
Some of us are very altruistic. We have the best intentions in the world. We think we are going to help everyone and everything. Then we graduate school nursing school and start working and realize the cold truth. Healthcare is a business. There are a lot of for-profit hospital systems who are in the business of making money. Even those not-for-profit hospitals you quickly realize are also in the business of making money. Keep in mind that while it is a business that doesn’t mean good things aren’t happening. Nor does it mean that people aren’t showing to work with the mindset of serving patients to the best of their abilities.
25. DO learn who your leaders are
The formal leaders are going to be obvious they are the ones that are going to have the title (ex. Nurse manager, team manager etc.). Formal leaders are not always the influential decision makers. You need to identify for yourself the influential people on your unit beyond the formal leaders. Who are the actual decision-makers on your unit? Learn this and keep that in mind because that will probably change your interaction.
26. DON’T make your supervisors look bad.
Let me say this again DO NOT make your boss look bad. “Butt” chewing is a top-down hierarchy. It starts from the top and works its way down. If your boss gets chewed out, especially if it's because of you...Let’s just say you will know!
Any other advice for a new grad nurse?
If you found this helpful or know someone this could benefit please share it. Stay tuned for the upcoming Do's and Don'ts for First Year Nurse Leaders.