Nurse Plus: 3 New Nurse Worries

Starting your first job as a new nurse? Congratulations! You’re launching an exciting career in the most trusted profession in America.

It’s normal to be excited--and nervous, too. Let’s look at three things new nurses are most likely to worry about and how to deal with them.

1. Lack of confidence.

First of all, take a deep breath. Then, take a few more. Everyone—EVERYONE—is anxious when starting a new job. If you’ve had any previous work experience, you already know how it feels to be a beginner. And how it feels to gain assurance as you train.

No matter where you went to school or how good your grades were, being a new nurse means being on a learning curve. You’ll be acquiring new knowledge and skills at a rapid pace. It can seem overwhelming. Take it a day at a time and a task at a time.

Experts say it can take a new nurse 6-12 months to feel comfortable, and up to three years to feel competent. Be patient; you WILL become proficient! In the meantime, here are some tips:

1. Accept that you’ll make mistakes. Mistakes happen. When they do, acknowledge them and view them as valuable lessons. Never try to hide them. Tell your preceptor or the charge nurse. Follow all policies regarding incidents.
2. Ask questions. Depending on the organization, you may have a preceptor who can guide you through a comprehensive orientation. If not, find an experienced nurse who’s willing to answer questions and explain procedures. Use the whole team: physicians, PAs, NPs, pharmacists, respiratory therapists, radiology technicians, etc. There is a wealth of knowledge just waiting for you to step up and ask.
3. Look for learning opportunities everywhere. Research shows that 70% of learning happens informally, from work-related experiences and assignments (including mistakes) or independent study. 20% comes from social interactions. Only 10% occurs in formal, structured environments. Keep your eyes and ears open to catch useful information from colleagues, in-services, and nursing resources.

2. Time management.

The clinical days of nursing school, when you were able to focus on a couple of assigned patients, are gone. Now every shift seems like a marathon combined with an obstacle course. It’s easy to preach “learn to manage your time.” But daily responsibilities and shifting patient needs can make organization challenging. The good news? Every nurse learns it—and you will, too. Some easy ways to get started:

1. Use lists or “nurse brain sheets.” You’re probably already carrying a pocket notebook to track things you need to remember or look up. Just take it up a notch. Ask your favorite nurses how they stay organized.
2. Prepare your pockets (or fanny pack). Head into your shift with some essentials, along with your phone:
   a. Bandage scissors
   b. Tape
   c. Hemostat
   d. Penlight
   e. Pens/highlighter
   f. Alcohol wipes
   g. Lip balm
   h. Hair ties
   i. Whatever else you find useful on your unit, such as IV flushes

3. Prioritize your shift. New nurses often rely on the “CURE” hierarchy to prioritize patient care:
   a. C= Critical needs. Use the ABCs (Airway, Breathing, Circulation), Maslow’s Hierarchy, and patient safety to prioritize decisions. Examples: SOB, chest pain, or loss of consciousness.
   b. U=Urgent needs. Patient discomfort or a potentially harmful situation. Examples: Administering pain medication, clarifying an order, or responding to a bed alarm.
   c. R=Routine needs. Important daily nursing tasks. Examples: Assessments on stable patients, scheduled medications, and basic hygiene.
   d. E=Extras. Activities that promote comfort but are not essential for the patient’s outcomes. Examples: Giving a back massage, styling hair, and getting a snack for an independent patient.

4. Take a break! You can’t take care of others if you are feeling tired and overwhelmed. Use your breaks to reset mentally and physically. Don’t be tempted to skip them or work through them. Give yourself the chance to relax. Eat a healthy snack.

3. Stress management.

What’s stressful about being a new nurse? A better question might be, “What isn’t stressful??” Nursing is a demanding career. The sooner you’re able to recognize and deal with your stressors, the happier you’ll be, both personally and professionally. Try to develop these habits from the outset:

1. Two words: Self-Care. Just like the flight attendants say, “Put on your own oxygen mask before helping others.” In order to succeed in the long run, you have to put yourself first. Get adequate quality sleep. Follow an exercise schedule. Go outside. Continue a hobby or start a new one. Discover what makes you feel calm and refreshed, and stick with it.
2. Start a routine to prepare for your shift. Make a list if it helps: Clothes clean, nutritious food packed, backpack/supplies ready, phone charged, gas tank full. Whatever it is that lets you leave for work with as little worry as possible, do it.
3. Hydrate, hydrate, hydrate. Do not avoid drinking water so you don’t have to use the restroom. Dehydration increases cortisol levels, which are linked to stress and anxiety. The brain needs fluids to think clearly and maintain emotional balance.
4. Ask for help and support. Many times, if you don’t speak up, people around you will assume you’re coping just fine. Be your own best advocate and tell your supervisor or charge nurse if:
   a. Your workload is consistently too heavy.
   b. You feel unprepared or need more training for your role.
   c. Expectations aren’t clear.
   d. You’re unsure how to delegate to others.

5. Set healthy boundaries. This can be difficult for all nurses. But self-care comes first. Say “no” to extra shifts when you’re exhausted or have other obligations. Let others know you don’t answer texts or calls when you’re on vacation.

Your goal: Avoiding burnout

Burnout is a syndrome that can leave health care professionals feeling exhausted and ineffective in their work. One of the primary contributing factors to developing burnout is the lack of self-care. Nurses are notorious for neglecting themselves in order to take care of others. As a new nurse, you have the rare opportunity to prevent burnout by addressing some of the worries that can hold you back from jumping-starting the career you’ve been wanting. With a little determination, you can:

1. Find your confidence and seek the experiences and resources you need;
2. Master time management and provide quality care to your patients; and
3. Use self-care to recognize and handle stress…now and going forward.