Dear Donna: New Grad Woes
by Donna Cardillo, RN, MA

Can this career be saved? This is an ongoing series about real nurses, real challenges, and real solutions.

Ayesha* had been a graduate nurse for five months when she told me that she was leaving nursing. Before I could ask any questions, she started to cry and said, "My unit is short-staffed. I’m constantly told that I’m too slow, and my preceptor doesn’t seem to have the time to help me — or the interest. I feel as if I’m drowning. I go home every night and cry. I don’t need this kind of stress in my life."

I began by reassuring Ayesha that many new grads feel overwhelmed, stressed, and in over their heads. I let her know that although she felt unprepared for the challenges of nursing, she was actually better prepared than she realized. I reminded her that she was not expected to know everything and that she still had a lot to learn. I relayed that it often takes a full year before a new nurse starts to feel some level of comfort in his or her new role and another year before he or she develops some level of competency. Ayesha seemed surprised but somewhat relieved to hear this.

I asked Ayesha some additional questions about her preceptor, and it seemed as if they hadn’t hit it off. According to Ayesha, her preceptor complained about everything and seemed generally unhappy; plus, she didn’t seem pleased about the responsibilities of precepting. I’m sure she was also stressed over her own patient assignments if the unit was short-staffed.

I advised Ayesha that, even as a new graduate, she needed to advocate for herself to ensure that she received the support and training she needed to grow into her new role as a licensed nurse. Before she made a final decision to leave nursing, I suggested that she speak to the person responsible for her orientation to ask about getting reassigned to a more compatible preceptor or transferred to a unit where the staffing was better. She was taken aback by the suggestion because she didn’t know that she could do that.

I then questioned Ayesha about the relationships she’d developed on her unit or elsewhere with other nurses. She said that everyone was busy and that she hadn’t really spoken much to anyone on the unit other than her preceptor.

I told Ayesha that since she was "the new kid on the block," she should take the initiative to get to know her new coworkers, rather than waiting for them to come to her. "How?" she asked. I suggested that she officially introduce herself to the staff, including the oncoming and outgoing shift, with a handshake and a smile. "Seek out the friendly members of the staff and align yourself with them," I added. "Have lunch with them, offer to help them turn patients or make beds, ask if you can observe when they do procedures, or better yet offer to assist. Model yourself after them, and thank them for their help and support when it’s offered."

Since staying isolated in nursing is a sure way to fail, I encouraged Ayesha to join her state nurses association and specialty association and to go to some local chapter meetings, even as a guest for the time being. I suggested that she should contact her nursing school instructors and former classmates to say hi and to see how everyone was faring. I assured her that she would hear that her classmates were facing many of the same challenges that she was and that she’d receive support and advice from her instructors.

I encouraged Ayesha to read Your First Year as a Nurse — Making the Transition From Total Novice to Successful Professional because it includes tips and strategies for staying positive and focused, forging relationships and allies, finding the help she needs, and immersing herself in the community of nursing.

I’m happy to report that Ayesha decided to give nursing another try. She wound up asking for a transfer to another unit where she felt she could get a fresh start and a new perspective. Things are working out better with her new preceptor, but Ayesha does not rely exclusively on her for help and support. She forged alliances with other nurses on her new unit and has acquainted herself with other available resources on the unit.

She is taking one day at a time, but the future is looking bright. She recently told me, "I really thought I wasn’t cut out for nursing. But by being more proactive with my learning and opening myself up to the help and support of the nurses who love nursing, I’m starting to see that it’s really worth it to hang in there. I’m not saying that it’s easy because it isn’t. It’s just going to take more time and diligence than I realized to be the kind of nurse I always dreamed of being. But I guess nothing worthwhile is ever easy."

*Name has been changed.

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