What They Don't Tell You About Being a New Grad Nurse

I’m ready to walk through my patients door, medications with fresh water and crunchy ice in hand, a proud smile on my face, and I am hit with the saddened expression and fearful eyes of my patient and their family members. I stand for a moment, debating if this is the right time, watching closely yet so far as the doctor in soft blue delivers debilitating news. I take the family members' silent nod as my answer, sit down at the nursing station, and prepare myself to follow the life altering reality this innocent family has to face.

Nursing school instilled an abundance of confidence in me my first year, not so much my second, and then when junior year hit and my teachers smoothly changed from “you guys are here for a reason” to “I am obligated to teach you this for the test but, you will never use this and nothing you learn here will be the same from the facility you end up working at,” I was terrified.

Three months zoomed by, and I was left with a badge clipped and my preceptor walking away. I was on my own.

Passing medications, assessments, and patient education came naturally- this is what we’ve been trained for. What I wasn’t prepared for were moments like these. How do I address heavy realities like these with patients and their families? How do I relate to someone when I haven’t had to face anything like this before? How do I fix something that cannot be fixed?

They don’t teach you this is nursing school. This is something you learn and face on your own, and I wasn’t able to recognize that it is inherently engrained in us until I had to trudge through this moment alone.

You are trained in nursing tasks, but not in nursing presence.

They don’t tell you that sometimes the most important thing during your shift is not perfect documentation or timely medication passes. Sometimes it’s pulling up a chair. Sometimes it’s listening in silence. Sometimes it’s saying “I am so sorry,” and meaning it.

They don’t tell you how heavy the feeling of walking back into a room where the words "terminal,” or “no more treatment options,” or “comfort measures,” dims the air like something physical you can’t touch. Crushing the hopeful expression used as a last stitch effort for what was before now. You feel like an intruder to someone's grief, a constant reminder of what has happened.

They don’t tell you that you will question yourself constantly.

Did I say the right thing?

Did I do this wrong?

Did I say too much?

Should I have waited longer to go into that room?

Should I have gone in sooner?

Am I meant for this?

They don’t tell you that imposter syndrome doesn’t stop when you pass your boards. It grows louder, sometimes screaming. You look at the seasoned nurses who are so calm, natural, ready for the next hard conversation, and you wonder if you will ever reach that status. You wonder if they have ever stood there, frozen in the doorway, eyes swelling with blunt fractures unfolding of someone's life.

They don’t tell you how physical the job is either. The twelve hour shift that feels like twenty. The skipped lunches. The constant stimulation. The feet that throb on the shuttle bus, and the restoration of quiet on your ride home. The feeling of a tired body overcome with stress after a long shift. The way you lie in bed replaying situations in your head, wondering how differently conversations could have gone if you changed your approach.

They don’t tell you that nursing will follow you home. You won’t look at people the same. You will worry over things the person next to you would never consider. You’ll sit at your kitchen table and see your patient's face. You will hear a family member's voice in your head making your morning coffee. You might even cry in your car before being able to turn the key.

They don’t tell you about the moral distress. The frustration you experience of not having enough staff, enough supplies, enough time to be there for your patients in times like these that last longer than your twelve hours. The quiet desire of wanting to fix things that are bigger than you.

But they don’t tell you this:

You are more prepared than you think.

Not because you memorized every lab value or stepped into the leader role during a simulation. But because you chose this profession. You take every unreachable moment and you reach it. You turn everything into a lesson and take it with you to the next room. You look at the fear in someone's eyes and don’t run away- you take it as an opportunity to take a step closer.

I sat down, took a deep breath, and made my way into the room. I haven’t built all of the tools I need to have a textbook conversation with this patient and their family, but I have myself. And myself is enough. Nursing is not about fixing everything. It is about not abandoning someone in the middle of their worst moment.

If you are a new grad reading this and you feel overwhelmed, unsure, or like you are always one step behind - remember, you are one step forward. You are here for a reason. You bring

something new to the nursing field that no one else can contribute, through your personal, academic, and everchanging perspective.

We are all human. Take a deep breath. Welcome uncertainty. Walk into that room.

Chiara D., BSN, RN | Health & Wellness Writer – Educational Content & Narrative Nursing