You are a new graduate, and life is exciting! You’ve finished your master’s nursing program, passed your APRN examination, and you’re certified to work as an advanced practice nurse. By this time, you’ve been hired for your first job, and you might think you’ve jumped over all the hurdles you’ll have in your new career.
The past years have likely been a challenge. But now, you’ll be facing new challenges: from your first day to the weeks and months ahead. Your education in nursing school has taught you many of the skills you’ll need to step into your new career, but there are many more you’ll need to acquire in your first year.
Each new nurse’s experience is unique, based on the team of professionals and the strength of the leadership at their first job. However, there are tips you can use to help you move beyond surviving and into thriving while establishing a strong foundation for your future.
Your First Nursing Job Guidelines
No matter how much experience you had as a registered nurse, your first job in an advanced practice role will bring with it a new set of challenges. There are things you can do to make life easier and advance your learning process. There are also things you should definitely not do, as well as some strategies you can employ to reduce the resistance you’ll experience during your first year of nursing.
Consider these tips like guidelines to help your first-year process. You can also use them as a base from which you can discover some of your own strategies to help you acclimate to your new unit.
First-Year Nurse Practitioner “Must Dos”
This is a list of “must dos” to help you get established as a professional and fit seamlessly into a well-formed team. It is important to remember you are the new kid on the block, and you’re going to be working with an established group of medical professionals.
No matter how much experience or knowledge you have, you must fit in—the team will not change for you.
Recognize Book Learning is Different From Real Life
In your advanced practice program, students are taught what “perfect” looks like. The hypothetical world of your APRN examination is not a foundation from which to judge the real world. Instead, you must listen to your practice physicians, get advice from experienced nurse practitioners, and don’t expect perfection in a world that is often messy.
Be a Team Player
A good nursing unit or physician office is a well-oiled team. If you expect to fit in and do well, you must be a part of the team. Get to know your colleagues by name. Everyone enjoys hearing the sound of their own name, and it speeds the process of others getting to know you better.
Say hello to people and engage in conversation. Developing relationships in the first month is crucial to your survival. These are the people who will be there to support you, answer questions, and celebrate with you on good days.
Team players take the initiative to help other colleagues. Not everyone will ask for help, so be sure you’re proactive about offering. Nurses on the unit appreciate a helping hand, and the people in your office will think more of you if you pitch in to take your own vitals on busy days.
The ones you help will likely be there to help you in the future. These strategies help to build a strong and united group of professionals and show you’re a team player.
Remember to ask questions! You likely learned quite a lot of information in school, but it’s important to remember you don’t know everything. Some people find it uncomfortable to admit they’re not sure and ask a question. You are not expected to know everything, and asking questions makes you a better nurse practitioner and a team player.
Nurse practitioners are patient care advocates. It’s important to put your patient first at all times. Whether you are helping a patient with a language barrier, or they are facing a unique challenge with family members, you are their advocate. Listen to your patients as they know their bodies best. As you listen, you can pick up on clues to mental or physical conditions that others may miss.
In your first year and beyond, you will have good days and bad days. It’s important to prepare yourself because, in medicine, the unexpected happens. Try to not be too hindered by sudden changes.
When you can roll with the punches, you’re better able to have a positive attitude, function efficiently, and contribute to a positive and successful outcome. Look for something positive in each day and write it down to help you stay focused on staying positive. What you focus on will increase in your life.
Find a Mentor
A mentor is different from a preceptor. During your first weeks and months you’ll be working closely with the practice physicians who will help you learn how things are done and answer your patient care questions. The hospital and office staff can tell you where to find the supplies and answer questions about systems.
A mentor is an experienced nurse practitioner and a trusted advisor. It is important to seek one out yourself. Your mentor may not work on the same hospital unit or physician office but must be someone with years more experience than you. A mentor will help set the right foundation for your advanced practice career.
Reflection Will Serve You Well
Spend time at the end of each day reflecting on the decisions you made and the outcomes from them. You may find it helpful to keep a journal to reflect on your growth as a practitioner. You’ll likely make a few mistakes along the way. Not every patient is a textbook presentation, and the right answer for your patient isn’t always what’s recommended in the textbook.
First-Year Nurse Practitioner “Must Nots”
As important as it is to include things you should do in your first year, it’s important to avoid the things that you should not do. Steering clear of these things makes your life as a new nurse practitioner easier. The sooner you can ditch these ideas and habits, the smoother the road will be.
Take the Job You Can Do
Fresh out of your master’s program, it may be tempting to take a job with minimal supervision. Especially if you have years of experience as a floor nurse, you might be tempted by the autonomy and excitement.
Yet, it’s important to remember that you are practicing in a new role, and you’ll need time to acclimate to the added responsibilities. You’ll have the opportunity to take your dream job after you gain a couple of years of experience.
Design Your Own Advanced Education
Specialty advanced practice nurses must proactively seek out advanced education in their specialty. Even though you have an MSN, and potentially a BSN as well, not everything is taught in your master’s program! As you continue your education independently, you’ll reap the rewards in your practice and with your colleagues.
One Bad DayDoes Not Mean You’re a Bad APRN
You are human! You will have good days, and you will have bad days. There will be days when you feel great and accomplished at how well your day went, and others when you’ll be discouraged by a mistake, conflict, or the loss of a patient.
One bad day does not make you a bad nurse practitioner. It’s important to remember that in any relationship or job, there will be days that are better than others.
Keep Work at Work
Do not take your work home with you. Work should stay at work. Talk to other nurses about what went wrong or how bad the day was. It will be difficult for family and non-nursing friends to understand and comfort you. It’s important to remember when you mentally take your work home, it impacts your mental health and the health of your relationships.
Don’t Rock the Boat
One of the quickest ways to become unpopular and feel ostracized is when you come across as a know-it-all. You may have done well in your master’s program, but you’re not in school anymore. This is the real world and textbook answers often do not apply.
It’s important to listen to more veteran nurse practitioners and your practice physicians, and consider what you say before you say it. In other words, instead of telling people how something could be done better, ask if it could be done another way.
Perfectionism is highly sought-after in school. As a nursing student or in your master’s program, it’s always great to get 100% on your test. In the real world, there is no such thing as getting a perfect 100.
In an ideal world, you would have time to finish every task well, chat with your patients, identify physical and mental conditions perfectly, and treat every patient flawlessly. But it’s not a perfect world. It’s important to learn how to prioritize, and to remember that everything takes a little bit longer when you’re new.
Goals Must Be Realistic
Set realistic goals for yourself. In school, progress was measured by the speed at which you learned new concepts and how well you performed on tests. As a new nurse practitioner, you’ll want to give yourself a little more time to learn the ins-and-outs of working in your specialty.
Some seasoned professionals say it took years before they were experts in their fields. Remember to set small, reasonable goals that build your confidence as you achieve them.
Talking about other people behind their backs will always come back on you. The person you’re talking about will learn what you’ve done, and the person you’re talking to knows you will likely gossip about them.
Gossiping destroys trust and relationships in close-knit teams. Throughout your nursing career—as a newbie and as an experienced practitioner—it’s best to avoid gossip.
If you feel the need to vent about something, talk with your mentor or people outside the unit, and only for a short time. If it’s a serious matter, speak with the practice manager or the head of the practice. It’s important to remember to never gossip, as it only creates problems.
Self Care Tips for First Year Nurse Practitioners
In your first year, there are going to be strategies you must employ in your life. These will make your transition from staff nurse to advanced practice medical professional much smoother and easier. As you read the suggestions below, consider how you can integrate them into your life.
It’s important to remember that self-care is not an option but, in fact, a necessity. If you do not care for yourself, you can burn out before the end of your first year.
This can impact not only your health but also your patient safety and health. If you’re not sure what burnout looks like for a nurse, we’ve written a guide to help you identify it, prevent it, and begin treating it.
Showing gratitude to others is a powerful way of taking care of yourself. As you acknowledge the impact someone had on you or the impact they made in a patient’s life, it helps keep a positive frame of mind.
Being in the presence of illness and death nearly every day gives you a newfound respect and gratitude for your own health. Be sure to recognize that and accept it.
Take Care of Your Physical and Mental Health
Even when you’ve been on your feet all day, this is movement and not exercise. When you exercise, your heart rate goes up and breathing increases. While movement is also necessary to reduce your risk of heart disease, so is exercise.
Exercise helps reduce stress and improve your mental health. Seek out activities that get your heart rate elevated for at least 30 minutes. You should enjoy doing the activities, and you should also be able to measure your improvement.
Activities such as yoga, Tai Chi, rowing, elliptical trainers, running or jogging, and team sports all fit the bill.
If you don’t have energy when you get home, be sure to spend some time outside in green space. Research shows spending time in nature helps improve your mental health.
Consider activities that help you relax, such as meditation, coloring, reading, or catching up with friends. While it might feel good in the short-term to unplug in front of the television occasionally, this is not a long-term solution for good mental health.
Your body runs on the fuel you feed it. You will enjoy better physical and mental health when you feed yourself mostly whole food and steer clear of processed foods, junk snacks, and refined sugars.
When you go grocery shopping, stay along the outside walls of the store, This is where you’ll find most of the whole foods, vegetables, meats, and dairy products.
When you’re at home, limit your number of processed foods and refined sugars. Consider eating your last bite of food at least 3 hours before you go to bed at night. This will also help you feel better, lighter, and more focused.
Establish a Strong Support System
Every person needs a strong support system to maintain their mental health. These are the people you can trust and rely on, who will be there when you need to talk. They are also the people who tell you when you’re veering off base. Be sure you establish and maintain a strong support system with your friends and family.
The First Year for New Nurse Practitioners Can be Challenging, but Rewarding
Nursing is a challenging and rewarding job. It takes a lot from you and gives back when you learn to take care of yourself. The first year of practice is demanding on your physical and mental abilities. But, when you take the time to learn skills and strategies that help make the process easier, you reduce frustration and raise the level of your nursing care.