What to Know as a Graduate Nurse

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Written by Morganne Skinner, BSN, RN Content Writer, IntelyCare
Nurse with glasses showing graduate nurse how to use computer system.

Becoming a graduate nurse is a significant milestone in your nursing journey. You completed your formal nursing education, you’ve learned the practical skills, but you have not yet received your nursing license. Essentially, you have the knowledge of a nurse but no RN license to prove it.

Nurse graduates are at the very beginning of their nursing career. While this may sound daunting, it’s actually a huge opportunity. This is the time to learn as much as possible and ask as many questions as you can.

You’re a nurse. You are naturally detail-oriented and curious. You might feel uncomfortable not knowing everything quite yet — so here’s what you should know, and what most experienced nurses wish they knew about what a graduate nurse can do.

1. Ask Questions

Here’s a little secret: No one expects you to be perfect or to know everything. Don’t worry about asking “dumb” questions as a new graduate nurse — experienced nurses are more afraid of the newbies who don’t ask questions.

During your nurse residency program, take advantage of the time with your preceptor and ask them questions. Why did they see the patient in room 9 before the patient in room 11? Why did they call the internist, not the attending physician?

Know when you should be concerned. If you don’t know, that’s okay. But at least know that you should ask. Something as simple as, “Hey, when should I be concerned about this patient?” is a great question to ask your preceptor.

2. Know Your Resources

Along with asking questions, it’s just as important that you take this time as a nurse graduate to learn who and what your resources are. You will never arrive at a place in nursing where you suddenly know everything. Even the most seasoned nurses of 25 to 40 years may need help finding the right support at the right time.

The important part is that you must know whom to go to with your questions. Find out who your people are for the common concerns. Whom do you call for a meal tray at midnight? Which nurse on the unit is the expert at inserting IVs? Whom do you call to get an interpreter?

Not only will this help you provide stellar nursing care, it will equip you with the tools you need to handle any situation. As you know, no day at work as a nurse is the same. Knowing your resources can provide a sense of certainty and order to the otherwise chaotic day.

3. Take Care of Yourself

Nursing is challenging. You have to think quickly and be on your feet for 12 hours at a time, and you’re constantly reprioritizing your day.

It’s emotionally and mentally exhausting. You will require extra care. You are not tougher or a better person because you don’t “need” a rest. Take a break. You need it. You deserve it.

Self-care looks like:

  • Eating consistent meals
  • Moving your body
  • Prioritizing your sleep
  • Seeing a therapist
  • Keeping a journal
  • Spending time with friends and family

You know the self-care basics — make sure you are practicing them consistently.

4. It’s Okay to Change Specialties

This is an unspoken rule of nursing and one that any experienced nurse will verify: It’s okay to change specialties. While changing jobs may be discouraged in other professions, in nursing it’s normal and expected. A well-seasoned nurse has worked in multiple units, making him/her a valuable resource because they’ve encountered many different situations and know how to handle them.

Sometimes there’s a lot of pressure in choosing your first nursing job or selecting your nurse graduate residency. You can relax knowing that you have the freedom to change units or facilities.

One of the beauties of nursing is the range and variety of opportunities available to you. You’re not locked into one unit or one facility your entire career. So if you’re really struggling as a graduate nurse, try changing up your specialty.

Maybe the pace of the ER isn’t for you, or maybe the patient load of long-term care doesn’t align with your nursing strengths. That’s okay! Make a change and find your nursing niche.

5. You’re Going to Be Okay

Starting work as a graduate nurse is going to feel very different from being on a unit as a nursing student. You may even feel overwhelmed by all of the responsibility you just inherited. Breathe. It’s okay.

It will probably take at least a year for you to start to feel comfortable. Expect it to take time. Being a nurse is a hard job — and you can do it.

When you need an extra push of inspiration, go back to your “why.” Why did you decide to pursue nursing? Remind yourself of that frequently.

5 Great Specialty Areas for Residency

Just a few years ago, med-surg was nearly the only way new graduate nurses entered the profession. Today, large acute care facilities have new-graduate residencies across specialties. If you’re about to finish nursing school, consider these specialty areas for residency:

1. Pediatrics Nursing

If you like working with kids, a pediatrics nursing residency might be the best route for you. Peds nurses gain essential knowledge of childhood physiology, early development, medications, and family communication. As you probably learned in nursing school, kids aren’t just little adults, and caring for them requires a specialized skill set that you’ll gain during your first few years working in pediatrics.

The average salary of a pediatric nurse is $78,000 per year.

2. Critical Care Nursing

New grads who are looking for an intense start to their career might consider a residency in critical care. ICU nurses learn to manage patients with complex illnesses, and they interpret data from advanced monitoring tools like arterial lines. As a new grad in the ICU, you’ll learn to care for patients on ventilators and pressure support medications. If you want to gain critical thinking skills under pressure, critical care could be the specialty for you.

The average salary of a critical care nurse is $83,300 per year.

3. Surgical Nursing

Surgical nursing is unique from every other specialty, because you’ll care for patients by the case, not the shift. Operating room nurses learn specific skills, equipment sterilization, time-out procedures, surgical positioning, and OR documentation. If you enjoy working with a close interdisciplinary team, and you don’t mind less conversations with patients, consider an OR nurse residency program.

The average salary of an operating room nurse is $85,000 per year.

4. Emergency Department Nursing

If you want the adrenaline rush of working in the emergency department, a nursing residency program there could be your first choice. ED nurses learn focused assessment skills, as well as trauma care, pain management, and diagnosis. You’ll get really good at placing IVs, caring for wounds, and collaborating with your teammates in a fast-paced setting. If you like thinking on your feet, and you want every shift to be different, check out emergency department nursing.

The average salary of an emergency department nurse is $79,494 per year.

5. Medical-Surgical Nursing

Med-Surg is still the Swiss Army knife of nurse residencies — you can go into nearly any other specialty with an MS background. It’s a great place to start, because you’ll practice valuable skills and multitasking. You’ll do detailed assessments, documentation, medication administration, and you’ll be thinking on your feet. If you don’t have a strong preference for any of the specialties listed above, med-surg can help you build the foundation of a lasting career.

The average salary of a med-surg nurse is $104,838 per year.

Find Your Place in Nursing

During your time as a graduate nurse, you may have realized it’s time for a change in work environment, unit, or schedule. If you need some guidance during your professional nursing career, IntelyCare is here for you. We can help you find an opportunity that best suits your career goals, and your life. Get started on the IntelyCare job board today.

Marie Hasty, BSN, RN, contributed to the writing of this article.