When you begin orientation as a new graduate nurse, you know one thing for sure: nursing school does not teach you everything you need to know to be successful on the floor.
Watching the experienced nurses might make you wonder, when will I become that nurse? The one who walks around with an endless air of certainty, seems sure in every decision, and takes on any patient assignment without getting cold sweats or feeling a sense of impending doom.
Developing confidence in general is a challenge for most people, and the nursing profession just adds on another layer of difficulty (we are dealing with people’s lives here). But confidence is a skill just like anything else, and with a little bit of practice, you can learn to generate this feeling on demand!
What is confidence in nursing?
Let’s break down the definition of confidence first. It’s important to remember that confidence doesn’t come from external factors – contrary to what many believe, it’s not about what you know, what you can do, or anything outside of you. Most of us know that building confidence takes time, and while this is a true statement, it’s not for the reason that people think!
When we “become” confident, it’s because we believe that we have enough knowledge or experience to handle something. Believing in yourself as a person first can help you to extend that feeling into any setting – including as a new grad nurse!
Learning to be confident before you’re “ready” comes from the thoughts you have about what you are capable of. Feeling confident means knowing that regardless of an outcome, you are going to be okay. When you feel centered in that belief, you can take on anything!
Here are six steps you can take to start gaining confidence and feeling good about yourself as a new graduate.
1. Accept that you don’t know everything, and let go of the expectation that you are supposed to.
This is easier said than done, but it’s an important first step! Nurse Managers and preceptors are well aware of the gap between nursing school and “real world” nursing, and that’s what orientation is for! No one else expects you to know everything, and you shouldn’t expect it of yourself, either.
We are constantly learning from each other, and experienced nurses ask a lot of questions, too. Healthcare is continually evolving and we are all lifelong learners. The key is to always be willing to ask questions, and figuring out your resources so that you can find the answers!
2. Be aware of what you can control, and be as prepared as possible.
It might seem like everything is out of your control when you start as a new nurse. You are assigned your preceptor, your patients are chosen for you, you have no idea what a doctor is going to order… there is an endless stream of “what-ifs” throughout your day.
A key practice in nursing and life is being aware of what you can control, and acting on those things. So how can you set yourself up for success?
You can control starting your day off on the right foot: making sure you are well-rested, that you are on time or early for your shift so that you can get settled and look things over, and that your mindset is in the right place.
You can also control how proactive you are in your learning throughout the orientation process. Come prepared with a strong basis in the basics like normal vital signs and lab values, and then let your orientation guide your learning! Each day, write down your patient’s diagnosis, and either during down time or when you get home, research the pathophysiology, common interventions and prognosis, and integrate that knowledge with what you learned that day. That way the next time you see the same type of patient, you’re prepared!
3. Get comfortable with being uncomfortable and embrace vulnerability.
A lot of our thoughts around confidence come from knowing that you will be able to handle anything that is thrown at you, and that is where experienced nurses shine. They’re comfortable with being uncomfortable, and have made peace with the fact that if they don’t know something, they’re going to figure it out!
For new nurses, this is difficult, because they’ve never been in this environment before and have no basis for believing they can handle the situations they’re put into.
So how do you combat this? Think about all the hard things you’ve done before! While you can’t be certain about your knowledge and skill in this particular environment, you’ve survived all of your tough days so far including the entirety of nursing school – no easy feat!
Bad days will happen and you will be uncomfortable, but you will come out on the other side stronger than before. Knowing and believing that simple fact can make all the difference.
Another tip: try to choose action over anxiety. When there’s an opportunity for you to take a sick patient or to try an IV on a patient who is a tough stick, go for it! Treat every experience as a learning opportunity and realize that there’s courage in simply being willing to try.
If you shy away from new experiences, you will begin to develop more and more anxiety around them – what you resist persists! But when you embrace being uncomfortable, the negative feelings will start to dissolve, and you will begin to feel motivated to seek out new things often. This will keep you out of your comfort zone and in your growth zone, which is exactly where you want to be.
4. Focus less on what your co-workers think of you, and focus more on being safe and doing the best you can.
It is so easy to get caught up in thinking about how your co-workers are sizing you up. And while you want to be part of the team and fit in, it’s so important to not let other people’s (perceived) opinions about you cause you to lose sight of why you’re really there!
Focus on being the safest and most compassionate nurse that you can be, and let people have their opinions. The honest truth is, human beings make judgments, and typically their judgments have far less to do with what you’re doing, and more to do with themselves! Spending time trying to make other people like you (and not acting like yourself as a result) is a recipe for disaster.
Find your tribe within your unit and keep them close, they’ll be the ones that won’t judge you for a bad day.
5. Practice self-compassion and limit comparison.
If you miss an IV attempt and spend the next few hours (or days) berating yourself in your mind, it won’t serve you or your patients!
When things don’t go the way that you want them to or you make a mistake, speak to yourself the way that you would your best friend. You wouldn’t tell them everything they should have done differently or suggest that this isn’t for them over one misstep, would you? Never! And you shouldn’t treat yourself that way either.
Here’s an example of shifting from negative self-talk to self-compassion:
“I’m never going to understand all of this. It’s too much and I’m not cut out for this.” ➔ “I am a new nurse who is learning a lot of new information. I will be patient with myself and accept that this is a process.”
Also, do your best to limit your comparison only to how well you did yesterday. Thinking about how Susie finished her assessment and morning med pass in record time is not going to make you go any faster. And just like we never know what’s going on behind the scenes in an Instagram post, you don’t actually know what’s happening with Susie and her patient.
Who knows – maybe she had that patient the day before, maybe the patient only has one medication and her preceptor actually gave it for her – regardless of the situation, directing our attention to other people will never get us any closer to where we want to be. Focus on what you need to improve and take action on those things! Remember, there is always going to be someone who doesn’t see your worth – don’t let it be you.
6. Recognize what you are doing well, and celebrate every small win!
We are all our own worst critics, and we have a tendency to focus solely on what we did wrong and how to improve for the future. It makes all the difference to turn that around and also take time to recognize what you are doing well.
When your shift comes to a close, reflect on your day, and instead of ruminating on the small things that went wrong, choose to think about three things that you’re proud of. Something as simple as making your grumpy patient smile is a big thing to celebrate!
Feel free to take time throughout the day to write down your “wins” as well. Everything from finishing your med pass on time to taking a full lunch break counts! Just like we are our own worst critics, we can be our own biggest cheerleaders, too.
You may have heard the old adage “fake it ‘till you make it” when it comes to new or challenging situations like working as a new grad nurse. Personally, I find it outdated and offer you something a little bit different – “face it ‘till you make it”.
Don’t be afraid to show up imperfectly – that’s exactly what confidence is. Continue to show up even when it’s hard, even when you’re not sure of yourself, even when you know you might mess up. Face every situation and take what you can from it.
You don’t need to fake anything to succeed, and nothing truly builds confidence like choosing to bring your best despite not knowing exactly how things are going to go. You will continue to prove to yourself that you can do hard things, and soon you’ll be walking in that certainty and sureness that you admired so much in the beginning.
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