What makes the transition from student nurse to staff nurse so difficult?

School is over, the NCLEX is passed, and your first job landed!

But now you have to go and actually be an RN.

Chances are, you’re not feeling prepared, and rightly so.

Multiple Reasons Why Transition is Tough

The student nurse to staff nurse transition is challenging. One minute you’re an idealistic student nurse with two patients, and the next minute, you’re a staff nurse with accountability for six patients or more. It’s overwhelming.

Aside from facility specific orientations of varying lengths and quality, there’s not much of a bridge between the two worlds. Bridge? It’s more like jumping in and swimming across!

Don’t underestimate the magnitude of this role transition. Here are just a few of the many challenges you’ll face:

Reality Shock

Nurse researcher Marlene Kramer addresses this well in her classic book Reality Shock: Why Nurses Leave Nursing (1974).

Being a student nurse on a floor and a staff nurse on the same floor are two entirely different experiences. Students aren’t affected by short staffing issues and generally are sheltered from stressful situations such as getting an unstable patient from ED, rushing a discharge to facilitate an admit, interacting with providers, and so on.

Students aren’t employees, hence they haven’t had to deal with the never-ending new requirements constantly being heaped on nurses by their employers.

Starting Over

Maybe in your nursing class you were Class President. Or the Social One. At any rate, you had an identity and a tribe. Now, essentially, you are starting over. You have to find your place on your new assigned nursing unit.

A new place, where no one cares that your GPA is 3.98, or that your senior practicuum poster board on hand washing received top awards.

You have to prove yourself to your new coworkers and MDs.

Self-Identity Change

Your self-identity has to change from that of a student nurse to that of a staff nurse.

The buck stops here. I’m it. I’m the Registered Nurse. The well-being and safe passage of patients are in my hands.

You begin to assume the responsibility, accountability, and mind-set of a Registered Nurse.

Life Style Changes

For a long time now, you’ve lived in a nine-to-five world. Say good-bye to that world.

Many RNs in hospitals work twelve-hour shifts, days, nights, weekends, holidays. You simply can’t underestimate what shift work does to your being.

It affects sleep, appetite, social life, family, everything. It’s especially important to make healthy life style choices right now.

Multiple Stressors

Many new nurses are getting married just because it’s that time of life. Many are also balancing many of these:

New job

Family and relationship responsibilities

Buying a house

Pregnancy

Relocating

Now you’re finally making some money, which is a welcome change! But a change nonetheless, and you have to learn to manage a new budget.

I’ll never forget a new nurse who looked at her first payroll stub, squinted, and asked “What is FIT (federal income tax withholding)?” She was from another country, and had never worked in the States. But several of her (American) classmates gathered around and wanted to know, as well!

I told her “Well, basically, it means you need to get some deductions. Like children or property.”

Learning to Think Critically

Critical thinking is one of the most important skills. Most newly graduated nurses are thrust into the workplace with critical thinking skills that are not fully developed.

New grads tend to want everything to go step one, step two, step three like they were taught in school. The real world is frustrating because situations don’t go by the book! The transition from tunnel vision and doing one task at a time, to recognizing the big picture and prioritizing, is essential.

It just takes time. It does happen, trust me.

Transition TIPs

Take it one day at a time. Breathe. Every day you’re getting closer to your goal of being the well-adjusted, competent nurse you want to be. Focus on what you can improve on today.

Gain perspective. Understand that this, too, shall pass. Remember way back in first semester when you thought graduation day was so unattainably far away? Same thing.

Gain even more perspective. Look around you at the other staff nurses. Courtney over there was once just like you, and now she’s a calm, competent nurse. Jacob, the Charge Nurse? He was just two classes ahead of you in nursing school. Courtney and Jacob are no different than you.

Give yourself credit. Are there student nurses on the unit today? Look at them and you’ll instantly see how far you’ve already come.

Give yourself grace. You are not perfect, and no one expects you to be.

For some helpful and practical nursing tips, read

First Day off of Orientation!

10 Signs You Might be a Lifelong Learner

Calling MDs is like Playing Football

Here’s wishing you a smooth transition, friend. Leave me a comment, I’d love to hear your experience!

Until next time,

Beth