The desire from educators and nurse leaders to develop nurses’ critical thinking skills is undoubtedly pressing for new graduate nurses. Why do nurses, who have just completed their education, have a difficult time displaying the qualities and skills educators and leaders want? It’s important to understand that new graduates face many stresses as they transition from being students to being registered nurses, and these stresses impede their ability to learn and progress.

Stresses for new graduate nurses

The following four categories have been identified as factors that lead to stress in novice nurses:

1. Reality of practice. New graduate nurses think they are supposed to have all of the answers, are overwhelmed by the volume of work, and feel guilty because they cannot spend more time with patients.
2. Unfamiliarity with the structure of the organization. For example, they spend valuable time looking for supplies.
3. Lack of professional relationships. They lack an understanding of the roles of healthcare providers, and their dependence on other staff may cause them anxiety. They often lack mentors and support people.
4. Lack of clinical judgment. They have decreased confidence in their skills and decision-making abilities. This leads to apprehension.

Strategies to minimize stress

There are ways to minimize these stressors for new graduates. The following strategies can help with orientation or on an on-going basis:

• Regular support group meeting with fellow orientees
• Having a mentor or a buddy who builds a relationship and follows the nurse for a year
• Roundtable meetings of the institution’s staff nurses who have been out of school for two to five years and can offer tips and support
• Spending a day rounding with a teaching physician who frequently admits to the unit

The most dangerous situation is when nurses do not realize what they do not know. The best orientee is the one who realizes when to ask for help. Surprisingly, weaker students are frequently confident, partly because they don’t grasp how much there is to learn or the potential risks.

Part of developing critical thinking skills for new graduates should include thinking about the areas where they still need to grow.

Editor’s note: This excerpt is adapted from Critical Thinking in the Obstetrics Unit: Skills to Assess, Analyze, and Act, an HCPro, Inc., publication.