Graduation day is in sight for many nursing students. And whether you’re saying farewell to nursing school this month or in May, your first year as a real, actual, honest-to-goodness nurse is fast approaching. Your first 12-hour shift. Your first real patient. Your first day without your preceptor. Your first run-in with your manager. Your first, well, pretty much everything. And to help you out, this week, we’re going to dip into one of the books in the Stressed Out series to give you some advice.

Stressed Out About Your First Year of Nursing was written by Patricia Duclos-Miller and its practical, simple advice has already helped thousands of new nurses get their feet on the ground. Here’s a glimpse of what’s inside:

Nurse researcher Marlene Kramer, RN, PhD, FAAN, studied the transition from student nurse to new-graduate nurse and found that there are four phases of reality shock: the honeymoon phase, the shock (rejection) phase, the recovery phase, and the resolution phase. Let’s take a closer look at the shock phase:

Your orientation program is over and you are now working on your own. You get your own assignment and have to complete your own nursing tasks. When you ask a more seasoned staff nurse about a particular task, you get an answer that does not match what you learned in school. Or, you may get a “Because that’s the way we do it here” response.

During this phase, you may feel a bit like each of the following types of nurses, which is natural during your first months on the job. Consider yourself a work in progress.

• The native. These nurses decide they cannot fight the seasoned nurses and join in the way they do things. They begin to take shortcuts, even when they compromise patient safety (e.g., not looking up medications with which they are unfamiliar.)

• The runaway. They decide to “run away” from the profession because it is too difficult/not what they expected.

• The appliance. These nurses decide to do just what is needed to get by. We call these nurses “appliance nurses” because they only work to get new appliances and other material things.

• The burn-out. These nurses keep their feelings and internal conflict to themselves. They burn out because they do not manage stress effectively, and/or take on too many responsibilities. They begin to feel tired all the time, have frequent headaches, difficultly sleeping, mood swings, and anxiety. Ultimately, the quality of their work (and health) suffers.

• The loner. They decided to just keep quiet and do the job.

• The new nurse on the block. These nurses decide to change jobs whenever the work environment does not meet their needs. They are always the newest member of the team.

• The change agent. These nurses decide that it is better to stay and work with the system to make the changes necessary. They go to their nurse managers with suggestions on how to improve things.

During the shock phase, Kramer suggests you ask yourself two important questions:

1. What must I do to become the nurse I really want to be?
2. What must I do so that my nursing contributes to my patients and the community?

By answering these questions, you will get a better grip on your priorities and on the path you must follow to become the best nurse you can be.

Editor’s note: This excerpt was adapted from Stressed Out About Your First Year of Nursing. For more information on this book, click on the book cover on the left side of the page. It’s the purple one.