Transition from Student to Graduate Nurse
You’ve made it! You’ve successfully gotten to the end of your degree and can finally breathe! What a relief, you can feel your shoulders drop and relax…but, only for a minute!
Honestly, the transition to graduate nurse begins much earlier than your actual first day as a registered nurse. It probably begins somewhere through your final year as a student but could be much earlier or later than that. This is a HUGE topic; you could write a thesis on it. It’s been done, and there are so many studies and articles on the transition to grad nurse. We’ll keep this as brief as possible but provide some valuable advice and insights.
Firstly, being a graduate nurse doesn’t mean you will be in a graduate program. Whilst this is the easiest way to get into a hospital setting, it isn’t the only way. This may not be where you want to go, that’s ok. So, this is for every grad transitioning, not just into a grad program.
Top things you can do as a student nurse to get prepared…
Start working independently on your clinical placements. Of course, you will be supervised. At the beginning of your placement set goals to work towards increasing your patient allocation. By your last clinical placement, you should aim to be doing almost everything for all your patients, you should be telling your preceptor what is happening and how they can assist you.
Talk to new grads. Ask them how they have found the transition period. What have they done to make it easier. What would they change. Their advice would be the most invaluable, they’re living it now. Yes, experienced nurses will be able to give you advice but it’s likely been a while since they were a grad and it’s easy to forget what it’s like.
Just say ‘Yes’! Step outside your comfort zone on clinical placements, this is the safest time to try new things. You will never have this type of support and guidance again. Do you want to give CPR a go…yes! Do you want to see a procedure in cath lab…yes! Do you want to follow the patient to surgery…yes! If an opportunity arises, just say ‘yes’.
Start good habits. Nursing can be one of the hardest careers to maintain a good work/life balance. Yes, shift work can be amazing for this but it is also proven to be very hard on your body. Did you know shift workers are at an increased risk for many health problems and below-average life expectancy!! Start eating healthy, get into an exercising routine, create self-care habits and generally be kind to yourself.
I have written an ebook on the nursing shift routines, having this foundational knowledge of the day-to-day routines early will be one less thing to stress about.
So, now you’re a registered nurse how do you transition to an independent, competent practitioner. From what I can see in the commonly asked questions on graduate nurse social media groups and chats, most nurses just want to know what to expect. This just comes down to wanting to be prepared and understanding what they’re getting themselves into. Hopefully I can break this down for you.
“The expectations you put on yourself will be much higher than what your manager or senior leaders have for you.”
Graduate Application Process
At some point in your final year as a student, the graduate application process will commence. It’s important to be prepared for this and I would imagine most universities offer information sessions about this. Hospitals may also come and provide sessions on how this process works. Essentially, you will need to submit your resume, cover letter, references, academic transcript and identification documents either online or as hard copies. At this point, you will likely need to preference which hospital and/or specific area you would like to complete a grad program. It’s important to note here that, from my experience, your first preference is the only one that will be looked at.
Interviews
Usually, the graduate nurse educator is the point of contact for all students and NUMs. They are likely running and organising the graduate application process and programs for their hospital. Once the application process closes, the nurse educator will divide up potential grads to their preferred areas and provide NUMs with a list of names which will then be shortlisted for the graduate assessment day (which may or may not include the interview, clinical scenario and other assessments). If you have been shortlisted, you will attend the graduate interview or assessment day. Usually within two weeks (sometimes longer), you will be notified whether you were successful or not.
Letter of Offer
Once you have been notified that you were successful, a formal letter of offer or contract will be sent to you for you to sign and return. This will usually have information regarding your start date, starting salary, ward or unit and how many hours per week you will be working. This usually comes from HR or the recruitment team and will be quite wordy. It’s important you read all the information, sign it and return it ASAP. If something is amiss, don’t hesitate to reach out to the contact numbers to discuss or ask questions.
Merit listed/Wait-listed
What happens if you’re successful on the graduate assessment but unsuccessful in first round offers? You will be merit-/waitlisted - your name goes onto a list, and you will wait for a position to become available. This usually happens because all positions have been filled and there were more grads that applied than positions available. Don’t lose hope here, there are many opportunities for you to still be offered a position within twelve months. Some grads drop out shortly after they have started, some don’t respond to their letter of offer, some were successful with another hospital. Stay in contact with the hospital regularly to check on positions available but otherwise feel free to pursue other avenues if you want to keep up with your clinical skills (ie GP land, nursing homes, clinics, apply anywhere and everywhere).
It might also help to notify the hospital if you are willing to change your initial preferences as this will open further opportunities for you – be willing to go to a rural facility or if you preferenced something specific like ED/ICU/Theatre that you would be happy to start on med/surg wards. These areas are highly competitive and often it’s who you know unfortunately, but by offering a broader preference you may get your foot in the door and then have the opportunity to get to where you want to be later.
Alternative Options
What do you do if you were unsuccessful in being merit-listed? You didn’t pass the assessment day? Or, you have no interest in a grad program and want to work for a non-government organisation (NGO)? Unfortunately, if you were not successful in a grad program, you will not be merit-listed and may have the opportunity to apply the next year. Were you aware most grad programs can be commenced within two years of finishing uni, so there is a second chance.
But, what do you do in the meantime? Same as someone who is merit-listed – apply anywhere and everywhere if you wish to maintain your clinical skills. I’m not going to lie, you will be knocked back many many times for inexperience. You will be disheartened and upset, feeling like a failure. Ensure your resume and cover letter are on point (get some professional help), keep doing CPD – upskill as best you can to make yourself stand out from other applicants. It’s important to tweak your resume and cover letter so they are unique to each job you apply for. There is no quicker way to be passed over if you send in generic, boring resumes and cover letters to every job application. Be honest, explain your situation in the cover letter. It will only take one employer to give you the chance, and then you are a step closer by gaining experience to get to your goals.
If you simply do not wish to obtain a grad program and would be happy to work for a GP, health clinic or other organisation you may have skipped all the info above. The rest of this blog will be insightful as most onboarding programs for new nurses run relatively the same, just with different content and support systems. My advice on obtaining a position would be the same for someone who was not successful in a grad program above.
Workplace Orientation
Once you have a start date, you will hopefully also be sent information on the ward/unit you will be working on, how to get uniforms, what the orientation period looks like and other housekeeping information (where to go, where to park etc). You should attend the hospital orientation, there might be a specific nursing orientation, complete any mandatory training required prior to commencing (such as BLS, patient handling, infection control etc). You will attend your workplace, meet important people (NUM, educator, preceptors or buddies) and commence working.
In a supportive environment, you will be given enough time to transition into caring for your patient allocation independently and safely – there is usually a set amount of time allocated to this but should be flexible depending on your progress. Try not to compare yourself to others, it may take you less or more time depending on what opportunities you had as a student nurse.
Initial Transition/Supernumerary Period
This is known as a supernumerary period – you are part of the team but not technically counted in their overall numbers for staffing. This allows you to orientate and transition without increased pressure on you to perform independently yet or your colleagues to carry a heavier workload. Once you are out of your supernumerary period, you may notice a slight drop in support/assistance from other nurses on the floor but not from preceptors/buddies or educators. If there are any issues with your practice, they should have been ironed out or increased supports applied prior to this.
The supernumerary period could be anywhere from 4-12 weeks dependent on unit/areas. I have personally overseen grads who have not transitioned well and remain on supernumerary periods for four months or longer with extensive support systems around them. As leaders in nursing, our priority should be safety – to keep patients safe first and foremost; and to keep nurses safe.
Awareness of Processes
Having an awareness of processes isn’t something you will necessarily understand straight away, you will be focussing on more important things in your day-to-day. I’m not talking about clinical processes either, this is purely HR or admin related processes etc. If you don’t know how something works, ask. Never assume.
You might be thinking, what on earth does she mean ‘awareness of processes’. This is important, it is having an understanding of the steps, sequence and interconnectedness involved in a specific activity or system. It is ‘what steps do I take to call in for sick leave?’ or ‘how do I escalate my concerns about a colleagues behaviour?’. How do you do something from A to Z in your professional capacity? So, get to know your policies and procedures. Talk to your seniors and leaders to ensure you are following the correct steps.
An example of not following correct processes is sending a scathing email to payroll because you were underpaid. Not only is this unprofessional but it’s not going to get you anywhere – first steps would be to discuss your underpayment with your line manager (ie NUM). They will initiate an investigation and complete any paperwork to ensure you receive what you are owed, and payroll will process this. Having an awareness of processes is beneficial for efficiency, problem solving and accountability.
Support
Your grad transition year is a time of immense growth and development. It will easily be one of the most stressful years of your career so it’s important to have the right support systems in place. There is so much information online for graduate support so we will only touch on this briefly. Find your supports in family, friends, colleagues and develop good healthy, sustainable practices to look after your health and wellness. Nursing is exhausting – physically and even more so, emotionally. You can’t drink from an empty cup.
I have provided links to the following nursing supports:
Challenges
It will take you about 3-6 months to start to feel at ease and more confident in your own practice. Every day will bring new challenges, and then one day those challenges will be ones you’ve dealt with before and you’ll finally feel like you might actually be able to do this nursing thing. Not gonna lie, I’ve been nursing for over fifteen years and I still get new challenges, but with experience they’re not as scary to manage. Here are some of the more common challenges faced by graduate nurses:
Lack of experience and confidence
Theory to practice gaps
Performance anxiety
Heavy workloads and time management
Caring for complex patients
Medication administration and patient assessment
Documentation skills
Effective communication skills
Lack of access to mentorship and guidance
Shiftwork and long hours
Exposure to illness
Bullying and blame culture
Emotional resilience
What Everyone Expects From You
Honestly, the expectations are very little. The expectations you put on yourself will be much higher than what your manager or senior leaders have for you. Don’t be too hard on yourself if your transition takes longer than others. At a minimum, you must meet the registered nurse standards for practice in Australia. Your leaders want you to be safe and competent. They want you to be an active participant – you won’t be spoon fed. You will need to study and look things up that you don’t understand, think things through and discuss your findings. They want you to come with a positive attitude, ask lots of questions, take initiative and accept that you will make mistakes.
The transition from student nurse to graduate nurse is a pivotal phase in your life. With the right support, dedication, and resilience, you will navigate this transition successfully, paving the way for a fulfilling and impactful career in nursing.
Did we miss anything? Send us a message with any questions and we’ll be happy to answer them.