What Happens After Nursing School? Advice For New Graduate Nurses

What Happens After Nursing School? Advice For New Graduate Nurses

There is nothing that compares to the sigh of relief you take when you walk out of your last day of nursing school. With such a huge accomplishment checked off, you are one step closer to your dream nursing career. But what happens next? Here is the inside scoop on some of the most pressing questions you may have fresh out of school as a new graduate nurse.


New graduate nurse celebrating
Melissa Mustafa


April 8, 2022

When Should New Graduate Nurses Apply for Jobs?

As you have likely heard throughout your time in nursing school, networking is key. Being proactive in the months before graduation can make the transition into the world as a new-graduate nurse much easier.

I would recommend making a list of hospitals, clinics, and organizations that you want to apply to and see when their new-graduate programs begin. This will help you plan and decide if you want to apply for a position before you take the NCLEX®. Many hospitals will accept an application as long as you have an authorization to test or a scheduled test date. If you had a favorite clinical site where you felt a great connection with the staff and could see yourself working there, now is the time to reach out to them and express your interest. Many of my classmates contacted managers of units and specialties that they knew they wanted to pursue such as the NICU or ED. A personal letter or call goes a long way in standing out among potentially hundreds of other candidates. 

When I was in nursing school, I started working as a Nursing Assistant per diem at a local hospital on a telemetry unit. I had no experience working as a Nursing Assistant, but they took my current enrollment in an RN program as sufficient to qualify me for the position. About six months before completing my RN, I spoke to my manager about what it would take for me to  transition from the NA to RN role. I was fortunate to not have to apply for our new-graduate program, and I scheduled my NCLEX® a week before starting my new job as a Registered Nurse in the same unit I had been working in. A little stressful, yes, but I was excited to start working as a nurse!

How Much Do New Graduate Nurses Make?

The big question that all eager new-graduate nurses want to be answered when first applying to jobs is, “How much am I going to make?” It is no secret that nursing is a great career that comes along with equally great compensation. Registered Nurses earn an average of $75,330 annually according to the U.S. Bureau of Labor Statistics. Before you start calculating, however, it is important to realize that there is quite a discrepancy in nursing pay between states and even within a state depending on the cost of living, degree type, and years of experience. For example, working as a RN in South Dakota the average hourly wage is $28.63, and in California that bumps up to $54.44. Even starting out as a new-graduate RN in Southern California in 2016, many of my classmates realized that different hospitals and organizations pay vastly different amounts. Some accepted positions at local community hospitals that paid almost ten dollars per hour less than at other hospitals. 

When it comes to pay and a new-graduate nursing job, I always recommend not having pay be the ultimate deciding factor. Your learning environment, work culture, support, management and so much more are what will count in your first job. Making a few dollars extra an hour but having poor training or working in an unsafe environment is simply not worth it. After gaining some experience, you can be as picky as you want when you are turning down job offers!

Do Nurses Need Malpractice Insurance?

Once you accept that new-graduate position, you may be asked if you are going to get malpractice insurance.  Think of malpractice insurance like an extra layer of protection as you venture into your nursing career. In the event a mistake is made, it will help to pay for coverage if claims of negligence or injury are made against you. Don’t think that malpractice is only needed if you are an unfit nurse: every healthcare professional should have malpractice insurance. 

Always inquire and know what and how much your employer covers when it comes to malpractice insurance. The tricky part is knowing whether the portion of the policy covered by your employer would be sufficient in the event it has to be used. Many nurses opt out of paying for extra coverage, but I worked with many others who decided to have additional coverage through organizations such as the NSO (Nursing Service Organization). These nurses, along with myself, also had NSO coverage as a student and then they simply upgraded to professional nurse coverage once they started working. This gave them added peace of mind knowing that they would be covered. Many feel that their employer’s malpractice will ultimately protect the institution and not necessarily the nurse. Additional coverage will also protect you in the event a complaint is made against your license. These complaints can potentially be made by the organization you work for, in which case you would not be covered, and you may find yourself owing a lot of money.  A big takeaway is that adding extra malpractice insurance is not a reflection of who you think you are or will be as a nurse

What Advice is There for a New Grad Nurse Struggling with their First Job?

Don’t be so hard on yourself

Some of the most important lessons begin the first day you clock in as a new-graduate nurse. One of the best pieces of advice I was given going into my first nursing job was to not be so hard on myself. Between learning a new charting system, knowing when to page a MD, and getting to know the quirks of all your co-workers, there is a lot of information coming at you in a short amount of time. Seasoned nurses will tell you that you won’t feel confident in the first weeks or even months. There will be days where you feel insufficient and that nothing worked out, and that is completely normal! Rest-assured you are doing a great job. It is the best feeling once you start to hit your stride and become more confident.

Focus on teamwork

My first preceptor always reminded me that nursing relies on teamwork. You are never going into a shift alone. A safe nurse is one who asks for help when needed, and doesn’t see it as a sign of being incapable. Not a shift went by where I didn’t ask for help from someone, and in return someone asked for my help as well.  All members of the patient care team: MD’s, RN’s, CNA’s, EVS staff, transport, etc. all work together with the patient as their priority. You will see that everyone plays a valuable role and that prioritizing teamwork will help you feel less overwhelmed when first starting out.

Watch, do, teach

One thing that helped me the most when first starting out was a method that I utilized to ensure that I remembered new concepts or procedures used on the unit. This was the watch, do, and teach method.

  1. Watch –  I would first have my preceptor teach and walk me through something that I had not done before, or if I wanted to make sure I was utilizing the correct policies of the hospital. I would take notes and ask all the questions I had. Later, I would go home and read those notes and do further online research if I needed anything clarified. 
  2. Do – The second time the same procedure/concept came up, I would take the initiative to take the lead and my preceptor would watch. This would still have me in a safe place if I had questions and if anything needed to be corrected. 
  3. Teach – Finally, the last time, I would explain and teach the concept throughout to both my preceptor and the patient, which helped to solidify everything on my end and feel confident moving forward. I used this for everything from NG tube insertion to charting an assessment on a patient. When it came time for me to fly solo as a new-graduate nurse, I felt like I was more prepared and less worried that I was going to forget a step.

How Do I Not Get Overwhelmed in My First Year as a Nurse?

The first year as a nurse is often filled with intimidation, and it is easy for imposter syndrome to creep up on you where you doubt your ability as a new graduate. You will find out that learning how to give insulin in class feels a whole lot different than it does when you are caring for a patient who is experiencing symptoms of hyperglycemia and at that moment you must decide what steps to take.  Although these scenarios can be nerve-wracking, each time you take on a new skill and work towards having a patient being discharged you will feel such a sense of accomplishment. It is important to recognize the daily victories at work. I remember the first time I confidently gave a report to one of the most intimidating nurses on the unit, I had a celebratory breakfast the moment I clocked out. 

Don’t forget that every nurse you meet had a first year when they were the new one. It is a time to ask questions and not feel guilty or as if you are a burden to others. I knew which charge and seasoned nurses were willing to teach, and those were the ones I always went to. There will definitely be others who are not as receptive to you asking for help and that is okay. It is about finding your allies on the unit with whom you feel safe and those will be your go-to’s! As you begin to find your stride, it is important to always lead with confidence moving forward. Be proud of when you learn from your mistakes, or ensure a great patient outcome. This isn’t an easy career but it is definitely rewarding. 

Saving the best for last, during your first year as a nurse it is also important to prioritize yourself and how you are feeling. Don’t forget to take the time to do things you love outside of work. Spend plenty of time with family and friends who you may have not seen much during nursing school. Maintaining a work-life balance will help you to feel refreshed, prevent burnout, and be mentally prepared to take care of others during your shift. 

Further Reading

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