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Nurse Relationships
Finding Allies at Work
Build your network of support before you need it.


My first year of nursing, I considered becoming a forest ranger. Nursing was bleeding my emotions.

When I first got out of school, hospitals faced a big nursing shortage—not unlike today. The unit was understaffed, and the level of responsibility quickly overwhelmed me.

Worse, I became trapped in a destructive internal dialogue. I’d constantly tell myself: I’m not doing a good enough job. I stink at this. I’m a huge failure.

I had no one with whom to process my emotions.

Snowballing Thoughts
At the time, I worked on an Oncology unit, when people were in-patient for much of their chemo. Horrifically sick, many of my patients died. Alone, I internalized my thoughts and emotions. I kept thinking, If I were just a good enough nurse, I could handle this better.

I shut down rather than going to people and admitting that I was having a hard time. But the truth was, I didn’t know whom to go to.

The head nurse quit about two months after I started, so that relationship was gone quickly. Then the new head nurse started—but it was her first job as a head nurse. She was overwhelmed, too. I don’t blame her, but her attention to the new nurses was minimal at best because of her other responsibilities.

With my confidence plummeting, my negative internal dialogue increased.

Who’s in Your Corner?
Here is an obvious takeaway from my experience: New nurses need to get proper support from colleagues who understand them. That’s priority number one.

The transition from student to professional is difficult. Student nurses may find support from a variety of sources, but as a new professional, I found it tough knowing whom I could trust. There were colleagues in the unit who couldn’t be trusted with my emotions – those who would see my struggles as weakness or incompetence, or those who simply didn’t care.

Most new nurses are hesitant to share these feeling with their colleagues. So the new nurse’s internal dialogue plays out in a negative way—and perhaps makes him or her want to quit trying.

All nurses experience feelings of inadequacy. The good news is that many experienced nurses are willing to help you work through your questions of “Am I doing a good enough job?” or “Are these realistic expectations?” or whatever you struggle with. Let’s face it, when you voice your inadequacies, they often feel less ominous—even silly, to a point.

Get Connected
So why aren’t new nurses connecting? Time constraints and the fear of being the only one feeling like Nurse Know-nothing.

The best advice is to make time for this both inside and outside of work. Extend yourselves to colleagues. Ask them to lunch or make a point of going to happy hour at week’s end. Or maybe even work-out after your shift. On especially stressful days, even 15 minutes of exercise and experiencing an emotional connection with like-minded people can effectively manage your stress.

One of the best forums is within the recent-grad program, offered by many hospitals. While the main intent of these programs may be skill-building, a side benefit is the friendships and camaraderie with other nurses. These relationships can provide much-needed empathy and become a sounding board for strategic problem-solving. It’s the perfect environment to practice asking the questions rattling around in your head that keep you from being the confident, productive nurse you can be.

Amy R. Morton-Miller is currently a nursing instructor in the associate degree nursing program at College of Lake County in Grayslake, Illinois. Though she is now a full time instructor, she occasionally works as a per diem staff RN at Advocate Good Shepherd Hospital with the help of her 25 years of nursing experience. She is also working toward her doctorate at University of Wisconsin-Milwaukee. She is a member of the Midwest Nursing Research Society, the American Nurses Association, the Wisconsin Nurses Association, Sigma Theta Tau, and the American Psychiatric Nurses Association. Remembering the difficulty of her first years as a nurse, Amy feels that helping new nurses is a worthy ambition. “I am concerned about their transition to the ‘real world’ of nursing and feel RealityRN is a great resource for the beginning practitioner.”


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11 Responses to “Finding Allies at Work”

  1. Diane Alvy Says:

    Amy

    I loved your article and your mission to help students during their first years. I too had challenges when I went to nursing school and began working.

    I live in California and have written a resolution which incorporates support groups within all nursing programs here in California. California has the worst nursing shortage across the United States. 50% of the nurses are trained elsewhere.

    Would like to contact you to run ideas across if possible. I’ve become a member of the American Nurse’s Association and will present my resolution to their general assembly early next month. They’ve accepted a number of my previous articles

    Sounds like we share same missions. Would like to connect with you if possible. I love this website. I wonder if many students know about it.

    Sincerely
    Diane Alvy RN
    dalvy@earthlink.net

  2. Caroline Collins Says:

    Thank you for this article – I couldn’t have come across it at a better time!

    I can draw so many parallels to your descriptions, especially the comments about ‘Nurse Know-Nothing’, ‘negative internal dialogue’ and ‘feelings of inadequacy’.

    I shall do my best to take your advice and try to ‘connect’ with my more experienced colleagues as well as to ‘share’ with my peer group.

    For the record, I am a recently qualified ‘mature’ Nurse (40ish!) in the UK – you see, fears cross all boundaries!

  3. Amy Morton-Miller Says:

    Glad you found the article helpful. Good luck with your nursing adventures. Take care…and hang in there!

    —Amy

  4. Michele Says:

    Wow!! This is exactly how I feel! I ask myself everyday I work, do you really think you know what you are doing? What are you doing here? I do talk but am not a very good conversationalist. I feel like I get lost even in my own conversation so I just clam up most of the time. Something I need to get over but not sure really how to strike up the conversation and again don’t always want to look like “Nurse Know-Nothing”. I’m not afraid to ask questions and so I don’t know how to do things, patient safety, but to talk about it later, I definitely feel like the big dummy and maybe it’s something I should already know.

  5. Jenny Says:

    I’m so glad I subscribed to this site b/c from time to time I’ll check out what article relates to me. One thing that hits me was the article, “Nurse Know-Nothing”. I’ve been a RN for a year & 1/2.

    An incident happened when I ask a seasoned nurse a simple question it had nothing to do with patient safety nor bedside care. The reply given to me was, “who trained you?” It’s hard to find a comfort zone when you are not getting the support to need.

  6. Andrea Says:

    Being a student nurse in an ADN program, this totally hits home with me. I’m having these fears and anxieties already during my clinicals. Sometimes I feel plain stupid and wonder if I can really handle this job. I know I love nursing and love working with people. But there’s so much responsibility. People’s lives are in my hands and that’s a really scary thought. I’ve already seen how unsupportive the staff can be. It’s very discouraging. I wonder what will happen when I graduate and my instructor is not there to ask questions. Who will I be able go to?

  7. Kelly Says:

    This article was sent to me by the very nurse I was FINALLY able to confide in about how scared I am and how inadequate I feel. I have worked as a patient care tech for 4 years in the ER and graduated from RN school last spring. I didn’t think the ED would be as hard as it is because I was familiar with the flow and all, but it has been very much challenging. How the new grads who haven’t worked ED previously are surviving, i don’t know because I feel I’m just barely hanging on. Of course, like the article said, there will be those colleagues who will view my feelings about the care I give as a weakness, but the vast majority of the people I work with are understanding and willing to help with the adjustment process in that 1st year of nursing. I am so glad to work with such awesome people.

  8. Valentina Says:

    You have so gloriously voiced my internal feelings as a new nurse (1.5yrs) in pediatric ICU, and now that I have finally gotten over the almost paralyzing fear of what might happen on my shift, I am constantly doubting myself in situations. When a patient craps out on me and I react, I can be told I did a good job by all of my colleagues, but I still feel inadequate somehow. I am fortunate enough to have STRONG support of my fellow RN’s, but I’ve been experiencing low self-confidence in my abilities that’s been unprecedented in any other job I’ve ever had. I kick myself for days about not anticipating quickly enough, or not knowing how to do a certain task…or feeling too emotional about a patient. I think it stems from the fact that being a nurse is EXTREMELY difficult and takes alot of time to fine tune notwithstanding factors such as exhaustion, stress, language barriers, etc. I don’t think anyone knows how hard it is to be a new nurse until you find yourself hunkered down in the madness of it all. I can personally attest that I appreciate the support I have from my colleagues, but I acknowledge that I need to believe in myself and give myself constant pep talks to bring myself up. SOLDIER ON NEW NURSES!!!

  9. sara Says:

    help i am seen as cocky and a know it all and this couldnt be further from my truth. i am a new grad and work in long term care, its been two months and ive been moved around because nobody wants me, this is not a pity party, i truly am loving and open and am seeking to change what i must be emoting. Ive been told i have a quality that gets under peoples skin and i dont see it so i dont know how to stop and let people get to see ME

  10. andrea Says:

    What fantastic writers!!! And, such a good and relevent article. Truth be told, every nurse who hits the floor knows he/she has had all the feelings stated by each writer. Nursing is so involved with so many personalities that it takes a good deal of time to learn where to place trust and when friendships are built. I’ve found some of the worst personalities I’ve nursed with, have been the best ‘technical’ nurses and I am grateful for their shared knowledge, even tho they tended to treat me with less than respect. Sometimes it’s about getting the job done and doing it the very best way you can. Nursing is ever changing and always ‘trying’. And, not everone stays in the setting they start with. What a surprise to find that eventually you either fall in love with nursing, or~~you don’t. Then it’s time to move on. But, give yourself years before you make that tough decision. It don’t come easy.

  11. Jasmin Says:

    2 weeks left in my preceptorship/residency program, 5 shifts then actual, no nets nursing, or is it? Just got the call today that I now have a fulltime position, it’s been a long time coming since I had graduated in December and had my license since February. Very grateful and very fotunate to have supportive nurses on the unit because just 2 days before, an omission on my part and the staff has been brought to my attention. I thought I ended my career right there and then. So when I got the call today, I thought that was it, in Trump fashion it seemed like it was going to be, “you’re fired!”. But it wasn’t, it was not the catastrophe I thought it was. The nurses, including my preceptor, told me to get out of my head and work through the fear, the self-beating and just do better. 2 hours later, I was too busy to be nursing negative thoughts along with my patients. It happens, the low moments, all we can do is move on, hopefully with the support of those who’ve been there and done that. Good luck, newbies and God bless those who shepherd us along.

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