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Does your nurse manager see you as confident?

Image: Jack Hollingsworth | Photodisc | Thinkstock

At what point in a new nurse’s orientation or career do they start to feel confident in themselves as a nurse and their skills?  The reason I am wondering is because I have a new graduate nurse who started a couple weeks ago and this is her main issue.

She has been on orientation for two full weeks now. Last week, she called me at home crying because she thought she was not doing well.  She said that she took care of two patients that day and was feeling overwhelmed.  She said she knew what she needed to do, but was constantly questioning herself.

I tried to explain to her that that was normal and that by comparing herself to her preceptor, who has several years of experience, she was only going to drive herself crazy.  I told her that I would be more concerned if she felt confident or overly confident at this point in her orientation. I even used my experience as a new grad as an example, explaining that I didn’t feel confident until at least nine months AFTER orientation ended, and even then I was just happy I didn’t kill somebody whenever I worked.

I had the nurse educator on the unit talk to her and explain it to her. I also talked with her preceptors and made sure they were helping to build her confidence. I asked one of my new grads who had just reached her one year mark to talk to her, too.

It’s difficult getting through to new nurses sometimes.  It’s been their dream for so long to be a nurse, and now that it’s a reality they realize they actually have people’s lives in their hands.

What I told her was true about being more concerned if she were over-confident.  I have seen too many new nurses fail because of their cockiness.  They end up facing the reality that they don’t know as much as they thought, or more likely doing something they think they know but really don’t and hurting a patient.

Mistakes are going to happen.  She’s going to make an error at some point in her career.  Being overly-cautious because of that fear is not going to change anything; in fact, I really feel it will make her even more likely to make a mistake.

How confident are you in your career?

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Rob Cameron

Rob Cameron is currently a staff nurse in a level II trauma center. He has primarily been an ED nurse for most of his career, but he has also been a nurse manager for Surgical Trauma and Telemetry unit. He has worked in Med/Surg, Critical Care, Hospice, Rehab, an extremely busy cardiology clinic and pretty much anywhere he's been needed. Prior to his career in nursing, Rob worked in healthcare finance and management. Rob feels this experience has given him a perspective on nursing that many never see. He loves nursing because of all the options he has within the field. He is currently a grad student working on an MSN in nursing leadership, and teaches clinicals at a local university. Away from work, Rob spends all of his time with his wife and daughter. He enjoys cycling and Crossfit. He is a die hard NASCAR fan. Sundays you can find Rob watching the race with his daughter.
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5 Responses to Does your nurse manager see you as confident?

  1. Mo Earle

    I have been a nurse for approx.30 years, over the years seeing new grads coming into the various areas. I disagree with Managers that bring new grads into high acuity areas, such as Trauma, ER,ICU, for fear the nurse is only being set up for frustration and failure. New grads should spend at least a year on a telemetry area, before moving onto the high acuity areas, and in each area, should be kind to themselves and realize they may not feel comfortable and settled in for a good six months.

  2. Mike

    I respectfully disagree with Mo. As a recent grad (in the past 3 years) and seeing what happened to many of my classmates, new grads who genuinely want to go to higher acuity areas off the bat will often get bored or frustrated with floor or telemetry nursing. Better to have some deeper growing pains in an area that you want to be, than completely lose an otherwise skilled nurse because they feel that they’ve been “forced” somewhere that they don’t want to be.

  3. Diana

    Hiring a new grad is really on an individual basis and depends on the nurse manager. New grads usually take more time to become competent in high acuity workplaces vs. experienced nurses, and nurse managers know this. Now, in regards to being overly confident or overly cautious, new grads have to fight to find that balance. Overly cautious brings me a sense of stress, and with stress one cannot think clearly and this does not at all benefit the pt. I think Mr. Cameron did the right thing by calling a meeting with the nurse educator and her preceptors. Support will decrease anxiety resulting in less stress, better pt care, better pt outcome. Not all new grads will admit that they are struggling through orientation for fear of looking incompetent, so I think it’s important for a nurse manager to meet with them and their preceptor about his or her progress. I think if my manager had done this, I would had been less stressed during orientation time. She was usually in her office and not communicating with staff. In the same token, new grad have to take responsibility in their own learning. Micromanaging their progress will only enable them to rely on others when they should be making autonomous decisions.

  4. Resi

    thank you for this post! I am a new grad and will be starting my new job soon and I know I’ll have to deal with confidence issues. It’s something that I’ve always struggled with, but usually am able to overcome over time and with experience. Even with my final preceptorship in nursing school, having good support is essential! I had such a great preceptor, who seemed to understand my learning pace so I never felt too incompetent. Anyway, I will take your advice to heart once I start working as a new nurse! (:

  5. sue

    Thanks for this post! As a new grad and being in my 50′s I am feeling like I should be quicker to learn and basically have no confidence in my abilities right now. I guess my worst fear is that I’ll get a reputation for being stupid, and that bothers me. I just want to make sure I do things right and got very few days orientation. Unfortionately things in the real world aren’t the same as nursing school.