Dear Graduates: Here's How You Can Overcome Your New Nurse Anxiety

Keith Carlson, RN, BSN, NC-BC - 03/14/19

When a new graduate enters the nursing workforce, anxiety can be overwhelming. Since worries about harming a patient are understandable, how can new nurses cope with the feelings that keep them lying awake at night?

New Grad Support is Key

With the exception of those lucky enough to enter robust internship programs, new grads have a tough journey to proficiency and confident practice. For those who are left to sink or swim on their own, fear can be debilitating.

In high-tech and acute situations, the stakes get even higher and worries about mistakes more powerful. New nurses need keen support to succeed, and only some are blessed enough to get what they truly deserve.

All nurses must remember that they too were once novices, and while they may have been bullied or treated poorly, there is no reason to continue such treatment of the new nurses who are truly the future of the profession.

When a new grad steps into the workplace, they must arm themselves against fear and anxiety while also developing the communication skills to ask for what they need and demand respect, oversight, and high-level support.

Locus of Control, Fear, and Anxiety

For new nurses waking up in the middle of the night riddled with fear, overcoming that anxiety is crucial. First, new nurses need adequate rest in order to be at their best in their new positions. They must also realize that they can only do so much on their own and must also rely on the expertise of others for validation and guidance.

The concept of locus of controlis common in psychology. Those individuals with an internal locus of control put the pressure on themselves -- this can be simultaneously empowering and anxiety-producing since the person in question believes that they alone are responsible for everything they experience and will quickly blame themselves when things go south. The literature points to the belief that people with an internal locus of control are more likely to feel anxious.

For a person with an external locus of control, there may be an increased likelihood to feel a sense of powerlessness over outside circumstances and other people. Neither locus is wrong, per se– this is simply a framework for understanding the self in reaction to the environment.

New Nurse Self-Empowerment

New nurses have the right to competent supervision and to demand what they fail to receive. Granted, some employers are better at supporting new grads, and when new grad jobs are hard to land, nurses jump at whatever offers they receive in order to launch their new careers.

In order for the novice nurse to feel empowered to work hard and stave off unnecessary anxiety, there are many strategies to employ, including, but not limited to, the following:

  • Recognizing one’s habitual locus of control and making appropriate behavioral changes
  • Finding a skilled nurse mentor
  • Creating and nurturing a network of like-minded professionals
  • Leaving positions or employers where new grads are thrown into the fire
  • Speaking with other new grads online and offline to share survival strategies
  • Engaging a coach in order to boost confidence and learn coping techniques
  • Working with a skilled cognitive therapist or counselor who understands the management of anxiety
  • Meeting with nurse managers and leaders to communicate needs and worries
  • Learning the technical skills and proficiencies that can increase competence and confidence
  • Seeking out internship programs that truly support new nurses’ success
  • Finding supportive allies within the workplace
  • Learning cognitive strategies for leaving work at work
  • Examining the appropriateness of one’s choice of clinical milieu and whether it’s a good fit for the nurse’s personality and goals
  • Joining nursing associations and organizations friendly to new grads
  • Attending conferences and seminars that strengthen skills and knowledge

New nurses must be willing to speak up when their supervision needs are not being met. Being a novice can feel isolating in the best of circumstances, so new graduates need an understanding community in order to truly succeed.

Self-empowerment and a deeper understanding of one’s own motivations and fears is essential to making internal psychological change. Early career success relies on feeling stronger in a new and sometimes scary role with great responsibility, often involving life-and-death decisions.

New graduate nurses are in a unique position to create the careers they truly want by overcoming anxiety and digging deep into their burgeoning professional life. Overcoming anxiety and reaching towards competence and expertise are made easier when the new nurse knows what he or she wants and takes inspired action to achieve it.