Three must-know myths about new graduate nurses

Clinical Nurse Executive Tammy Purcell, MSN, RNC-OB talks to us about myths surrounding new nurse residency programs and why these nurses can struggle as they transition to practice.

MYTH #1 — New nurses are perfectly positioned to recognize and treat life threatening conditions

“Tammy, thanks for speaking with us, and I want to start by exploring our first myth, and this is that new nurses are perfectly positioned to recognize and treat life threatening conditions. Fact or fiction?”

Tammy Purcell: “Thank you—and good to talk with you too. Unfortunately, I’d have to say ‘fiction.’ It’s actually pretty common for new grad nurses to miss life threatening conditions. In one study, 50% of new graduate nurses said they would not recognize life-threatening complications—that's frightening [1].

It’s a significant number, and one that suggests that new nurses just don't have enough practical experience with direct patient care to pick up on the subtle changes in a patient condition, and so they end up missing the big picture, and they miss these subtle changes, which causes the patient to decline.”

MYTH #2 — New grad nurses arrive full of confidence on day 1

“What about the idea that new grad nurses arrive full of confidence on day 1? Would you say that’s generally true?”

Tammy Purcell: “Unfortunately, I think that’s a myth too. Confidence levels among new nurses can vary wildly—in fact, there’s a 2020 survey that found that 56% of new graduate nurses lack confidence in their abilities [2].

I think there’s the fear of making a mistake. In the quiet, after their shift, they often begin to think about things they might have missed and second guess their own expertise —it just takes time for them to begin to trust their own ability and judgement.”

MYTH #3 — The COVID-19 pandemic is over.

“Thank you, Tammy. And lastly, how would you respond to this statement? The COVID-19 pandemic is over.”

Tammy Purcell: “That is most definitely a myth. The effects of the pandemic are still shaking up the nursing world. Think about nursing schools—they were completely disrupted. For those students, clinical experience basically came to a standstill and now many of those nurses are on the frontlines caring for patients. Also, think about turnover—COVID-19 continues to be a huge problem. In fact, the average new grad nurse turnover rate is around 35% [3].

Another big change related to the pandemic has been the significant increase in travel nursing. During the pandemic, we have seen absolutely off-the- charts hourly rates and bonuses paid to travel nurses, so taking a travel assignment can be very tempting. There are huge incentives for nurses with very limited experience. That can result in less experienced nurses caring for more complex patients which puts both patients and nurses at higher risk.”

References

1. Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B., Fogg, L., & Alexander, M. (2015). Transition to practice in hospital settings. Journal of Nursing Regulation, 5(4), 24-38.

2. Pulse on the Nation’s Nurses COVID-19 Survey Series: Mental Health and Wellness, American Nurses Association, July 2020.

3. Windey, M., Lawrence, C., Guthrie, K., Weeks, D., Sullo, E., & Chapa, D. (2015). A Systematic Review on Interventions Supporting Preceptor Development. Journal for Nurses in Professional Development, 31(6), 312-323.