New grad nursing—From surviving to thriving in the ICU

Nursing isn’t just a job; it’s a calling. Many chose their calling in the midst of the COVID-19 pandemic. I started nursing school in 2019, and just a few short months later the world shut down as the World Health Organization (WHO) declared COVID-19 a global pandemic. Fast forward 2 years to my first day of work as an intensive care unit (ICU) nurse, feeling woefully unprepared for the demands and expectations of an environment in flux.

Perhaps drowning is too strong a metaphor. However, for many months, I was barely treading water. In other words, I merely survived my shifts.

New graduate nurses had the same transition to practice woes as previous generations with the added complexity of navigating nursing during the peak of the pandemic and the forever changed landscape of healthcare. Researcher, storyteller, and podcaster Brené Brown defines vulnerability as “uncertainty, risk, and emotional exposure.” These characteristics of vulnerability perfectly describe the experience of new graduate nurses in the ICU during their transition to practice. Rather than viewing vulnerability as a weakness, vulnerability is an uncomfortable element of authentically connecting with both self and others. Arguably speaking, embracing vulnerability was essential to my success as a new graduate ICU nurse, especially in the midst of the pandemic. By embracing vulnerability, my new graduate colleagues and I transitioned from merely surviving to thriving.

Vulnerability roadblocks

To embrace vulnerability, I first asked myself, “What stops me from being vulnerable?” My colleagues and I faced the harsh realities of being new graduate nurses dealing with historically high turnover rates and staffing shortages. More specifically, at the beginning of the pandemic, we were uniquely isolated when starting our careers due to the shutdown of nonessential services, decreased travel resulting in reduced social connection, and virtual delivery of hospital orientation.

Uncertainty is uncomfortable. Taking a risk is uncomfortable. Emotional exposure is uncomfortable. In other words, vulnerability is uncomfortable, but essential to human connection. We can’t choose whether we want vulnerability; we choose how deeply we embrace it and how we use it as a strength. As nurses, we connect with both each other and our patients to provide the compassionate care that defines our profession. To embrace the uncertainty, risk, and emotional exposure that are part of the everyday experience of new graduate nurses takes immense courage. To be courageous takes strength. Therefore, embracing vulnerability is strength.

Seek feedback

Having acknowledged the roadblocks to vulnerability and embraced the discomfort of vulnerability, the key to success in moving from surviving to thriving as a new graduate nurse in the ICU was to seek feedback. The two most powerful statements a new graduate nurse can make are “I don’t know” and “I need help.” The truth of the matter is that I found myself making those statements more often than not.

Asking for feedback is an incredibly vulnerable process that takes courage and strength. Outside of meetings during orientation and annual reviews, many new graduate nurses didn’t receive additional feedback as unit managers struggled to address staffing shortages, attend numerous meetings, and tackle other pandemic-related issues.

Unit mentors, former preceptors, or even more experienced nurses were all ideal candidates for giving quality feedback. By being courageous enough to want the feedback and strong enough to endure both the positives and negatives, I adapted the feedback into my nursing practice. At a certain level, my colleagues and I shifted the unit culture to one that embraces providing and receiving feedback. Ultimately, this created a better work environment where staff at all levels sought continuous improvement.

The courage to be vulnerable and thrive

Thrust into the metaphorical deep end of the pool, new graduate ICU nurses felt as if they were drowning in the critical care concepts they didn’t learn in nursing school, drowning while applying these concepts to their very sick patients, and drowning in the attempt to find work-life balance.

I know this personally; I was that new grad.

Even without the COVID-related challenges, the learning curve for a new graduate ICU nurse is incredibly steep. Regardless of capstone clinical experiences and critical care classes in nursing school, successfully managing critically ill patients requires a degree of knowledge that can be learned only from repeated exposure. Yet, no new graduate nurse is perfect, nor are they expected to be. Anyone who has been a nurse long enough can clearly recount a mistake they made in the past. I gave myself the same compassion I give to my patients when mistakes inevitably occurred and learned from them. Having the courage to be imperfect is how I embraced vulnerability and transitioned to thriving in the ICU setting.

With the WHO declaring an end to COVID-19 as a global emergency in May, the landscape of healthcare forever changed. New graduate nurses who graduated and transitioned to practice during this period faced an unparalleled set of circumstances. Shortly after graduation, and new graduate nurses (including myself) were placed at the front lines of a global pandemic. We rose to the challenge and dove into the deep end. We dove into the uncertainty, risk, and emotional exposure of providing care to others with a poorly understood disease. Although we floundered at times, we eventually learned how to swim. And we ultimately embraced vulnerability to successfully transition from surviving to thriving as new graduate ICU nurses in the midst of the COVID-19 pandemic.

References

Brown B. Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. New York, NY: Gotham Books; 2012.

World Health Organization. Statement on the fifteenth meeting of the IHR (2005) Emergency Committee on the COVID-19 pandemic. May 5, 2023. who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic.

World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020.

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