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The transition from clinical placements to full-time employment as a graduate nurse can be a daunting milestone in your nursing career.
Reflecting on my own transition, the feeling of excitement of officially entering the workforce is undeniable, however, there were also feelings of uncertainty and fear that arose.
Who wrote this Guide?
I’m a nurse educator at Ausmed, with seven years of nursing experience across both acute care and specialty areas. I started my career in various acute settings before transitioning into cosmetic nursing, which is now my area of focus. However, one of my most formative experiences in my career was during my graduate year, particularly my time in the haemodialysis rotation. I had no prior experience in this area, but the challenge of learning and adapting was invaluable, and it shaped me into the nurse I am today. I transitioned into a role at Ausmed because I truly believe that education can make a significant difference in a nurse’s career. I am passionate about sharing my experiences and insights to help new graduate nurses navigate their transition into full-time employment.
In clinical placements, we are guided closely and have more direct supervision. In contrast, full-time employment comes with greater responsibility, autonomy and the need to make critical decisions on a daily basis.
It is normal to feel overwhelmed by the challenges that come with this shift (excuse the pun), and it is important to know that these feelings are part of the growth process.
While the road ahead may feel scary or stressful at times, know that you are not alone. Every experienced nurse has been in your shoes, and there are numerous resources and support systems in place to help you navigate this transition with confidence.
In this guide, we will explore some differences and similarities between clinical placements and full-time employment to help you thrive in your new position as a graduate nurse.
In clinical placements, nursing students often work under close supervision with buddy nurses who provide guidance and support throughout the placement.
However, as a full-time nurse, I quickly took on greater responsibilities for patient care. This included planning out my own shift, prioritising patient care and working more autonomously.
Whilst this newfound independence can be empowering, it can also be a big adjustment, especially when managing multiple patients with diverse needs.
Many new graduate nurses feel a sense of pressure as they transition to being “in charge” of their own workday, and that is completely normal. The key is to remember that it’s okay to ask questions, seek clarification from your colleagues or double-check your decisions when unsure.
Confidence comes with experience which will come over time. Don’t be afraid to lean on your team for support!
During clinical placements, nursing students often have a lower patient load as they care for fewer patients and work in a more controlled environment designed for learning.
The emphasis is more on developing clinical skills, building confidence and observing the nuances of patient care under supervision.
However, as a graduate nurse, while the number of patients may not have drastically changed, the workload often feels heavier because you are now responsible for managing your patient load more independently.
The shift to handling tasks on your own, such as prioritising care, managing medications and completing assessments, can quickly add up, making the workload feel more demanding, even if the patient numbers remain the same.
When managing a heavier workload, I made sure to organise and prioritise my tasks effectively by breaking down the tasks into manageable chunks and focusing on more urgent tasks.
Again, do not hesitate to ask for support when necessary, whether from your colleagues or nurse manager. Over time, you will learn to develop your own strategies that allow you to navigate your shifts more efficiently.
During clinical placements, nursing students typically follow a more structured schedule, often working Monday through Friday with no night shifts.
This provides a relatively predictable work-life balance, allowing students to plan their personal lives in advance.
However, as a graduate nurse, the reality of full-time employment came with the need to adapt to shift work, which can include 8- or 12-hour shifts, weekends and nights.
I personally found adjusting to this new schedule challenging, especially when managing late-night shifts or irregular hours. It’s important to prioritise self-care and establish a routine that supports your physical and mental well-being as the rosters do come out in advance.
I found ways to manage my energy, such as if I had a few night shifts coming up I would prepare a day before to adjust my sleep schedule, what I had for meals and meal time to ensure I was ready for night shifts.
For example, I often get tired after having a carbohydrate-heavy meal, so I would avoid having such meals during my night shift.
Everyone has their own way of adapting to shift schedules so find what works best for you!
Clinical placements are typically organised by the university, and therefore, students may not have the opportunity to select which area they would like to work in.
However for a graduate year, you can express preferences for the areas you’d like to work in. Unfortunately, not all graduate nurses will get their choice or may find themselves in specialities they haven’t worked in before.
I myself have gone through this as I was placed in a gastrointestinal surgical ward which was not a preference nor an area I had worked in before and it was daunting at first.
Whilst the shift may feel unsettling, it’s an important part of your professional growth. The diverse rotations are designed to expand your skills and knowledge and expose you to a range of different nursing specialties.
One key piece of advice is to fully utilise the study days provided during your graduate year.
These days are valuable resources for revisiting or learning new concepts you may feel less confident about. Use this time to prepare for upcoming shifts, refresh your knowledge and feel more equipped to face new challenges.
During clinical placements, nursing students primarily practice and build foundational skills under the guidance of their buddy nurses (preceptors) and the focus is more on developing technical competence.
However, when transitioning into full-time employment, the focus shifts to actively developing your professional identity as a nurse.
When I became a graduate nurse, I found myself unsure about my role on the team, especially when interacting with senior staff or even patients.
Professional identity is more than just technical skills, but understanding your own values and how you approach patient care and interact with your colleagues.
While it’s easy to feel like you need to adopt a particular persona to “fit in,” I think it’s important to remember that authenticity is a strength. Embrace your individuality, whether it’s your communication style or your approach to patient care and build confidence in your own professional identity.
When you are more confident in who you are as a nurse, it will show in your skills and interactions.
Also, remember that mistakes are part of the journey, and it's through them that you'll learn and grow. Don’t be hard on yourself when they happen - one mistake does not diminish your skills or your potential as a nurse.
Be patient with yourself, seek constructive feedback and use it as an opportunity to grow.
Throughout clinical placements, nursing students are exposed to stress and emotional challenges in a controlled learning environment.
While I still encountered emotionally difficult situations, such as witnessing a patient's decline or experiencing moments of patient distress, I always had a buddy nurse or mentor to lean on.
This support made it easier to process these experiences, knowing I had someone to talk to and guide me.
However, when I transitioned to a full-time employee as a graduate nurse and began working more independently, it did feel harder to reach out for support. The emotional stakes felt higher, and I found myself more emotionally invested in my patients as I was more directly responsible for their care.
Managing situations like critical illness, end-of-life care, or patient loss, experiences that are challenging and personal felt more intense without the same level of immediate support. These situations can be particularly difficult when you’ve formed bonds with patients and their families.
Building emotional resilience is crucial as you learn to process and cope with these experiences. It’s normal to feel overwhelmed or emotionally drained, but remember, emotional resilience doesn’t mean being unaffected, it means learning how to recover, reflect and seek support when needed.
During both placements and your graduate year, it’s important to acknowledge the emotional toll nursing can take, and not shy away from seeking help when necessary. I found debriefing with colleagues, mentors, managers and even mental health professionals helped significantly when dealing with these emotional challenges.
During clinical placements, one of the biggest benefits is the direct mentorship from preceptors and buddy nurses.
They provide regular feedback and are readily available for guidance that helps navigate the learning process in a structured, supportive environment. This consistent support allows students to build their confidence and skills.
However, once you transition into full-time employment as a graduate nurse, the support system shifts. While help is still available, it tends to be less formal and immediate feedback isn’t always present.
I had to be more proactive when seeking guidance or support. However, one key element that became especially important during this time was connecting with my fellow graduate nurses.
As peers, they have likely or might be going through a similar situation. Talking with other graduates allows you to share experiences, exchange advice and provide emotional support to one another whilst being less intimidating to approach.
Often, having someone who understands exactly what you’re going through can be incredibly reassuring. Don’t hesitate to reach out to them, whether for practical advice about handling a tough shift, or simply to talk through the emotional challenges that come with the job.
Building a strong network with your fellow graduate nurses can provide invaluable support during your transition, helping you feel less isolated and more empowered.
During clinical placements, we would typically need to have filled out evaluations to take back to the university for grading.
In addition, feedback is typically more frequent and given in real time due to the buddy system nature of clinical placements.
However, I found that in full-time employment as a graduate nurse, the feedback process is a little different. Whilst feedback can still be obtained informally, performance evaluations become more formal and structured and can feel more daunting.
At first, I felt uneasy about these evaluations. As a new graduate, I worried that being evaluated again would feel like being treated as a student nurse, especially when I thought I should already "know" everything as a nurse.
However, I quickly realised that performance evaluations aren't tests or exams, they are essential for professional growth.
Rather than judging my abilities, these evaluations provided an opportunity for reflection, allowing me to learn from my mistakes, build on my strengths and develop new skills.
Rather than highlighting my shortcomings, evaluations were a way to evaluate which areas I needed more support in.
As mentioned earlier, it’s okay to make mistakes, and these evaluations are not just for a grade, but to help identify areas where additional support or guidance may be needed.
In both clinical placements and full-time employment, communication with a multidisciplinary team is essential to providing comprehensive patient care.
During my placements, I had already received a glimpse of how to work with doctors, allied health professionals and other health care professionals. But in my graduate year, I took on more responsibility in coordinating care and communicating effectively with these team members.
One of the biggest learning curves I faced was knowing whom to speak to and how to communicate a concern, particularly to the medical team.
It’s not just about relaying information but about presenting it clearly and concisely to ensure optimal care for the patient.
Some other tips on communication:
Building confidence in these interactions takes time, and if you need help, never be afraid to ask.
Transitioning from student to graduate nurse is challenging and there’s a lot to learn in a short period of time. Here’s some advice I wish I had heard during my graduate year:
Embarking on your journey from clinical placements to full-time nursing is a significant step. It's natural to feel a mix of excitement and apprehension. Remember that this transition, while challenging, is a normal part of professional growth. By acknowledging the differences, seeking support, and prioritising self-care, you can successfully navigate this exciting new chapter and flourish in your nursing career.
Go well!
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