Reality Shock: What They Didn’t Teach You in Nursing School

Reality shock is something that you may have heard about in nursing school, but know very little about. Most nursing programs do not adequately prepare their students with coping mechanisms to effectively manage each phase of reality shock. 

Once you start your new job as a nurse, having straight A’s or being the most popular student among your professors won’t matter. You’ll have to establish credibility among all your new colleagues and that’s not an easy task. In fact, it can be shocking and quite intimidating.

Let’s discuss what reality shock is, and tips for managing each phase.

The Four Phases of Reality Shock In Nursing

The idea of reality shock is applied to those who are new to the nursing profession or new to a nursing speciality, where they go through a learning and growing transition. This process has four phases: honeymoon, shock, recovery, and resolution.

 

Honeymoon Phase

The honeymoon phase is a period of excitement for new graduates. You may be very excited to be joining the profession and find yourself eager to learn as much as possible. You will be guided by your desire to do your very best and become confident in your new roles and responsibilities. 

Tip: It is important to establish working relationships where trust and respect are demonstrated between you and your preceptors during this phase. This will help to minimize complications in the following phases of reality shock.

 

Shock Phase

The new nurse is the most vulnerable in the second phase – the shock phase, as this is when negative feelings towards your new role may surface. This is often when the new nurse realizes that the expectation of their new role is inconsistent with the day-to-day responsibilities and work flow. When nurses find themselves in the shock phase, they are at risk to quit, leave their unit, or experience burn out.

Tip: Critical strategies to ease through the shock phase include: finding a mentor for guidance, taking care of yourself physically and emotionally, being sure to get adequate sleep, eating a balanced diet, exercising regularly and having fun with family and friends. It is also essential that you develop a strong support network, and workplace buddies that have your back.

 

Recovery Phase

During the recovery phase, new nurses begin an upward climb back to the positive side. Now able to  consider all sides of your new role as a nurse, you will begin to see the job realities with a more open perspective. You can begin to accept the challenges of your day-to-day responsibilities, and find creative solutions to barriers in providing safe and effective nursing care. 

Tip: To ensure that you do not move back to the shock phase, it is important to seek out constructive criticism, and let your preceptors and mentors know where you are having trouble adjusting. Seek out clarification, and be sure to always work within your limitations. Don’t be afraid to admit that you don’t know. Once you become confident in your roles and responsibilities, you will move to the resolution phase. 

 

Resolution Phase

The fourth and final stage, which is typically after one year of nursing experience, is the resolution phase. During the resolution phase the nurse fully understands their role and fully contributes to the delivery of safe and effective patient care. 

Tip: It is important that you continue to focus on the positive aspects of your job in order to maintain ongoing satisfaction and career success. Engage in continuing education by earning an advanced degree, or becoming certified. When you remain engaged in your own professional development, you are sure to find fulfillment within the nursing profession. 

 

Here are some additional coping skills that you may find helpful as you transition into your new role as a nurse:

Focus on mastering your skills

Making sure that your nursing skills are being performed in the way that follows facility and state regulations will help you to avoid mistakes and help to build confidence. The first six months to a year is an important time for you to work on improving your ability to perform all client care and administrative skills independently, thus boosting your confidence and satisfaction within your new role.

Seek Guidance from experienced nurses 

Just because you finished orientation at your new job does not mean that you are all alone in providing client care. In fact, nursing is always a team effort, and you are encouraged to seek guidance and resource experienced nursing staff to help you when you need it.

When juggling the complex treatments, and patient care of today’s healthcare system, we all rely on one another to deliver the safest and most effective client care possible. Be sure to identify your learning needs as they arise and seek the expert guidance you will need to feel confident in your roles and responsibilities.

Find a nursing specialty that fits 

Not all nursing specialty areas are created equal. The expectations and responsibilities of nurses in an emergency department are very different than those of a medical-surgical unit. In many cases, new graduate nurses are eager to begin working and accept the first specialty that they are offered.

In the event that you find yourself really struggling with the specialty you are working in, be sure to discuss your concerns with your supervisor before deciding to quit. They will be able to identify your struggles and may offer effective coping strategies and/or specialty alternatives accordingly. Switching specialties within the first six months to a year is quite common, and many times healthcare facilities will accommodate your requests to keep you on staff.

We hope that these tips for managing reality shock help you as you transition from student nurse to professional nurse. If you have any additional tips you’d like to share, please leave your thoughts in the comments section below!