Managing New Graduate Fear and Anxiety

By Rose O. Sherman, EdD, RN, NEA-BC, FAA

I have recently spoken with two classes of senior nursing students who will transition into practice in the next few months. The good news is for them is that jobs are plentiful in most specialty areas. The not-so-good news is that this is probably one of the most challenging times for new graduates to transition into professional practice. I use the metaphor for this year’s graduates because it is like going on vacation to a Caribbean island right after a Category 4 or 5 hurricane. Even if your hotel is completely operational, you will see the stress and the fatigue that the storm caused the employees and island residents.

There is no way around it. The nursing workforce today is a different workforce than it was pre-COVID. Many nurses are exhausted and suffer from burnout. There are rising levels of disengagement, and turnover is skyrocketing. Finding engaged preceptors for these new nurses will be difficult in some settings. Many of these new graduates have had much of their clinical time in simulation versus practice settings. Nurse leaders see noticeable skill gaps. When I ask them what they are most concerned about – they tell me that they worry about getting the support they need as they transition into practice. Their fear and anxiety were evident to me.

Most of these new graduates will either be Generation Z (born between 1997 and 2015) or younger Millennials (1990-1996). Even pre-COVID, data from the American Psychological Association indicates that younger Millennials and the Generational Z cohort reported far lower baselines of excellent or very good mental health. Data from a large sample participating in the NurseWellbeingAtRisk-Final2020-web indicates that Generation Z nurses were the most likely (57.3%) to report that COVID-19 negatively impacted their overall well-being. Gen Z was also the least likely (only 23.5%) to report effectively managing work-related stress and anxiety or to decompress after work (only 19.2% could). The rising levels of fear and anxiety among younger populations have also been linked to social media. In the highly acclaimed documentary Social Dilemma, researchers reported correlations between lowered mental among Generation Z and the widespread introduction of social media sites in the early 1990s.

These new graduates are at high risk for emotional problems when placed in stressful environments without support. It will be important to build content and stress debriefing into transition programs to help these new nurses manage their fear and anxiety. New data from Gallup indicates that well-being initiatives can also be an important differentiator for both recruitment and retention with these generational cohorts. So what should organizations do? I recently co-authored an article for The American Nurse Today that ANA has now offered as an open-access manuscript. Readers are finding it to be beneficial. You can link to the article here, and be sure to share it with your residency coordinators. Coordinators.

The fallout of untreated stress, anxiety, and depression in the nursing workforce has serious long-term consequences, so all of us should try to be proactive in our efforts.

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