New Graduate Nurses: We're Not in Kansas Anymore
With the lovely winter weather that 2019 has brought us, we’ve had a lot of quality time indoors. This past weekend my kids and I settled into another fun afternoon of being stuck inside due to the drastically low temperatures. While looking for something to watch, we stumble upon the classic movie The Wizard of Oz. I am sure I am not the first person to realize that this movie provides a fantastic metaphor for new graduate nurses transitioning to practice.
If you recall from the classic 1939 film, Dorothy finds herself, despite her best efforts, not fitting into her life on the farm and she doesn’t feel her aunt and uncle understand her. She yearns for something more - possibly something ‘somewhere over the rainbow’. When Dorothy finds herself in the Land of Oz (clinical practice) after a tornado (nursing school) landed her there, all she wants is to return home to Kansas (dream job). Glinda, the Good Witch of the North (residency coordinator), shares with Dorothy that in order to see the Wizard, who will hopefully grant her heart’s desire which is to go home (dream job), she must ‘follow the yellow brick road’ and gives her the ruby slippers to wear along the way.
Throughout Dorothy’s journey down the yellow brick road, she meets a trio of unlikely characters, a scarecrow who believes he doesn’t have a brain, a tin man without a heart, and a cowardly lion who acts big and tough, but is really scared on the inside. It dawned on me that these three characters might just represent behaviors that a new graduate nurse must obtain to excel in the profession. You see, to be a great nurse, the nurse that most nursing school students dream of becoming, you must have each of the characteristics depicted in this movie. Courage, compassion, brains, and maybe most importantly for new graduate nurses, the ability to persevere despite difficult circumstances.
Scarecrow – If I only had a brain …
The scarecrow believed he didn’t have a brain. He tells Dorothy he is anxious, self-conscious, and insecure because he is just a scarecrow without a brain. Many new nurses start out thinking they don’t know enough. They can be anxious, self-conscious, and insecure because of their limited experience.
Tin Man – If I only had a heart …
The tin man had a dark past that left him to live as a recluse in the woods until he rusted in the rain. Being rusted in place, he was given time to think, and he decided he wanted to live and love again. New nurses can find they feel very isolated. They often feel like they are all alone and the only one struggling with their transition to practice. They might ‘toughen their skin’ in an effort to blend in with their more experienced co-workers.
Cowardly Lion – If I only had courage …
When Dorothy meets the lion, he initially tries to attack the group but was immediately put into place by Dorothy saying he is nothing but a big coward. The lion admits that he is a coward and while he is supposed to be king of the forest, every time there is danger his heart beats fast and he feels like a fraud. Fear is a common feeling for new graduate nurses. They fear they don’t know enough, they lack confidence, and they can be hesitant to step into unfamiliar territory.
Dorothy was able to overcome many trials faced along the way with the help of the scarecrow’s good sense, the tin man’s kindness, and the bravery of the lion. The anxious scarecrow didn’t think he had a brain, but his knowledge expanded with each new challenge he came up against. The tin man believed he didn’t have a heart, but responds with great compassion when things get difficult. The lion believed he lacked courage, but grew his confidence and courage with each new encounter and challenge that came about. Are you seeing the resemblance?
This is a great reminder to the new nurse that during the first year of practice, they may feel like they don’t know enough, they are going to be unnecessarily hard on themselves and possibly others around them, and will feel inadequate and uncertain. They might find themselves wishing they could wake up where the troubles of the first year of nursing are behind them, but unfortunately, they must make their way through that first year to get to (the) Emerald City.
All Dorothy wanted to do was get back home. She had to have faith that by following the yellow brick road, she would get to (the) Emerald City, find the Wizard of Oz and get where she wanted to go. When she gets there, however, she finds that the ruby slippers provided her at the beginning had all the power she needed to get where she wanted to go, she just didn’t know how to use it.
The story of The Wizard of Oz isn’t just about what you see on the surface. Its underlying meaning is about self-discovery. For most, the first year of nursing is also about self-discovery. It’s about learning how to use the knowledge gained in nursing school. It’s about learning to have compassion for patients, co-workers, and maybe most importantly themselves. It’s about learning to have the courage to admit when you don’t know something, to stand up for what you believe in, ask for constructive feedback, trust your intuition, and challenge the status quo. New nurses must discover for themselves through their clinical experience and reflection on their experiences that they have knowledge, passion, and courage to be the nurse they want to be. Just like the foursome in the movie, many already have all the qualities they need to be competent, but they must develop and discover them. And just like Dorothy, the new nurse will only come to believe they are the nurse they always wanted to be by rising to the challenges experienced during that first year and developing those qualities and behaviors into the foundation of their nursing identity.
It is not uncommon that new nurses don’t understand the power of a nurse residency program. It isn’t just one more thing that you are wanting the new nurse to do, but instead the ruby slippers, the power to be set up for a successful future. While there will be several other powerful characters that new nurses will meet throughout their first year that can be encouraging and point the way, no one can do it for them. They must go through the journey down the yellow brick road. Once a nurse gets through their transition-to-practice, the self-doubt subsides, confidence soars, and their passion shines, nothing can hold them back. With just the click of the heels, the new nurse can find themselves right where they belong.
Program Manager, IONRP