When I work with new graduate nurses, we always ask what they are most excited about, but also what they are most afraid of as they step into practice. The answer to that second question is almost always some version of safety.

They’re afraid they’ll miss something. They’re afraid they’ll administer medication incorrectly. They’re afraid they’ll fail to recognize deterioration. They’re afraid they’ll harm someone.

Why are these such common concerns? Because it is the nurse at the point of care, carrying out orders and holding the system together at 2 a.m. They are often the last line of defense against a system that can, at times, be setting them up for failure. If an error isn’t caught in those final checks, the wrong medication, ordered by a provider and approved by a pharmacist, reaches the patient. And it is the nurse who feels the very real weight of that moment, even when the error was shaped by a long line of system failures.

What don’t I hear as often? New nurses rarely lead with fear about contracting an illness. They don’t usually start with, “I’m worried I’ll get hurt lifting a patient.” And they don’t always name their fears about bullying, retaliation, or being shut down for asking questions. Even though those forms of safety are there, shaping how they show up, whether they name them or not.

In my recent conversation with Dr. Heidi Gilroy on the Beyond Nurse Residency podcast, we talked about safety as an ingredient for engagement. She shared three types of safety that influence how nurses experience practice: physical safety, psychological safety, and professional safety.

Physical safety includes the conditions that protect the body. Think equipment, infection control, workplace violence prevention. Psychological safety is what allows someone to say, “Can you double-check this with me?” or “Something doesn’t feel right,” without fear of embarrassment or punishment. But after our discussion, it was professional safety that seemed closest to what new nurses were trying to describe. It’s the sense that I have what I need to do this work safely here.  

So how do we help nurses feel more safe in that space? We talked about one part of professional safety being internal, related to competence. It builds over time through repetition, experience, and eventually mastery. But that’s only part of the story. Professional safety is also shaped externally. As Dr. Gilroy shared, it is influenced by the systems, relationships, and expectations that surround the nurse.

Which raises an important question: what are we building around new graduates that actually makes safety possible?

Infrastructure is one part of that answer. This is something we’ve talked about as a key contributor to engagement, but it is just as central to safety. Clear workflows, consistent expectations, accessible resources, and reliable support all matter. Infrastructure is what allows a nurse to know what to do, when to do it, and what will happen next. Without it, even a clinically competent nurse can feel unsafe.

We also talked about the work environment as well, one where expectations are clear and consistently applied. Where feedback is direct enough to be useful, but constructive enough to support learning. Where boundaries are held in a way that reduces confusion rather than creating it. When those elements are inconsistent, the environment starts to feel unpredictable, and that unpredictability erodes safety.  

So when a new nurse says, “I just want to be safe,” while it can sound like fear of making a mistake, I think they are talking about something much bigger. It’s about their need for systems that are reliable, expectations that are clear, and an environment that supports them as they grow into their practice.

If these ideas resonate, check out my latest conversation with Dr. Heidi Gilroy on the Beyond Nurse Residency podcast. 

Listen to the episode with Dr. Heidi Gilroy

Nicole Weathers, DNP, RN, NPD-BC 
Iowa Online Nurse Residency Program Director 
nicole-weathers@uiowa.edu
Wanting a Program Overview? Need to schedule a meeting? Book time with Nicole 
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