Accountable Healthcare - 10 Tips for Starting Your Nursing Job off Right
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May 26, 2021

10 Tips for Starting Your Nursing Job off Right

Acknowledge Informal Leaders

Find out who the informal leaders are. There are informal leaders on every work unit. Informal leaders can be a peer or a subordinate and do not hold formal leadership titles. Nonetheless, they do hold influence and referent power. They are often top performers and have organizational expertise.

Evelyn has been a unit secretary on her nursing unit for 11 years. If she likes you, she can help you in countless ways. She can call to get a stat diet tray for a patient, or pull an extra pen out of her drawer when you have lost all three of the pens you brought to work. She knows to call Eddy in IT on his cell and not Greg on the main extension to get a computer fixed.  She can unjam the copy machine when no one else can, and can even persuade nurses to come in and work extra.

Informal leaders generally want acknowledgment and respect, and then they will be loyal and helpful coworkers. Acknowledge Evelyn and make friends with her.

Be Organizationally Savvy

Not many nurses enjoy politics. Politics are basically about work relationships and power. Some nurses consider it a  badge of honor to remain naive about organizational politics. But being savvy doesn’t mean you have to play politics, it means you understand how decisions are made that influence you,  your coworkers, and your patients.

Understanding how your work unit fits into the larger organization provides context and perspective.  It’s wise to familiarize yourself with the org chart at your facility.

Who does your manager report to, and whom does that person report to? In hospitals, most nurses fall under the department of nursing, but not always. For example, Surgery and outpatient area nurses may fall under a non-nursing department and executive leader. In that case, it can be harder to advance nursing agendas.

Some managers are  more influential than others if their department is large or generates more revenue. Those managers are likely to have more resources at their disposal, and are better able to influence policy.

Who are the movers and shakers? Is there nepotism? It’s quite helpful to know that the new nursing assistant, Amy, is the niece of your director.

Know When to be Right and When to Let it go

When is it wrong to be right? It’s wrong when someone doesn’t know when to let something go, or when he or she perseverates on a minor point.  The person who insists on being right to prove that they are smarter than others…. is not relationship smart.

During orientation, a new employee, Steve, makes edits to the handouts he was given, correcting the grammar and sentence structure. On the last day of orientation, he returned the handouts to the instructor, complete with his corrections and suggestions for improvements.  Was he right or was he wrong? Yes.

What’s Important to Your Boss is Important to You

In your relationship with your boss, your work efforts must align with your boss’s agenda. If patient satisfaction scores are the priority for your boss at the moment, then patient satisfaction scores must be your priority as well.  Likewise, if VTE prophylaxis must be documented a particular way, it doesn’t mean that your priority of spending time with patients is not important. It means that your organization’s leadership has determined that certain things need to be done a certain way to stay in business, to succeed more in business, or to meet regulations.

Listen to your boss to learn what he/she values. People repeat important things. The rule of threes says that if someone repeats something three times in a conversation, then it is highly important to them.

Helping your boss succeed is smart and will not go unnoticed.


It’s important, especially when new on a  job, to graciously accept social invitations and get to know your co-workers. This shows that you value them and want to get to know them.

Be careful not to get overly comfortable in social situations outside of work and say things your normally wouldn’t. Never gossip in a misdirected effort to quick-bond with coworkers. Maintain relationship boundaries that are comfortable for you.

Get involved with organizationally sponsored activities, as you will be seen as an engaged employee.

Avoid Drama

Identify and steer clear of the drama people.

Ashlee is new on the unit and her preceptor is known to be curt. One day Ashlee’s preceptor speaks to Ashlee somewhat sharply in the nurses’ station. Another nurse, Jena, overhears the encounter and later approaches Ashlee. “I saw how she treated you. She runs people off the unit all the time. Don’t put up with that”

Jena is attempting to befriend Ashley by bonding with her against the preceptor.

Be aware of people who take you into their confidence inappropriately or try to establish an emotional connection prematurely. They are acting out of their own neediness, and not on your behalf.

Be polite and friendly, but don’t be manipulated.

Emotional IQ

Emotional IQ (EQ) is the ability to recognize your own and others emotions and is important in healthy work relationships.

Be aware of your own triggers and manage your emotions professionally at work. When a certain patient or coworker pushes your buttons, you have an opportunity to learn more about yourself and manage your responses.

Network: Professional Relationships

Anybody could be laid off at any time without warning and most nurses change jobs several times over their career. Never get so comfortable that you forget to network.

Are you keeping track of your accomplishments, such as sitting on a committee, or working on a performance improvement project? If not, you will forget them when you go to update your resume later. Keep your resume current, and I recommend an online portfolio such as Staff Garden. As a bonus:

Are you on LinkedIn and social networks? Join a local chapter of a nursing organization and purpose to meet other nurses.

Relationships trump resumes when it comes to getting jobs.

Be Positive

Smile and make eye contact. Do not complain about work as the negativity will stick to you, not the subject or topic. Knowing how to express that your frustration at work and asking for what you need without spilling over into anger is a needed skill.

Focus on yourself and your own work and not others.

Choose your attitude at work- choose happiness.

Handling Setbacks and Rejection and Constructive Criticism

Our worst traits come out under stress. People are looking to see how you respond to conflict and constructive criticism. Thank others who give you constructive feedback, and take it under consideration. Remain even keeled and professional.

Your relationship with yourself may be the most important. Learn from your mistakes, but don’t identify with your mistake and become paralyzed. In life everyone makes mistakes but people who succeed are able to forgive themselves and put them in the rearview mirror.

These are 10 Tips for Starting Your Nursing Job off Right.  I hope these tips help you to be the best you can be and succeed in your career.

Article By: Beth Hawkes