Guiding New Graduate Nurses to Success

REGENIA: Hi there. I want to welcome you to The Heart of Health and Science podcast. I'm so excited about this episode today because we're talking to nurses who are newer to the field, newer to that front line and newer to that bedside care.

They'll be able to share what it's like to go from school into the profession of nursing and what it's like on a day-to-day basis to provide the excellent, high-quality care that nursing is known to provide. So, I want to welcome our guests to the show and allow them to introduce yourselves.

JASON: I'm Jason Roy, I graduated in 2024 from Park University. Happy to be here.

LIZZIE: I'm Lizzie. I graduated in 2023 from Park University as well. I'm also excited to be here.

REGENIA: You know my history in nursing. I've been a nurse for a very long time. That's as far as I'll go with that, but when I started, I went into critical care, where I worked for probably five years. I went in as a critical care float, so I was able to work in surgical, critical care, medical, ICU, and cardiovascular care. Then we had a stepdown unit, so I could be oriented and trained in all those areas, and I was well-rounded in that critical care.

Five years is not much time to gain experience in those areas, but we had a great support structure there, and I learned a lot after those five years. I went over to OB, and I was in high-risk OB at the time, then I wanted to go back to school. By that time, I had seen things that I thought we could do differently, such as documentation. There's a lot of documentation in nursing. We have to document the care we provide, and I saw a lot of duplicate documentation.

I was talking to someone in the break room, and I said, we're having to double document, we're having to, this and this and this; somebody should do something about it. And she said, well, you see it, and you see the solutions. Maybe you should do something about it.

And I just looked at her and thought, maybe she's right. So, I went back to school, earned a master's in nursing with a minor in administration, and went into a leadership role. I was able to get acclimated and oriented to the entirety of the hospital. I was oriented to the emergency department and worked there for a time in pediatrics and the NICU.

I got well-rounded in those areas, and I love everything about nursing. You know, you have this personal contact with the patients you would never otherwise have. No other field has the level of intimacy, if you will, with someone. We can help educate them about their health. We can help bring them back to a state of wellness as much as possible.

That's a bit about my story. Now, I’d like you to share your background, and what led you to nursing.

JASON: I came from a very nontraditional background. I didn't graduate high school and go to college with this dream of being a nurse. My parents are both nurses, and growing up, they were like, this is what you're going to do. This is what pays well, and that wasn't me. I rebelled a lot, didn't apply myself in school and ended up in the Marines.

So did some time in the Marines. It was an excellent way to grow up and gave me the tools I needed. I apply everything I learned from the Marine Corps to what I do now because my work ethic stems from that. So, I got out, and I wasn't sure where I would go with life.

And I still wasn't sure about healthcare, but something convinced me. My mom said you can work in Alaska on a crab boat because our cousin needs a person to work there. Or you can go to EMT school. And I was like, I'll go to EMT school.

And I loved it. I loved working in EMS. That was my first introduction to health care. And I realized that this was something I really enjoyed doing because, like you said, that intimacy of being able to help people is what really got me into it.

I worked 9-1-1 in Monterey County, California, and I loved it until I burned out. In healthcare, when you love something and work so much, you get to a point where you burn out. I was very aware of where things were going. I dreamed of being a paramedic working for San Francisco Fire and making money doing that.

In 2017, I went on a road trip from California to Ohio. And on the way to Dallas, a big hurricane hit Texas. So, all of Southeast Texas was flooded, and rather than going to Dallas, we decided to help out. And so that was my very first intro into relief work, like disaster relief.

My buddy and I decided to spend two days volunteering. We decided to do something useful since we are EMTs. He left after two days, but I stayed for a month. During that time, I did triage for the National Guard and set up a field hospital. I did water rescues with the Cajun Navy.

I did armed hotel security for this family because looting was going on, and this guy was like, hey, you're a veteran, and we're like, let's do that. So that lit a spark. I came home revitalized in healthcare because I was already burning out and looking for an outlet.

I want to do something more with that, and many of the nurses I worked with that month were like, don't be a firefighter, go be a nurse. Go to nursing school. I didn't think I was smart enough.

That December, I came home from a shift, and my parents handed me a manila envelope with the White House seal on it. I was awarded the Presidential Volunteer Service Award because of that. So, it's framed at my parent's house. I took that as a sign, right? I need to do something with this because this is a great thing that happened.

I quit working on the ambulance and did some relief work overseas. I worked with a bunch of nurses in Puerto Rico, Indonesia, the Virgin Islands and the Philippines. And when I came back in 2018, I told my parents I was going to nursing school. I started classes in 2020.

So, I ended up in Kansas City at Park University and worked through COVID. I worked as an EMT. We did a COVID deployment from Kansas City to New York. We drove our ambulances all the way to New York City. For a month, we did a FEMA deployment.

That was a crazy time, but it was like my Super Bowl because I've done everything possible as an EMT from relief work. And there wasn't one moment in that deployment where I didn't know what to do next. That solidified that nursing is where I need to have that fresh reset and apply everything I've learned to this.

I might be a new grad on paper, but I have a lot of healthcare experience, and that's how I got here. And I love it. I love what we get to do. I love the time we get with our patients because I'm so used to a 30-, 35-, and 45-minute pickup and drop off in the E.R. I now have 12 hours to see interventions play out. And that's the best part about this type of job.

REGENIA: When COVID first arrived, I was doing interim leadership work. I had contracts. I was working from one contract to the next. Typically, my contracts were extended wherever I was working, but then COVID surges started. Hospitals started really changing the way that they were doing business. They started shutting down elective surgeries, shutting down elective anything, and having people who had to be in the hospital, at the hospital, contracts disappeared. You know, all the needs were filled internally, and traveling stopped.

I got a call from New York saying we need someone to partner with our CNO because he works 20 hours a day. He's completely exhausted, and we need an experienced CNO to offset him. So, he would be working 12 hours of the day, and then I would relieve him and do 12 hours at night.

That way, they would have a CNO on site, and then we would do our handoff, which would be more seamless for them. And it was the hospital that had the big ship. Is that where you were?

JASON: Yeah, that was us. Watching documentaries about COVID in New York is funny because a lot of it focuses on the hospitals and what was happening. I was there but on the ambulance side. And so, we picked people up from their houses.

We had no PPE and ran out of Narcan. We were running out of oxygen bottles because of the number of times we were doing CPR. Buildings in New York don't have elevators that fit stretchers. We're carrying one of these people down flights of stairs.

But it was my proving ground because even though it was such a crazy, crazy time, I felt so confident in my skills. I want to get to that point in nursing where, you know, I see a patient, I see someone sick, I can figure out or work my way through a problem, and I look forward to getting to that point again.

REGENIA: Nursing is so amazing, actually. It gives you the foundation to do what you just described.

Wow. I had no idea that was your background. That was that's an amazing background. I was more of a traditional student. I did not have that until I married in the military. And then I was able to have different experiences through that. But certainly not those types of experience. I don't have a medal from the president. That's incredible. Congratulations.

JASON: Yeah, I wasn't expecting it. A lot of nursing is selfless. I didn't stay for a month because I wanted to get something out of it in order to get recognition. I genuinely felt that, hey, I'm an EMT, I can do something more.

REGENIA: Lizzie, share with us a little about your story. What brought you into nursing? You’ve been in for a little over a year now? Yes, so what brought you into the field of nursing? And what is sustaining you?

LIZZIE: I took a more traditional path in my education. I completed high school and my prerequisite courses at Park University. What initially drew me to this field was a family member who frequently spent time in the hospital when I was a child. I also had my own hospital stays as a kid.

And so, I remember all the nurses, not so much the doctors, but definitely the nurses who would bring in the little stuffed animals. I still have a little purple hippo named Rosie.

She was one of the nurses who gave her to me. And they always made me feel so warm. Just like that warm, tingly feeling, and you're just like, I feel so cared for right now. Just wonderful. Then, my sister ended up going to nursing school as well. So, I was like, okay, maybe I'll try that out.

After working as a CNA in nursing school at a different local hospital, I did a flu shot clinic at Liberty. I met Heather, one of our educators. She told me about The Earn While You Learn program. And so, I switched over to Liberty, and here I am.

REGENIA: Your journey has been really a lot of fun to follow. I'm glad you brought in the Earn While You Learn program. I want to talk about that and share with us what that is and your experience with that program.

LIZZIE: So, my experience was awesome. You come in from nursing school as a nursing student, become a student nurse tech and get paid for your capstone. And you work there, like I said, as a student nurse tech, and I did my capstone in the birthing center, and it was so much fun. It was amazing. I loved everyone I met.

REGENIA: You really do make really great connections. I was a CNA before going into nursing. That's how I paid for nursing school. I worked nights, holidays and weekends while I was in nursing school, and it made me a better nurse because I saw how the CNAs care.

That is the most vulnerable and intimate time for a patient. If they are unable to get out of bed or go to the restroom on their own, it is typically the certified nursing assistant (CNA) or, in our case, the patient care technician who helps them with these tasks. This includes getting them out of bed, assisting them in the restroom, helping them shower, or preparing their meals so they can receive the nourishment they need. They also tidy the room to create a more healing environment while the patient is in the hospital.

During my nursing school experience, I could perform all of these tasks, which is exactly what the Earn While You Learn program allows. Having that level of interaction with patients while the nurses handled assessments, developed care plans, administered medications and provided education was invaluable. While I focused on the basic needs of the patients, my colleagues were managing the more complex aspects of their care.

When I transitioned from being a technician or CNA to working as a nurse, I carried those responsibilities with me and integrated them into my nursing practice. I often faced criticism from CNAs who would ask, "Why are you doing my job?" But my response was always the same: we are here to care for our patients. It was rewarding to move from one area of care to another and continue to grow in my role.

Now, Jason, were you in the Earn While You Learn program?

JASON: In nursing school, you're constantly learning new things every semester, and you gather a wealth of knowledge. As a student nurse tech, when the nurses on the floor realize this, they are more likely to answer your questions about school and explain why, like the path of the patient.

There have been many times when I've done all my work, and there'd be some downtime. Hey, why are you giving this med? Why is this person this way? And why are they here? I was exposed to different floors and learned from other nurses how they do things and their habits throughout the shift, and I liked what they do.

That's really powerful to see because you pick and choose over time what you want to do and what you want to incorporate. Nurses always want to share their experiences and like, oh, like, this is what you can do or how I do things. And so, if this is something you like, then take that. And everyone's been so welcoming at Liberty for that.

One of the things about the Earn While You Learn program is that you can come in while you're in nursing school. You've completed the fundamental nursing coursework, and then you can do a bit more and have more responsibilities than our techs who are not in nursing school or still need to complete the fundamentals of nursing.

REGENIA: And you get paid a little bit more and more exposure to things with the nurses, which is exactly what you said. They'll bring you into procedures and say, " I know that you can't do this yet, but this is how we do it. I want you to stay here and be present while this is happening".

It's a really good program. And we developed it very intentionally for that reason. We wanted the nurses, the people in nursing school and nursing students to come and say, hey, I can be paid to use the skills I'm learning and develop those skills. I can continue to be taught by the existing registered nurses, and this is a great place to work. We're trying to develop a pathway for people to come in and work at the hospital to help us serve the patients and our community. And, you know, clearly, it's working. Both of you have already developed such a reputation for excellence in nursing in a short time.

You were in residency, and when you graduated, the project you did during residency was great. Graduation was so much fun. Do you want to talk a little about that? Let's talk about the evidence-based project. The research project that you did for your residency program.

LIZZIE: So, I did my project with a couple of other people I work with, and we did it based on the IV catheters to see which would be better. Mostly, it's for our patients and our nursing staff not to have to keep replacing the peripheral IVs. But it was more about patient satisfaction. I can't tell you how often patients say the worst part of coming to the hospital is getting an IV because that poke is like, it's not like other pokes. It's different. It's the mental part of it.

So, we were looking at the BD Nexia, which is an IV catheter. And I think we are considering using that at Liberty or something like that where it's a closed system, a peripheral IV catheter. So, instead of connecting the catheter to the J loop, it's already connected. You put the catheter in, the needle draws back, and you're done. And it's so much simpler, much easier. At least, that's the hope. And it just helps with things like drawing blood cultures, less contamination and stuff like that. Overall, it seems like a really good system for patient satisfaction and employee satisfaction.

REGENIA: I love everything that you just said. That was such a great project. I want to highlight two things about what you just said. We have listeners with our podcast; some are in healthcare, some are not in healthcare, some are thinking about it, and they're listening a little bit to our conversations.

They have no idea what you just said. Basically, you researched how we can start an IV on each person a few more times and how it can be the safest process possible. So, we also talked about residency and an evidence-based project. And I want to allow both of you to talk about that.

I know you recently completed what we're calling residency, and you're currently in residency. So why don't you tell us just a little bit about your experience in residency and its completion, and what it's about? And then we'll come to you, and you can tell us your experience thus far.

LIZZIE: So, residency is like continuing education in a clinical setting. You come to the hospital, you do your normal shifts, do orientation, all that good stuff when you first start and then once a day, once a month, you meet with educators, and we meet with you and other unit managers, just kind of everyone throughout the hospital, to learn about different processes, what different people do.

We participated in a charge nurse class and other educational classes. Respiratory therapy professionals came to speak with us, and we also completed EKG classes, and others. This range of classes makes sure that we develop a real well-rounded understanding of what goes on in the hospital and how to be better nurses.

REGENIA: It's a very deliberate program. For those of you who may not know what we're talking about, it's a year-long program that invites all of our newly graduated nurses to participate.

They meet one day a month all together. So, if we have 40 nurses who have recently graduated from nursing school, they all come together and share experiences about their orientation, what they're learning, and what they're seeing. We bring subject matter experts to them to share more information about the different types of care in the hospital and answer any questions.

It develops camaraderie among this group of nurses. It helps them to share their experiences to say, this is how I handled a situation. What would you have done? And the expert would be in the room to help guide those conversations. So it's really helping to strengthen the abilities that each of our nurses come in with and really highlights that knowledge that you have and get all of that knowledge out of your head and into your hands so that you can then use your hands to provide that care for the patients.

So, nurse residency is very deliberate. It's very pointed to be the next step for nurses to get into the nursing field and feel continually supported. That's a little bit about the purpose, how we developed it, why we developed it.

We've had the opportunity to talk about pre-nursing experiences. I want to switch gears and ask you about some of the biggest challenges you see in nursing specifically. And even though we have some challenges there, what are the things that still bring you hope for nursing and the future of health care?

JASON: Yeah. So, man, COVID did a number on the nursing field. A lot of experienced nurses, my relatives who are nurses in California, and a lot of those nurses left the field. It was just a crazy time, and that left such a big shortage. And because of that, travel nursing became really attractive to a lot of people. From what I've seen in nursing, a big challenge is hospitals retaining their experienced nurses. That's such a broad question. How do we keep our experienced nurses? What's going on? How do we get them to stay on our floors?

One of the biggest things incentivizing me as a new grad to stay after my contract is I'm 30, right? I'm looking to settle down. I'm looking for a home. I'm looking for a place to stay. But your average 22-year-old new grad they do their two years on the floor. What's stopping them from taking a contract in Nashville, in New York or Hawaii? Alaska, of all places.

So, the first step would be to ask how we get them to stay. You know, because insurance is great. Tuition reimbursements are great, a 401K is great, but a 22-year-old isn't really looking at that at that age.

If you can keep your experienced nurses in, that helps everybody because, as a new grad, I depend on those experienced nurses on the floor. And it's tough when you don't see many of them running around. I really do hope that changes. I hope that hospitals do something to incentivize people to stay longer.

REGENIA: Yeah. We need to find out what that basic need is. I don't know what will fulfill someone. The most important thing is that we need that expertise here. And how can we make sure of that?

JASON: You end up in the cycle of new grads teaching new grads. You have preceptors who have been nurses for only so many years when, typically, that role is reserved for people who have been there and done that for a great amount of time. And the cycle continues because, after two years, what's keeping people from staying?

That's just a big question for all the administrators out there. How do we get nurses to stay longer than their sign-on bonuses? Whether it's better incentives, better staffing, whatever that is, it's a step in the right direction. There was a time when you had experienced nurses, and there was a kind of hierarchy. You become a new grad, you get your experience, and that's the case.

But a lot of people are leaving for travel contracts. And, maybe you travel, nursing might not be that great and lucrative at some point. If you are 20 or 22 years old and have completed your two years, you would consider working in Nashville or New York, especially if you've only experienced the Midwest. I think that's a challenge.

REGENIA: On one hand, it's great for nursing because it's keeping nurses in the field and there are needs all over the country. But I really want to focus on the needs we have right here in the Northland. I want the best nurses here, and our nurses are incredible. Their heart for nursing and their heart for patients and their knowledge base. It's just truly impressive. Did you talk about what brings you hope for healthcare and nursing?

JASON: It's interesting when you work with people in healthcare because everyone's cut from the same cloth. You meet people who love what they do. And yes, money plays a big factor, but there's a reason why people who work in healthcare still show up on time.

They clock in on time every day, and only a few fields exist where you can really help people. We're fortunate in healthcare that we get to help others in a way that most people don't get the chance to. I could have been in finance, I could have been a fisherman, I could have done all kinds of things.

But what brings me to work is when I get out of my shift, and I round on my patients to say bye, and they say, are you coming back tonight? Now, I will be somewhere else, or I have the day off, and they say, thank you for taking care of me. For someone to genuinely thank me for caring for them, I think that that matters. I think a lot of nurses resonate with that type of feeling. And I hope it brings people in.

REGENIA: Yeah, yeah. I couldn't agree more. I couldn't agree more. Lizzie, I want to ask you the exact same question.

LIZZIE: Healthcare is a really demanding job physically, mentally, emotionally. You're responsible for 5 or 6 people for 12 hours, which could take a toll on you. Personally and professionally, the biggest challenge for me is setting boundaries with not only patients, but coworkers and managers.

You have to be able to know your own limitations and know when someone is mistreating you or if a patient is being violent or aggressive. Because we do take care of those people. Even those people need care. They do. Everybody needs healthcare. So, when you have patients like that, you have to be able to say, hey, this is not how we treat people here in the hospital.

This is not okay behavior. You're in the hospital. I'm here to take care of you. All I have is your best interest in mind. So, reminding people of that is hard because you can feel mean sometimes. After all, they're sick. They're not feeling good. Of course, you'd be upset, too.

And maybe you lash out like that, but just being able to speak up for yourself and say, this isn't okay.

What gives me hope is the same as Jason, like going back through the hallway in the morning with your bags and being like, hey, bye. I'll see you tonight. I hope you have a good weekend.

I won't be back. They're just like, oh my gosh, I'll miss you. Yeah, that's always the cutest. When they say, oh, I'll miss you. And I really love that, having those patients. It's so rewarding, even when you see a patient who maybe left the hospital and came back, and you see them, you're like, oh my gosh, what are you doing here?

It's so weird to see you. I'm happy to see you. But I'm also sad to see that you're back here. So it's definitely a conflicting feeling. And a very emotional job, I would say. Yeah, it's very personal.

And when patients are in this situation, they tell you very intimate details about their life. And it's so nice to sit and listen and talk to them. But you also have to deal with the fact that you can't always sit and listen and talk to them. So, it's just kind of finding your own coping capabilities.

REGENIA: I could sit and talk to you guys for hours and hours and hours. Unfortunately, we're winding down with our time together here today. I have one final question, which is always my favorite question. And that is what is your favorite story about your experience as a nurse so far?

JASON: One of my first orientation shifts at Liberty, up until this point, I've been so used to checking in with our preceptor and saying, hey, I'm going to go give this med. I'm going to go do this and go do that. And, there was this night where I didn't have to do that.

I walked into the bedroom, I went in the Pyxis unsupervised, and I pulled out Tylenol, of all meds, and I was like, this is crazy. Like, I'm doing this. I remember reading this quote somewhere, and it said, you right now are where you wished you were five years ago and five years ago, I was considering going to nursing school.

Like I had this plan to start this process, to relocate from the West coast, to come here. And here I am in this Pyxis in the Midwest, pulling Tylenol unsupervised. And it was emotional for me because I wasn't looking over my shoulder. And I gave the medicine, I scanned it, I did the things and did my assessment like I should as a nurse.

And it all kind of fell in place and it was just overwhelming, so simple. I called my dad after work, he's a nurse, like dad I did it. Like I'm doing the things he's like, you just give Tylenol. It's not a big deal.

But nursing school is not easy, and it's a challenge. And you'll never forget the fever dream of that experience. But all that hard work led to me giving Tylenol unsupervised. And I almost cried because of that. Because it was just such a big moment for me.

I wish for those thinking about going into healthcare that that will happen. Time doesn't stop. You know, time doesn't end. It's going to continue going. So why not invest in getting your education? Because what's nice about healthcare is that if you want to make big money, you go to school.

There's no waiting for someone to retire. There's no waiting for a position to open. You want to be an NMP, you want to be an RN, you want to be a physician, you go to school for it. And there you are. I encourage people to challenge themselves and do it.

I started college at 26, I'm 30 now. And I have no regrets. I'm glad I did it. At that moment in 3 South giving Tylenol was huge.

They give you your RN badge for the first time in orientation. It's like, this is it. I've been working for years for this moment. And, you know, and it's real. It's real. Yeah. And, you know, here we are.

REGENIA: Yeah, that's a great story. That's a great story. Lizzie, what story do you have?

LIZZIE: I really remember a couple of my patients so well. It's just like when you apply those skills that you learned and realize something is wrong and this should not be happening. And you're able to actually help the patient and fix what's wrong. I called you in the morning, actually, after that shift and I was just I was so worried and I was like, well, I just need to call Regina. She will be able to do something about this. And, you know, that patient went to a higher level of care and eventually ended up leaving. But I just felt so glad they got the care they needed. And I felt really proud of myself for advocating for a patient. Because that's really what nursing is about.

Advocating for your patients, making sure they're receiving the best care possible and making sure they are leaving better than when they got here. And if they're not, they shouldn't be leaving. So Regenia, that morning when I called you was probably my favorite story. And seeing the resolution for that patient, I was really very happy. I was so happy to see them.

REGENIA: I loved getting that phone call. And, as soon as I heard it, I started making a bunch of phone calls only to find that you had already taken care of everything. You put everything into action that was right and necessary and needed for that patient. And I felt like just a proud mama, I really did.

Here, we have our nursing staff who are doing the right thing at the right time and for the right reasons for the patients they are serving. And I was just so excited, for you, for the patient, to have gotten that phone call. I will share that story with you. I like that one, too.

I want to thank you guys so much for coming. Honestly, I just said it already, but I could just sit and chat for hours about this. I've learned so much about both of you. My goodness. These stories just always reconnect me, and I'm sure every nurse that is listening and watching these episodes, just reconnects us to the why and to the beauty of nursing. So thank you again.

And thank you for joining us for this episode. Until next time. To discover new episodes or explore career opportunities and more, visit us at The Heart of Health and Science.