Experienced Nurses Share Advice for New Grads

Carol Pehotsky

You've earned your degree, passed your boards, and are ready to begin your nursing career. But what comes next? For many new graduates, the first year of practice brings a mix of excitement, anticipation, and uncertainty.

In this special episode of Nurse Essentials, veteran nurses and leaders share the guidance they wish they had received when they were starting out, and I'll share a little bit of my own. We're here to provide reassurance, practical tips, and honest reflections from our collective journeys.

Whether you're preparing for your first shift, settling into a new role, or an experienced nurse looking for a little bit of advice, this conversation is filled with advice from Cleveland Clinic caregivers who have truly been there.

Hi, and welcome to Nurse Essentials, a Cleveland Clinic podcast where we discuss all things nursing, from patient care to advancing your career, to navigating tough on-the-job issues. We're so glad you're here. I'm your host, Carol Pehotsky, Associate Chief Nursing Officer of Surgical Services Nursing.

Welcome back, everyone. We're trying something a little bit different for today's episode. We're recording this episode in the summer of 2026, but no matter when you're listening, we think there's something in it for all of you.

But if you think about summertime, it's when most nursing students graduate in about May. It's peak time for that and maybe you're one of those people and you've probably been studying for the NCLEX, you're looking forward to starting your nursing career.

You might be getting ready to move out of the dorms across town, across the country, wherever you have found that first nursing position, you're so excited about it. We all remember, within all that activity there are so many emotions and just even sitting here behind the mic, I can feel them as real as I did.

For me, it was a winter graduation and a winter start, but nevertheless, you're excited, you're relieved, especially once you pass the NCLEX. There's that weight that comes off your shoulders. "What am I going to do with all this free time now that I'm not doing all this studying?"

There's that excitement, but there's also probably some pretty serious nerves. Our nursing schools do a fabulous job of preparing us as much as one can be prepared, but it's a whole new world. What is life going to be like?

"I'm going to be a licensed nurse. Yes, I'll have an orientation and a residency perhaps, but at some point it's going to be me." I remember feeling that and I'm sure if you're there, you're feeling some of that too.

Well, over the past several months, we have asked guests on the podcast to offer some words of advice to all of you. What they have to offer, perhaps what they wish they would have known in that first year of practice as well.

Even if you're not a new grad, keep listening. I know I learned something from each guest and what they were able to offer. We started this episode with Alex Jordan from our episode on supporting patients with lung cancer. Although Alex is a certified physician assistant, she has wise words to share with any nurse.

Alexandria Jordan

Trust your gut. I was given this information as a young grad myself and it has been very helpful. It takes time, but constantly reeducating yourself, researching, making sure that you are comfortable with the medicine that you are practicing and asking questions.

When you're a new grad, ask questions. No one's going to be upset. I'd rather a new grad ask a question so I can educate them so they know rather than trying to just wing it. It's okay to ask questions. That's the whole point of medicine. We're at a teaching hospital.

Carol Pehotsky

Many of our guests highlighted the importance of continued learning. We hear next from Dr. Barb Zinner, vice president and chief nursing officer of Marymount Hospital and Dr. Julie Gurecki, vice president and chief nursing officer of Fairview Hospital.

Dr. Barb Zinner

My advice is to be a continual learner. Don't stay stagnant. Look, learn, ask questions, continue to develop yourself as that nurse, as that leader that you are. Continue always asking questions and know that you make a difference in our patients' lives.

Dr. Julie Gurecki

I would say don't be afraid to try new things and learn from those around you and never stop reading. I think as a new nurse, I wish I would have known that I needed to continue to read.

There was a time when I thought I had read every anatomy and physiology book and knew what was happening. So, continuing your education I think is really, really important. Things are changing rapidly.

Carol Pehotsky

It's so easy to get caught up in everything new, but it's also so important to take it all in. Dr. Kristen Vargo, institute nursing director for the Neurological Institute, and Amanda Hancock, pediatric nurse, both highlight this importance.

Dr. Kristen Vargo

I think back 20 years ago when I graduated nursing, and I think it's just to enjoy being a new grad. You're going to have so many things coming at you in that first year of nursing, and I think it's so easy to get wrapped up in everything that you are going to be learning. I hope you just enjoy it. Enjoy building your career. Enjoy learning all about nursing and enjoy learning your specialty.

Amanda Hancock

I think it's important for new grads to embrace every opportunity that comes their way. Asking questions and being involved in committees on your units really expands your knowledge and makes you a better nurse.

Carol Pehotsky

There are so many possibilities and opportunities for nurses, more now than at any other point in my nursing career to be sure. We're so glad to welcome nurses from specialty nursing to hear what they have to say.

We hear next from Shanon Schady, perioperative nursing education program coordinator, Wendy Simmons, perioperative nursing director for outpatient surgery, and Dr. Angela Milosh, CRNA program director.

Shanon Schady

Make sure that you spend enough time shadowing in the specialty that you think that you are interested in working in and choose an institute that focuses on your professional development and lifelong learning.

Wendy Simmons

What I've shared with my daughter is never stop learning. Always be inquisitive, but if you aren't heard, speak up. Somebody's going to listen.

Dr. Angela Milosh

Every year for my own graduates within our program, I always leave them with a few comments. One of the comments that I always say to every graduating class, because I think it's important, is that patients trust us and it's critically important that you strive to be worthy of that trust.

And everything that you do, every part of your practice, your knowledge base, they deserve our best self every day. So, you always strive to be worthy of their trust.

Carol Pehotsky

Within all the excitement, it's easy to get overwhelmed that first year. Dr. Sue Behrens, vice president, chief nursing officer of Hillcrest and Mentor Hospitals and Dr. Lisa Baszynski, associate chief nursing officer of nursing education and professional development, remind us to stay in touch with our why to keep us grounded.

Dr. Sue Behrens

I would say to know who you are and make sure that that comes across in the care that you provide. Never forget the reason why you went into nursing, but always ask why so that you can grow, succeed and provide the best care to your patients.

Dr. Lisa Baszynski

Well, first I want to say how proud I am and I'm so pleased that you chose this wonderful profession. I think first piece of advice is to be the best clinical nurse you can be this first year. That is really your job and there are so many support systems out there to help you be the best clinical nurse. But don't forget why you went into nursing.

It is all about human beings and the human spirit. Never forget those little things, the touch, calling people's names, taking care of families, taking care of patients, and taking care of yourself. Those are the things that you keep close to you as you move through your career.

Carol Pehotsky

In preparing for this episode, I reflected on my own career and what I wish I knew in my first year as a nurse. And as I was thinking about that, I remembered that about 10 years ago, I had a really fabulous opportunity to be the commencement speaker at a nursing school graduation.

I share some of those words with you today. I was struck by how true they were then and how true they still are for me and I hope you find the same.

"As you leave the familiarity of school and transition to a career as a nurse, I would like you to consider three thoughts. Take care of your patients, take care of each other, and take care of yourselves."

And audience, if you've listened to the end of the episodes, you know that every time I say that same thing. "Many of our patients are very sick. They're scared. They feel helpless and alone, even when they're surrounded by supportive loved ones."

"They need us as nurses to meet them where they are, to advocate for them, not just with this knowledge, but with empathy, compassion, and respect."

There is one thing all of us, no matter who you are and where you're listening from, we all have in common. If we're fortunate enough at some point in our lives, we will be the patient or someone we value most in this world will be that patient. Remember that through that first year and through the rest of your career.

The call lights are all going to be ringing. You're going to maybe try to find five minutes to organize your thoughts and prioritize what needs to happen next. Your back might be aching, your feet might be tired, you're hungry, you're dehydrated.

Maybe the tears are flowing and those might be yours; they might be the patients but remember that the patients are counting on us to be their advocate. No matter what type of nursing you pursue, no matter what specialty, this will happen and it will happen often.

When it does, remember this, our patients often give us a gift they don't necessarily want to give. It's a period of time, anywhere from a few minutes to days and months where they're very much dependent upon us.

They've given up their independence and they're counting on us to be their eyes, their ears, their advocate. Honor that gift, treat it with care and respect. What type of nurse will you want caring for you when you or that person you value most in this world is in need of care?

Some of your worst days will be those that you end up remembering and treasuring the most in nursing. I still remember very early on in my nursing career, I was working on a med surg floor, and the first patient I cared for that had a do not resuscitate order. It was, of course, getting into the evening, I was a night shift nurse.

And keep in mind this is 22 years ago, and I can still remember it crystal clear sitting behind this mic today. He'd been with us for quite some time before that DNR order was written and had family members, of course, that spent lots of time with him, but they traveled long distances to be with that patient.

And one night the family member stopped me and had a feeling that the patient would pass that night, but told me that they felt better knowing I was there. Little old me. I might have been a nurse for four to six months and that trust that they put into me, they didn't care that I was a novice nurse. They cared that I was the nurse for their loved one.

In that time that I had cared for that patient, the family had been so gracious to share the stories they had with the patient, and I really felt like I got to know all of them. Fast forward to about 2:00 in the morning and I was in the patient's room when they passed. And I had the privilege of holding their hand.

Of course, then that sets all the things in motion that if you haven't yet experienced you will where we need to bring the physician in, there needs to be a declaration, there needs to be a phone call.

That phone call was made and the family member asked to talk to me after they were done talking to the physician. And they asked if I'd been there and were so grateful when I said yes.

I learned so much from that night. Although our patients and their families deserve and of course, they expect excellent clinical skills, they also need compassionate relationships and we as nurses are uniquely prepared to offer just that.

Perhaps in your life before nursing, you participated in team activities, sports, band, drama, and I'm here to remind you that healthcare is the ultimate in team sports.

But what takes this teamwork up a few notches in healthcare is that many aspects and settings of care change, the team members themselves change and each individual member of that interprofessional team has such an important piece of advice, different perspectives, different objectives.

Our patients and our teams need you to remember what you have learned and take care of each other while you're taking care of your patients. Have each other's back. Take accountability for your actions and the actions of everyone on the team.

You are entering the nursing workforce with some of the most current knowledge in patient care and teamwork. Challenge yourself to find your voice in the nursing team and to share that knowledge.

One of the beautiful things about nursing is the continual opportunities for learning and growth and taking care of yourselves. Growth can mean returning to school. That's certainly what it meant for me but also can be to continue developing yourself in the day-to-day.

You've learned how to reflect upon your nursing skills in school. Continue to develop on that. As you're ending each day, as you're driving home, take a moment and ask yourself, 'Did I have the knowledge to properly care for my patients? And if not, what am I going to do about it?'

Take ownership of your learning. Do you have the right information to help inform your decisions and think about your career. At some point ask yourself, 'Am I still being challenged? What do I still need to learn in the specialty? Is it time for me to try something new? Is it time for me to go back to school to get certified?' All of these options are yours and they just make you a better nurse and human being.

Dr. Kelly Hancock

Pay attention to what makes you fulfilled. If there are different things that you're trying, see what really jazzes you up, what gets you excited, what gets you fulfilled. And don't forget that because that may be a pathway.

So, whether it's around being an educator, a researcher, excelling at the bedside, advanced practice, there's so many different things that you could do.

I think secondly, seeking mentorship is so important. Just somebody that you can bounce ideas off, ask those questions that you may be afraid to ask elsewhere and that's a trusted confidant if you will.

And then the last thing I would offer is to focus on impact and your why may evolve over time. I think that's important to know, but if you start thinking about the difference you want to make for others, then you can let your purpose grow through that daily work and then see how it evolves over time.

Carol Pehotsky

As always, thanks so much for joining us for today's discussion. Don't miss out. Subscribe to hear new episodes wherever you get your podcasts.

And remember, we want to hear from you. Do you have ideas for future podcasts or want to share your stories? Email us at nurseessentials@ccf.org.

To learn more about nursing at Cleveland Clinic, please check us out at clevelandclinic.org/nursing. Until next time, take care of yourselves and take care of each other.

The information in this podcast is for educational and entertainment purposes only and does not constitute medical or legal advice. Consult your local state boards of nursing for any specific practice questions.