Guest: Joanne Purdue
Tags: graduate nurses and midwives, career development, education
Soundcloud: Listen to Episode 39
NSWNMA Senior Professional Officer Joanne Purdue was a whole hospital nurse educator and ran a new graduate program for eight years. She is still passionate about supporting new graduates to flourish in their chosen career. Joanne joins the Nurse & Midwife Support Podcast to discuss what she’s learned about supporting grads and to offer advice and resources to new nurses and midwives preparing for their graduate year.
Joanne tells us that being prepared for the year is vital to your success, as is seeking support when you need it. She also wants grads to know that despite the stress, nursing and midwifery are wonderful professions:
“Even if it's challenging at times, you do make a remarkable difference in people's lives when they're at their most vulnerable. So be proud of yourself, and proud of what you've achieved because you're the future of our workforce, and you're important, don't ever think that you're not.”
Listen to the episode for more wisdom on how to thrive in your grad year. You can also check out Episode 38: Stories of the graduate year with Francis and Robyn, recent grads who joined us to share their experiences and what they’ve learned.
Nurse & Midwife Support is here to support you: 1800 667 877 or by email.
Your graduate year matters!
Joanne Purdue is a Registered Nurse currently working as a Senior Professional Officer with NSW Nurses and Midwives Association, the NSW branch of the Australian Nurses and Midwives Federation.
Joanne is also an ICU nurse and still works in this field casually. Joanne’s nursing passion is education and supporting early career nurses. She developed this passion through by coordinating and running a New Graduate program in a large tertiary teaching hospital for 8 years. Joanne continues this passion in her current role through the ANMF Early Career Round Table and other projects that focus on early career nurses. Joanne’s other passion is horses and outside of work hours most of her time is spent with these magical creatures.
Mark Aitken [0:09] Welcome to the Nurse & Midwife Support podcast: Your Health Matters. I'm Mark Aitken, the podcast host. I'm the Stakeholder Engagement Manager with Nurse & Midwife Support, and I'm a registered nurse. Nurse & Midwife Support is the national support service for nurses, midwives and students. The service is anonymous, confidential and free, and you can call us anytime you need support. 1800-667-877, or contact us via the website: nmsupport.org.au.
Welcome to this episode of the Your Health Matters podcast, Supporting Graduates. This is our second podcast in the Graduate Support series. Today I'm going to talk to a very impressive Graduate Coordinator who now works with the New South Wales Nurses and Midwives' Association as a Professional Officer, Jo Purdue. Hi, Jo, and welcome.
Joanne Purdue [1:15] Hi, Mark. Thank you for having me today. I'm really looking forward to talking with you about how we can support new grads.
Mark Aitken [1:23] Thanks, Jo. First of all, I'll begin today by acknowledging the traditional owners of the Kulin nation, the Wurundjeri people on the land in which I record this podcast. I wish to acknowledge them as traditional owners. I would also like to pay my respects to their elders past and present, and Aboriginal elders of other communities listening to this podcast, and indeed acknowledge Aboriginal and Torres Strait Islander people who may be listening to this podcast from anywhere in Australia.
Jo, if you don't mind, give a bit of background about yourself and your current role. I know your extensive history and passion for supporting graduates.
Joanne Purdue [2:06] Thanks, Mark. So actually, I'm a Senior Professional Officer with the New South Wales Nurses and Midwives' Association, which is the New South Wales branch of the ANMF. In my role we support nurses around professional practice issues, around regulation and all those sorts of things. But also, prior to coming to the Association, I was a whole hospital Nurse Educator and ran a new grad program for eight years, which has always been my real passion, the importance of supporting early career nurses or our new nurses to the profession in that first few years.
I also sit on the ANMF Early Career Roundtable, which has brought me closer to being able to help support grads across the whole of New South Wales, but also nationally, and work towards how we can help them. Also, in the Association we run an education series to try and help support new grads. So it's always been something that's really close to my heart. In the years that I ran my program, it was always really important to help them process that transition period, and guide them and support them really well. I'm really pleased to be able to help support Nurse & Midwife Support in supporting new grads in any way we can.
Mark Aitken [3:29] Thanks, Jo. I think that's a really important point, and one I hope grads listening to this connect with, that support is available. Many of us want to support you, have your back and are here to support you. So if you're a grad or Grad Supporter, Coordinator, Educator, or somebody else who's in the business of supporting grads, thank you very much. And we want you to know support is available whenever you need it. Nurse & Midwife Support is here 24/7, 1800-667-877, or via the website, nmsupport.org.au. Please don't hesitate to reach out. Our experienced nurses and midwives are on the end of the phone waiting to support you.
Jo, what are some of the challenges that grads tell you that they experience, or you've observed they experience?
Joanne Purdue [4:28] I think the biggest challenge is [that it's] probably one of the steepest learning curves of a person's life, professionally but also personally. I think that first 12 months of moving from that student [status] to the actual health professional. They've worked really hard to gain that recognition as a health professional, so lots of mixed emotions. I think they feel the excitement of being able to call themselves a nurse or midwife, but also then the fear and the expectations of being able to take on those responsibilities as health professionals.
I think the biggest challenge I've found is the expectations they put on themselves. Often they'll put high expectations of being able to go in and be able to do everything straightaway, which they've obviously going to find extremely challenging. In my experience, usually the first six weeks is the most challenging for the new grad in that transitional process. Lots of mixed emotions, developing those skills of dealing with rotating rosters, working night shift, and learning how to deal with life in itself. Sleeping and working out [how to] fit those things in their personal life as well as their professional life, but also actually getting themselves prepared for the environmental things of the area that they work in, fitting in with the culture of the workplace, which can be challenging at times, understanding what they know and what they don't know.
I find in that first six weeks, often in that first week or the second week, very emotional things [come up]. I'd always feel like I'd go and speak to my new grads, and I'd [ask] "How are you going?" and they'd burst into tears! I thought, "Oh, I seem to be the person who always makes them cry," but it was just a feeling of relief, that it was okay to be upset and feel those emotions. I used to always say to my new grads, "This is normal." In eight years, it [was] the same year after year, lots and lots of mixed emotions in those first few weeks. I think the biggest challenge that I saw new grads have was around idealism and reality, [that's] what I call it, and this is part of what we call transitional shock. Working through how you transition into that role of a nurse, it is a process and it does take time. As a student, they've come out, they've done their placements, but they've never really taken on the full role of a nurse and midwife.
The two things that I found that nurses got most challenged with is time management and medications, because you never really do them fully on your own as a student. One, you're not registered, and you don't take on that full caseload, even though you thought you might have in some of your placements, you don't really ever do that. Now you've got all this responsibility, you've got to manage your time, you've got to get through your medications, and it just feels like the world is caving in on you and you don't have the skills. I think what happens is that a lot of those new grads come out with the idealism that nursing is this ... "I can have time to spend nurturing, caring, and doing all these things." But the actual environment that we're working in, and the workloads that we're working in, the reality is that often as a new grad, you actually don't get that time.
A lot of them will leave the shift, often, going "Oh, I didn't get time to do this," or, "I didn't have the time to speak with my patients the way I'd like to." I'd always say to them, "Look at the positives you have done and how you have actually made their day better and what you did achieve. Don't focus on what you didn't achieve, because you've done what you could with what you had." That's the reality of the work environment that we live in now. The pressure is there, and it is a lot more intense. So being prepared not to be too harsh on yourself, and asking for help.
Asking for help is one of the most important things that grads need to feel confident with. When we talk about who they can go to for support, I always used to say to them that it was really important to focus on looking at who you connect with. You might be given a mentor, you might be given a preceptor. But if you don't feel comfortable and don't have a relationship with them, you need to find someone on that ward that you do have that relationship with, that you can go and ask those questions and that you feel comfortable [with] and [who is] supportive of you. I think that's really important.
And understanding that transitioning is a process. This is where you come to develop those skills. You won't have those skills of time management, those assessment skills you're going to put into place. These are all things that are going to develop. Your teamwork skills, working and knowing how to work with a multidisciplinary team. These are all things that you develop and [are] part of that transition period. How that transitional period works is that generally, [for] most new grads those first six weeks are quite a [inaudible]. It's not a merry go round, it's a bit like a roller coaster, it's like, hang on, here we go. At the end of the six weeks, I found that they tend to challenge themselves. They go, "How come it takes me so long to do my medications? I should be faster by now." Or, "How come it's still taking me so long to get all my patients showered or get myself sorted?" But I always say to them, "How long have you been registered? How long have you been a health professional? Six weeks? These other people have been doing it for 10 years, 15 years, eight years, whatever, they've got that down pat. I'd prefer you to take an hour to do your medications and be safe, then try to take shortcuts and not be safe."
[10:53] So about the six week period, they start to question themselves. Some don't, but that's the general rule. I have found about the three month period, everyone starts to get a little bit more comfortable. Always question when you're shown shortcuts because [as] I always say, "Nurses and midwives can be the most innovative people in the world, and if there's a shortcut we find it. Doesn't always mean it's safe." Always ask [yourself] the three questions. Is it within my scope of practice? Is it within the legislation and policy? Have I got the training and expertise and confidence to perform it?
If you can't say yes to all three, then maybe you shouldn't be doing it, because at three months, we find that you start to take a few of those shortcuts, feeling a little bit comfortable, and that's when I'd see errors occur. If a new grad [has] a medication error, it would normally be around that period, because you're starting to feel comfortable and starting to feel comfortable in that transition process. So it's being diligent, because those first three months is the time that you build those good practices. It's important to keep doing the things the way that you should be doing them in the correct manner, and not picking up poor habits or poor culture, which you will see, it is out there.
The hardest part is, as a human being we want to feel like we belong, and we want to feel like we can fit in, so we tend to pick up some of these habits, so that we can be part of the crowd. But it's important for you to understand, moving on, that your practice is safe. You are responsible for that. It's about having good practice skills built right at the beginning.
These are just some of the things that challenge grads the whole time. I think it's learning to have assertive communication, and I always say, "Ask for commitment at the beginning." So if you're asking somebody for a medication check, you can say, "Can you do a medication check with me? Are you good to come to the bedside, I need this right now." It's you enforcing it, this is a practice you need, it's not questioning someone else's practice. But also things like, if somebody's doing something some way, asking them why and how they've done it, because you have a lot to offer the workforce as well. You've come from university, you've come from education, you've learned best practice, you can be an educator and a teacher, even as a new grad. You have lots to offer too, don't think that you're a burden, or you are someone that everybody's got to nurture, because you will have things to offer as well. So be proud and confident of the skills and the knowledge that you've come out with. This is just a chance for you to develop them and embed them in what you're doing.
They're just some of the tips and resources I suppose that you can look for. Another couple of tips that I used to always give my new grads is around time management. When you're trying to manage your time, I always say, "Look at your shift-orientated tasks related to your nurse-orientated tasks." Your shift-orientated tasks are those that you can't go home without having done. Your medications, your documentation, those type of things, or things that have been handed over that need to be done in that shift. Other things that are nurse-orientated tasks may be like showering, maybe a wound dressing, it doesn't specifically say it has to be done on your shift. That's how you do your prioritisation, looking at those things. Get yourself a shift planner, make sure you've got your shift planner so that you can write down and tick things off as you do them. Remembering asking for help and delegation is really important when you're a new grad. That's the most important thing you can do, is ask for help before you start to feel like you're floundering. If you're starting to feel overwhelmed and all the things are starting to build up, that's when you ask for help. Don't let them continue to build until you completely lose control. So it's in the beginning, when you work out it's starting to get a little bit overwhelming.
[15:20] You need to make sure you take breaks, because I think that's a big thing that new grads tend to [let slide]. "I've got too much to do, I haven't got time for my breaks." You need to do your breaks, and you need to make sure you take care of yourself. Your self-care is really important because during this period, it's both physically and mentally draining because you've got so much going on. You're learning how to do shift work, you're learning how to do quick shifts, and night shift, manage your personal life and fit things in with your personal life. But you're also trying to mentally get through all the things that you're learning within your shifts. So it's really important to make sure you give yourself some downtime, do the things that you enjoy doing, that you find pleasure in, whether that be bushwalking, whether that be meditating, but you need to give yourself some you time as well. Very, very important in your grade year. You will be so fatigued that you find that you don't have time for your personal life, because by the time you finish your shifts, [on] your days off, you're just trying to recuperate from your shifts. It's important to look after yourself, and notice that fatigue.
The other tip that I really think is important for that 12 month period is make sure you put some leave in during that 12 months. I always found that about six months in, that's about the time when you're starting to feel a bit burned out and it's starting to get all a bit much. It's a good time to try and take your leave if possible, if your grad program allows it. Not waiting to the end of the year, actually trying to take some leave anywhere from five months in is really important because I notice that's when the fatigue and [those] burnout signs start to come with the new grads. This is over eight years of looking after new grads, there is a distinct trend that you actually see. I think that's really important, to manage that self-care, and if you can connect with other new grads, looking at support networks.
As we've said before, Nurse & Midwife Support have some really good resources and things available to help you if you're feeling overwhelmed. I think it's really important to reach out and understand that this is normal, and a lot of new grads feel this way. Having a peer group that you can connect with, whether it's the other new grads on your ward, or it's other new grads in the hospital, or it's even other new grads that you might remain friends with that you graduated with, went to uni with. It's good to talk with each other because you find out that often the experience that you're having is similar to each other. I think they're really important things to look for. And look for those on the wards or the areas that you know you can go to and have conversations and that chance to debrief about things that might have been challenging. I think that's really important for your own wellbeing and your moving forward. That's especially if you feel like you're struggling.
Do not compare yourself with other grads, because everybody does transition differently. Even though I've said there's a bit of a trend, everybody will be different, and some new grads might take longer to do that transition. That's okay, too. I've got some really brilliant new grads that did take that bit longer that are in really great positions now. I've got one that works in the retrieval team for the rescue helicopter, I've got one that's an educator, and I've got one that's the CNC, and they all took a little bit longer to transition. It's your journey, it's your individual journey as well. Remembering that and not being too critical on yourself. I've always found that you will be your own worst critic, as a grad, you will always be your own worst critic. Be kind to yourself, okay?
Generally most other people are supportive of grads, you might find some that aren't and they're the people you just don't associate with and don't take on their negative aspects. I always say it's them that has the issue, not you that has the issue. It's them that has the issue. Connect with people that are going to give you the support that you need. I think that's most of the things ... I can go on with this for so long. It's just really important to remember that this is a journey, and it is going to be challenging. I don't want to sugarcoat it, it can be tough. But reach out and get support if you're finding it tough.
A really good thing that I found to do as a new grad, is do some reflective journals. Write your emotions and what you're feeling at the beginning of your rotations. What you experience, and then when you transition. If you look back at them after 12 months, and look at how much you've grown, it's actually quite fascinating. This is one of the steepest learning curves that you will have, or transitions that you will have in your lifetime, transitioning into professional practice. That's why there's lots of documentation around transitional shock and those type of things. It's generally those emotions and those feelings that you feel in the first three to six months of transitioning and some of the things that I've talked about. I hope that this helps prepare and let you be kinder to yourself when these things happen and you experience these things. Feel confident enough to reach out for help to those that are around you, and connect with your other grads to share experiences, because I think that's really beneficial. So I really thank Mark for allowing me, I'm not sure if there's anything else Mark would like me to cover. Like I said, once I start on this topic, it's pretty hard to stop me.
Mark Aitken [21:34] Thanks Jo, your passion for supporting grads really rings through here. I thank you very much for sharing your wisdom, experience, advice and support for our graduates. What I've really picked up here Jo, is some great take homes for our graduates. I think that is: preparing for your grad year is vitally important. So if you're a new grad about to embark on your grad year, do some homework. Do some research. As part of this podcast, we've got a newsletter, and we've got 12 Tips for Preparing for Your Grad Year, and some great resources in that newsletter. We'll put the link to that in our show notes for this episode, and you'll be able to find those. But if you're a grad, and you've already started, and you're about six weeks, or even six months, and you don't feel okay, then a lot of these resources and supports will assist you.
So I think some take homes from Jo that I've heard ... seeking or finding a mentor is really important, and that may not be the person that you think it will be. It might be somebody that you work with on your ward or in your unit or the area where you're allocated, that you actually admire the way they work. I've actually in my career adopted mentors, whether they like it or not. We didn't have a formal mentor program, so I thought, "I really like the way you practise nursing." I'd actually tell them that and say, "Can I buy you a cup of coffee and talk to you about a few things?" They never said no, and in fact, they were really proud and chuffed that I admired them and wanted to pick their brains about a few things. Actually, several of those people have ended up good friends. So adopt a mentor and make a friend is my philosophy!
As Jo says, take time, don't be too hard on yourself, and don't expect to be an expert straightaway. We all needed to take time to become an expert. Time management, vitally important, and you will learn that over time. Assessment skills are fundamental to good nursing practice, and they're also skills that you learn over time. So remember, you're part of a team, and that team is there to support you. My experience is that they will support you. Now keep in mind that the people in your team are also dealing with the challenges in their own lives. You may not always get the response you would like to get. That's not necessarily about you, that could be about what they're dealing with. If you don't get the response you're looking for from the person you go to, find somebody else to go to on that day. Just receive that with compassion and reflection that it's probably not about you. It's probably about them needing something.
Of course, Jo, I love talking to you about the importance of self-care and looking after yourself. That's one thing Nurse & Midwife Support preach and we put a lot of information out there about your self-care. As Jo says, on our website, we've got some really great resources to support you. Go into the Nurse & Midwife Support website, www.nmsupport.org.au, and just put into the search engine 'graduates', you'll find some great tips, strategies and a template for a wellness plan. We really encourage you to create your own wellness plan, set goals and intentions for your self-care, print it out or store it on your phone and check in with it and update it regularly. It'll keep your self-care on track. As Jo says, be kind to yourself and each other, because your health really does matter and your grad year matters. It's going to set you up for the rest of your career.
Now, Jo, we've been talking recently about grads who are a bit isolated. They might be in small health services or hospitals, they might indeed be the only grad in that place, and they don't have the support that grads might have in bigger health services. What would you suggest those people do when they're seeking support and they don't find they have it in their workplace?
Joanne Purdue [26:13] When we're talking about small isolated areas, I think it's important to try to find someone, even if they're not on shift with you, but from the workplace. If that's not possible, I think it's important to connect with other grads that you may have gone to university with and stay connected, whether that means you have a once a week FaceTime catch up, a bit of a debrief or something like that, so that you can at least nut things over. Or if you've had somebody that you found was a little bit like a mentor during your studies that you can maybe reach out to. I know that I've mentored a few new grads like that in that situation, so it doesn't have to be somebody that you physically work with that can mentor you and support you. Looking for somebody and making sure that you find someone that you can have those conversations with and debrief about what you're experiencing and help guide you in what you need to do to help ask for assistance. Even if that doesn't work, like I said, Nurse & Midwife Support have counselling services where you can just ring up and have a conversation. Because sometimes it's just having that conversation that will help guide you to come up with the answers that you need, because you're speaking it out loud. I think that's really important.
If you're really struggling at times, I know that is part of what we offer in the Nurses and Midwives' Association in New South Wales. Sometimes if you're having great difficulties in the workplace, we can help give you some support and guidance in that professionally as well. So it's finding some resource that can help guide you and support you. If you can find it in the workplace, [that] might be another nurse that works opposite shifts to you, but you can ring and have a conversation with and ask for that guidance. That's really important to try and find that right at the beginning, not waiting till things start to maybe fall apart or become difficult, or those sort of things. Trying to build a network of who you've got for support if things do start to get a bit difficult, I think is a really good tip. Try and have them sorted before things possibly do get difficult.
Mark Aitken [28:42] Great, Jo. So creating a community and a community of practice is really important. If you do feel isolated, please know that you're not alone, contact Nurse & Midwife Support, we'll support you, 1800-667-877. If you'd like to talk to me, or indeed, Jo and I, about a community of practice, please get in touch. My email address is Mark.A@nmsupport.org.au. Jo and I are very committed to supporting you, our grads, as are our organisations. We can maybe help you set up that community of practice and certainly we can jump on to your Zoom meeting or however you set it up and come and talk to you about some of the issues that you may be experiencing and how to get your grad year back on track, but also how to access support. So please know that you're not alone.
Jo, what a wonderful conversation. So important to be putting this information out there. Thank you very much. As we finish, what final words of wisdom do you have for our grads?
Joanne Purdue [29:51] Just that it is a wonderful profession. Even if it's challenging at times, you do make a remarkable difference in people's lives when they're at their most vulnerable. So be proud of yourself, and proud of what you've achieved because you're the future of our workforce, and you're important, don't ever think that you're not.
Mark Aitken [30:14] Thanks, Jo. Great advice, and great words of wisdom. Well thanks everybody, for listening today. Please know that support is available whenever you need it. Nurse & Midwife Support, the national service for nurses, midwives, students and our graduates. Anonymous, confidential and free. Look after yourselves, and each other, I'll speak to you next time. And remember: Your Health Matters.