What I Wish I’d Known When I Started: Nurses Share What It’s Like to Provide Care in a Post-Pandemic World

Whether you’re a recent graduate navigating the job search or you’ve already earned a spot on the hospital floor, it goes without saying that every nurse deals with challenges and uncertainty. Here, three nurses open up about some of the surprises, joys and difficulties that come with caregiving — and explain what they wish they knew when they were starting out.

The insights below are shared by Cleveland Clinic nurses Megan Norris, BSN, RN, Medina Hospital; Chad Ziegler, BSN, RN, NE-BC, Medina Hospital; and Autumn Cooper, BA, BSN, Fairview Hospital.

What is the most challenging thing you encountered when you began your nursing career?

Norris: In the beginning, nursing is a whirlwind. Not only are you faced with all the challenges that accompany a new job – strange setting, new coworkers, unfamiliar policies – but you’re also expected to quickly learn unit-specific skills and assimilate into your institution’s unique culture. No amount of schooling can prepare you for those things. Once you’re on the floor, there isn’t much time to slow down, but I found that it was hugely helpful to train one-on-one with another nurse. Working closely with a more-experienced colleague boosted my confidence and gave me the opportunity — and time — to provide care, educate patients, engage with the care team, learn how to chart, and importantly, locate the bathroom!

Ziegler: Besides working the night shift, which is always a test of stamina, strengthening my nursing skills is an ongoing challenge, as is building a solid foundation for teamwork. Teamwork is so important to every aspect of nursing. No matter how talented you are, you can’t do everything by yourself, and you certainly don’t know everything there is to know! Your ability to learn from and collaborate with your colleagues is particularly important when transitioning between different hospitals. It’s nearly impossible to learn a new role and understand how an unfamiliar hospital operates unless you’re willing to lean on more-experienced members of your team.

Cooper: Losing a patient to a heart attack is the most challenging thing I’ve encountered since becoming a nurse. His death was totally unexpected. His family was notified and came to the hospital to say goodbye, which was very difficult to watch. I didn’t think that part of my job would affect me as much as it has.

Is there anything that has surprised you about nursing?

Norris: I was inspired to become a nurse after experiencing healthcare from the other side of the bed. When a family member got sick, I came to appreciate the difference that compassionate, competent care could make. But, despite what I thought I already knew about the job, I was surprised by the number and scope of responsibilities that nursing demands. Because I see a wide variety of patients and ailments in my unit, I’ve had the opportunity to learn a lot about preventing and treating disease in a very short period of time. These experiences are constant reminders that the interventions a caregiver provides can change the course of a patient’s life – or even save it. I continue to be amazed by that.

Ziegler: Again, I think a healthy teamwork dynamic is crucial – and the power it has to affect the quality of patient care has really surprised me. Like every nurse, I’ve faced my share of challenges, and I remember the colleagues who have helped me through those experiences just as vividly as I recall the events themselves.

Cooper: I think most nurses enter the profession because they simply want to help everyone in any way they can, but I quickly realized that it can’t always be done. I was surprised – and a little discouraged at first – to see that some patients don’t actually want the help you provide. Those situations can be difficult, but they give you a chance to step back and rethink your role as a caregiver – and what it means to “help” that particular patient. You just have to remember to meet people where they are.

I am also surprised by how fast I gained confidence. As a “baby nurse” with only six months on the floor, I was already providing care to stable ventilated patients. I was lucky enough to start with a unit that is super supportive of new nurses, and that reinforcement has really allowed me to grow. Our nurses never think twice about helping out another team member, and we all know that the favor will eventually be returned. I’ve also been surprised by all the bizarre reasons patients come to the hospital. I never would’ve imagined some of these scenarios!

Can you share any specific insights about being a nurse during such an incredible time in history?

Norris: Attending nursing school and starting my career during the COVID-19 pandemic was hard, but it was also an invaluable learning experience. It really has been a privilege to serve at the bedside during this extraordinary time. I can’t even find the words to express how in awe I am of my nursing colleagues, who have shown unbelievable resilience and skill in the face of such hardship. I’ve also come to understand a number of critical issues that affect our current healthcare climate. Especially in the Information Age, it’s troubling that so many Americans truly don’t understand the basics of health hygiene or the proper use of medications. It has been eye-opening to see the number of patients affected by healthcare disparities and limited health literacy. That’s something that I hope will change.

Ziegler: We are still in the midst of an incredibly challenging time – politically, socially and professionally. The professionalism and empathy that nursing demands has been greatly challenged in recent years. Although we’re still not clear of these challenges, nurses have continued to withstand the pressure with remarkable strength and grace.

Cooper: What a learning curve! It was obviously difficult to cope with the pressures brought on by COVID-19, but I found myself facing new challenges once those cases waned and patients with other diseases started to arrive. I’d almost begun to think of myself as a “COVID nurse” – I’d gotten so used to providing the same care, listening to the same lung sounds, providing the same type of oxygen, administering the same medications. It was jarring when we finally began to see a greater variety of cases. I don’t think I really felt like a “regular” nurse until after the Delta wave.

Is there any advice you’d like to share with those contemplating a nursing career or just starting out?

Norris: I think most Americans have received a lot of mixed messages about nursing, but my experience at the bedside has been even more rewarding than I expected it to be. If you are considering nursing or are just starting out, trust your instincts and acknowledge the reasons you are drawn to the field. Nursing is a “work of heart” that can open you up to so many meaningful experiences. It gives you the opportunity to truly make a difference. Surprisingly, the job has also refined my sense of humor, which is something I never would have expected!

Ziegler: Nursing is an extremely rewarding but challenging career. I encourage new nurses to become engaged with their hospital and nursing team and continue to fine-tune their skills. At Cleveland Clinic, I have seen how the bedside voice can improve clinical workflow and influence the way we manage our patients. When interviewing nurse candidates, I always emphasize the key role that we play in healthcare. Regardless of title, degree, or job description, every Cleveland Clinic employee shares the same goal: providing the best possible care to our patients.

Cooper: When I talk to a nurse who’s just starting out, I always like to stress how important it is to protect yourself. Longevity in this career demands that you safeguard your health, your wellbeing, and your nursing license. If you’re managing an impulsive patient with an infectious disease like C. diff, gown up before entering the room. If you’re concerned about a patient, ask a doctor to evaluate them at the bedside. It is also critically important to set boundaries with patients and their families at the start. This not only enables you to manage your time, but it also comforts the family and helps keep the patient safe. I’ve learned how valuable it is to ask the patient’s family to appoint a spokesperson to serve as the key point of communication.

Confidence in nursing is something that comes with time. One day, you’ll look back and think, “Wow, I really did that.” Take pride in your work, and give yourself credit for the accomplishments you’ve made.