The most common challenges for nursing students and new nurses include transitioning to unpredictable clinical practice, managing nursing’s emotional demands, and finding one’s voice as a nurse. These challenges of being a nurse are a natural part of learning and can be prepared for through self-reflection, skill development, mentorship, and more.
As nursing students graduate and earn their licenses, they are preparing to enter a field with incredible demand for their skills and expertise. With such a demand comes challenges. Students and new nurses will need to learn to navigate the unpredictability of clinical practice, manage the emotional demands of nursing, and find their voices to excel in today’s healthcare landscape. Fortunately, these challenges of being a nurse are predictable, meaning we can prepare for them.
As a professor of nursing at Felician University with over 35 years of experience in clinical practice and nursing education, I’ve experienced these challenges and guided students through them.
At the heart of everything that I do is helping students move beyond simply learning content to developing confidence, judgment, and the presence needed to care for patients in real-world settings. Through preparation and self-reflection, students can meet these challenges and help shape the future of nursing.
The Current State of the Nursing Profession
Nursing is at a pivotal moment. With significant demand for nurses and the increasing complexity in patient care, nurses are being called to provide care, think critically, adapt quickly, and advocate for more than ever before. There is also a critical shift in how nurses’ voices are heard.
Today, nurses’ perspectives are being considered and integrated into healthcare spaces, systems, and workflows. Nurses are at the forefront of patient care. They understand how care is delivered in real time. By including their voices early in policy and healthcare conversations, we can achieve practical, patient-centered, and effective solutions.
I believe the future of nursing is not simply about adapting; it’s about nurses leading the change. As students graduate and enter the nursing workforce, they will need to develop the skills to become compassionate providers and advocates to foster a brighter future.
The Most Common Challenges Facing Students and New Nurses
Challenges are not signs of failure or character flaws. They signal where preparation, support, and voices are needed. Nursing students and professionals will face many challenges in their education and careers as they grow, but the three most common challenges include:
- The unpredictability of professional practice
- Nursing’s emotional demands
- Finding one’s voice in clinical environments
The Unpredictability of Nursing
Nursing is inherently unpredictable. Patient conditions can change rapidly, and emergencies can arise without notice, requiring nurses to adapt quickly. Students will need to manage this unpredictability as they transition from the classroom to the realities of clinical care.
In the classroom, students learn the “what and why,” memorizing medical terminology, lab values, and bodily systems. While students gain hands-on, practical experience in nursing school labs and clinicals, they primarily acquire theoretical knowledge.
In clinical practice, however, you learn the “how and when.” They must now apply their knowledge and learn to rely on their clinical judgment and critical thinking, rather than memorization. This is not a failure of education; it’s the nature of the practice. Humans are unpredictable, and as a nurse, you must be able to adapt and shift priorities under time constraints.
I tell students it’s not about knowing or remembering everything. I often use an analogy of a toolbox: Store your nursing knowledge and experiences in toolboxes. Keep the skills you use every day, such as self-awareness, critical thinking, and compassion, in a toolbelt, so they’re always close.
You also keep toolboxes for specific situations that you can pull from when needed, storing the tools in larger containers as you learn and grow. You don’t always have to know everything right away; you can pull what you need when you need it.
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The Emotional Demands of Nursing
As a nurse, you’ll have to care for patients during vulnerable moments, manage loss and complex family dynamics, navigate uncertainty, and learn to be comfortable with discomfort. It’s important to remember that these situations are not just clinical; they’re relational, and you can learn to manage them.
To maintain your mental health and cope with stress and difficult patient situations, you must learn not to carry these experiences alone. After a challenging patient interaction or experience, confide in a trusted nurse.
Ask them, “Have you ever had such a patient?” or “What was it like and how did you deal with it?” or “What would help or what could I have done differently?” Talk to someone immediately so you don’t bring these feelings home.
Emotion is not a sign of weakness. It’s part of being a compassionate nurse. Emotion shows the patient that you’re human, and they will connect with you. The confidence to cope with difficult times is built through experience and sustained through reflection, whether self-reflection or with someone else.
While the emotional aspect of nursing can be demanding, it is also filled with rewards. As a nurse, you may help bring new life to the world, be by your patient’s side after a successful surgery, or help send patients home fully functional after a stroke or a heart attack. There will be many happy moments in your nursing career, and it’s important not to lose sight of these.
Finding Your Voice in Clinical Environments
Nursing students learn a lot about patient advocacy, but very little about advocating for themselves. We cannot have one without the other. Learning to advocate for yourself is a common nursing student challenge, and overcoming it starts with learning that your voice matters. As educators and leaders, we must create environments where that voice is welcome.
Nurses spend more time with patients than anyone else on the team, and their insight is valuable; however, it can be very intimidating for students and new nurses to speak up, contribute, or ask questions in the decision-making process.
Finding your voice does not mean speaking loudly or confronting but, rather, speaking with clarity, purpose, and confidence. In other words, advocacy requires you to be assertive. Ask questions, seek clarification, and speak up when something doesn’t feel right or safe.
How Students Can Prepare for the Challenges of Being a Nurse
These challenges in nursing affect every nurse, but we can prepare to navigate them. Preparation is practical and doesn’t have to be overwhelming.
Prepare to Transition from Student to Nurse
I encourage students to start small. Take advantage of simulation experiences as a student. Labs help bridge the gap between theory and practice, while providing a safe space to make mistakes and learn. Repetition is key to making tasks and communication feel natural. Practice as often as you can.
I’ve identified ten small steps students can take to help them prepare for the realities of clinical practice:
- Think like a nurse: Ask yourself, “What should I do first?” and “What could go wrong if I do or don’t?”
- Practice speaking out loud: Recite mini reports using SBAR with classmates, family, or friends to make communication feel natural.
- Become an active observer: Watch how nurses prioritize tasks and communicate, not just what they do.
- Organize tasks for each clinical: At the start of each clinical shift, write down and organize patient priorities. Think about what you need to do this shift and what you should do first.
- Reflect after each clinical: Think about what went well, what confused you, and what you should do differently tomorrow.
- Learn to stay calm: Calm your nerves before entering a patient’s room, such as by taking a few breaths.
- Practice confidence in small amounts: Confidence starts with a simple greeting to your new colleagues. Small gestures can make a big difference.
- Know where to find answers: You don’t need to know everything, but you must know where to look for answers. Don’t be afraid to ask questions or for help.
- Find your support person: Identify someone you feel comfortable asking questions or seeking advice from.
- Reframe and embrace discomfort: Discomfort is natural and an indicator that learning is happening.
Get the Most Out of Clinicals
In the clinical setting, learn not to focus solely on the task at hand, such as drawing blood or assessing blood pressure. Observe how other nurses think and ask them questions to understand the “why” behind their actions.
Pay close attention to how nurses interact with patients, each other, and other members of the healthcare team. Watch how they prioritize tasks and manage their time. Clinicals are where students begin to see how everything they’ve learned through coursework and simulation comes together. By watching the nurses around you, you’ll see the pieces start to form a bigger picture, not perfectly but realistically.
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Develop Strategies to Manage Stress
It is normal for students and nurses to feel stressed. Stress is a natural part of learning something new and complex. It’s critical for students and nurses to self-reflect and discover how they feel at their best, so they can recognize when they’re not and care for themselves.
I encourage students to discover what brings them joy, peace, and comfort so they can identify their most effective self-care practices. Self-care can be as simple as talking to a friend, going for a walk, listening to their favorite music, or cuddling with a pet. Students have come back and told me they didn’t know why they enjoyed facials or painting their nails in the past, but after self-reflection, they know it’s because it relaxes them. They do it with purpose now.
It’s also just as important that students know it’s okay to ask for help, that it’s not a personal failure and, in fact, a strength. I believe these small habits add up and make a real difference.
Explore Mentorship in Nursing
Feeling unsure is part of the process of becoming a nurse. Nursing is complex, and it’s okay not to have the answers. That’s why mentorship in nursing is essential. Mentors provide guidance, support, and a sense of connection.
While mentorship programs exist, mentorship relationships often form naturally when students and new nurses show curiosity and engagement. To find a mentor, look at the nursing professionals around you and ask yourself:
- Who is approachable?
- Who is supportive and willing to teach?
- Who do you have a rapport with?
Building Confidence as a Nurse
Facing the challenges of being a nurse requires confidence but know that confidence builds over time through experience, reflection, and small moments of growth. Every question you ask, every patient interaction, and every moment you reflect will contribute to your growth as a nurse.
Students who take the time to reflect on their reactions, strengths, and areas of growth are better prepared to handle the complexity of real-world patient care. Nurses must never stop reflecting. It’ll help you recognize how you respond under pressure and how you are growing.
Remember that you don’t need to be a perfect nurse. You just need to be present, willing to learn, and committed to showing up. Over time, your voice can help shape the future of nursing and patient care.
Start Your Nursing Journey with Felician University
Felician University’s School of Nursing and Health Sciences has a long history of preparing the next generation of nurses to become leaders, patient advocates, and problem-solvers. As an extension of our commitment to nursing education, the Accelerated Bachelor of Science in Nursing (ABSN) program provides a pathway for career changers and transfer students to enter the nursing profession quickly.
If you have a non-nursing bachelor’s degree or at least 60 college credits, you may be eligible to earn a Bachelor of Science in Nursing (BSN) in as few as 16 months. The New Jersey ABSN program offers a values-based curriculum that includes nursing coursework, hands-on skills and simulation labs, and clinical rotations, preparing students for the NCLEX-RN licensure exam and beyond.
Students have the choice between two ABSN program delivery options: a hybrid program in Parsippany, New Jersey, that combines online coursework with hands-on labs and clinicals, or a fully in-person On-Ground program in Rutherford, New Jersey.
Request more information and connect with our admissions team today to learn if Felician’s ABSN program in New Jersey is right for you.
Carleen Graham, PhD, RN, FNYAM, is a registered nurse and assistant professor at Felician University. She has more than 35 years of clinical and education experience, including in the emergency room and inpatient psychiatric care. She holds a doctorate in nursing education from Capella University and is a Fellow of the New York Academy of Medicine.