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An Unofficial Guide to New Graduate Nursing

Your countdown app alerts you that you have 100 days left until you graduate nursing school. A wave of emotions comes over you – excitement and pride, but also apprehension and some anxiety.

You’ve grown accustomed to the ebb and flow of nursing school but now it is time to take your first steps as a new graduate nurse. How do I apply for my license? When am I going to take the NCLEX? What jobs are available for me and how do I best prepare myself for interviews?

As a recent graduate from Concordia University St. Paul of Portland’s ABSN program, I experienced all of these emotions and asked the same questions. There is no written guide for new graduate nurses in Oregon. There is a lot of information to process and it can become overwhelming! I aim to shed some light on the process of entering the nursing field. These are the steps that I personally took to land the nurse residency program of my dreams.

Your journey to your first nursing job should begin prior to your last semester of nursing school. The break before your final semester is a wonderful time to get started. Your knowledge of the nursing process will come in handy here!

Assessment and Diagnosis

What kind of nursing jobs are you most interested in? Are you staying in Oregon or moving elsewhere? (Please stay! We need you!) Would you like to complete a nurse residency or transition-to-practice (TTP) program, or do you want to go straight to the floor?

New graduates have a few options when it comes to nursing jobs. You have all heard that you have to start on a medical-surgical (med-surg) unit before transferring to a specialty unit like the intensive care unit (ICU) or operating room (OR). There may be some validity to this statement. Many employers ask for at least one year of experience before hiring to a higher acuity unit. The skills you learn during your time on a med-surg unit can serve as the building blocks for more advanced skills required in a specialty unit. However, nurse residency or TTP programs are one way to start on a specialty unit without a required year of experience. Think of a nurse residency or TTP program as an extended clinical. During your program, you will learn nursing skills specific to your unit, practice hands-on skills and work with a preceptor to build competency.

I personally opted for a nurse residency program. The pandemic complicated my clinical experience and I felt I could benefit from some additional training. During my semester break, I found a residency program through OHSU that spoke to me. I printed the job listing and hung it on my wall with a quote from Walt Disney that said, “If you can dream it, you can do it!”. This motivated me through my last semester of school. Visualize your dreams and believe in yourself! You have made it this far and you will land the job you’re dreaming of!

Planning

Now that you have a rough idea of the direction you’re headed, it’s time to look for jobs. The Oregon Center for Nursing (OCN) has a page dedicated to local nurse residency programs and transition-to-practice (TTP) programs. Take a look at start dates and deadlines. If you want to start work immediately after graduating, look for start dates about 5-6 weeks after graduation. This will allow enough time to take your NCLEX and complete the onboarding process. Some students opt to take a break before starting a job. Most new graduate orientations do not allow for time off, so keep this in mind if you are planning a celebratory vacation!

If you want to work at a specific hospital or healthcare system, visit their website and look for new graduate openings. Other places to look for jobs included LinkedIn and Indeed. Pay special attention to signing bonuses and contracts. Some hospitals require that you sign a contract for 1-2 years to develop competency within the unit and offset the cost of hiring new employees. Be open to looking at night, as well as day shift opportunities.

Intervention

Time to put your plan into action! Here is a rough timeline to follow.

4 months before graduation

This is a good time to begin researching what new graduate positions are open. Now is the time to update your resume and start writing cover letters. Cover letters are your opportunity to tell your employer details about yourself that you did not include on your resume. I included a personal story about what called me to nursing and why I am passionate about quality health care. I like to format my cover letter to match my resume. Your resume should include previous work experience, education, off-campus and on-campus clinical experiences, organizations you belong to, and certifications. There are free templates available online to build your nursing resume. I also looked on YouTube and Reddit for advice from hiring managers on what to include. It is also a good idea to create a LinkedIn profile if you do not already have one. LinkedIn is a great way to network with other nurses and potential employers.

Some new graduate positions open and close at the same time each year. Others do not follow a schedule and open when the unit needs additional nurses. If you do not see a program that matches what you’re looking for right away, keep checking back! It is best to apply as soon as possible when a position opens. Submit your cover letter and resume with your application and you are well on your way!

3 months before graduation

Soon you will be receiving invitations to interview for the jobs you’ve applied to. Nursing interviews are kind of like a speech or a performance; you have to practice your lines before showtime. Most interviewers will ask behavioral interview questions. They might also ask why you want to be a nurse, why you want to work at their facility, or a crowd favorite: “Tell me about yourself!” Before you interview for your dream job, write down some significant patient interactions you had during clinical, simulation, or at previous healthcare jobs. You might be asked about things like conflict, communication, and patient safety. Practice answering these questions with a friend so that you feel confident in your answers.

Another tip for interviewing is to do some research on the facility you are applying to. Go to their website and have a look around. What is their mission statement and why do you feel their values align with yours? Why are you going to be a stand-out applicant in their job pool? Finally, have some questions prepared to ask your interviewers. Some questions might include the start date, how long their orientation period is, and what kind of continuing education they offer. Another good question to ask is what the organization is looking for in an ideal candidate. This is a great way to tell your interviewer why you are a good fit for the position, get a pulse on how the interview is going, and gain confidence that you are competent for the job.

Most interviews are currently done via video call. When it’s time to interview, dress business casual and make sure you have adequate lighting with a good microphone. Have paper ready to take notes and send a thank you email when the interview concludes!

The first interview that I did was not my best. I learned from my mistakes and practiced interviewing with another student over Zoom. I looked to YouTube for advice from experienced nurse managers and hiring managers around the country. They spoke about the kinds of questions that might be asked and the kind of answer they are looking for from a candidate. The second time around, I felt more confident and prepared. I wrote out my answers ahead of time and especially practiced the “tell me about yourself” question. I talked about what drew me to nursing, why I was interested in working for the facility, and discussed my experiences in nursing school that prepared me for the position. Sometimes it just takes a little practice to get the hang of interviewing!

2 months before graduation

There are two websites you will use for your licensure: The Oregon State Board of Nursing (OBSN) and Pearson VUE. OBSN is responsible for licensure, while Pearson VUE will be used to schedule your NCLEX.

On the OSBN website, you can start your LPN or RN application. The LPN application is called “LPN Exam – U.S. Nursing Education” and the RN application is called “RN Exam – U.S. Nursing Education”. It is important to start this application early because the national criminal background check can take some time to process.

Even though you are in the process of finishing nursing school, there are a few continuing education classes you will need to complete as part of your license application. The first is cultural competence continuing education (CCCE). Nursing licensure applicants are also required to complete the OPMC pain management module.

After you have completed the application and paid the fee, you will receive an email from OSBN with instructions on how to schedule your fingerprinting appointment. It is best to complete this appointment as soon as possible to complete the background check requirement. The background check must be complete before your nursing license is issued. If you are planning to get your license outside of Oregon, allow additional time for fingerprinting. Fingerprints are generally mailed to your state’s board of nursing and will take extra time to process.

If you are applying for an Oregon license, your school will automatically send your transcripts to OSBN. If you are applying for a license out of state, you will need to request your transcript be sent to that state’s board of nursing after your grades are finalized and your degree has been added to your transcript.

Once your application is complete you can check for status updates on this website.

Pearson VUE is the company that administers the NCLEX. To register for the NCLEX, head to this website and create an account. Next, click “Start the Registration Process”. Make sure you are entering the correct program code for your nursing program! Incorrect program codes can complicate this step. After your application has been submitted, you will receive an NCLEX registration acknowledgment email. You have 365 days after you submit your registration to be approved for testing.

Evaluation

After you have completed these steps, all you have left to do is finish out your degree, take the NCLEX, and accept a job offer! You should receive your Authorization to Test (ATT) from Pearson VUE within two weeks of your degree conferral. The ATT is your ticket to schedule your NCLEX. It’s valid for three months. If you don’t receive your ATT, check the status of your OBSN application. Keep in mind that you are able to take the NCLEX in any state regardless of where you plan to be licensed. If you do not see a testing time that works for you in Oregon, try looking in Washington or another neighboring state.

For reference, I graduated on December 19th and I received my ATT on January 6th. I passed my NCLEX on January 19th and received my license from the OBSN the same day. This timeline may vary depending on where you live and the time of year you take your exam.

Going to nursing school during a pandemic has been challenging. I would like to speak to some of the anxieties you may be feeling if your clinical placements have been changed or even canceled. I was originally placed in an acute care setting for my senior practicum, but this placement was canceled due to a spike in COVID-19 cases. I was then placed in a long-term care facility to complete my clinical hours. I also worked in a few COVID-19 vaccine clinics around Portland. I was concerned that my lack of acute care experience in school would inhibit my ability to obtain an acute care nursing position after graduation. However, that was not my experience. There are many acute care nurse residency and TTP positions available in the Portland metro area. I accepted a position in a NICU residency program before I graduated. In fact, I turned another acute care offer down. I had choices.

During my interviews, I spoke about how my experiences in nursing school made me resilient. My senior practicum did not go the way I had planned, but I have learned to keep an open mind and trust the process. All of the things you learn during your practicum will shape you into a better nurse regardless of the location. In the long-term care facility, I wasn’t taking care of neonates, but I was hanging IV antibiotics, administering tube feedings, and performing basic nursing assessments – all of which are important NICU skills. I learned how to manage my time effectively and communicate within the interdisciplinary team. I used my knowledge of evidence-based practices to brainstorm when bumps in patient care arose. When it was all said and done, there is nothing I would have changed about my practicum. It taught me exactly what I needed to know. The rest I will learn during my nurse residency program. My message to all new graduates and soon-to-be graduates: it’s going to be okay. You are going to get where you’re going. It might not look or feel the way you wanted, but you will grow through the process in ways you could not have imagined. It is okay to feel frustrated and nervous. Remember why you started and find peace in the fact that nursing school will not last forever.

If you want to talk about new graduate jobs, the licensure application process, job interviews, the NCLEX, or just want a listening ear, please feel free to reach out to me! You can email me or connect with me on LinkedIn. I am also active in the OCN mobilize community.  I know you all have made endless sacrifices and have shown true resilience through your time in school. I can empathize with the struggles you endured and I am confident that you will all be great nurses for it. Your hard work is finally paying off! I am so excited to work with all of you future nurses!


Sarah Torrella is a registered nurse at Oregon Health & Science University, where she is a nurse resident in the NICU. In her free time, Sarah enjoys spending time with her partner, Josh, and their dog, Odin. She loves a good happy hour with friends, working out, travelling, and advocating for nurses and nursing students alike.


This article reflects the personal experiences of one recent Oregon graduate. Individual experiences may vary.

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