The First 90 Days as a New Nurse: What to Expect, Why It’s So Hard, and How Confidence Is Really Built
Hello, friend and welcome.
If you’re brand new here, I’m so glad you found your way to this post. And if you’re a returning reader, thank you for being here. Truly.
This post is for you if you are:
In your first nursing job
About to start orientation
Somewhere in that first 90-day window thinking,
“Why does this feel so hard… and is it supposed to?”
Let me say this right up front:
If the first 90 days feel overwhelming, emotional, exhausting, or confidence-shaking, it does not mean you’re bad at nursing.
It means you’re a new nurse.
Today we’re going to talk about:
Why the first 90 days feel so intense
What’s actually happening behind the scenes
The phases most new nurses move through
And how confidence is really built (hint: it’s not what you think)
If you’re in the thick of it right now, I hope this gives you clarity, reassurance, and a deep exhale.
Why the First 90 Days Feel So Intense
The first 90 days of any job can be challenging — but nursing is different.
You’re not just learning a new role. You’re learning:
A new unit
New systems
New people
New expectations
All while caring for real human beings who depend on you for their safety.
Your brain is processing an enormous amount of information every single shift. So if you’re going home feeling drained, emotional, or questioning everything — there is a reason for that.
Let’s walk through the first 90 days by phase, because understanding what’s normal can be incredibly grounding.
Before the Unit: Hospital-Wide Orientation
Most new nurses start with New Employee Orientation, especially in larger hospital systems.
This may be:
In person
Virtual
Or a mix of both
This phase is very big-picture and organization-focused. You’ll learn about:
Safety policies
OSHA requirements
Infection prevention
The organization’s mission, vision, and values
You’ll likely hear from leadership, employee health, and security. It often feels very classroom-style — and that’s because it is.
Think of this phase as foundational learning. It’s not hands-on yet, and it’s not unit-specific.
You may also have EMR training (Epic, Cerner, etc.). Let me normalize this right now:
No one leaves EMR training feeling confident.
That comes later — through repetition and real-world use.
Days 1–30: Orientation Shock & Survival Mode
Welcome to information overload.
During the first month, you’re learning how to:
Chart
Pass meds
Find supplies
Understand unit flow
Work with your preceptor
Collaborate with the care team
And not feel like you’re constantly in the way
Most new nurses feel:
Slow
Awkward
Dependent
Deeply unsure of themselves
You might think, “Did I actually learn anything in nursing school?”
Here’s the truth:
You are not supposed to feel confident right now.
Your brain is in data-collection mode, not performance mode. This phase is not about being impressive — it’s about being safe.
If you’re asking a million questions, writing everything down, and double-checking yourself, that is not weakness. That is professionalism.
A Critical Mindset Shift
In the first month, confidence is not the goal.
Learning is.
Focus on:
One win per shift
One new skill
One thing you understand better than yesterday
That’s how real progress happens.
Why Asking Questions Is a Strength (Not a Weakness)
Orientation is not the time to pretend you have it all together.
The nurses who grow the fastest are the ones who are:
Curious
Honest
Teachable
Vulnerability might sound like:
“I’m nervous.”
“I’m not confident in this skill yet.”
“I’m eager to learn and open to feedback.”
That kind of communication builds trust.
From years of precepting, I can tell you this honestly:
Questions don’t worry experienced nurses — silence does.
There are no stupid questions. Every question helps prevent errors and protect patients.
Days 31–60: The Confidence Dip (“Oh No” Phase)
This is the phase no one warns you about.
By days 31–60:
Orientation may be ending
Expectations increase
You know just enough to realize how much you don’t know
This is also when comparison sneaks in — especially if you’re part of a new grad cohort.
Let me say this clearly:
No two orientation experiences are the same.
Someone may appear “ahead” because:
They’re on a different unit
Their ratios are lighter
They worked there as a tech
They have a highly experienced preceptor
Comparison will drain your confidence faster than almost anything else.
What Many New Nurses Feel in This Phase
Anxiety before shifts
Hyper-focus on mistakes
Feeling exposed or unsupported
Questioning their job, unit, or nursing entirely
Here’s what’s really happening:
Awareness increases before confidence does.
Discomfort does not mean incompetence.
It means you’re stretching.
This is where real learning begins.
How to Protect Your Mindset in the “Oh No” Phase
If work thoughts are consuming you outside of work, try this instead of ruminating:
Ask, “What did I learn today?”
Seek feedback, not reassurance
Identify one or two safe nurses you trust
You probably already know where you feel less confident — and that’s a good thing. Awareness allows you to be intentional.
Orientation is the safest time to practice and ask. Use it
Days 61–90: Early Competence & Finding Your Footing
Somewhere between days 60 and 90, something shifts.
Things don’t feel easy — but they feel familiar.
Signs you’re doing better than you think:
You know when to ask for help
You anticipate needs
You recover faster after hard shifts
You trust your judgment a little more
You may still think, “Am I really ready to be on my own?”
Here’s the truth:
No new nurse feels fully ready when orientation ends.
What matters most is that you:
Understand your workflow
Know your common meds
Can prioritize
Speak up about safety
Know your resources
That is competence.
The Truth About Confidence as a New Nurse
Confidence is not something you’re supposed to arrive with.
Confidence is built through:
Repetition
Reflection
Support
You do not need to love your job yet.
You’re allowed to grow into this role slowly.
Safety, humility, and self-awareness matter far more than “looking confident.”
When Discomfort Is Normal and When It’s Not
Normal new-nurse discomfort is expected.
🚩 Red flags include:
Being shamed for asking questions
Unsafe assignments
No consistent support
Fear of speaking up
Self-advocacy is not complaining. It is professionalism.
Big Sister Nurse Pep Talk (Read This Twice)
If you’re in your first 90 days thinking,
“Why does everyone else seem to have it together except me?”
Please hear this: You are exactly where you’re supposed to be.
This season is temporary.
You are not failing, you are becoming.
One day, you’ll look back and realize how much you grew.
And when that happens, you’ll be the nurse reassuring someone else that they’re not alone.
Until next time —
As always — I have one hand for me, and the other for you. 🤍
Signing Off…
Caroline
PS. Want more on this topic? Listen to Life After Nursing School Podcast Ep 48