If you’re looking for a new position in nursing, you have lots of company. According to a CareerBuilder.com survey, 32% of nurses plan to change jobs within a year, and 18% plan to change within 6 months. Of course, a new job can be stimulating, but it can also be stressful.

Not only will you have new responsibilities, but you’ll also have a new setting, new leaders, and new colleagues. And the quicker you can figure out who’s who and what’s what—without stepping on anyone’s toes—the better off you’ll be.

But establishing positive relationships while performing your new job well can be tricky. And early missteps can have a lasting effect on your working relationships and your effectiveness. That’s why I recommend using the four tactics below, starting on day one.

Be positive and prepared for orientation

Most healthcare settings have established orientation processes. You may have to attend an orientation class, work with a mentor, complete an orientation checklist, and read required materials, such as policies and procedures. Orientation can seem mechanical because it’s the same for everyone and may be similar to orientations you’ve gone through at other jobs. But you must project a positive attitude because during orientation you will meet your new leaders and colleagues. And first impressions do matter.

Plan to come to orientation well rested, even if you’re used to working nights and must attend a 7:30 a.m. class. Being well rested gives you more energy for eye contact and positive conversation with your new colleagues. Introducing yourself with a pleasant smile and a firm handshake are important unwritten expectations in health care. They tell people that you care and you’re ready to work in your new position.

Early in the orientation process, you will likely see areas ripe for improvement. Taking the time to complete evaluation forms is one way to begin expressing yourself and your opinions.

Build goodwill 

Most nurses are hard-working, devoted employees who often feel unrewarded. Bringing candies or a light snack to share on your first day of orientation can open opportunities for conversation and give your colleagues a sense that you care. Of course, you should ask your supervisor or review the healthcare setting’s policy before offering such treats. 

You can also win over your colleagues by simply doing the job you were hired to do as well as you can. You may feel that asking questions places a burden on your new colleagues. But questions show that you care about getting things right the first time.

Usually, showing respect and common courtesy helps you build goodwill, too. Sometimes though, no matter what you do, you will be working with people who are unreceptive or difficult by nature. Breaking down their defenses may be easier than you think. Start by asking their opinion about a process or procedure. Giving prickly people the respect they think they deserve is one way of disarming them. Acknowledge their experience and skills when seeking their assistance. Most people want to be recognized for what they know and what they contribute.

Listen to gossip

When you’re new, pay attention to the grapevine but don’t participate in it. Listening to gossip can help you understand an organization’s culture, key events in its past, and the idiosyncrasies of coworkers. It can also help you avoid awkward situations. Suppose the coworker you thought was difficult by nature is dealing with a major family illness or loss. Knowing about the situation can prevent you from causing embarrassment and hurt feelings.

One method for obtaining such information without appearing to pry is to ask an approachable colleague who seems to be “plugged in.” Ask simple questions about processes. For example, you might ask, “How does Jane like to receive report at the change of shift?” Chances are good that knowledgeable coworkers will pepper their responses with personal and useful information. Your coworker might reply, “Keep report short. Since her divorce, Jane seems to want the “cut-to-the-chase version.” With this approach, you get the information you need without looking as though you are angling for it.

Let your light shine

Initially, you will want to impress your coworkers by telling them how much you know and by sharing all your great ideas for improvement. Face it: No one really wants to hear, “At the last place I worked, we did (fill in the blank), and it worked great!” Resist the impulse. Such statements can sound threatening to established employees. The staff members may think they’re doing pretty well already—or at least well enough that they don’t need advice from someone who just walked in the door.

A better tactic is to identify the influential people in your area and find a reason to work with them. (Hint: A nurse who is quoted by other nurses is an influential person.) Gain the trust of influential people by being professional, competent, and pleasant. Keep in mind that it will take time for these people to get to know and trust you.

Nurses tend to follow the opinions of only a few people in the work setting, regardless of experience or clinical evidence. And gaining the trust of those few influential people can provide opportunities to create a buzz around your thoughts and ideas.

Valuable experience

You were hired because someone in authority thinks you have what it takes to do the job. But to do your new job well, you also need to develop positive relationships, so you fit in quickly and gain valuable experience for wherever your career takes you.    

Selected references

Mortell N. Adjusting to your new job. Lab Anim (NY). 2007;36(8):46.

Nearly half of nurses plan to change jobs in the next two years. http://sev.prnewswire.com/health-care-hospitals/20050718/CGM04018072005-1.html. Accessed November 6, 2007.

Nolan S, Murphy J. The tried, true, and new: a traditional approach to critical care education with a new twist. Crit Care Nurs Q. 2006;

29(3):199-206.

Steen M. Office gossip can be productive. http://hotjobs.yahoo.com/jobseeker/tools/ept/careerArticlesPost.html?post=72. Accessed November 6, 2007.

Thompson C, McCaughan D, Cullum N, Sheldon T, Mulhall A, Thompson DR. Research information in nurses’ clinical decision-making: what is useful? J Adv Nurs. 2001;36(3):376-388.

Gregory S. Kopp, RN, MN, MHA, is a staff nurse in the intensive care unit at the Joint Venture VA/DOD Hospital on Elmendorf Air Force Base in Anchorage, Alaska.