“…then you were just expected to be ready”

The reception and integration of new staff are among the key prerequisites for building a strong, resilient, and sustainable healthcare service. In her Master’s studies in health sciences with a focus on healthcare management, Helga Margrét Jóhannesdóttir, Director of Nursing for the Blönduós region, examined the experiences of newly graduated nurses during their first years in practice. Part of her work also specifically addressed the successful onboarding of all new staff, regardless of profession. The study was conducted among newly graduated nurses across diverse workplaces nationwide.

“First steps in a new job are crucial for everyone—whether nurses, nursing assistants, other healthcare professionals, or support staff. A good reception, clear communication, and active support lay the foundation for a sense of safety, job satisfaction, and a desire to remain in the workplace.

”Unrealistic expectations relative to experience

In the study, titled “…then you were just expected to be ready,” participants described experiencing unrealistic expectations in relation to their level of experience. Many noted a mismatch between expectations and reality and did not feel genuinely secure in their role until after one to three years.Participants described early difficulties in separating work and personal life, experiencing sleep disturbances, persistent fatigue, and physical pain. High responsibility, insecurity in their roles, and fear of making mistakes significantly affected their well-being, and three participants had already experienced burnout. Most had considered leaving, particularly during periods of high workload, and many found it difficult to envision themselves continuing in the job long-term under such conditions.

Managerial reception and support influence work experience

Participants’ accounts also clearly showed that the reception and support from managers were crucial to their overall work experience. Where support was structured, individualized, and managers were visible, participants reported greater feelings of safety and job satisfaction. Conversely, unclear onboarding, lack of communication, and limited follow-up increased the likelihood of distress and thoughts of leaving. The onboarding of new staff and ongoing support thus proved to be key factors in determining whether the first years in the profession became a constructive or a burdensome experience.

Summer staff are arriving—and we are ready

At this time of year, HSN begins welcoming summer staff, many of whom are taking their very first steps into healthcare—or even into the labor market.

“The first experience this group has of the workplace, communication, and support can have profound long-term effects on their well-being and their attitudes toward working life. Whether individuals feel safe, respected, and supported from the outset can determine whether they thrive in their role or withdraw. We carry a strong responsibility to take good care of people at this critical stage.”

Helga’s study showed that managers play a key role in the onboarding of new staff. Through visible leadership, regular dialogue, and active follow-up, managers can have a decisive impact on employees’ sense of safety, well-being, and job satisfaction.

“At HSN, we have a range of strong and diverse tools to support this role. These include newly approved policies aimed at strengthening well-being, communication, equality, and professional development. In addition, clear procedures have been established for responding to bullying, harassment, and violence. Such frameworks create security, foster healthy communication, and enable managers to intervene early and support new staff—not least those who are entering their first job. Our responsibility is to create a working environment where all new employees, especially those taking their very first steps, receive the support they need to feel secure, develop in their roles, and become part of a strong and professional team for the future. We look forward to welcoming new staff this summer and hope their experience will be positive, that they will feel comfortable in their roles, and that they may wish to stay with us in the future.”

A peer-reviewed article based on the study has been published in the Icelandic Journal of Nursing, and the full article can be accessed here.