Saturday, December 3, 2011

Reflecting on my first year as a nurse

There is so much you just don't learn in nursing school.  Really.

Nursing school teaches you how to pass your NCLEX.  Yeah, you learn the pathophysiology of disease processes and all that stuff, but nursing school really doesn't teach you to "be a nurse".

I had worked in the hospital for a couple years as a CNA.  I knew every day was not perfect.  I knew nursing was hard.  I knew there was a lot going on that the patient's and family don't realize is going on "behind the scenes" to make happen what we accomplish in a 12-hour shift.  I knew that even after I graduated I'd still have a lot to learn.  Still, I was a little bit shell-shocked into the "real life" of nursing.

Even 4 months of orientation with a preceptor doesn't really teach you to be a nurse.  Though, you sure do learn A LOT more than you do in school about real bedside nursing.  But I don't know if you are ever really prepared for the first time things go south, or your first emergency, etc.

This day last year I was a couple of hours into my very last night of preceptorship, and on December 9th I graduated at the top of my class with a 4.0 GPA.  And when I walked up on that stage to get my GPA award and my 3 year old daughter shouted as loud as she could "Good job mommy!" it made my eyes well up with tears.  Because all that hard work I put into my schoolwork was worth it.  I had done what I had set out to accomplish.  I'd become a nurse, and I was going to be a damn good one!  I was going to help people!  I was going to help make them better!

I started out and had a GREAT preceptor right off the bat.  And I mean great.  She really helped me learn to think for myself, build confidence, and learn to start trusting my judgement.  She was always there when I needed her to be, but she also knew when to step back and let me do my own thing, even when *I* thought I wasn't ready yet.  And I learned very quickly that as an RN you are NEVER alone.  If you feel alone where you work and like there is no one to help you, no one you can ask questions to, then there is something wrong.

My 4 months of precepting with another RN though were relatively uneventful.  In a way that was good, but my first day on the floor taking my own assignment by myself I experienced TWO things I'd never had to deal with before.  Nothing anyone could have done to prevent that, it's just the way the cards fall.  My whole first week was tough, full of surprises, LOL.  But everyone told me I did great.  I stayed calm, I asked for help when I needed it, and everything was good in the end.  Stressful day?  Yes, but I went home reflecting on it - what did I learn?  Should I have done anything differently, and if so, what?  I try to do that whenever possible.  If you ever stop learning as a nurse, then I think you probably need to go do something else.

I've also had days where I went home frustrated, or upset.  I've come home in tears from that frustration.  I think all new nurses probably have.  I've had great days, I've had bad days, I've had mediocre days.  Most of them have been good.  I work with a great group of people and never once have I really felt like they didn't have my back.  Even when I've been sent to other units, other hospital campuses even, I felt like the other nurses where there to help me, and tried to make it the best they could.

I'm not really a person who likes change.  Especially not sudden ones.  As long as I have time to prepare, I'm OK.   In nursing however you don't always get time to prepare.  Sometimes there's not really much warning when a patient starts going south, or you have an emergency.  Still, I'm OK with that, mostly.  I say mostly because I'm great in a crisis - I can stay calm and focused for the patient.  I just tend to fall apart when it's over.  But I recollect myself and move on.  I've come to terms with the fact that nursing is ever-changing, and sometimes it changes quickly.

Something I haven't come to terms with yet is that I can't "fix" everyone.  I want to.  I want to make them all better.  Today was one of those absolutely hellish days.  It just started out chaotic with technical difficulties abound, but the patients were all OK.  I sent two home and picked up two new ones, and my third was all set to go home tomorrow.  And then things went bad.  And it upsets me.  It's nobody's fault, and nobody could've done anything differently.  Sometimes it just happens.  

But you are always rooting for your patients.  As a good nurse I think you want to see everyone get better and go home.  And when they are so close and then something else happens it's just upsetting.  You are upset for them, as well as upset because you can't just "fix it".  At least that's how I feel.

I'm sure that as I am a nurse longer I will learn to accept the things I cannot change.  Sometimes I know that even when you can't make someone 100% better you can still be there to help do the little things and support them and just keep doing everything you can until they really ARE better and DO get to go home.

I feel I have really come far over the past year.  I've learned a lot, I am trusting my own judgement more and more, but I still ask a lot of questions.  I've never been afraid to ask for another opinion on something I was unsure about.  I'd always rather be safe than sorry, and not be overconfident.

I wonder how things will be this time next year.  How will I feel as nurse?  How will I be doing?  What obstacles will I overcome?  What will I learn or experience next?

Overall, I love my job.  Yup, some days are tough, but I love being a bedside nurse.  Even when things aren't perfect, or a person is having trouble and not getting better as fast as they'd like or whatever the situation, I hope that I made a difference to them, even if it was just for my 12-hour shift.