A New Grad’s Year Reflection
Today you’ve got 8 patients, and you’re feeling overwhelmed; you’ve got three discharges planned, one patient to go the OR, one scheduled for contrast and CT, and one trying to climb overboard… you see that the board has about four admissions waiting to come up. You take a pause, and remind yourself, you can do this. You remind yourself that about six months ago, you could barely handle two patients on orientation without feeling overwhelmed, and now you’re up to 8 patients. A heavy and stressful day, but you’ll get through it.
Today you have a patient who coded. You have a moment of panic as you look around the room, and you see you’re the most experienced nurse on this night-shift, and you’ve only been here 8 months. The charge nurse is on a break, and you’re wondering how this happened that all the new grads are together with no real support. But then you jump in and start working with the code team, and you realize, just over 8 months ago, you were the student watching - and back then you had no idea what to do in a code…so today, you may not be an expert, but you’re part of code team that’s working well together, and even though it doesn’t feel like it on a normal day; a lot’s changed in such a short amount of time.
Today, you have a CVVHD patient, and you feel like roadrunner with just one patient, a room that looks chaotic, maintaining an extraordinary amount of infusions, nervously working around the vascath, titrating meds, and just trying not to kill the patient. You feel like you’re treading water trying to stay afloat with the accuracy and measurements, and you’re sort of wishing this patient had a nurse who was more confident and maybe anticipated care a lot better…. and then you look around the room. Today is the first day you’ve had one of these patients. Yesterday you didn’t know how to do this, today you do.
Today you were standing around in rounds; with the intimidating jackass Attending, his group of residents, the scary charge nurse, case manager and social worker, and they’re grilling you on your complex patient, ( the one you freaked out when you saw you were assigned to them). They’re grilling you for minute details, and you pause for a moment. The brand new baby nurse you would have been terrified by being put on the spot, but you realize that now you actually know the answers, and you weren’t in this place before. You aren’t an expert by any means - plus you’ve got a steep hill ahead of the learning curve, but you are confident in your assessment, and you know your patient, so you’re standing your ground. You didn’t do that yesterday, today you did.
Today you have a weird feeling that something is wrong with your patient; you look at him, and you can’t pinpoint what it is. He’s sitting up in bed, vital signs normal, no ectopy on the monitor, nothing out of the ordinary. But you feel it, and you want to dismiss it, except you remembered about a year ago, you didn’t trust your instinct at all, and a patient crashed when you didn’t follow through with it. Today you will. Your trust in yourself is evolving. A lot has changed in a year, even if on your very worse day, you don’t feel it.