What I’ve learned in my first year of nursing….

HEY GUYS! I haven’t updated this in a while, but it’s a very gloomy Tuesday morning and my creative writing juice is flowing so I’m about to let it go…(insert Frozen soundtrack.) February 2014 marked 1 whole year as a registered nurse, and to be honest…it seems quite impossible that the amount of “crazy” I’ve experienced could have happened in one whole year. Nursing is by far one of the most eventful, tiring, hilarious, testing, rewarding, and most disgusting jobs out there. I’m not sure there are many out there that can get close to all of these in one day. Luckily, it hasn’t driven me away. I’ve had my days…trust me. I’ve cried both bad and happy tears. I’ve laughed at the things we have to do as nurses to keep a patient safe, whether it be swaddling an old confused patient in bed like an infant to keep them from getting out, or taping panis’ to the side of beds so we can hold adequate pressure on groins when pulling heart caths. For those of you who are unfamiliar with the term “panis”, that would be the giant fat fold an obese person’s stomach creates that can sometimes fold all the way over their private area. Yes, it has a name, and yes, I just said this. 🙂 Although the past year has brought unique new smell, bleeding groins, crazy patients, and intense code blues, I am still assured 100% that I have one of the coolest jobs out there. On that note, here are a few things I’ve learned as a first year nurse and a “professional.”

1. Do the best that YOU can.
There will always be emails about the documentation not done, or that isn’t enough. There will always be those pain reassessments you never followed up on. There will always be those patients and managers that you can never please. You CANNOT compare yourself to another nurse. Everyone is different. Everyone has their way of doing something. It does not make your way wrong, it just makes it different. There are plenty of routes to get to the same place in this world. Same with nursing. Some people will criticize, or come behind you and “fix” something you did. That’s okay. You will learn that many nurses have a Type A personality and are very particular with what and how they do things. When you care for YOUR patient on YOUR shift, things are how you know to do them. Be open to learning and doing things differently if it makes sense, but just don’t take it personally if someone critiques or corrects you. The first year is a big learning curve. You will learn that you have your own brain and can think for yourself, and make decisions to keep or change your ways of practice. You will evolve into a smart, efficient nurse, and get into the swing of how YOU will do things. You will start feeling confident and comfortable. You may feel at the end of your day that you were “not enough.” Or you felt like a “bad nurse.” I have those days still! They happen. Don’t compare yourself to a seasoned nurse. They have years under their belts and you will start to understand why they know so much! They’ve been around the block and most likely know A TON and do things the way they do for a reason. Don’t compare, learn from them. Do the best that YOU can EVERY DAY. You are you. You are becoming your own nurse! I have slowly, but surely accepted that I can only do the best that I, Kelsey, can do. It helps to remind myself that on a daily basis.

2. Ask questions.
I feel like when I was in nursing school, my professors were really demeaning and unkind. I was afraid to ask questions, and chances are when I did, they’d tell me to look it up. Looking back on it now, I sometimes think they just didn’t know, HA! Who knows. But I am THE question queen. I never gave a drug without asking the charge nurse it seemed! I was scared every single shift. Really though, its a big deal! These are peoples lives! You learn more on the floor than you do in school. Over time I became more comfortable with my role because of the experience, but I would not have learned if I didn’t ask. I still ask a lot. I never feel dumb, I just feel safe.

3. Talk with your patients.
I am really BIG on this one. I love people. I like to say that I don’t meet a stranger. In nursing, you meet some crazy cats, but you also meet some really awesome ones. Everyone has a story. I’ve heard and seen things from patients and their families that just break my hearts. You witness a lot of neglect. A lot of homelessness. A lot of everything. I’ve noticed in my past 5 years of working in healthcare how much patients change their response to you in a good way when you take some time to sit and chat with them. I may go through the same routine of questions like” So are yall from this area?” or ” Do you have any children/grandchildren?”….but those few generic questions open up to stories into the lives of these people. I love that. I will admit that I am quick to analyze and judge some of my crazy patients, but I have had instances where they’ve become some of my favorite ones and we were able to really help them out both in and out of the hospital. Nursing has become a very technology based profession. It demands a lot of time for documentation and passing medication. If you get caught up in the tasks, you’re going to miss the fruit of nursing. The ” God” factor in my job. And that’s people. People and their stories. And really making them feel loved and cared for in hard times. Sit and talk with your patients. SIT and TALK with your patients! You’ll get the gold nursing medal in my book!

3. Fly under the radar
Don’t be out to impress anybody. Take care of your patients safely, effectively, and be efficient. There will be times where you will need to speak up as a nurse. And that will be when its personally affectes you and your practice, or when you have felt disrespected or offended by a patient or someone in the workplace. Those are valid and need to be addressed. But my biggest piece of advice is to do your job, do it well, and then go home. The beauty of being a nurse is that you can leave your job at work. No papers to grade, no projects to complete, no research to be written. You’re done! If you have plans to do a side PRN job, or you are planning to move, just keep those between you and your family. When it is set in stone and things have to be said, THEN move forth with telling the appropriate peron.There will also be people and management you can’t please, or nurses who come onto opposite shifts complaining about what you haven’t done. Don’t complain, raise fists, or make a big deal out of things. Even if you feel you haven’t done wrong. Just listen to what they have to say, and move on knowing you did the best you could do. If management has an issue with the way you are doing things, take the criticism, change it, and move forward. Don’t get up in arms. It’s NOT worth it! You have to go BACK to those people at work, and you will also bring home the emotional burden. Bridges will be burned and things could affect you in the future. I’ve made my share of mistakes with this, and I’ve learned to change my response to them for the better.

4. Laugh
You have to laugh at this job. Some days you are doing things that many people on this earth wouldn’t even do for money. I’ve cleaned up trails of diarrhea, emulsified nasty suction contents, been peed on, bleed on, spit on, and the list goes on. I’ve had patients walk out naked in the hall wondering where they were. I’ve had confused patients converse with me and I couldn’t help but laugh right then and there because I was unable to hold it in! I can’t tell you the amount of laughing I’ve done at this job. Some people would be so angry at some of the tasks we endure as nurses, but I know this job is a calling. I don’t enjoy doing most of the above, but I laugh my way through it. Because I know whether they are able to express it or not, they are thankful for someone to come in and meet them where they’re at with their health and intervene where they can’t. Their families are greatful too. I’ll be honest, if I did’t laugh through my day, I would hate my job. Laughing heals. Not only for myself, but for my patients…and remember to smile 🙂

5. Don’t compare
I guess this kind of branches off of “do the best you can”, but I need to say this. It is so easy to look at other nurses and down yourself. I see them walking every single one of their patients in the hall. I see them laughing with families in the room. Then they come around to me and ask if I need help with anything while I’m drowning in a list of tasks, and they’ve passed all their meds and some by 9 am. You want to punch them and scream! There will be those times. But let me remind you again. You are your own nurse! You are in charge of your patients and the way you do things that shift. Although another nurse may be caught up and sitting at the nurses station on Pinterest while you’re drowning, you are doing your job the best that you can. Every patient load is different. Every day is different. There will be those nurses who seem like they have it all together, but that’s not you. You bring something unique to the table. Something no other nurse has. And I promise that if you ARE doing the best that you can do, then you are doing it just fine! Don’t be hard on yourself.

6. Lastly, be confident.
Be confident in your decisions. Use all of your resources available to be confident in them. Patients can tell when you’re flustered or don’t know what to do. If you don’t know something, don’t pretend you do. Stop, tell them “you know, that’s a good question, lets look it up.” They will appreciate your honesty rather then you give them an uncertain answer. You are trained to do what you do and like I said, the resources are there to help you succeed. When in doubt with any clinical situation, ABC’s. Someone starts actin a fool or is becoming lethargic, do what you KNOW to do. Check their vitals, check a sugar, get a urinalysis if it’s an old folk, 02 sat, hand grips, an EKG and maybe some labs. It’s annoying when you can’t figure it out, but more often then not, it’s related to one of the above. Stop, go through the list in your brain that you know to do, rather than running around, searching through the patient chart, and feeling like you don’t know what the heck to do! You tend to forget all about why the patient was here in the first place when things go wrong. The body is the body. I’m still learning in these critical situations, but it’s gotten to the point that by the time the physician gets there, I’ve completed and ruled out most of the above and we’re able to move forth with orders. My confidence and critical thinking skills are slowly but surely sharpening. It’s definitely taken time, but the reality is that they were already there, just having that plan in my head to implement during such a time has been super helpful. Be confident in your ability, and ask for help when needed!

I’m not going to sit here and lie, saying I’ve never questioned my decision to become a nurse. There have been days where it was SO rough that I just felt I could not do this the rest of my life. Then those needed days trickle in where I truly felt I made a difference. That satisfaction is hard to come by at other jobs in the way that nursing does. Nurses are some special people and I’ve been blessed to work along side some awesome ones at both of the hospitals I’ve worked at. We all have such a special common bond. Any nurse would understand what I mean. The past year and a half has been a crazy one. Lots of learning still to come, but I am finally at the point where I’m not scared of work. 🙂 It took me a while. I still get nervous in situations, I still become exhausted and question my sanity, and I still struggle with a lot of the above, but I’ve recognized how to do better. These few points I hope can encourage any nurse out there. I’m thankful for my job and training. I feel important in my role, and feel valued. Nurses are amazing. Love to all of mine out there!!!