Tuesday, December 16, 2008

Nurses eat their young

Their are certain animals in the world known to eat their young. Monkeys. Kitty cats. Hamsters. Spiders. And finches, to name a few. Chomp Chomp! Nurses are no different. 

I am a new nurse. Three months off orientation. All the beginning whirlwind bliss of formal introductions is over. With my 90 day evaluation in tow, I am on my own. I am left to bridge both the doctrines of nursing held steadily over generations (and generations...) of seasoned nurses before me, with all the rules and regulations of a unit breathing new life from ambitious young nursing grads. In some respects, life as a nurse is incredibly good. There are so many great nurses in the world to learn from. The depth of intelligence, the scope of clinical expertise, and the grace of a tenured hand eludes me. I can only wish to be such an extraordinary nurse one day. But for now, I learn. 

If only all wonderfully experienced nurses could see themselves for who they really are. If only all wonderfully experienced nurses could step back and imagine themselves at the beginning of their own learning curve. If they could do just this, they may learn to reserve judgement and give new nurses the opportunity to learn from their practical knowledge. At best, this would be the most optimal environment for everyone. A nursing utopia! In the end though, more positive nursing relations would create better clinical outcomes for patients, and optimal communication for the entire medical team. I know this not because I have numerous years of experience on the hospital floor, but simply because I can understand the nature of what it takes to make people work effectively together. Moreover, I've seen first hand what can happen when nurses treat each other disrespectfully and communication falls apart. 

I must admit though, being a new nurse is terrible at times. Just dreadful. I hate being a "newbie". I just want to embrace my new life as a nurse, but I am constantly being put back in my place. To be exact: 169 on the seniority list, with apparently very little movement upwards once you reach about 59. This is really not something I am used to because my life before nursing offered me continuous opportunity to launch forward. I was once the best at everything I took on. Always excelling and always taking on ambitious endeavors. Nursing, as a whole though, jerked me into new reality. The same ambitions you take on in regular life, don't translate the same in the medical world because it involves the well being of other people. I find that my old perfectionist ways now translate into, at times, overly-cautionary acts on my part. And in turn, judgement on my competency level by others. Although, if I wasn't so cautious then my clinical judgement would be questioned in that case as well. You're basically smoked either way. Cautionary examples I can think of- checking with another nurse on a med I haven't given in awhile or asking someone to double check my nursing notes on a particular incident. To me, this is how a competent new nurse should operate, but to others who may have brief encounters with me in the med room, a slightly different interpretation could potentially occur. Potentially. In my defense (as if this whole blog isn't in my defense), I'd like to point out that I have seen on more than one occasion some of these very same nurses become extremely flustered by their own patient assignment. It seems as though, there is a general acceptance that if an experienced nurse gets overwhelmed it's because she is really overwhelmed, but if a new nurse becomes overwhelmed it's because she must not know what she's doing. Anyway, I could be completely wrong in thinking this, but I'd like to revisit this idea in about 5 years and see how I feel.

It may take awhile, but I'm finding my balance. Everyday I am becoming a better nurse, and I immensely appreciate the nurses that take the time to be genuinely good to me. One day, I will be able to take on more. The sickest patients on my unit, if need be. That will be a great feeling. Until then, I begin my passage from novice to expert here.