Working as a nurse has gone from being a terrifying new undertaking in life to being a normal part of life's routine. I am almost 4 months into starting my first job as a nurse and every shift continues to bring new and often fascinating learning experiences, but I have definitely noticed a change with the passing time.
When I started this job, I was constantly learning and absorbing so much new information. Now the rate that I am learning things has slowed down considerably, and I find myself starting to refine this newly acquired knowledge and using my own intuition to think outside the box and be more proactive. Don't get me wrong, I still continue to encounter brand new situations every shift, such as protocols like the diabetic ketoacidosis care pathway, which put a strain on my brain while deciphering it during one recent night shift. I also continue to gather ‘fun facts’ such as: when the arterial line tracing has a swing it indicates that the patient could be dehydrated. I am often still faced with tasks that seem like they should be simple and straightforward, but then turn out to be irritatingly difficult or just plain awkward. For example, simply loading a syringe into a syringe pump has had me cursing to myself quietly behind my surgical mask.
I have found there to be a lot of problem-solving in critical care, and I am realising the value of being able to step back and see the whole picture when nursing a critically ill person. For example, the numerous monitors and machines used in this setting can easily become the main focal point of the bed space and I sometimes find myself fixating on the readout values too much and having to consciously break away from the technology to prioritise basic nursing assessment. This might be feeling pulses, listening to air entry or simply generally looking at the patient for physical signs of deterioration. This can be difficult to do, especially when surrounded by the added sensory impact of the panicked alarming of monitors. Although daunting at the time, these moments of being challenged regularly make nursing stand out as a profession, and I think they are helping me grow in other aspects of my life too.
There are two main elements that I am finding incredibly valuable for my personal progression and growth at this stage of my career. These are, first, being provided with constructive feedback, and second, receiving positive reinforcement. This support doesn't have to be delivered by somebody in charge or somebody senior, it can be equally as effective and motivational when coming from my colleagues. It's easy to dwell on the things that went wrong, but for some reason it comes less naturally for us to recall the things that we did well, which is why I find it so valuable when somebody provides me with that bit of reassurance and encouragement.
Most of the people I have spoken to in this profession have said they can relate to this idea that they are their own biggest critic. It is of course important, when a mistake is made, to ensure that it is acknowledged and corrected in the future, but it is also worth noting that the individual is likely to have already been quite hard on themselves. I know I am! The importance of finding a balance and acknowledging both the positives and the negatives in my practice has become more and more evident over the past few months, and I hope to remember this for when it is my turn to mentor student nurses and new starters in the future.
‘The importance of finding a balance and acknowledging both the positives and the negatives in my practice has become more and more evident over the past few months’
As for plans for the next couple of months, I am hoping to get my intravenous medicine administration competencies signed off (now that I have stopped swearing at the syringe pump), which will help me continue to build my confidence in managing the workload of my patients independently. I also hope to expand my knowledge of the ventilated patient so that I can start to wean patients with confidence and troubleshoot problems more effectively. Last, but not least, I aim to cut myself some slack and reflect more on my achievements and the things I have done well, rather than dwelling only on any negatives, and I hope those of you who are reading this can do the same!