my first year of nursing...

Today, I started a critical care class put on by the Greater Washington Area Chapter of the AACN. We will be covering a wide range of information regarding the care of critical care patients throughout the course (now through the end of March). During the introduction today, the instructor referred to someone she knew that had kept a journal of her first year of nursing which happened to also be in a NICU. The instructor gave us a summary of each month's entry basically chronically the ups and downs, excitement and depression, achievements and let downs of this girls first year. It seemed like such a good idea, I wished I had begun one when I first started (not that that was very long ago). But it does make me think of everything that has happened in my career since I have graduated.

Most all nurses you talk to will tell you that there was some point during their first months or year of nursing that made them think they chose the wrong profession, that they wouldn't be able to "stick it out" and I can't say that my experience is any different.

Since I began about a year ago, I have been through my fair share of scary moments, learning moments, crying moments, night shift moments, mistake moments, rounding moments, and "first time" moments. All these experiences have shaped who I have become as a nurse. Although some new grads get preceptors who don't really care about their new grad's progress, I have been lucky enough to have had two great preceptors in my first year. Since we moved half way through my first year of nursing, I got two "new grad" orientations, which I truly feel fortunate to have gotten. I learned so much during my first six months, this is where I feel like I got used to my role as a nurse, what was expected of me, how to manage my patients, which things should take priority, my assessment skills. I learned how to speak with physicians and other members of the healthcare team. After my first six months, I was still very much doubting my skills, but feeling like I was keeping my head above water. I felt like I was learning all these things but not necessarily completing the circle of how to use all my skills completely on my own, my "nursing judgment" as they say was incomplete. I was frequently uncertain of my decisions. Being me, I found my self wishing I had this skill, I hate being uncertain, but it takes years to have really great nursing judgment, and it is always evolving even in the most experienced nurses. My first hospital, preceptor, and manager gave me the tools I needed to put my education to a great start.

After we moved to Maryland, I was unemployed for two months, my newly formed skills were already getting rusty! Luckily I found a job and yet again was assigned an excellent preceptor. In such a new place, so far away from everything I know, my preceptor was able to be more than just my clinical mentor. She was able to listen to my homesick ramblings about my family, the excitement of all my new married experiences of buying a house and getting a puppy. She took care of my clinical needs and my emotional needs. She is an exceptional nurse who taught me that taking time to do the "little, insignificant things" can often be the most important things. As a new grad sometimes you see your day as being a list of tasks that all need to be complete and correct at the end of the day. She was able to teach me how to see the little needs of the patient and that sometimes those are the important things. While being kind and seeing the patient as a person, she was also able to teach me how to be an ICU nurse. She taught me about insulin drips, vasoactive drips, chest tubes, more in depth assessment skills, assisted physicians with procedures like Central Venous Line placements, ventilators, so much that I'm kind of at a loss right now to remember it all. She was able to give me confidence to start making recommendations on the patient's care during rounds and to really understand the patient's status rather than just hoping I make it to the end of the day without any mishaps. I would be lying if I told you I didn't still feel like that sometimes, but I also feel like I am making more connections with patient diagnosis and how the patient is clinically presenting and with how we are treating those symptoms. That nursing judgment I was so longing to have is beginning to build!

I, of course, still have a long way to go, but all in all I would consider my first year of nursing as a success. And I only cried and wanted to quit once! haha. Anyway, I suppose being in class today and hearing about this random girl's first year as a nurse reminded me that my first year is over too. This post is more about my gratitude for both the managers who took a chance and hired me, my two preceptors who have filled my head with all the good things about nursing, for all the other coworkers who tolerate my incessant questions, that patients who thank you when you have done something great for them and the ones who forgive you when you have been so busy your forgot something for them. Basically, thanks to those who treat others the way they would like to be treated, isn't it golden what makes the world go 'round?