Nurse: Year One

It is unreal that I have been a nurse for a year, but I can say that there has been a palpable change in my life because I actually feel that I am a nurse, a professional... like an adult, haha. I am happy to report that I still love it and it has been everything that I thought it would be. There are many challenges and they are all as rewarding as the next, some are more difficult to overcome than others. I think that has been the most surprising thing this year, the things I find most challenging. I thought learning all the clinical nursing skills would be the biggest challenge I would face this year, and at first it was. 


The first few months I was still struggling with recognizing all the physiological indicators and nursing skills to measure them so when I started being Charge (which in Churchill means doing Emerge), I was seeing so many different patient presentations. Some days I would have a bunch of patients with cold and flu symptoms so by the end of that shift I would get good at assessing these patients, and then a patient would come in with a swollen an ankle and that would throw me right off. I could do my basic head-to-toe exam but being able to prioritize, compartmentalize and then organize a thorough report was a big challenge. I would call the doc with my assessment and then I would have to go back to the patient and ask things I hadn't thought about in my initial assessment, like if they had taken pain killers already, what it was and how much... This was an important phase to go through because I learned very quickly to check my insecurities and nerves at the door and stay calm in an intense situation so that I could assess the big picture and all the minute details at the same time for one patient and then turn around and do the same for someone else right after. In this way I have become much more effective, but I have in no way become an expert emerge nurse, I just have had enough experience now that I know to take my time and use my resources in order to be able to recognize the important indicators and to know what questions to ask. And maybe even more importantly now if I forget to ask something important and the doc sends me back to collect more information, I don't take it personally. 


Being Charge nurse was not my favorite thing to do for a long time, but I've been lucky to have many excellent examples of people that do it well and really enjoy it. I think I'm a confident person and I am comfortable with who I am, and when I make a decision I almost always stick to it. But when you are Charge your decisions effect others more than I am used to, and because of this you have to defend your decision - maybe defend isn't the right word - but at first that's how I felt, you need to be able to rationalize. And most of the time the decisions are made quickly, often these decisions are about patient load, triage, resource allocation and time management. I was timid and I questioned myself because most of my colleagues had more experience than I did so I looked and often still look to them for advice. The difference now is that it is less frequent because I have more experience and when I do ask a colleague for advice it's because it's an important decision that effects patient care and I am totally comfortable doing that now. Whereas I used to be disappointed in myself when I asked for advise, now it gives me peace of mind and often it confirms my first intuition.


I love that in my job here in Churchill we all support each other, we really work as a team. I know that in  all the crazy situations we find ourselves in, I have friends and colleagues that are working just as hard as me to make sure this patient gets the care they need and deserve. I hope that they feel the same about me.


I have always loved patient care and when I go home after work I have always been able to go home with "a smile in my heart," (like my mom always says); but lately I have been struggling with balancing hospital politics and keeping them out of my mind so I can enjoy caring for patients the way I always have. I know that every workplace has politics and that it is easy to let them weigh you down, and I have recently had moments where I've let that happen. So part of me wants me to just keep my eyes closed to it, keep blinders on... Because I really don't want to become bitter. But I am not convinced that this is the way to go, I feel that eventually it would eat away at me and I would be bitter anyway... I don't think its part of my personality to be able to look away and still remain an effective professional. But how to evoke change... I'm also not the type to speak out knowingly causing confrontation. I don't like confrontation.  But this recent inner turmoil has brought to my attention that in the future there may be a place for me in those who write evidence-based policy and procedure, but for now and the foreseeable future I am loving the change I can effect by caring for patients. 


Words that helped me come to this conclusion and inspired this post:
Mes amis, l’amour est cent fois meilleur que la haine.
L’espoir est meilleur que la peur.
L’optimisme est meilleur que le désespoir.
Alors aimons, gardons espoir et restons optimistes.
Et nous changerons le monde.


My friends, love is better than anger.
Hope is better than fear.
Optimism is better than despair.
So let us be loving, hopeful and optimistic.
And we’ll change the world.


Jack Layton's final message to Canadians.