I’m still here, although the 3p-3a shift almost did me in. Do my bosses not see that I am OLD, and haven’t been up until 3am for at least a decade!?

First impressions :

There is a lot of extra training for new graduates at work. Some of it I am very happy to receive. Please, show me how to access a port. I would much rather learn on a mannequin than a person. There is other extra training, and this unfortunately seems to be the majority of it, that is designed to create jobs for people who create trainings and then need metrics by which to measure their success. I feel like a real asshole asking a nurse, who is already doing extra work be precepting me when they have NO extra time, to sit with me at the computer and click boxes giving my skills in SIXTEEN different areas a numerical rating. Ugh. So sorry. Also no thank you scavenger hunt. And no thank you to any education involving children. There is a whole separate half of the ED for that.
I have spent a total of 20 hours “on the floor”. I can do all of the tasks. Drawing blood, taking people to CT, starting IVs and scanning bladdars and wiping butts. The two places where I have SO much to learn are:
- The computer. Holy hell I am just WAITING to forget to click “ready for MRI” and have a patient taking up a room for hours and everyone mad at me because there are 30 more waiting to be seen but no room because no one ever came to get my person because I didn’t click a button. It will happen. I will (probably) cry. There are so many small steps, clicks, “dot phrases”, notes. It slows me down more than a old person with a UTI.
- Critical thinking. The experienced nurses can take a look at the chief complaint in the computer and a glance at the patient and have a pretty good idea of what is wrong with them. They anticipate what procedure to set up for and labs to order and weather to get them a gown with or without metal buttons. Not me. (Unless, like, you’ve sawed off your finger. Then I’m pretty clear on what’s going on and what needs to happen.)
The good news is that I love it. Being married to a disillusioned doctor has taken the surprise out of all the crappy parts of medicine. I know the system is falling apart and there is pressure on all sides to focus on throughput instead of on people. I know there are grouchy people. I know that no amount of education or prestige makes you infallible. I anticipated all of these things so am not as upset by them at work. Jeremy has also advised me never to make eye contact with a trauma surgeon unless I’m ready to get yelled at. Noted.
I love feeling like a nurse. Sitting at the nursing station. Bustling around with a pocket full of flushes. Working calmly on the computer as someone is screaming and security is running down the hall. I love hearing the patients stories and getting to help them. All of the nurses in the ED have been nothing but supportive and welcoming, and the people who started at the same time as me are all great. Since I’m still a baby nurse they’re not letting me near the big traumas yet. I feel just fine about it and also confident that, when the time comes, I will be shitting-my-pants scared and make mistakes but will, in the not too distant future, be able to handle it.
I wear my mom’s necklace for every work shift. I had to get a cheap chain that would easily break on the off chance that a patient grabs it, but it is with me. I think about everything I have learned over the past two years and how much that knowledge, had I had it when she was sick, would have changed my actions. I would have told her how sick she was. I would not have left her at home in NC. I would have asked more questions of the surgeons and doctors. I would have been a better advocate. I could have done more to alleviate her suffering. The things I did wrong fill me with sadness and regret. Every patient that I make a connection with, that I help to feel safer or more understood, I think of her. It makes me sad beyond measure but it also assures me that I am in the right place, doing what I am supposed to be doing, and that feels pretty damn good.