Thursday, November 1, 2012

Time and Patience

Today I stopped by my nursing school to drop off a couple things and as luck would have it there was a faculty meeting and so I waited a bit and got to see a handful of my instructors and the program director. It was really good to see them!  They asked about where I was and how I was adjusting. It made miss having people in my life that care about my success. The faculty do care, despite what students think.

There are days when I wish I was back in school and enjoying the slower pace and low pressure environment. I am far happier on night shift because things are a bit less hectic and whirlwind. I've had a couple doozy nights. On night shift, we are pretty much non-stop between 7 and 11p but after that the work ebbs and flows depending on our patient load, acuity and any admissions, but usually there's another nurse that can come help when needed. There are still plenty of things I have not seen before or dealt with. In those instances, I HAVE to find help. Last night I administered blood and it was my first time. I printed out the hospital policy and procedure and with help and coaching from my Charge Nurse, things went well. Last week I had my first NG tube-fed patient that required me to do flushes and meds according to hospital policy. Every week there's something new to learn. Obviously learning is good, but I really hate asking for help (but of course I do). It's inexperience, and I hate it. One of the instructors that I saw today said that it's usually at 9 months where you start feeling a bit more confident and less insecure.  Guess I need to start another countdown timer.

Those who know me know that I don't lack self-confidence or strength. I am strong. I am confident. I just HATE feeling out of control. And honestly, that's probably the hardest thing for me as a new nurse. I have NO actual control over my patients and what happens next. I can certainly plan how I will go about my shift, but hypoglycemia, fever, arrhythmias, delirium, vomiting, chest pain, stroke, bleeding, and pain can totally disrupt those plans and I must respond accordingly while also still managing to get everything done that I must get done. I will become more proficient - more efficient. But it will take time and practice. So daily I am practicing patience with myself and others. 

The BEST part of my job is the opportunity to make a difference for a patient. Just this week I had a patient who was having trouble sleeping because of his shortness of breath combined with claustrophobia. He was a handful at night as he was uncomfortable and needed to move around but was not physically strong enough to move himself safely. He rotated from in the bed, to side of the bed, to the chair and back around and around.  At one point he said, "I'm sorry that I keep calling and needing your help... can you tell me why is it harder to breath when I'm laying in bed and a bit easier when I'm sitting on the side of the bed?" So while he was sitting on the side of the bed, I just sat down on the stool and sat with him and took the opportunity to spend time with him and explain how positioning makes a difference for people with heart failure and/or COPD. He was so grateful for my explanation. No one had ever validated his feelings or explained this in a way that helped him understand. Fortunately, I was finally able to get him some medication ordered that took the edge off his anxiety and shortness of breath so that he could sleep. In the morning I came by to check on him before I left for the day and he said "I want you to know that I really appreciate you taking the time to  explain things and your help last night. Thank you." Yes, he was a lot of work for three nights, but it's so satisfying to come alongside a patient who is really struggling and to not only help them with their physical needs, but to also see the light bulb go off after providing just a little bit of education about their situation. 

When I look to the future, I don't see myself doing bedside care for the long-term, but rather I see myself in a patient education role or working in a clinic where I can spend more time with patients. Perhaps a cardiac device clinic? I think I'd be happier in a position that is a bit more predictable, consistent and is less "in the moment" acute care.  But who knows - maybe with time and increased experience, I will grow to love bedside care such that I can't imagine being anywhere else. Time. And. Patience. Oh joy!



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