Impatience (10-29-2008)

I am so frustrated with this place in my nursing journey. I know I am in a transitional position and I suppose that perspective is the only thing getting me through, knowing that this too shall pass. Right now I am at the point where my head is full of knowledge and I have to learn to transfer what I know… to what I do. (Easier said than done.) Nursing is one of those things that you can read about your entire life but until you actually “do” a procedure on a real life unpredictable patient you really don’t know it at all. That is why I understand we need to be tested and tried. Coming back for our second year it feels a little like our instructors have just pushed us in the pool and are watching from the bleachers to see if we sink or swim. And I get that. Right now if we sink they can rescue us, we still have backup. Soon enough it will just be us against the tide. Understanding however doesn’t always bring comfort.

         Now we are working in the hospital on the Medical-Surgical floor. This is the real testing ground in my opinion. We have done specialties such as Long term care, Pediatrics and Obstetrics but here you get people with all kinds of problems, here you have to understand it all. Here you have to know how each piece of the puzzle ripples its effects on to the next piece and the next piece. With each patient you have to look at them holistically. If they have come in for a knee replacement, I can’t just focus on their knee. They have had surgery so I have to take into consideration all their pre and post operative needs related to the surgery itself. How will anesthesia and pain medications affect this person? Will it make them lethargic, constipated, or nauseated? How do their medications in the hospital interact with the ones they take at home? I have to look at their current overall health. Do they have a chronic condition such as diabetes, heart disease, or asthma? How will that affect their care? What kind of surgical wounds will need to be treated? How strong is their immune system, how soon will they heal? What are their nutritional needs? What will the treatments and their health conditions do to their electrolyte balances and therefore their kidneys, their liver, their heart? How will being immobile affect them? How will I ensure they are safe when they do begin to walk post-surgery? How is their psychological outlook? Do they hate being in bed, or do they want to lie there and whine for days? How is their cognition? Can they understand my teaching and care for the surgical wound when they are discharged? What about their social situation? Do they have support for recovery when they are ready for discharge? The answers to these questions and more determine my patients care and in turn their outcomes.

                While I have been reminded that I know a lot, I also know there is a chasm of things I do not. It is that portion that strikes fear in me. I am not generally a fearful person, but when you are this close to having a person’s health and well being in your hands I think it may be healthy to have some fear. I want to reach the point where I have a balance between reverence for the responsibility I take on and confidence in my knowledge and ability to care for my patients. I have concluded that the main source of my current frustration stems from my lack of experience. So for now I will try to remain patient, choosing to believe that confidence and comfort will come. For now I will try to focus on the opportunity I have to learn and spend my efforts soaking up all that is presented to me that will in time shape the nurse I will become.

I am so frustrated with this place in my nursing journey. I know I am in a transitional position and I suppose that perspective is the only thing getting me through, knowing that this too shall pass. Right now I am at the point where my head is full of knowledge and I have to learn to transfer what I know… to what I do. (Easier said than done.) Nursing is one of those things that you can read about your entire life but until you actually “do” a procedure on a real life unpredictable patient you really don’t know it at all. That is why I understand we need to be tested and tried. Coming back for our second year it feels a little like our instructors have just pushed us in the pool and are watching from the bleachers to see if we sink or swim. And I get that. Right now if we sink they can rescue us, we still have backup. Soon enough it will just be us against the tide. Understanding however doesn’t always bring comfort.

         Now we are working in the hospital on the Medical-Surgical floor. This is the real testing ground in my opinion. We have done specialties such as Long term care, Pediatrics and Obstetrics but here you get people with all kinds of problems, here you have to understand it all. Here you have to know how each piece of the puzzle ripples its effects on to the next piece and the next piece. With each patient you have to look at them holistically. If they have come in for a knee replacement, I can’t just focus on their knee. They have had surgery so I have to take into consideration all their pre and post operative needs related to the surgery itself. How will anesthesia and pain medications affect this person? Will it make them lethargic, constipated, or nauseated? How do their medications in the hospital interact with the ones they take at home? I have to look at their current overall health. Do they have a chronic condition such as diabetes, heart disease, or asthma? How will that affect their care? What kind of surgical wounds will need to be treated? How strong is their immune system, how soon will they heal? What are their nutritional needs? What will the treatments and their health conditions do to their electrolyte balances and therefore their kidneys, their liver, their heart? How will being immobile affect them? How will I ensure they are safe when they do begin to walk post-surgery? How is their psychological outlook? Do they hate being in bed, or do they want to lie there and whine for days? How is their cognition? Can they understand my teaching and care for the surgical wound when they are discharged? What about their social situation? Do they have support for recovery when they are ready for discharge? The answers to these questions and more determine my patients care and in turn their outcomes.

                While I have been reminded that I know a lot, I also know there is a chasm of things I do not. It is that portion that strikes fear in me. I am not generally a fearful person, but when you are this close to having a person’s health and well being in your hands I think it may be healthy to have some fear. I want to reach the point where I have a balance between reverence for the responsibility I take on and confidence in my knowledge and ability to care for my patients. I have concluded that the main source of my current frustration stems from my lack of experience. So for now I will try to remain patient, choosing to believe that confidence and comfort will come. For now I will try to focus on the opportunity I have to learn and spend my efforts soaking up all that is presented to me that will in time shape the nurse I will become.

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