I’ve been thinking of writing about my first year of being a nurse for a couple months now, and I just haven’t had the energy or the inclination. I’ve been worn out and didn’t have a scrap of romance left, sufficient to write a nostalgic post about being a nurse.
This is a picture of me over a year ago… I had just graduated and look at all those books and classes I had conquered! I look the part of a victorious nurse, ready to take on the task of patient care, right? Well, let’s be real. (I don’t always like being real, because it’s scary somehow, but I’m just going to be that anyway.) Nurses don’t wear bright, happy colors outside with flowers on a beautiful day, and they aren’t accompanied by stacks of textbooks to look up textbook scenarios that don’t apply to real life anyway, even if there would be the time to look things up in an emergency. The only thing real-to-life about that nurse picture is the stethoscope that has accompanied me through my first year of being a nurse. And I don’t think I even knew how to use it when that picture was taken.
In this past year, several people have said, “That’s cool that you’re a nurse! I would like to be a nurse.”
And I had to stop myself on the verge of saying, “Trust me, it’s not that ‘cool’, and no, I don’t think you want to be a nurse.”
Not because I didn’t want to be a nurse, but some days when I was driving home, questioning everything I’d done that day, and all the things I didn’t get done, I felt like I hated being a nurse. This year has been ROUGH, in all caps. I got a job right out of school that included floating between Pediatrics, Medical, Surgical, Post-partum, and Nursery. I started out with energy and enthusiasm. I thought I could be good at everything, but I learned that you just can’t be super-nurse when you do everything, because the super-nurses are the ones who work on the same unit every day- the ones I run to when I can’t find gent pump tubing or need help with the procedure for hanging blood. I’ve cared for everyone from the newest born babies to the oldest hospice patients.
There are so many things that every new nurse has to adjust to, and maybe I had to adjust even more because of the lack of a routine team and work environment. Being a nurse in any unit or care setting is not glamorous. It’s rewarding some days. But it’s also a lot of hard work and accountability. Nursing school can’t completely prepare you for the reality of being responsible for people’s health and lives.
Nursing school doesn’t prepare you for that time when you have a post-op baby who falls asleep and has periods of apnea. His oxygen levels drop low every time he quits breathing and you can’t get ahold of the surgeon for about fifteen minutes. Nursing school doesn’t prepare you to handle family members who want their child transferred to another hospital and then get angry because they don’t want to pay for the transport. You don’t feel prepared when you’re in the middle of a patient crisis with the patient’s blood pressure dropping way too low. The patient is unresponsive, you have to give a STAT steroid, and the med won’t reconstitute and just clumps up in frustrating little blobs. So, you waste time getting another concentration of the med out of your Pyxis and then you do the math over again, and you feel like it’s taking you forever, and you wonder if you can do anything STAT? And all the time you’re trying to do this another one of your patients IV pumps is beeping because it’s finished and another of your patients keeps ringing and complaining to the aide that she needs her anti-anxiety med. But in reality, nobody needs an anti-anxiety med as badly as you do.
Nursing school can’t prepare you for when you make your first med error like I did the other week. It doesn’t tell you how to handle the fear and the thoughts- “What if that would have been morphine? What if I would have given a child the wrong dose of morphine instead of Zantac?”
Nursing school doesn’t tell you that your first year you will drive home in tears some days, asking yourself if you even have what it takes to be a nurse. It doesn’t tell you that for every situation there will be a couple right ways of handling it, and you’re the one who needs to decide what you’re comfortable with in your own practice.
Nursing school doesn’t teach you the favorite nursing concept of “CYA.” Nurses say this a lot, but I can’t tell you what it means, because it isn’t a Mennonite approved acronym. This is what people say when you call the doctor because your patient’s heart rate is in the 40s, and the doctor says that there’s nothing we will do about that… That’s when you chart like crazy to cover yourself just in case something happens, and you get called in to court. Because they also don’t teach you in nursing school that every time you make a decision you will have to think about your nursing license and what if someone sues?
There are so many things that I’ve learned in the past year. I’ve done new procedures or dealt with unknown situations nearly every single day. Just this past week I straight-cathed a baby for the first time and not that long ago I sank my first NG tube since the one I kind of assisted with while I was on orientation. I’ve lived with an enormous amount of anxiety and fear of making a bad mistake, and I’ve made mistakes too. Because nothing can entirely prepare you for the reality of your first year as a nurse.
But also, nothing prepares you for the feeling when you get someone a PRN neb treatment and watch their oxygen level come up and their breathing get easier. Nothing prepares you for the joy of helping parents give their baby her first bath. And it’s incredible when you give someone a bolus for their low blood pressure and watch their blood pressure come back up, and they suddenly wake up and start talking to you. Nothing prepares you for these victories.
You don’t expect to be a little girl’s “favorite nurse,” or have old ladies comment to the unit director that they just love their nurse. It makes you question if you are doing as much for them as you should be, and if you really deserve the praise, but it’s so encouraging.
And in the end, that’s why you have to keep going. At the times you feel your most inadequate and someone with years of experience comes alongside of you and says, “It’s ok, we’re all human, and we all make mistakes,” you suddenly find that maybe you have the strength to keep caring for your patients despite everything. Despite doctors growling at you for things that aren’t your fault, and patients calling you “Typhoid Alison” because they want more narcotics (actually, that made my day 😊). Despite the tears and the anxiety, I have to stick it out. For God and my patients and my coworkers.
So, if you want to be a nurse, my advice is this: ignore all the negatives I’ve pointed out and just do it. By the time you start questioning if this is actually what you want to do, you will know what being a nurse is really like. And probably, you will find it in yourself to say that no matter how awful it is sometimes, you can’t leave. Because it’s more than just a job.
It’s a lifestyle and a calling and, with God’s help, I’ll do it in all my inadequacy.
He said to me, “My grace is sufficient for you, for My strength is made perfect in weakness.” Therefore most gladly I will rather boast in my infirmities, that the power of Christ may rest upon me… for when I am weak, then I am strong…