New nurse flying solo

Thursday, April 13, 2017


I know I have been absent from the blog, because I have been trying to find my own two feet to stand on at work. My hospital offers new grads a little over a month orientation. It totals out to 16 shifts on the floor with some extra classes during the first month. 


My 16th shift was November 1st! How exciting is that! Everyone at work kept asking if I felt ready, and to be honest I was not sure how to answer. I felt like I have grown a lot since my first shift, but by no means am I an excellent, experienced nurse. I have a lot of growth to do not only in my first year, but also my whole career.

So to answer everyone's question, I told them I was as ready as I could be. That at some point I knew that I would have to fly on my own and I did. November 2nd was my first official shift on my own.

I was very nervous and had a mild breakdown in my car before heading into work. I always arrive early to read about my patient prior to getting report, so I was thankful to learn that I was starting the night off with my max patient load of four patients. On nights, admits are frequent and unavoidable, you just cross your fingers and hope that they come around 2300 or later in your shift.

Having four patients is not easy, and there always seems like one or two patients always get less quality time than the others. I wish nursing was different, that administration realized the importance to have better ratios. Not only for the safety of the patient, but also for the nurse. Out of whack emotions from the nurse can lead to dangerous errors. 

For my first shift on my own, I tried to mimic the routine my preceptor and I were taking. unfortunately, things quickly got out of hand and I had to stop and remind myself to take a breath and just complete one thing at a time. This meant completing all my 2000 medications and grabbing vitals, before worrying about getting an assessment on all my patients. 

I was very lucky that one of my patients ended up leaving the floor for an MRI scan that lasted a little over two hours which allowed for me to focus on three of my patients and get them all settled and everything all completed before they arrived back on the floor.

Had my one patient not have left the floor, then it would have been a disaster trying to scramble to get it all done.

Fast forward a few months and the sleep habits of night-shift got to me. I was becoming angry, distant, and depressed from items that brought me joy in life. I was also very emotional and crying all the time. I approached my unit manager about my concerns and we quickly switched me to working days during the new year!

My previous experience with day shift was brief.I only had four shifts on days with a preceptor before transitioning to nights. I knew that day shift required more of the nurses' time than on nights. During the day, I have to be available to round with doctors, answer questions from family and loved ones, and be prepared to send and receive patients from procedures and surgeries. On night shift, most families were just there to visit, they had all their questions previously answered. And the majority of my interaction with doctors was over the phone or very rarely when they came to assess their newly admitted patient. Also, I never discharged a patient on nights, only admitted.

During the day shift, I am responsible for not only sending patients home but also welcoming new ones. I am on constant alert for not only the admitting doctors but also those who were consulted so that I can get an accurate update of the plan of care for the patient and report any changes or concerns. I serve as the buffer for families. An individual to re-explain what the doctor just said or to provide further pieces of information. When you think about it, it is a lot more than I was doing on my own during the night.

Was I prepared to make the switch? I am not sure, but what I do know is that it has been better for my health and quality of life. 





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