Care Plan: Initiated

Always good to have goals, right? Today I had two.

  1. Learn about tracheostomy care.
  2. Don’t cry.

Last week was tough. Really tough. But let me put it into perspective for you. I moved here about a month ago. (One could say I took the “New Year, New Me” mantra a step further and also got a new job and new apartment.) I decided it was time to leave the comforts of my 25-bed critical access hospital and take on a 505-bed challenge.

My floor is made up of 2 parts: general and intermediate care. In laymen’s terms, intermediate care (IMC) is fairly comparable to an intensive care unit (ICU), minus some higher-status medications and procedures. During my first month of orientation, I was on the general care side of things. Where I recognized a fair amount of patient diagnoses, associated medications, and overall prioritization of cares. During this time I also became familiar with the hospital’s IV pumps, scanning system, charting expectations, and pager systems. (For the record, still unsure of the fellow-resident-intern hierarchy…) This all made for a smooth transition. Some may even call it my honeymoon phase.

Well. Flight’s landed. Home from Hawaii. Tan is fading. Time to get to work.

It wasn’t ever that I regretted moving. Or felt that nursing wasn’t for me. It’s that I was in a juxtaposing state of doubt. I could acknowledge what I already knew. The foundation I worked hard to build. The routine responsibilities I didn’t think twice about. However, I was also painfully aware of what I didn’t know. Medications I had never heard of. Diagnoses I had only read about. Procedures that were previously outside my scope of practice. I. Freaked. Out. I felt hopeless. Stupid. Annoying. I felt bad asking questions but knew I’d feel worse if I didn’t and a patient was harmed because of it.

So I cried.

I told my preceptor I was overwhelmed. I apologized for getting emotional. But that it was coming from a place of frustration and worry. Frustration with myself for not picking things up quicker. Worry that I might not ever get there… She told me what I already knew. “Kate, it’s your third day. You can’t be so hard on yourself. This is hard work.”

This is hard work.

Nursing is hard work. I think, for a moment, I forgot that. In the words of my mother, “I think God made the transition easier than harder to tell you that you made the right decision.” I found comfort in this. It isn’t that I’ve made a mistake, it’s just all part of the process. And as the sun sets on my “honeymoon phase” of orientation, I’m moving forward with a clearer mind, softer heart, and new goals to get me to where I know I can be.

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