Wait…you mean I have to do this by myself? Take all my own patients?? Coordinate my own transfers??? Make decisions????
This week was my first off of orientation, and I gotta say, it actually went well! I went into each shift with an I-can-do-this mindset and an acceptance that it’d be okay if I still had to ask for help. Which, thank goodness I did because I had to give IVIG and a blood transfusion which were two things I hadn’t covered in the previous 12 weeks. Also had two roadtrips (MRIs/CTs/ultrasounds) which always manage to throw off my whole day.
What scared me most was not having someone immediately available to back me up. To give me the thumbs up when making clinical decisions. To explain my reasoning to the MD. It was all me. This was, and still is, a tough concept for me. Being new, I don’t feel like I’m in a place to question MDs or offer suggestion. But at the same time, I know I’m capable of more than just blindly following orders. I’m in a place where I’m developing my practive and being confident in my assessments. Learning to speak up and draw the teams attention to a creatinine of 6.1 and a total output of 70 mls. Advocating for a repeat swallow study so my patient can eat more than pureed pizza and soggy pancakes. It all comes with time and frankly I’m just getting started.
I’ve also found myself incredibly thankful for my supporting staff of other RNs, my charge, and even my clinical nurse specialist. Without hesitation they’ve aided my critical thinking and provided policy-based resources in uncertain situations. Even if that means gloving up and assessing a patients coccyx pressure ulcers and replacing a dignishield (aka rectal cather). I think veteran nurses offer most support when they are able to remember what it’s like to be new. What it’s like to be constantly trying to retain the overwhelming amount of information new nurses take in during orientation and the months following. I’m fortunate to not work in a “we eat our young” environment.
However. Amidst all the new. All the uncertainty. All the questions. My dedication to my patients has never waivered. Yes, sometimes I find myself jealous of the stability and direction a chicken with their head cut off has… But I’ve always been able to fall back on patient connection. On listening to their concerns. Being at the bedside. Advocating for their wishes. At the end of the day, charting can wait. Labs will get drawn. Doctors will recieve one too many pages. But if my patients are taken care of, I make myself count that as a successful shift.
So here’s to the next few months of figuring out this whole off-orientation thing! As long as I can keep track of my brain sheet, I think I can swing it.
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