After working successfully for more than 20 years as a graphic artist and structural designer, I decided to enter nursing school at the age of 43. After graduation, I faced a new career and the rumor about nurses “eating their young”? What was that supposed to mean? Was this a reference to Little Red Riding Hood and the Big Bad Wolf? We were told by some senior classmates that veteran nurses were simply too busy to answer “stupid” questions from students and new graduate nurses. Where did this attitude come from, I wondered? Isn’t nursing all about helping people? Yes, nursing is absolutely about helping people. So far in my experience, most nurses I have worked with have been eager to help when someone had a question, needed help with a procedure, or asked for input in making a clinical decision.
A network of support
The golden rule of nursing is to treat others as you would like to be treated — offer help and you will be offered help. My favorite instructor in nursing school, Sharon Harper, PhD, RN, said it best, “You are only new once so don’t hesitate to ask questions.” I learned that you don’t have to know everything but it is critical to know whom to ask. If you don’t feel comfortable asking questions, get over it.
It took about 18 months before I began to feel comfortable and confident in my abilities. Every decision that we make as nurses can affect a patient’s life positively or negatively, through acts of omission and commission. I often wondered how my performance measured up. When was that form added? When did that procedure change? Where does this copy go? I learned that the process is quite dynamic and necessary in the Plan-Do-Study-Act method that is commonly used to drive continuous improvement.
“It ain’t easy being green,” as the song implies, and during my first few months as a nurse I was as green as they come. In my mind I wore glowing lime green scrubs with a neon sign flashing “rookie” in large red letters above my head. I suppose if Dr. Seuss were to write a book about me it might be called “One Fish, Two Fish, Green Fish New Fish.” Thankfully my supervisor saw potential behind the green façade and took a chance on a new grad.
I was paired with excellent preceptors for several weeks at first. They were my new mentors and watched my every move, giving me the support and guidance that I needed. How many times did I ask for a second set of eyes to double check a dosage calculation or make sure that I had hung a piggyback medication correctly? How many times did I ask about filters for TPN and for help hanging blood? Each time I asked, the answer was always, “Of course I’ll help you!”
Ready to solo
After four or five weeks I was informed that I would be “going solo” the next week. What!? Houston, we have a problem! I didn’t know if I was ready! Even though I remembered that I could always ask questions, I was still terrified. What if I missed something? What if a patient had a problem and I didn’t recognize it? I guessed it was truly sink or swim time.
I put on my best game face and jumped right in. The process got easier with practice. I developed my own assessment sheet to remind me of the things that must be addressed and documented. I developed my own style of interviewing patients that seemed to put them at ease. Wouldn’t you rather have a nurse who seems to care about you and takes a few minutes to talk with you rather than talking at you?
One of the first things that I do is introduce myself and ask my patients what name they would prefer to be called – first name, last name, or a nickname. I find most patients appreciate having a choice. They usually smile and say, “No one has ever asked me that question before. Please call me John (or Mary, or ‘Doc’), no need to be so formal.” However, there was a case where I had to draw the line. A patient said that his wife always called him “Son-of-a-(beep).” I laughed and explained that we would simply have to choose another name for me to use.
Patients sometimes feel that they have lost some of the freedoms that they have at home; freedoms that include eating and bathing when they want, or walking outside to simply enjoy the day. Creating a good rapport with patients early in the relationship helps ease unpleasant tasks that may come later such as repacking and dressing a painful wound per doctor’s orders. A good rapport makes saying “no” a little more palatable when “no” is in the best interest of the patient.
After about 18 months of working as a new nurse, I was told, “You are the charge nurse for the next four hours today.” You must be kidding! Was that thunder that I heard in the distance? I smiled a bit nervously and sat down, remembering that I had lifelines all around me.
That first day as charge nurse was eye opening. I knew that the whole tone of the floor and would be affected by my behavior. I remembered other charge nurses I had worked with and how they handled the job. I called on my experience working with non-medical professionals in the past. People are people, regardless of what they do for a living. A calm, assertive demeanor helped in dealing with them and it was invaluable working as a charge nurse. I learned that a good charge nurse is not afraid to ask for input when making assignments. The charge nurse has to advocate for the nurses on the unit as well as the patients. It just makes sense to spread around the “busy” patients so one or two nurses aren’t so overwhelmed.
To my great surprise, I was assigned to be the charge nurse a second time. I grinned and asked, “Does this mean I did a good job last time or am I being punished?” I was assured that I was not being punished and that my first hours as charge nurse were not the tempest that I had imagined.
I have worked as the charge nurse many times now and I must admit it’s a nice change occasionally from the constant demands of patient care. Working on a fast-paced medical/surgical/oncology floor will definitely teach you to manage time regardless of your role that day. As with patient care, my skills as a charge nurse are becoming more honed as I gain more experience.
Continued support from nurses
Adding to the pool of experience, I became qualified to administer chemotherapy last year. Where did I put my shiny green scrubs? I work with excellent chemo nurses who are very helpful and patient with me as I’m learning. They have helped me to become comfortable navigating through the frequent tangles of intravenous tubing often necessary when administering multiple infusions concurrently and consecutively. I’ve learned to check and double-check to be sure that roller clamps are open so that the fluid in the bag can actually infuse. Although still in my infant stages of administering chemotherapy, I learn more each time.
I truly get a great deal of satisfaction working with cancer patients and their families. I’ve found most of them to be among the most gracious, grateful, and appreciative people! I’ve cried with/for some of them who had bad outcomes and celebrated the good outcomes. All things considered, where does that leave me now after my first two years as a nurse?
Only a few nibbles…
Do I think that veteran nurses eat their young? No, at least no more so than people in any other profession. It’s fair to say that I have been “nibbled on” a few times but most of my hide is still intact and remarkably regenerates itself. Typical group dynamics happen whether you are a medical professional or you work at the local convenience store. Would I become a nurse all over again if given the chance to go back in time? Absolutely!
Suzanne M. Kasper, RN, works at Yakima Regional Medical and Cardiac Center in Yakima, Washington.
Dedicated in loving memory to Virginia Ortega, RN, who always took time to help me and encourage me.
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