One of my buddies/clinical group-mates is leaving the state. He got a job at a hospital in Oklahoma, and so he’s departing from the great state of Texas and heading north. In honor of his departure, he threw a little get together at a local bar. A handful of people from my nursing school class showed up, and we all sat around and swapped stories about what it’s like to work in our own little corner of the hospital. Transplant, L & D, ICU, Med Surg — There were all sorts of different types of nurses represented. We all finished nursing school with the same (ish) knowledge base, and now each of us have specialized into different areas. Each of us has our own daily nursing vocabulary. Each of us has a different set of problems that we face every day. Some of us deal with ventilators and central lines. Others deal with Apgar Scores and fetal monitoring. Becoming more specialized is part of growing as a nurse.
What I didn’t realize, though, is that it hasn’t even been six months. Some of the nurses that were there tonight aren’t even off orientation yet. Six months isn’t a very long time. But in six months, we have all developed our practice to the point that we would be able to discuss our jobs with our co-workers in a way that our classmates (in different areas of the hospitals) wouldn’t understand exactly what we were talking about.
So much has changed in six months.
Today I had to insert a feeding tube into a patient. Inserting a feeding tube isn’t an overly complicated task. You just measure a tube, and then you put it in the patient’s nose (or mouth, sometimes). But there are different types of tubes, and some are more complicated to insert than others. Today, I had a patient who had the most complicated type of tube, so of course, the patient pulled the tube out about halfway through my shift. I’d been in that kind of a situation before — a situation where a patient pulled out some tube that they weren’t supposed to pull out. The first time that happens, it warrants a freak-out. I called in other nurses and flipped a lid, and they all helped me through the process of fixing the situation, making sure they docs were aware, and then documenting all of the happenings accordingly.
Today, I didn’t freak out. I walked into the room, realized the patient had pulled the tube, and then I just… fixed it. I stopped the tube feeds, I got a new tube, and I put it in. I got an x-ray to make sure it was in the right place, just like I was supposed to do. Then, once the tube was cleared, I started the tube feeds again. And I did all of that because I knew what I was supposed to do. And not only did I know that all of that was supposed to happen, I knew that I was the one who was responsible for making it all happen. The situation didn’t call for me to get one of my former preceptors to walk me through what I should do step-by-step like I would have 4 months ago. The situation just required the nurse (that’s me) to use her brain and do her job.
I know that sounds kind of simple. I know it’s like, “Yeah, good for you because you did your job.” Or maybe you’re reading this and you’re a nurse, and you’re thinking, “Are you seriously making a big deal about dropping a Dobhoff?” And if you’re thinking that, I totally understand where you’re coming from. But bear with me, because the fact that I put in a Dobhoff without any other nurses in the room today isn’t really the point. (It is the first time I’ve done that, but, again, not really the point.) The point is that there is a change happening within me — a change that is taking me from a terrified brand-new nurse who doesn’t feel empowered to do ANYTHING without supervision, to being the kind of nurse who can see a problem, know what the solution is, and then make that solution happen. (And moreover, who is willing to make that solution happen without first consulting a whole gaggle of nurses and doctors to validate her thinking.)
Basically, what I’m saying is this: Today I felt like I knew how to do my job, and that, my friends, is a very good feeling.