My orientation is flying by! I can see myself growing a lot as a nurse, but I still have a long way to go. As a new nurse, I feel unsure of myself constantly. I’m constantly looking up medications, triple checking orders, asking other nurses how to do procedures… Heck, half the time I have trouble even finding the right equipment on my own. I come home at night and think of a million things I could have done better, or should have done differently.
“Oh no, I forgot to go reassess her pain after that Vicodin.”
“I probably wouldn’t have sounded so stupid on the phone with the doctor if I’d remembered to pull up his labs first.”
“Did I remember to chart that apple juice in the I&O’s?”
I know I’m providing adequate, safe care for my patients, but sometimes it’s hard not to think that they could be getting more from a more experienced nurse. Seeing how my preceptors manage their time and do everything so easily, it takes a lot to remind myself that these things will come with time. I’m getting better, but I have a long way to go.
I’ve been caring for one particular patient lately, though, who has taught me that sometimes good nursing care goes above and beyond getting everything in on time and efficiently. The actual art of caring for someone is something that can’t be taught in school, and that is every bit as important.
This patient spent close to 4 weeks in the hospital, with a new cancer diagnosis, acute renal failure, pneumonia, thrombocytopenia, anemia, a compression fracture… He came in for what he thought was just an asthma attack. Despite everything that was thrown at him, he carried himself amazingly well and was constantly in extremely high spirits. On several evenings I cared for him, I actually watched as he gave his wife emotional support– her breaking down about an additional complication in his condition, and him consoling her. I was baffled.
There were rare moments when I would see him break, and my heart told me he was surely internalizing more than he was letting on. To some extent, his optimism might have been a brave face he put on to show the world. I saw that mask slip off one night when another nurse and I went to access his newly placed portacath. I saw him wincing as we manipulated the port, and finally he told me the pain was just too much at the fresh site. I got him an order for some IV pain meds, all the while feeling guilty for maybe being too eager to get at that port. When we went in later in the evening, pain meds on board, the nurse who finally did the access was a little less than gentle with the site so I stayed in the room a moment longer to hold his hand, offering what I could.
The following night I found him on my assignment again, and I wondered if he would hold any grudge about the ordeal from the night before. The shift started off normal enough, but after his visitors left and I went in with his evening medications, I asked how he was doing. Again, that mask slipped away for a moment and he admitted he was finally starting to feel worn down by everything he’d been going through. I stayed and talked for a few minutes, reminding him that he has every right to feel tired– that with everything he had been through, it was okay to give himself a break. He grabbed my hand and said “Today’s been my hardest day yet. You’ve been the highlight of it.”
…I melted. I come home from so many shifts feeling so inadequate– my meds were late, or I forgot to log an I&O, or I forgot to bring that patient the extra blanket she’d asked for. This patient reminded me that sometimes the biggest way to make a difference isn’t through flawless technique, but through genuine care: a hand hold, a conversation, a warm smile. Compassion, encouragement, and hope don’t come in a vial, but they’re some of the most important things a nurse can dispense.
Newly a Nurse 