With Freedom comes Responsibility

Last night was the my first shift off orientation, a few shifts earlier than anticipated. Orientation is a period of 6 weeks where we still work 'underneath' another RN just for the extra guidance and support so we can get used the ward and the systems and thinking like a nurse. I'd been having 3-4 patients during orientation, and last night I had 7. I had done the night shift the night before, and it was chaotic and very tiring, and even though I had slept for 10hours straight when I got home, I was slightly apprehensive before starting last night's shift. However, last night went very smoothly and although we had 3 admissions, nothing drastic happened and I managed to get everything done. I also felt completely awake and on the train and bus home, was able to keep my eyes open. I also only slept for 6hours, a more reasonable amount of time, and was awake throughout the evening to see the sun.

It is quite a big step no longer being in orientation. It means that I am no longer extra hands on a busy shift, but instead required to do my bit and it's all my responsibility. That's one thing that I have really started to think about, everything I do, whether it a mistake or the best thing to do is my responsibility and my decision. My registration and colleagues and my patients rely on me doing the right thing, and not making any drastic mistakes; and in healthcare a small mistake can be drastic. 

Nursing isn't about us, it's about our service.

In the line of healthcare professionals, nurses are often the last one in the line when it comes to decision making. The doctor can prescribe a medication, the pharmacist can deliver the medication, it can be checked by two nurses if required, but the nurse administering the medication has the full responsibility that it is the right thing to do. With this responsibility there are safety precautions to help including the 5 Rights of Administration, where you check it's the right drug, dose, time, route and patient, but even then mistakes can happen. 

Part of my new graduate year requires me to attend study classes and undertake a postgraduate paper. One of the things a speaker said was not to focus on patient centred care, but instead strive to be the best nurse I can possibly be. I've really taken that statement and applied to my nursing, thinking about what I could do to ensure it's the best for my patients. This includes correct infection control, accurate documentation, effective communication with the team and any referrals to offer specialised individual care; and then also thinking about my patients as humans who require food and drink and sleep and comfort and someone to talk to when their scared, someone to laugh with and someone who is honest. As exciting for me as nurse to be able to do all these tasks, it really all falls back onto the small acts and the attitude I hold towards my patients and my nursing care. This is how I will strive to become the best nurse, remind myself that they're human and not just another body in a bed. 

The title of this post With Freedom comes Responsibility portrays exactly how I'm feeling as a new graduate, especially now that I'm no longer in orientation. I am free to make my own clinical judgements, to work as I deem appropriate, and to become the nurse I strive to be, but I also now hold all the responsibility for the actions I take, and for my attitude and my nursing care. I am definitely supported by the team I work alongside, but as part of the team, I must play my part and provide competent and effective care.  

A Dream Come True

Living my dream

Today was my first shift working as a Registered Nurse. I've wanted to be a nurse since I was 13 after reading the 'Sue Barton' book series. On the train on the way to work, I wrote the following:

Today is my first proper shift as an RN, I've got my scrubs on with a purpose, dinner packed, my ID, swipe and watch in my pockets. Walking to the bus stop, I felt like I was walking with a straighter back and a purpose in my stride. This moment makes being a nurse feel so real an incredibly exciting. Today is the day I've dreamed of since I was 13, and after studying for three intense years and aiming my whole life towards nursing, it's finally happening. A dream come true. Nursing is a career where I get to make an impact in peoples lives, to be with them when they're most vulnerable and to provide support and a friendly face through the hard times. I often see my patients out in the street, and they mostly don't recognise me as I'm not in my uniform or in the context of the hospital. It's so great seeing them out enjoying the rest of their lives, looking healthy and back to their normal self in their normal clothes. I look forward to the challenge that nursing brings, this year and for the rest of my life.

- once a nurse, always a nurse - 

Today was an afternoon shift in the short-stay medical ward that I am working in. I know the nursing staff already from my student placement, and felt like one of the team in the same coloured uniform. It's such a small difference, having that distinguishing uniform. The staff and the patients treat you very differently. I had two patients this shift, two admissions. The first was not as straight forward as initially anticipated, very demanding and requiring frequent pain relief and reassurance. The second was a sweet older lady whom was fiercely independent and a great inspiration. The majority of the shift was straight forward, vital signs, pain relief, small comfort measures. But it was the smaller things that made it so realistic for me. The fact I could give oral medications by myself, the fact that I didn't need co-signing on my notes, or permission to anticipate my patients needs. The doctors and other staff were more open to consulting with me and hearing my opinion, and I felt a valued member of the team. Although I felt almost out of my depth, I knew that I was supported and all I needed to do was ask for some help or assistance. 

Just as I was leaving and commenting with the other nurses that I could sign things off independently, I was reminded that this really means that it is all up to my professional responsibility to ensure that everything is completed and my patients are safe. I'm no longer in the safety net of being a student, and as amazing as that sounds to just spread my wings and take the first leap, I'm still a fragile new bird, not quite strong enough or brave enough to fly solo. I have to remember that I am responsible for people's lives, and those people are someone else's mother, father, sibling or child. It's not an easy thing being a nurse, and it'd definitely not something to do alone. It's about the support and guidance and the small steps that make the experience truly life changing and worthwhile.

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