Tuesday, May 28, 2013

New Grads Pt. I : Commencement

Today's missive, the first of three, is directed at those of you just-minted or imminently about to be so shiny new nurses.

First of all, congratulations on all your hard work. I know what you've gone through, and sacrificed, to get to this point. Pat yourselves on the back. You've definitely earned it.

For those of you not there yet, but approaching your turn: hang in there. Your day will come. And for frick's sake, hurry up! We can use the help!

Those of you about to be spawned as larval nurses, into whatever specialty, are going to need to know some things. Doubtless, you've heard them before, but in case I have any influence anywhere, you need to hear them again.

I titled this "Commencement", because you are at the bare beginning of nursing. In other words, despite a looming appointment with the NCLEX, and 2-4 years or more of pre-reqs, classes, clinicals, and drinking from a firehose of medical knowledge pointed at you since you began, in terms of your lifespan as a nurse, you're only now just coming out of your cocoon.

I can't tell you how many times I heard from older, experienced nurses, how long it would take me to know what the hell I was doing, and I would struggle to express how much it sincerely and royally pissed me off when they did that, but I can tell you all right now exactly how many times each incident pissed me off: that would be "twice".

Once when they told me so, and once when I found out they were right.

It really blows, IMHO, that we build up so much into getting potential nurses amped up about graduation. To me, it's like if we told Olympic high divers that the biggest day was the day they got to climb onto the ladder.

Because really, despite how much time, and mental and physical energy you've invested to get to where you are, that's where you are. You've studied the physics of diving, played on the trampoline, memorized the moves, done your exercises, splashed around in the shallow end of the pool with a lifeguard or ten nearby, but that's really all it amounts to.

You don't really learn how to do high dives until you jump off the board, and start doing the moves yourself.
You don't learn how to be a nurse until you jump off the board, and start doing the moves yourself either.

And from that first jump, if you pay attention to what you've been taught, and what you learn in the next few months, in order to actually start doing what you've set out to do, it's going to take every one of you, on average, at least one solid full-time year, and as much as two years, on your own, to be fully what you think of when you think of nurse.

If you aren't palm-sweaty scared shitless about that prospect, somewhere inside, whether you talk about it or not, you're a moron. Fear of screwing up, of killing your patient, or harming them, or just being a crap-headed idiot, is healthy, to a point. The point when it isn't is when it so rules your every waking thought that you can't function. Don't be that person.

But, as my brethren of the military persuasion say, "Embrace the suck". You're going to get help, and precepting, and watched, and managed. Some very well, and some of you, criminally poorly. I can't help you with that, because life isn't fair.

But even if you get the best preceptors in the world, who make sure you're competent at everything, and you check every box on every training sheet for everything they want you to know, they're all, sooner or later, going to reach the decision that it's time to push you out of the nest, and make you take a crack at flying on your own. And it's going to make you sweat, palpitate, hyperventilate, and maybe even shake and spaz out.

Welcome to the club.

If you aren't uncomfortable with what you're doing, you aren't learning anything. And for your first year-plus, you're going to be a sponge. And it's going to be just as hard on Day Two, and Day Twelve, and Day Two Hundred and Forty Three. Some of you may not make it past that. You'll quit. I wish you the best of luck with your future endeavors. And I really mean that. Think it over long and carefully beforehand, but if that's the answer, you have to make the right decision.

Some of you will decide, despite all you've endured, that nursing isn't what you want to do. To you, I want you to know something: if you really know that's true, and you get out of nursing, you are some of the bravest people I've ever met, and I salute you. And I mean that with every fiber of my being. I know what making that choice will cost you, but please believe me when I say that you're saving lives by making that choice, and saving your own soul. The people who stay in nursing long after they should have moved on are the biggest problem in the profession, bar none. Take what you've learned, and put it to good use somewhere else, and remember the people you learned with and worked with, and go with all my blessings. If you don't want to do this job, there's no paycheck on the planet that will ever keep you from being a bitter, miserable, pitiful excuse for a human being, and by not staying you're saving yourself, your coworkers, and your patients from ever having to deal with your evil twin. Vaya con Dios!

But most of you, the vast majority, will get through the tough times at the beginning, and the seemingly endless days (or, let's get serious newbies, nights) and somewhere down the road, you're going to wake up for your shift, and somewhere between rolling out of bed, putting on your scrubs, driving in, or getting report, you're going to realize, "Hey, after last week, there's nothing I can't deal with. I don't know it all, but I've got this!"

You're still going to be learning stuff, and you may occasionally get dropped in the deep end and be dog-paddling yourself to exhaustion, but you aren't going to wake up thinking you're going to wet your pants at work anymore, or wondering whether your co-workers will discover you're just a poser.

But the first step on your new journey, is coming to grips with the reality of that truth.
You, your instructors, your textbooks, and all the work you put into sucking the last drop of knowledge out them all, haven't made you, on this occasion, Nurse Badass.

But you've worked hard, you've trained hard, and you've learned well. You're like all those guys in the landing craft on D-Day, headed for a distant shore, as prepared as anyone could make you to that point, but there comes a point where the only thing to do for you is put you on the boats and head in.

So enjoy your graduation events, have fun as your family and friends hold their celebrations, and look forward with some pride at the paychecks you're about to get, because believe me when I tell you, you're going to earn every penny, every day.

And start psyching yourself up, because very very soon, it's time to hit the beach.

1 comment:

  1. Thank you for this. I go back to class next Tuesday. Three. More. Semesters. All I know is how little I know, and I am scared that I might make a mistake that harms a patient. Or one that makes me look like a total idiot. Oops, too late! (Forgetting to carry the one and documenting really low urine output and having the DOCTOR call you on it, in front of the patient and her family: Totally humiliating.) I'm under no illusions that somehow clinical over the next three semesters is magically going to make me know everything, and I just hope I have a good preceptor after I start work. Anyway, thanks again.