During my last set of day shifts I was sent out from the comfort of the intensive care unit (ICU) (I never thought I would say that!) to an acute stroke ward to help as they were short-staffed. This is the first time I have been moved since I started working as a nurse. I found it very daunting and was quite honestly dreading this moment. I didn't train in the hospital or health board that I now work in, so I was not at all familiar with the wards and the way they worked, and it had been a while since I'd had a placement on a ward as a student.
I tried not to think too hard about it as I got ready to go because I knew I would just start worrying. I already had a big enough worry to deal with anyway – how to actually get there. At one point when I was en route to the ward I managed to take a detour into a disused stairwell, becoming progressively more confused with each floor I ascended, until a kind maintenance worker found me and pointed me back in the right direction. There is something quite embarrassing about wearing a nurse's uniform and being lost in a hospital. Especially when you are trying to lead a patient out of the hospital and you manage to get them lost too – yes, this actually happened. Quite recently too. I sheepishly played the ‘Sorry, I'm new to this hospital’ card, even though I had in fact been there for the same amount of time that it takes to grow an entire new human.
Once I eventually made it to the ward I was relieved to have been met by some lovely members of staff who were happy to show me the ropes. As the shift progressed, I felt like I was more of a hindrance than a help as I didn't know where anything was, or the routine of the ward, and it was so different from what I had become used to. Having to navigate a hand-written (or hand-scribbled) medicine Kardex again was a sweat-inducing blast from the past. It seems I have grown complacent with the technology available in the ICU.
It was especially daunting when I was asked to do the medicine round to allow the other nurse to get away for her break, as this was my first ever solo medicine round. In ICU we have a policy that all our medicines must be checked by another nurse prior to administration, but on the wards only certain medications, such as insulin, have to be double-checked by another nurse. It was probably one of the slowest medicine rounds in the history of time but, nevertheless, I felt like I had completed it well and was pleased with the achievement.
Going from having only two patients maximum and knowing their details inside out to having 12 patients about whom I knew very little in comparison made things a lot more challenging. Somehow, despite all this, the nurse I worked alongside genuinely seemed grateful for my help. I left that shift feeling a sense of awe at the multi-tasking abilities that staff nurses working in wards possess, and I also felt a bit proud that I'd faced a fear of being moved somewhere new.
I am feeling far more confident in my role as an intensive care nurse and with that I find myself being allocated more complex patients. I recently took over the care of a patient who had neuroprotective measures in place. This meant that the targets for electrolyte levels and other clinical parameters, such as cerebral perfusion pressure, were particularly narrow and had to be strictly adhered to. The patient also had new monitoring in place that I had never seen before, including an intracranial pressure bolt (measuring pressure in the head) and a bispectral index monitor (measuring depth of anaesthesia), which was quite overwhelming as I had to quickly learn how to interpret all these new values and how to alter therapy to keep within the required targets.
At the beginning of the shift I really did doubt my own abilities, but I took a few breaths and did what I always do, I asked a multitude of questions, queried anything I was unsure about with the medical staff and made sure that no stone was left unturned. I was exhausted by the end of the shift, but it filled me with confidence that I had managed to deliver the high quality of care that this patient needed.
I look forward to taking on more challenges like these in the future, although I am also enjoying the new-found sense of comfort and confidence that I have in my role most days, which I could not even have comprehended I would possess just 9 months ago.