Settling in to a high-pressure environment makes you see the importance of self-care

23 February 2023
Volume 32 · Issue 4


In the second of the series on the early steps of a newly qualified nurse, Heather George, Critical Care Staff Nurse, Aberdeen Royal Infirmary (, is on a steep learning curve but enjoying moments of hilarity

And breathe… The past 2 months as a newly qualified nurse in the intensive care unit have been, for want of a better word, intense. I work in a unit that treats both level two and level three patients, so there is never a dull moment.

I spend almost the entire 12-hour shift in a state of high alert, so as not to miss something vital. So much so that sometimes, when I'm sleeping, I have vivid dreams of carrying out nursing duties and wake up in a panic thinking I've fallen asleep on the job. I have also replaced my brain for a sponge (which I'm hoping is not an upgrade) and have been soaking up information like there is no tomorrow – from how to interpret blood gas results and prepare for a tracheostomy procedure to where that one incredibly useful, but annoyingly illusive piece of stock lives.

My biggest challenge as a newly qualified nurse so far is probably the lack of self-confidence, served with a side of self-doubt and a generous sprinkling of imposter syndrome. I have been reassured, however, that this is something of a rite of passage for baby nurses, and with time and experience things do get better.

I have also been faced with some bitter truths about the buzzwords I have frequently used in the past to embellish cover letters for job applications. I remember once upon a time genuinely believing that I was a very well-organised, proactive and forward-thinking individual. Then I became a nurse and realised that I was merely average at these skills.

To put it in context, there are times when I have found myself striding to one side of the patient's bed space, halting abruptly, turning and marching away purposefully in the opposite direction, before stopping and quickly striding around to the other side of the bed. At this point I will have managed to collect a 60 ml syringe, a pair of compressions stockings, and a cold cup of tea, while accomplishing precisely zero tasks. After a couple of minutes of malfunctioning, I have to perform a system reboot, which usually involves stopping, taking a couple of breaths, pulling out my notepad and making a priority list with tick boxes. I am now trying to kick my practice up to the next gear and pre-empt these episodes of ‘flapping’ by being at least one step ahead at all times, though it is definitely easier said than done.

Sense of purpose

It is an incredible feeling to see people recovering from critical illness and knowing that I have helped them in their healing process. I am one part of a big team made up of multiple disciplines, but my role is important. The sense of purpose that I have felt since becoming a nurse has been life-changing. Yes, there are moments where my confidence takes a hard knock, and I go home from a shift feeling inadequate – that I should have done better. Those times are upsetting, there is no way of sugar coating it, but it is so very important that, as nurses, we are reminded to cut ourselves some slack.

‘Being able to find appropriate moments to relieve that pressure for even just a few seconds makes such a difference’

Nursing is a difficult job and we are only human, so there will be times where we may forget something, or mess up, or just don't complete a task to the level we were hoping to and go home feeling a bit deflated. What matters is that we are trying our best. This is something I have to remind myself of regularly right now as I fledge the supernumerary nest and have to find ways to manage this new sense of vulnerability.

Another realisation that I have had over the past couple of months is about the importance of laughter. Whether that's having a laugh with your patients, their families, or your colleagues. There is a lot of seriousness in the world, and there are a lot of quite understandably serious moments when working as a nurse too, so being able to find appropriate moments to relieve that pressure for even just a few seconds makes such a difference.

Moments of hilarity are inevitable as a newbie nurse, as I am quite prone to a silly mistake or two. Immediately popping into my mind is the mischievous second port on the nasogastric tube, which has made a fool out of me a couple of times now. First was when I was attempting to aspirate a nasogastric tube and pulled out syringe after syringe of air in complete awe as to why my patient had so much gas in his stomach, until a senior nurse stopped by and asked if I'd shut the second NG port. Whoops.

Not too long after that I went to administer some liquid potassium through the NG, and I forgot to shut the second port… again… so, instead, I managed to fire the potassium straight back out and hit the nurse that was helping me with my IVs. I did feel bad, but nevertheless lots of laughter ensued. Anyway, with these moments are good for learning, and I am proud to say that I haven't forgotten to shut my second port since.