How far I've come: reflecting on my progress after 6 months in the role

25 May 2023
Volume 32 · Issue 10

Abstract

In her series on the early steps of a newly qualified nurse, Heather George, Critical Care Staff Nurse, Aberdeen Royal Infirmary (heather.george2@nhs.scot), considers how experience is improving her confidence

The past 6 months as a newly qualified nurse have flown by. At this point, it feels like things are starting to flow more smoothly at work and, dare I say it, become a bit easier.

There are still moments, such as when my first sedated and ventilated admission arrived on our unit, when I clearly noticed myself retreating into my shell and allowing more senior, confident nurses to take control. Quite frankly, I felt like a bit of a lemon until the patient was settled in and the retrieval team had left.

After I'd reflected upon it, I realised my shyness stemmed from the experience I lacked in swapping patients from transfer ventilators to the ventilators in our unit and switching over continuous infusions. I just didn't know enough, and usually it's all done so fast and efficiently that I hadn't had the opportunity to learn. Once I had realised this, I didn't feel like such a lemon any more!

I explained this to one of the senior nurses before I received my next level 3 admission and asked for her to talk me through each step. Now I'm feeling far more confident for next time. With regard to situations like those, I am definitely still travelling over road bumps from time to time, but they occur less frequently and are becoming easier to level out.

The most prominent obstacle that I've faced recently, which I have realised stems from my own limitations in communication skills, is knowing what to say to patients and their families when they have received bad news, or when a loved one passes away. I am really fearful that I might say the wrong thing. Very often, when someone is critically ill, we can't predict how well they are going to do in the early days, because they might have to be kept under a lot of sedation, for example. This can be just as hard to navigate.

‘I am definitely still travelling over road bumps from time to time, but they occur less frequently and are becoming easier to level out’

In these situations, families are seeking comfort and reassurance and, sometimes, all the reassurance I can give is that their loved one will be closely monitored, well looked after and given the best possible chance of recovery. This is especially because I am still learning about illnesses and the short- and long-term impact they can have on a person, so the details that I can provide are limited. Putting myself in their shoes also helps me know what to say, and it allows me to realise that sometimes words are not going to help. At times, a simple hand on the shoulder to express the empathy that I feel for them in this situation provides the most comfort. These are situations I am navigating more frequently as I settle into the role and, with time, I hope I'll feel more confident.

Having reached the 6-month mark, I decided to take some time to reflect back on the previous columns I have written in this series. It made me realise that I have actually come a long way in terms of progress. Things that I mentioned I struggled with in earlier articles are no longer such a problem. I feel more organised and proactive in my practice, and I am far more confident in knowing when to escalate care to the medical team. I have also noticed that my tunnel vision has improved significantly.

I'm now able to see beyond the numbers on the machines or the task that I'm doing in that moment. I am even able to extend more awareness to patients who are allocated to other nurses, which is allowing me to contribute more effectively as a member of the team.

This fills me with hope and confidence about where I could be in another 6 months, and I feel a sense of achievement that the hard work and learning is really beginning to pay off.