The "new nurse".

This past week was my first as a "real nurse" on the telemetry/PCU unit. 

I am more exhausted than I think I have ever been. 

Throughout the week I've been continuously evaluating myself, identifying what I need to change, how I need to adapt the knowledge and skills I've gathered in my years of school to the real world.  A few highlights:

#1.  There is no way that I can give every patient of mine the kind of attention and service that I'd like to when I have 5, 6, 8 of them at a time.  It is simply impossible.  I need to learn to streamline and prioritize... the sickest patients get the most of me, the most stable patients get the least.  Unfortunately, this means that occasionally my patients and their families will simply have to wait for some of the things that they want from me.  This reality is very, very hard for me to swallow.  I am praying that our unit manager succeeds in convincing the higher-ups to mandate a 1:4 nurse : patient ratio.

#2.  "The nurse does the nurse things, the aide does the aide things".  This is what my preceptor has been trying to teach me all week.  The reality is that I cannot be assisting a patient to the bathroom when another patient needs insulin.  I'm struggling with this, as I don't want to be one of "those nurses" who passes off every single bedpan and bath to the aides and makes them feel taken advantage of.  I want ALL of my colleagues to feel like I respect and appreciate them.  So, I need to learn how to delegate in a way that shows gratitude and grace. 

#3.  While I must continue to be empathetic and caring, I cannot give 150% of my energy to every single patient, every single day.  I've found myself coming home feeling like I just spent the day in the hospital with an MI... I am so completely drained of all emotional and spiritual energy that I have NOTHING to give to the people I love at home.  I couldn't even handle my cats coming to me for attention one afternoon this past week.  I don't want to live like that.  I have to learn to insulate myself from being leached of all lifeblood during my 8.5 hours at work... I need to titrate the amount of energy I give to the people I care for to keep myself from burning out. 

Aside from all of that, I am learning an INCREDIBLE amount on a daily basis.  I'm building confidence and becoming more fluid and comfortable with the tasks presented to me.  I even had a patient I cared for come back after being discharged to bring a nice little snack and thank you note for my "compassionate care".  A little encouragement goes a long way!