Playing the swan…

The transition from student nurse to registrant is something I spent the final furlong of my nursing degree preparing for however nothing could have prepared me for that day when I introduced my self as a staff nurse.

My main concern is that the person I say “hello my name is Claire and I am your staff nurse” to has no idea whether I have been qualified for ten minutes or ten years and as they don’t know this they have high expectations of me. I worry all the time that I won’t be able to meet those expectations but I’m conscious to try to never show that worry as whether a patient or a family member they need to have faith in their nurse. The people I come into contact with must feel able to have confidence in my knowledge and ability and hopefully one day I may share that confidence!

By the end of my degree I was a fairly confident student who trusted my knowledge base and my skill set so have been surprised how this has changed and my internal monologue runs a mantra of ‘am I good enough?’
I question everything I do ten fold and I haven’t even take responsibility for meds rounds yet so goodness knows what I will feel like then! The feelings that registering with the NMC and its associated accountability generate are quite phenomenal.

I receive positive feedback from patients and from their families which is great as I am able to recognise that maybe I’m not the incompetent fool I manage convince myself I am. Staff on the ward are great too, they offer informal supervision each time I shout ‘help’ in a slightly hysterical tone in the nursing office, guiding me with their experience and nurturing my newness.

My first staff nurse job is on the ward where I did my management placement so I am fortunate to know the team well enough to lean on them when I need to and for them to pick me up when they recognise me struggling. The NHS trust I work for has a comprehensive, year long, preceptorship scheme so I know I am supported amazingly well as I fumble my way through my first year as a qualified mental health nurse. My preceptor is an experienced band six nurse who offers me reassurance and her experience as I need it with her also offering challenges of which she believes I am capable knowing it will boost my confidence when I achieve what she has asked of me.

Each time I think I am moving forward a new experience sets me another challenge to get through and my anxiety levels reduce a little when I achieve it. When I first started I was lucky if I slept for a couple of hours the night before a long shift but this has settled somewhat thank goodness!
A couple of weeks into the job and an incident knocked my confidence it left me wondering if I was capable of nursing at all, I dwelled upon it and worried to obscene and totally unnecessary levels making myself nauseous with anxiety but I can look back and realise that this will be the first of many situations which will come up over my career leaving me wondering ‘what if’. What if doesn’t have to be a negative thing if learning comes from it.
Throughout university we were encouraged to reflect and I would describe myself as a reflective practitioner as this is something I now do without hesitation however if anything I need to practice reflection without always being critical of myself something I am unconsciously prone to doing. I reflect daily as I make my 1.5 hour journey home from work and can sometimes have convinced myself I’m incompetent before I even leave the car park! I think those I work with would be shocked to hear how nervous I feel at the moment as I do my best to ensure for the most part that I at least look like I know what I’m doing!

Yesterday I was given positive feedback about how I handled a situation which escalated quickly and how I remained calm which was great to hear however I struggled to receive that praise, she pointed out that I had deflected back to debriefing over what had happened rather than simply accepting the praise. I wasn’t even aware I had done that until she pointed it out. I used to be able to graciously accept praise when it was offered and have no idea why I have lost this ability over recent years.
I lost so much to my own experience of mental illness, I lost my last career then I lost my business so I struggle to accept that this career which I have worked so hard for will not be taken in a heart beat also. I have a fear roaring away in the pit of my stomach which I hope will disappear eventually. Everyone assures me that as a new nurse a level of anxiety is normal and that I will not feel like this forever so I hope that one day I will just suddenly have a moment of awareness that I am no longer afraid and that I feel confident in my decision making. My preceptor who is very supportive is also very perceptive and I think she has begun to realise that I am playing the swan; gliding along gracefully on the surface and paddling away in a permanent state of utter panic underneath. She gave me a piece of advice that just about everything can wait so I should pause and take a moment if I find myself caught up in the hustle and bustle of the ward. An acute ward is a fast paced environment where decisions often seem to need making quickly but her words gave me the permission I need to tell myself it’s ok to wait a minute and take stock. Better to make the right decision than one I make in haste and regret later. I think this is a piece of advice I will value for years to come.
Today I co-ordinated the whole shift from 7.30am until 8.30pm and other than a couple of small oversights like writing the staffing allocations on the board in the main ward area for example I did ok. Some tasks I did came naturally and others felt more forced but the one thing I do feel confident in is that the patients and for the most part the staff did not register my nerves. Today felt like an achievement, a significant moment in my nursing career as a whole day’s co-ordination went without major issue, there were hic ups but then it’s an acute mental health ward so that is to be expected when nursing 16 very unwell people. Some people even had a good day, a board game mid afternoon generated laughter and friendship amongst ladies thrown together in illness.

The over arching thing I have learned since qualifying is how much I love being a nurse and how blessed I am to be doing a job I love in a team many of whom I class as friends as well as colleagues.
It’s terrifying and humbling in equal measure but it’s the best thing I ever did and I hope I will have a long, happy nursing career over the coming decades.

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