Fledgling Nurse

Whelp, I've been working toward this goal for literal years, walking the path to RN.  Andy and I have been working toward being financially able to make the move, assessing what our best choices were, and determining our most appropriate timings.  It was a lot of calculating, prioritizing, and a fair bit of luck to get to where we were, able to make this kind of leap.  

My view walking into work the other day

And here we are.  This is real.  I have a license and a job in a hospital and a coach and days scheduled and a direct deposit setup completed.  It's strange to me to accept the benefits of the hard work after working toward it for so long.  It's almost like same feeling as a book hangover, that the absence of having something to look forward to, to be working toward, there's a strange void there.  It's time to construct a new goal.  

In the meanwhile, my goal is to absorb as much as I can.  I've learned a LOT as a CNA, regarding how the hospital works in general and how my floor "moves" specifically.  My role and its pace will change--I think probably the most difficult part of that transition might be delegation, figuring out how to best utilize team resources.  

There is so much to learn, but the real trick as I see it is trying to feel out two important things:  my own independence and the balance in transference I feel with my patients.  

Let's dig into those.  

Independence:  I now have the power to administer medications without someone over my shoulder approving them.  There are administrative and procedure powers, sure, but I can give people medications that are within their orders without double-checking each one with another body, allowing me to create a blending between my time schedule,  my judgement, and the verbal contracts I have made with my patients.  I can reach out to their doctor on the patient's behalf with their concerns.  I can ask the client what goals are important to them today and with what I know about their case.  I decide what order to do different tasks.  And yet, there are still places where I need to have my coach present, partly for my own safety and partly as they are gauging where I need additional hands and insight.  This leads to some waiting times, where we have to find a place that lines up between tasks.  In other words, there are places where I am asking a lot of permission that are necessary for a number of reasons, which does then impact how much independence I can grow at once--not a complaint but a recognition of what simply is.  

Transference:  I remember what it was like to be a patient, in very vivid detail in some places and otherwise some important, formative moments.  It is VERY easy for me to see myself in a lot of their situations, to want to fight for them in the way that I wanted people to fight for me.  I now have the power to do some of those facets, but I do not have the time nor resources to be all things to all people.  I can ask the doctor questions; I can encourage the patient to ask questions; I can help connect the patient with different referrals and resources; I cannot, however, take all of their urgency unto myself nor can I be overzealous and take pieces of their autonomy with me.  The solution will be finding balance between hearing the patients' concerns to then turn them into actionable pieces but also not pulling on more empathy than I have available, to ensure that I don't make it personal to me.  I have to be mindful of what and where my boundaries are.  I also need to demonstrate self-compassion in enforcing those boundaries.  

There are many, many other pieces to sort through:  I am finding a groove in some spaces; I am stumbling my way through others; I am adjusting to the crisis that needs addressing, which means I have to re-adjust my whole day; I am providing emotional support, even when I have other tasks that need doing; I am learning that one more thing that was policy that I was hitherto unaware of and adding that to the mental list of things that need attending; I am refining my scripts; I am starting to get to know my teammates.  

And walking around with all of this uncertainty as I do explore these spaces is exhausting and fulfilling and terrifying and encouraging and a number of other adjectives all at once.