A Newbie Nurse and his Universal Lessons

As a new nurse, there is so much to learn. I, like so many others, came out of nursing school thinking I knew most things I needed to know to be successful at my new profession. I was mistaken. When I began working my first real nursing job for a home health organization, I quickly discovered there were a great number of things for which nursing school did not prepare me.
There are, of course, the life events that amount to insurmountable stress while your career advances; birthday parties that you will miss, holidays that will go uncelebrated, and nights that will go un-slept. Those things were to be expected, albeit untaught in nursing school. Many of you might remember how difficult it was to find a nursing job that suits your interests post graduation. I was also one. I began my career in utilization review for a hospital. After three weeks of having insurance company representatives yell at me via telephone, I bowed out, rather unceremoniously with what can only accurately be described as a 2-hour notice, something I have since regretted. After that, I took a job working for a drug rehabilitation center close to my home. I left there after 3 months of working 12-hour noc shifts took it’s toll.

At that point, I was a dart cutting through the air with no board in sight. I eventually landed at my current job in my best pair of scrubs and a resume that I was embarrassed of. I interviewed with a clinical supervisor named Ron Coronado, BSN, RN. He explained to me that because of my lack of experience, California state law forbade them from hiring me to do home care. There was, however, one exception. I would need to be a part of what they called the Novice Nurse Program, which Ron oversaw. Ron explained to me what exactly this entailed. I would need to complete a didactic training course with him where I would brush up on skills I learned in nursing school, such as Foley catheter placement, nasal cannula insertion, and a basic head to toe assessment. In this training, I would also learn about airway clearance vests and nebulizer treatments, G-tube placements and Mic-key buttons, and ventilators, all things with which I had no prior training or experience.

Ron reinforced how important these devices are to the patients that rely on them, and stated that I would need to be certified to operate a ventilator. After that long day of training, we discussed what types of cases I might like to take on. I told him that I was not afraid of a challenge, but did not have any interest in taking on a pediatric case. Ron, rather matter-of-factually, informed me that, as a Novice Nurse in their program, I would most likely take on a pediatrics case. I thought back to what I had learned about pediatrics in nursing school, and drew a total and complete blank. It is entirely possible, and plausible, that I paid no attention when anything relating to children was taught because I always assumed I would never work with children. Peeds are more my wife’s, also a nurse, speed. I repeated the words I had just spoken to Ron, “I am not afraid of a challenge.” He told me that the company’s training programs would give me the confidence and skills I needed to carry out my duties in a safe, responsible way that would allow my focus to be on the patient and not on my fears of messing up.

About a week later, I reported to my first patient’s home. Ron had called me a few days before to brief me on my patient. He was an 11 year old quadriplegic boy, who we will call Buzz Lightyear, who had both a tracheostomy and a Mic-key button. I was nervous, but felt confident in the training I had received thus far and was comforted by the fact that I, as a requirement of the program, would have a nurse trainer with me for 60 hours of mentorship before taking this patient on my own. After receiving report, my trainer gave me a detailed schedule of Buzz Lightyear’s day and reviewed his chart with me. She showed me where to find current and expired orders, the medication administration record, and documentations for review. I felt fortunate that I was not thrown in to such a high caliber case and was given the resources needed to succeed, not just for myself, but for Buzz Lightyear as well. I also humbled myself before my trainer to accept the criticisms she politely offered and changed accordingly with the benevolence of knowing that this field is down to a literal science and I do not know it all. This is a lesson that will stick with me for years to come.

My take away from being a part of this training program, which I believe to be universal lessons for others in my profession are:

1. Do not be afraid to admit you do not know everything. It is better to feel dumb to yourself than to look dumb to a patient or their family.
2. Do not be afraid to ask questions. Many nurses won’t mind teaching a new nurse how to do something and would rather be questioned by a new nurse about required skills than by the nursing board about negligence.
3. You may have graduated, but you are never done with nursing school. This job develops and evolves everyday. Each shift is an opportunity to learn something new.
4. Something Ron told me on a follow up phone call recently, “Have fun!” You are doing what you trained for, studied for, missed parties for, cried in your car on the way home, and grew to hate the lack of realism in Grey’s Anatomy for. Enjoy it!

Brendon Kouhou is a Pediatric LVN RN/BSN Student. You can follow him on instagram.com/NurseBrendon