My favorite part of a nursing education is its potential. The potential for professional and educational experiences is vast and sometimes to the extent that it is a difficult to decide where to specialize. After years of ICU nursing; I have begun the process of working towards an advanced degree. While I know what I want to do professionally, there are many, many different possible routes to get there. It’s overwhelming to think about which fork in the road to start down next.
Talking with nursing students recently, I know that they feel the same anxiety. While they are working towards a specific degree, they are overwhelmed by which professional route to take.
Over the years, I have enjoyed talking with colleagues and hearing stories from nurses who have worked in many different areas of health care. Each specialty and each transition is an opportunity to learn and create new challenges for yourself. There are vital characteristics a nurse carries with them and that you can see woven into their bedside practice when they have a wide background of experiences; adaptability, flexibility, problem-solving, critical-thinking, and open-mindedness to list just a few.
My years working as a travel nurse broadened my professional experiences and opened my mind to learning. As I think about that time period in my career; it is easy to take count of the experiences I’ve had, the lessons I’ve learned, and what I don’t know.
When I was in high school I worked as a nursing assistant at a nursing home. I don’t remember a time when I didn’t know that I wanted to be a nurse. This however was first exposure to nursing practice and it didn’t deter me.
While I was in college, I transitioned to an acute care setting and worked as a nursing assistant on a medical/pulmonary floor. There were trachs, airway and respiratory issues, bleeding, emergency surgeries, blood administration, vital signs, IV’s, telemetry, and more: I was in love. I worked a 0.8 FTE on the night shift during school. There were 4 RN’s I worked with on my weekend caring for 36 patients. We were an amazing team. I remember the workloads they had; 10 patients on the night shift. They were all graceful, knowledgeable, and professional; I was in awe.
After about a year and a half, I made a job change to the ICU and continued working as a nursing assistant. That’s when I knew I was home. In that unit I saw that it was the nurses who were there to save lives at 3 am. It was the nursing staff that made decisions about what medication needed to be started and talked to the doctors about starting it. It was the nursing staff that started CPR, called a code, stabilized airways until the RT or the MD could get there. It was the nursing staff that monitored critical blood pressures, airways, oxygenation and managed continuous dialysis. The nurses were there for everything. They knew the patient’s family like their own and were the foundation of the patient/health care provider relationship. I found mentors, was inspired, and applied to the critical care nurse residency. One of my first shifts as a new nurse on orientation in the ICU, my preceptor Lynn said to the medical resident “He needs an inotrope.” At that moment, I knew who I wanted to be and that I needed to learn what an inotrope was.
Since my career began, I have been an ICU nurse. It’s how I define myself, it is what nursing looks like (to me). Over the last nine years I have learned so much about body systems, how they function, what they look like when they fail, how to treat them, and how to talk about organ failure with patients and families. I have learned how to talk about death, how to be present, and the compassion you demonstrate by sitting with someone when they are dying alone. I learned to hate the colon and love skin. I am amazed everyday by the physics of our body systems and the immense understanding of science you need as a nurse sometimes. I have learned the power of sleep, patience, and effective communication (some lessons I’m still learning). I’ve witnessed how terribly sad holidays and birthdays can be, and what a gift aging can be. I have learned how terrible it is to wake up a patient’s family at 3am with a phone call. I have seen the power of granting someone their last wish and of saying thank you when you mean it. I have supported and encouraged patients when their health takes 2 giant steps backwards and applauded them with each success and step forward they achieve. I have stood beside life as it is lost and witnessed, in the same breath, the selfless decision that families make for organ donation.
Reflecting on where my professional practice has taken me, it is easy to be aware of what I’ve never done and the many patient populations I have never cared for. I have never seen or helped during childbirth. I have never heard a newborn or brand new parents cry; or ever cut an umbilical cord. I have no idea how to measure effacement, or an apgar score. I have never given chemotherapy, scrubbed in for an OR case, or put in a PICC line. I have never done CPR on or for that matter even taken a blood pressure on a child.
When I reflect on nursing as a profession it’s easy to see it’s magnificence. I’m proud of what I have done and the knowledge I have gained. It’s also amazing to think about what I have never done and how much more there is to learn. I love being a nurse.