After I graduated from nursing school, I took my first job as an ED nurse in a level 2 trauma center in Baltimore. I was proud to have the opportunity to work in a trauma ED with some of the most intelligent nurses and physicians, although I was afraid I would never be able to match their level of expertise or I simply wasn’t smart enough to be there. I hoped that whoever had the task of training me was patient and understanding.
I recall early in my career, I took care of a patient who had COPD and arrived in respiratory distress. As I cared for him, his spouse held his hand and prayed. He did not want to have an invasive airway, so a do not resuscitate order was initiated. His priority was comfort care. This was a difficult concept for me to understand because, as an emergency trauma nurse, I had learned to rescue those who needed rescuing. On this day, I had to learn that sometimes there is no need for rescuing, only comfort and peace.
When he passed away, I excused myself and cried. Later, I remember feeling as though I should have been stronger and not cried. I assumed that it was because of my lack of experience, but my preceptor assured me that caring doesn’t take experience, only the ability to care.
My preceptor was a brilliant nurse named Susie. She was a no-nonsense nurse, but she supported me and protected me, whether she was just making sure I submitted my schedule on time or she was standing up for me when I wasn’t as quick on the orders as some of the physicians would have liked. Instead of berating me, she would give me advice, and she was always encouraging. I remember asking Susie as I neared the end of my orientation, “How will I be able to do all of this on my own?”
She simply replied, “You’ll never be alone.”
Twelve years later, as a nursing educator, I continue to use Susie’s lessons, and now I get to share them with you.
She taught me that a nurse’s voice is stronger than his or her insecurities, and that if I didn’t know something, it’s important to ask for help. Speaking up when you don’t know the answer can save someone’s life.
Also, each shift, identify another nurse as your go-to teammate — someone you’re comfortable approaching to ask questions. And become familiarized with your hospital’s policies and how to access them. This will guide your safe practice and provide a consistent resource when the answers seem difficult to find.
Some of the best organizational advice from Susie was this: As nurses, we must focus on patient-centered care first, but we must not forget the importance of timely documentation. Make sure your documentation is completed and updated. Time management and staying organized are important in nursing. Having checkpoints throughout your shifts will help keep you organized and in communication with the healthcare team.
Don’t forget about your patient. Lying in that bed is a person who is scared, in pain and perhaps frustrated because they want to return home to their family. Think about how patients are relying on you to be their voice and advocate.
And please be kind. Don’t forget the emotions and fears you experienced when beginning your first nursing job. Support new nurses and your colleagues.
By Tabitha Legambi, MSN, RN, CEN, an instructor of nursing at Community College of Baltimore County, and an emergency nurse at Saint Agnes Hospital in Baltimore.