Winding Down

Just like that, three months have passed and my semester is over. Well almost over. I still have a couple weeks of classes and another couple weeks of exams, but this week I finished my last full shift on the surgical floor.

As our last weekly assignment, my instructor asked us to write an informal paper on how our time on unit had gone and what we hoped to accomplish in the future. I thought I would share it with all of you:

When starting this clinical semester, I honestly had low expectations of enjoying the surgical unit. I hadn’t enjoyed my last clinical on a medical floor and was told that surgical is very similar, just with a faster turnover. While I’m still certain that I don’t want to work on a medical or a surgical floor in future nursing practice, the skills I learned were invaluable.

Nursing is not just about using a stethoscope for assessments and keeping a patient as close to baseline as possible. It encompasses all of the patients’ responses to their medical diagnosis.

On the surface, it seems that the patient’s responses always manifest as a physical task, like administering medication or managing their hardware. But a major part of easing the burden of a patient’s illness includes comfort measures; simple gestures such as a warmed blanket or a tidied up room. These measures provide a non-judgmental presence, validate a patient’s concerns and assist them with their rehabilitation.

In my first year of nursing, the emphasis was on skills. I saw my patients as a task or a to-do list of considerations, rather than holistically. This clinical semester incorporated so many different components that it was impossible to check a patient’s needs off a list and continue on with the day.

Patients are dynamic and require a delicate combination of time management, proficiency, and planning. I learned how to combine necessary assessments and physical care with health teaching and therapeutic listening. I learned how to multi-task and pay attention to a patient’s behavior or their words as I was completing a skill. I learned how to include family in my definition of patient. I learned how to collaborate for a successful multi-disciplinary model. Regardless of where I end up working, these skills will be an asset.

This semester, I also had the opportunity to spend the day in OR, the outpatient clinic, and in day surgery. It was here that I was able to expand my understanding of the numerous roles a nurse can fulfill.

While I had never felt fully comfortable on a medical or surgical floor, outpatient and day surgery was where I could see a future for personal practice. I enjoyed the volume of patients that I was able to see and care for, I enjoyed the mutual respect and collaborations between the surgeons, nurses, and volunteers. I enjoyed being able to see patients who had been hospitalized, return to their normal lives.

The different settings I experienced allowed me to evaluate the importance of a supportive work environment for personal job satisfaction. I observed ORs where nurses were clearly uncomfortable and anxious, but I also witnessed surgeons thanking nurses for helping them in tough situations. I compared these nurses to those on the surgical floor and was shocked at the difference.

Even though there was an overlap of patients between the two units, there was an entirely different approach towards care on either floor. The surgical floor nurses seemed over-worked, hostile, and simply grumpy. This translated to the care they offered their patients and their treatment of students. This isn’t a generalization of all surgical or medical nurses. Many nurses on the unit were elated to have students help out or to take an extra minute to explain their rationale.

It was clear that these nurses were managing the stress of their jobs because it was outweighed by their love of the profession.

I believe each person must make the best of the situation they find themselves in. A positive approach does not guarantee a positive outcome, but it is more enjoyable than counting down the hours until the day’s over.

On the surgical unit, I had some great days and I had some bad days. Each of those days taught me about my needs as a learner and what I’d like out of my career. Overall, the semester cemented three major concepts for me:

  1. A supportive work environment is crucial for personal satisfaction.
  2. Building a rapport with patients makes it easier for cooperation. Encourage their independence, and there will be cooperation for difficult tasks.
  3. Asking questions is the best way to learn and keep from making mistakes.

While this clinical semester was grueling, it’s helped me to gain confidence in my abilities as a future nurse. I’ve cared for over 30 people. I helped more than 30 people through some of the toughest times of their lives.

That alone is enough to keep me motivated for the rest of my career.

– S.

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