Dreams and Plans

You guys. I finished my RN program!

If we were to rewind 5 years ago I would have been in absolute disbelief at the thought of such a thing.

I truly never thought this day would come, and guess what... I graduate tomorrow! Amazing.

The most daunting tasks are ahead of me however. I must pass boards, which will determine whether I get an actual license. Which, without it, my education is kind of useless (depending on how you look at it). Then after that I need to learn how to function as an brand new registered nurse at whatever place I get hired at.

If you are a long time reader you will recall several years back when I started working as an LPN how difficult that was for me on an emotional/physical/mental level for about the first 12 months. I have a bit of a fear that will all repeat itself when I start working as a new grad RN at the hospital. I am hopeful however that since I already have 2+ years of licensed nursing experience under my belt  that it won't be quite as bad.

I mean I know how to do the basic nursing tasks with relative confidence... place a foley, give meds, draw blood, start an IV, call the MD, perform an assessment, complete a dressing change, etc. etc. So I'm not worried about doing those sorts of things.

What I am worried about is learning how to function in a completely different work setting, learning the culture, learning how to take care of sicker, less stable patients. Sharpening and polishing critical thinking skills, and learning how to adapt to the specialty I work in. Getting to know the doctors and fellow nurses (hoping they will like me and don't think I'm a total idiot), making friends, and practicing and learning skills and new information that I'm not so familiar with yet!

Pretty much all the fears that come when starting anything brand new. Which I suppose is normal and healthy to a certain extent.

And to add to the anxiety over the course of my RN year I've also come to understand that the place I want to be, without a doubt, is the ICU. Which is the unit of the hospital with the sickest, most critical patients. The thought of learning to become a great ICU nurse is frightening in and of itself.

I laugh at that because several years ago all I would've told you is I just wanted to have some cush, low stress nurse job at a clinic - ha!

There are few things that I have wanted in life or felt as strongly about as I do about wanting to work in the ICU. There are several stories and experiences I've had throughout clinicals and just recognizing how my brain works and functions in nurse mode that led me to want to be in ICU, but there is one in particular that I will never, ever forget.

 To be HIPAA compliant I can't share any details, but to share briefly - it was my turn to go to the ICU for clinical and that day I was assigned to the nurse who had the very sickest patient in the entire hospital. The 12 hour day went by so fast, but also seemed to go in slow motion at the same time. Observing how with proficiency and speed she titrated 12 different IV drips that were simultaneously being infused, and managed the various lines and tubes our patient was hooked up to - foley, central line, arterial line, ventilator, etc. and all the while vigilantly monitoring and assessing the patient - vital signs, urine output, breath sounds, fluid input, etc. etc. etc. was so amazing and incredible to me! And then watching her as our patient coded and she began chest compressions and seeing how no effort was spared by the code team as they diligently tried to keep this person alive, and then personally being able to do chest compressions was such a deeply touching and personal experience for me.

It made me realize what a special place the ICU is. The patients there are often walking a very thin line between life and death, which means the nurses there have a great responsibility to continually monitor and intervene to keep these patients alive and help get them better so they can go home to their families. What a special and sacred responsibility that is. I have a deep respect for ICU nurses and what they do.

Every shift of my preceptorship in the ICU all I could think of was "Why would you want to work anywhere else?!" and that is really what solidified it for me.

So now as I wait to sit for my boards and start applying for jobs, I pray that I can get hired in an ICU where I can learn and grow in the best possible ways! Nursing is such an amazing career and I feel so honored to be a part of it. I have soooo much still to learn and although I'm nervous, I'm also very excited to start working as a Registered Nurse.