One year ago today ...

... I started as an RN I in the ED. Yes, I survived my first year without doing anything too boneheaded, knock on wood. I was super-cautious yesterday, figuring Murphy's Law might rise up and bite me in the @$$ one day short of a year. Ha ha.

My one big piece of advice, if I may be so presumptive to assume you might want it: stick with it! I know being a nurse is tough at first, even with lots of healthcare experience; it's just such a different level of responsibility, and man did I feel that. I've been a tech in the same ED since 2005 and I've been a paramedic for 6 years, and even with that experience, I was a bit overwhelmed at first. I think part of it was the volume of paperwork!

I also never truly appreciated the techs until I wasn't one any longer. I went from being the tech on a Saturday to being the "RN Applicant" on a Sunday last year, and suddenly there was no tech to help me! I was it. So thank your techs ... they can truly save your behind. Case in point: a couple of months ago I had two patients simultaneously trying to go into the light, a third with pneumonia, and a fourth with abdominal pain, and you can bet they all needed a LOT of stuff -- ECGs, meds, labs/blood cultures, Foleys, nebs, etc. I told my charge nurse that I'd like a hand, but he was helping the other RN across the room who had not-so-sick patients but who was unable to keep up with her patient load. So it was just me, and my tech. My tech rocked it out and got all the tasks within his scope done for me, and I was able to get my two wanna-be-dirt-nappers stabilized and get all the meds administered, while assessing and reassessing my four patients. I think that day I truly felt like "THE NURSE" for the first time -- I had some very high-acuity patients, but I had the situation in hand; I constantly re-prioritized in my head from minute to minute as the various situations changed, and I knew my course of action. I got the outcome I wanted, and it was all with the help of my tech. He rocks! I never let him do something for me without thanking him. Sometimes you can't be "THE NURSE" without the help of your teammates. My charge nurse later apologized for not being able to help me, and I told him it was really okay -- the experience allowed me to really feel how I've grown as a nurse in the last year.

Could I/would I have had the same confidence in my first couple of months? No way. It just takes time. It's tough because I work with a lot of RNs with 10 to 20 years of ED or ICU experience, and so much of what the do/know has become second nature to them. Don't compare yourself to these people! Give yourself the time to grow.