You ask a very timely question that has caused me to post after a very long absence here.
I very vividly recall how I felt as a brand new nurse. I was eager to join the team in the ER, learn as much as I could, and truly do some good by making a difference for the patient population I chose to care for. I jumped out of bed every morning because I could hardly wait to get to work. I tried to gain the respect of my coworkers and become a trusted member of the team, and a tough bunch of type A personalities it was! I tried to help the brand new residents, because I sure know how they felt--new and lost! I would gladly skip my lunch because everyone was too busy to cover for me. Hardly a shift went by that I did not cry in my car on the way home, thinking about the patients I cared for that day--those that made it, and those that did not. I thought to myself, "I will always remember every patient we coded that died..." My nights were spent trying to find a way to fall asleep because I was so ready to get up and do it all again.
Then things began to change. I was exhausted but happy to get up and go to work. I was beginning to feel like part of the team, but still painfully aware that my glaring lack of experience was a barrier to gaining the respect of my coworkers. I still tried to help the residents, but I was quite busy watching my own backside because I'd been burned by the residents too many times. The nights that I drove home crying were getting less, and I spent more time at the bedside holding a family member's hand and feeling like I had finally achieved composure enough to comfort people most effectively. (Since I had been told multiple times I was way too caring for the ER.) My nights suddenly became battles to get to sleep---all day I had kept a stoic demeanor, but when I laid my head on that pillow at night the images just would not stop. I wondered if I triaged that patient correctly, or if I had just done something different the outcome would have been better. It haunted me that I could not recall the number of codes I'd been in, or the faces of people I had watched die.
And things still change more even now. Just today on my way home, I thought back on the day, and I wonder what on earth is wrong with me. Am I sick in my head? Have I become some kind of monster? I did not sit and hold the hand of a heroin addict who came in for a broken needle, instead I gave him teaching on drug abuse and informed him he should be more worried about the heroin he just injected than the needle broke in his arm. I make sure I get to eat, even if it is sitting at the nurses station looking like I am being lazy. I don't trust the residents for a second, but I still manage to be nice to them. My coworkers have become like a second family, and a closer group of people I could not imagine. I've gained trust and respect, and am part of the team. No longer do I dream at night, but when it's been really bad at work I might have a glass of wine so I can drift off to sleep as quickly as possible. I wonder how I arrived here, because sometimes it hits me that I no longer cry on the way home from work, and I think something must be wrong with me. The other day I realized that I had lost track of how many failed pediatric codes I'd been in on, and I could not recall all of their faces anymore or what happened to them.
But I still do what I need to do. I am efficient, I prioritize, and I give excellent patient care. Have I taken vital signs on a person and then not gone back for a long time--yes, I have, if the person came in for papercut or a runny nose. Yet it is probably because I am at the bedside of a patient we are about to send to the cath lab or intubate, and because this is what I do for a living I am certain the runny nose will be okay without me at the bedside. Do I want to be at the bedside, holding the hands of patients and family members, fetching pillow and socks, or getting snacks for them? Yes, I do, when someone is sick and/or sad. Do I have time to fetch a pillow for the third visitor of the runny nose? No, and it makes me aggravated to be asked something like that as I am running down the hall with my arms filled with fluids and supplies. Have I ever referred to someone as "the bloody GI bleeder"? Yes, I have--because thinking of him as the 'sweet little old man who is probably going to die as his wife sits crying at his bedside' keeps me from functioning to do what I need to do.
Daily I remind myself that I have not changed inside as a person--I still am the same, brand new nurse, who wanted to help people and make a positive difference in the community. I still care. But I have to care for myself, too. I prioritize my care for the patients I see in the ER, and I prioritize care for my own sanity. I have to grow and change, and I can see that the way I cope is by adapting along the way. I love my job, and love nursing. I miss the "old" me, but I know the change has happened to allow me to keep doing what I love.
So this was a lot of rambling, but I hope you can see how things can change. I wish you luck in your future career.