Six Month Introspective

When I worked in ICU and precepted new nurses, the ones who had the hardest time acclimating to the new role were seasoned nurses. Sometimes, it's tremendously difficult to go from the top of one's game to not being sure of anything. Only time and repeated exposure to procedures and situations make a nurse comfortable in new positions. One opportunity after another to be successful is what gives us confidence (practice makes perfect). I used to tell new nurses that it would take six months to begin to feel confidence and up to a year to feel fairly good about things. Feeling expert at tasks can take years.

My transition from an intensive care environment into hospice has been no different. After six months, I'm feeling a bit more confident. I was not happy with certain aspects of my hospice training and promised myself that in six months, I'd re-evaluate where I stand. If still unhappy, I'd give myself permission to admit defeat and jump ship. In this time, I've developed a rapport with the doctors who support my efforts in the field; this has made a tremendous difference. I'm making fewer mistakes, really, only minor omissions on paperwork and that's helped in a huge way. It's so nice to seldom get a pile of papers back that I have to tweak. While I don't feel I've completely mastered the computer program we use, I do think we're on better terms these days. Very little cursing accompanies my interactions with my work laptop.

I've embraced the patient care aspect completely. I no longer feel unsure of myself in those encounters either. I use everything I have at my disposal-especially, the doctors. I still feel called to do this line of work. It's not true of everyone and I do work with some who seem a little jaded, as if this is just a way to pay the bills. Families and patients can always detect this in a caregiver. A nurse or hospice physician has compassion for a suffering human-or they don't. The fakers are almost always outed for what they are. This is my biggest time management issue. I am not a faker-out there only to make a living. This leads to those epic visits and starts of care that seem to go on and on forever. On a slow night, it's not an issue but on a busy night, there is no reprieve and nobody available to help. Other nurses tell me I need to get better with my time management and learn how to keep my patients and family members directed to the task at hand. Really?

How do you interrupt and redirect a dying person when they are discussing major issues? I can't. I'm giving notice that I won't. If my colleagues have a problem with this, I consider that their problem, not mine. I will practice the skill of being in the moment and most certainly will never leave a patient dangling in emotional crisis. I believe that dying a good death is a goal that can be achieved, one that requires attention to all aspects of life including the physical, spiritual and psychosocial aspects that make us human. To do otherwise would be a betrayal of the oath I've taken as a nurse.

It's only taken 25 years to heed the call and find my niche in this profession. I'm well rounded because of the detours but, I feel that I've found what I need to do with my career. I am finally, a hospice nurse. I think I'll stay here for awhile. My next mission will be to change the minds and behaviors of jaded nurses.

Do you think I stand a chance?