The Proficient Nurse

I have been a nurse 7 years now. People would usually say time flies but no, in this case, it feels like aeons ago because so much happens on a daily basis in one's nursing experience that one week can feel like a lifetime sometimes. So it feels a lot longer. There is a theory by Patricia Benner called the "From Novice to Expert" theory.  The idea is that in one's nursing career, you go through a growth chart with various phases; from Novice -- Advanced Beginner -- Competent -- Proficient -- Expert. Simply put, you go from relying heavily on rules and orders, nose to the grindstone, just trying to get through all your orders for the day to being able to step back, rely on intuition, and have a more holistic approach to a situation.  You are better able to anticipate outcomes and make suggestions as you work with your provider to provide the best care to your patients. You feel better placed to guide your family when they ask you health-related questions and your response to emergencies is more intuitive. 

It has been 7 years. In that period, most of my growth has been through COVID and beyond as I experienced different hospital settings in rapid succession - Surgical ICU, Medical ICU, Coronary ICU, ICU burn units, pulmonary stepdown, trauma and neuro, intermediate care, and others. Despite all this, there is still SO MUCH to learn and I still feel in some settings like that Advanced Beginner simply because in working at different hospitals, you have to start by learning the policies and procedures applicable at that particular hospital. For the last three years, I have been a contract nurse which allows me to maintain a better work-family life balance, but it also means that I work at 2-3 different hospitals a year. 

Nevertheless, when I stop to take stock of how far I have come, I am nothing short of grateful for how much I have learned.  When someone comes in with a head injury, I don't need to go into my orders to know that there will be a CT scan, neuro checks, what red flags to call the provider about: sudden headaches, fluid or blood draining from anywhere, slurred speech and so on. When someone comes in with chest pain, you know the drill.  When family members ask questions, your teaching, which is a big part of nursing, is richer because you can better relate different body systems. When your patient asks you in frustration why he came in with pain and swelling in his legs and they are doing scans of his chest, you can explain to him how his heart and lung function can be related to the swelling in his legs. You can alleviate his/her fears and those of the family because you are your patient's number one advocate. You can relay their fears to the doctor and any changes in their condition and get them answers and the medication they need. 

And at home, when my husband takes his blood pressure and turns to me to ask if that's a good reading, or my son exhibits certain GI symptoms, I can take a step back, ask some questions, and determine our next steps. It does help tremendously to be able to tap from the wealth of experiences over all these years. Remembering when someone came in with a similar situation, what elements we ruled out to narrow down to the problem. Nurses don't play doctors, no, that is outside our scope, but it does help to know what to look for. 

Yes, nursing is such a rewarding career! Not a dull moment because every day, you have several patients at different levels of illness, experiencing different problems, and from different backgrounds.  They are at a vulnerable stage in their lives and they need help.   And you are privileged to be going through this part of their journey with them. 

So, at this competent - proficient phase of my nursing career, I go to work every day, hoping to make my patients feel that they are safe and in good hands, hoping to put a smile on my patients' faces even in their darkest moments.