Friday, December 12, 2008

The Hard Way Pt. 1

This is a long ass post, my apologies. I know shorter posts are easier and more fun to read. But I don't have much time these days, so I crank it out when I can. I seperated it into two parts so you can take a break, go to the bathroom, make some pop-corn, grab a beer, make love to your signifigant other, WHATEVER YOU NEED TO DO, so you can read the whole thing. Tally Ho!

Hard thing, to be a new graduate in an I.C.U. Trying to acclimate to steady stream of new information, theories, styles of practices, sometimes mellow- sometimes brutal clash of personality. It’s a hard thing. I’ve grown a lot these last few months. It’s been a wholly healthy experience, trusting a hospital unit to mold me into a functional nurse that can be trusted to take care of a very sick human being. So many defenses pop into my head when I trust my unit. I work for a corporation, it’s image or brand is that of Catholicism. I am precepted by various instructors, of all nationalities, sexual preferences, mentalities, experiences, I am open to their criticism, their warnings that something I may be doing is not working or will lead to more trouble down the road. I am even open to the ever stinging and painful attitude adjustment. I put trust into my I.C.U. that it’s interests are getting me up and running, not degrading my worth as a nurse and person.

I don’t know why nurses feel it is so important to remind newer nurses that they are new. I know only a tiny fraction of the over all incredible tidal wave of information required to run an I.C.U. I mean, I know this. This realization occurred to me my first week: In my career I will never learn every condition and procedure in great depth of detail enough to be masterful in all workings in the unit. This truth was stunning and provoked fear in me. That in itself as humbling as hell. More experienced nurses, however, are so threatened by the fleeting moment of recognition that every new grad has, when training comes together, when that smile comes on our face, “Hey, I learned this. I know this. I know why it happened, I have enough background knowledge and theory to manipulate this situation to favorable outcome because I’ve seen the outcome of this situation before.”

My preceptor with 3 years experience says to me, “Yeah, well, I think you just got lucky here.”

Then I go into my patient’s room and the noise by the charge’s desk drops. It gets eerily quiet. Cuz they are talking shit. That is the attitude adjustment. Not that I have done anything wrong but the attitude adjustment lies in the fact that the words that come out of my mouth reverberate around the unit and can leave a favorable or unfavorable impact, depending on the disposition of the nurse gossiping. I can control some of this, I must retain the attitude that I know so little and am awed by the skills of those more experienced. Sadly, my true feelings are threatening and infuriating to the more experienced. By claiming some victory over a situation I have hit a nerve with any nurse with more than 3 years of experience. Some of my preceptors let me have opinions let me make the mistakes that change those opinions wisen me up while most are too insecure to let me do so. To the insecure nurses, my attitude has changed. For the sake of peace, and career longevity, I swallow it and oblige their weakness. My attitude has changed.

Well sometimes. Mostly, I’ve been good, kept my mouth shut. I know better than to point out the 5000 contradictions that preceptors have amongst each other. I did try to point this out one time out to a preceptor that while I had no problem doing the task they asked of me or the way they asked me to do it, my previous preceptor the night before felt just as strongly about doing it completely different. That never chills ‘em out though. They just feel more threatened and insecure. Secure preceptors don’t give a shit about minute differences. Insecure ones cannot fathom that one single task can be done safely and appropriately 20 different ways. Especially when it comes to charting. That night’s preceptor kept saying, “But do you understand why I do it this way?” I was like- fuck, I understand you rationale is perfectly understandable but DO YOU UNDERSTAND THAT IT CAN BE DONE THIS WAY?
Preceptor: “What’s this?! You haven’t tallied up any of your I/O’s? You’ve already gave report. You’re behind.”

The following is my response after 2 months of my 27 year old preceptor acting like a cocky ass, making nothing but negative comments, criticizing my questions as repeats and therefore-stupid, not making any attempt to communicate, looking only for inane mistakes in my paperwork ( I put the MD’s name after the telephone order as opposed to putting the MD’s name UNDERNEATH the telephone order), all around being pretty worthless. Acting as if my dumb mistakes are somehow a reminder of my total failure as a new nurse. Each “Tssk" and deep sigh pushing me closer to the edge. Each day he’s got closer and closer to being out of line.


No comments: