This year has been full of learning and being pushed outside my comfort zones. Before and during my nursing degree I worked as an Assistant in Nursing, where, although I had lots of responsibilities, I was always under the supervision of a Registered Nurse (RN). I did not do certain things like medication administration or hang IV fluids. So to start as an RN and have people asking to check medications with me was difficult to get my head around. I was scared that I would make mistakes. However, on the Neonatal Intensive Care (NICU) ward, medications are always checked and administered by two RNs, so that came as a huge relief to me, knowing that there HAD to be another someone to check the medication calculations and would also ensure the five rights were adhered to.
Another big learning curve was how often the policies and procedures should and need to be looked up to find the correct information. When I am unsure of certain tasks, I generally would ask other senior staff. This can be quite valuable, however, many staff have different ways of practicing, and may not be following current policies and procedures. Many staff also have different ways of practicing amongst themselves, which is also confusing to get told very different things, and almost “in trouble” for not doing it the same way as them. I am getting more used to taking on the advice of others, however also looking them up on the intranet to confirm which way/s are correct. I have found it can be quite frustrating when I have been shown the correct way and have confirmed it with the guidelines, only to have older staff tell me that is incorrect. Sometimes, as a junior registered nurse, I feel it would be out of place to say something. However, I know I need to gain more confidence in being able to correct them, especially when it has to do with patient safety.
My confidence in talking to parents about their babies is also improving as I learn myself, but I still struggle sometimes when asked a question I do not know. The best way for me is to tell the parents when I am unsure of the answer to their question. Often I find myself telling them that their question is very interesting and something that I would also like to know. I then ensure I either look it up, or ask a senior staff member if they are able to answer this question for the both of us.
I have recently been trained up to care for babies on CPAP in the ICU. While I am still not 100% confident, I also feel that my confidence will grow with time and experience, so I am not getting ahead of myself or being too hard on myself either. I learn by experience and being hands on, rather than watching others. I have made this known to the educators that this is my learning style, so I find that they have been great with finding me opportunities to practice these skills.
Recently, I have had three amazing opportunities to attend births and play the role of “admission nurse”, where I have built a little bit more confidence and been more hands on each time. I still know I need support and supervision for a while, but I definitely feel more confident and calm about attending births and working with the doctors to ensure the best outcome possible for these babies.
A few weeks ago, we had a very bad week, with one baby suddenly and tragically passing away and another the day after. The first baby, I was on shift in the next pod in ICU, when I returned from my dinner break, there was a resuscitation well underway. I had my own babies to tend to, but in the times I was not busy, all I wanted to do was be of assistance, but I was also terrified at the same time that I would be asked to do a task but not understand or have the confidence to do it, and then I would only be a hindrance. I have never felt so scared, sad and anxious at the same time. This baby did not make it, and I had to witness these parents and grandparents suffer in ways I could never imagine. I have made a conscious decision to make every effort to learn how to confidently prepare IV medications, so that I can be helpful in these scenarios. I have also taken note of how calm the doctors and nurses were in this situation, as rushing and being stressed does not get the team anywhere, but patience and taking the time to do things correctly works faster in the end.
This year has had many up and down moments, both professionally and personally. Depending on these times, I have either wanted to pick up the pace and push myself to learn, or, I find I am holding myself back and wanting to stay in my comfort zone. I want to learn and gain confidence, but at the same time, I feel scared and intimidated by these new skills and of sick babies in the ICU. But I know confidence will come with time and practice, which I will slowly continue to gain as I continue my registered nursing journey in the NICU.