Nurse Residency Part 3

Nurse Residency Part 3

Last Leg of the Nurse Residency Program Adventure

When last I left you I was anxiously preparing for transitioning to a critical care unit, taking my ECG exam and beginning prep for interviewing. My cohort and is spent less time in the classroom and more time in our units as we prepared to move into our various areas around the hospital. We are all now ready to truly prove ourselves and make it clear to our overseers that we are ready.

Again no week is exactly identical and I can honestly say this rotation was completely different from my first one. Instead of being assigned to just one nurse preceptor I had as many as five nurses I worked with over a six week period. The usual pep I have in my step when starting a shift was missing and at times I was frustrated more often than focused when walking out on to the unit. New schedule in hand and goals established I was now ready to get through these next few weeks so I could finally move on to my final placement.


Week Nine: Wait! What happened to the music?

Eight weeks ago it was like celebrating my birthday and Christmas every day. As I went through my foundation classes and floated to the different departments, I am still riding high from the experiences. Then I receive my schedule for my next rotation and although it was not my first choice to go to this unit I am trying to have a positive attitude. I am scheduled to work every weekend and there is no consistency who I will work with from week to week. Just like there must be rain and sunshine for anything to grow, I too am learning that I need these experiences if I am to grow as a nurse.


Week Ten: Code Frantic

By the third code blue, one of which was on a patient I was assigned to, I was over being on this unit. I learned a great deal about myself as I handled these emergency situations. One, I can do it. My education and training had prepared me and once I swallowed down my anxiety I was

able to do what was needed to be done. My hat was off to my nurse colleagues who thrive in the adrenaline units such as the PCU and ED. A small dose of that from time to time I can understand but after two weeks I knew that this was not where I wanted to work week after week, month after month and year after year. My eyes were also opened to how nurses do not always treat each other in the best way. I saw ICU nurses look down their noses as PCU nurses who in turn did not have much positive to say about Acute care nurses or those who may work in Physical Rehab. My heart was saddened to see this but it did not reduce my resolve to still do my best no matter where I was. We are a body, the hand’s job will be different from the stomach’s but is it still just as necessary. The culture of nursing needs a refresher course about us standing side by side and not on top of each other.


Week Eleven: Have you seen my preceptor?

By the time I get to interview week, I will have worked with seven, I kid you not, seven different nurses. Most were great to work with and the conversations we had were encouraging. What made the experience less than great was I had not continuity. Some of the RN had not real training on how to offer guidance and be teachers. Some just hovered as if I needed hand holding each time I entered a patient’s room. This would be something I would keep in mind when I started precepting nurses in the future. A new nurse must remain flexible to changes. I used this opportunity to work with multiple individuals to practice my communication skills and learn to just flow with whatever may come.

Along with dealing with ‘I’m better than you’ nurses the hazing and bullying begin. Now as a nontraditional student who is not in her early twenties there are certain things I am not going to put up with. One of them is being set up. Unfortunately someone thought it was a rite of passage that a new nurse needs to go through. I have never been interested in sororities, clubs,

or exclusive groups, yet I know the mentality to “break-in” the newbie can quickly get out of control. For example the preceptor nurse has a patient with extreme constipation. A seasoned nurse would start with the less evasive to help give the patient relief.  The nurse recommended a painful medication and I tried to not roll my eyes. Instead of lactulose or prune juice this nurse wants to me to add to the patient’s misery. One a side note, this patient had been a high maintenance, grumpy tyrant and the nurses were ready for send this patient home. No excuse and I am thankful I didn’t take the bait. Another nurse, who was caught up in checking off tasks, wanted to offer a pneumonia shot to a DNR patient that was being discharged to a hospice facility to spend their remaining days. I didn’t agree with doing this and the RN could not give me a rationale for this other than is was part of the discharge plan. She had me call the physician and I must say it was very gratifying to have the MD agree with me that this was an unnecessary task. This was a great lesson in making sure I stand up for myself and be a strong advocate for my patient.

Week Twelve: Making the most of every opportunity

So the learning continues…such as nurses are to work every other weekend. I was duped into working every weekend. It would be something I would make sure all newbies understood so they wouldn’t have the grueling schedule I had while in training. Still I used this time to observe, learn, and grow. A shift might start badly but it didn’t have to continue to go badly if I made the choice for it not to be so. Instead of being upset at the RN that just wants to report back to the CNS about everything instead of talk to me about concerns or give me advice, I make the choice to not be that way. Being trivial with one another while patient care is to be our priority will not define my nursing career. My course is clear. I want a caring relationship with my patients and a positive working relationship with my colleagues. I am now ready to be placed on my home unit.


Week Thirteen: Let the interviews begin

The excitement is back! Not since preparing for NCLEX have I felt this nervous. The manager for the unit I hope to make my home has called and the date and time has been set. I review everything I can get my hands on about interviewing and research the mission, vision and values of the company I aim to make a cornerstone of my nursing career. The big day arrives and the panel interview is different from when I entered the nurse residency program. Things are more laid back and casual. They goal is to see if I will make a right fit for their unit. My goal is to work on a unit that will utilize my skills, talents, and gifts. The nurse residents are allowed to interview for two different units, three if they are so inclined. I only interviewed for one. Although nothing is guaranteed, I know where my heart is leading me and where I want to start my journey as a nurse.


Week Fourteen: Going our separate ways

I get the call that I will be making Acute Physical Rehabilitation my home and I look forward with anticipation my last week on the PCU. The discussions now turn to certifications and advanced degrees. I don’t quite find the time to ask why do you want to get a masters or Ph.D.  I am curious what these individuals want to with degrees. Is it to better the profession of nursing? Is it to run away from being at the bedside? Is it about the money? My cohort of thirteen have now been hired onto their perspective units and our larger adventure is about to begin. We aren’t completely disbanding since the residency program is a year-long commitment. We must still meet over the next eight months in small groups working on an evidence based practice project that we will present at our graduation. We are all sighing in relief as we are placed on the unit we all hoped for and have great anticipation to finally move to the next level in nursing.


Week Fifteen: Yea, Home at last!

Orientation. For the next month I will work with a seasoned nurse and I will on my own. I start my first of many nights on the unit. Adjusting to the night culture and sleeping during the day. I make friends quickly and just as swiftly I fall in love with my unit. It isn’t perfect but the patient mix and the collaboration of nursing with physical therapy, occupational therapy, speech therapy, recreational therapy, social work, and the physicians I get a taste of how health care should be. All our unique entities working together to help patients achieve their medical goals.


Week Sixteen: Thank you NRP!

Whew! What an amazing sixteen weeks. I will join the unit practice council and take every opportunity to engage in my unit as much as possible. I will remind myself before each shift, why I wanted to be a nurse in the first place. I will carry my joy and smile into each patient’s room and not take it personal when a patient lashes out or decides they do not want me to be their nurse. I will stay encouraged and look for ways to encourage my fellow nurses especially during overwhelming situations and challenging staffing issues.

I am grateful for the nurse residency program and the opportunity to see the various options nurses have to serve and care for patients. I have been effectively and efficiently prepared to be all I can be as a nurse and take a larger step into the nursing profession. I know each new chapter will only grow me as a nurse and an individual. I have been set up to succeed and I look forward to being the confident, caring, dependable nurse we all would want taking care of us and our loved one.

Kimberley Ensor, MSN, RN, NE, PHN, is a clinical nurse on an Acute Physical Rehabilitation unit. Nurse Kim is also a mentor and preceptor, and nurse educator.


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