BY: Luis Sanchez-Vera, BSN, RN, BSPH At the nurse’s station, the charge nurse switched back and forth between her clipboard and various documents, focused and ready to lead the transition of patient care from the night staff over to the day RN staff. I slowly made my way past the nurse’s station quietly chanting the list of supplies that I needed for the last hour of my shift. Before I could reach the supply room, one of my colleagues sprinted past me yelling, “code blue, code blue, airway!”
I sprinted to the patient’s bedside; a physician was already on scene attempting to suction the blood that was dripping from the patient’s mouth. The patient was familiar; she had been under my care one week prior. Quickly, I raised the head of the bed to stop the patient from aspirating. I opened an additional suction canister and made sure the tubing was connected and ready to go. Before the Yankauer could reach her mouth, copious amount of dark red, projectile vomit forced itself from the patient’s mouth and from both nostrils. The room went silent for one long second. The high-alert alarms abruptly became audible again and our attention centered back to the task at hand. The patient lost consciousness and we instinctively started CPR just as the charge nurse entered the room with the code cart. At this point, I stepped aside and allowed the experienced staff members take over.
My first year as a new graduate at NYU Langone Medical Center has been one of exponential growth, moments of overwhelming challenge but ultimately a fulfilling experience. Being a new nurse, one is plunged into uncharted clinical waters that one never experienced as a student. The nurse residency program at Langone kept me buoyed safely in my transition to becoming an expert. The lectures, skills labs training and shadowing experience all adds up to my on-going professional development.
During orientation, I had to quickly learn about the basic operational duties of the institution. Learning how to page different medical teams, answering phone calls, mastering the electronic medical record and directing family members were just a few of my responsibilities that were essential in order to coordinate the high quality care of my patients. It was extremely important to continually ask contextualized questions with any task or responsibility that seemed unclear in order to promote the safety of my patients. During my first IV insertion attempt, finding the vein for the IV was pretty easy. However, I had to exit and enter the room a few times because I had forgotten supplies and this made my patient increasingly nervous and anxious. I was so embarrassed that I had to keep leaving the room for supplies that it was manifesting in my body language. Ultimately, the patient was uncomfortable with having me insert an IV. I felt slightly crushed but I wanted to respect the patient’s rights and reassure him that he was in safe hands. As I moved forward, I took the time to plan ahead carefully and make sure that I was prepared for every task.
Currently, I am one of four males in my unit. We have always worked as a cohesive team regardless of the male to female nursing staff ratio. One of the challenges I encounter in the field has been defending my decision to become a nurse. Very often, patients would confuse me as a physician. One of the more common questions I am asked is if I would consider pursuing medical school and become a physician. One patient asked, “You’re really smart--why aren’t you a physician?” Nursing is such a dynamic and holistic approach to patient care. I love nursing! The time spent providing direct patient-care at the bedside continues to motivate and validate my decision why I am a nurse.
Nurses are life-long learners, we are continually enhancing our clinical knowledge and life-saving skills in order to provide safe patient-care and most importantly to advocate for our patients. Learning to make plan of care recommendations to the medical team is an invaluable skill that is strengthen with experience. A year ago, my mind seemed to dwell in completing individual tasks and making sure I completed all of my documentation on time. I have so much to learn but I am proud of my growth and increasing confidence at this stage of my career which has been possible largely because of the competent and supportive nursing team on my floor.
As a new nurse, I had to become comfortable with adapting to a continually changing environment. I find myself planning ahead for my shift but often I find patient needs continually changing and having to adjust the plan of care for these patients as well. There have been numerous discouraging moments in my career but I have to learn to reflect on my experiences to allow my confidence to grow and cultivate my professional identity. These reflections are what I have to share to those who are just entering the nursing profession and those who came before me. We are all here for good.
Luis Sanchez-Vera, BSN, RN, BSPH