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Not What I Expected

Not What I Expected

As I struggled my way through nursing school, I never expected my first job as a nurse to feel like this; I was too busy dreaming of the day when I could hold the title of Registered Nurse.

I never expected to come home crying. I never expected that, at times, I’d mumble the words “I hate my job.” I never expected many of the challenges I face daily–but here I am, six weeks into my first hospital job, fighting to make it. Here I am, figuring out what it means to be a nurse, learning what to expect.

It is early afternoon, and I have just finished administering my last midday medication. I emerge from the patient’s room to find that five call bells are buzzing; there is no other nurse or aide in sight. I begin to wonder if everyone is purposely disappearing in order to test the new kid.

I walk into the closest room. The patient asks me to adjust her bed; I begin elevating its head.

“Tell me when to stop,” I say.

“Stop,” she says. “No, no, go up some more…wait…back down…a little more up.”

Buzz. Buzz. Buzz. I feel the anxiety building inside. I have several assessments to document, two wound dressings to change and endless other menial tasks to complete. Buzz. Buzz. Buzz. I pull the covers up to the woman’s neck, give her the call bell and ask if she needs anything else while silently hoping she doesn’t.

I walk out of the room; four call lights are still on. Buzz. Buzz. Buzz. I look desperately for someone to whom I can delegate something–a critical survival skill they drilled into our heads in nursing school. There’s still no one around, so I run to the next room.

The patient in this room has been incontinent of bowel. I will need to do a complete bed change, give the patient new briefs and new clothes, thoroughly clean him and provide skincare; this will take a while. Buzz. Buzz. Buzz. I feel a little sick. Then I remember that Room 25 wants his pain medication promptly at 1:51 p.m., and I have nine minutes before he’ll be leaning on the bell.

I roll my patient to the left over the mass of soiled bedding, then to the right, pull the soiled sheets and pad away and straighten the fresh bedding. Then I pull the blankets up to his neck and hand him his call bell.

“Is there anything else I can do?” I ask, managing a smile.

Buzz. Buzz. Buzz. My anxiety is choking the words as they come out of my mouth. If he says he needs something, I may not survive this day….

I walk out of the room; three call lights are still on!

Where is everyone? I scream silently, heading to the next room.

I reposition the third patient; I toilet the fourth; I give Tylenol to the last, then sit down to document all that I have done. Then I remember Room 25’s pain medication. I jump up to pull it from the Pyxis (the medication-dispensing machine) and bring it to his room. I feel overwhelmed and stressed–certain that the other nurses and aides are hiding so that I’ll have to answer all the call bells. I chuckle as I imagine them all hiding in the supply room together. A more likely explanation is that they themselves are tied up. Given the number of severely ill patients in this hospital, the nurse-to-patient ratio is unrealistically low.

Either way, I’m too stressed, overwhelmed and naïve to the profession to know. What I do know is that there’s rarely anyone around to help, and it is wearing on my soul.

I knew that, as a new nurse, I’d need to take my licks. I was warned about passive aggression by the staff, and how nurses are sometimes said to eat their young. Perhaps this is happening here, or perhaps my fellow nurses also feel stressed and overwhelmed.

I expected some of the challenges I face, but I never imagined that it would be like this.

Today I missed my lunch again. I haven’t used the bathroom in more than eight hours, and I still have a pile of work to do before the end of my shift.

Buzz. Buzz. Buzz.

Mustering a smile, I walk into the patient’s room.

“Can I help you?” I ask.

“I need to use the bathroom,” she says.

Tenderly, I help move her legs to the side of the bed. Patiently, I wait while she eases herself forward. Gently, I help her to a standing position while she finds her balance on her walker. I walk with her to the bathroom. I help her with her pants and briefs. I wipe her bottom and add protective cream. Then, carefully, I help her back into bed.

I pull the blankets up to her chin, hand her the call bell and ask, “Is there anything else I can do for you?”

She grabs my arm. “You’re a good nurse,” she says. “They’re not all so gentle.”

My heart feels full, my anxiety melts away, and I remember why I wanted to be a nurse. I could never have expected it to feel this fulfilling or be this meaningful. And yet I’m still figuring out what it means to be a nurse.

A day in the life of a nurse is hard, with challenging patients, demanding doctors, and a nearly endless task list. A day in the life of a new nurse is brutal, with layers of additional challenges–learning new systems and procedures, establishing working relationships. It can seem at best daunting, at worst impossible.

Sometimes, like just now, my patients give me a little reminder of why I do what I do; most of the time, I have to remind myself.

So while working through my day, I find myself chanting a little mantra. I say: “I do what I do to touch people’s lives, to give them a glimpse of kindness in a world that is so often unkind.”

And I recall my own personal experience–the one that helped me persevere through nursing school.

For many months I lived bedside with my two critically ill sons during their hospitalizations–one during treatment for brain cancer when he was one year old, the other with an anoxic brain injury when he was thirteen. During those hospitalizations, a handful of nurses absolutely transformed our experience. They offered hope, they offered joy, they provided safe and competent care, and they conveyed genuine concern and acceptance. Through the ways they cared for us, they made the unbearable almost tolerable.

Those nurses made such an impression on me that now, every day, I strive to emulate them. Every day, I strive to touch someone’s life the way they touched mine. A part of who they are as nurses has become part of who I am as a nurse. It’s entered into my mantra and my philosophy–and, hopefully, into the way I care for my patients.

Did those nurses cry during their early days on the hospital floors? Did they struggle to adjust to the nursing profession? I don’t know–but I do know that they must have persevered.

And so will I.

About the author:

“I am a wife and a mother to three daughters and two angel sons, for whom I grieve endlessly. After a rocky start in professional nursing, described in this story, I decided to take time away from hospital nursing to pursue my passion for humanitarianism through volunteer work. I have found great fulfillment as a nurse with the Disaster Health Services team of the American Red Cross, and through service with the Water Street Mission health clinic in Lancaster, PA. The time away from hospital nursing has helped me find my path, and I recently accepted a position in home health. Additionally, I’m a student at the Pennsylvania College of Health Sciences, where I am seeking a BS in nursing. For now, I write to fulfill my coursework requirements, although as I live with the loss of my two boys, these assignments have also become a written expression of my grief.”


12 thoughts on “Not What I Expected”

  1. Dear Samantha
    Thank you for sharing – I feel your beautiful soul all the way here to Denmark.
    A big hug –

  2. Elizabeth Caplan

    Why is misery inflicted upon new nurses as a matter of course? Why is this accepted, and acceptable? Why do nurses flee the misery and leave the profession, in self-preservation; why is it necessary to survive a trial by fire? It think the answers may be found in 1.) understaffing as a part of the for-profit nature of healthcare, and 2.) internalized oppression in this traditionally women’s profession. It needs to stop. As an RN, I say it is just wrong and unacceptable. Stop thanking nurses for suffering. Just stop the suffering.

  3. God bless you .. for being where patients need you, for carrying on your mission, for honoring your sons in a way that others will know your kindness.
    I have always said nursing is not for the weak hearted.. it gets better.. i am so sorry your first years were so rough.
    Thank you for being you

  4. D. Williams-Camps

    Thank you for sharing your story. GOD continue to bless you and keep you as you are a blessing to your patients. .

  5. As a retired nursing administrator, trust me, Diane, you will make it. There will be times you will doubt your professional decision but at the end of the day or your career, you will know you did your best and you touched others. And that is all we can ask of this life.

  6. Samantha,
    Thank you for sharing your heart. What a beautiful and well-told story. I wish you much reward as you traverse your professional world. It sounds like you have found a niche that serves you and the world well. Peace, Nancy

  7. After getting her nursing degree, the daughter of a friend got a hospital job. She lasted two years and left because of the kind of stress written about in this article. Too few nurses for what needs to be dome. The nurses suffer. The patients suffer. Hospice nurses have it much better despite their patients dying. They have the time to give the care that’s needed in the interim.

  8. This story reminds me of how much I don’t know about all that goes on behind the scenes in the world of medicine. Now more than ever, people in this profession leave me humbled and in awe. Thank you.

  9. Oh, YOU are all it, Samantha. You have it all, truly. After years in nursing, RN, BSN, MSN, PhD and teaching, I found my peace in home care and hospice as well. There, while you will be pressed, you will also be in one home at a time, helping one family or caregiver after another assist their recovering or dying family member. The BSN will give you a more global perspective needed to address aggregate and public health issues. You can go anywhere and do anything because nurses are independent practitioners. You have all the experience in life and in the world to touch and facilitate the well-being of so many who have not had your gifted life. Blessings and are we lucky to have you among our ranks of millions. You rock! Thank you. v

  10. A perfect example of why we should still have LPN’s as well, how many of these tasks required a RN or BSN? No wonder nurses are “burning out” at an alarming rate. And shame on the hospitals for not providing adequate staffing ratios. Healthcare should not be run as a business, staffing down to minimal levels. Who will want to do it, if we continue on the path?

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