Your first year as a nurse is likely to be a whirlwind of new experiences. Many nurses recall a rollercoaster of emotions from fear, anxiety and nervousness to happiness and sadness. Almost every nurse has a story to tell or a lesson learned. And in some cases, it helped shape their career path. These Nebraska Medicine nurses share some of their most memorable stories.
Michelle Schulte, MSN, RN-BC, ambulatory supervisor for the Dermatology clinic, recalls her first year as challenging. She had just started working in a Medical-Surgical Unit and was still getting her feet wet.
One weekend when she was driving back to Omaha with her parents after a visit with extended family in western Nebraska, they witnessed a car full of teenagers veer out of control, cross the median and flip over into ongoing traffic. Several teens became airborne.
“We pulled over to see if we could help,” recalls Schulte. “My mother immediately pushed me out of the car and told me to go help them. I was nervous. I had never treated a trauma patient in the field before.”
One of the teens closest to them had exposed bones and no pulse. All the basic principles of nursing care that Schulte had learned in school began to kick in. She had a CPR mask in the glove box and immediately started the steps. An ambulance arrived a few minutes later and asked who she was.
“When I told them I was a nurse, they asked me if I could start an IV,” recalls Schulte. “It was scary and nerve-wracking, but also an exhilarating experience.”
Unfortunately, the young teen did not survive, but the experience left an indelible mark on Schulte’s nursing career. “From that day on, I was a much calmer nurse when I went to work every day,” she says. “That experience helped me put it all in perspective.”
Several months later, Schulte found herself in another unfortunate situation. A young cancer patient whom she had been administering infusion therapy to, passed away after her shift. About a year later, a wrongful death suit was filed against Schulte and the hospital, requiring her to meet with hospital lawyers and defend her actions. Fortunately, Schulte had been very meticulous in her documentation and followed all the protocols to a “T” and was eventually dismissed from any wrongdoing.
While it was another harrowing situation for a first-year nurse, it was also a learning experience. “My advice to beginning nurses is if you follow all the policy and procedures, document meticulously and don’t cut corners, the hospital will have your back and you’ll be fine,” she says.
In reflection, Schulte says, “If something bad happens, always make sure you have carefully documented it, then reenact it, double-check your documentation and make sure the incident is engrained in your brain in case something becomes of it later.”
Tiffany Whitney, BSN, RN-BC, nurse supervisor for the Medical-Surgical Unit at Bellevue Medical Center, says her first years as a float nurse were a great opportunity to be exposed to a broad number of areas in a short amount of time. “I loved the idea of working in a different area each day because I learned so much,” says Whitney.
Dealing with the loss of patients can be difficult no matter where you are at in your career, but it can be especially emotional during those first few experiences.
Whitney recalls an emotionally difficult first day of orientation in the intensive care unit. “I had a patient who coded on the medical-surgical floor and was transferred to ICU,” she says. “Everyone was running around getting labs, calling doctors and notifying family. When the patient arrived to the ICU, they coded again, sadly, we were not able to save them. An hour later, I got another patient with my preceptor who was not doing well. They were ventilated, on multiple drips and the physicians were doing their best to figure out what was going on. But even with all the life-saving efforts we made, this patient also did not survive.”
That day alone was the most exhausting and emotionally filled day Whitney had ever had. “I was very emotional,” says Whitney. “I could not wrap my head around what just happened but the chaplain put it in a way that was understandable. As a new nurse, we want to save every life, he said, but sometimes that is not possible. The chaplain emphasized that throughout my career I am going to have many ups and downs and emotional cases but the one thing to remember, is why I became a nurse and that is to help others and support them in their time of need. This has not only stayed with me but has also been why I love what I do each and every day. I would not change my nursing career because I know that what I do makes a difference.”
Support and understanding from co-workers can make all the difference during difficult times, says Emma Warner, BSN, clinical nurse in the Neuroscience Intensive Care Unit. “I was in orientation when I experienced my first death,” recalls Warner. “It hit me really hard. I went to the break room to cry shortly after we called time of death. I was embarrassed with how upset I was, but I was completely overwhelmed with support from my manager, my preceptor and my peers. I was told I could take as much time as I needed and that a few other nurses would watch my patients until I was ready. I still think about that day and the amount of love I felt from my fellow nurses that barely knew me. We are all in this together and that makes the difficult time so much more tolerable.”
Getting a mentor made all the difference in the world, for Derek McCroy, MHA, BSN, RN, ambulatory supervisor for Pre-surgical Screening and Surgery Scheduling. “During my first year of nursing, I had periods of excitement, fear and stress,” he recalls. “I found a nurse on the unit, different from my preceptor, that I could confide in and bounce off ideas. It was nurse who been practicing for only a few years, so she could still remember back to when she was a new nurse. She helped me realize that I am not alone in my feelings of stress and fear and reassured me that they would soon pass. She was right. One day I went to work and I remember it was the first time everything just "clicked," and I thought to myself, I can do this!”
Kylie Byman, MS, RN, learned the value of following her intuition during her first year while working in a Medical-Surgical Unit. One of her patients had an arm fracture and kept complaining of pain throughout the night. When she couldn’t get it resolved, she escalated the complaint to the resident who suggested more pain meds. “I kept thinking something wasn’t right,” Byman says. “I remembered learning about compartment syndrome and its symptoms and thinking that their symptoms were very similar. When the additional pain medicine did not help, I contacted the resident again.”
The attending physician came to see them and upon evaluation, diagnosed the patient with compartment syndrome. “He congratulated me for saving this man’s arm,” says Byman. “It was a very pivotal moment for me. As a nurse, we often wonder if we are making a difference. This confirmed that we really are the first line of defense for our patients, and we can make a difference!”
Joshua Beerman, BSN, RN, supervisor for the Solid Organ Transplant Unit, remembers an incident during his first year that helped shape his nursing career going forward. A very petite patient was in the hospital waiting for a second multi-organ transplant. The patient was very ill so the staff helped organize a wedding on the floor with the significant other.
“It was very touching and has had a lasting effect on me,” says Beerman. “It’s about being able to help people in moments like this that is why I got into nursing.”
Mary Clarke, RN, A PRN nurse, remembers a few pranksters on the floor that helped lighten the atmosphere and bring laughter to the floor during her first year. “They would put silly things in the dumbwaiter that would make you laugh, like your lunch. Other times, they would stuff themselves in the dumbwaiter to scare the heck out of you!”
Karen Moran, RN, remembers the benefits of being observant during her first year and learning from the older, wiser nurses. “I recognized the good nurses, watched them and learned by their example,” she says. “I picked their brains and figured out who my mentor would be. You just can’t know it all in a year. Follow your gut feelings, bounce questions off co-workers and never act like you know it all. Older nurses are full of experience and knowledge!”
She also remembers the playful antics that went on during the night shift to help them stay awake and alert. “Exercises like squats and push-ups in the nurse’s station, listening to music and singing,” recalls Moran. And then there was the time when she removed her powder-coated gloves and then put her hands on her behind. “My co-workers let me walk around with hand prints on my bottom all day long.”