There are days when I wake up fully rested, emotionally vested, and ready to attest to my ability to care for my patients. There are days that I literally cannot wait to go into work because I have the privilege of helping someone’s teeny tiny family member get well enough to go home. There are days when I know that THIS is exactly what I’m meant to be doing with my life.
And then there are the days that none of that rings true.
It isn’t due to what may seem like the obvious reasons for that: lack of sleep; lack of support from those not at the bedside but making decisions regarding bedside nursing; nurse burnout; stressors outside of the workplace; etc. These can, of course, impact a Nurse. However, for me, there is a far bigger factor that makes it hard to be a Nurse.
Doubt.
I have been told that this goes away. That eventually, when you are a Big Girl [Guy] Nurse, you get to have your Nurse Gut. And in case you aren’t aware, your Nurse Gut is basically the magic unicorn dust of nursing. It’s the thing that makes you check on that patient just one more time because something just doesn’t seem right. Or what prompts you to call a Practitioner at 0325 to lay eyes on a patient after they just said they were going to sleep only an hour and a half ago because the monitors and the patient are telling different stories. It’s what makes really amazing nurses seem telepathic because they see things coming from miles away. Nurse Gut is a super power unique to those on the floor with patients. Nurse Gut saves lives. And mine is broken.
Don’t misunderstand me, I have had my share of ‘good calls’ or ‘nice catches’ in both of my nursing specialties. I work hard to provide the best quality care to my patients (and their parents) in the NICU just as I did in L&D. I seek out new information as much as and as often as possible to make sure that I am learning all that I can from those around me. Perhaps that is where my doubt comes in. Because let me tell you – I am surrounded by AMAZING Nurses and Practitioners. I am in awe at the ease by which these individuals can rattle off statistics, and values, and potential diagnoses (that are most often correct), and varying treatment options. I am humbled by the confidence with which they can proclaim that something in particular is going on with or has changed in these babies with a simple glance. That’s not me. When a Practitioner poses a question my way in a teaching moment, my knee jerk reaction is to doubt the answer that comes to mind (even when I’m pretty sure it is correct). When I find something different in my assessment than the nurse that I just received report from, I often seek confirmation that I am hearing or seeing what I think I have found. I will ask questions about procedures or medications to my co-workers to ensure that the rationale that I have in my head is actually accurate. I doubt myself, even if it turns out I am correct. Simply put: I have Nurse Gut envy. And I have it bad.
I see all of these big confident Nurse Guts around me that are teeming with the ability to prevent an issue with a patient before it even starts. Nurse Guts that tell a Practitioner at the beginning of the shift that they will be getting a call in the middle of the night because a baby is going to crump before day break. Nurse Guts that stave off an invasive procedure for a baby that just needs a little bit more time to figure it out. Nurse Guts that push that more conservative Practitioner to do the more invasive treatment because this baby really needs the extra help. Nurse Guts that guide timid new Residents through their rotation with us in a way that builds their confidence and keeps our babies safe. My Nurse Gut on the other hand seems to have been doled out to me with a healthy dose of IBS.
My Nurse Gut (assuming I do actually have one) is nervous. My Nurse Gut is worried that I will miss something. My Nurse Gut is uncertain that the problem I think I see unfolding, isn’t actually a problem. My Nurse Gut is afraid that when something goes really wrong, I won’t know what to do. My Nurse Gut has doubt. Lots of it.
I am terrified of being that Nurse without a Nurse Gut. We all know that Nurse. The one that you both hate receiving report from because you know you’ll be dealing with the mess created in the 12 hours before you arrived. The one you hate giving report to because you know you won’t be there for the next 12 hours to keep an eye on the patient that you worked so hard to keep stable all night. The one that you cringe about having to work with because their assignment will be carried by everyone else working that shift. The one that you are extra cautious about co-signing with and double-triple-quadruple check the accuracy before you do. The one that is there to get a paycheck. The one that goes through the motions but doesn’t seem to really get it. We all know that Nurse. And I desperately do not want to be her.
The days when I wake up and I can feel my Nurse Gut cowering in the corner are the days when it is hard to be a Nurse. In a unit full of robust, confident, spot on, unicorn dust Nurse Guts, I am petrified of being ‘that Nurse’ on the unit. More than I want to be a Nurse with a savvy Nurse Gut, I want NOT to be the Nurse in the room without one that in turn makes everyone else’s job harder. I have too much respect for this field and for all it takes to be a Nurse to impede those around me. I know the gut wrenching, stress evoking, joy bringing, soul healing, adrenaline spiking, peace making, beautiful chaos that is this profession. I know what those around me sacrifice and what they gain by doing this great work. I know that being a Nurse is hard. It is because of all of this that I find myself waking up to days when it is hard to be a Nurse.
Nurse Gut is real. Nurse Doubt is even more real. I’m not certain that the two are mutually exclusive, but then that uncertainty seems par for the course. So today I have Doubt. Today it is hard to be a Nurse. But there is always tomorrow.
xoxo,
Mrs. Medical Mess
(^Oh yeah…I got married!)
ChartingError 