Fumbling toward competency

Note to self: next time you think you're knowledgeable, confident, and oh-so-smart ... shutdahell up.

My official start date was 28 days ago. On that Monday I walked into my new position as a Neurosurgical Intensive Care RN - fresh out of nursing school, the ink still wet on my license. But hey, ten years of experience as a Paramedic counted for something, right? I at least knew how to talk to, approach, touch, assess a patient, right?

Ha.

Three weeks before I even saw a patient. Didn't even lay eyes on one till then - spending my time in classroom study, computer modules, competency testing ... til my head spun. Then - the day.

I actually get to do a floor shift. Cool! Here's what I've trained for, gone to school for, done all that clinical time - plus my experience in prehospital care and in the ER ... YES! Now I can finally start to do patient care!

Um. Hey. Is there a patient, in there, under all that machinery? And, um, I seem to have forgotten which way to turn the stopcock on the a-line when I zero it oh crap there's blood on the sheets I need to change the linen can someone help me turn the patient hold the tube mind the vent lines watch out for the ventriculostomy rezero the ICP monitor chart those vitals did you give the 9PM meds crud is it 1045 already what's the urine output I need to send off an osmolarity someone help me get him down to CT rezero everything again draw an ABG good waveforms neurochecks okay and damn did I forget anything here's report at 1500 ....

And this was a light assignment. With a lot of help.

Oh man, can I do this?