It seems now I am a student nurse, people presume I am the font of all knowledge for any medical condition, ailment or general problem, regardless of whether I'm on duty or not.
One time, I was lucky enough to have an afternoon to myself, without tests or tasks. I decided I would go out, have a long walk, get myself a book and settle down in a café to enjoy a good read and a bit of people watching.
I'm at the counter ordering my coffee when one of the ladies who works there spots me and tries desperately to get my attention. She beckons me over to a secluded corner and tells me she's so glad I came in; she wants my advice about "a lady problem."
Being a student nurse isn't just about learning and providing advice and education, it's also about undertaking different roles to different people.
I have found that one of the most difficult but rewarding roles is listening. When I'm on the wards patients seem willing to reveal concerns to me that have never previously been mentioned.
Sometimes I feel like a sponge as I absorb all these things. I have come home some days and sobbed with the weight of some of the secrets that have been shared with me.
Every now and then, I find it a real struggle balancing all these different roles. Sometimes I feel like I'm being suffocated with the pressure of placement, home life, college life, being a young adult and hanging out with friends.
Occasionally, and I know this is incredibly selfish, I wish I didn't have all these responsibilities.
It gets overwhelming with people relying on me to do the housework, go to gym, go to church, write a good essay, read more journals/books or fill in massive loads of paperwork for lecturers or mentors to mark.
I feel like I don't have time for my friends anymore as I'm always busy, on placement, tasks or tests. In fact I barely have time for ME anymore.
But then I remember why I love what I do, when I look at my patients and see the love and appreciation they have for having someone that just listens, I know that all of this and all the sacrifice is well worth it. And then I press on for another day or being everything I was born to be.
The last couple of months I have been struggling to find my purpose in life. Did I choose right and all those sorts of questions. And lately after two bad test results, I felt like such a failure at life I should just give it up. I am not good enough. But nursing is my dream, and all I want to do is be the best at what I do. My whole life has led up to this phase of my existence.
So I have decided to carry on, to push on and work harder. Do I stop feeling sorry for myself and lift my head high and start to believe in the gift that God had given me, to be able to touch and love people unconditionally?
Albert Einstein said:" You have to learn the rules of the game. And then play it better than anyone else." Harsh words to some, but when you look at it, it is so true.
In life when we love and believe something, we have to take all the challenges that go along with wanting success.
One of the most inspirational people in my life, my mother Christa Coetzee, said to me this week that I was her pride, that she loved me and what I have accomplished in my life up until now and that she knows that I can and will be successful.
All I have to do is give everything to God so that he can lead me and give me the strength to carry on. She has always pushed me to break my boundaries. She allowed me to fly high and has always been my safety net and warm blanket of unconditional love in my life. I will always be grateful to having such an inspirational mother and best friend in my life.
I realized last week that I am stronger than I thought I was, I have the courage and conviction to achieve my God-given dream.
I am a strong, independent, powerful and blessed woman of God and through my nursing I have the opportunity to live an exceptional life.
So I choose life, I choose my passion, I choose to be stronger than ever and to finish my dream
Like Patch Adams said, "The most radical act anyone can commit is to be happy."
Have you ever gotten to a point in your life where you wonder to yourself, "Did I make the right choice?"
Lately I have been wondering just that. Am I where I am supposed to be? Why did certain things have to happen to me? Have I listened enough and made the right decisions? Did I do enough in my life? Strange questions I know, but I have realized in the last year that life is so fleeting. We aren't assured that tomorrow will come, or that we will have a long and happy life. In the blink of an eye, your whole life can change.
A year ago I thought that life couldn't be sweeter or happier for me. I had finally found my Mr. Right. But in less than a month my whole world came crashing down, and changed irrevocably. Everything I believed, dreamed about and wanted so badly was taken away from me because of a choice that was basically made for me.
I am a nursing student, I know how to treat people that have gone through suicides, but now I am in this boat and I have absolutely no idea how to handle this. I keep myself busy, I don't think about it, or at least try not to, I fill my days completely, that assures me that I am too tired at night to think, but the problem now, I fear, is that I have come to a point where I am so exhausted, sleep has become a luxury, and when I do sleep, I dream.... Dream about love lost, life lost.
The closer it comes to the year anniversary, however strange that sounds, to his passing, my head and my heart ache, and all I want to do is run away...so far away that I don't feel anything anymore.
Being a nurse I know that there are stages of grieve that I have to go through, but being who I am, I keep actively avoiding that, by giving all my love and all my attention to my patients. I feed of their gratitude and their joy, just to get through every day.
How are we supposed to, as nurses deal with our own pain and hurt, and still attend to the pain and hurt of those around us, without letting our emotions influence how we react and feel???
I wish I had a magic genie to just poof away what I had to go through and still am going through. I wish I could see my future and know that I will eventually start to feel like a whole person again. Because now I feel like a ghost living a half-life, a fake life.
And this make me wonder how many other nurses face this same pain and hurt, but as we are taught, we smile our way through it all. Always gracious, kind, warm and professional, never letting our smile fade or our emotions show.
I am a nurse, I will always be smiling if you see me...even though every cell in my body is hurting. I just pray that one day, I will look back on this and smile, knowing that I had made it.
Being in nursing college is really teaching me, not only valuable professional skills, but also, life skills. As I am going through my general nursing work, I am realizing what is expected of us, what rules we must adhere to, what the government expects from us as nurses. But are we actually practicing the one fundamental rule or right that all these legal instructions tell us to do?
Do we as nurses stand up for and fight for the human rights of all our patients?
In South Africa's Bill of Rights, it states that people have the basic rights to housing, nutrition, health care, education, protection, and safe living environments. Elderly people have the right to government assisted care in their old age. Children have the right to be protected, have basic education and nutrition; all have the right to Government Social assistance.
What an overly Utopian idea.
The more I study the Bill of Rights, the more I realize that we as nurses try our best to assist and protect, stand up for and defend our patients basic rights, but most times we do this with limited resources, difficult situations, and no assistance from the government. No wonder so many nurses just give up. Just do the bare minimum of what is expected of them, it seems easier than fighting a losing battle.
With it recently being Youth Month and Elderly Abuse Week, I struggle with the fact that the government is throwing lavish functions for youth, and shaking hands with the poor and elderly. Where are they the rest of the year when these same people need their assistance?
It is horrible to see elderly persons standing on street corners, begging for food and assistance, working to just survive. And to see people just look away, turn up their windows, blocking out the person, the human being, standing in front of them. What dignity do they have? What happened to their rights as stated in the South African Bill of Rights.
It is heartbreaking to see children begging for food, with glassy blank expressions on their little faces. Gone is the innocent child in them, and in its stead is a "walking dead" person, high to forget life and what it has dealt them. What defense has a small child have against the hatred of the world, the abuse they have to face daily, the hunger they must feel, the rejection from people. What dignity do they have? Where are their rights stated in the South African Bill of Rights?
The Father of our Nation, Mr. Nelson Mandela said this about the way we treat each other, but more importantly how we treat children:
No one is born hating another person because of the color of his skin, or his background, or his religion. People must learn to hate, and if they can learn to hate, they can be taught to love, for love comes more naturally to the human heart than its opposite. - Long Walk to Freedom
The true character of a society is revealed in how it treats its children.
It always gives me great pleasure to be surrounded by the beautiful children of our land. Whenever I am with the energetic young people ... I feel like a recharged battery, confident that our country can look forward to great things. South Africa, April 23, 1997
Together as a nation, we have the obligation to put sunshine into the hearts of our little ones. They are our precious possessions. They deserve what happiness life can offer.
I am proud to be a nurse, taking care of all children, no matter what race, gender or skin color they have. We all bleed the same way.
I salute all the Nurses out there fighting the good fight for their patients. "UNkulunkulu osindisa futhi avikele abahlengikazi" God save and protect nurses.
Okay let me start by saying; "I have new found respect for Registered Sisters."
I have started my first official block period at college, and okay I knew it wasn't going to be a walk in the park to do this Bridging Course, but I did not think it would be this overwhelming, either. I don't know if it is the fear of the unknown; or the fact that I am actually on my way to one day-not so far away- being a Registered Nurse, having to take full accountability for all my acts and omissions and that of my team working with me.
I never fully understood why Sisters are always running around, always busy, looking sometimes tired, but never once do they look stressed, disheveled or unnerved. They always have this serenity surrounding them in chaos...and I truly admire that. I believe it is a God-sent talent, because if I look at all the responsibility resting on the shoulders of a registered nurse, I doubt if I would be that serenely calm...
But then again it is probably something that you learn through experience and time. In my first month I have learned to always be accountable, respectful, empathetic, loyal, diligent, and above all humane in all your actions towards the patient, who is a human being, a whole person...not just symptoms and tasks to be nursed.
I have learned that we are not only governed by our own ethical and moral values, but we have to adhere to those of the Nursing Council and The Constitutional Law and the principles of your employer. There are so many rules, regulations and legislations that determine what a nurse has to do, it feels like nursing could be presumed as task orientated more than people orientated.
But on the other hand if it wasn't for all these regulations and legislation, nursing would have no clear and fundamental structure and things would probably be a lot more messy. So not all rules are so bad I guess.
We must never forget, though, to nurse the person first and the condition/illness second. Human interaction is a gift not to be squandered or lost. I praise and salute all the Registered Sisters and everything they accomplish. To me, you are all Super Women...
A future RN
Well to start off let me say this, nursing is not at all as it is portrayed in Grey's Anatomy. If you think you will look as fresh as a daisy at the end of a 12-hour shift and meet Mr. McDreamy, I have really bad news. That rarely, if ever happens at all, ladies and gents. Nursing has so many challenges that we have to face on a daily basis.
Being a student has its benefits and struggles. You are and will be until you graduate, a "work horse" to the people you work with. Not everyone will treat you this way, but you do get those people who, because they were treated a certain way when they studied, automatically assume it is their right to bestow the same courtesy too you as a student nurse. You have to learn to control your emotions and leave your "backstage" personality at home-you know the one, where if they give you a hard time, you automatically just want to jump on your hind legs and give it to them straight!
One very sweet, and very wise nurse taught me a very crucial lesson in being a nurse: "Always remember that we are all the same, we all were students, but it is WHY you started nursing that defines WHO you will be in the future as a nurse!"
Those words will never leave my head or my heart. You have to have a reason why you chose this path in life. If you did it because you thought it would be easy-STOP RIGHT NOW-because it isn't. If you did it to meet hot, young doctors-STOP RIGHT NOW- because they are too busy, and might already have a loving person in their life.
If you chose this to make easy money for doing little work-STOP RIGHT NOW-because nurses will never be rich in money. We will be rich in love, faith, compassion, patience and endurance!
If you are willing to face trying and sometimes heartbreaking situations, heartwarming and unbelievable miracles, long hours in front of your books, and long hours at work, then the world of human interaction and nursing care is for you.
I truly and deeply believe that no one chooses to be a nurse; you are born to be a nurse. It is a part of who you are, how you love and believe. It is a heart journey, not a hard journey to be a nurse.
I love being a nursing student, dreaming of one day being a registered nurse and changing the world one patient at a time. Every day I get to meet and touch the life of a patient, gives me strength, makes me brave, and keeps me humble.
When people told me in nursing school that the first year of working as a nurse would be hard, they were right. Even after the first year there have been many challenging days on the job. Somewhere around month 9 or 10 you begin to make connections between nursing school and the repetition of patients you have cared for. A great deal of growth begins based on past experiences. When one year comes around, things continue to click and you don't feel like such a new nurse to the game. Now that I am nearly at one and a half years, I couldn't be more happy with the experiences my unit and hospital have provided for me. As I mentioned in my previous posts, I am now a heart nurse. At this point I have cared for 4 post-op first 24hrs open heart surgery patients on my own, in addition to the 5 orientation shifts I have done. Our heart program has slowed down slightly in the last few weeks, but the hospital has been booming with a full census. One night this last week our unit had a few extra staff available since we had transferred several patients. I received a call before my shift from one of the managers and she had a question for me. She asked if I wanted to have my first orientation for charge nurse of the unit. In a few seconds, dozens of thoughts went through my mind. Although her request gave me confidence, I graciously declined the position for now. The one reason: rapid response. Although orienting to charge would take six shifts, once on the track, you can get those days completed very quickly, just as the heart training happened. I have not had any experience as the main RN attending rapid response calls on the floors. I have accompanied the charge from my unit on several instances, but never called the shots. I have witnessed the process several times as the recorder and in each instance given a little more input. When I told this to my manager she understood. Sometimes we close one of the ICUs when the census in low, this could potentially mean that if I was charge I could be the only ICU nurse attending the rapid response calls. With that being said I don't want to shy way from the experience. We made a deal that now when I work I will let the charge nurse know that I want to go to the rapid response calls and have a larger role in the experience. When I went to work that night I let the charge nurse know the situation and she agreed. Hopefully a month or two of attending rapid response calls will give me the experience I need to start orienting for charge. I'm sure there will be plenty of new things for me to talk about in my next few blogs!
With each posting session that comes and goes on this blog I am able to see my progress while I reflect on the passing weeks. Last post I discussed that I was nearly designated as a post-op recovery open heart nurse. So much has happened since that posting three weeks ago and I feel as though I have grown up as a nurse and as a person. After writing that post, my next shift I was given the task of taking a fresh post-op heart without a designated preceptor and the patient was not doing well. I arrived at work to find my name assigned to the heart and was explained that unfortunately I would not be given my last orientation session. At that point it was sink or swim. The patient had been taken back to surgery after bleeding too much when originally arriving in ICU. I came to find that the patient had been in surgery for over 12 hours in total. Needless to say it was one of the most challenging nights I have ever had as a nurse and as a human being. Myself and my charge nurse did everything we could to help the patient through the night, but at a certain point we knew what would be their fate. It was devastating to see the family struggle through the situation. There seemed to be not one moment where I had time to breathe. After that night I became a different nurse and a different person. I know now from that experience that I can handle anything that is thrown at me. Since then I have had 2 other post-op hearts on my own and tonight will be my third. By no means am I a veteran but I think you have to be humbled by one experience to grown. Sometimes you give your all and you can't save that person. I understand that now.
About a week ago I had been talking with a friend about writing this blog. I started way back in nursing school and now have written an estimated 30 to 40 posts. After talking with this friend I looked back through my archives and read a few of my old entries. It is absolutely crazy how time changes you based on experience. After my first semester in nursing school I was nervous doing nearly anything nursing related. I remember those feelings like they were yesterday. I could not escape the anxiety!
Now at 24 years old (25 in November) I have so much to think about in my future. In March I will have two years of work experience. Although I am not thrilled about it, I'm sure I will start to train as charge around that time since our night crew continues to cycle through. As much as I enjoy the thinking that goes into the ICU, I know I don't want to do bedside nursing care forever and the idea of management makes me sick. That leaves me with two options that I will have to think a great deal about as time goes on: NP or CRNA.
The recent grilling of Dr. Oz in front of the US Congress sparked great debate. It was important reminder for all healthcare providers: Practice what you preach. As a nurse, you have more than just a professional license. You have signed an oath to practice healthcare safely, responsibly and effectively. You have signed on to be a lifelong supporter of science, evidence and progress. And, most importantly, you have volunteered yourself to be an example of wellness and health. Dr. Oz does not take the supplements he so adamantly recommends on his popular show. He supports miracle cures and magical solutions for obesity (one of the most prevalent and emotive public health concerns today). Health does not come in pill form nor does it appear overnight. It is our job as nurses to help people find their optimum wellness in the only way that works: through self-discipline, support, compassion, patience, knowledge and acceptance. This, we all know, is a lifelong journey. It is our job to help facilitate the ride.
Well it’s crazy to say, but now I have 5/6 first-day post-op open heart recovery orientation. After my next orientation shift I will be able to recover these patients from surgery on my own. It’s a thought that makes me quite nervous, but I feel as though I am ready. My last patient was an aortic valve replacement and I was able to work the patient towards extubation during the night. We successfully extubated in the morning on my shift, which was the second patient I was able to complete the weaning/extubating process with. I am pleased with the mix of patients I have had thus far. Two I received directly from surgery, which is an entirely different process all together. The process of initially getting them settled, figuring out the drips, covering the labs that need to be addressed, and getting the initial hemodynamic measurements, while being mindful to their blood pressure makes the first hour a complete hustle to stabilize them. The other three patients I took over from day shift, which is much easier, regardless of the patient’s acuity. Each one had different drips, some with a few and others with almost none. I have not had the dreaded bleeding patient yet. I was hoping to experience this while still on orientation, but unless my next patient has complications like this I will eventually have to deal with post-op bleeding on my own. I hope that won’t be until after I have several on my own, although I know I could handle the process if I had to.
It’s been a just over a year and four months since I started working. The knowledge and comfort of being a nurse exponentially increases at a certain point. For me I think the one year mark started to tie everything together. Once I became comfortable with the routine I was able to start noticing the similarities and differences with each patient situation. In many causes your past experiences help you predict or at least be prepared for what can happen to each person you are caring for. This intuition helps a great deal when caring for post-op open hearts. Predicting decreases in urine output based on cardiac output, knowing the possibility of covering lab values based on the patient’s trends, and being on alert for potential complications all play a vital role in caring for the sickest of patients.
While looking for a full-time job, I've been working for a home health care agency. I've been working an every-other-weekend case for about three months, and it's gone well enough that I'm readying to take on another case.
I recently oriented on the new case, and I'd be lying if I said it wasn't intimidating. My case manager warned me it would seem that way. The nurse I trained with acknowledged she was overwhelmed with all the information when she first started on the case. Even the patient's mom joked about how it seemed like so much to do.
It's a familiar situation. A few months ago, I was very nervous about starting my first case -- about being able to actually do this nursing thing, especially since I hadn't gotten all that much hands-on skill experience in my clinical rotations. But a few months later, I know I'm giving competent and confident care. For instance, I feel much more comfortable with tracheostomy care, transportation via Hoyer lift and G-tubes just to name a few things. It's amazing how much of your book learning comes back and how easily you can take to the skills you've been taught to perform.
My new case won't be all that different-- it's another ventilated patient. I've got experience in my back pocket, which is comforting, but this patient has a lot more meds, advanced respiratory treatments, and unfamiliar equipment. In some ways, that can be pretty intimidating. But it's also pretty exciting to have that type of learning experience before me.
Even though I'm intimidated now, I know I'll be confident in short order. History is proof.
Recently on my unit we have been receiving a great deal of patients post MI and related interventions. We certainly are a cardiovascular ICU, but it was strange how almost every one of our beds was being taken by a traditional heart patient. All of these patients have provided our unit with a large census of CABGs and balloon pumps. I had my balloon pump orientation and took care of the patient independently. Luckily I had taken an educational class that was offered to our staff on the mechanics of the device, so I felt comfortable caring for the patient. I learned some interesting things along the way with this experience. Urine output is always important for all critical care patients, but for these patients its especially crucial. Although the balloon pump is helping with workload and perfusion, patients are still at high risk for cardiogenic shock due to the poor functional status of their heart. Once the urine output starts to decrease, cardiogenic shock could be creeping up. Urine output is also important because migration of the balloon downward can cause blockage of the renal arteries, obstructing a vital pathway of blood flow. I found this experience very interesting since you have to take care of the patient, but at the same time take care of the machine and pump to ensure all are safe.
At our hospital we require 6 orientation sessions of CABG day-one recovery in order to take them right from surgery independently as a 1:1. With our high census, I have had the opportunity to complete 3 of my 6 sessions in the last two weeks. I have another set up for Monday since we have an elective procedure that has been scheduled in advance. During the last few weeks I have learned much more about hemodynamics and their connection to physiology and drugs. It has been nice to have these experiences so close together since there has been consistency in my learning. I now have a better understanding of preload, afterload, and contractility in relation to PVR, SVR, CO, and CI. It has been informative and educational to see the direct effects of interventions based on specific measurements, then reassessing these measurements to find improvements. I'm not sure I can go as far to say that its "fun" yet, but I am enjoying the thinking that goes into caring for these individuals. In a few days I will have my 4/6 CABG recovery, and it will be one step closer to me being independent at another exciting skill.
One of the most difficult aspects of my jobs has been learning how to let go. It's easy when the day runs smoothly. When I'm not accosted with the sorrow behind a tragic story or the euphoria accompanying an epic feat, it's easy to go home, unwind and sleep soundly. However, as nurses, there are many days which don't end up perfunctory. It is my challenge on those days to learn to let go: let go of the sick child, the suffering homeless man, the family in denial of mother's illness. The profundity of our days as nurses requires that we have skills to nourish ourselves, even during the hard times. Time and experience have been my friends and allies in this department. I have spent many fitful, sleepless nights tossing and turning reliving uncomfortable moments of my day, week, even month. I have learned that it is so important to learn how to sit with discomfort without running or reacting. I do recommend the new nurse find an outlet sooner rather than later. It can be meditation, yoga, deep breathing, music. Whatever you choose, make it a place that brings serenity, peace, acceptance and restoration. Quiet work. Do it often. Eyes closed, heart open. Especially on the bad days. I know as your begin your first job the days are filled with learning clinical tools, medical knowledge, critical thinking. Please leave some room for the inner work; make this a priority, too. It has helped me grow more empathetic, allowed me to be more grounded. And I guarantee it will help you be the best nurse you can be, regardless of the circumstance.
An interesting thing about being a nursing student, and you can double down on that when you're actually a licensed nurse, is that those around you expect you to know just about everything related to healthcare. If they are sick or something is wrong with them or a family member, they will come to you expecting answers.
This isn't something I'm all that surprised by. As a former editor, people often come to me to call on my "expertise," which basically means I've edited a lot of papers, resumes, and so forth. I'm ok with that, and, in fact, I think it's natural. If you have a friend who is a mechanic, you're going to ask him about the noise your car is making. If your sister's a lawyer, you're going to seek her out when you need legal advice. That's the way it works.
But, now that I'm actually a nurse, I feel more responsibility to know things, and sadly I'm still going to be stymied a great deal of the time. People often share test results, tell me symptoms or show me physical findings, and expect some great insight. It's kind of scary -- every time someone approaches me, I feel like my license is on the line, that my legitimacy as a nurse is being tested.
Recently, a middle-aged man who works in my building sought me out because he wasn't feeling well. Someone had told him he should get his blood pressure checked, and my name came up, and then boom, I was taking his BP. He had a perfect reading, and his respirations and heart rate were in normal range, and yet he was feeling unnaturally lightheaded. No pain or any other symptoms. No history of cardiac issues personally or in his family. No medical issues at all really.
The man wanted to know if he was having a heart attack or a stroke or was at risk for either. What was I supposed to say?
I spoke in uncertain terms, saying he seemed healthy, but without access to EKG, blood results or a more experienced healthcare professional, I couldn't really say what the problem was (keep in mind, I still don't have a fulltime nursing job, so I work in an office building).
I discovered he ate healthy, no frills meals and that he worked out often. In fact, he had just started a new intense exercise regimen, and the dizziness was only happening on the days following his classes. I suggested that perhaps he needed to rethink his diet -- that maybe he was just experiencing some hypoglycemic dizziness due to the increased workload and that eating more might help. But I didn't have a glucometer, and I really had no idea what was going on. I closed by telling him it might be best to talk to his doctor, which obviously wasn't what he wanted to hear -- avoiding that was why he had come to me in the first place. He wanted reassurances, and I didn't have much to offer.
I think I handled this particular situation about as well as I could, and I believe that the more hands-on experience I get, the better equipped I'll be to provide useful and confident feedback to my family, friends and coworkers. I want to be able to field questions and be the super knowledgeable nurse guy, but I'm still very much a work in progress.
As a newer nurse it can be hard sometimes to look forward to going to work. There are uncertainties with the types of patients you will be getting, if you will be receiving a difficult admission, or even if there is an emergency situation that may come up relating to one of your patients. So many uncertainties arise from one day to the next in this profession. Recently I have started to relax a lot more about getting ready and going to work. I have had a few weeks of complicated patients that needed around the clock attention, as well as nighttime physician calls. In each situation I did what needed to be done, and with my close supervision, my patients were managed safely through my shift.
It may seem like an obvious statement, but experience and repetition make all of the difference. I have decided that the only way to become an advanced practitioner is to take every opportunity I can for improvement. This means attending all of the continuing education classes provided by my hospital as well as taking my own personal learning at home into account. My biggest down fall would be my knowledge in the specifics of all types of medications. I can genuinely say that I know a great deal about pharmacology, especially for my experience, but I want to be a master at the subject. I feel like one area that physicians think nurses are lacking is our understanding of pharmacology. Antibiotics and vasoactive medications especially. If I can learn these medications thoroughly, I can discuss certain clinical situations more competently and give appropriate recommendations.
As a new nurse if you are consistently weak in some areas (which we will always be as new nurses). The first assumption is to shy away from those tasks or duties, but I have noticed a change recently that I am trying not to do this anymore. It feels good to want to take on more responsibility. The weird thing is that I guess I am not so much of a "new" nurse anymore. Everyday I move further and further away from that, as all new nurses have done. My advice out there to other new nurses: take every opportunity you can to improve early on so you can avoid the feeling of anxiety that can come from being new. It really helps.