One day in November I did my first student clinical rotation. It was my first time pulling into a hospital parking lot before sunrise, my first time wearing a contact-isolation gown, my first time charting a set of vitals.
I was assigned to a patient who needed a lot of attention throughout the shift. Thankfully, my patient was gracious and funny when not consumed by pain. (I’m not going to venture any closer to a HIPAA violation than that.)
On the drive home I got lost in some inner-ring suburbs, and I was exhausted. But beneath that exhaustion there was a humming euphoria: I’d made it through the shift. No one had died. There had been only a few moments when I’d felt completely at sea. I hadn’t (as far as I know) disgraced myself or my program.
That’s a natural reaction after a first clinical, I guess.
But here’s the thing: I can easily imagine myself feeling that same mixture of exhaustion and euphoria on a regular basis, even after being on the job for years.
You got through a twelve-hour shift in which you juggled 55 tasks, and you only dropped one or two of them (you think). You helped your patients get through their illnesses, and you’ve tried not to give them any new ones. You had some good banter with the physicians and techs on your unit, and if some of them are assholes, you’re thick-skinned enough to cope. A few patients and family members barked at you, but more thanked you. You’ve endured. You drive home feeling a certain satisfied glow, even as you’re desperate for sleep.
I don’t trust that feeling.
I’m afraid it might act as a narcotic. It’s comforting to drive home thinking, Damn, I made it through another day. Time for sleep. But floating in that feeling every day might crowd out two other emotions that nurses need to face.
One of those emotions is self-scrutiny and self-reproach. This is an obvious point, so I won’t belabor it. The nature of the job is that you need to ask yourself hard questions every day about where your performance is deficient. Are you really using adequate hand hygiene each and every time? Are you cutting corners when you manage catheters and IV lines? Are you sure that you did a decent job of explaining to that post-op patient’s family what they’ll need to do when they go home?
The second emotion is anger. Is your unit short-staffed in ways that are putting patients in danger? Are patients being overmedicated and overtreated? Is someone at your hospital falsifying medical records or submitting false claims? Do you see unnecessary suffering in low-income or unemployed patients who have a hard time getting adequate care for diabetes and other chronic illnesses?
Then you’ll probably want to organize. And to summon the energy to do that, you’ll need to snap out of that exhausted, euphoric, made-it-through-another-day feeling.