Ah, the shock of role transition.

Somebody, I don't remember who now, with a glass of wine in me, asked what I would say to the newbies who are having the SHOCK of ROLE TRANSITION as they go from being a student to being a new grad/new nurse/newbie.

Honestly? All I remember from the first months of nursing practice is this: I prayed every day that I wouldn't kill somebody, and I felt horribly alone.

Both those feelings, it turns out, were bogus. Like, "Boh-oh-oh-oh-oh-oh-GUS!!" the way Tom and Ray say it on "Car Talk". Bogus, like we never imagined it could be in the 80's. Bogus, like carob is to chocolate, or Cool Whip is to whipped cream.

Being a newbie is *hard*. It's almost as hard as nursing school in that the amount of information you have to absorb is huge; it's just more focused. Being a newbie is scary, in that you don't really know what you're doing yet. Being a newbie is frustrating, in that you know some things you're being asked to do are wrong and stupid, but you don't know how to communicate that to more experienced nurses and doctors yet.

The thing to remember is this: If you're a newbie in a precepted program, you have somebody following you every step of the way, making sure you don't screw up. Nobody is going to let you kill a patient. And even if you come close, we're not going to let the worst happen. *Everybody*, from pharmacists to physical therapists to the other nurses, is looking over your shoulder--not to catch you in mistakes, but to make sure you feel confident enough to make decisions on your own and yet stop you if they're the wrong ones.

As for not knowing what you're doing, the honest truth is that a lot of times I don't know what I'm doing either, and I've been doing this for six years. As in, this specific thing, and nothing else. And I *still* run into stuff that flummoxes or stumps me. There are always people around that know more than you, and who won't make fun of you if you ask very basic questions. The trick to being comfortable as a nurse is not in learning everything; it's in getting rid of your ego so you can admit comfortably what you don't know.

And, finally, frustration. I have a story to tell about this particular problem:

Years ago, when I was still being precepted, I had a patient admitted with fulminant meningitis. It could've killed her; it's considered a huge huge huge fucking run around with your hair afire emergency. 

The very moment she was admitted was the moment that our computerized drug distribution system went down. Pharmacy was totally unable to fill any orders, since they didn't have access to anybody's allergies or tolerances or drug levels or *anything*. So, because I was a newbie, my patient with fulminant meningitis went for six hours without her first dose of antibiotics. I gave myself an ulcer in the meantime, trying to do things by the book.

I will never stop being grateful to her doctor. Rather than call me out on the floor and ream me a new one, as he had every right to do, he took me aside and explained what the problem was, and asked me why the patient hadn't gotten her meds. I explained as best I could, suddenly not 31 any longer but 10, stuttering and tearful and ashamed, and he was firm but kind. No harm had come to the patient, but he was unhappy with the level of care. He offered to go to bat for me and get the drugs from pharmacy himself--not in an "I'll go down there and kick their asses" sort of way, but in a "maybe they don't understand how serious this is" way. 

The thing I learned from that awful experience was this: No matter how set the procedures and protocols are, you can always do an end run around them. Sometimes it means finding a sympathetic doctor or pharmacist to write you an order or float you the first dose of meds. Sometimes it means going down to the kitchen to talk to the folks there about what, exactly, "halal" means. If it can be done, you can find a way to do it. The best thing to do is to set up a reputation for being pleasant, creative, and a little stupid right at the start, so when you start doing imaginative things to get your patient good care, people shrug and say, "What the hell, it's only Jo."

The upshot of all this lecturing is this: Good nurses remember, if not the details, at least the general outlines of being a newbie. They will help you out. Glom onto them like death, and do not let them go. I have a mentor at work, and you should too. Don't fret about feeling like an idiot; other people do every day, too, and you'll develop a callus against that sort of self-consciousness. And don't forget: At some point, someday, you'll find that you're finally swimming with the current rather than struggling to stay afloat, and you'll feel like a Nurse. Finally. And you'll grin like an idiot, and go on to make a stupid mistake, and realize that that's what the profession is all about.