Six weeks ago, I felt like every day at work was like trying to climb up an escalator covered with bacon grease while somebody yanked on my shirt-tails at random moments. Now I feel like a barely-adequate skiier slaloming down a slope rated for Olympians. If I just go with what's happening, don't think about it, and don't try to look too far ahead, I do just fine. It's just a matter of not relaxing, of doing things right when I get the chance, and of being as efficient as possible.
Which is frustrating. It's hard to go from an area where you've been able to know without thinking what needs to be done, where the synthesis is second nature, to an environment where you have to stop, think, and double-check that you're even asking the right questions.
The head of the CCU internship program for Sunnydale and I had a conversation about that the other week. She wasn't exactly encouraging about my progress (though I thought I had done pretty well), and she expressed some serious doubts about my ability to form a comprehensive picture about my patients and anticipate/prevent problems. I left that interview feeling about three inches tall, until two things happened:
1. I realized that I cannot possibly be expected to think like an experienced CCU nurse yet. Fourteen weeks is barely enough time to review the things you have to review to keep from hurting somebody in the unit, let alone learn how to integrate all of those things into a cohesive whole. Everything right now is going to be task-based, and I'm going to feel like a complete idiot for a while, and that's just part of the learning curve.
2. The other interns in the program said that they'd had the exact same meeting with the head. The upshot of everybody's discussions with her was that she felt we're all safe nurses, but she's encouraging everyone to ask lots of questions and get help when they need to (collective "Duh"). In her defense, she's been a CCU nurse for about twenty years, so I think the thought processes involved have become so second-nature for her that she can't get into the headspace of a new nurse/new CCU nurse. Anyway, I felt better about the whole thing after we all got together and looked blankly at one another.
After the last couple of days on the floor, during which I had two not-really-critical patients who quickly turned critical, I feel more confident about my ability to at least keep people alive. Right now it's more a matter of being fast on my feet (as my Sainted Mother says) than of being a really good CCU nurse, but I'll settle for that for the moment. One patient yesterday shook off the propofol and Versed and tried to extubate herself in a particularly creative manner while shooting liquid stool all over the place, and the other had a fistula between an abscess and an artery break loose near the end of the shift, but I still got out on time and gave a good report.
As I was leaving work, passing the very last computer monitor on the very last computer cart near the furthest edge of the station, the monitor on that cart suddenly caught fire. I did not stop, I did not look back, I merely kept walking. That, my friends, is what the CCU is like.