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Meet Brooke Nicolosi! Prior to nursing she had an extensive career within the corporate sector before a restructure led her to her long term passion for healthcare. This is Brooke’s journey into nursing as a mature aged student.
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Studying nursing as a mature aged student
My original journey into nursing started many years ago, after completing my Year 12 studies and being accepted into Monash to undertake my Bachelor of Nursing. I was a young 17-year-old due to embark on uni life and enter into the world of nursing.
I personally found at such a young age, nursing at this point in time wasn’t right for me and I made the hard decision to defer my studies. I then began a completely new direction, working in the corporate industry. Throughout this period, I had various successful positions working as an Executive Assistant within global and well-known national companies. I worked in the corporate sector for just over 15 years, and during this time had my two beautiful girls.
After working for close to a decade in one of my positions, a restructure occurred which resulted in being offered a redundancy. Although at the time stressful, it allowed me to stop, think and assess where I was at. Determine what mattered most, where I saw myself working, as well as finding where my passion was regarding the next step in my career. With many years of experience working in a highly stressful and demanding environment, having my own family and juggling this with my career, I found that life experience gave me added direction and desire to pursue what I really wanted to be; a nurse.
The next step was returning to full-time study after working for many years and being fortunate to earn good money, I needed to adapt to being a student again, and this time around it didn’t just involve me, I had a family to factor in. I was nervous about recommencing studying and excited at the same time. I knew once I started, I had made the right decision, I just loved it.
I was fortunate to have some inspiring teachers and meet some amazing people that I still keep in contact with. Despite relishing my return to study there was still the juggle with young children, school drop off’s making sure I could be there, being able to take them to after school activities, and then go back to studying mode once they were in bed. It was a big adjustment having to stay up late most nights completing assessments, finishing assignments, preparing for exams, osce’s, attending placements and managing family commitments.
The change from student to nurse
During my studies I was successful in applying and obtaining a Fellowship with a major private hospital in Melbourne, allowing me to complete all my placements within their various facilities which included; sub-acute/orthopaedics, rehab and my 2 x acute care placements with my final placement in Vascular and Plastics. I specifically chose this area for my final placement, as previously wound management wasn’t an area, I felt I had gained a great deal of exposure and experience in.
My ward incorporated a great variety of conditions and built up my confidence in managing these. My final placement gave me the opportunity to cement and consolidate theory and knowledge applying it to my clinical practice. I ensured that I made the most of my opportunities and having the awareness this is the last time I will do this as a student and having a preceptor with you throughout. I personally believe the transition from student to a practising Nurse is one that needs to be focussed on more.
You are attuned to having your preceptor watch you perform a new task, administer medications etc and then you move to being fully independent and on your own. I will never forget the first few shifts post my supernumerary and despite being an independent learner and having initiative it also felt surreal to be doing this myself, whether it be IVAB’s, administering medications, having DD’s checked, taking care of your patient’s dressings and completing care plans for each of my patients.
During my studies, I constantly kept an eye out for upcoming graduate programs. With the second outbreak of covid occurring just as I finished my final placement this altered the number of opportunities for EEN graduates as many programs were postponed some indefinitely. A concern of mine was having a large gap between my final placement, obtaining my registration with AHPRA and not being able to secure a graduate program.
Fortunately, my concerns were averted, and I successfully secured a graduate program within a Private hospital, in an acute setting starting 3 months post my final placement. In hindsight, having the break was positive, as once you start your graduate program it is a steep learning curve and you are constantly on the go mentally and physically, taking everything in and with not much downtime.
The Graduate Nurse Program
The Private Hospital where I completed my program offers an extensive range of healthcare services. Including 5 Wards providing Medical, Surgical and Rehabilitation Services, combined Intensive Care and Coronary Care Unit, Emergency Department, 7 Operating Suites, Catheter Laboratory, Day of Surgery Admission and Day Infusion/Oncology Services. My speciality saw me working in Urology and Plastics, a very busy surgical ward that also incorporates medical presentations. The standard ratio is 1:5, I was working 0.8hrs (4 shifts a week) and on my particular ward, we don’t operate under team nursing.
Urology was a completely new area to me, I had previously experienced Plastics during my final placement, so I was keen to ensure I understood the procedures that I would be seeing. Some of these include flexible/rigid cystoscopy, insertion /removal of stents, lithotripsy, nephrectomy, penile prothesis/implants, PCA management, TURP’s, TURBT, CBWO, manual bladder washouts, TOV, IDC insertion and removal, SPC management, Bladder scans, FBC, VAC dressings, PICCS /Ports.
Management of different types of drain tubes, wound care, SSG and debridements. On top of this was the management of my post-surgical patients, sometimes you could have up to 3-4 post-op patients to monitor. Some of the medical cases include exacerbation of CCF, pancreatitis, diverticulitis, DVT and appendectomies. No day is ever the same, there are always new presentations to learn and gain a further understanding of.
Met Calls as a graduate nurse
Aside from clinical presentations, other key areas of learning that I have gained are as a result of ‘met calls’ and patient deterioration. I have been involved in a few already initiating the met calls and have been a strong advocate for patient safety, ensuring they get the best care possible especially in the presence of patient deterioration. I believe even as novice nurses it’s important to understand your patient, conduct your relevant assessments, apply critical thinking, looking at the data collected and back your judgement If you can clearly identify your patient is deteriorating, understanding why then you need to escalate and seek further assistance.
I have also been fortunate and grateful to have the support of our educators who were only a phone call away should we need them, or if we were performing a new task, they would be available for us. Utilising the educators to gain experience and learn from their high-level skillset has been of great benefit. Combined with this was setting specific goals which also worked well, providing me with accountability and direction.
Being self-directed and using initiative was important to me, and by doing so I was able to complete my competencies in accessing PICCS and Ports, complete blood transfusions and shortly complete my cannulation competencies. Finding mentors that you can model yourself on is important, as you can learn and see how they do things and what works for them. I made sure that despite the initial stages of feeling overwhelmed I would always ask questions and seek out best practices.
Talking with your colleagues and learning what works best, how they manage their patient load and being keen to leverage off that I believe was a great benefit and allowed me to grow personally and develop my skillset and own routine for my shifts.
Importance of reflection
One other area that I leveraged off during my program related to the importance of reflection. I created a document that I would update sometimes after each shift and then it could sometimes occur weekly/as required. I would have clear subheadings and could add as much to these, which included “what worked well for me this shift”, “what didn’t work well”, “what could I do better” and “what do I want to achieve in my next shift”.
This simple tool was of great benefit, as I could identify what is working as well as then work on what I need to change or where I need to improve, it also allowed me to reflect on my feelings in terms of how I was managing my transition to working in an acute setting as a nurse.
Where am I now?
Now I have completed my graduate program and have been fortunate enough to have been offered a permanent role within my ward which I couldn’t be happier with. Reflection again plays a vital role, as it’s hard to believe how much my life has changed, from having self-belief in making such a big change, sacrificing a lot to do this and grateful for my family for such wonderful support and to be here now doing what I have always wanted to do.
My role as a nurse is a privilege, we are fortunate in our positions that we can make a difference, providing the best patient-centred care possible and have a positive impact on their condition and wellbeing. I am very excited about what the future holds and the opportunities ahead and plan to make the most of these!
