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Prashikha recently finished her graduate year and now works in a busy Emergency Department. Her journey to nursing is unique and very inspiring! Prashikha writes for you about surviving a graduate nursing year!
For other amazing articles from recent grads go here.
Introduction
I was born and raised in Nepal. I moved to Melbourne as a student in 2007. Fast forward 14 years, I still live in Melbourne but with my partner and 2 adorable dogs. When I am not working, I am either walking the dogs, pottering in the garden, reading, amongst nature somewhere whether a hike or camping with my partner and friends. My partner and I are both volunteers with the local State Emergency Services so that keeps us busy with operational and training work.
I took the leap and changed careers
I was always interested in health but never ended up taking any clinical degree. With a background in Social Work and Public Health, I spent 10+ years working in International Development with NGOs, INGOs and the UN. Finally, in 2018 the stars aligned and I enrolled for the Masters of Nursing Practice with Monash University. Surprisingly, my really good friend also decided to enrol, out of the blue, what were the odds!
I come from a culture where people find a secure job and stick to it till retirement. My decision to change my career was a shock to my parents. Every day they asked me why do I want to leave a perfectly fine job and start all over again. My answer was – I will most likely be working till I am 70 years of age. In which case I’d rather be working a job I love, enjoy and grow. Initially, it was difficult for them to understand that I wanted to do more meaningful and hands-on work. Now they are proud of me.
Being a mature entry student, the Master’s (entry to nursing) course was fantastic as I was able to get qualified in 24 months. However, it was tough. Three years condensed for someone with a very little science background, I initially struggled quite a bit. The human body and diseases were fascinating but really hard to get a grasp of. I struggled a lot with pharmacology. In addition, having a long gap between studies meant I was out of touch with assignments and referencing.
Having my friend in the same course was great, she was my sounding board and she understood what I was going through. We encouraged each other throughout the course. My then work was also super supportive and flexible with my hours enabling me to go for placements. Most importantly my partner’s support was my lifeline. He was probably more stressed about my assignments and studies than I was.
Now, I work as a Registered Nurse in the Emergency Department of a busy public hospital in Melbourne. If you had asked me in 2007 this is what my life would have been like in 2021, I would have laughed, but here we are.
The graduate year
Applying for the graduate year is up there in my list of stressful things I had to do! Being a mid-year entry meant I had very limited hospitals to choose from. I wanted to go public so that added another layer. The preparation, the wait, the interviews, I had a lot of sleepless nights then. My poor partner had to cope with a very stressful me, all the time!
I was fortunate to secure a graduate position with a large public hospital. My first rotation was in the then Gastro ward. On my first day, I was so nervous that I actually felt nauseous. I went early for my AM shift. I walked in and introduced myself to the staff at the station, asked where to store my belongings and went to check the allocation book. Ummm my name was not there. I started to panic. I rechecked. My mind was running millions of miles an hour. Did I get my date and shift wrong?
Turns out I was in the wrong ward! On my very first day as a grad. It was almost handover time, red-faced, stressed I gathered my belongings and rushed to my ward! What a start! Luckily I could not have started in any better ward. The staff were amazing. They really looked after their grads, supported them and checked on them. It was a perfect entry to real-world nursing. My second rotation was in a respiratory ward. Once again amazing staff and great support but a super busy and highly acute ward. I learned a lot and it definitely prepared me for my final rotation in ED.
Grad year was a rollercoaster ride – surviving a graduate nursing year
I had a fantastic grad year. When I look back now, I am amazed and so proud of myself for making through it!
Every day for the first three months of my graduate year I questioned my decision of career change. Every single day I felt like I was on my first day of placement. The good thing is I had mentally prepared myself that the next 12 months are going to be tough. It is going to be stressful and I just have to push through it. The good thing about being a mature entry grad was my life experiences had made me resilient and able to look after myself.
It is hard to believe that I went through my nursing placements without having to respond to a single proper emergency. So when it happened during my grad year, I froze. Luckily my buddy was nearby and she took charge. I stepped back and watched. I felt awful. I felt like a failure. But, no one judged me. Everyone reassured me that it’s normal to feel like that in the early days. The best advice I got was if you feel something is not right just press the emergency buzzer or call someone. The worst that could happen is someone will get annoyed!
I have forgotten the count of how many times I was flustered, couldn’t manage my time (still an issue sometimes) and there was so much I didn’t know. I still don’t know a lot but I know that nursing is lifelong learning.
An important thing I learnt is: when flustered, take a step back, take a deep breath and prioritise – who is the sickest, what interventions are a priority and what can be handed over.
Prashikha
Identifying the go-to people is really helpful as well. Although everyone I worked with was helpful, there was a handful that I could go to with the most basic question knowing I won’t feel stupid.
My final rotation in the ED was my dream job. I was so excited. I had heard really positive things about the team from other grads and I could not wait. Two months in I was still struggling. I was like a deer in the headlight. I was thinking I want to be in ED but is ED the right place for me? I could not even find the pan room for goodness sake! (I know where it is now!). I worked alongside recent ex grads and they all seem to have it together. They were so confident and there I was just flustered.
But with time and the amazing support of the team, I found my feet. It took me a while but I got there. I think it is important to keep reminding yourself that you are a grad, this is all new, you are learning and you need help. Importantly don’t wait to ask for help, worse that could happen is someone will say no, then you move on.
It’s interesting how in the first rotation, everyone knows it’s your first so they are lenient towards you. From 2nd rotation onwards the expectations increase a bit. Having said that, I always reminded the staff that I am a grad and I will need help.
It’s the basic stuff that got me through the grad year and still helps me now
When I started my grad year I was apprehensive. I was not sure if I was going to make it. I have made it and I am proud of that. It was tough. It was testing. It was emotional. It was challenging. But it was all worth it.
From my limited experience, I feel it’s the basic things that helped me get through the grad year:
- As I mentioned earlier, mentally prepare yourself for a challenging year. Understanding it’s going to be tough reduces the shock you get when you actually start.
- Always go to your shift early. I was extreme and would go at least 30 min early or even earlier. It allowed me to settle, draw up my planner and get ready for my h/o.
- Set up your templates and shortcuts in the EMR, it will save you a lot of time.
- I have given some common antibiotics so many times, but I do not assume I know how to make it. Always look it up.
- Listen to your patient. My first medication error would have been prevented if I had listened to my patient properly.
- Focus on getting the basic things right such as time management, handover, assessment. You don’t need to know everything. We have the rest of our career to learn everything else.
- Speak up. Ask for help.
- It’s a cliche but be a team player. Help others but also learn to say no.
- Try not to take things personally.
- Some days the shift will go out of your control and that’s ok
- Be kind to yourself and your colleagues and patients.
- Vent but don’t gossip, it can be a fine line
- Another cliche but I always think “how would I like myself or my family to be treated as a patient?” – helps reframe your approach.
One of my elderly patients in ED once held my hand and thanked me for looking after him. He kissed me on my forehead out of sheer gratefulness. I held the hand of a young anxious girl on spinal precaution to help her calm down. A patient was grateful just because I managed to get him panadol. It’s little differences like these that makes everything we do worthwhile. I always try to remind myself that by being a patient they are putting themselves in a vulnerable position, try and treat them well.
There is no looking back
I have pressed the emergency buzzer a fair few times, made medication errors, had incident reports done on me, had few patients falls, performed my first CPR on a real person, experienced patient death, been verbally abused and so on. I got upset, annoyed at myself but each incident was a learning experience. Throughout all of this, I was fortunate to have an amazing team and colleagues supporting and reassuring me.
In the next 12 months, I want to focus on upskilling myself and honing my assessment skills. I am currently doing an Intermediate ECG course. I am planning to apply for a Transition to Specialty Practice which is a 6 months course in-house for new ED nurses for up-skilling. ALS is on the list. I want to be able to provide good support to the newbies on placement and new grads. I still remember my buddy nurses who patiently helped me learn the basics right.
I want to gain enough experience and confidence to eventually do some rural nursing and make my way into international humanitarian nursing. There are still days when I feel I know nothing but I have the rest of my career to learn, that’s for sure!
Who are some people who have supported you along your journey?
My parents – they always emphasised on education. They supported my every decision from moving to Australia to changing careers whether they liked it or not. and they are always proud of me.
My partner Joel – to go from having full time permanent job to going part time work and full time student was a big change in our lives. He supported me throughout the journey. He stayed up with me during my assignments and exams. He cooked me meals. He just made my life easier so that I could focus on my studies.
Any final words!
We have to look after the newbies. I always try and remember what I was like and how I felt when I was a student or a grad or a new nurse in a new place. We need to be patient with them. We need to teach them and correct them but in a supportive, encouraging and kind manner. It’s not about power play. It’s about passing the right knowledge to the others.
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