A New Nurse's Naivety

Jun 11, 2013, 10:25 AM, Posted by

 A nurse updates information on a white board in a hospital patient's room.

After getting my nursing degree in 1980, I got my first nursing  job at Presbyterian Medical Center in San Francisco. At the time, many of the experienced nurses had been hospital trained and  lacked bachelors degrees. So where did they put me? In charge, of course! I worked the night shift. It was notoriously understaffed, and ripe for crises. I can remember the terror I felt when I realized that I did not have the experience or judgment to lead the team. I had this overwhelming feeling that I was way in over my head. I didn’t sleep for a month.

In a new book, True Stories of Becoming a Nurse, a series of essays about new nurses, one author recounts the transformation of the nursing workforce from “the old guard, the hospital-trained, diploma-prepared nurses” to nurses like me who had a bachelor’s in nursing (BSN). I had my degree, but I still had so much to learn.

When you decide to be a nurse you more than likely don’t realize that the excitement  and joy of helping someone comes with  the feeling of not being able to help them enough—that you can’t “fix their lives.” That many of their challenges go way beyond their medical problems and that sometimes listening and caring is just as critical as managing their diabetes. That most likely early in your career you will be in a position where you are in uncharted waters—going into rooms with a flashlight, checking to make sure your patients are breathing. Is he in trouble? Should I call a “code” and risk making a commotion for no reason at all—or even worse—scare my patient to death?

I can remember so many patients that made me realize just how naïve I was. One in particular, a man who struggled with alcoholism who had been in and out of the hospital for complications of liver disease, and who was still drinking. After many conversations with him during his clinic visits, I asked him if he wanted to get into a rehab program and offered to take him downstairs right then to get enrolled. He said, “yes” and so I walked him down, and said goodbye. I felt great—thought “I think I really helped this man.” A couple of minutes later I had to go back down the hall and I saw him walking out the back door. He had no intention of joining the program but he wanted to please me, so he said he would.

Am I glad I got my BSN? Absolutely. We know that the need for well trained nurses with degrees, both at the baccalaureate level and the masters or doctoral level is great. But we also need to remember that  nothing can replace the hands-on  experience that you gather actually working with and learning from patients, their families and other nurses. That’s why some of my early experiences as a nurse will stick with me forever.

Headshot of Susan Mende

Susan Mende, BSN, MPH, a distinguished health professional with more than 25 years of experience working with underserved populations in the United States, Asia and Australia is a senior program officer for the Robert Wood Johnson Foundation. Read her full bio.