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Transitioning into your first year of nursing is a constant learning curve of peaks and troughs. Throw in a global pandemic and you have learning through experience at the max.
Back in my second year of being a student nurse, I wrote an article between finding the balance of learning and helping a struggling NHS; and since qualifying I have truly experienced it from the other side.
I have spent the last seven months working in the emergency department in my newly qualified period. My first few months included gaining competencies on drugs, cannulation, and also additional ED-specific skills such a trauma, minor injuries, triage and CBRN for major incidents.
There are a huge variety of areas you can be allocated to each day within the department, such as being the first face patients see when they either walk through the door or are brought in by ambulance.
Being able to adequately assess a patient’s acuity to ensure they get the most appropriate care in a time-critical manner is a skill that takes both practice and confidence in your clinical judgement.
Since the beginning of the coronavirus pandemic, the role of the ED has been changing. To begin, we set up drive through swabbing for those with recent travel to affected countries. This involved a mandatory PPE update as and when Public Health England guidance changed, and assessing if and when patients would need to be admitted.
Eventually this evolved into the development of the respiratory assessment unit and both Red ED and Green ED – separate departments mirroring each other with ambulatory, major and resus areas, as well as minor injuries and paediatrics.
On top of the patients who may have Covid-19, you have your medically unwell patients and those with traumatic injuries.
Managing these patients who are experiencing potential Covid-19 symptoms on top of their injuries is complex, especially when taking into account the likelihood of needing to perform aerosol-generating procedures (such as intubation) while ensuring you are adequately protected and in the correct negative pressure environment.
“It is forcing us to have an adaptability you wouldn’t usually experience in your first year”
A study by Sun et al undertaken in China by the University of Henan showed a correlation between nurses required to conserve protective clothing by reducing the number of times they wear it, since protective equipment was in short supply, resulting in fatigue and discomfort. Failing to meet physical and psychological needs brought a sense of helplessness.
The constantly changing standard operating procedure is new territory to new and old nurses alike. But for those new nurses like myself, it is forcing us to have an adaptability you wouldn’t usually experience in your first year.
I am constantly reflecting on the care I am giving and realising that doing your best and giving the gold standard care to every patient in conditions like this isn’t always possible and that we must do the most for the most amount of patients. This change in mindset was a very difficult adjustment.
“We must remember to take the time to look after ourselves so that we can continue to look after others”
Additionally, another issue faced by newly qualified nurses is burnout, a phenomenon due to constant levels of stress both physical and emotional. The want to help out in times of crisis have resulted in an increase in my working hours, covering those who are self-isolating themselves.
We must remember to take the time to look after ourselves so that we can continue to look after others. More than 70% of nurses who participated in Sun’s study stated that professional responsibility prompted them to participate in the mission to contain the epidemic. This is something we have seen with the return of many nurses who had left the profession and students stepping up to the challenge.
I wanted to take the time to share my personal experience and remind others of my generation that together with the support from those around us, the learning we experience is simply consolidating what we already know and will propel us with such force into already successful nursing careers.
The growth all registered professionals will have gained from this, if nothing else, is the knowledge to look after yourself, your colleagues and ensure that even in hard times, there are always listeners to support you in escalating any concerns you may have.
The department I work in is nothing less than supportive and has enabled me to feel confident in what I do and comfortable to ask about that I do not. Every single professional has done nothing but take it in their stride and for that, I am proud to call them my colleagues.
Sun’s study has shown that in China during times of stress, staff cared and helped each other and showed support for stress relief. Most nurses said that they felt the collective power and the team cohesion was stronger.
This resulted in a collective sense of gratitude for the support from colleagues, relatives, friends, and all sectors of society; realising the importance of health and family with most staying they would carry this feeling of gratitude with them in the future. I hope to follow in their footsteps in this regard.
Caitlin Adeniyi-Jones is an emergency department nurse