By Abby Sniegocki, BSN, RN
Most nurses can attest to the immense personal and professional growth that takes place during the first year of their nursing practice. When I graduated in May 2019, I began working on a blood and marrow transplant (BMT) unit. The BMT process is long and intensive, but it provides opportunities to develop strong connections with our patients. We often care for the same patient for multiple weeks or months and then again a year or two later if they experience longer-term complications. As a newly minted nurse, I had a lot to learn about my specialty and about nursing in general, but my fresh perspective made learning exciting.
Secrets in the Subtilties
My experiences throughout my first year of nursing taught me both expected and unexpected skills. I learned the basics of caring for immunocompromised patients and how to administer chemotherapy. I learned which situations warrant notifying a doctor, nurse practitioner, or physician assistant: fevers, abnormal assessment findings or vital signs, and new or uncontrolled pain. I can now identify the signs that a patient could be taking a turn for the worse.
However, I also learned how subtle the initial signs of a patient’s decompensation can be and the value of nurses in noticing and reporting those observations. Oncology nurses are trained to recognize the subtle changes in our patients: anything from a slight deterioration in mental status, fine tremors, and vital signs gradually trending one way or the other. It could be as simple as a nurse getting a “gut feeling” that something is off with a patient they know well.
As a new graduate nurse, it is all too easy to push those gut feelings or small observations away. Never doubt yourself, your ability to assess the situation, and your judgement. I have found that when your focus is on being an advocate for your patient, you will never be wrong for speaking up. Even if you are correct only 10% of the time, if something is caught early then every other time you may have been wrong was worth it.
Experienced Nurses Offer Support
We should never shame nurses, no matter their experience level, for speaking up about their patients. If nurses are fearful of expressing their concerns, the care team won’t have crucial information about a patient to make decisions or intervene in emergencies. Seasoned nurses and providers can help new graduates find their voice to be patient advocates.
I was fortunate to begin my career on a supportive unit that respects nursing judgement and intuition. My coworkers with many more years of nursing experience encourage me to trust my judgement and to speak up when something feels wrong. I have witnessed how patient care benefits when all nurses feel empowered to voice their concerns and assessment findings. All new graduates should be supported this way to help them find their voices as effective and caring patient advocates.