This June, I’ll turn 9 as a nurse. In January of 2007, a full six months before my graduation, I landed my first job in the Medical Intensive Care Unit of the largest hospital in our nation’s capital. I started my career on June 25th, 2007 after moving to my first solo apartment in DC with little more than $1000 in my bank account, a pending NCLEX test result, and no idea what I was getting myself into.
Somehow, I managed. I paid my bills, I found my way around a city for the first time, I even acclimated to the Southern cultural ways hidden in DC’s natives. I learned to give bed baths by myself, and to manage the most complex ventilator patients.
On my days off, I felt exhausted, mostly. I wondered why in the world I had enlisted in a career that felt so misunderstood to the public and so wasteful to me. Many days, after long shifts of saving peoples’ lives or helping people die the way they wanted to, I pondered, “What am I doing with my life?” I had no idea that these confused feelings were the result of unprocessed stress.
As I grew in my unit and as a nurse, I began to find my niche, and to find means to make sense of my weighty job. After a patient death that traumatized our entire team, I sought out the bioethicist assigned to our unit and we started a “Moral Distress Journal Club” together. My colleagues and I shared tears and stories over scholarly journals proving to us with numbers and statistics just how hard our work was. People thanked me, and we got better at our end-of-life care together. I also started working on an idea for a pilot study with the nursing research council. I got certified. I started to feel purpose and clarity in my work.
Looking back on that first year, the thing that I remember the most was my own anxiety and stress. Nobody told me about this at nursing school, or in clinical, or in the incredibly expensive textbooks I was tasked to buy. I was never taught strategies to prepare myself for stress, or how to think about my behaviors while under stress. I just became a nurse, and then for 365 full days after that, I was full-on stressed. This phenomenon echoes throughout the profession, and is solidified by research; old and new.
In my first year, my manager pulled me into her tiny office one afternoon: “The fellow just came to me and told me you yelled at him. What’s up?” It didn’t take long for me to gush my stress to her; I had foolishly signed up for overtime shifts as soon as I finished orientation leaving myself no time to breathe. I knew my words under stress were often misconstrued, and I confessed I had no malicious intent, but no idea how to change, either. “Let’s meet and check-in about this from time to time?” she offered. We did, and mostly, we just talked about things that bothered me at work – processing stress together.
Admitting stress is the first step at managing it, preparing for it. This conversation with my manager helped me move forward, think concretely about stress, and grow. I write about this process in my new column, “Transition to Practice,” in the June 2016 issue of the American Journal of Nursing. Nine years later, I’m happy to help new nurses avoid the stress I felt in year one, giving them tools to meet it as head-on as they do any clinical emergency that they learned how to manage in nursing school.
Special-est of special thanks to Shawn Kennedy and the staff at AJN. Shawn envisioned this column long before I ever knew I had it in me, and her belief in me is surprising and exciting! Check out her inspiring June editorial, Welcoming Our Bright, Shiny New Colleagues.
Special-est of special-est thanks to Victoria Gill, my first and only preceptor. Without her, this column (and my nursing career), wouldn’t be worth writing about.