The Novice Nurse

Submitted by Dana Oppenheimer RN, BSN

Tags: experiences expert humor novice nursing experiences professional socialization

The Novice Nurse

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This article is an ode to doing new things in an old profession and a guide to being funny.

I work with a nurse who has been working in the same department for twenty years plus. When she is asked to do something, she often remarks,

“I don’t know what the hell I am doing”.

It is actually very funny. She is not being cynical or complaining. She just is being candid. She is good at following up this remark with putting effort into what was asked of her. Sometimes she poses specific questions related to use of tools, measurement, timing, but she always makes an attempt. I greatly appreciate her openness to ask questions— to be the novice nurse, despite how many years of experience she has. It is refreshing, and when I am working with her, there is always something to laugh about. I couldn’t figure out why I always was laughing when working with her, and then it came to me. She gave me the permission to let go of having to be knowledgeable about nursing.

In nursing school, we learned about the different stages of nursing— there are levels. The first level is called being a novice and they go all the way up to expert. I always found this system threatening. Firstly, I was threatened because I was once again labeled an amateur, a nobody that knew nothing, and my inexperience was tangible to me. How could I justify doing a physical assessment on a patient when I was a fumbling idiot? Half the time I put the stethoscope on backwards. Sometimes I would pretend that I could hear through those piercing plastic earpieces just so the patient wouldn’t know I had put it on backwards.

The second reason that I was threatened was because I felt like I had taken on a never-ending challenge. How could I become an expert? I knew I could never reach that level. How would I store those eon’s of nursing information in my puny head? I couldn’t remember my password to my Gmail account half the time. How would I sustain keeping up with all that new information? I pictured myself holed up in a suffocating hospital office reading stacks and stacks of nursing journals inhaling the light mothball fragrance. I became worried that someday I would meet the expert nurses in the system that would kick me out.

“You aren’t a real nurse. You haven’t even read one nursing textbook”

Okay. Enough worry. Just because we work in an industry labeled ‘professional’, doesn’t make us certified experts in anything except putting one foot in front of the other like everyone else.

Side note: I do call myself the professional human butt plug after an illuminating experience during a colonoscopy, after which my husband remarked,

“I hope you were wearing a glove”

"Suppose you should contradict yourself; what then? ...Speak what you think now in hard words, and tomorrow speak what to-morrow thinks in hard words again, though it contradict every thing you said to-day... Is it so bad, then, to be misunderstood? Pythagoras was misunderstood, and Socrates, and Jesus, and Luther, and Copernicus, and Galileo, and Newton, and every pure and wise spirit that ever took flesh.  To be great is to be misunderstood"  Ralph Waldo Emerson

We should let go of trying to know everything. Even if I were miraculously gifted with the ability to know all, I wouldn’t want it. The more I try to control the way I think or do something, from cutting an onion, to starting an IV, I loose all spontaneity.

When I feign ignorance, I am happy. I realize that this is the natural state that humans are meant to be in. The release that comes from this is comical for some reason, but I kid you not, you will laugh. Letting go of the labels of knowing will free you. It’s an act of taking away authority, not only from yourself, but from anyone or any system that is trying to exert some kind of control over you. You will start to find that doing the same menial things in new ways is invigorating and fun.

“Though this be madness, yet there is method in’t” Hamlet

I used to greet every patient,

“Hello, My name is Dana. I am going to be your nurse for (insert allotted time frame here), while you are at (insert allotted location here)”

Once I started really thinking about it, I realized that I don’t know what the hell I am doing when I greet patients. They are not my hotel guests— I am not trying to sell them some idea of miniature shampoos and wake up calls at six a.m. Why was I using prescribed greetings from the hospitality industry?

Maybe it’s the fact that the call light always connoted images of room service to me,

“Ping, how may I be of service to you? Oh, your bleeding from that gash on your head, let me just stitch that up in a jiff.”

Or was it the miniature plastic apple juice containers we offered patients.

“Here is your one-sip-serving-sized beverage for your enjoyment”

It seemed like it should be so simple. All I had to do was neatly explain my context for being in that person’s life, preferably in one sentence. Actually, it was not so simple. It was damn hard. I needed to create a realistic expectation of what I could offer someone. I knew that individual could be scared, or in pain, or needy, or angry. I had to somehow give that individual a purpose for allowing me to care for them as a perfect stranger. I needed to establish a goal that I could achieve with that patient, to justify my existence in their life.

The first couple of attempts were comical.

“Welcome to here, where you are going to be”

“Hi Steve, it’s a pleasure to meet you. How’s that surgery feeling?”

I don’t know why I hadn’t thought to try this out alone first, but after a couple tries I started to get the hang of greeting patients.

Each greeting is tailored to the specific patient. If an individual is in pain, I never introduce myself. I just start helping them. I turn off the lights, get them medication, and rearrange them in a comfortable position. I even give massages. If an individual is angry, I listen while they vent.

For these two types of patients, I don’t give my name until they ask for it. They are not ready for any information I have to give them yet. Once they ask what my name is, they have given me their permission that they are ready to interact with me on a social level— as a dialogue with two intelligent people.

For most other patients, I cannot tell you one line or phrase I use. I only know that my creative powers are donned as I try and pick out something particular relating to that individual.

“Look at all your fans,” to the patient with five plus family members

“If only I could get my makeup to look as fresh as yours after a shift, let alone surgery!"

“Workin’ hard or hardly workin’,” to the bright and smiley patient

Like I said it’s funny when we try something new. The best part is with my new formula I cannot make a mistake. No one has told me,

“You can’t greet people like that”

So everyday is new experiment that plays out with each patient I meet. The goal is to set up the expectation that I am present, aware, and willing. The rest is up to the patient. After all, it is the patient who decides how long they are going to be there based upon when they are able or willing to leave. And it is not up to me if the patient is tired, or sore, or needs more instruction. I just do my best to fulfill their needs, whether they know my name or not.

Go ahead, take a chance the next time you meet someone. Even if they think it is weird, they won’t walk away, probably.

Case and Point 

Once I was waiting to pay for a sandwich at Einstein’s and the guy at the cash register quoted me the price. Fumbling for my change purse, I said,

“Did you say 61 cents?”

As I looked up at the price on the register, He said,

“Did I stutter?”

We both laughed. I was so startled by his choice of phrase. It was so bold and out of context for the situation. I left not knowing that employee any better than when I had entered sandwichless, but I did muse about how creative he must’ve been. And where did that damn phrase come from anyway. The Breakfast Club, it turns out. Just what the doctor ordered:

"Don’t you forget about me"  Simple Minds

Dana Oppenheimer is an endoscopy RN practicing in Boulder, CO.  She graduated Phi Beta Kappa with her B.A in English Literature from the University of Colorado and received her Bachelors in Nursing from Regis University in Denver, CO.