Nursing: Expectations Versus Realities

ThisNurse grew up in a family of nurses in Ohio. She has been working on a medical-surgical unit for a little over a year, and maintains the blog No Crying in the Med Room.

My first job after nursing school was on a medical-surgical unit. I had never worked in health care before, and had never even been hospitalized. I had all sorts of expectations about nursing, which I had acquired in school, but I soon found out that the reality of the field was a lot different than I had imagined.

Here are five expectations I started with, and how I became a better nurse once I lost them.

I thought that everything was black and white.

Visiting hours are over at 9 pm. ALWAYS turn patients every two hours. Medicine MUST be administered when it is ordered.

I didn't think my patient would make it until the morning, so I let her husband stay the night. I waited three hours to turn my bone cancer patient who had finally gotten comfortable enough to drift off to sleep. And, my exhausted patient who had been awake for 18 hours? I gave her the bedtime meds early.

Nursing is a science. Most of it is black and white, but sometimes it can really benefit your patients to be flexible.

I thought that Doctors know everything....

Doctors know a lot, but not everything. Remember there are many times when doctors have more patients and less sleep than you do.

I used to argue with myself before confronting a doctor. I would think, "They wouldn't have missed something like that? I must be the one who is wrong."

Be confident in yourself. It's ok to ask a doctor to change an order to Bumex, for example, when your patient has an allergy to Lasix.

....And everyone else knows nothing.

The ward clerk whose name you can't remember? She could tell you that your patient in 210 had gastric bypass five years ago, an important piece of history forgotten in the report. The nurse aide you dismissed as an airhead? She's worked at the hospital 15 years and could be your saving grace when no one else remembers where the suture removal kits are.

I thought that the experienced nurses would eat me alive.

Experienced nurses are filled with the wisdom you can only gain from years on the floor. They are tough and confident. They are role models, and I was terrified of them. Learn from the experienced nurses. You will probably get your feelings hurt once or twice, but as long as you always give your best, they will never let you drown.

Embrace the unique camaraderie you can only experience among your fellow nurses. Who else will listen to that story about the exploding ostomy bag and react with laughter instead of disgust?

I thought that nursing would be just a job.

I thought I would be able to clock in, clock out and enjoy my bigger paycheck. I thought I would sleep soundly at night now that exams were over. Instead, I clock out, and then replay the last 12 hours in my head, making sure I didn't miss anything. I lie in bed at night and think about that poor family crying at their mother's bedside. I call in on my days off to check on my patients. It's not just a job; it's your passion and your identity. More than one of your patients will find a way to twist themselves into your soul. Embrace it.

You're changing lives. Welcome to nursing.