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Critical care nurse blog: Moving on to better things

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Critical care nurse Cassandra Leese's decision to move to a smaller hospital raised a few eyebrows, but the new job has brought a whole new set of challenges

As a newly qualified nurse, new to critical care nursing, and having recently moved to a new intensive care unit, I’m currently consumed by all there is to learn, the best ways to learn, and the best people to learn from.

In a bid to answer some of my many questions, I recently made the perhaps unusual decision to move from a very busy ‘state of the art’ hospital with a large critical care unit, to a small local hospital with a more intimate intensive care unit.

Colleagues and friends scratched their heads and warned that not only would I lose confidence by moving so soon in my career, but I would also miss out on all the ‘interesting’ patients that tend to get transferred to the ‘super hospital’ via air ambulance; namely patients with head injuries and polytrauma. Surely my learning experiences would diminish?

Since the move I’ve been amazed at how very different the two workplaces are. New ventilators to grapple with, different monitors, charts, different approaches to care, a completely different demographic of patients, and of course, a whole new set of colleagues.

In one sense my previous colleagues were quite right. Being the new girl again has left me feeling a little lost, and the self assurance that (eventually) arrived post-qualifying has slipped a little. But a mere two weeks into the new job, I think I can tentatively say it was one of the best decisions I’ve ever made.

Yes, the unit is small. Yes, it is far more personal, and no doubt I am ‘missing out’ on a few gunshot wounds here and there. But the size and management approach at the smaller hospital have opened a whole new set of doors.

This is a great emphasis on personal autonomy. Self-rostering is in place, days are set aside for critical care training for everyone, not just the chosen few. Staff are expected to take individual responsibility for factors integral to the unit’s success. This ranges from auditing documentation, to providing learning packs sharing previous nursing experience. Hoarding knowledge isn’t an option here. Nor is watching from the sidelines.

In my first two weeks, senior colleagues have provided me with three days of in-depth, knowledgeable critical care training. My learning needs have been assessed and study days booked. I’ve been thrown in at the deep end by one nurse in charge and hugely supported by another. Scary? Yes. Quiet and uneventful? Not a chance.

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