Qualifying as a nurse is always going to be a nerve-wracking time, but when Jodi Shaw started to needlessly doubt herself, her anxiety became a problem that affected every part of her life
Every final year student nurse is well aware that there will be a stage of ‘transition’ as they move from student to registered practitioner.
Universities bang on about it, there are articles galore and even entire books dedicated to it; but do newly qualified nurses really know what transition is?
As a newly-qualified nurse and recent victim of transition-shock/reality-shock/6-month-wobble (call it what you will), I’m not sure if NQNs are prepared, or even if they need to be.
As a mature student nurse, with a wealth of life-experience behind me, I felt ready, really ready, on completion of my management placement, to be an actual-full-time-real-life nurse. Maybe that’s why when reality did kick in, I didn’t manage it as well as I met have done.
“I would like to say there was one specific thing that caused me reconsider nursing”
I would like to be able to say something horrendous happened to me, that I was involved in something so terrible that I reconsidered if I even wanted to be a nurse, but it didn’t.
I would like to be able to say that I work in a really difficult area, that’s extraordinarily busy and pressure is high, I do, but that’s besides the point because what area of nursing isn’t like that?!
I would like to say there was one specific thing that caused me reconsider the career choice I had just put three years worth of blood, sweat and tears into training for; but it wasn’t that either.
No-one was mean to me, I had plenty of supernumerary time and was adequately inducted to my area and role.
There was no single trigger to my mini meltdown that caused me to consider applying for a job outside of nursing.
Put simply, at around four months in, the novelty of being a new nurse had worn off. The excitement of a new adventure had lost its shine. Shift patterns are different to when you are a studen. I quickly realised there were no more early finishes and the overwhelming feeling of responsibility had raised ten-fold.
“I’d be annoyed with myself because I knew I already knew the answer”
I don’t remember the exact moment that the realisation of being registered practitioner with a pin actually hit me, but what I do remember is how unsure I felt. I questioned everything; this is usually a good thing and a quality a good nurse possesses, but I questioned things I knew, to the point where I became a burden on my colleagues. This only added fuel to my already-anxious mind, and then I’d be annoyed with myself because I knew I already knew the answer but my low self confidence just wouldn’t allow me to trust myself.
So, what did I do?
Well, I didn’t do all the things I should have done. I did the opposite: I went home and cried (on a number of occasions), I dreaded going into work, I worried and felt almost reluctant when providing patient care because I was so anxious. I couldn’t sleep properly and I wasn’t eating well but still I carried on, going into work and convincing myself that I just wasn’t cut out for nursing.
It wasn’t until a team educator asked me if I was alright (always the tipping point if you are permanently on the verge of tears) that I was given no choice but to be honest about how I was feeling. I told her everything; all my worries, how it was affecting my home life and how I had been looking for alternative jobs.
“She assured me that it was ok to not be ok”
The empathy and compassion she showed me over the next 20 minutes made all the difference. She assured me that it was ok to not be ok. She confirmed what I was experiencing was a ‘wobble’ and told me her, now funny, wobble story. We had a really open conversation about how I felt and she helped me organise some ‘supported working’; support that I have now been discharged from because I’m actually doing alright, my hindrance was my own self-doubt not my lack of skill or knowledge.
I am an ‘every cloud has a silver lining’ kinda gal but there was great, blinding sunshine behind my clouds. The shock I have now experienced has given me greater self-awareness, I am a more thorough practitioner because of it. I now have insight into what transition shock may look like and so will be able to better support my newly-qualified colleagues in the future. It has driven home the utter importance of being open and honest, not just with our patients but with our colleagues and, most importantly, ourselves.
“We are surrounded by nurses and all they ever want to do is help”
It has shown me that if you ask for help, help is available in abundance (we are surrounded by nurses and all they ever want to do is help!)
At the time, I would have argued that I hadn’t been prepared for the shock of transitioning but on reflection I’m not sure how I could have prepared. I think what’s most important to learn from this is that we encourage our newly-qualified colleagues to talk to us should they experience anything that makes them doubt themselves or their abilities; to create an open, safe environment in which they feel confident to able to talk to their peers. Most importantly, experienced staff should be aware and able to recognise the signs of transition shock/reality shock/6 month wobble and know how to support and signpost our NQNs.
At a time when recruitment and retention is high on the NHS agenda; it will be the compassionate, supportive teams that accomplish high staff morale and sustain desirable staffing levels.
Jodi Shaw is a newly qualified staff nurse working in the emergency depoartment at Nottingham University Hospitals