Thursday, July 6, 2017


I loved travel nursing. So, so much. It was everything I always wanted - fun, adventure, shiny new places, mountains and lakes and friends and road trips and sunshine and spontaneity. The single downside to that job was the lack of working trauma - in the smaller non-designation hospitals, we of course saw some walk in stuff; in the larger ones I was inevitably assigned to the non-trauma sections due to being temporary staff.

As such, I've lost a good amount of trauma skill.

Or to be more precise, I've lost a good amount of confidence in my trauma skills.

Recently I started orienting back into the trauma section of my current hospital, and it's been a rough start. I know what to do, I know how to do it, but it seems like the ability to adapt to the new protocols and new ways of doing things is a steeper curve than I expected and it's been a huge drag on my outward confidence.

I started my career in an absolutely fabulous trauma hospital. I was regularly assigned to the most critical of critical-care rooms, because I was great at it. I honestly don't mean to sound self absorbed, but I was truly good at managing those type of patients.

And now that I've been out of that constant trauma game for five (!) years, it's a different beast. The specific protocols, the phone numbers to call blood bank with, the organization of crucial trays and supplies within the's all different. I'm having trouble letting go of the old ways - why is it that I can remember the phone number to the CT read room of my home hospital, but can't retain the number to the page operator? Why can I remember the location of O2 Christmas trees and the precip tray and the luer locks in the supply room of a hospital I last worked in four years ago, but can't find things in the stock pyxis without using the lookup function? Why do I still recall the phone number of the local ambulance company but can't remember the damn zip code of my own current hospital? Why could I handle the grumpy surgeons at home hospital, but still feel on edge with the ones here? If I were dropped back into patient care at my old place I'd be running the show in five minutes flat, just like before I left.

I know how to take care of a trauma. It's all that routine, hospital-specific stuff that is killing me. And I inevitably feel like I'm a shitty critical care nurse when I can't quickly locate things or numbers or policies, and thus my confidence in the patient care side of it falters.

It's frustrating as hell.

I think I'm being harder on myself than I need to be, but I'm used to being the best and it's disheartening to not be that right now.


Solitary Diner said...

It sounds like you're definitely being too hard on yourself! When I was in training, we rotated through different areas about once a month, and it took longer than that full month to get fully oriented to a new place with all its routines/phone numbers/locations for things. You'll figure out the new place soon enough and be just as invaluable a team member as you were before.

Old FoolRN said...

You are overthinking on this one. You have the experience and trauma instincts that make you an asset to patients at one of the most critical times in their life. The fact that you are obsessing over the minutia shows what a competent, experienced nurse you are. Trauma is stressful enough, don't sweat the small stuff.

Anonymous said...

The first is imprinted forever ... all those that follow will take six months to become muscle memory. Hang in there

Aesop said...

Don't sweat the petty $#!^.
Trauma is trauma, and after the first 500, all the other ones are the same.
True 20 years ago, true now.

First week doing registry, after decade-plus of being staff nurse, I did five different ERs in five consecutive nights.
Nothing is as un-fun as being the new kid in school, every damned day.
And no patients were harmed, but my ego was bruised and my ass was dragging, just a little.

Carry one of those little pocket notebooks, and write shit down. (Trust me, your brains will thank you).