1. Doctors are humans too. Every member of the team can make a mistake, so be vocal when you’re confused or have a concern. You’ll either learn something new or catch a potential problem. Patient safety is my priority at all times. (Sorry, hospital administrators, but it’s not patient satisfaction. Safety will always trump satisfaction.) And the best way to prioritize that is by double checks, expert advice, and allowing everyone a voice. My resident the other night caught something I’d missed. The next night, I caught something he’d missed. It’s a team effort. Neither of those misses caused harm to the patient because the other team member caught them before they reached the patient. 

I had a patient years ago with a low hemoglobin. No one could figure out why and it got low enough that we had to transfuse at least two units of blood. The day after the transfusions, the lady who cleaned the rooms came to me with a trashcan from the patient’s room. She told me she thought I’d like to see what was in it. Piles and piles of bloody Kleenex. The patient had been throwing them in a trashcan on the side of the room I rarely walked to, and we’d all missed the now obvious problem of chronic nose bleeds that the patient hadn’t thought important enough to bother us about. All members of your team are important. 

2. Look at your patients.  Like actually look at them. Don’t just look at the labs or the monitor. Really look at them. Listen to what they’re saying, verbally, with body language, and their breathing. Half of your head to toe assessment is done between the door and the bed.

Don’t just listen to what someone says to you. HEAR what they’re saying to you. Be present and available when you interact with anyone. Be honest with the people around you, be real, be open, because you may need someone to truly hear what you’re saying some day too.

3. The day you stop studying is the day you should think about switching careers. This world is amazing. The scientific world alone is so detailed, so intricate, you can spend your entire life learning about it, and never come to an end. And that’s just science. Add literature, art, music, social sciences, and you’ll never be bored. Learn. Dig deep to understand something new. Study for that new certification. Someone prescribe a new medication? Read up on it before you administer it. Ask for explanations. Research the answers from a reputable source. Never stop asking questions. Never stop learning. 

4. Inpatient care is important. Give bedside care a shot. Learning how to care for someone completely reliant on you is eye opening. Their food, their movement, their water, their breathing, their basics of all functionality, rests on you. But if it’s not the right fit, move on. Take the experience, then find something that works for YOU. Nursing has this amazing plethora of options to experience, and they’re all wonderful. SANE and forensics nursing, insurance, education, clinic, research, public health, flight nursing, hospice, legal consultant, dialysis, case manager, academic writing…pick something. But give inpatient nursing a shot. Even if it’s not right for you, it’ll teach you important skills and perspectives that will help in your life and your career.

5. Know the drugs you’re dealing.  Know the generic and the brand names of the drugs you’re working with regularly. Peeps in America use them interchangeably and patients may know one name, but not the other. Always look up unfamiliar drugs before administering them. The one time you don’t, will be the time the patient or family has 10 questions and if you can’t answer them all–you’ve lost their faith, which is rarely retrievable. But more importantly, the one time you don’t look up the unfamiliar, is the time you miss some detail like, it worsens liver failure and your patient is already jaundiced. Refer to number 1. Every member of the team is important because patient safety relies on the Swiss cheese holes mismatching enough that nothing falls through.

6. Hire a CPA.  My life supposedly “slowed down” this past year. I still worked in 4 different states, and had two different state residencies, one state which I never actually worked in. My taxes are complicated. I study regularly to keep up my nursing skills. I can save someone’s life, but I cannot interpret tax forms and questions from the IRS if my own life depended on it. And that’s ok. Be OK with what you don’t know and ask for help. If that’s with your taxes, OK. If that’s with a healthy diet or how to exercise, or how to change a tire, that’s OK. We can’t know everything in life, but we should know how to find the answer, and that usually involves asking an expert in the area.

7. Get the hell outta Dodge every once in a while. As much as I advocate throwing yourself into your career through study, time, energy, and passion–take breaks, and take them regularly. Find a hobby, an outside passion, something to remove you from your day to day. Monotony will kill you emotionally and mentally, kill your passion for your career, and those two combined could physically kill a patient. I hike. My free time consists of hiking, preparing to hike, and writing. I spend time studying every day, but if I don’t mix it up, change my scenery regularly, and give my brain a break, I won’t be functioning well at work soon enough. In the ICU, the lights, the beeps, the constant monitoring, causes anxiety. It’s hard to come down from that most days. Won’t lie, a couple glasses of wine after work usually help, but so does being in the woods and climbing a mountain. Replacing heart monitors and ventilator alarms with running water and birds chirping recharges me. Find what recharges you and purposefully schedule regular time for that activity and only that activity. Put away your email, your phone, and embrace whatever it is you’ve chosen as your recharger. You’ll be a better nurse and a better person for it.