Changing roles as a newly registered nurse…

My name is Dawn Marr and I am a Newly Qualified Mental Health Nurse, I qualified in September 2019.

I started my Nursing career within a low-secure forensic ward. I had spent time within this environment as a student and it really intrigued me, the amount of time that staff had available to spent time with patients was something that really drew me in. Patients within these settings often have complex needs which intertwine mental health, social and economic needs, I was excited to start my career here and make a difference.

Due to having to make up hours my transition from student nurse to newly qualified nurse was a very fast one, I was a Student Nurse one week and a Registered Nurse the next. I remember feeling at this point I was ready to become a Registered Nurse, I had spent 3 years on placements and studying the theory behind the practice and was confident in my abilities however, I soon realised that nothing could have prepared me for the moment my training wheels came off.

I no longer had the security of “I’m a student nurse”, I walked into a world where the full responsibility of being a registered nurse hit me hard and I went from “I’m ready for this” to “do I even know what I am doing?”. I struggled with imposter syndrome, the first time I introduced myself as a Staff Nurse I had this feeling that people were going to “find me out”, on the outside I was a nurse however on the inside I still felt like a terrified nursing student.

This feeling of being an imposter was a common theme within my first 6 months, it came in waves and appeared to be directly correlated to my confidence levels. I was soon in a position where I was helping nursing students who were in placement within my ward, this allowed me to support and pass on knowledge to these students, these experiences helped increase my confidence in my abilities.

During this time, I became involved with the RCN Newly Qualified Network. I soon found out my experiences were commonplace, speaking with other Newly Qualified Nurses gave me a space to voice my experiences and worries and gave me a sense that I was not in this alone. Feeling part of a community helped me to process this transition from student nurse to newly qualified nurse and it has been invaluable.

After 6 months in my first post I was beginning to settle into this new world of being a Registered Nurse. I however began to notice my mental health was becoming poor, I felt unable to switch off from work when I was at home, I struggled to sleep, my mood was low, and I could feel myself becoming withdrawn. This led to me to experience an identity crisis, I had spent 3 years juggling academic work, placements and part time work to finally fulfil my dream of being a Registered Nurse only to run into the stark reality that I was not enjoying it.

I engaged in reflective practice, clinical supervision and spoke with my colleagues and peers, this helped me identify that it was not being a nurse that I was not enjoying, it was the setting I was nursing in that I did not enjoy. This realisation came with lots of conflicting emotions and I eventually came to the conclusion that I needed to change work environments.

After I came to this realisation I began to search for a new job, this came with feelings of guilt and failure, guilt for leaving a fantastic nursing team who needed staff and failure for not being able to “stick it out” in my first post.

I applied for a job within an acute admission ward, was invited to interview and ultimately was offered the job.

I was nervous to start this new chapter in my career, I would be working with up to 25 patients in my new job when I had previously been working with 8, my new environment would be very fast paced, and I knew could be chaotic at times. I joined my new ward and realised I had a lot of learning to do however felt I had a strong foundation to build on from my previous experiences.

I am now 3 months into my new job role, it has reignited my passion and my “fire” for the profession. My mental health has also improved, and I am able to switch off from work when at home and my mood is better.

The lesson I have learned through this experience is to be true to yourself and don’t ignore warning signs of your own mental health. Each one of us are individuals and finding a space within the nursing profession that “fits” with you will benefit you as a nurse and ultimately your patients.

Dawn (www.twitter.com/DawnMarr20)

Taking the ‘theory route’ during the pandemic.

Start of placement and pandemic…

There I was finally on my management placement reminiscing about the last three years of my training and how I got there. Wondering how ready I’ll be after my 450 practice hours. Will that be enough time for me to be an expert on all subject’s general paediatrics? I have been told by nurses before that these feelings are normal and that everyone goes through these notions.

Of course, the plot twist to this story is that it’s the year 2020 and we know by now that nothing really goes as planned. So, in true 2020 fashion, I was faced with a few dilemmas. I was placed in general paediatrics, and the pandemic was becoming more and more real. Guidelines and laws were changing in what felt like every half an hour, the Covid19 virus was taking over the planet.

Very little was known at the beginning of March, and things seemed a bit strange because of the unknown. There we were treating the bread and butter of general paediatrics during the spring months; difficulty in breathing, wheezing, coughing, asthma and allergy rhinitis. Next thing we know new guidelines were being released two weeks in with possible symptoms of the famous virus. Anyone that comes in with any of the following listed symptoms has to be tested for Covid19;

  • Coryzal
  • Coughing
  • Fever
  • Difficulty in breathing

Wait HOW? This is general paediatrics in Spring, how will you be able to test every child that comes in with these symptoms? That will be every patient that I’ve had before these guidelines? This will mean that literally, every child will need to be tested.

Of course, the obvious was happening after that, every child that came into the ward was COVID positive or suspected COVID. I should also add that at the time PPE was scarce.

I remember being asked to go and collect my patients from ‘dirty’ accident and emergency that was dedicated to anything respiratory. My two patients were suspected of COVID. I remember asking the manager at the time to give me a mask before entering as every other professional inside had one. Her response was that I was only going to be here for 15 minutes maximum, so I will not need one. I had to take handovers for both patients at the ‘dirty’ A&E without any personal protective equipment. Did I feel safe doing so? Absolutely not, but I stayed professional and carried on with providing my patients and worried families with the best care I could.

So, we’re nearing the end of March and numbers of infections were rising, and PPE was not getting any better. The government decided to shut down the schools, and my two DDs had to now stay at home. More updates were coming out, some students that I knew were now moving into hotels to avoid contact with their children. I knew that I had to start making some difficult decisions, I had worked so hard to get here, yet I did not want to put my daughter with underlying conditions at risk. After some pondering, I made the decision to take the theory route and shield with my daughters and put a pause on my placement.

Anxiety Galore…

I knew I had made the right decision for my family, but I started to suffer from a lot of anxiety, wondering if I did. It was always worse at night, and a friend suggested that I use apps such as Calm and Headspace. I gave them a go, and they were great for helping me sleep. I then realised that my anxiety was not only caused by the fact that I was no longer at work but also because I had stopped exercising as the gyms had closed too.

So, I started to exercise at home and began doing challenges such as planks and tummy exercises. Sixty days into the challenge, I saw a change in my body and soul. I know that sounds a bit like a mindfulness magazine, but it really did wonders. The results motivated to do more, so I stayed consistent.

The children being around and home-schooling was a blessing in disguise. Getting to know how each of them learnt and their style of learning was a valuable experience. I loved learning with them and trying to read my research articles for my assignments once they had gone to bed. So, the sort of new routine was enough to relieve my anxiety.

My new found love for indoor gardening was also a very relaxing hobby. I had owned plants before but never managed to keep them alive longer than a month if not weeks. This time I was determined to be more intentional. I was ready to know each plant and their specific needs so I can cater to each of their needs. Maybe this was a way of getting my need to care and give met? Maybe but whatever it was or is it helps me focus on something more significant than overthinking.

Returning to work and anticipation…

So, four months into this new routine with lockdown, I now have a start date to return to placement. I have received my off duty and anticipating what it will be like to be back. I am looking forward to getting back to work but also worried about possible lost clinical skills.

I also have so many questions about what the ward would be like. What will it be like post the four months of the pandemic? Will there be a second spike? Will I have to shield again? Will schools remain open, or will they have to close again? Is there adequate PPE?

I guess I will never know the answers to these questions until the time comes. Meanwhile, I am mostly positive about getting back into placement and coming out the other end as a ‘Newly Registered Paediatric Nurse’. It feels bizarre to even write that. But yes, after working hard on all my final assignments and passing two of them with 1st class grades and one with a 2:1. I am now only 10 weeks of placement away from becoming a paediatric nurse. I am nervous and most excited.  

Lily (www.twitter.com/MissWolday)

Considering the Potential Resurgence of Eugenics

Recent world events have quite rightly caused me, and much of the rest of society, to consider our relative privileged status. And reflect on the fact that minorities within society face significant challenges in their lives that many people may not even have realised existed.

 Pleasingly this seems to have led to an increase in people’s interest in campaigning for positive change in things like legislation and more people looking to be allies to minority groups.

Eugenics developed as a sub-branch of the study of genetics. Large industries have developed out of the careful breeding of plants, to improve crop yields, make more interesting flowers or increase disease resistance. During the 19th Century, people started to consider whether the same ideas might be applied to people. In simple terms, the answer to this question is yes; if particular people have a child, they are more likely to pass on positive genetic attributes such as the probability that the parents of an Olympic athlete passed on athletic prowess. In a consensual relationship, this creates few issues. However, as the field developed, people started to talk about enforced control over breeding, which creates a vast range of ethical issues. There is not enough room to fully explore these here. But it includes the discussion on what are desirable characteristics, which inevitably excludes and devalues the people who don’t have those characteristics. The most famous example of this is probably the mass killing and sterilisation of a broad range of people under the Nazis, including people with a learning disability under the T4 programme. I was lucky enough to attend a fascinating talk on this at the Positive Choices 2019 conference by Helen Atherton and Florian Schwanninger, which really improved my knowledge in this area. I was surprised to learn that people from around the world, including the UK, found themselves victims of this program.

I must admit that before I began my studies, I probably considered eugenics to be a thing of the past, consigned to a similar part of history as Nazism.  I was aware that discrimination remained an issue. Still, I probably felt both that it was significantly reduced compared to the past and that it was limited to people’s personal opinions rather than being the state-supported general consensus.

 I am increasingly aware that my privilege significantly impacted that opinion.

I recently watched the Eugenics Science’s Greatest Scandal documentary on the BBC, which highlighted that for people with a disability, eugenics, though not called that, is potentially very much part of their life and the complicated ethical issues that go along with that. For example, does being able to genetically screen to avoid having a child with a particular disability devalue the life of a person with that condition?  Will advances in genetic selection revive the idea of creating the ideal human, and if so, who decides what that is? 

The recent Covid-19 crisis has brought sharply into focus the challenges faced by people with a learning disability and highlighted that eugenic thinking is still prevalent. I have every reason to think that life is as good as it has ever been in general for people with a learning disability. People are often able to live fulfilled lives in the community away from historical institutions. And increases in medical knowledge and technique mean that people are living longer than ever before. However, the Office for National Statistics has recently advised that two out of three people who died of Covid-19 had some sort of disability. And the CQC suggest that just between April and May the death rate for people with a learning disability, which was already above the national average, rose by 134%. There have also been reports of record numbers of requests for unlawful DNR orders for autistic patients and patients with a learning disability during the crisis. All of this leads me to think that for many people, the lives of people with a learning disability are somehow seen as less valuable than those of non-disabled people.

Why might this be?  As I began to study more about people with a learning disability, I began to appreciate the challenges that they face. At around 1.5 million people, even collectively, they represent a relatively small part of society, getting their opinions across is further exacerbated by a high prevalence of communication difficulties.  From a healthcare point of view, virtually all available evidence from government policy and research shows that people with a learning disability experience significant health inequalities. These inequalities are caused by general factors, such as social inequality. However, there are also discriminatory practices, such as diagnostic overshadowing, whereby symptoms are automatically attributed to the learning disability rather than the specific health complaint that the patient is presenting with at that particular time.

So what relevance does this have for us as student and newly qualified nurses?  As a student and soon to be newly qualified nurse, I am passionate about trying to reduce these health inequalities and help people with a learning disability access the best possible care for the problems that they have. But I can’t be everywhere and do it all by myself. Whatever your field of nursing, it is highly likely that you will have a patient at some point who has some of these additional needs. It might feel scary and challenging to deal with, you might not know what do to, and that is okay. But I would urge you to take the time to give them the best possible experience. Have they brought a hospital passport detailing how to help them best? Do they have a parent or carer who could provide you with advice? Do you know a specialist nurse or doctor who you could consult with in the same way you might for a complex physical health issue? By working and learning together as newly qualified nurses, we can make healthcare a safe and helpful environment that is accessible for everyone.  

Daniel (@MAGEOFJUSTICE)

Starting as an NQN in the Community

“You should go to the ward first? Shouldn’t you get some experience before you go into the community? Oooh, are you sure about doing that?”

These are some of the common statements I heard from fellow students, nurses, and lecturers when telling them my Newly Qualified Nurse (NQN) role was a Mental Health Nurse, also known as a Care Coordinator, in the community. Why are we still questioning and doubting our student nurses’ decision to go to the community or a slightly different path to the ward as an NQN?

Nursing is varied. That’s why we have numerous placements. So that we learn how to nurse in a variety of settings. I’m now a year into working in community mental health, 10 months of that as a Registered Mental Health Nurse. Of course, being a community nurse is different from being a ward nurse. Like being a ward nurse is different from being an A&E nurse. And being an A&E nurse is different from being a research nurse, which is different from being a nursing home nurse. None of these roles requires fewer skills. But all these roles require different skills, which as an NQN, you can learn and develop.

Over the past 10 months as a newly qualified Mental Health Nurse in the community, I’ve learnt so much. Some of which, I would like to share. So, whether you’re thinking about heading out into the community, have a job in the community lined up, are currently working in the community, or are just interested, I hope these help.

1) Supervision is not all about your patients, but it’s also about how you are emotionally, academically and personally doing. You need to be open to receive constructive criticism. Open to receive support. And honestly admit when you are struggling or if you don’t know something. For me, supervision has been so helpful and a vital part of my first year as a Registered Mental Health Nurse.

2)The to-do list never ends. But that’s okay. In the wards, you hand things over to the next nurse. In the community, this is a little harder. My to-do list seems to go “one thing done; three things added”. You have to learn to accept that you can only do as much as you can that day and prioritise. I personally like to highlight my to-do list in different colours, so I can visually see what need to be done when. 

3) Teamwork. Although you’re care-coordinator for your patients, it’s mega important to work as part of a multidisciplinary team. Seek advice from Occupational Therapists, Support Workers, Social Workers, everyone, as they will all give you a different perspective. Before my role in the community, I had no idea how to apply for social care funding (we don’t learn that as a nurse in my area). But thank goodness the Social Workers in my team who were there to talk me through it!

4) Team dynamics can be challenging. Some people don’t get along with others, some people may not get along with you, some people may gossip & try to draw you in. Be professional at all times.

5) Every day is so different. But that’s why I love it. One day I’m in depot clinic, the next I’m having a meeting with a cleaning company, the next I’m doing risk assessments and care plans. Embrace the difference.

6) Not all patients will take your advice. And because they are in the community, you have to respect that, even if it means that the patient’s mental state may deteriorate. This can be frustrating, sad and difficult to manage. Use your colleagues to discuss cases and gain emotional support yourself.

7) Positive risk-taking is necessary but can be scary as NQN in the community when you don’t have the protection of a ward environment. Gain support and advice from colleagues and remember to document and risk assess.

8) You get to know your caseload of patients and their families over time as you build that therapeutic relationship and also get to know yourself. I’ve learnt so much about myself these past 10 months.

9) Switch off. As I explained above – that to-do list can be never-ending. But it’s so important to switch your phone, laptop & mind off at 5 p.m. Because you can’t pour from an empty glass!

10) Paperwork. Tribunal reports take half a day at least. Social care funding forms take another day or so. Case notes are a must. Then there are plans, risk assessments, letters, housing forms, emails, etc. etc. Being good at organisation and timekeeping is very important in the community, so find a routine to your day and week that suits you and the team you work with.

I loved the past 10 months in the community. Sure, at times, there are some not so great days, but we all have those. Working in the community as an NQN, for me, has been amazing. It’s taught me so many skills, strengthened me both as a professional and person, given me many opportunities to develop. And I feel so privileged to have started my registered nurse journey there. If community nursing is something that you have a passion for then go for it and embrace that passion.

Abby (www.twitter.com/MHnurseabby)

First day in the numbers in critical care.

Yesterday I worked my first shift in the numbers in intensive care as a newly qualified nurse. After a slightly unorthodox supernumerary period including a seven-week long absence due to sickness, as well as starting in the midst of a global pandemic, I had, in total, around six or seven weeks clinical practice before being assessed by a very supportive senior nurse who deemed me capable of looking after critically unwell patients without supervision, which seems to be about average for a lot of ICUs.

Prior to going into the numbers, I had a lot of anxiety about all the things I just didn’t know. I know I can (and I do) ask a LOT of questions, but what about the bits I don’t know that I don’t know?! Will I miss something serious? What if my patient rapidly deteriorates and I freeze up? All of these questions were constantly whirring around my head. Nonetheless, I had to bite the bullet eventually, and I went into work for my first shift working ‘alone’.

Thankfully, I’m not really alone, the education team and senior nurses are incredibly supportive of new nurses into ICU where I work. I was placed working near to very experienced nurses who would be able to help me if I needed it. The patient I was allocated to was a bit of a mixed bag in terms of their nursing requirements with some elements I had previous experience of, and some not.

I set out planning my day which was easier said than done; this patient had a LOT of medications (all IV) and not many free lines, as well as various pumps and drains which needed regular maintenance, and not to mention a very pressing need for regular physical rehabilitation to help clear chest secretions. All in all, my time management was definitely going to be put to the test as I tried to scribble out some kind of rough plan that I was sceptical I would be able to keep anywhere near to.

The day went very fast, and lots of curveballs were thrown my way; a radiographer turned up for an ultrasound I wasn’t expecting, morning physio took much longer than I had anticipated (but was extremely beneficial), stitches popped on the patient’s central line which needed re-suturing. All of these meant I was continually reassessing the tasks that needed doing and rescheduling according to priority. Additionally, due to happenings in the areas surrounding me, I had a much-reduced level of support from colleagues for a lot of the afternoon (through no fault of their own) Needless to say, it felt a bit relentless all day.

At last, the end of the shift came, and I handed over to the nurse for the night shift. I looked back at my shift and weighed up how my first shift had gone. Had I managed to perform every task I had wanted to? No. But I had carried out the essential tasks and any non-essential ones I could manage and handed over the ones I hadn’t been able to do and, I might add, there was no judgement from the night nurse for handing over a couple of jobs.

So, did I manage to do a good job? At the time, it certainly felt like I wasn’t keeping it together, but I talked briefly with the nurse in charge at the end of the shift, and I expressed that I hadn’t done as well as I’d have wanted. However, she highlighted to me that I had managed to deliver all the patient’s essential medical care (including all those pesky IVs!); managed to help them get out of the bed for their longest stint yet with help from the physios; managed to wean down on their O2 support; managed to sort out getting the patient to speak with their family; managed to autonomously deal with issues as they popped up, and managed to ask for help when I wasn’t sure. I realise I said ‘manage’ quite a lot there, and that’s because the penny dropped for me, I had actually managed, not merely scraped through my first shift in the numbers.

Sure, I didn’t do things perfectly, but I left work leaving behind a patient who was a little better physically, mentally and socially at the end of my shift than when I went in at the start. All in all, I’d say that was a success. Bring on day two.

Michael (www.twitter.com/MLJCarter)

An ideal transition…

So, it’s here, you’re doing it, your last placement as a student. I had worried a lot beforehand that I needed to know everything by the end of this placement, and that I would be ‘good enough’, not only for the team, but for my own expectations.

But that first day in blues came around, and amongst the high fives on the way in (after the nearly vomiting with nerves in the car park beforehand!), I remember saying to one of the nurses, who stopped to give me a hug and ask how I was feeling. I confided “I feel a bit like I’m walking around pretending I know exactly what I’m doing”. And her response? Horror? Shock? Escorting me off the ward? No, she just looked at me and said:

“Yeah, what were you expecting? That you’d wake up this morning knowing everything you didn’t know yesterday? Welcome to nursing. I still have days where I don’t know the answers. Every day you’ll learn something new. You know more than you think you do, and you’re doing just fine”.

It is nothing new, and its widely documented that the transition period from student to registered nurse faces NQN’s with many challenges (Duchscher et al. 2009). However confident and ready you feel at the end of your management, that first week in blues feels completely alien. It’s the mix of changes in priorities, schedules and values along with getting to grips with different staff attitudes to NQN’s, combined with not only learning but acquiring the evidence behind new skills and practices (D’Ambra & Andrews, 2008; Rush et al. 2014).

I don’t think I realised during my time as a student just how protected I was. It’s like a tightrope walker, you’re so busy looking ahead, desperate to reach the destination, that you don’t look down and notice the safety net. Until suddenly, you’re in blue, with patients to look after, you’re acutely aware of its absence. But, three months in, I’m starting to realise that instead of looking down, if you look around, you’re not up there alone, there’s a whole team of you, all willing each other on, supporting each other, and keeping each other up.

Although prescribed by the Nursing and Midwifery Council (2018), the level of support each nurse gets during their preceptorship seems to be dependent on where you choose your first job. This would be my advice about first jobs. Obviously, it has to be somewhere you enjoy and in an area you’re interested in. But go where there’s a strong team ethic. Where people work together and where you’ll be supported. Ask what the preceptorship looks like. How much support will you get, who can you go to. We’ve had lots and lots of extra training since qualifying, learning skills relevant to the job. The preceptorship framework includes regular meetings, feedback, encourages regular reflections and a large number of competencies to work through. All of this helps you to feel more secure.

Although many theories exist surrounding the transition period, all would agree higher staff attrition rates occur when the new registrants wellbeing is looked at, alongside the learning of new responsibilities and gaining the increased confidence needed in both learning and performing new skill sets (Duchscher, 2008; Martin & Wilson, 2011). This is further discussed by Rush et al. (2013) who added by starting these discussions during the student period – feelings of shock and abandonment can be decreased.

Cole-King (2018), Peterson et al. (2008) and Wilson & French (2001) have offered many definitions of the term ‘emotional resilience’ – combining the need for, among others, the physical, emotional and psychological resources to cope; to be flexible enough to thrive in the face of adversity. Connor and Davidson (2007) offer characteristics and behaviours of ‘resilience’ – including prioritisation and time management, continuous self-development and pressure management techniques. Wouldn’t it be ideal if we could combine these into a standardised preceptorship programme, beginning during university, to equip new registrants with the ability to not only survive, but thrive in a long career in nursing. With tools such as simulation and scenario exercises, true to practising life as NQN; access to both closed and open forums for NQN’s to openly reflect, share and learn from experiences; an extensive list of available CPD courses relevant to each field, as well as extended access to university VLE’s which, arguably would be most useful at this time, and access to a link tutor contact for those first few weeks, someone who, while impartial to the workplace, has been in the same situation and can perhaps offer support.

I’m really enjoying NQ life, it’s harder than I thought it would be. I’ve laughed, and I’ve cried. Not cried because I wasn’t enjoying it, but some of the things you see, and some of the conversations you have, are, quite simply, overwhelming. But it’s all about support and learning to trust your own knowledge and recognising the areas you need to gain more knowledge on. It’s a new confidence you learn, being able to confidently ask for help without feeling incompetent. Not comparing yourself to others, for their journey is their own, their experiences different, and it takes a variety of people to make a team – this part seems to be all about working out where you fit in. Like a driving test – you’ve passed it, your competent, but now you’ve a car of your own and you need to figure out what kind of driver / nurse you are. 

It’s easy to be negative, especially when under great pressure.  It’s even easier to feel alone when you’re struggling, and to see asking for help as a weakness.  But my time as a student, and in fact more so my time as a newly qualified nurse, has showed me you’re only as strong as the team around you.  

And a great team is full of people who lead in a range of different areas – those who innovate; those who organise and co-ordinate work efforts; those who encourage trust and co-operation; those who litigate; those who act and both inspire and engage others, and those who support, develop and empower people. 

All the research into leadership tells us great patient care comes when nurses feel encouraged and supported by their leaders, and in turn where the work climate is positive and supportive , and where people are given opportunities to participate in decision making, they report higher levels of organisational belonging and job performance increases as a result.

In studies where all nurses are encouraged to be involved in quality improvement -higher levels of empowerment and performance shine through again.  Put simply – where all members of a team are supported and have a voice – they feel involved  and have the emotional capacity to care for others.

Personally, perhaps controversially, I think the capacity to lead is inside everyone, it only shows in different ways.  The temptation at times like these, when everybody in every role within healthcare is stretched and pushed to their limits, is to look for some inspirational celebrity or historical figure, someone who’s achieved greatness despite incredible hardships and measure yourself up against them.

To be inspirational means to make you feel full of hope or encouraged.  And these people are all around us.  It could be your favourite author who uses words like a paintbrush, painting emotions and feelings so real you can reach out and touch them and feel strengthened by their proximity.  Or it could be a friend, who’s going through the most awful time, struggling with the worst kinds of crippling anxiety and consuming depression, but still manages to get up every day and just carry on. It could be a lecturer who invokes such inspiration it’s hard not to be swept along and strive to be as passionate, empathetic and hardworking. And it can be your work colleagues who cheer you up, cheer you on and keep each other going.

In a culture where we’ve grown to measure success by status, perhaps we should instead measure success by innovation, and the effects of such on other people.  By innovation, I’m not exclusively talking about those bringing about huge changes, but also those whose actions and ideas inspire actions in other people.  The carer who sits with a patient with dementia who is unable to communicate their wishes in the way they used to and is afraid – and develops a way to ease this confusion during their shift.  The lecturer who changes and develops modules to suit the learning and perhaps family needs of their students.  The practitioner who helps develop new guidelines and courses to enhance future patient safety.  Work mates who take that 20 seconds to ask “Are you ok? How’s your day going? Let me know if you need anything”

These are all, surely, equally both successful and fundamental to any great team, and furthermore, surely all equal leaders?

Being kind, mindful of the stresses other people may be going through, being respectful and compassionate.  They are none of these passive states.  They each require action, and equally as important – reflection.  Measuring the success of an individual not merely by results, but the growth and development of the actions which preceded it. The end result may be fabulous, but I’m a great believer in celebrating the whole team behind it.  Instead of searching for the negative, which sadly our media seems so intent on –  acknowledge and celebrate all the positives and draw from them. Shout from the rooftops about them. Where negative experiences happen, share them openly and frankly, reflect on them and then keep on moving forwards. 

Don’t Just be a nurse, don’t just be a leader –  be a cheerleader.  Tell the world about all the incredible people who make up your team, who make your day easier.  Tell the world and celebrate the best kind of team – nurses, doctors, midwives, healthcare support workers, porters, domestics, ward clerks and everyone else who, however bleak the outlook, always pull together to look after others.

Kayte (www.twitter.com/kayte83)

Help! I’m a newly qualified nurse starting in the middle of a pandemic.

I’ve just completed my first four weeks as a newly qualified registered nurse. Like many of you, I’ve taken up my first post, working in infectious diseases, in the middle of the global COVID-19 pandemic. I don’t remember the module that covered starting your career during these “unprecedented times”. And I don’t think anything could have prepared us.

In Scotland, to gain NMC registration, most student nurses complete a three-year Bachelor of Science degree. I gained my registration in September 2019 at the end of my third year. But stayed on at university to complete my Honours year, which takes four years in Scotland. I watched my friends who had finished their third years start their nursing careers. Many of my peers completing their Honours year worked part-time as registered nurses while doing so. Due to my workload as RCN Students’ Committee chair, I chose to take my fourth year as a solely academic year.

I didn’t believe I could juggle my studies, RCN responsibilities, and working part-time. I worried all the balls would come crashing down. That I would fail at everything. While I don’t regret my decision, it meant when I started this job, I hadn’t been in a clinical setting since my management placement in August 2019. I was confident in my abilities as a student. I was an “expert” at being a student nurse. But now as a “novice” nurse, I’m constantly worried that I don’t know what I am doing. That I will make a mistake. That this will affect my registration. But most importantly, that it will affect patient care or safety.

I have an incredibly supportive team and preceptor. They have all made me feel so welcome and like no question I have is stupid. I know I can turn to them. But I can’t shake this fear. I think a large part of this is because of when I’ve started. I am the only newly qualified nurse in my ward. Due to the pandemic, our face-to-face induction and preceptorship programmes are not currently running. Also, I work with six nurses who qualified and started working last September when I could have. I see how much they have developed and grown as professionals. I’m so impressed. But it makes me feel so far behind.

The reason I am telling you this is because I know I’m not alone. Last year as RCN Students’ Committee chair, I heard so many stories about newly qualified nurses who needed support: from peers, from colleagues, and from the RCN. The voice of students is loud within the College, but once qualified, newly qualified registrants can feel like they are no longer a priority. Like they don’t’ belong. Like their voices are drowned out by louder members of the College. And that is why RCN Newly Qualified Nurses is so crucial. Because it is yours. We want to hear what you want and need. I want you to know you’re not alone.

This quote from RCN Congress 2018 really resonates with me, “I’ve got your back, you’ve got my ear”. That’s what we want to do at RCN Newly Qualified Nurses. Support and listen. I certainly know I need it.

Lastly, my biggest piece of advice, ironically the one I find the hardest to follow, is to be kind and patient with yourself and take time for you.

I have attached links for our online Newly Qualified Nurses Handbook, and an interview I did with Dr Ruth Oshikanlu, where I discuss the aims of RCN Newly Qualified Nurses (from 19:00) if you want to access them.

We got this!

Craig (@CraigDavidson85)

Welcome to RCN Newly Qualified Nurses

This week, the Royal College of Nursing (RCN) Newly Qualified Nurses launched on Twitter, reaching over 1000 followers in its first 24 hours, demonstrating the need for the voice of newly registered nursing professionals to be heard both within the College and the wider nursing profession. The Twitter site is targeted at all final year nursing students and newly qualified registered nurses, in addition to all those who would like to support these professionals at the early, crucial stage in their career. 

You can follow RCN Newly Qualified Nurses on Twitter at https://twitter.com/RCNNQN

RCN Newly Qualified Nurses aim to provide a voice for newly qualified nurses within the RCN and provide support from six months pre-registration throughout preceptorship. The project is sponsored by the RCN Students’ Committee who states, “The RCN Students’ Committee is thrilled to support RCN Newly Qualified Nurses. It is a very exciting project, shedding light on the unique perspective that the newly registered add to the voice of nursing, providing support and guidance at the beginning of their nursing journey. We know it will make a huge difference.”

The RCN Newly Qualified Nurse Network was initially launched in November 2018, by former RCN Students’ Committee Chair and student member of RCN Council, Charlotte Jakab-Hall. The network began with a closed Facebook group for newly qualified RCN members https://www.facebook.com/groups/RCNNQN/

Subsequently, former RCN Students’ Committee Chair, Craig Davidson, and former student member of the Trade Union Committee, Clare Manley, developed a project plan, leading to the creation of “RCN Newly Qualified Nurses”. This project is now lead by Clare Manley and the current student member of the Professional Nursing Committee, Kendal Moran. Joining Clare and Kendal to curate the RCN Newly Qualified Nurses Twitter account are a team of final year nursing students and newly qualified nurses. This team includes Craig Davidson, RCN Students’ Committee Chair, Jessica Sainsbury, RCN Students’ Committee members, Dawn Marr and Lynsey McLaughlin, RCN Student Information Officer of the Year 2019, Aimie Morgan, runner up for RCN Wales’ student nurse of the year, Kayte Powell, Michael Carter, Daniel Branch, Beth Phillips and Abby Martin. We are currently recruiting more curators, making sure we equally represent all four UK nations, fields of nursing, and promote equality, diversity and inclusion among our curators.

RCN Newly Qualified Nurses will provide content and support, showcasing and signposting newly qualified nurses to all the RCN can offer as both a Trade Union and Professional College. Additionally, we will promote the newly qualified registered nurse’ voice to shape the RCN and wider nursing agenda. We aim to hold regular Tweetchats, and we are excited to announce there will be an upcoming RCN Newly Qualified Nurses podcast hosted by Clare Manley and Craig Davidson. Most importantly, we want to hear from you, the newly or soon to be newly qualified registered nurse and those who support us to find out what you want from us. We welcome you to join us on our exciting new journey supporting this often underrepresented group.

RCN Newly Qualified Nurses.