about work

 好像，我需要一场很深很长的对话。慢慢的道说一切。整理出一个方案

目前，什么都需要一个说法的未来，害我不敢轻举妄动。

这个年纪，这个看似职场打滚很多年，但实际也是初出茅庐的我，

充满了抗议，异议，争取，容易相信，希望，等等等等五味杂陈的每一个possibility

 这工作，做了五年，同样的病房待了四年，被耗尽的精力，停滞了自己接触新鲜事物的explore机会，常常被问到，到底我的未来计划是什么，为了强硬给与答复，我害怕我看漏了什么，为了回答而回答，却忘了自己真的要什么。 

好吧，撇开私人恩怨，我先自己整理自己的答复吧。 

护士，一个我埋头四年的行业，这四年，我好像从来没有后悔过什么决定。 

而成为病房里的轮班制护士，成为一个integrated care model 医院的护士， I'm given a lot of chances to have the autonomy to involve in patient treatment care plan. I have fewer encounters with acute conditions for active case patients but work on chronic disease complications and health education for patients. meanwhile, I am a leader who guided my junior nurses in the decision-making and handling of their complex patient cases. I am a preceptor who train and teach staff who are inexperienced and transform them into ready nurse. I am a resource that staff with problems that will look for to rely on and consult with. I am also a trained peritoneal dialysis nurse who has a hand on real patients to help them with the CAPD and APD exchange. I have a skill that is able to perform VAC wound therapy, and care of patient who is on BiPap/CPAP during night time. I am a trigger code blue trainer who guides ground nurses on handling triggers and code cases when they happen. I am a trainer on SC needle insertion to my ground nurses. I am a medication team leader who has led a project that helps minimize medication errors and late return of medication causing patient overcharges on medication fees. I also helped to voice out how to improve the proper workflow on handling patient belongings during the inpatient stay to minimize incidences on patient-reported loss of belongings. recently, with a degree of nursing background, applications my knowledge to participating in nursing L1 lead programs that review patient general condition, and coordinate with multidisciplinary teams to work on patient discharge plans. 

Throughout the year by providing bedside nursing care, I was able to encounter patients with pneumothorax that underwent chest tube insertion and drainage care, even with double tube insertion, and proceed with the blood patch procedure. I was also able to work hand in hand with the team when the trigger process going on, I remember one time that an elderly patient had an abnormality from the vital signs but physically looked fine, not in distress, but we still worked as a team to do what we can to make sure patient is safe and out from critical signs. On top of that, I am able to provide palliative care for a patient who nearly dying and maximise their comfort care. With the privilege of a general medicine ward, I am also involved in a geriatric specialty on looking after elderlies. Especially on dementia, and delirium clinical pathways. 

Looks, like these have been what I gained from the past 5 years of working experience, that really make me feel so worthy and living as a real adult. I am dealing with a real physical life, I am talking to a real patient to get to know their symptoms and chief complaints, not something over a textbook for a template answer and I am giving the chance for error and failing to address their concerns. Maybe I just feel like yeah, I did learn above, and definitely, I can learn more in-depth from each diagnosis but to remember that I had years that not able to learn and explore new knowledge from seniors where the time I should have learned on my field, I was occupied on patient's care, preceptor students that unable to leave them unattended for awhile. Most of my life has transitioned to how to teach a person to be rational, and how to stop a person from being not thoughtful enough. 

AH does have lots of opportunities to grab for promotion, as long as you dare to voice out good things, and actively participate in all the roles, for sure anywho who has good communication skills will gain more experience. The challenges that left behind that no one remembers to address, included starting off my working adult life in a team with a group of people, and now, it is close to everyone who left the team and worked in their new place. Time went on then I only realised, my hands were no longer there. Everything just suddenly gets tough, because there are not much of people who see what I see, feel what I feel, or know what I mean. I felt lonely to get thing done. I felt not worth to work harder. I felt no more support on finding out solution. 

There was a time, I wanted to change the workplace, yet due to the bond, I had only choice to rotate within my current workplace, with not much of exposure, it is, but when you have a voice out to all the supervisors what they see is different. literally like everywhere is the opportunity, what exact that you want to explore on. I use to have thought, and now people questioning and doubt on my thought that give me a sense of yeah, am I really not having smart goal on my plan, but why would I have a long term goal while I am not really achieve my small goal by find the correct place that suit me in? 

I am a person that who wish to have explore on different aspect speciality to ensure I am giving a chance to know what suit me the best, but not just sick of finish what I am capable for. Get things done just a step of being familiarise with your comfort zone, I am pretty sure when place me into other department, I will start to show lot of learning challenges where people never thought that I would have their problems too. Stubborn on what I am thinking on, having slow time digest on what people have just taught. See, if I never go somewhere else, I will have never know, what I lack of. AH, the opportunity to be honest, I am not so sure what I can I comment on that, yeah, it come with palliative, there yes I am not really working in that whole team with palliative team, but I am nursing overflow case of palliative patient, if I am not equip with that skill, how it possible that the nurses is nursing the patient everyday. If the say is only a train staff came from palliative ward give the best care for the patients, then am I saying that is not fair for my patient who under the team but not receiving the best care ever? No, right, I still need to maintain my professional that work on the best palliative care practise to nurse my patient, and yes, it make no difference if I request to transfer to palliative ward for exposure. Next, speciality with rehab ward, a place where I from, a care that nursing just carry out ADLs care, and the key role to help in patient recovery like others multidiscipline team is more important, they advise good in positioning, strengthening, nutrition, communication skills, working on their discharge plan, but nursing are being train to take care of them, and follow instruction that given by other teams. Good to see a person to recovery from a sick, but yet the involvement of nursing care just make me feel like, I can be do big in other speciality that really achieve me working satisfaction. Next with telemetry ward, but trust me most of the time patient all is the same general medicine and come in with some underlying stroke or heart disease that require to put on telemetry monitoring that in the end still taking over by ICU staff to monitor the trend. Ortho case, same same, our ward with the overflow case, we may not so familiar to what the team style but standard surgery patient care we still manage to handle. 

Hence, one of the conversation and stressful event, there's new thing call Home NUHS. A speciality that totally something different from what I am practising right now, as a general ward nurse, more on task and routine, and bedside patient care, be with patient at all time for early detection abnormal symptoms.when patient not well just one call away to activate the doctor and the code team. 

I may not really know Home NUHS how it work, but I pretty sure it need more knowledge and skills that to think of a comprehensive of history taking with some limitations. And, also a essential good communication and collaboration skills among the teams to make sure the information is deliver correctly.  From what my strengths, that I like to be bedside care, but I really feel like current ward base routine has trapping in and limiting me to have a chance to learn from basic and also let me to give a pause to realise maybe I am really not as good as I thought. I may have difficulty like my precept, its just that I overlook it.  by this age of 27, working experience 5 years, I am a senior staff nurse 1. to all the SSNI that I know off, they have been working for 8-10 years to get into this position with lots of experience, and they mostly not only from one speciality. Sister S who from respiratory ward previously, and it make me feel more reliable when I m having case of patient with respiratory support treatment care.  I wish to have all these embarking in my resume, but not just a general medicine nurse. 

I am just a fresh graduate degree nursing, and I have yet to think of studying again, because, I haven't returned my knowledge from my degree. I haven't really felt the worth of my degree. Changing of something that I really not know off, like cardiac, ENT all these it will need to rotate to NUH with this exposure, to remember I am bonded, I have not much of right of this, despite all supervisor say they will do as much to support what we wish, and the next day hear of gossip about this by pinpointing the staff. 

So maybe put aside all the hate, I really need to look as a whole big picture to think of what exactly that make me feel Satisfaction and happy and worth for. 

Working wise, what I hate like most was preceptoring. I love to teach, I love to share, I love to guide people to think rationally and make decision and be confident. but in real life facts was, different learner style I truly understand, but when it come to attitude I couldn't stand. In nursing, while I am dealing with.a real life situation, why I need to spend so much of extra time to forgive a person who don't treat patient life as a life, and just being irresponsible to their own career, not work hard on what they suppose to be. I provide guidance, leading them, but their goal is just want to get pass out without going through lots of ups and downs, when things happen not willing to work on it, just choose to avoid it. I m truly having a big difficulty dealing with these students and staffs. That keep draining me and make me doubt on whether I am really not a good candidate to precept people. they choose not to approach me just because I am strict, this sound ridiculous right, and turn around they rather just follow with wrong instruction also not dare to learn a correct thing. Am I suppose to lower down my standard? no right, I change my way, I offer a better tone of guiding, in the end, what my return was, people take it for granted, thought that I can be continuously feeding them with answer and chose not to do anything, just enjoy with someone back them up, clean their shit. you see the culture, while I am trying to adapt in, to suit in, to modify it, in a return preceptee say that is preceptor responsible, and them have nothing to do with that. people just don't like to listen advise and correction and give a change. 

I felt like I really need to step out from this, and a position twitch, my turn to be new staff need to get buddy, and see how challenges to listen feedback and be better? I don't want because of these people, make me just want to give up on what my strength. make me swear that I will never be a educator anymore. that is really bothering me. 

so move on, my short team smart goal. I really wish I able to switch to a new environment to know what the best thing that suit me in, and if I manage well I will definitely want to study more and work on that area. but there's something that not my ideally nurse care, I will keep myself stay on in general ward base to work on harder on preceptoring and thinking of way to improve on ground nurses knowledge and standard of practise. meanwhile, work harder on grabbing chance to work as a quality nurse in coordinating care with others team. dare to voice out. dare to ask question when in doubt. if I continue stay in AH, I may really want to work on chronic disease management as this is what something that back time I m looking forward into it. if able to change to other clusters, defiantly I can't think big, drag myself back to a new beginner to touch on cardiology which some terms and commonly happen in public that I can return in future. maybe when I much clearer on what really suit me, then I proceed with further study again, but if possible, I probable just wish to stay on clinical. not back to office not dealing with paper, but is patient.