Tuesday, 21 April 2020

Being a Newly Qualified Nurse

Now 17 months qualified as a paediatric nurse, I thought I'd take a look at what it means to be newly qualified, and how I don't feel like an 'experienced' nurse!

I think that's probably due to the fact that although I started my first job as a qualified nurse in November 2018, I've been in 3 different roles! I worked in PICU from November until May... and then got a new job quickly after moving back home (I remember I had an interview on 13th May and got offered the job that day), but it took just over two entire months to start working in A&E following that initial offer. So I started in A&E with 6 months experience behind me, although I'd technically been qualified 8 months. In addition to that, I never actually did a proper preceptorship - I brought it up in my A&E job but as I was 6 months qualified they didn't see me as 'newly qualified' anymore and so saw no reason for me to do it! At the time I accepted that as that, and thought that 6 months must have been the point that you stop being 'newly qualified' but reflecting now I think nurses should be classed as newly qualified for the first year of their careers, regardless of if they move trusts or not.

Because of that, I stopped seeing myself as newly qualified, but always wished to have the support and training that I felt I lacked, and a newly qualified is probably offered (or should be!). Whilst my role is different where I am now (and in fact the training in my current trust is really, really good), while working in my more clinical roles I always wished to have some sort of structured support and training in place. I wanted theoretical as well as practical learning, practice of how to care for children with chest drains in a safe simulated environment, I wanted a training day on how to look after a child who is about to get retrieved while in A&E. Instead, I think I've relied a lot on the training I had as a student (I got great training on one of my placements as a student on tracheostomy care and that's been a great foundation to this day) and I do self-directed learning at home, which has helped sometimes.

As a new starter in PICU I was supposed to have training days to teach me blood gases, intubation, pharmacology etc., but because I started in November instead of September when most of the other newly qualified starters, I had to wait until April to get all of that foundational training. I still had an 8 week supernumery period and had competencies to complete, but in some ways I think not having that theory knocked my confidence a bit, and by April I had already handed in my notice, albeit that was mostly because I needed to come back home to be with family & friends and wanted to be nearer to my boyfriend.

I remember whilst being very new in A&E there was a training day with a retrieval team coming up and I really wanted to go, but due to funding only 2 nurses were allowed to go, and because of my previous PICU experience it was decided someone else should go instead (despite the fact they had been in A&E a year). This isn't meant to be a dig at the A&E where I worked, but just a small moment in my catalogue of experiences where I wished to have the opportunity to have more training, and why when I'm job hunting in the NHS, it's so important for me to work somewhere that values developing and educating its nurses.

I only stayed in A&E for another 6 months and started my new job as a research nurse in January. I had long since stopped worrying about a preceptorship by then, and I've had some really good support in a great hospital and team. Although I'm Band 6 now, I feel like if I wanted to go clinical again I would have to be a Band 5 again, because I feel like there are a lot of skills I still need that I haven't developed in the clinical world, despite on paper being nearly 18 months qualified. On the other hand, I've learnt skills from going into this research role that I never would have by staying a Band 5 in A&E, and I'm so grateful for where I am right now.

I think it's clear how much I think having good education, training and support is important for newly qualified nurses, especially in demanding areas such as PICU and A&E. I can obviously only speak from my own experience, but I do worry about the newly qualified nurses who are qualifying during COVID-19, and even more so for the final years who are doing their extended final placements. Will they get the support they need? Will they get any supernumery time? Will they get good support, a good mentor, a solid preceptorship? I really hope so, because I think it's one of the most important things in regards to newly qualified nurses building their confidence, developing as nurses, and in retention of nursing staff.

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