Nursing: Looking back...

My career in nursing came an end in December 2020 and on this page I look back over the last 36 years that I have spent working in a public hospital as a Registered Nurse, with 32 years of that time spent in the strangest of worlds, the world of Intensive Care. I am attempting to not only look back at this time but also to see what I have to take away from such a career into the (hopefully) long years of retirement. It is a page that I have been writing for several months now, mostly because I have a certain dislike for looking back when my goal in retirement has always been to look forward. Nevertheless I have completed this page now and I sincerely hope that it ties off some of my past for me and perhaps also is useful page for other nurses who are coming to the end of their careers...

A nursing timeline...

I was not entirely sure how to structure this examination of a long nursing career but when I was interviewed in my workplace about 'nursing in the old days' I could see a few naturally occurring divisions in my career that might help you, Gentle Reader, in making sense of this long page. And, dare I say it, perhaps this division will also help me to see the structure in my own nursing career; a career that was neither particularly well organised nor particularly well structured!

Training years...

My training to become a Registered Nurse began back in 1984 when in Australia the last groups of nurses were being put through Hospital based training. Subsequent to this of course the training of Registered Nurses moved to University degree programs. But for me, the somewhat callow young man of the times, this was an opportunity to be paid for three years and I put no more thought than that into this decision! The training back then consisted of periods of lectures in a school type setting on the grounds of the Hospital interspersed with substantial periods of hands on 'on the job' training. Working in the Hospital we were given somewhat desultory supervision while providing basic and then increasingly more complex nursing care for patients. The entire training took three years and at the end there was a State exam to be passed with various practical skills asssessed in the Hospital before this final exam was attempted.

I have often heard people claim that the training of Registered Nurses should return to this system but as one who went through this training I would disagree. It was an entrenched system that reeked of military training with power held by some pretty scary women who did not tolerate questioning and did not tolerate change; believe me when I assure you that it was long past time for change in that system! I went through the whole system and came out the other end well qualified to be a Registered Nurse but it was a bruising and many times unsympathetic system that was ready for the major changes coming.

As this section of the page is not meant to be an encyclodaedic account of my early experiences as a very, very junior nurse I have chosen instead to highlight about half a dozen or more experiences from that time that still live in my mind. I will add to these memories as they come back to me over time:

I have left out from these bullet points my darkest memory from those early years, a memory of a baby who died in the ED; this was a truly traumatic incident for me and after all of these long years I still have unresolved feelings about that baby and that evening shift in the ED. Perhaps one day I will include this story but not right now...

And so I completed my training, passed the required registration exam and thus became a Registered Nurse. I was completely unaware that this would be my career, my work, for the next couple of decades but then in those days I did not look ahead too far or think about anything too deeply. I easily found a job in another Hospital and after the obligatory year in the trenches there I found my way yet again to the Intensive Care Unit.

Intensive Care, the long years...

Gentle Reader, I then spent 25 long years working 'on the floor' in the Intensive Care Unit and this is a course that I would strongly advise against for anybody reading this page! It was an extremely important time for me as an Intensive Care nurse as this 25 years is where I slowly and painfully assembled my ICU skills. I learnt to care for patients undergoing conventional ventilation, HFOV (it was a bit thing in its time Gentle Reader!), iNO, dialysis in all of its myriad forms, SB Tubes (also big in their time), Pulmonary Artery Catheters and all of the assemblage of ICU technology. But 25 years is too much for even the most level headed ICU nurse and I now know that the work for a bed side nurse in the ICU will eventually consume anybody that stays for too long.

And in this 25 years on the floor I have a few memories that still remain as high points in my career despite the long passage of time that separates me from from most of these memories. I place them here, in no particular order, and I suspect I will add to these memories over time as I attempt to sort out my thoughts and memories:

Doubtless there will be more memories to place on this list as I look back over my long career 'on the floor' but here at least is a starting point for my recollections. I enjoyed it all hugely and for the most part I lived up to all of the challenges thrown my way. I met some incredible nurses and was part of a team that was as good as any Critical Care team in the world. But at the end of this 25 years I could tell that my time as a 'hands on' nurse was coming to an end. I was becoming angry, a little bitter even, and I could see small mistakes creeping into my work particularly during and following night shifts. By good fortune a change then came my way...

Education......

After some life changing experiences in a Yoga ashram I finally looked up from a quarter of a century working on 'the floor' in ICU to seek other things. I applied for a position as Clinical Nurse Educator (CNE) in the Intensive Care Unit and I was not only accepted in this position but I worked as a part of the Education team for the next 8 years until my eventual retirement at the end of 2020. In many ways for me it represented the pinnacle of my career in Critical Care and I remember this time with enormous affection, in part for the many obstacles surmounted by myself and others in the Education team and in part for the many fine Critical Care nurses the Education team produced over that eight year period.

I have many, many memories of this time but I can perhaps isolate a few memories and achievements from this time, which I give below, again in no particular order:

And then on Friday December 4th I chose to leave my nursing life behind and start a new life in retirement. It is not often in life that you will get an opportunity to start again and it is my plan to grasp this opportunity firmly with both hands. To not only build a new life but to also build a life that has grown out of the lessons that I have learned in the old one. And writing this page and editing it again and again over the coming years will help me to both clarify and learn from these lessons. And still I am working at the meaning of my long career in ICU, trying to find out if I was a good nurse and was useful and kind to patients and their families as well as colleagues that I have worked with over the years; trying to work out if during all of this time I was a good man, if I have made a difference?