Nursing Milestones: Career Firsts We Never Forget

From The Floor

Nursing Milestones: Career Firsts We Never Forget

From the Pinning Ceremony to Becoming an Activist

By Genevieve M. Clavreul, RN, Ph.D.
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There are many milestones in our lives, some personal, some professional. Sometimes we mark them with pomp and circumstance, and sometimes with a shudder of dread. But at the end of the day we often take away lessons from these experiences that shape our lives and careers in ways nothing else can.

The Pinning Ceremony

The pinning ceremony is something unique to nursing, and recently I had the privilege of being the keynote speaker at the school where I received my licensed practical nursing education and training. As I looked at the young — and not so young — faces of the LPN graduates, I thought to myself that this class of nurses reminded me so much of my own.

The pin received is small and round with the name of the nursing school emblazoned on it. It represents the culmination of a student’s journey into the professional world of nursing, and nurses often wear their pin well past the start of their career; others keep them in a safe place at home as a memento of that special moment. Do you know where your pin is? I do.

Your First Assignment

It was 1966, and I can remember that patient as though it were yesterday. It was my first day in med-surg and I was assigned to a Topeka police officer who was being admitted post-op. He was suffering from multiple stab wounds after answering a call  about a possible burglary in progress. His assailant was a 12-year-old who got the “drop” on this veteran because the officer saw a child and not a possible armed suspect standing before him.

Though his physical wounds would heal and were well within my skill set, his psychological scars required a great deal of compassion and finesse that this LPN had not received during her schooling. It did, however, spark a desire in me to learn more about psychology and its role in nursing, which later translated into a bachelor's degree in psychology.

Your first assignment can be the most pedestrian, giving you an opportunity to put your training and education into practice without the fear or pressure of making a dreaded mistake. Or it can present itself as a challenge in battlefield-like conditions, pushing you to integrate all the knowledge imparted to you by all your nursing instructors, preceptors, mentors and so forth. Either way, it shows that you can call forth what you’ve learned from the recesses of your mind when they are most needed. You are a NURSE!

The First Patient Who Dies on Your Shift

Whether we like to acknowledge it or not, eventually there will be a patient that will die during one of our shifts. He or she will die not due to medical or nursing error, or lack of appropriate care, but because it’s their time to leave this Earthly plain. This death can affect a nurse, both new and experienced, in different ways, but ultimately how the nurse is supported through this grief process is key to whether or not the nurse will continue their career or choose a less risky nursing specialty.

Some deaths stay with us, others haunt us for only a little while, and still others slip away from memory. I can’t recall the first time I “lost” a patient, but I still remember with crystal clarity the young patient we lost not because we nurses failed him, but because his loving family failed to follow through on getting their son a diphtheria booster.

This sad event occurred during the diphtheria outbreak in San Antonio, Texas, in the early 1970s. When the first wave of critically ill children were admitted to our pediatric unit, the doctors and nurses hardly knew how to treat this mysterious illness. I recognized the symptoms of diphtheria since people in my native France still contracted and died from this dreaded scourge. Once we confirmed that we were indeed confronted with a diphtheria outbreak, our team of doctors and nurses worked round the clock to stabilize, treat and cure our young charges.

One of our first successes was a preteen boy who was admitted to our unit after his family made the decision to cross the border to seek medical care for him. We successfully treated him and he was able to return home to Mexico, but not before we advised his parents that he would need to receive a booster to help prevent a recurrence. A year later he was readmitted to our unit, once again diagnosed with diphtheria. His parents had forgotten to get him his booster shot, and this time there was little we could do.

Our team of nurses had all been there when this young boy had walked out of our hospital, albeit weak from his recent illness but nonetheless healthy once again. Now we all grieved at our failure to save this boy again, frustrated that the young life we had saved just the year before had been snatched from us by the same illness that he had survived.

We cried our tears, shared our grief and provided each other with the support that helped us muddle through what would become the next wave of a mini-diphtheria epidemic caused by the failure of many patients to receive a booster.         What could have been an experience that left me despondent and disillusioned about my career choice became a clarion call for me to pursue pediatric intensive care nursing and additional education so I could help educate patients and their families on the need to complete their treatment course and protocols.

When You Become an Activist

Whether you want to acknowledge it or not, every nurse is an activist in his or her own right. It begins when we're licensed and we take an oath to be our patient’s advocate. Some nurses may never experience more “activism” than this; but others will experience a seminal moment when they will step beyond their role of  “just” a patient advocate and become an advocate for their profession and patients on a grander scale.

This road to activism often begins when a nurse joins his or her first nursing association or organization. As a member they will become exposed to such things as policy development and lobbying, and once bitten by the activism bug, a nurse may find him- or herself attending a board of registered nursing meeting, testifying before a legislative body, writing letters to editors and elected officials, and occasionally coming together in numbers that would make Florence Nightingale and many of our nursing founders proud.     

These milestones are as significant to a nurse’s career as the  curriculum itself. They mark the nurse’s path as she or he moves from being the novice nurse to the experienced nurse to the sage nurse. They also mark moments when a nurse can either turn his or her back on their career or soldier on in triumph, learning from the experience and integrating those lessons into their “nursing” being. From time to time we should look back on our nursing career and try to identify those milestones that helped shape it and our character, for without them we would surely be lesser individuals.   

Geneviève M. Clavreul RN, Ph.D., is a health care management consultant who has experience as a director of nursing and as a lecturer of hospital and nursing management.

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