Five Personal Survival Tips For Newly Qualified Critical Care Nurses In Nigeria – My Humble Five
The first point here, maybe not a tip, it’s a secret, and it goes thus:
You will find it easier to pass the NCLEX-RN [National Council Licensure Examination] examinations if you have a strong background in Critical Care Nursing because the questions are Critical Care Nursing Questions, designed to make you think, and Critical Care Nursing is an aspect of Nursing where you will be doing a lot of critical clinical thinking (I assure you this).
The NCLEX exams are designed to be tough on your thinking faculties as a registered nurse. It does not bring to you business as usual. You have got to sweat it out, squeeze your gray matter, chew some pens, and make adrenaline pump into your brains.
More on this line of thought in another blog post.
Now, let’s dive into what I have for you.
Lately, I have been interacting with newly qualified Critical Care Nurses here in my country, Nigeria, and I have observed a lot of things. This article captures some of my thoughts [not all of it] about what I think, and the advice that I have dished out to the few colleagues that I have interacted with.
I know you will find a lot of good stuff in this piece.
These tips are personal. I have not seen them anywhere, they are mine – personal ones, and custom made for Critical Care Nurses in Nigeria. These are not just tips, in between the lines, I have included some special advice for my Critical Care brothers & sisters. And as usual, I have read a lot on this topic, and I am not going to include any research jargons [I never actually do much of that In my articles], I am keeping the grammar & vocabulary simple & easy to comprehend, just pure sincere gist here.
WHAT YOU ARE WORTH?
In Nigeria, Critical Care Nurses are among the most highly paid nursing professionals – especially in the private healthcare sector.
You must know what you are worth.
You are now a specialist, giving out specialist care, so your worth should be special.
Before you take up any job, always try to find out from your senior colleagues what the remuneration looks like. Hospitals will pay you according to your years of experience, qualifications & exposures.
And hospitals in Nigeria better start respecting Registered Nurses, before they have a workforce of Nurses who are all dreaming of leaving the country (if that’s not already the situation).
Know your worth. If you want to know how much you should be paid as a newly qualified Critical Care Nurse in Nigeria, send me a mail, and I will give you some tips.
A NEW CLINICAL ENVIRONMENT
The Critical Care clinical environment is very different from the regular clinical environment that you are used to. You have more gadgets & pieces of medical equipment to work with. More autonomy is given to you (more on this later). This means that you have got to adjust.
You don’t just run up & down looking for a Doctor when your patient is becoming hypotensive. Before you run to the market and back, maybe the poor patient must have dived deeper down the tunnel of shock. Whose fault will that be? Yours? Or…?
Though a new clinical environment, the nursing theories that you know have not changed a bit. The principles that have guided your practice, are still the same principles that will guide you, the only tiny difference may be that you will be required to use them more often.
The theory of safety, confidentiality, utilizing the environment to promote wellbeing, cultural theories, etc. You will be making use of all of them in Critical Care.
It is a new clinical environment where you are required to make use of critical thinking. Which will be applied more to the physiology of critically ill patients. Your knowledge of human physiology must be extremely sound, because, in Critical Care, one of our most important clinical duty is to support failing human physiological processes – failures everywhere.
CRITICALLY ILL PATIENTS
From my own perspective, I like to see Critical Care beyond the Intensive Care Unit or Coronary Care Unit (I don’t know what you think). I see Emergency Room Nurses as Critical Care Nurses, Operating Room Nurses as Critical Care Nurses. Critical Care is not just limited to the Intensive Care Unit or Coronary Care Unit.
Where Nurses are given more autonomy and nursing care is intensive, should be called critical care.
But in this article, the theme will be built more around the Intensive Care/Critical Care Unit & Coronary Care Unit (Cardiac High Dependency Units).
Patients in Critical Care are extremely sick. Many of them might not make it out alive, it’s a 50-50 bargain you know. A slight mistake will cost life to cease, and you, the Critical Care Nurse will be held responsible.
You know, in Critical Care, you have every right to question the judgment of even a consultant, if you know what you are doing. It is your primary duty to protect that patient, and you should do all in your power to protect them, that is why becoming the best is a mark that shows that you have the best interest of your patient at heart.
In Critical Care, Kidneys have stopped working, hearts are failing, lungs have collapsed, brains are shutting down, intestines have stopped moving, livers are tired, phew, it is a cocktail of organ/physiological failures here and there. You may be too busy trying to repair the lungs, and your attention has been taken away from the kidneys that have shut down for two hours, and then you have to return to trying to salvage the kidneys, and then the brain starts to sleep – Critical, I must tell you!
A HIGHER DEGREE OF AUTONOMY
In Critical Care, time is tissue. Critical Care Nurses are tasked with the responsibilities of thinking critically.
You are with the patient through every breath. In Nigeria, we do not have enough Critical Care Physicians or Intensivists, instead, we have Anaesthetists taking the place of Critical Care Physicians (and not many of them have the required experience needed to man an ICU – talking in terms of INTENSIVE CARE here).
This lack places the Critical Care Nurse in a position where they have to take some urgent clinical decisions themselves within their own clinical responsibilities, training/experience & the policies of the healthcare institutions, herein lies one of the reasons why Critical Care Nurses are expected to think critically.
Intensive/Critical Care is 95% Nursing & 5% Medicine. Do you agree with me? Yes, you should. I am not undermining the role of the Doctors here, what I am saying is that the role of the Critical Care Nurse is more pronounced in Critical Care. They are the ones, who administer management & coordinate care and they have the right to question any form of method or prescription that they think is not in alignment.
TO STAY RELEVANT, KEEP LEARNING
You must keep learning to stay relevant in Critical Care. The moment you decide to stop learning, then you begin to see that your value starts to decrease. This is what stands you out, your ability to keep learning new things, and mastering the older concepts.
Go over a procedure again and again. Master a medication, read about it again and again. Study pathophysiologies more, you need to, the usefulness of knowing these things can not be neglected, never.
You have got to be the best that there is because you desperately want to give your patient the best care available.
You have got to be tough on your brain. Stock it with stuff. You don’t have to get extra serious because you have an exam to write (many of us suffer from this syndrome, errm, I am also guilty). It doesn’t have to be like that. If you are used to the habit of learning consistently, you will find out that studying for exams will be way easier for you.
How long have you been in Critical Care? Have you stopped learning? Or are you are an ardent student in the school of learning?
CRITICAL CARE NURSING IS NUMBER ONE IN NIGERIA
There was a time when Nurse Anaesthetists were the ones who topped the list of the most interesting, adventure-filled & maybe, well-paid nurses in Nigeria, but today, the story is different, it is changing.
Anesthesia Nurses have been relegated to the background in many Government controlled healthcare institutions in Nigeria today. Why? If you may ask. Well…
As usual, the Doctors are taking over again. There was a time in the history of anesthesia in Nigeria, that Nurses were the ones who wielded the scepter of command, then gradually, these guys [I mean our friends, the doctors] observed the trend and started training more Doctors to fill the so-called perceived void. And today, what do we have? We have Nurses trained in Anaesthesia care, relegated to the recovery rooms. The only few ones who may still be practicing what they know are those in areas where there are no doctors trained in anesthesia care – maybe rural areas, and in some general hospitals that still make use of Nurses trained in anesthesia care.
But that’s different for Critical Care Nurses (In this case, I mean Nurses trained to give care in traditional ICUs, CCU’s & other High Dependency Units). Critical Care has always been designed to run on the shoulders of Nurses. And the pandemic exposed us a whole lot.
I am not trying to discourage anyone from studying what they love, I am only exposing you to my own thoughts. I have some authority to speak on matters like this one (winks). Critical Care Nursing could be HARD! Because you will be taking care of people who can’t do anything for themselves.
We have heard of people who abandoned ship when they experienced first hand the rigors of Critical Care Nursing. No Doctor will be around to save you, and give you a lollipop to suck when you are stuck! You have got to be on your toes at all times.
And let me chip this thought in – Doctors, respect Critical Care Nurses a whole lot. They see them as an entirely different breed of Nurses because they are tough. Yes, they are.
In Nigeria today, if you are a Critical Care Nurse, I can tell you that you are sought for. Hospitals with Critical Care Units are looking for you. They need you, and they will pay you more than what they pay the average Nurse, especially private hospitals in big cities, like Lagos state.
There are still a whole lot of stuff that I would love to let you know, but I do not want to make this article too long (It’s already too long). In another blog post, I will continue. I promise, just stay connected with us.
One Problem That I Have – Listen
Nurses should be given the chance to do what they should do. There are a lot of duties that Registered Nurses should not be doing. What is your business with making beds in the hospital? It’s not scientific, and it is a big time waster. We need to be occupied with clinical activities that are primarily important to the patient. Let other unskilled personnel take charge of some of these unscientific roles.
It’s not your duty to run errands in the hospital. It’s time wasting. Some very big private hospitals in Nigeria have not been able to imbibe these advance cultures into their weak systems that are more concerned about making money, it’s sad and pathetic.
I can make a dictionary list of these activities that Registered Nurses should not be found getting involved in.
Well, this was just by the way. Don’t forget to share this article with your colleagues.
What are your thoughts? I know you don’t agree with all that I have said, well, let’s have your own perspective. Drop a comment, I’d love to know what your think.
“a dyadic, long-term and reciprocal process
between senior experienced nurse and a junior nurse and or
a nursing student, facilitating knowledge and skill acquisition
while providing psychosocial and emotional support with the
aims of fostering both personal and professional development
for effective role change into the nursing profession” – Shaikh Abdul Matin, Deparment of Internal Medicine, Singapore General Hospital, Singapore
“We are on the front lines of patient care and medical technology, which gives us the prime advantage when it comes to new ideas.” – Alice Benjamin.
I wrote a little introductory April note for you. I wrapped some tiny inspirational gifts in it.