March 6, 2010

This fecking self-assessment

I admit that I'm a damn good nurse.  I'm told it by many I work with, from techs to other nurses to doctors.   But I also hold myself to a high standard...somtimes, too high of a standard.  And that, I've also been told by many I work with, from techs to other nurses to doctors.  It is probably because of those high standards I hold myself to that while I admit I'm a damn good nurse, I'm also insecure about my performance.  It's hard to explain, but that's how I feel.

I hate self-assessments in that I honestly can't give myself the highest marks.  I'm still learning the ways of the psych world, I've made mistakes (though have owned up to every one), and given that I spend most of my time in a certain area (detox), my experience and skills are stronger in that area; areas I spend less time in, my experience is less strong due to lack of experience.  I'm good, but I'm not perfect.  So I filled out my self-assessment accordingly.

Other people tell me to just score myself highest marks for everything.  I tell them I can't as it would not be true.  One person said they did this for themselves, neverminding that they've committed several serious medication mistakes and was once written up by a patient for their behavior I didn't have anything to say to that...couldn't think of anything to say to that, actually.  In all fairness, it's not my place to judge whether their assessment is truly accurate as I'm not them nor their superiors...though I did admire their cojones for a fleeting moment.

So we'll see what happens.  I'm wondering if my self-assessment even matters at all, that they're just going to rate me however they want and what I think has no say in the matter. 

Now that I'm in the downhill side of the first year hill...I feel more seasoned.  I'm now precepting new staff, which is cool.   I'm putting my foot down on things when I feel they're inappropriate or if I feel that I'm being taken advantage of because I'm a new grad.  I'm not letting the fact that I'm a new grad stop me from giving input on programs and voicing my opinions.  And I now give great PPDs--it helps when you have to do 6 in two days.

There's always new things to learn and I'm always open to the lesson.  I learned a lot about the best medication administration times from the LPN I worked with last night.  Did you know Wellbutrin can keep you up at night?  I didn't...I do now, so I know to suggest to the doctor they may want to move the evening dose up earlier.  Or the lesson from the tech about the safest way to arouse a patient who's difficult to arouse:  gently rub their shoulder, then jump immediately back out of arm's reach?  I hadn't thought of that.  I can bring on the Voice of God whenever I have to (I had a lot of practice on the preschooler), but doing that plus banging the wall did nothing to get this patient awake.  But damned if I didn't brush his shoulder and he sprung up wide awake.

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