Over the past couple weeks, I have had a whirlwind of experiences – both familiar and new – as I have started my job as a critical care nurse in the Texas Medical Center (TMC). In fact, it is a little difficult for me to believe that two whole weeks have even passed since, as one can imagine, the process of orienting new nurses to the workplace is a gradual affair. This even more so is the case for newly graduated nurses such as myself; although I am indeed fully licensed as a Registered Nurse, most reputable hospitals put greenhorn nurses through a training period called a “Graduate Nurse (GN) Residency”.
GN residencies can vary widely from hospital to hospital. The general idea behind offering such a program at all is to help acclimate new nursing school graduates to the practical nursing field by putting them through in-house classes to reinforce competency along with supervised training on the hospital floor. As one can imagine, this is a rather expensive undertaking for the hospital, but one that serves as an investment to ensure better patient outcomes to maintain the institution’s reputation. For this reason, many hospitals, especially community hospitals based in suburban areas, offer orientation periods that span six weeks or fewer. Most major hospitals in the Texas Medical Center however find themselves in the global spotlight and hold themselves to a higher standard; along with some of the other famous faces of the renowned medical metropolis, my hospital’s orientation period spans sixteen weeks.
I should clarify – at my institution, training actually lasts twelve weeks, but ICU nurses such as myself have an additional four weeks of guided orientation. I find the sixteen-week duration significant however as it is the same length as a standard college semester – an apt transition from school life to the working life.
Thus, I must say that the first two weeks of the residency period have brought with them an amusing amalgam of conducts. For example, the very first day of New Employee Orientation (NEO) had all employees, from health care workers to the janitorial staff, meet at a professional building downtown where documents were signed, Metro commuter passes were issued, and employee badges were created before being shown formal presentations detailing the hospital’s core values. Especially due to the fact that their badge photos were being taken, everyone in attendance was dressed in prim professional attire – exactly how one would imagine “employees” to be dressed. The next day however, when new nurse hires were singled out to meet at the hospital’s auditorium for further specialized presentations, they were merely dressed in a business casual attire. On the third day of NEO, the new grads were further separated from the rest of the hires into a classroom that seemingly snapped most of them back into “student” mode, along with disheveled appearances that are characteristic of college students.
It was a curious sight to see – at their core, everyone in the classroom was there as hospital employees. Yet, despite a general desire to be professional when necessary, the group’s obvious familiarity with student life would often shine through and result in classroom antics no different from those found in the traditional classroom. Everyone in the room was about my age – twenty-five – and straddled the line between “college student” and “self-sufficient adult”.
I found this theme to be closely reflected in my day-to-day experiences as a new hire. Every day I would arrive at the Smith Lands parking lot in the medical center, an enormous lot shared exclusively by TMC employees, and every day I would dash to the Metro rail alongside numerous employees to quickly squeeze into its cars before the doors would shut. The experience is not unlike riding the rail line in Persona 5, in which one is usually forced to stand while pressed up against the other passengers – everyone’s shifts are starting at the same time, after all. Although chaotic, there is a certain peace in starting the day in this manner; the trip feels less like a business commute and more like the bustle of students from various schools scurrying to class. Indeed, I have met a lot of former classmates onboard despite the fact that they are working at different hospitals from myself.
The train stops in front of the gigantic twin towers denoting my hospital’s clinical offices. At their base, an array of coffee shops, eateries, and drug stores stand unimposingly before the elevators leading to the classrooms designated for orientees. The complex is vast and, despite being a full-fledged hospital, there is also a library, a museum, and a grand atrium onsite; the configuration gives the faintest flicker of familiarity as a place not wholly dissimilar to a college campus.
Even as I get to class, antics are abound as I enter to hear the normally soft-spoken John questioning the feisty red-headed Mallory whether she switched seats away from him without permission, to which she coolly responds, “maybe, maybe not.” The rest is business as usual: lectures, activities and quizzes – failure results in remediation. By the second day of class, we had initiated a GroupMe conversation amongst ourselves to better stay in touch outside of work. By the third day of class, a few of us began to spend out lunch periods with one another, exploring various facilities in the hospital complex.
Then, just like that, the first week was over. Somehow they had tricked us into working for one week while disguising it as school.
By the time the next week started, our group had become far more convivial with one another as we once again repeated the routine that we had established the week prior. Classwork remained classwork and my endurance for the long lectures admittedly waned with each consecutive day. My classmate seated next to me, Casey, had one day taken note of my glazed expression in class and was prompted to ask if I was feeling well… to whom I reassured that this was normal for me. Come to think of it, I never really was the model student in the classroom – even as class representative, my conduct would be rather unorthodox.
Nevertheless, I was far from the only one suffering through the dry lectures detailing how to use the fancy electronic medical record. At one point, the instructor prompted the class with a question along the lines of, “what should you do in the chart if you are unable to give your medication on time?” While most of the students dispensed the answer that she was looking for in unison, I distinctly heard Mallory nonchalantly answer, “you kill yourself” – clearly bored with the class. Yet, despite the dry nature of the mandatory classes, we were getting paid, which was a big improvement from our time as nursing students.
One needn’t have worried however since, with the majority of the hospital policies covered, the second week largely marked the end of our classroom sessions. From the third week onwards, the new hires would be sent to their respective units to train alongside their preceptors; classes thereafter would take place only once every couple weeks for the purposes of discussing unit experiences.
Still, the imagery was charming on our final classroom day. For the first time, we had all decided to eat lunch together in the atrium with Mallory helpfully giving directions to the meeting spot. The atrium itself was a large expanse towering multiple floors in height and with large windows stretching from the ceiling to the floor. For this reason, one surely would have laughed to see our group huddled around a tiny circular table, unable to find seating anywhere else. Instead of accommodating three individuals as intended, the table ended up fitting eight fledgling nurses who had squeezed themselves together to make sure nobody would be left eating elsewhere. And while the spirits at lunchtime were somewhat benumbed by the end of the afternoon lectures, it only took a small spark to bring them back –
We piled into the elevator on the fifteenth floor at the end of the day, ready to go home. The slowest elevator in the building was packed with teal scrubs – our entire group. As we stood there in silence, I muttered just loud enough for everyone to hear, “… time to see how many floors we’re going to disappoint today.” Understanding that I was referring to the fact that the elevator had the unfortunate tendency to stop at every floor on the way down and the fact that there was never any room for others to board it with our group taking up all of the space, the elevator car burst into laughter – not the polite sort that you might expect from coworkers who can’t wait to reach their floor, but the loud carrying laughter of boisterous students. It was as if that remark had uncorked the group’s collective decorum of maintaining the professional image of an “employee” and brought them back them to the absurdity that had taken place at lunchtime earlier in the day.
Two weeks in, I’ve been presented with a charming hybrid of school life and the life of a working employee in the professional field. A fitting transition for someone such as myself, I cannot wait to experience what is to come tomorrow when I finally begin to work full twelve-hour shifts on the unit with my coworkers.