I started the week off by going to an awesome pediatric nursing conference on Monday & Tuesday, called "Touching the Future of Children". It was fantastic, I learned so much and definitely feel like I became a better nurse because of it. Some of the topics were SIDS, Management of Stridor (taught by a great ENT who had cool pictures and videos as learning tools), Traumatic Brain Injury, Toxicology, Internet Predators & Cyber Bullying, Disaster Planning & Emergency Preparedness (taught by our very own Dr. Olympia), and my very favorite - I got two classes with Scott DeBoer. He's an AWESOME teacher - completely engaging and exciting. And he's extremely knowledgeable, having over twenty years experience in ER, PICU, and flight nursing. One of his classes was a "playtime" skills station with pig anatomy (airway, lungs, heart). Those of you who know me realize that doing anything with animal carcasses is NOT my cup of tea. But I gotta say, this was really cool. We got to practice intubating the pig's airway and then during our bagged ventilation we got to see the actual lungs rise before our very eyes. We also got to cric and trach as well, and played with ventilating each. Wicked cool.
Today I had my PALS (Pediatric Advanced Life Support) renewal class. Although many people I work with view these renewal classes as an annoyance, I actually really enjoy them. They really put in perspective how simple the algorithm of life-saving measures should be. Sometimes this can be easy to lose sight of when you're in a code situation with a dying person.
But the biggest accomplishment I had was on Wednesday, when I had my interview with the Clinical Ladder panel and later that day found out that I was promoted to Nurse Clinician IV on the clinical ladder. This is a huge deal for me and I feel so elated and proud. I've been working on this process for months and having it pay off is awesome. Basically, all staff nurses are a Nurse Clinician II and through a rigorous process can be promoted to Nurse Clinician III or Nurse Clinician IV. The process starts with submission of a portfolio which includes: letter of intent explaining why you are qualified for promotion on the clinical ladder, current curriculum vitae, two clinical narratives showcasing not only extraordinary nursing but how you specifically went above & beyond the call of duty and made a significant difference in a person's life with your clinical skills and critical thinking, letters of reference (I had four - one from a peer, one from a member of leadership, one from a physician, one from a nurse that I had precepted), commendations from your nursing file, and another document specifically addressing how you meet each domain criteria that the professional clinical ladder committee evaluates. Completing the portfolio alone was agonizing and took me forever. I wrote a total of FIVE narratives because I kept second-guessing whether the ones I had written were good enough. Then once you hand the portfolio in, the committee reviews it and decides if they even want to advance you to the next step. If so, the committee members come to your floor when you're not working and interview your peers to find out exactly what kind of person you are and what you're like to work with. They speak with your supervisors and managers. They can also audit your charts and review your file. They may even observe you working, unbeknownst to you at the time. After all of this comes the interview with the panel.
I had envisioned sitting in rusty chair in a darkened room in the middle of a bright spotlight and maybe a little bit of waterboarding. But it actually wasn't all that bad. We had some really good conversations about nursing and patient care and I felt really comfortable. Until the one lady asked me to extrapolate how I utilize each tier of the Magnet Pyramid in my every day nursing. I realize this is Greek if you're not a nurse. And guess what? It's still Greek even if you are a nurse, to most of us anyway. It's one of those things that we intrinsically use to guide our nursing care but don't actually think about:
Luckily I'm pretty good at coming up with random things on the spot that somehow sound really good. And they must have liked it because they delivered the good news of my promotion in a leadership meeting that I was in. I was so giddy that I was literally dancing in my chair and unable to focus on anything else for a good 20 minutes as I was admiring my shiny new Clinical Ladder pin.
Achieving Clinical Ladder IV doesn't make me a better nurse though. I may have helped save lives on more occasions than I can count, educated patients and families and how to live better, held the hand of a dying man and watched as the light dimmed from his big green eyes and his body finally became at peace, cried over the tiny frail body of an abused baby, supported patients and families at their scariest time and darkest hour, hugged a father on his knees whose daughter just died minutes before, helped deliver a baby, seen what a person looks like without skin, been sprayed with blood/urine/vomit/bone fragments/poop/brains, laughed and danced and rejoiced at the awesomeness that is human life. But we all do that as ER nurses. Maybe not each thing every day. But that is part of us and just what we do. Achieving Clinical Ladder IV gives me a little pat on the back for a job well done, but more than anything it's helped me examine who I am as a nurse and inspired me to try to live up to being the very best that I can be every day.
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