Finding my Voice Through the CCP

I was incredibly proud to become a Registered Nurse. And all these years later, I still am proud to have RN behind my name! I was the first in my family to become an RN which meant that I did not grow up hearing stories of the rewards and challenges of transitioning into the role. So, I learned on my own that the rewards are plentiful and although there are challenges, they can be managed. One of my early professional challenges was digging deep and finding my voice to advocate for what was in the best interest of the client, especially when they could not advocate for themselves. I think that this was partly because I grew up in a household where one parent avoided conflict at all costs, and the other would blow up on occasion and then move on and pretend nothing happened. So, I didn’t have good role modelling on how to address situations of potential conflict in a positive way and how to communicate effectively in terms of expectations or needs. I think it was also a challenge that I was so very new to the role and a little unsure of myself and my own clinical judgment. And everyone else seemed like an expert in their role, so it was a little intimidating to challenge them. As a student, I had the safety of a clinical instructor or preceptor to run things past and they would act as a buffer. But as a novice nurse, I needed to stand up tall and act on issues that impacted the patients I cared for. I recognized this as an area that I needed to work on and remember selecting it as one of my earliest CCP learning goals.

Once I knew what I wanted to work on, I committed to reading anything I could on productive conflict I could get my hands on. I looked for articles in professional journals or books, read chapters from books on business that highlighted communication and conflict resolution, and of course, re-read the RN practice standards and competencies and code of ethics to ensure that I fully understood what was being asked of me professionally. I worked with the librarian at our facility to see if they could find resources for me too. I made lists of key points and wrote out scripts so I could practice up. I identified ways in which improving my skillset would impact the patients I cared for and help me practice in ways that aligned with the standards, competencies, and code of ethics. I watched the way my manager and charge nurses on the unit handled things when questioning physicians’ orders for example. I observed these interactions to learn what seemed to work well, and what clearly did not. I spoke with my manager about my learning goals and asked if she could highlight resources or skills she found helpful as she was developing in this advocator role. She let me practice with her in preparation for when I would need to implement some of my learning. She was a great mentor for me. Back then, there was no access to podcasts and resources there are now, but if there had been, I would have found credible sources and accessed them.

On a Saturday evening in the middle of a snowstorm, I arrived for my shift and was assigned to care for someone who was very, very ill with what I believed to be postop complications. Following my initial assessment and a review of the chart, I feared that this patient would likely not survive if action was not taken soon. The nurse on shift before me realized that the patient was very ill as well and had placed calls to the physician. But their concerns were not acted on as the physician refused to come in. I mentally organized my talking points and placed the phone call and when the surgeon tried to tell me they would not come to assess the patient, I strongly advocated. I remember talking about the value of the patient’s life. And how his life, like all human life, mattered. He was a husband and father of 3, he was someone’s child and brother, he ran a local business, he contributed to the community, and he was now at his sickest and most vulnerable. I described all the clinical findings I had recorded during my assessment and asked the surgeon to come to assess his patient and to work with me on sorting out a plan of care as this was not the post-op journey that anyone would expect or should accept as normal. He and I needed to act together. I could tell he was angry with me, but he eventually agreed to come.

The patient needed to be life-flighted to a tertiary centre for emergency surgery to deal with the postop complications and although his recovery was long, he survived. Later, I was thanked by the surgeon for handling the situation professionally and for pressing him to come. And by the patient and his family. That was nice to hear, but what was valuable to me was that I had been able to successfully implement my CCP learning plan to truly make a difference, and at the same time, I had done the right thing professionally.

One of the things I have always embraced about CCP is that every year I get to direct my learning and evaluate the impact of that learning on the care that I give and in the nursing role I am in. I love the fact that when my roles changed, there was flexibility for me to change my plan so that it made sense. And that if I feel that I am not quite done learning something, I can carry it forward so I can finish up my learning in a satisfying way and just add on some new learning as well. It fuels my endless curiosity and guides my nursing journey!

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