“Change is hard at first, messy in the middle, and gorgeous at the end.” Robin Sharma

Two years ago I was a newly graduated nurse, waiting to take my state board exam and stressing about the big scary world of nursing. I had very little confidence in myself and was afraid of what the transition process might look like for me as a Registered Nurse. I had just wrapped up the most challenging clinical experience of my undergraduate education in the Medical Intensive Care Unit (MICU) at UVM Medical Center. The weeks I spent in the unit opened my eyes to a much bigger world of nursing than I had ever experienced before. Each shift was a challenge, a puzzle to figure out what was going on with the patient, and why. While the patient situations were all different, it made me think critically and examine the big picture like I had never done before. After two hundred and sixty-eight hours, I found a love for critical care that I had not anticipated.
The end of my clinical experience in the MICU was bittersweet. I was sad to be leaving the unit and the people I had come to know there. I was also happy because I now knew one thing I wanted: to work there one day as a nurse. I started my first RN job shortly after graduation in a cardiac step-down unit with the goal of establishing a strong foundation of experience to build on.

Fast forward a year and a half, and I started asking others what inpatient unit they thought I should apply for at UVM Medical Center. I already had some expectations for what I would hear… “Something similar to where you are now” or “Nothing that would be too big of a change”. Admittedly, I was scared, partly of change itself and partly because of the high expectations I had set for myself.
A conversation with one of my prior clinical instructors named Mary helped me to reconsider. Mary was one of those clinical instructors who could look at you all the way across the unit, read your body language, see the look in your eyes, and deduct exactly what was going on. The entire semester she taught me, she pushed me to be the nurse she knew I was capable of, despite the ways I held myself back. When I called her about applying to UVM Medical Center, she was excited. She asked about the experience I had and the kinds of things I had seen at my job. When I finished, she didn’t hesitate: “Apply to the MICU! You would be great there!”. I couldn’t believe it. The part of me that doubted my own capabilities wanted her to tell me to apply to one of the other floors and work up to that. It sounded more achievable, less threatening. I was quiet for a minute and then responded “Really? You really think I’m ready for that?”. Her response was simple: “I have no doubt”.
I asked coworkers at my job for letters of recommendation and was floored by the positive feedback and encouragement they had to say about me taking the next step in my career. I told myself that it was worth a shot and tried to keep my expectations low, but officially submitted the application. This was the job I had been telling myself I would work at “one day” and the thought of landing the job seemed out of reach from my reality. Weeks later, I had a video interview for the job and my nerves were at an all time high. By the time the interview was over, it was clear that they were interested in hiring me, and would begin working on the details to make it happen. Human Resources gave me a call shortly after, and it became official. I had gotten the job! I was going to be an ICU Nurse!
The night before my first ever clinical day on the floor in the MICU, I was pretty nervous. The reality was starting to set in, and my fixation with being a “perfect” nurse was threatening to destroy me. I got some sleep and went to work the next morning with the determination to not let my nerves get the best of me. I channeled the momentum I had and pushed forward.

A few weeks later, for the first time in my life, my patient lost a pulse and stopped breathing. A code was called, and people rushed into the room like a flood. Although I had participated in code situations before, this one felt different. Time seemed to stand still with each intervention and after nearly an hour of CPR, my patient was pronounced dead. There was not a dry eye in the room as we paused and offered a moment of silence for the person who had died. Despite our best efforts, someone far too young to leave this world was gone. I felt stunned and my heart hurt more than I realized was possible.
In the days that followed, I continued working and providing care to my patients and families until I realized a part of me had grown numb. I took a long weekend off, did some soul searching, and shed many tears. I agonized over my position. I didn’t know if I was good enough to be an ICU nurse or not. As the weekend came to a close, I had a conversation with my fiancé that made me think. He stared right into my eyes and asked me “Who is telling you that you can’t do this?”. I thought about it and stared back at him. “Well, I guess it’s just been me”. “Exactly!”, he said, “You are the only one saying that and you are the only person holding yourself back. If you want to do this, you have to change the way you view yourself and start looking at each shift for what you can learn from it!”.
It hit me that night that I was exactly where I aspired to be in my career. Additionally, I had the support from those around me and the only person keeping me from becoming an amazing ICU nurse was myself. I realized my mindset towards my new position was illogical and I knew that needed to change. I started journaling and actively developing a routine that would focus on the things I needed to restore myself mentally, physically, and emotionally between shifts. Day by day, I found more clarity and learned to be thankful for the hard moments that brought me to my knees. In those moments, I was forced to work through my self-doubt and develop better coping mechanisms that would inevitably help me in my career and my life.

This morning marked the end of my first week off of orientation. As I walked off the floor at the end of my shift, I felt a sense of pride. It wasn’t that my nights were flawless or that my assignments were easy enough for me to do everything perfectly. In fact, it was the opposite. I felt pride because I am finally learning that perfection is impossible. As I looked in the mirror at my tired face and messed up hair, I was able to strip away the self-criticism for a few moments and truly just see growth. With deep gratitude for the journey, I realized that the nurse I am now is someone my younger self would be proud of. The brand new nurse I was two years ago only dreamed of being where I now stand, and after seven years in healthcare, I worked hard to get here. By allowing myself to be human and simply do my absolute best to be a great nurse, I have grown to be better than I was when I started this journey in Critical Care six months ago. The more I have allowed myself to learn and grow freely, the more I have blossomed into a stronger, more capable nurse.
I can now say with pride that I am an ICU nurse, though I still have so much to learn. With all the changes in modern medicine, working in critical care means committing to a lifetime of learning. As I continue on this journey, I am grateful for the nurses, respiratory therapists, physicians, and nursing assistants I work with. In the short time I have worked here, they have been patient with me and gracious in the way they have supported me and answered all of my endless questions. I look forward to continuing to expand my knowledge and skills caring for some of the sickest patients in the state alongside some of the most incredible colleagues.











