Challenges I Faced As A Newly Registered Orthopaedic Nurse

“Despite the challenges in my early months as an Orthopaedic Nurse, I truly believe this role has given me lots of inner strength and confidence…”

Orthopaedic Nurse Jonathan talks openly about the challenges he faced as a Newly Registered Nurse, from the impact of staff shortages to developing confidence in your new role.

Working as a Newly Registered Orthopaedic Nurse means there are many pressures that come with the role, most of which are out of your control. Universities do their best to prepare you for life as a nurse but can’t explore all possible settings you could take your first nursing job role.

Lack of staffing and lack of training all impacted my first few months of being an Orthopaedic Nurse. Read on to see how it affected me personally and what you may be able to implement to prevent it from happening to you.

Pressures From Staff Shortages

When I started my first nursing job, there were around 35,000 open vacancies for nurses in the UK; staff were over stretched everywhere in the country, in all hospitals and all wards. I had a slight advantage compared to some Newly Qualified Nurses as I had completed placements in both year one and year three of my nursing journey, so I had a good idea of how the ward worked daily.

I remember being very nervous on my first day, but after a couple of hours I settled in quite easily and really enjoyed it. One of the first challenges I can remember was turning up to work a shift and being one of four members of staff (two nurses and two healthcare assistants). The staffing levels should be at least six members of staff, so I knew the shift would be tough.

I was responsible for looking after eleven patients along with a healthcare assistant, also knowing that there were some tasks I was unable to complete as I had not done the training/competencies. I survived the shift and looking back that really helped shape me as a nurse, as well as helping me to feel calm and in control in acute/emergency situations.

The pressures of a lack of staff impacted me quite a bit, as it meant my skills training was cancelled because I was required to cover staff shortages on the ward. That then put pressure on my colleagues as they had to manage tasks I was not qualified and competent for.

Issues With Training

There are skills which you need to learn by attending courses and in house training. Orthopaedic wards administer intravenous medications on a regular basis but unfortunately this was not part of university curriculum when I was a nursing student.

My first two course dates were cancelled due to staff shortages, meaning that it took me six months to do my training and get my competencies completed. I felt guilty about asking other nursing staff to do this for me, but now being qualified for almost 5 years find myself volunteering on a regular basis to help with others who to need get their competencies completed or if they are after some advice.

Orthopaedics also uses many pumps/devices etc to help with patient’s pain level which often includes epidurals and patient controlled analgesia, for example. This training was delivered in house by the Trust I worked for. Due to limited number of specialist pain nurses, the course was not very regular, and places were also limited.

Again, it took me around five months to complete the training and get my competencies completed. I have since completed some additional training around pain management and would certainly consider a specialist role in this field in the future.

Despite the challenges in my early months as an Orthopaedic Nurse, I truly believe this role has given me lots of inner strength and confidence...

Confidence And Skills

The previous two challenges I have discussed are more around environmental and structure problems within the NHS and its Trusts. The challenges involved now are the hardest as they really test your confidence and skills you have learned through your nursing journey as student to Newly Qualified Nurse.

Orthopaedics naturally involves lots of surgery and this presents many challenges. These can present as acute emergencies in which you need to have the confidence to decide for the benefit of a patient. Understanding how to spot compartment syndrome in patient often using colour, sensation, and movement (CSM) as indicators to identify is essential, as is knowing the possible early signs of sepsis and your role in implanting the Sepsis 6 bundle.

Working With Recovery Departments

The biggest challenge for me personally was going down to recovery to collect a patient who needs to return to the ward. Recovery departments utilise all assets they have at their disposal, which includes highly skilled nurses, consultants, anaesthetists, and most medications you could need.

The Recovery Nurse may deem the patient fit to return to the ward, but you must assess whether the staff levels and skill mix on the ward can care for the patient appropriately if you take them back. I remember the first time I refused to take the patient back to the ward was intimidating because you have lots of senior people around telling you there is no reason for not returning them to the ward, but you must be the advocate for the patient even when this happens.

Despite the various challenges I have spoken about in my early months as an Orthopaedic Nurse, looking back, I truly believe this role has given me lots of inner strength and confidence to develop into the type of nurse I am proud to be and hope to continue to be.

Thank you for reading.