First-day jitters


Thoughts crash in my mind, like a storm brewing in an endless sea of desolation fueled by anxiety and fear. It’s my first day on my own as a nurse—a day of reckoning. It’s a day I will remember for the rest of my life, one that I have been looking forward to with excitement and bewilderment. The anticipation leaves an unquenchable emptiness in the bottom of my stomach, causing my thoughts and emotions to take an uncharted journey through hopelessness and helplessness. Each minute of the shift is wrapped up in anticipation like a gift, waiting to be carefully unwrapped and enjoyed. The moments elicit questions not answered during orientation. I feel like a lone wave in the sea brewing into a storm.

I tried to rest on the eve of my first shift, but dreams of potential errors and mistakes kept me awake. As I tossed and turned, I forced my eyes closed, hoping the dreams would pass. Instead, my dreams became more realistic, and the line between fact and fiction slowly blurred until I was clocking-in and taking responsibility for the care of my patients—alone. I fumbled through simple tasks that were once routine, like putting on gloves and hanging I.V. fluids. I reached for a pair of gloves after washing my hands and inadvertently grabbed gloves two sizes too small while my hands were still wet. I felt like a clown, making balloon characters out of broken nitrile thumb pieces, knotted IV tubing, and embarrassment. I wore my nervous jitters like a brand on everything I did.

General Patton said, “Courage is fear hanging on a minute longer.” My first day was filled with fear and uncertainty. I wasn’t sure if I could tell the difference between a heart attack and the downtown Cleveland skyline on an ECG; my hands trembled as the rest of my body failed to keep up with my mind. It was exhilarating. It was an adrenaline-filled shift full of excitement that left me with a deeper sense of appreciation for my coworkers and their ability to effortlessly navigate through the chaos that engulfed me.They managed their patients and took the time to help me manage mine when I had questions. They started I.V.s, gave me support, and provided an invaluable resource for me to rely on.

The first day on my own was reminiscent of previous wars. Caught in the crossfire between confidence and failure, I slowly approached each objective. Unlike the soldiers on D Day who stormed Normandy beach and started the ally invasion during the WW II, I felt more like the sand that was trampled, walked on, and left to drift back into the sea of thoughts and confusion that originally brought me there. I was helpless and drowning and it was only the beginning. Time stood still as the hands of the clocked refused to move forward, leaving my overfilled jostling bladder as the only reminder that time was passing. Coffee and adrenaline fueled my every move as I took small steps forward.

In the end, my first day was not someone’s last day—and I made it too. I couldn’t have done it without the support from the ED staff and leadership. From the bottom of my heart I thank everyone who has made my first day possible. As tomorrow comes near, I look forward to more firsts: first traumas, first STEMIs (ST-elevation myocardial infarctions), and the first time I get to help a new nurse as they fumble through their first day. It has taken months of training and education to get to this point and it’s only the beginning. I look forward to growing and developing and am thankful to be surrounded by amazing doctors, nurses, and techs.


Eric Keller is an RN in the emergency department at Cleveland Clinic Akron General in Akron, Ohio.

The views and opinions expressed by Perspectives contributors are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. These are opinion pieces and are not peer reviewed.

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