I Am A Recovering Perfectionist

I am a recovering perfectionist. 

I spent the first twenty-five years of my life creating safe spaces for myself. Year by year, this attitude snowballed right under my nose.

Let me tell you, spending over two decades working at the same few things is a pretty darn good way to get good at them. I pursued what I was already successful in or what I already knew how to do, and I ignored anything that required new training, fumbling through a new skill-set, or letting loose and looking, what I felt like everyone else was thinking of as, foolish.

Without realizing it, I became great at avoiding things I knew I wasn't good at. It made me incredibly adverse to making mistakes; it made me especially avoidant of stumbling through things. I never lived by the motto "practice makes perfect." Instead, I lived by continuing to further master what I was already near-perfect at or by engaging in hobbies that required little-to-no skill.

And then, I graduated from my Masters program, left my safe bubble of academic success, and entered the nursing profession in a specialty unit. It has opened my eyes to just how deep my perfectionism has rooted itself and has forced my hand at beginning to overcome my perfectionist ways.

I'm reading The Checklist Manifesto by Atul Gawande, in which a 1995 study by Donchin et al. that found that the average ICU patient required 178 individual actions per day is discussed. It's been 24 years since this study, so the numbers are likely different nowadays, but these findings absolutely set the tone for the vast amount of tasks I perform as a PICU nurse. I see patients with new diagnoses and new medications every week, and I still perform new skills all of the time. Being in the PICU for my first nursing job has provided a steep learning curve.

There is, quite frankly, no world in which someone (new or not) in such a specialized and demanding unit can get everything right all of the time. 

There will be days where I need help from my neighbors every two hours. There will be mornings where the night nurse gently points out something I failed to mention during report the evening before. There will be rounds when the doctors look at me blankly as I just challenged the notion of "there's no such thing as a stupid question." This environment can sometimes be challenging on the ego, especially when you have deep-rooted perfectionist tendencies.

I "graduated" from my RN Residency two months ago, and the new RN residents are already here, making me no longer the least-experienced on the unit. In some ways, this has subconsciously made me feel like I should have it all figured out by now. I sit at the station without a preceptor just like the nurse next to me, I give and take report from experienced nurses, I speak independently with the interdisciplinary team just like any other nurse on the unit. Wearing the same "NURSE" badge as everyone else, I almost blend in amongst the women and men who have worked in the PICU for years. I recently had an MD Fellow who I interacted with very often as a recent orientee forget that I'm new, telling me he thought I'd worked on the unit "forever".

So I myself forget that I still have barely half a year of nursing experience under my belt. I forget that I am still experiencing "firsts" on every shift I show up to (first time independently assisting in a bedside insertion of an A-line, first time my patient gets extubated, first time my patient almost needs to be emergently intubated, first time having a patient on pressors, first time having a patient on a Ketamine or Propofol drip, first time traveling to CT). I forget that I don't need to be perfect, not now, not ever.

I drive to work some days with anxiety over what type of patient I will be assigned. I leave work some days wondering when I'll stop feeling like such an idiot all the time. 

This stress and defeat sometimes bleeds into my personal life, and it definitely does not set me up for mental success in my professional one.

Yes, there is a healthy dose of striving for excellence; yes, there is an appropriate level of fear that holds you accountable as a new nurse. But does anxiety have to be my norm? Because countless nurses have told me they sometimes cried in the bathroom throughout their first year as a nurse, does that mean I have to too? I have heard, "I didn't feel comfortable until a year or two in", so many times, I've accepted it as fact.

And I know that no amount of mindfulness or self-forgiveness will allow myself to be on par with more experienced nurses so early on in my career, but I owe it to myself to practice for my emotional wellbeing. I have to find a way to be easier on myself, or else I won't be putting my best foot forward for my patients, and I will run myself into the ground.

I want to feel empowered, I want to be excited to learn, I want to experience humility and confidence in my growth.

I suppose it starts with the way I talk to and about myself. 

"I can't believe I let my feeds run dry all day long" has to become, "I'm grateful for teammates who hung my breastmilk for me, and I will continue to work on noticing how much I have left throughout my shift."

"That attending thinks I am so stupid for asking that question" has to become, "I work at a teaching hospital, and I am learning everyday."

Last night, I jokingly told my roommate, "I don't even know how to give PRN Tylenol". 

When I say things like this to myself and to others, I tear myself down a little. Altering these statements are likely not the be-all and end-all to overcoming perfectionism at work, but it's a place to start.

I cannot control how much more learning I have ahead of me. Whether I like it or not, there will continue to be days that I don't perform as well as a more experienced nurse may have.

What I can control is the amount of grace I give myself. These early stages of my career are happening no matter what, and it's up to me to determine how I want to experience them. I am human, I am trying, I am growing, and I will be okay.