That afternoon in the Sewing Room I tried on my uniform and looked at myself in the long mirror. The Sewing Room – that dates me too, together with having 7 uniform dresses and being told that they would be laundered for me. All I had to do was drop the worn ones in at the Laundry and pick up a couple of fresh ones from the carousel marked ‘W’. They were actually my OWN dresses, with my name marked indelibly on the collar; not a ‘one or two sizes fit all’ set of scrubs. Anyway, looking at myself in that mirror was a sobering moment. Everyone around me was laughing and trying not to show how proud they were, calling each other ‘Nurse’, checking their new fob watches, showing off their scissors – ‘Look! I had my name engraved on them!’ – although engraved names didn’t stop scissors going missing on a regular basis. So much so that we soon discovered the little chains you could buy to pin your scissors to your pocket so they could be used without putting them down and losing them (infection control wasn’t such a hot topic, then). The person in the mirror looking back at me was a Nursing student, there was no getting away from it. Blue uniform, pens in pocket, fob watch and name badge all proclaimed it. Sensible shoes and folded cap reinforced it. That uniform labelled me as someone who was in the process of gaining specialist education. People would have expectations of me. Expectations of behaviour, of knowledge, of dexterity, of decision-making. Vulnerable people would have expectations of me; that I could, and would, help them. Probably for the first time in my life I knew what it was like to feel significant responsibility, and this was before I got anywhere near a patient. I was scared.
In this context, it was good to be scared. Ignorance, in a health care setting, is most definitely not bliss. Knowing that you are ignorant is a very welcome insight. Being conscious of limitations is what helps to keep nurses, and their patients, safe. Confidence can come later, when there is some knowledge and some practice experience; enough to know what to look for, how to respond to it, and how to recognise when you are out of your depth. This is what nursing education is really teaching. Trust your knowledge, and when you’re not sure, get help. All through my career I’ve seen people who have taken a while to develop that insight. A little knowledge creates self-confidence, but it’s not enough to recognise the more subtle signs and changes that need fast appraisal. This takes time, more education, and experience in the field. Sometimes I have seen those with the least knowledge talking with the most confidence about what they can do. Beware. That is much more frightening, and likely to be much more unsafe. If I was talking to nursing students now, I would say ‘Embrace your fear, acknowledge your ignorance. They are keeping you and others safe. Keep learning, more and deeper knowledge. Be mindful in your practice and notice when things go well and you are having a positive impact. The right sort of confidence will grow. It’s less about self-confidence, and more about confidence in your knowledge and skills.’
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