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It is my first day of work after graduating from nursing school.

I am currently in a remote island of Maldives. It is a small hospital consisting of 50 beds and almost 20 staffs working in 3 shifts. I came for morning duty and the nursing in-charge shown me maternal and surgical ward as my first work place. After taking handing over from the night shift staff I made everything ready for the ward round as the doctors will be here in no time. Just before the doctors arrival we got a patient in labour pain and my junior nurse took her to labour room.Till now I am not aware that the staff in maternal and surgical ward has to go in to labour room and conduct the delivery. Doctors came for rounds. Gynecologist wants me to check her antenatal patient’s FHS and postnatal patient’s abdominal girth.

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All the doctors are foreigners so I have to be there as a translator as there is no one else to do so. There is no Doppler to check FHS and I am not trained to check FHS and there is nobody else in the ward today. Doctors are very unhappy and they left the ward.

I checked all the patients charts for doctors order. Before writing the orders I have to check the remaining medications from the previous day. I was unable to locate the medicine cupboards.Unfortunately there is no one I can ask where it is. As it is my first day I do not know the inter-come phone numbers and the directory is not there in ward.

I cannot leave the ward full of antenatal, postnatal and post surgical patients. I am busy searching for medicine cupboard when I got another postnatal mother and baby transferred from labour room and one more LSCS patient and her baby from Operation Theater with more new orders to start.In between some of patient files are taken to doctor’s room for writing discharge summary and new orders. It again leads in delaying my work. Finally I found the medicine cupboard and prescriptions given to the patients who are already in the ward. New orders started for two patients from labour room and Operation Theater. I finished my duty around 4 pm which is supposed to finish by 3pm. I was not given any orientation of the ward and its routine and there is no one to supervise my work on the very first day.

Feelings I felt extremely miserable at the time. I was also embarrassed and upset by my own inability to full fill my duty in front of all the doctors and the patient. I felt afterwards that the nursing in-charge has not given me orientation of the ward and I was posted in a ward all alone in a field where I was not trained. I decided to speak to the nursing in-charge regarding this matter.

Evaluation At the time, I did not feel that the situation had been resolved. I felt low self confidence and inability to work up to my expectation. After speaking to a

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