In January 2023 I began my career as a registered adult nurse. My first staff nurse position was on a 53-bed acute medical unit – a busy patient environment with fast-paced working. I had the opportunity to develop my nursing fundamentals further by consolidating my learning of the management of acute illnesses and long-term conditions. Throughout my time on the acute medical unit, I used and expanded my skillset, including building competence and confidence in completing A to E clinical assessment and how this would enable me as a clinician to detect a deteriorating patient, and then how I escalated that information and assessment to the appropriate clinician to support high quality patient care.