The other day, I had one of “those” shifts. I’ve mentioned before that I’m married to a nurse; this was one of those days when it’s a blessing. I didn’t have to explain my day. I didn’t have to break down what happened, who was there, what was the big deal, etc. I simply said, “One of THOSE shifts.” She nodded and hugged me. Nothing more. And that’s all I needed.
It got me thinking: How do you explain these types of days to the “non-nurse” or the “non-health care” person? I mean, these types of days are what define our careers. The makings of a good nurse are created during these shifts–you either sink or swim. And when I say sink, I mean something goes wrong. Something bad happens because you couldn’t “keep up.”
Now, I’m not saying I’m something great. Not at all. I’m simply pointing out, if I had been the type of nurse who is okay with just getting by, one of my patients would have been hurt.
I thought I’d try to break down what 15 minutes of my day was like:
Enter room 1 to begin assessment:
- Realize the room is a mess–layover from the chaos the previous shift endured
- Empty garbage cans since garbage is overflowing onto floor
-Interruption- PHONE RINGING *have to answer phone since all other staff members are busy and have their hands full*
Re-enter room 1:
- Try to resume assessment
- Realize patient is intubated and sedation drip is dry–my IV line is about to alarm
- Blood pressure is below parameters. Adjust vasopressor
-Interruption- CALL BELL RINGING. THEN A SECOND AND THIRD CALL BELL RING *have to answer one at a time*
I walk towards room 1 and realize I need my sedation medication that is completely out and alarming in the room. I double back…
Attempt to re-enter room 1:
- Coworker calling out for help
- Needs assistance with patient in room
Double back again to re-enter room 1:
-Interruption- Stopped by physician asking questions about my patient #2
Finished answering questions and discussing orders
Make another and re-enter room 1:
- Changed out sedation medication
- Titrate vasopressor medication
- Attempt to resume/begin assessment
-Interruption -…
And that was just 15 minutes of my day! I work in an ICU. I had two sick patients and got a third admission due to low staffing–things only got busier.
It’s the little things that eat up your day. But it’s also the little things that dictate my day and how efficiently I can perform my duties. We as nurses always have a plan of attack when we start our shift. The problem is, those plans never actually work out due to the chaos.
And my words still don’t grasp the pulse of the work environment. I actually had a family member of one of my patients ask me mid-afternoon, “Have you even sat down today?”
I actually had to think about it.
No. I didn’t sit down all day.
So, how does this compare to one of your crazy work days? Share your thoughts in the comments section below.
This article was republished with permission from SCRUBS Magazine.
One last comment. As a Nurse. Many times if you don’t buy it the Pts don’t get it. The economics in long term care has become that crazy.
I am an RN. Work the night shift. When on duty I am the only Nurse on duty for over 100 pts. The ratio is 2/3 psyche pts and 1/3 TBI pts. The story is self explanatory thereof.
Indeed I think every nurse can identify with your story. I did ED for years it is no different. There are versions and stories all around us. The fact is in those conditions we are not delivery care we are bouncing like ping pong balls of the floor, unfinished business. We think we have to be responsible for everything and we are do to a degress. But we are not alone – until we take a second to stop breath and realize the biggest thing that is happening; This is not a safe standard of care. So you throw water on the biggest fires and hope you can hold on and move forward. There is a big “but” here; until we start actually notifying charge nurses, the suprorvisors, adiminstrator on call, the managers, the nursing directors or the ceo and tell them the situation, starting is name rank serial #, location and explain your situation saying something like “we need help now, I am legally informing that we are delivering unsafe patient care right now and you need to send help or come assume assessment of the situation now.” And you fill out cause for concern form asap documenting timed &”prferably in quotes” if you can or a narrative explaination this and what the I said, this wase the response and action, short term outcomes and long term outcomes and then be an active part of the solutions, or it will not go away. Trackable data talks to management, enlightens them, gives them an opporuntiy to understand first hand and to assume their responsibility. Until then they know about it they can’t help. How they respond to that is driven by their perceptions and values and it says a great deal about the culture of the facility. Don’t take this lightly, however, or it will be ike the boy crying wolf and reinforce the asumptions of people like a certain senator in the news of late. The turth is many times the situations are due to staffing issues and you cannot deal with that in the heat of the experience. Do what can do for patients, document it, and access what is available and hold management accountable too. It’s a matter of patient safety. Thankyou for caring enough to share that. And you are not alone.
Sounds like ever day I step on the floor.
My wife and I are both Nurses and now our daughter is an RN in the ICU as well, she literally comes home needing to talk (unload) before anything else . She brings back so many memories of the challenges my wife and I faced while working in the ICU, and the fresh outlook we also possessed when we first started our careers, Much of what I read above is true but that knowledge and wisdom is paid for hundredfold with grief, pain and diminishing health until we realize that we have to take care of ourselves to be our best, Thank you Mary and spouse for those wise words “You can not be everything to everyone every minute of every day.” I am grateful my daughter has my wife and I to turn to, I send her articles frequently from Modern Nurse so that she is aware of those things that have existed before my wife and were RNs and continue still today in her career experience. It can be some comfort knowing that she is not alone in her observations, and experience both good and bad
We’ve got to quit blaming administration for ‘increasing the patient ratio’ when the Medicaid/Medicare system is what dictates reimbursement. They cut reimbursement, which means we all in turn get stuck doing more with less. It’s not your administrators, it’s your government, and it’s been happening gradually for the last decade. We need to ban together and make some noise in Washington DC, and quit blaming administration. That’s not going to change a thing. The blame doesn’t lie with them. It starts at the top of the ‘food chain’.
I’m a nurse for 30 Residents in a nursing and rehab center. Sometimes I have another nurse as ‘help’ so the load is shared. That makes an easy day for me! I have my med pass x3 down along with wound care treatments and the usual charting but throw in three doctors seeing their Residents and writing multiple orders, hospice visits and inquiries, answering the only phone for our hall and maybe an admission, time flies with no lunch, let alone breaks! I absolutely LOVE my Residents who in turn look forward to my care too. I truly love being a nurse!
good explaination!!! had many a days like that. I agree the small things can mess with your best layed plans. sometimes you just have to fly by the set of your pants! and hope for the best. Those are days you prioritize and perform crisis intervention all day. Until this article I felt like i was the only one going home feeling unfinished.
Thank-you
Reading all your post I can relate to all of them. I am married to someone in the healthcare field and when I get home I ask him to give me everything in 5 minuets and then will put it behind. Well, sometimes things are so hard that they are not worth repeating, but in my case I need to let it out. My manager is a bully, we work under staff and new nurses are running away. Sad part Is HR knows about and won’t do anything!!! Very sad. I often remind New nurses to take their brake, if a nurse faints during a shift …. she is not helping her patients, she is not helping management, and she is not helping me, because I am going to have to take care of her patients. I often tell them to follow the airlines philosophy “ you place the oxygen mask on yourself, then you help the other person next to you” sounds rough but stop for a minute and think about it.
After 35 years as an ER nurse, I left work one evening utterly exhausted, overworked and understaffed. I fell asleep at the wheel driving home…almost got kiled. I woke up in time to avoid the cement median. When I got home I promptly wrote out my resignation. No job is worth getting killed for.
I now teach in a nursing program. I am once again happy to be a nurse, with a slim chance of falling asleep at the wheel.
Yes, I think we all can relate as nurse’s at one time or the other. I have worked in the hospitals, nursing homes and for the past 20 years as a school nurse. Everyone seems to think school nursing is a easy job. But, they forget to realize that the school nurse is on call and on the front line all the time with anything that happens to students, staff and vistors. It’s just not handing out bandaides. A school nurse is the only medical person on site until EMS arrives ,which could take up to 15 minutes somedays. Not only taking care of emergencies but student are coming to school now with more health issues, and taking care of the severe handicap classroom needs are a challenge all in itself. So, most nurse’s can relate but when it really comes down to it we love what we do.
Health care depends on nurses. If working conditions do not improve the whole system is going to suffer. As for myself. I am going to retire
Another example of the results of putting too
Many tasks on the nurse so the hospital can
Make more money. I have had to cut back on hours after back surgery and a degenerating hip. But the
But the real frustration is the unrealistic
Expectations of the volume of work they
Think a nurse should be able to handle
I get tired of being sacrificed for corporate
Money.
Sounds like we have some management issues here. Nurses need to be accountable to their fellow nurses and not leave a mess.
Ahhhh. My every day. I work sixteen hour shifts six or seven days a week. I LOVE what I do. And I could not tell you the last time I remember being fully rested, however, I could not imagine NOT being a workaholic nurse. My significant other is retired military who now contracts in Afghanistan. We typically don’t talk work. We work hard while we contract and leave work at work when we are both home. If I need to talk about my day, he is receptive and listens, offers advice if needed. He reminds me often “You can not be everything to everyone every minute of every day.”. Something I think we healthcare providers have a tendency to forget.
That comes out to a 96 to 112 hour week. You are not safe.
Not working that type of job any more but from my previous years I was lucky enough to be married to someone who got really grossed out easily, so I just needed to say things like poop, blood, puke, or describe a the smells of things, like c-diff or pseudomonas infection, or when I working in surgery mention what we cut off, took out, or how big some anomaly was…. He would quickly reply Ok Ok OK and leave me alone to my aching feet and a quest for food!
A day in the life of a nurse
Pretty much sums up every shift… constant interruptions, sometimes look up half the shift is gone.. no lunch no potty break … typical day in the life of a nurse. I’ve been a nurse for 34 years and it’s much tougher than my earlier days in nursing. Administrators have added more demands and increased ratios… tough on staff… really want patient satisfaction… let your staff BREATHE and give us a chance to be there for our patients.
I have these kinds of days frequently. When I read the article I was actually breathing differently. My hospital is trying to get a wellness thing going. You know we nurses take care of everyone else, not ourselves. I am going to suggest either a ‘color hour’ or a meditation hour. Something so we can breathe once in our day. I worked almost 100 hours these last 2 weeks and finally got the flu. No more. Glad I am working on my masters so that I can be a provider.
My husband use to ask me why I am late, well honey just as I was trying to start report, my patient coded and I had not given report yet, so as it is my obligation to at least assist until things are a bit more settled I did. Are you sure you are not having an affaair, ME: only with my other lover–my job. Well what about me, sorry hon not tonight my other Lover just wore me out, maybe when their demands let up. This is all obviously in fun, but I do know other nurses who really can get it hard from their nonhealthcare S.O. I generally don’t talk alot about work with my husband, just bits and peices, it is too much for him, but he says he doesn’t know how I do it for the long hours, and the UTI’s and poor back.–I now am teaching after 38 years at the bedside in ER and ICU, and I love the regular hours and less back strain
Thank you for this post, I’m pretty sure any nurse can relate with this experience. I am married to a non-nurse,non-healthcare professional and sometimes is really hard to explain everything to him. He doesn’t gett it. Our days are nothing compare to an accountant, store manager, etc… day. During our shifts we are under mental and physical stress all the time, which is exhausting. But, even though it’s hard I wouldn’t change my career for any other. I love being a nurse.
Sounds like my day everyday when I clock in. Some times when you think that yes going to be a quiet shift something happens in the last hour like a toilet problem and housekeeping is gone for the day therefore I have to mop the floor. As a nurse you are everything.