15 Minutes in the Life of a Nurse

[NurseJulie31]

It's 10am, I have been here for 3 hours and "all" I have managed to accomplish is making sure everyone has their medications. In the middle of pulling a locked narcotic that a patient needs now, the phone rings informing me that a patient has a critical lab needing called to the doctor.

This particular lab can be deadly so I pick up the phone to call the doctor....wait....what are the patient's vital signs?

Because we know he will ask that.

On my way to get the patient's vitals, I am stopped by therapy letting me know that there is a patient complaining of dizziness and her oxygen is dropping. I go to the therapy room to assess the patient and she is struggling. I am now diverted outside to grab some oxygen and get her vitals. Once she is stable, I remember that I have another patient needing immediate attention based on a lab result so I grab those vitals and pick up the phone to call the doctor.

Wait.....what med is this patient on causing this abnormal lab? What disease process could be causing this?

I grab her chart to quickly get more background information because I am required to know everything on ALL patients so that the doctor can make informed decisions. As I'm on the phone, I hear a bed alarm go off and my STNA is in a room changing another patient. I can either tell the doctor to wait, or find a patient on the floor, hope they are OK and now do frequent neuro checks.

I put the doctor on hold and get this patient to the bathroom reminding him that he must call us before he gets up....he laughs, I laugh and we both know that "education" will go nowhere.

I receive new orders from the physician (who is now yelling at me because the poor thing had to wait) and as I'm working on squading this patient out, the original patient who has been in pain reminds me of how I'm not "doing my job."

This is only 15 minutes of my day....the prioritizing and re-prioritizing. Worrying that any move you make or don't make could harm another life. Having patients ask you where their breakfast is, what time is their appointment today and do they have a ride, what is the pink pill they are taking, why are they not getting their pain pill on time, etc.

I have messages from the social worker and dietician, a patient who is a full feed which takes my STNA away from all other patient care, another doctor who just walked in writing orders for a STAT lab and a patient telling me if they don't get to the bathroom NOW, they are going to poop everywhere.

This is all happening and it's up to me to keep it straight.

All of this while being reminded from someone who works in an office somewhere that you are not "documenting things in a timely manner as they happen." Being told that more paperwork is required and more thorough documentation needed is maddening because I'm meant to be on the floor, not at a computer.

My charting and initialing of everything I do isn't saving lives, my presence on the floor is. Please stop requiring nurses to spend more and more time at a computer and then getting upset when patient quality of care scores go down.

You want quality care?

Get us some help because we are drowning.

[Justanewbie, BSN, RN]

Quote

It is unfortunate, but learn to adapt. We are nurses, this is what we do. Computers are not going away. Like it or not, it's now our reality. Our Government has mandated computer use via Meaningful Use. If you want to make a change, get involved and stop complaining

Wow. How rude.

[Dizzyblue415]

Everyone should read this. Truer words were never spoken.

[applewhitern, BSN, RN]

The hardest nursing job I ever had was 5 years on a PCU. Too sick for a med-surg floor, but not sick enough for an ICU. We had to take our patients everywhere, too, for all cat scans, V-Q scans, etc. Wherever the patient needed to go, we took them there on a portable cardio-resp monitor. Tons of pressure/cardiac drips. Constant admissions and discharges.

[Carissalee]

PLEASE remember that the ones sitting in offices don't exactly agree with the charting requirements. As a DON for 10 years I'm thinking of getting out of nursing due to the ridiculous documentation demands and state surveys.

[CrazierThanYou]

Here.I.Stand said:

Yuck! Reminds me of when I worked in subacute. One year our cansus was down -- and when I say "our," I mean that my unit had 3/20 empty beds, and the other unit had 12/20 empty beds. 20 empty beds = low census...never mind that they were two completely different floors. But since "our" census was low, I would have 17 pts with a TMA. Had the other floor been full, we would have had 2 nurses. It made no sense then and still makes no sense.

One great thing about the hospital I am at now, is the lab staff page the MD about critical results. The RN can't exactly intervene medically without orders, so this way eliminates the RN-middle man, and gets the pt the required orders faster.

That is a fantastic idea! I've always said I don't understand why the lab can't just notify the doctor directly.

[mmorani44]

You hit the nail on the head. I work in an ICU where we are constantly being pushed to take 2 critical patients at a time and sometimes a third stable patient. It is difficult enough to keep up with titrating meds to stabilize a patient, nevermind then having a stable patient as well that needs to get up to the bathroom every 1/2 hour. We have no aide and at times no secretary to answer the phone. So tired of being told we need to document in real time. Management should spend time in the unit to see that we are saving lives in real time and do not have time to stop and put it all in the computer in a timely manner. I feel your pain.

[blondy2061h, MSN, RN]

desertace said:

Nursing is all relative, I'm float pool, everyday is my monday with a new assignment, take it as it comes, never bored, highly recomend float pool if ever given the chance.

Float pool is my version of a living hell. I oversee our float pool. Everyday I see them come in with their positive attitudes and often know I'm throwing them to the wolves. I don't know how they do it.

[NurseSpeedy, ADN, LPN, RN]

blondy2061h said:

Float pool is my version of a living hell. I oversee our float pool. Everyday I see them come in with their positive attitudes and often know I'm throwing them to the wolves. I don't know how they do it.

Probably because no matter how crappy the shift may end, they will probably have a different group the next day. A different group may bring even more crap, but it's better than being a staff nurse scheduled for four 12 hours shifts in a row with the same absolute group from hell for what will feel like an eternity.

Being float pool, I would schedule my shifts spaced out. If my day was a total mess I had the peaceful reminder that I didn't have to come back the next day. This was particularly nice when I didn't even get to start charting until the next shift showed up. Do I want to pick up tomorrow? Um, I got screwed today, so no thanks.

[TriciaJ, RN]

blondy2061h said:

Float pool is my version of a living hell. I oversee our float pool. Everyday I see them come in with their positive attitudes and often know I'm throwing them to the wolves. I don't know how they do it.

They do it because they have someone like you who appreciates them and "gets it". That can make all the difference.

[CeciBean, ASN, RN]

Boy oh boy! That is why I chose to work nights. Stuff still happens, but it happens at a slower pace, thank goodness. What you describe probably happens over a half hour or so, and usually before 10 or 11 pm. By 11 we (generally, at least) had everyone tucked in, and if anything happened, it was usually one thing at a time...until shift change, of course, or unless the ED decided to send us two patients at once, one of them without report for some reason. Having to call the doctor often meant the hospitalist; if not, the worst it could be would be getting fussed at because you woke someone up--well, s/he's on call, that's life!

[dla1618]

Bravo!!!! Well said. These are the primary reasons why i, as a senior nurse seeing and experiencing this....left the hospital scene. I now do VNA....and love it. Good nurses in the hospital are drowning and burning out fast! Shame on the fat cats who care only about the bottom line, although they claim to be patient centered.....those of us know the truth!!!!!

[Haarlem, BSN, RN]

It's stories like these that scare me so much to work in a hospital (I'm graduating this coming March).. I've experienced a lower level of chaos during my preceptorship and was very much overwhelmed, with less going on than what you described.