I've been a nurse for two years. I still feel relatively new to nursing, and lately I've been stressed out and overwhelmed and tired of bedside nursing in general.
I just worked a three day in a row stretch. One of my patients was a sweet old confused man. The first day I had him, he was sedated and slept all day because the nurse before me had given him 1 mg of Ativan IV. Now, I love Ativan as much as the next nurse, but in this sweet man's case, it wasn't appropriate. He wasn't combative, just confused, and he was too weak to even get out of bed. He would pick at his oxygen and his IV but as soon as you told him to stop, he would. I talked to the doctor and expressed concern about over-sedating the patient, and he agreed and dc'd the Ativan. I also did some intense oral care...his poor mouth was crusty and horrible, and I cleaned it all out, which was a big deal for me. (I can handle poop and puke and urine, but mucus and mouth crusties gross me out.)
The next day, I had a student with me. The little confused old man had been having small liquid stool bowel movements consistently for the past few days, and kept saying he had to have a bowel movement, but couldn't do anything when we put him on the bedpan. I checked, and he was impacted. We manually disimpacted as much as we could, and then I got orders for mag citrate and an enema. It worked (oh, how it worked), and he stopped complaining about needing to go to the bathroom, probably because there was nothing left in there to come out. We also gave him a complete bed bath, and washed his hair. He was more awake than the day before, and he was even joking with us.
On the third day, he was 100% better than the first day I had him. We had him up sitting in a chair, he could carry on conversations, and he just looked so much better. I went in to say goodbye to him at the end of my shift, and he grabbed my hand and said "I just want you to know how much I appreciate everything you've done for me." I don't normally get emotional at work, but I went out in the hall and got all teary eyed.
I really needed to be reminded that what I do does make a difference, because that's why I became a nurse, and I'm thankful that he was able to remind me of that.