There are so many times that people ask me what nursing is like, what I do in a given shift, how many hours I work in a day or how many days a week I work and what it's like to work nights. Often there is not enough time and I do not have enough stamina at the time to tell them what it is like, but today...today I will try and write some thoughts down for those who truly want to know. I'll start with the most simple to answer first.
Nurses get paid pretty well don't they?
When I get asked this I just want to say-Wow! That depends on your outlook. Yes, we get paid well if you are comparing it to minimum wage. However, for the work we do and how hard we work, most of the time it is just enough to pay the bills, take care of kids, put food on the table with very little extra to save. Now I'm not saying that the pay is the same for everyone everywhere, but if you look at what we do for the amount we jet paid, most people wouldn't be standing in line to put in an application. For example, nurses are scheduled to work 12 hour days, but usually end up working13 plus hour days. We often don't get a true lunch break because we are dedicated to our patients and will get up in the middle of our meal to give pain meds, help someone get repositioned, answer a phone call, or even chart because it's the only time we've had to sit down. I can't even begin to tell you how many days I've come home and finally was able to empty an exploding bladder and the funny thing is most of the time I was too busy to realize that I hadn't had a bathroom break in over 12hrs! Yep, I believe nurses really do have the largest bladders in the world! Should I even begin to explain here what microbes and bodily fluids we bring home on our scrubs?? Interested yet?
You'll never be out of work?
No, in theory we won't, but if you work in a specialty area like, critical care, there are many days you are called off during the summer months because there are not enough patients for the amount of scheduled staff. Working overtime is almost impossible making it even tougher on the paycheck.
How many days do you work? How is it working night shift? Do you actually do anything?
I work three twelve hour shifts a week and no I really don't have four other days off. You see I have to sleep sometime during the day the night I start working and then when I get off my three day stretch I sleep, so it's more like 2 to 2/12 days off. I love working night shift! The reasons: well, there are less people around, making fewer interruptions in my work and I don't have to deal with doctors constantly changing orders or the high-strung day shift co-workers.
But! Let me explain the down side to that! There are less people around, so if something does goes wrong, or a patient crashes your resources are a lot more limited! No, doctors aren't constantly changing orders, but if I need something I'm the one who has to decide whether to wake them up at 2 or 3 am to ask for it. Sound like fun? Yes, I do deal with family. I work in critical care and you would be surprised how many people stay around the clock or make visits at 2 am!
As for my co-workers, I love them. They are some of the most hardworking people I have ever met. Want to talk about teamwork---spend a night on night shift and we'll show you how fast we can get things accomplished with little help and limited resources!! Do I actually do anything! Oh my goodness, I cannot believe that actually just came out of your mouth! What do you think I do, sit around eat bon bons and watch people sleep! No way, I work my tail end of most nights to make sure people actually have a pulse, heartbeat, that they have a secure airway, that they are making enough urine, that their blood pressure is above 70's on multiple vasopressors (medications to help increase blood pressure), that they are turned and oral care is done every two hours so they don't end up with pressure ulcers or ventilator associated pneumonia, that they are getting all of their medications, that their blood is drawn so I can monitor electrolytes and replace them as needed.
Then there are the special nights when a patient codes (they don't have a pulse, heartbeat or have stopped breathing) that I get the pleasure of jumping on their chest and doing CPR , pushing meds, and catching the physician up on what happened. Other times, it maybe transferring a patient to another hospital because they have sometime of bleed or coded, brought back to life, put a balloon pump in at bedside, stabilized and then air lifted to a different hospital! Then there are the nights I find myself in a tangled web of ethical dilemmas and ethical gray areas Oh, these are just the nights I live for! Then to top it all off I have to chart every last thing I did to prove that I was doing my job! Ugh!
What is it like to be a nurse?
Wow! Always such a loaded question! Sometimes I want to ask, "how much time do you have?" or "do you really want to know?" What is it like to be a nurse?
Well, people often describe nursing as we seeing the best and worst in people, that we see the beginning of life and the end, but really that's not true. Yes, some nurses get to see the beginning of life--those that work in OB (aka baby nurses). However, those that work in other areas, like myself, never see that part of nursing. From my perspective, as a critical care nurse, death surrounds me. There is hardly a night that I work that I am not discussing code status (whether a patient wants us to do CPR, shock them, give them meds, put a breathing tube down, or do nothing), grabbing tissues for weeping family members, explaining why there are tubes coming out of every orifice of their loved ones body and if they will ever breath again without the ventilator (a machine that does the work of breathing for someone). So for me, no I do not get to see that happy side of new life. I do see other beginnings though. Sometimes they are happy, like the recovering open heart patient who is motivated--walks like they are supposed, does their breathing exercises, ect or the patient who recovers and is able to come off the ventilator and then there are other beginnings. The family who's first time ever having to terminally extubate/withdraw life support allowing their suffering loved one to make a peaceful, comfortable journey to the end.
There are so, so many stories I could tell you. Seeing the best and worst in people? Well, I would have to say we never really see the best in people. They are sick and uncomfortable or are recovering from surgery--does that sound like the place to look for the best in people? I don't think so. Often, they are at their very worst. There are multiple examples, but here are a couple of scenarios. For me, the patients who are not intubated (those without a breathing tube and ventilator support) are more demanding. However, two of the most frustrating things for nurses are: one patients who are constantly asking for pain medication. I cannot tell you how many times both as a medical-surgical nurse and as a critical care nurse how many times a patient will ask for pain medication, rate it a 10 (meaing that is the worst pain ever, top of the pain scale for hurting) while talking, texting and even smiling! They will turn on their call light, literally every ten minutes and ask for pain medication even though you have explained for the hundredth time that it's not due yet and the doctor won't give you any more pain meds.
So then you get this next bit of fun--if you are not in here on the very minute my pain medication is due, it's been hours since you've even been in here to check on me and you are a horrible nurse! Oh how very frustrating!! Secondly, there are the frequent flyers that you know the hospital, your hard earned tax dollars, will be paying for their stay. These are the patients that you find to be the most demanding patients who think that they have moved into the insert your hospitals name hotel! Aah! I want to scream! So once again, I cannot tell you I see the beginning and the end, the best and worst of people and life as a nurse even with its hard days is balanced out by all the warm fuzzies everyone wants to make it out to be. However, keep reading and maybe you'll discover why we are nurses and why we keep coming back.
How do you handle seeing people like that?
This honestly has always been the hardest question for me to answer because I never really have thought about that way. Most of the time people aren't very specific when they ask this question, so it is hard to answer-well seeing them exactly how? Seeing them with tubes and wires running everywhere? Well, to me I don't see them that way. Each tube and wire does something very specific that I need to help me monitor/assess or administer medication and do my job. Seeing them die? Well, often during that time I'm totally focused on making the patient comfortable, pain free and comforting their grieving family. Seeing them code? Well, there isn't time to stop and think. I need to act in order to save this patient's life. You see, nurses have a need to build walls that enable them to think and act with clarity and precision while caring for patients and their families. People often think us uncaring or cold, but to be truthful, we haven't had time to stop and think about everything we just went through with that patient or family member because our focus is needed on the next patient's need or task in front of us.
You'll often find nurses joking or laughing at what might seem the most inappropriate of times, but please realize it is not that we are making fun of or not taking the situation seriously. We do, it is soo serious to us that if we didn't laugh or make light of the situation the tension within us would break us in two. There are days after work that we are so exhausted that we simple fall into bed and get back up and go at it all over again. However, there are other days. Days that you may never see the nurse at the end of his or her shift, when the walls come down and the flood gates open. There are days when everything just hits you at once, the thoughts, emotions, what that patient or family had to be experiencing, what you did, or didn't do, and the question did you do enough? Some days a nurse will sit in the break room after work, climb into their car or go home and just hold a loved one and let the tears fall endlessly until we pull ourselves together, rebuild the wall and go back the next day. We keep coming back, because we care.
We care about people deeply. We want to see the best outcome for our patients, whether that is recovering or dying in peace. Truthfully, I believe in most nurses hearts there is a desire to make a difference in people's lives. However, that feeling comes rarely, but we keep trying, we keep going back another day for another patient, for another hurting family in hopes that we can help.
