Do Other Professionals Skip Restroom Breaks And Meals?

[TheCommuter]

I sometimes believe that inpatient bedside nursing is intertwined in a bizarre professional culture where the skipping of bathroom breaks and lunch periods is not only common, but occasionally encouraged by our peers and the powers that be.

Can you name any other professionals who systematically place the needs of their clients above their own?

Countless nursing staff members who work in inpatient bedside settings such as hospitals and nursing homes frequently bypass the breaks to which they are legally entitled. According to a study that was supported by the Agency for Healthcare Research and Quality (2005), nurses are regularly sacrificing their breaks and meal periods to provide patient care. Although many of us already knew that that this practice was going on for quite some time, it does not bode very well for our personal health or job satisfaction.

After all, who wants to work anywhere from eight to twelve hours in a physically demanding role without any breaks?

I can see why numerous nurses explore career options away from the bedside.

According to Fink (2010), while the research confirms what nurses have known for years-few nurses get full breaks; long shifts + heavy responsibility + lack of breaks = fatigue and increased potential for mistakes-part of the blame may lie with nurses themselves. Some nurses forgo their breaks, especially in facilities with toxic work environments, because their callous coworkers or unsympathetic supervisors will endlessly gripe about having to cover an additional patient load during the time away from the floor. Other nurses skip breaks because they feel they might fall further behind with their tasks if they sit down for an uninterrupted lunch or leave the unit to use the restroom.

And even though healthcare facilities must legally pay nonexempt employees who work through unpaid meal periods, the managerial staff at some of these workplaces may subtly discourage nurses from completing 'no lunch' paperwork by taking disciplinary action against workers who submit a large number of these forms.

It is clear that both bedside nurses and the powers that be share some blame for this problem. Facilities need to do their part by encouraging staff to take all legally entitled breaks while taking steps to ease the intense workload.

The workload of bedside nurses can be made more manageable through safe staffing ratios, more streamlined charting, less redundant paperwork, and supportive management. Nurses must do their part by taking all breaks to which they are entitled and willingly covering the patient load of coworkers who wish to leave the floor for a break. Some hospitals employ part-time relief nurses who are on the unit solely to cover for breaks.

In summary, we must take care of our bodies and minds by taking breaks. No reasonable person can work nonstop day after day, year after year without feeling some type of resentment and burnout. To optimally take care of patients, we need to take care of ourselves first.

work-cited.txt

[NiteNurse212]

I frequently hold my pee, and almost never have my "required" 30 minute meal break. I work LTC/Rehab and the nurse to patient ratio is crazy. Anywhere from 20-50 patients for one nurse. If something unexpected happens (a fall, death, hypoglycemic episode, etc...) you cannot possibly get "caught up." My feet hurt all the time, I am physically and mentally exhausted, and have had a couple of bladder infections. I stay because the pay is very good, and I had trouble finding a job as a new grad. Once in a while a patient shows some appreciation, and that makes my job more bearable. I agree that other jobs involve long hours on your feet and skipped meals and bathroom breaks. The stakes are so high in nursing though. When your work involves someone's health and life, it is very stressful.

[NurseCard, ADN]

My husband works in the restaurant industry as a cook... he has worked at two

very popular chain restaurants. At his first restaurant, he regularly complained that

he NEVER got a lunch break, though he routinely worked 8 hour shifts, 5pm to close.

I constantly told him to call the labor board.

The place in which he works now is much better; mainly because it isn't AS popular,

at least in our town, as the first restaurant. =)

[breaktime]

I don't understand, are your pts so unstable that they would die or come to serious harm if you popped in the BR for two minutes. Anything less than a true emergent situation can wait a couple minutes. Pain meds can wait. Assessments can wait. Dressing changes can wait. Enven a new admit or a transfer can wait as long as they're stable. Even if I'm way behind at work I can stop to take a leak. What are you afraid is going to happen in two minutes? No one will die.

In several of your posts you state, where do you work that _____. I work in a PICU, and 2 minutes with no one watching my patients is absolutely enough time for them to decompensate and die. Besides the fact that it is our unit policy you don't walk away from your patient area without another nurse there to listen out for you. When there are two empty rooms between you and the next nurse, and she is in her room with her patients, and the charge is helping with a procedure, or at a rapid response, there is no one to listen out so you hold it. Do I go entire shifts without peeing, no. Have I held it longer than is healthy, absolutely. I guess you're right though, I did choose not to go to the bathroom. I chose to follow policy, and put my pt's safety before my need to relieve myself. This doesn't happen every shift, and it certainly happened during my years in the military, however it happens more often now than in any previous position I've held. I also think my unit is generally well staffed and very supportive and encourages breaks. Certainly more so than the unit of any of my nursing friends whether they be within my own hospital system or other hospitals. I think many people may legitimately have difficulty finding the time, most commonly due to staffing issues. Given the current job market, few people (that I know anyway) are in a position to be able to go to their manager and say I want better ratios so I can pee when I want or I'm quitting.

I feel it's a bit harsh to say nurses, complaining about not getting lunch/pee breaks, to other nurses on a nursing forum, makes them sound like martyrs. If they whine to everyone they know about it, then maybe. There are jobs out there with far worse working conditions than any (or almost any at least) nurse has to deal with, and I sure hops they can complain to their peers about those conditions without being told things like they suck at their job, they chose it, they should man up, or they should just quit and find another job, or that they secretly want their work conditions to suck. The argument that other people have jobs where they have to go without pee breaks means we shouldn't care that we don't is about as asinine as saying an ED nurse who gets punched in the face by a pt shouldn't care because police officers get punched in the face by prisoners sometimes. So instead of comparing work conditions with other professionals, maybe we should try to fix the conditions within out own profession, and then we have time left over, we can do what we do best and help others and hey, maybe we can figure out a way to help waiters/waitresses get more pee breaks too.

I apologize for any typos and/or incoherent sentences. I have been awake for far too long at his point (that however, is definitely of my own choosing).

[Flatlander]

Yes, I definitely see the problem, after reading the many postings above. The discussion devolved into "well, you must be able to find 2 minutes to use the bathroom", and "well, of course you can take a tiny break or eat your lunch in a couple 5 minute breaks.". Or "certainly, you could keep a granola bar in your pocket to wolf down on the fly." No doubt about it, that is the culture of bedside nursing in the hospital setting. It appears to be a badge of honor to prove how tough and dedicated we are. Always placing the needs of the patient and the institution ahead of our own.

Every study I've ever seen about how employees function at their best, stresses the importance of taking a half hour break at least once in an 8 hour shift. Most studies recommend another one or two 10 or 15 minute breaks. This is for those who wish to perform at their peak. If you wish to risk burnout, poor health, exhaustion, fatigue, indigestion, stress-related illnesses, then you needn't concern yourself with the research that has been consistent over the past four decades.

But it gets a little more uncomfortable when you begin to read about the increase in mistakes that occur in conjunction with fatigue, stress, and burnout. Nurses I worked with on 12 hour shifts, not only did not take rest breaks or lunch breaks, they frequently came to work having had less than 5 hours sleep because there were not enough hours between shifts to get home, take care of household needs, and get to bed. After several days of pushing yourself to the limit, poor nutrition, and lack of sleep, how top-notch can your functioning be?

When management sent out an email asking nurses for feedback on what they thought might be the cause of complaints of fatigue among the staff, I just had to laugh.

[joanna73, BSN, RN]

I take my breaks 95 percent of the time. I'm more productive with my breaks. Any place that doesn't allow me to take my breaks, for whatever reason, is not somewhere that I want to work. Yes, I know nurses often miss breaks. But ask yourselves this: when you're fatigued and ill from all these missed breaks, who is taking care of you? Not your employer, that's for sure. Fortunately, Canadian nurses are unionized.

[ArrowRN, BSN, RN]

So you taking an assessment of a patient and they are describing how they feel to you and all you hear is "i gotta go, i gotta go, i gotta go" lol.:rotfl: that is really distracting. I do not see why it would be such a big deal. In my current job, cable/internet technician, I have missed breaks but its by choice. I work in customers homes and often feel uncomfortable using other people bathrooms but if its really urgent I just ask them or I leave the house and just take a break. Your patients will not die if you pop into the bathroom and any facility promoting such a culture into nursing is only demeaning the profession.

For me I've had previous kidney stones and I know that I should not hold a pee and noone should be allowed to either, it is dangerous and unhealthy.How can nurses give people advice and not follow it?

This is similar to what my wife does sometimes, and I'm sure its the same with many mothers, as I've notice she puts the kids first without taking care of herself. She would skip meals and so on, then I ask her "If you don't take care of yourself, who will be around to take care the kids? " Think about it.

I've also been an EMT and we often took pee breaks at the drop off hospital, ESPECIALLY when we are busy, because we never know how long the next call will take. I think nurses should also take bathroom breaks especially when it is busy. There must be some short period even in between patients where someone can fill in for a little moment. Its funny because this topic was one of my concerns with entering the nursing field and I'm glad someone brought it up. My current job is outdoors so I got a bit more freedom but I've never had a job in a stationary building day in, day out and I am not used to the indoor cold air and that normally makes me go more than usual.

[wooh, BSN, RN]

I feel it's a bit harsh to say nurses, complaining about not getting lunch/pee breaks, to other nurses on a nursing forum, makes them sound like martyrs. If they whine to everyone they know about it, then maybe. There are jobs out there with far worse working conditions than any (or almost any at least) nurse has to deal with, and I sure hops they can complain to their peers about those conditions without being told things like they suck at their job, they chose it, they should man up, or they should just quit and find another job, or that they secretly want their work conditions to suck. The argument that other people have jobs where they have to go without pee breaks means we shouldn't care that we don't is about as asinine as saying an ED nurse who gets punched in the face by a pt shouldn't care because police officers get punched in the face by prisoners sometimes. So instead of comparing work conditions with other professionals, maybe we should try to fix the conditions within out own profession, and then we have time left over, we can do what we do best and help others and hey, maybe we can figure out a way to help waiters/waitresses get more pee breaks too.

Brilliant post. Needed to be said again so I quoted you. :)

In my current job, cable/internet technician, ... Your patients will not die if you pop into the bathroom and any facility promoting such a culture into nursing is only demeaning the profession.

Your post made some good points, but perhaps a nursing student/cable technician should think twice before questioning a nurse's judgment as to how long they can safely step away from their patients.

As I said earlier, everyone keeps quoting "2 minutes." But there's stopping what you're doing, walking however far to where it is, for the majority of us we have to pull down our pants, sit down, pee, wipe, stand up, pull up pants, flush, wash hands, get back to where we were. (Add in the time to cover the toilet seat for the more germaphobic among us.) I cannot be the only one here that it takes more than "two minutes" to pee.

In an ICU setting, they might die. In a step-down, they could decompensate pretty quick. Most any setting, you could have a fall because it takes too long to stop peeing and pull up your pants, wash your hands and get all the way down the hall when a bed alarm goes off.

The fact is, rushing to pee because we have nobody to listen out for our patients while we go pee because those nurses our working with an unsafe ratio is a problem for a lot of nurses.

It's bad enough that management blames our inability to safely handle insanely unsafe workloads on our poor time management skills. Having our fellow nurses (or nursing students) blame our inability to handle insanely unsafe workloads on our lack of desire to carry around a granola bar in our pocket to scarf down while charting instead of taking the lunch that we get our pay docked for is just adding insult to injury.

I'm lucky now. I generally get a lunch. I usually get time to pee. That doesn't mean that it's not still a problem for a large part of our profession (especially those without a union.)

[jadelpn, LPN, EMT-B]

In some enviroments, the charge nurse does not take a patient assignment in part for this purpose. 15 minute breaks will be taken from 10-11 and 2-3 and lunches from 12-130 or something of that nature--and talked about when assignments are made. Also, when assignments are made a buddy nurse is who covers you for breaks and lunch, and you do the same for them should the charge nurse take an assignment. In the case of a RRT, or code or some other unforseen emergency, then the NM should come to the floor and assist. In an ideal world. The only thing that you can do to change this enviroment is to bring it up with a plan--in feedback forms, staff meetings, to your charge nurse and/or NM, It should be up to the charge nurse to say "are you in a good place to take a break?" and if it is "no I have to hang this med" then it is "hang the med and take a break" or "I will hang the med, you go take your break." Again in an ideal world. If you are working in an enviroment that doesn't allow you to take time to go to the bathroom, it should be brought up in every staff meeting, in every evaluation meeting, in every forum where it is you and your fellow nurses with managment until some sort of plan can be implemented.

[wooh, BSN, RN]

it should be brought up in every staff meeting, in every evaluation meeting, in every forum where it is you and your fellow nurses with managment until some sort of plan can be implemented.

Plan implemented in this economy: Get rid of the problem. (I guarantee the problem gotten rid of won't be the lack of bathroom breaks.)

[TheCommuter, BSN, RN]

Plan implemented in this economy: Get rid of the problem. (I guarantee the problem gotten rid of won't be the lack of bathroom breaks.)

Nope. The problem, in the eyes of some folks in upper management, is the nurse who dares to complain about not receiving his or her legally entitled meal periods and bathroom breaks.

Sorry, but a real lunch period should consist of 30 uninterrupted minutes. Most states also grant hourly workers at least two 10-minute breaks to allow for using the bathroom, smoking, hydration, and so on.

[sauconyrunner]

My hospital is very aggressive with nurses about taking breaks. We simply do not want to pay for the "No lunch" pay. So, people are sometimes told, "You are taking a lunch, and it will be soon. (Between the hours of 11 am and 1:30 pm, some nurses have tried to eat at the desk and then want a lunch break at 5 pm, when there is no one to break them.)

We are absolutely not unionised. But our hospital does believe in doing right by staff though sometimes it does come off a bit heavy handed about getting lunch....but they often provide a "Lunch nurse" which is more than a lot of place can say.

[Been there,done that, ASN, RN]

How in the world in 12.5 hours do you not find time to hit the BR or eat? I'll grant that there are nights when my lunch break comes in 5 minute increments, but how is it possible not to find time to take that short of a break? I'm not being snarky, I'd really like to know what your job entails that you have zero downtime. Either you work in the worst environment known to man (in any career) or there is some hyperbole in your replies.

Well, they have been pretty bad environments. .... sadly, most hospital units are . In the last two facilities I worked the patient load of 7 or 8 , constant turnover, excessive charting demands and the phone I am expected to answer... even if I do get in the bathroom.... most certainly cuts into any break time I DESERVE.

I've done this for 30 years, there is no need for hyperbole... the truth speaks for itself. Yes, there have been many times , if I were to have left that bedside ... it would have been unsafe for the patient. GI bleeds, Levophed drips , and ALS patients come to mind.