15 Minutes in the Life of a Nurse

I wrote this yesterday after having a hard few days at work and it seems to have struck a chord on social media with many. Enjoy! Nurses General Nursing Nurse Life

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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.

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.

2 Votes

YES,YES & YES!!! My thoughts & feelings every. Single. Day!! I love when the "clipboards" show up on the unit to judge us! I'd like to stick them where the sun don't shine! We need more help! End of story!!!

1 Votes

"I disagree. If I get a call from the lab about crazy electrolights or dangerous CBC, it's much quicker to intervene. I can immediately stop a drug that can be causing more harm, open fluids, check vitals and then... I call the doc and notify him of the problem. There is a lot that needs to be done before a doc makes a decision."

In my state that would be practicing medicine without a license. If I have NS running at 70 cc/hr and the pt becomes seriously hypotensive, I cannot open fluids full without calling the Dr. 1st, so I have to call a rapid & wait for the charge nurse. If I have proper parameters I can STOP a drip or slow it, but I CANNOT open fluids - I work in a PCU.

1 Votes

Send your story to your Senators and Congressmen and Congresswomen, on both the state and federal levels, also to the accrediting bodies of your institution - CMS, JCAHO, whoever accredits your place.

Think it through before doing that. Your facility will catch heat, you might get fired or blacklisted, but you might get Congress to make laws about staffing levels that have to be followed.

Can't docs dig into the computer and see history, labs, etc. without you having to spoonfeed them all of this info? And Lab can call them with criticals just as easily as you can.

1 Votes

Send your story to your Senators and Congressmen and Congresswomen, on both the state and federal levels, also to the accrediting bodies of your institution - CMS, JCAHO, whoever accredits your place.

De-personalize it as much as possible. That is, make sure to follow HIPAA. And give your facility an opportunity to address the problem first - before going public.

Think it through before doing that. Your facility will catch heat, you might get fired or blacklisted, but you might get Congress to make laws about staffing levels that have to be followed. Have some money set aside for a few months' expenses in case you get fired.

Can't docs dig into the computer and see history, labs, etc. without you having to spoonfeed them all of this info? And Lab can call them with criticals just as easily as you can.

I am aghast and amazed and in admiration of you for putting the prima donna doctor on hold to prevent a fall.

1 Votes
Kooky Korky said:
Send your story to your Senators and Congressmen and Congresswomen, on both the state and federal levels, also to the accrediting bodies of your institution - CMS, JCAHO, whoever accredits your place.

Think it through before doing that. Your facility will catch heat, you might get fired or blacklisted, but you might get Congress to make laws about staffing levels that have to be followed.

Can't docs dig into the computer and see history, labs, etc. without you having to spoonfeed them all of this info? And Lab can call them with criticals just as easily as you can.

So ... to improve pt care we should write letters to accrediting bodies that announce weeks to months in advance of coming, and risk our sole source of income and risk not being able to work in the field we spent tens of thousands of dollars in education? If the accrediting boards had ANY interest in knowing what was really going on, visits would be unannounced.

We should write congressmen and women who clearly do not care about medical care for their constituents, nor worker overload. State regulators will fine the hospital if we don't clock out for lunch, but could care less if we have to stay late by 2 hrs to chart, even when working the next day. The same government leaders that use "patient satisfaction" scores to lower reimbursement - scores based on the RN meeting the pt expectations for call light response that have NOTHING to do with medical acuity.

Congress knows full well the biggest problem in the health care system is lack of patient accountability (CHF pt stops at olive garden on the way home after being diuresed for 3 days and returns w/in 30 days for the same problem; end-stage COPDer on home O2 that won't quit smoking 1-2 packs a day and is re-admitted monthly, the repeat ETOH detox pt, the 85+, dementia pt in a memory unit and full ADL care receiving a pace-maker, ....). They will not set limits, they will not pass laws allowing EDs to direct a pt to see their PCP in the morning. God help you if you get cancer at 45 or 50 and need help with 100,000 worth of treatment.

We have to come together and get the voters to use ballot measures to force meaningful changes. But I can't see how. I wish I was smarter.

2 Votes
Specializes in ER,m/S,tele, stepdown.

This does pretty much describe a normal shift now to the "T". Been doing this over 18 years now and it's not getting easier. We definitively all need to stick together and have each other's back more than ever. People who post negative comments such as the previous one from Jane are more than likely the same type of Nurses who demand those ridiculous drawn out reports that make you late after the type of shift you described and will cut you down for not "memorizing " the chart because you were too busy out there actually caring for your patient. THEN when you get report from her, she will know nothing and rush you and need to "her home"

for some reason. It will get easier but the change is difficult. Hang in there.

3 Votes

You are not alone, unfortunately. On a PCU (Trauma, Open Heart, and any diagnosis), we have 4 patients and share 1 PCT for 12 patients in an L-shaped unit. If we need a sitter in a room, the PCT is the sitter!

For 2days my assignment was Room 9, quadriplegic with trach needing frequent suctioning and q 4-hour G Tube feeds/meds in isolation. Room 7, 270-lb man on bi-pap barely holding 91% and incontinent who removes the mask every 10 minutes, on isolation. Rm. 6, confused ALZ woman (no sitter) who suddenly "came alive and aggressive" -and at the opposite end around the corner at the top of the "L" in room 1, a 280- lb Trauma victim left side paralysis with resp. Issues, incontinent, and helpless even to call nurse. Same phone calls, demands, forms for SNFs and Nursing Home transfers, . WE take our patients to CT and Dialysis . WE do full admissions and some discharge paperwork, but all DC instruction. Doctor 1 says, "Call doctor 2 & 3 to consult and report labs...." I spent 15 minutes just doing G-tube meds and 240 mL gravity feeds while chair alarm beeps and BiPap alarms down the hall. Thank God for families and Charge Nurse! Our phones ring every time any patient presses call bell! It's a nightmare. And we are not "Nursing" - we are documentation - desperadoes. It's dangerous and sad.

4 Votes
Janeis said:
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.

Woah. Slow your roll and get off your high horse. You seem to have an attitude problem, big time. Someone can express their opinion or feelings without complaining. :rolleyes:

3 Votes

It breaks my heart to see residents/patients not recieving the care they need and deserve. The nurse/patient ratio is crazy these days!

2 Votes

Im a nurse here in the Philippines and this is what's happening to us. I love this post and I can totally relate to it.

3 Votes
Specializes in Addictions, psych, corrections, transfers.

Yes, indeed. You captured 15 minutes as a nurse so accurately. I worked in acute psych and addictions detox. I love the providers that actually will jump in and help. I used to work with a NP who, if she saw I was becoming overwhelmed, would actually write her own orders then put them on the MAR for me and have me double check them. I so much appreciated that. At the jail I worked at, our administration would complain that we weren't getting things done fast enough and as thorough as they wanted it. 700 patients to 2 nurses with 40 patients new admit checked needing full assessments, case management, medications, and medical triage. Think working in a massive urgent care/ED without staff or supplies. We were always shorted staff, we were supposed to have 4 nurses a shift. Anyway, we weren't meeting our sick-call numbers (these were patients already in the jail that requested to see a nurse) because we literally had no staff to see the patients for anything extra. Our wonderful PA felt so sorry for us he decided to whip 40 sick-calls out in one day. He was confident he could do it. He only got 10 done. He then went to the administration and told them how impossible it was to make these quotas when he couldn't even do it and he had a slow day. The administration of course took no action. I love that he actually tried to walk a mile in our shoes. The entire nursing staff quit along with the providers at the same time, and the company lost their contract for providing medical care for that jail.

5 Votes
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