At the end of the day.

[missmollie, ADN, BSN, RN]

I walk the mile out to my car, a cup of coffee in hand for the thirty minute drive home, and I think about my day.

My preceptor and I had a different floor than usual. A nurse had called in, one floor was jam packed with people, our hall had two beds open, which was two extra beds this other hall did not have. The patients have less acuity on this floor, but you have a bigger assignment there as well. My preceptor asks me how many I'd like to take. I tell her I'll take all of them.

I was able to sit down for report, dutifully jotting down notes for each body system, listening to the night nurse who looks tired. I gather my thoughts, look at the charts, and hit the floor with medication, insulin, and put myself into the "on stage" mode. I smile, I introduce myself, I do the assessment. I've learned to move a little quicker in the last few weeks. We're not afforded the luxury of time I was used to in nursing school, where my assignment would be two patients, and unbeknownst to me, very little responsibility comparatively speaking.

I give meds, I listen to the patients, their families, and ask questions while I assess. I ask about concerns, about pain. I enter quickly and leave quickly, with a smile on my face and a "can do" attitude.

I'm surprised how much my years in the service industry assists me with the customer service side of nursing. Customer service is big everywhere. Whether or not that belongs in healthcare is a discussion I don't care to join. It's there. I have to abide by it, while also keeping the best interest of the patient in mind. I feel at ease with this aspect of the job.

At 10:30, I finally have a chance to chart. I could sit down to do this, but I tend to chart slower when I do. No time. I need to stand. Halfway through the first chart of one patient, the new admit shows up. My preceptor takes this patient because it might be too much for me right now. She's absolutely right, but I can't help but think in a few short weeks I'll be on my own.

Back to charting. Tech whizzes by, announcing a blood sugar on bed 555 as she passes. I look at the MAR for the sliding scale to see how much insulin is needed. The call light in room 558 goes off. My patient. He's in pain. He needs pain meds. I head to the med room and gather the needed supplies. I slip in and out as quickly as I can to get back to charting. I need to have it finished before the second set of charting is required.

An hour passes full of disruptions and patient needs. Food arrives. I go in to eat as quickly as I can so I can get back on the floor. My meal is interrupted twice by patient needs. My food gets cold. I didn't need the extra calories anyway.

The day continues in this way for ten hours. I call a doctor, I ask for a pain consult. I get meds, assess, assess again a little later, and chart while standing. 5:45 hits, and I'm finally caught up. I'm tired and the cup of coffee I had is ice cold and has barely been touched. I grab some ice water and drink. The day, while busy, has been good.

At 6:30 everything goes to hell in handbasket. One patient is sundowning and threatening to hit the nurses. Another patient needs more insulin. Another patient has had a major event take place, has pulled out his IV, needs a new one placed, and the doctors need to be called ASAP. I assess him, my preceptor handles the phone call. I grab the IV supplies, the insulin for the other patient, and see the sundowner in the hallway yelling at the clerk. Through the doors comes my relief, a nurse who calmly handles the yelling patient.

I head to give the insulin, takes me two minutes. Head back with IV supplies to insert the line, blow a vein. Try again, blow another vein. It's 7:00 now. I'm supposed to be giving report, but my job is not complete. I have another nurse insert the IV, I head to chart. I need to give report. I feel pulled in a thousand different directions, so I focus on one task at a time.

7:20, I'm giving report. By 7:30, I'm charting, yet again, on the events that have happened. Still standing, fingers flying across the keyboard at record speed as I include all the things that have happened in the last hour. Finish at 7:45, and head to find my relief to see what I can do to assist her. She shouldn't have to walk into this mess. I complete a few tasks, clock out 70 minutes later than I'm scheduled.

I walk the mile to my car, my feet are tired, I'm starving, but at least the coffee is hot. My patients had the care they needed, I'm becoming more independent in my practice. The day was crazy and my only thought is: It's a shame I'm off tomorrow. I can't wait for my next shift.

Nursing school was hard, but being a nurse is harder. Through all the craziness and how much I have to learn, I love being a nurse. This is the best decision I've ever made, and I'll get to do it all over again, with an entirely different set of patients, the next time I work. I look forward to it.

[B,RN]

I love your heart for your patients and your coworkers. Please do not forget- nursing is a 24 hour, 7 day a week job. There will ALWAYS be tasks that are not able to be completed. That is part of the job. Do your best to get them all completed in your 12 hours, and then endorse the rest to the next shift. If you continue to stay late to help out the next shift, I guarantee you will eventually burn yourself out.

Congratulations on your new job and feeling like you are getting the hang of things!! Good luck to you!