How do nurses work with each other in the hospital?

KelRN215, BSN, RN · Apr 15, 2016

Hi everyone,
I'm 23 and just got accepted into a 4 year bachelors of nursing program (I live in Canada). I haven't always known I wanted to be a nurse, in fact I still am not 100% sure. But I do know I want to help people and not have a boring desk job.
My question for you lovely nurses is I'm not exactly sure how working in a hospital works. I know, depending on the floor, you have to take care of a certain # of patients. You give them meds, assess their vitals and many more things. But I'm just confused about how the system works as a whole. If I'm in charge of 6 patients, am I the ONLY nurse in charge of these patients?

Yes.

Or do I have nurses who also take care of them on the same shift?

No, your colleagues will have their own patient assignments. Each patient has one nurse per shift.

What if two of my patients code at the same time?

This is extremely unlikely.

How am I supposed to help both of them at the same time?

You're not, you're one person. When a patient codes, you're not singularly responsible for running a code. You call a code and the code team arrives.

I read once in a post about people saying "ask for help, get someone to get an AED" etc if someone codes or something, but am I allowed to ask other nurses for help?

Yes, of course. You won't be able to get through a shift without asking a colleague for help.

Don't they have their own patients to care for?

Yes, but not every patient demands the nurse's undivided attention. If someone is coding, pretty much anything else can wait.

And what if I'm busy talking to a patient's family and my patient starts coding and I don't realize and they die? Is that my fault and I'll be fired?

If you're talking to a patient's family and the code light goes off, you politely excuse yourself and respond to the code. And, again, you are not singularly responsible for running codes.

Another thing I'm confused about is lunch. I've read you need to get someone to "cover for you" if you want to eat. I'm aware this unfortunately is not always possible, but do you guys mean I have to ask another nurse?

Yes. You ask a colleague, "Hey Suzy, can you listen for me while I go grab lunch?" Or more likely, you eat something like a granola bar while standing up/running down the hall.

How could they cover for my patient if they haven't had a long overview of what is going on with them? And again, won't this impede with caring for their own patients?

You choose a time to go to lunch when your patients' needs don't seem to be that demanding. You don't go to lunch when every patient has an IV med due or one needs to go off the floor to a test. And the nurse covering your lunch is more just covering what pops up during that half hour.

Lastly, how much of nursing is bathing people, helping them go to the washroom, and all that other "unpleasant" stuff. Here in Canada we have personal support workers and practical nurses. They don't have as much schooling as nurses and I'm under the understanding that they do most of those things? But I was wondering how they tie in with nurses in a hospital? If my patient needs to be bathed, do I personally ask one of those workers to do it? Do they just know to do it? Or do I have to do it myself? (I'm not complaining, just genuinely curious as to how it works).

I can't speak for Canada, but the aides I worked with definitely didn't take the initiative to do these kinds of things themselves. More often than not, when I told my aide "we need to bathe this patient today", she would roll her eyes at me. They never did it themselves, I always had to help. I don't view this as the "unpleasant" part of nursing though. If you were quadriplegic, wouldn't you want someone to bathe you?

loriangel14, RN · Apr 15, 2016

Our PSWs are much different. They definitely don't need to be told what to do. Many times they know the floor better than we do and usually have their routine all planned out.

Here.I.Stand, BSN, RN · Apr 15, 2016

I work in an ICU so only have 1-2 pts, but have worked in acute with as many as 7 pts. Yes absolutely you can ask for help -- and the other nurses will ask you for help. I have never in 13 yrs of nursing seen two codes at once, even in the ICU. My large urban hospital has maybe 2 codes per shift, and scads of people show up to help. Actually it's so crowded our med students just stand outside the doorway, watch and learn. For standard stuff like help repositioning, we prioritize. "I can help reposition in 5 minutes, but I have to draw these stat labs first."

For breaks we have a partner, either assigned or in my case the RN whose patient rooms are adjacent to mine. We give a quick report of the essentials before we leave. "Can you listen while I go eat? Mr Smith was in an MVC. He has a very unstable C4 fracture, so he's flat bedrest. He's intubated, on propofol and fentanyl for sedation. His heart rate dips into the 20s, so we have atropine at the bedside. Wife says no visitors other than her and parents." Is it ideal, no...but we should take breaks, and you will return the favor when your partner wants to go.

Amount of time spent on personal cares depends on your setting. Many ICUs only staff RNs. Mine has nursing assistants, but I need to be present for that stuff anyway -- to manage their airway, sedation, vitals, pain etc during those linen changes. Plus the pts usually need the muscle of 2 people to move them. Sometimes the CNAs know who is due for a bath, like if they give each other a handoff report; sometimes we have to tell them. Or if plans change -- "I know this bath is usually done on nights, but he was just hugely incontinent of stool. Let's bathe him now."

Stuff like prioritization, delegation, and teamwork you'll learn in school. :)