Just Take Your @#*! Break!!!

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First a bit of background. There are a lot of posts about not having time to take rest and/or meal breaks- about working straight through a shift without even having a chance to use the restroom.

I do believe this happens, and have experienced it myself, where patient care demands are so great, or concern for patient safety is high enough, that the nurse does not feel they can afford to take their break let alone take a few minutes to empty their bladder. It does happen, it is true.

However.

I think there are many instances where the nurse could take their break without compromising patient safety, and yet they choose not to. They perceive themselves as "too busy" and can't break themselves away from the tasks at hand. Or, a break is offered when things are slower but the nurse is not ready to take their break then, so they don't go, then the floodgates open and the opportunity is lost.

I think when I was a newer nurse, I was more prone to this phenomenon. It was like I felt guilty for prioritizing my own needs and making my patients wait. I think it's also possible that nurses who aren't used to working in a high volume environment can be more prone to this too, so that when things get busy, they don't think they can go on a break, when they actually can. There are so many things that can wait. Everything doesn't have to get done *right now*.

I have coworkers that can't seem to peel themselves away, even when I'm telling them "Go, I've got this! Get out of here and go eat!". They are offered the opportunity, then *choose* not to go, and then complain about not getting breaks.

Example: Flood gates opened- everyone and their mother in law decided they needed to be seen in the ER right at that moment. We were full. But, we had nobody critical or unstable- most were clinic type patients, a few full workups but nothing remarkable. Co-worker is hungry and wants to go eat. Okay, great, tell me about your patients. Co-worker is frantic and starts to tell me about the ambulance patient we're expecting. Yes, I know. I took the call, remember? I got it. Tell me about your other patients. They're both stable, no new orders, one is getting fluids, the other waiting for the provider. Great. Go now. See you in a bit!

So I go in to settle the ambulance patient (not critical) and next thing I know, said coworker is in the room "helping" me. "I thought you were going on break", says I. "I'm just helping settle the patient, then I'll go" says she.

This is the slippery slope. "I'm just (fill in the blank), then I'll go". Famous last words.

I've settled dozens of ambulance patients by myself. I don't need help. I've got this. Take your dang break, for heaven's sake, or you might not get one at all!!!!!

I feel like it's a patient safety issue when you have a coworker who is so frazzled and frantic that they can't concentrate, who won't go on their break. I feel like I need to get firm with this coworker and tell them in no uncertain terms to GO ALREADY.

Agree or disagree? Why?

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Specializes in Peds critical care.

Agreed!

Sometimes I have to wonder if its an ego thing (yes, even in the newer nurses). That whole "I'm the only one who can keep this all together."

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I agree. Especially about going to the bathroom. Who can concentrate while brewing a UTI? That can't be good. Just go and come back a better person.

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Specializes in Med-Surg.

Agree 100%. Only once have I ever not taken a lunch break, and in hindsight I could have made the time. I felt like I was too busy and "I will go after I do this" stated x10 turned into it's 06:00 and it's not happening. Ever since then I have made the time, even if that's just ten or fifteen minutes to eat quickly. I also vowed to always go to the bathroom when I need to pee. My coworkers laugh at me sometimes because due to massive amounts of coffee, I pee a LOT each shift, but I am not holding my bladder until it hurts.

If it's an antibiotic to hang, a new admit to settle in, pain medication to give, ect... You can ask the charge nurse to help. Most medications can be given in a 30 minute window so it can probably wait until you get back from lunch, unless it's time sensitive. If it's not something that needs to be done STAT, then it can wait 30 minutes while you take a lunch or 5 minutes while you go to the bathroom. It's a disservice to yourself not to take your lunch. Usually it's a time management problem, and if someone is "too busy" for lunch on a regular basis, then they need to re-evaluate their time management and prioritization.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

I guess I'd put my break on hold if CPR was actually being done (or even seriously contemplated) on my patient, but most things can wait for thirty minutes while you go eat lunch.

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Specializes in ICU, ED.

I don't know how people don't take their breaks, I get hangry if I don't eat! I'm a new grad, so I'm still pretty bad at time management and pretty much continuously busy my entire shift, but I ALWAYS make time to take a break. Sometimes it's not until the last 3 hours of the shift, but I still eat. You just gotta know when you're going to have downtime and then you go and don't look back!

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Specializes in Emergency, Telemetry, Transplant.

I agree. In our ER, unless we are super busy and/or short staffed, we have a nurse dedicated to doing lunches. If possible, nurses will cover each other for lunches. As a charge nurse, you will hear it if a number of nurses claim "no lunch" especially on a day that was not super crazy. What irritates me are nurses that are offered lunch multiple times, always come up with a reason they cannot go to lunch and then, at the end of the shift they complain that they didn't "even" get a lunch (yet everyone else managed to go).

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Specializes in Acute Care, Rehab, Palliative.

On floor you take your break. Our charge gets seriously upset if you don't.

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Specializes in Emergency, Telemetry, Transplant.
On floor you take your break. Our charge gets seriously upset if you don't.

Probably because the charge nurse gets the blame from above when the unit is over budget because nurses are being paid for "no lunch." Now, before someone gets all upset, there are times when breaks/lunches cannot happen and a nurse (or any staff member) does not get a lunch, he/she should get paid for that time. However, there are some times when nurses could take a break and they choose not to--that is the issue. For example, we had a nurse who "refused" to go to lunch. She was offered the break by another nurse, but she told the charge "I just don't feel comfortable with someone else taking care of these [perfectly stable] patients." Not only was it annoying, the nurse who offered to break her for lunch was a bit insulted.

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Specializes in Acute Care, Rehab, Palliative.

No, she just really wants us to take our breaks. people aren't putting in for no lunch.

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As I stated in the original post, I have experienced being too busy to take a break. For instance, when I worked on the floor, having five patients, two of which were fresh post PCI, one on a heparin and nitro gtt, one on a Lasix gtt, the other a stable medical overflow, or in the ED with a critical vented patient on pressors plus my other three non-critical full workups, and nobody available to cover because everyone else is just as busy (the critical care house float is unavailble, the house supervisor hasn't done patient care in years, the charge nurse won't leave their desk, and all my coworkers have busy assignments too). This sort of stuff does happen and I will not deny that. It's a problem and I'm not trying to minimize that for those who work in environments like that.

But when it's just "busy" as in a lot of patients, a lot of tasks, but nobody is critically ill and none of the tasks are so important they can't wait a few minutes, then I just don't understand why it's so difficult to peel oneself away to go eat.

In the place I work now, we can ask our supervisor or the house supervisor to come help if we're struggling to get our breaks in, but honestly with our staffing level, we really shouldn't have to do that very often. We're a small community hospital with few beds and we're bypassed by ambulances for traumas and STEMIs, so all of our rare traumas and STEMIs come by POV, so our volume is mostly clinic level stuff.

The other night, there were two of us in the department, and I sent my partner (a traveler who, like me, has worked in large, busy trauma centers, so can handle our "busy") on break, and then BAM! I had four discharges, a pain med request and couldn't find the doctor, and a triage. I did the triage, started hammering out the discharges, and when the doc reappeared from wherever he had gone, I put in the pain med request. Before I knew it, my partner was back from her thirty minute meal break, and guess what- nobody had died! The poor guy in pain had to wait a few minutes, but that would have happened regardless of whether my partner had gone on her break or not.

I guess my real question is how aggressive I should be about encouraging others to take their breaks? We do not have a charge nurse because we're too small. We have a manager during business hours, and an RN house supervisor at all times, but mainly we supervise ourselves, particularly at night and on weekends.

Should I be assertive about my coworkers taking their breaks because it's a patient safety issue, that working 12 hours straight through is more likely to result in mistakes, or should I just let the chips fall where they may and try to lead by example by taking my own breaks? In other words, whose responsibility is it to make sure everyone takes their breaks?

I feel like it should be each individual's responsibility to their team, to the patients, and to themselves to perform self care, but sometimes it feels like I need to pry the other nurses away with a crowbar, and I'm just running out of energy for it.

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Always take at least 15 minutes to eat and go when you have to relieve yourself. You need to be healthy to care for others

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