So...What Kind of Nursing Task Do You LIKE?

[VivaLasViejas]

We've got a really good thread going on the kinds of nursing tasks we hate, so I thought I'd throw this one out there to get people talking about the kinds they actually enjoy doing.

For me it was IVs. I stunk at them for the first couple of years after I got out of school because I didn't have much of a chance to start them in the LTCs I worked in. But when I got into acute care, I didn't have a choice but to learn, and within a year I was getting calls from the ICU to come down and start an IV in someone they couldn't get a line in. Frequent flyers would actually request me by name to start their IVs because I could do it quickly and on the first try. I don't know why I had so much luck with the hard sticks, when sometimes I'd miss a big plump one in the hand; there was also the occasional shift where I wasn't "in the zone" and couldn't hit a barn door with a two-by-four. We all have those days. But I sure miss holding a 20-gauge angiocath in my hand and sliding that baby in smoothly and effortlessly.

[swimmingpoolblues]

Suctioning (trachs). I love being able to get all the 'rattles' out.:)

[Kooky Korky, BSN, RN]

On those days I can do a shampoo and shave, I just love how they look. Families really focus on the patients face, and when you can shave or shampoo, it really makes people happy. I carry my own shampoo that means business. None of those shower caps here-they don't clean like real shampoo.

Maybe I like these things because it means that the day has gone so well that beyond the basics of survival (assessments, meds and charting) there is time for those satisfying things that are further down the priority list.

Killjoy here - for legal protection, you should not be using shampoo not supplied by your employer. I know you mean well, but what if someone has a bad reaction to it? Or reports you?

[wannabecnl]

In reading this, I realize that while PACU lets me give 1:1 care, which I do love, and we do all our own vitals and frequent assessments, etc., we don't get nearly as physically involved with our patients as other nurses do! I wish I had these skills people have mentioned!

But I do have some favorites:

1. I LOVE assisting with pre-op procedures (blocks, spinals, etc.).

2. I love seeing a patient go from sound asleep/disoriented/howling in pain to sitting up, drinking juice, and asking for lunch (and I love my part in getting them to that point). Great to get to know them a little bit and be there for them.

3. I actually love getting into the nitty-gritty of surgical wounds, which really doesn't happen that often. I wish I could do more with wound care; I'd like to understand it better, and most of my dressings fall off because I never have to put them on! As a former poster said (best quote of the thread, I think): sometimes wound care is almost like a craft. Love it.

4. Giving my post-ops Ativan if they really need it. It is truly a beautiful product. Phenergan is a close second. And Valium for spine pts whose nerves are waking up for the first time in months (and those nerves are P****D!). Heck, labetalol and neo drips are pretty cool, too. Basically, I like the relatively instant gratification of the meds we give in PACU; in our time frame, meds need to work fast, and I feel like I'm really doing something useful when I give a med that works.

Favorite direct-care task example thus far, though, had to be straight-cathing a post-spine surgery guy retaining 1200 cc of urine and sporting a ridiculous BP as a result. So gratifying to help him feel comfortable, see that lovely pee coming down the tube, and watch the numbers all come back down to earth, too.

[decembergrad2011, BSN, RN]

Port access and central line dressing changes. Stat lock? Bio patch? Sterile gloves? Why yes, yes I will. I also like that usually visitors in a room shut up when they have to wear a procedure mask.

[ixchel]

I do love establishing rapport with the notoriously difficult patients. I've only given up once (in my defense, he punched me because he didn't want his meds).

I also love, love, love when my advocacy changes plan of care. Full codes (at the family's insistence) going DNR (at the patient's insistence), seeing that things were missed, noticing a med that is bad for the patient, catching sudden changes that are subtle but significant, stuff like that. Having an MD say thank you for these things is such a fantastic feeling. Having an MD blow me off? Not so much. (Chased a surgeon down a hallway because he ignored me and a hospitalist saying a patient needed a closer look from a surgical stand point. He blew me off. Two days later the patient a septic after a bowel perforation, when her admission dx was partial bowel obstruction.)

Flushing a foley and getting a fantastic amount of urine flow afterward.

Ending my cold streak on IV starts and finally getting one last night after a very long period of failures to successfully start one.

Having a shift with some of my favorite coworkers who don't mind when I get tired silly. Profanity flies out of this mouth and the stuff I say is so dark and twisted that I'm a little bit surprised I haven't been approached about it yet. Honest to god I absolutely love my coworkers. (No, that's not nursing skills, but I have a feeling this might be a normal coping mechanism for the crazy stuff we see and do on such crazy long shifts.)

[Lev, MSN, RN, NP]

I just learned how to access ports. That was fun!

I'm also really good at IM injections. Patients tell me all the time that they didn't even feel it. My technique is to use the thinnest possible needle (25g usually) and I insert the needle into the arm or leg with the same amount of control used to give a sub q injection. I do not flick my wrist I almost place the needle into the arm or leg.

I also like getting in NGs and OGs. Especially in intubated patients. So fun!

I also get a kick out of blind sticks in the AC. Even if you can't palpate anything. Go in slowly at a 45 to 60 degree angle.

I also enjoy straightening patients rooms up.

[loriangel14, RN]

Bed baths, taking out staples and feeding people. We buy our own pretty smelling soap and I love using it on people. Washing and drying the hair if some little old lady that hasn't had it done in a while is a great feeling and they always appreciate it.

[AliceTrout]

I love how my rooms looks after I organize it at the start of my shift (and how I keep it crisis permitting). IV Lines all orderly, labeled, untangled, neatly strung from bag to pump to patient. All the other various tubes and lines (OG/ETT/Chest/tele etc) neat, orderly, and tucked from view as much as reasonable. No clutter anywhere. Patient assessed and pulled up and looking as cozy as possible in a shoddy ICU bed. I literally can't even bear to sit and chart until my room and patient look anything short of that! I always tell new coworkers that I picture how the patient's mother would want them to look in that bed. If they don't look good enough for momma, they don't look good enough for me!

I also really, really love dressing changes. The look of a clean and perfect new dressing makes me giddy.

[SleeepyRN]

Assessment and f/u interventions. I LOVE assessing patients and implementing care. Like last night. I had a pt who was supposed to be on her last day of IV ABT. But through my assessment, (auscultation of lung sounds, observing the pt with SOB and rapid RR, getting her O2 sat of 85% and administering a neb tx and her inhaler....)

[OCNRN63, RN]

I do really like sticking people; esp. if it's a hard stick or difficult port. I don't get to do it anymore now that I'm no longer working, and I miss that.

[OCNRN63, RN]

I really like placing Foleys especially in females. I like the challenge and to be honest I'm just really good and fast. I get teased so bad about it all the time! My goal is to be on the on call hospital wide DUC team that does difficult Foleys. I guess I'm weird!

You have an on call team for Foleys?

[Sisyphus_01]

I work as a CNA so I don't do all the stuff nurses do, obviously, but I really like the following tasks:

*I actually don't mind cleaning super gnarly poop, mostly because I have a superhuman tolerance for nasty and as a result I get these looks of utter shock and awe from gagging coworkers because I'm wiping, humming, and making chit chat with the patient while some inhuman stench is raping the air.

*Catching a clinical sign or symptom that is important that no one else noticed :)

*Being able to calm and/or connect with a patient that hates almost everyone

*Emptying urinary drainage bags (I know, weird... I think it's because there's nothing subjective about it. When I'm done I can say with confidence that I didn't mess it up, plus I like the clicky noise the foley makes when it locks back into the bag *hahaha!*)

*Putting patients on telemetry, I love getting all the stickies lined up, filling out the telemetry request form and faxing it off :)

*Feeding patients

*When I'm one of the only ones able to understand what a patient is saying who has trouble speaking, it feels awesome to see the frustration melt from the patient's face

*Winning over an abusive/crabby patient to the point that they say, "thank you" and are excited to see you come on shift

*Preparing Blood collection kits (placing the tubes, the gauze, the butterfly, etc. into the baggie and collecting blood when I can get a good stick) :)

*Placing catheters, nothing better than seeing that first bit of pee flow!

*Sending stuff off through the tube system *WHOOOSH*

*Stocking supply carts (not sure if this is a nursing task, but I really like doing it... I can organize things, and again, it's something where I KNOW I did a good job when I'm done lol)