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So Why Do You Do It?

Med-Surg Article   (14,299 Views | 26 Replies | 3,259 Words)
by BeinganRN9 BeinganRN9 (New) New

1 Article; 1,727 Profile Views; 6 Posts

A typical day in med/surg nursing... and why stick with it. You are reading page 2 of So Why Do You Do It?. If you want to start from the beginning Go to First Page.

Butterfliesnroses specializes in LTC.

348 Posts; 5,203 Profile Views

Wow, you've almost described my day as a nurse in LTC! I worked evening shift as a CNA for years...I'd often see the nurses sitting at the nurses station, then would hear them complain about never getting a break of lunch. Now as a nurse I see exactly what they meant! My days are filled with med passes, dressing changes and other treatments, on the phone with doctors, and charting. I never take a lunch or break b/c I can ALWAYS think of something that needs to be done! As a CNA I got my lunch and all my breaks...The work is less physically demanding as a nurse, but I'm 100% busier.

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tralalaRN has 21 years experience and specializes in pediatrics.

168 Posts; 4,244 Profile Views

Very eloquent!! Very realistic. I too, am reminded why I left the hospital setting. I remember thinking how odd it was (at the time) that so many of my co-worker nurses suffered with unmanageable migraines. How can this scenario be good for anyone - the patient, nurse or hospital?? So glad I jumped ship. I'm a much happier person now.

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Leda1st has 9 years experience and specializes in ER, Cardiac, Hospice, Hyperbaric, Float.

50 Posts; 2,428 Profile Views

Oh boy! I'm jumping BACK into the hospital after a stint with Hospice. I still have a love for Hospice (it's more like the "nursing" I really pictured doing), but when I clock out, I want to be FINISHED with work. I've finally gotten enough experience under my belt to be PRN in a couple of different areas. Sometimes I LOVE being a nurse, and sometimes I wonder what the heck I have gotten myself into. The thing is, the stuff I hate really has nothing to do with the patients - it has to do with being assigned TOO MANY patients to give the quality care I would like to give (and still have some shred of sanity and small bit of energy left for my family). I am hoping that with PRN I can take enough "breaks" and have enough "variety" to keep me from burning out. I was born to do this nursing thing - I just know it. :)

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HyperSaurus, RN has 8 years experience as a BSN, RN and specializes in NICU.

758 Posts; 11,313 Profile Views

I read this and I think 'God help me'. Now I know why it's the more experienced nurses who usually end up on days. And are then super crabby.

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1 Follower; 1,016 Posts; 13,756 Profile Views

Wow, this REALLY describes a typical day in med surg. I might even show it to my husband/children in hopes that they might develop a small understanding of what I do and how my days are at work. I love how the day starts . . ..the report, the instant calls on critical values, etc. Only, usually, a couple of those patients are on isolation and have crazy blood sugars as well! Oh, and dont' forget the PHONES that ring on an average of every 12 seconds throughout the day, throughout it all . ...

It's why I left my job at the hospital for a supposedly less stressful job in rehab. Turns out now I'm coming close to breaking my back everyday at work . . .there is just NO easy place in nursing on these floors. Your only choice is to get into critical care, but even there it seems the nurses live in mortal fear of actually killing their patients from one wrong move .. ..nursing just isn't easy.

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Doc Lori, R.N. specializes in Dialysis,M/S,Home Care,LTC, Admin,Rehab.

6 Articles; 135 Posts; 7,775 Profile Views

This article needs to be sent to Oprah, Ellen, or news media outlets, for this is the real deal! I wish I could give kudos a thousand times. Not only are you an excellent writer, but you are an amazing healer! I loved reading this! I imagine that the process of writing this was really cathartic for you. Beautiful and real. Funny and sad..this is real nursing..these are the real issues. I applaud you!

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bunmitope specializes in LONG TERM CARE/ACUTE CARE.

2 Posts; 618 Profile Views

I enjoyed your article and I could relate to it, because I work in a hospital setting too! I went through a similar scenario a couple of days ago. May God bless all those wonderful nurses out there, who are going beyond the call of duty, to care for their patients!!

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1 Follower; 1,016 Posts; 13,756 Profile Views

I'll NEVER forget the day I came in with a typical load like this, almost to the T. The night "float" nurse left the floor after not having checked off her some 3-4 pages of orders on not one but TWO patients. Somehow I didn't check them w/ her before she left and she got awaywith it. My day was SO out of control from the a.m. on ....I was almost panting physically by the end of the day ... I think that day one of my co-workers had to relieve me bec. I was so spun out from being so behind . ..and I was relatively new. I'll never forget it.

And don't forget at the end, you'd better clock out by 7:30 or the Powers that Be will be breathing down your neck. So you try to convince the oncoming shift that you didn't get one or two things done and it's 24 hour nursing, but somehow they never got that memo ...and the inevitable dirty looks and rolley eyes come as well.

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2 Posts; 563 Profile Views

I truly enjoyed reading your realistic, well-written article that helped validate what most, if not all nurses experience. Thank you for taking the time to share such a gritty, detailed and hectic daily scenario that ONLY A NURSE could completely understand.

I have been a nurse officially for over 12 years, but worked in the hospital setting for about 18. I have worked all different fields of nursing including in a county jail, emergency, rehab, and an well-renowned orthopedic unit. At some points, I took on more than one job. My adventurous, anti-hospital-politics nature eventually steered me into areas such as agency and travel nursing where I continued to pursue the above with less politics (so I thought). After enduring frequent cancellations from agencies (no contracts) and experiencing travel nursing assignments not meeting my expectations, I decided to learn a new field of nursing about 5 years ago as a psych nurse. "This should be easy, I won't have to lift anyone and my carpal tunnel won't be a problem anymore with all the heavy lifting, twisting and turning, like when I was doing med/surg or rehab." Well, I suppose overall, it did alleviate the aches and pains attributed to the physical demands of floor nursing, but psych nursing brought about a much different stress. This type of stress involves a nurse who wants to promote recovery (while upholding and enforcing the unit rules, guidelines and boundaries), but at the same time required to increase customer satisfaction scores (a.k.a. patients rule the roost and should not be redirected, or else they may complain, lowering scores). Can both be accomplished always, for every patient? I don't think so. Let's be realistic here!

I consider myself to be a compassionate person and really care about seeing my patients get well. I have invested countless hours into helping my patients and have provided a much needed listening ear. I enjoy teaching my patients to eat better, think better, get more sleep and use their coping skills. Things should be going well then right? Not necessarily. I understand that people have different stages of recovery, and unfortunately I think several patients linger in the pre-contemplative stage only (frequent flyers who are helpless, hopeless and angrily resistant to change). As a psych nurse, don't I have a duty to professionally redirect patients as needed (not harshly), keeping them on schedule with treatment expectations? How else are they going to get well, if they just blow off groups and not follow the required schedule. "Ok phone time is over and it's now group time." Did you ever get handed a banana with "Nurse Cratchet" written on it with a Sharpie marker? I have! It was after I encouraged a male patient to go to group and he just wanted to do his own thing and not abide by the rules. Wasn't it "Nurse Ratchet anyway?" ;)

Just the other day I attended a staff meeting and a "pros" and "cons" list from the satisfaction surveys was passed out to the staff. Yes, someone actually has a job where they type in everything a patient writes from the surveys and they get handed out to us to see how wonderful or awful we are. Although I did find my name on the "pros" section, I found more elaborately descriptive negative comments under the "cons" that really frustrated me, yet at the same time was humorous. "She didn't give me any pain medication and then laughed at me when I walked away." Could that have been the comment made by a drug-seeker who exhausted all of his pain medication? (scratching my head) Blatantly laughing at a patient in pain? Never! Laughing at a med-seeking patient who purports to be in pain, but is incongruently joking with his peers and freely moving around without restriction? Still not laughing. I find it sad that patients are so dependent on pain medication and that our system feeds into their habit. I know that pain is subjective and that some people function with constant pain, but come on, at least throw me a bone and show me some sort of sign you are in pain. Otherwise, I am just part of the problem. I remember telling this patient I would have to call and would call the doctor and he didn't like that he didn't get pain medication right away, even though it wasn't time. When I brought this example up to my manager, the response was "well, all I'm saying is if you see your name on this side ("cons") more than once, there is probably an ongoing reason." (Yes, that means I am doing my job!)

I think having patient satisfaction surveys in psychiatric facilities is ludicrous! Many of these patients are anger, suicidal and not wanting to be alive on earth, let alone in a psychiatric facility. They are not necessarily themselves and not really in a right state of mind. So a resistant, petitioned and certified patient (who is involuntary) is going to fill out a survey in a positive way by the end of their stay?. Really? How about giving one to the patient with BPD who scratched her arms one day and blamed staff for "not keeping me safe." Forget her taking any sense of responsibility. Did she approach staff before she scratched herself? No, even though she was encouraged to do so and even contracted to do so. Yes, she is going to fill out a survey too and I wonder who will be on the "con" list.

It got me thinking about all the different scenarios I find myself getting involved with, not necessarily by choice, that usually get patients upset. .....(thinking back)....The diabetic patient (who I never met until the moment she walked up to the nursing station) demanding her glucose monitor and as I directed her to the medication nurse (who I gave it to) came back and said she didn't have it and became furious with me. The nurse actually told her she had it, but it was in a different location, yet the patient came back and got upset with me. Really? I wonder how I score with that one? How about the patient who hated me from the very beginning because he stated "I don't think you like me!" (first time meeting him) and reflected back to when he was a patient in the hospital several years prior and he didn't think I liked him back them. Newsflash "I didn't even work here at that time Mr. So and So." He still remained guarded and paranoid even after learning that is wasn't me. Here's your survey sir, make sure you give me good scores you hear? How about the patient who was deeply offended when I encouraged her to eat a healthy diet, esp. being a diabetic. Offended! Do you think I got good scores from that? Who gets offended when given teaching information about healthy eating? My score is sinking lower!!! How about the diabetic man in his 40's who refused to do his own diabetic care and expected the nurses to do everything. I encouraged him to poke his own finger and demonstrate that he is able to do his own care, since the facility I work in wants us to have patients do as much as they can. It is not therapeutic for me to do something a patient is able to do him or herself. He raised his voice and said "I don't want to!" I calmly asked him not to raise his voice and explained that he needs to be proactive in his diabetic care while in the hospital, so we can feel comfortable knowing that he is competent when he goes home. I then quickly shut up, poked his finger and gave him the result. It wasn't worth the power struggle. How about getting on the "pro" list after that one?

There are so many other stories that I could share of me having good intentions, but those good intentions backfiring and burning me in the arse. I am at the point where I am getting paid to play along with the system and please patients at every whim, even if it is to their detriment, just for the sake of increasing the satisfaction scores. If a patient wants to talk on the phone while it's group time, go right ahead as long as it makes them happy. If a diabetic wants to eat simple sugars, go for it! I know those sweet treats will help keep a smile on your face and hopefully sway your to give us good score. If a drug-seeker wants pain meds even when it is not time and he doesn't appear to be in pain, I will not only call the physician, but request the physician to order a PCA pump to help increase our satisfaction scores. I am learning that treatment is not about being therapeutic for the patient and calling them out when they are not taking responsibility for themselves, but it's really about how to increase the scores.

It's either be a nurse who cares and encourages the hospital recommendations for betterment (probably will continue to get negative scoring from resistant patients), or be a passive nurse who plays along and allows patients to do what they want, breaking the rules and recommendations just so they can give us high marks on satisfaction surveys at the end of their stay. If I advanced my career and entered into the administration realm in a psychiatric facility, I would certainly take the survey results with a clear understanding that they are coming from mentally ill people who are coming from different stages of recovery. At the end of the day, I have to continue to do what I know is best. If that gets me terminated because patients don't want to hear what they need to hear, then so be it. I suppose it's time for me to move on to something else before that happens, because I don't think I can put on the facade for too long, just for the sake of scores.

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Nurse-One specializes in future speciality interest: Nurse Midwif.

158 Posts; 4,067 Profile Views

Excellent writing!

I always felt "bad" for the nurses as I worked as a unit secretary

in a hospital. This is exactly how their day went; mind you, I was in nursing

school and didn't want to continue at some point because of the treatment I saw the nurses

receiving, especially from the doctors.

Being a past CNA but working as a unit secretary, I always tried to do the

simple things: what CNAs didn't or couldn't do and what the nurses couldn't get to.

Being a nurse now, it come with the territory.

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Nurse-One specializes in future speciality interest: Nurse Midwif.

158 Posts; 4,067 Profile Views

To answer your question: so why do I do it?

I do it because i CARE.

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hecallsmeDuchess has 6 years experience and specializes in LTC, Acute care.

346 Posts; 11,361 Profile Views

Thanks for this true depiction of a day in the life a hospital nurse.

So very like my typical day at work, except that I envy you for having a secretary that at least fields the calls and phlebotomy that draws labs for you. Many times when I'm in a patient's room and the phone is ringing on my desk, I wish we had a secretary but these days I no longer run like a headless chicken out of a patient's room to answer whoever is on the other side. I feel that whatever it is, if they need it right away they'll definitely call back and I can't tell you how coming to peace with letting the phone ring when I can't pick has taken some stress off my day. And don't even get me started on the orders for 3 different antibiotics to run at the same time through one peripheral line!

Why do I do it? It's because I care so much, if I didn't I would not have lasted a week.

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