home     about     submit your story/contact     best of     rss

A Day In The Life

This is a very very long post. It details the first 5 hours of a 12 hour shift. Things were especially frustrating on this day.

I had two patients, both of which I had had the day before. Patient 1 is a 300lb. woman in her 40′s with multiple medical problems. By this point, she was on a ventilator in a coma, had a history of spiking temps to 107, was on 70% oxygen with 10 of PEEP (5 is normal) and sats in the low 90′s. We were basically keeping her alive until her grandmother could get there that evening. Patient 2 was a man in his 50′s with an infected toe. He came to us in CCU because his BP in the ER went to 70 one time, which made the docs worry about sepsis. Every vital sign that he had taken in CCU was normal and stable. Prior to admission the day before, he had been independent at home and had a job.

7:45AM: I have 10 medications due for my comatose patient at 8am. Yesterday, I had problems getting one of those meds from pharmacy. Today I check early – it’s not there! I go to the computer and re-order the medication. I mount my patient’s EKG strips and organize my day.

8AM: I check for the med – not there. Okay. I hang/administer the other 9 meds. This takes me 1/2 hour, as the pills need to be crushed and dissolved, other drugs need to be drawn up and pushed slowly, etc. It also takes longer because the stopcock on the patient’s NG tube is cracked and leaking. Got another one and changed it out. Also, the tape on patient’s nose keeping the NG tube in has come off from sweat. I change that after struggling with the old tape – the nurse who put it on didn’t fold over the edges of the tape, so it was all stuck together. I have to be careful tugging at the tape so I don’t pull the tube out of the patient’s nose.

8:30AM: I check for the 10th drug. Not there. I call pharmacy and ask where my drug is… they say that it’s a once a day drug. Yes, I know this. It’s due once a day at 8am. I tell them that this is the 2nd day in a row that the medication has not been available for me when it was due. They say they’ll make a note of it, and they’ll mix it up right now. This is fine, except that the purpose of re-ordering the med in the computer was supposed to take the place of this phone call.

8:35AM: I get the call that nuclear medicine is ready for patient 2. I get the gurney to get the patient on it to go down for this test, after I’ve paged the doc (twice) to get orders for him to go unmonitored (he’s very stable). I do this because I know that the flex nurse that must go with monitored patients is very busy and it will take much longer to arrange for her to come.

8:40AM: Transporter (in record time) is waiting here for my 2nd patient, who has decided that he has to use the urinal right now. I beg the transporter to stay and wait a few minutes – transporters in our hospital are very very busy and in demand. They usually won’t wait more than a minute or so. If you aren’t ready, they leave and you have to call again. This can take up to 30 more minutes. I don’t want my patient to be late for his test, so I tell her it will only be 3 minutes, hoping that he can pee fast.

8:41AM: I check for patient 1′s med in the tube delivery system – I find that the delivery system is not working right now. Great.

8:42AM: I check on patient 2. Still peeing. Transporter still waiting.

8:43AM: I check on patient 2. Done peeing. I quickly unhook him from the EKG leads, BP cuff, O2 sat probe and IV and ask him to move over to the gurney. I am trying to be fast.

8:45AM: I tell the transporter that patient 2 is ready for his test. She asks where the transport sheet is (yes, another sheet to fill out). I hurriedly fill one out and tell a coworker that I am going to the pharmacy to get my medication for patient 1.

8:53AM: I return, distribute 3 other meds to other nurses that the pharmacist has asked me to bring over, then hang my 8AM med one hour late. This means that my 9AM med will be late, which means that my whole morning’s IV meds will be off. Get patient 2′s breakfast off the cart and put it in his room before someone takes the cart back to the kitchen with it still inside.

9:00AM: Patient 1 has an insulin shot due. I check the fridge for insulin – we usually have several bottles of each type of insulin open because people take them into the rooms, someone else needs the insulin and since it isn’t there, assumes that the bottle is empty and opens another bottle. Yesterday, there were two 1/2 filled open bottles of Aspart insulin either on the counter or in the fridge. It can take a week or so to deplete insulin bottles. Right now, there is no Aspart to be found. Re-order Aspart from pharmacy. Patient’s blood sugar is over 300. Oh yeah, tube system still down. Damn. Check with other nurses to see if they’ve used Aspart recently. None have.

9:05AM: Second trip to pharmacy today. Why do I go myself? Well, it’s true that the pharmacy can call transporters. Transporters, as I said, are very busy and it can take 30 minutes for them to bring something over from pharmacy. I’m already feeling behind and don’t want to wait that long, as I might get distracted with other things and forget altogether.

9:07AM: I get to pharmacy. I tell the person helping me that I ordered Aspart insulin and am here to pick it up. She gives me a quizzical look (like I said, we usually have several bottles of each type of insulin around) and asks if I checked the insulin bin in the fridge. This is where I start to lose it a little bit. Yes, I say in a controlled voice. Of course I checked. There isn’t any there.

9:10AM: I give my insulin. Patient 1′s temperature is about 103, and I check the cooling blanket that she’s laying on. Did I mention that she weighs 300 pounds? The blanket is warm. There is no cool/cold water circulating. It might be because the nurse before me didn’t clamp the blanket before putting it under the patient. The patient’s weight will have pushed all the water out and seeing as how she weighs 300 pounds, it’s not going to refill until I take it out.

9:15AM: Patient 2 is back. I get him back into bed and hook him back up to everything (EKG monitor, O2 sat probe, BP cuff, IV) myself, and take his temperature. Get him set up for breakfast. Patient reminds me that he is lactose intolerant, and there is milk on his tray, despite the fact that I entered in TWO places that the patient is lactose intolerant yesterday when I admitted him. Get him juice instead. Give his meds, give his insulin.

9:35AM: I manage to find 2 other nurses to help me roll the patient over so that I can take the blanket out. One of these nurses can’t lift more than 25 pounds due to a recent injury. She’s the one that takes the blanket out. Now free to fill up, we watch it. Nothing. No filling.

9:37AM: Order new blanket and new cooling machine, just in case.

9:40AM: Give rest of 9AM meds. Think back to yesterday when patient 1′s potassium level was low. Realize that I just gave 80mg of Lasix and no one had ordered a chem panel for this patient this morning. Order it myself, draw it up and send it to lab. This takes several more minutes than I had anticipated because the blood flow through the catheter is very sluggish. Thank GOD tube system is now working and I won’t have to have it hand-delivered. I get another nurse to lift up the fat folds on patient 1 so that I can put anti-fungal powder there so she won’t get yeast infections. There is no way that I can lift her pendulous belly, arms, and breasts myself with one arm and put the powder on with the other … I will surely hurt myself. I’m not being mean, I’m being realistic. The little, tiny hole on the top of the powder bottle won’t let any powder through. I stick a needle in it – it’s not clogged. Still, every time I squeeze, only a few faint puffs come out. I get a pair of hemastats and jam them into the hole. Ahhhhh. Much better. Powder everywhere!

10:00AM: Time for patient 2′s pain med. He’s been asking for it for an hour, but it wasn’t due until now. Had no time to call the doc and ask for more frequent dosing. Patient 2 was not in that much distress; he said his toe only hurt when he moved it. I give the med.

10:15AM: MD decides he wants a cat scan of patient 1′s head. I tell him that when we had her laid flat to get the cooling blanket out, she turned a bit purple. He wants me to show him. I put the head of her bed flat again, she turns a not-as-dark shade of bluish. He tells me to get the scan. (You have to be completely flat for several minutes to get a head CT.)

10:30AM: Put in order for CT of the head. Get potassium results back – ACK! K+ level is 2.8. Very low. Start replacing potassium via IV. Check on patient 2, as he has put his light on. He wants the dressing on his toe changed. I take off the band-aid and put another one on it. He asks why I did not clean out the 1cm x 1/2 cm wound. It had been draining, yes, but I didn’t feel as though I had time to sit there and irrigate it. I feel guilty, like I’m neglecting him or something, so I say I’ll be right back.

10:45AM: Return with towels, irrigant, dressings. Take off band aid, irrigate wound with saline, dry it gently with sterile gauze, apply dressing.

11:00AM: I call the CT scanner for patient 1 to set up a time for her scan. They say that they have a patient on the table, but I can start getting her ready and that I should call them before she leaves the unit. I am used to dealing with PM scanner techs, and we have an understanding that when they say get the patient ready, I am going to start assembling several people: 2 Respiratory Therapists (RT’s) – one to bag the patient on the way over, and the other to take the vent to the scanner and get it set up. I need to call the flex nurse (“flex”) to accompany the patient, as she is critically ill and needs monitoring. I cannot go myself because I have another patient. I get a portable monitor and the flex nurse shows up. The flex and I transfer all of the monitoring boxes from the bedside monitor to the portable. I stop the patient’s tube feeding and flush the tube. We disconnect other various tubes and wires.

We call transporter to come and help push the bed – they say that they’re on the way. The RT’s were eating lunch, but came up anyway to take this patient to CT. I call the CT scanner and say that the patient will be over just as soon as transport gets there.

The tech says that there is still a patient on the table. How much longer, I ask? I have coordinated 3 other people (with a 4th on the way) because you said to get her ready. The tech says it’ll be another 25 minutes. 25 MINUTES??? I have to tell 4 other people that they have to wait another 25 minutes, especially when 2 have left their lunches to come as soon as possible? It seems like an eternity. I tell the tech that the other tech said to get the patient ready and call. She said no, the other tech said to get the patient ready and call to see if we could come then. I am livid. LIVID! She KNOWS how difficult it is to arrange to take a critically ill patient to CT. I hang up on her.

11:20AM: I tell the flex nurse that the tech wants him at 11:45AM. The flex tells me that’s probably how long it will take transporter to get here. (ha ha) I intuit that that will not be the case. I go to the other side of the unit to get a dressing change kit and see a transporter walk up (really on the ball today, those transporters) and ask the secretary who paged them. I see that there’s a patient on this side that needs to go to another unit, but the nurse says she isn’t ready; she doesn’t know who called. I ignore the situation thinking it will buy me time. Yes, I’m not proud of it, but I was prepared to blame the delay on the transporter rather than tell the RT’s that they had to wait another 20 minutes, when they could have finished their lunch. I knew the flex would take the patient early, where the patient would sit out in the hall being bagged. I just didn’t feel right about it; I felt better having the patient wait in our unit.

11:30AM: I sit down for 3 minutes and catch up writing my vitals.

11:33AM: The flex nurse re-pages transport. I did not tell her that they had already been here. She specifies this time which room to come to.

11:38AM: Transport shows up. The patient is ready to leave. I call the scanner to let them know that the patient is coming NOW. I am feeling sheepish since the last time I talked to her, I hung up on her in frustration. They don’t answer. I let it go – there’s nothing I can do now. The patient will just have to wait in the hall, being bagged and monitored, until the patient on the table is done.

11:40AM: Sit down to chart my assessments (yes, at some point I did manage to listen to lung and heart sounds, etc. on both patients).

11:45AM: Patient 2 puts light on. His urinal needs to be emptied. I go to empty it and he says that he spilled some on his sheets. I realize that it must not be an easy feat using a urinal in bed (it hurt his toe too much to stand to use it), but if 100′s of other patients can do it without spilling, why can’t he? I admit that this is going through my head and probably shows on my face. I empty the urinal, noting how much was in it, then go get new sheets. I pull the curtain and tell him to roll over. A little more, sir. Ok, a bit more, please. (GOD! TURN ON YOUR SIDE!). Ok, now turn the other way, there will be a bump where the linen is folded over. Great. I start to walk out and the patient calls to me. I turn around and his hands are up. I look at him, realizing the second before he announces it that he wants to wash his hands. I think soap and water will be messy in bed, so I go and find some of those antiseptic towelettes that come on the patient’s food trays.

I find one and take it to him, opening it for him, and he says, “What is this?” I say it’s antiseptic, to wash his hands with and hand it to him. He reluctantly takes it and looks at me like I have 3 heads. I say What? He says in his best “Well, duh” voice: “I need to wash down there, too.”

(Side rant:) Ok, forgive me, but in 7 years of nursing (ugh – actually it’s almost 8!), I have had very very few male patients ask to wash themselves down there after peeing. That’s just how it’s been. Females almost always want to, but males.. not so much. I do realize that he spilled some. I still have patient 1 on my mind, wondering if she’s about ready to code in the scanner while being flat, thinking of all the meds I have to chart, the assessments I have to chart, and yes, I was thinking that I wished the aide was there, but she wasn’t.

This was probably somewhat reflected on my face. It was sort of the last straw that was precisely placed on a pile of a whole bunch of other last straws. There was just someting about the way he looked, the tone of his voice… I felt like a handmaiden. Even so, I turned and went to get him some washcloths. I went into the room, straight to the sink and held my foot down on the pedal until the water that came out was very warm. I put soap in two washclothes, plain water on the other two, and had a dry towel. When I went to give these items to him, he was looking straight at me (NOW the aide is in the room, preparing to test his blood sugar) and said,

“Have I done something to make you so cold and uncaring towards me? All of my other nurses [He'd had ONE other nurse, overnight, and yes - she's probably a pillow-fluffer] have shown me such caring, but you are so cold.”

This statement was met with stunned silence on my part. I had answered his light every time within minutes of him putting it on, instead of waiting for the aide to get it, like many other nurses do. In between coordinating all of the SNAFU’s with patient 1, I had gotten him his pain med on time, gotten him to his test on time, gotten his meds into him on time, and changed his dressing, which is NOT something that needed to be done right then, especially in light of my other patient, who’s temp was up, who’s cooling blanket was on the fritz, and who’s sats weren’t the greatest on (now) 100% O2 with 10 of peep. I had brought him several warm blankets when he was cold. I made sure his breakfast was there when he got back. I did all of this between dealing with Patient 1, AND patient 1′s family, who understandably had a lot of questions.

I finally managed to stammer that I was sorry he felt that way, but that my other patient was very busy, and….

And then is when I plopped his damn washcloths down and walked out. I never went back in.

I told the charge nurse (through tears) that I needed to switch assignments and told her what he had said. It HURT. Right after that, I went into the bathroom and cried for 10 minutes. When I came back out, I found that my coworker was totally willing to swap one of her patients for mine, and we did just that.

I was very grateful.

12:15PM: Patient 1 is back from the scanner. Although the head of her bed is up, she is purple. Very, very purple, with bloodshot eyes that are bulging out of their sockets. Still comatose, she’d had her eyes open for days. Every hour or so, I’d put artificial tear drops in to keep them moist.

We got her hooked back up to the vent and had to switch monitors back, and plug in all of the other stuff. By then, I’d gotten a new cooling blanket and machine and got that back on her (not under her; not enough nurses around at that time to help me roll her.) Gave her Tylenol and had the aide do her blood sugar. Covered that with the insulin that strangely cloned itself in the last 3 hours – there were now 3 open bottles of Aspart insulin on the counter, 2 of which were half empty. I hope they had a nice time wherever they were when I needed them before. Hung more potassium, hung antibiotics.

1:00PM: I have finished charting now. My charge nurse tells me that I have to transfer the patient that I have just swapped for to the telemetry floor.
I get his belonging sheet checked off and get him in a wheelchair (small miracle that one of those were available) and get him to the other unit after calling report. Not before giving him his 1PM meds, of course.

1:30PM: I have just one patient now. I go into her room and find that her cooling blanket stopped being cool. And there’s a funny red button on the cooling machine that’s blinking.

1:35PM: I call central supply to see if they have another machine. They say that one’s in biomed (no kidding), and that they do have one more. They bring it to me in record time (thank you) and this 3rd machine works great the rest of the day.

2:00PM: I go to lunch.

The rest of the day was fairly uneventful; certainly nothing like the morning. Interspersed with what I described here, I had to take phone calls and patient 1 needed to be suctioned frequently, sometimes several times an hour. Patient 2 was in the unit all day, having to go on an insulin drip for his high blood sugar. I asked the nurse to pull his curtain a little so I wouldn’t have to look at him through the glass door. I catch him staring at me anyway, because he can still see out into the unit. I resisted the urge to glare at him, and tried my best to ignore him.

Post to Twitter


Comments

Good holy leaping Krishna on a popsicle stick. I know exactly what you mean. I do hope you got to rest that night, preferably with a glass of wine and a footrub.

HolyMoly!
I’m a nursing student (starting in May, that is) and I love reading posts like this. I’m really curious to compare the real world that I read about here with what my instructors will have to offer.

Wow! That was a fun read. I’m a senior BSN student, graduating in May and I’m doing an internship in the ICU this summer. Can’t wait!
Thank you for sharing your day with me.

your time management skills amaze me. I think you showed great restraint with your one patients almost”self centered attitude.” I mean he is being nursed in the critical coronary unit. I don’t see washing your genitals after urinating as “critical” especially when others around you are hooked up with various tubes and machines.
Glad your day ended on a better note. I enjoy your blog.

Sounds like a tough day! Is everyday in the ICU like that?
Almost sounds like the toe guy was the hardest to deal with–what do you say to accusations of neglecy when you’ve done everything you can for them?
Hope you went home and had a nice, relaxing evening.

Wow. What a day. What that guy said is really too bad, it’s no secret that nurses are very very busy.

I understand the hectic nature of your job and the frustration. While I don’t work at the hospital and probably don’t keep nearly as busy, I work with Durable Medical Equipment and know the cranky nature of the suffering and sick. Keep up the blogging!

As always, I admire your incredible skill, stamina, and devotion. Even if your patient did not recognize your outstanding care, you can take pride in the fact that you were EXEMPLARY in your care and your tremendous example of professionalism. You are always an inspriration to me. and to all you nursing students out there…for every patient that is unappreciative, there are MANY who are grateful, and show that gratitude in simple and wonderful ways!

AAAAAAAarrrrrrrrrrrrgggggghhhhhhhhhhhhhh!!

I’m surprised that you were able to remain so calm in front of the patient. It truly is a tough row to hoe sometimes, isn’t it? I’m sorry that you had a bad day, but remember, our patients don’t always understand what we have going on once we leave their rooms. To so many of them, we’re little more than chambermaids at a hotel – there to cater to them alone. Had you been able to explain it to him, I’m sure he’d have been more sympathetic, but since you couldn’t, you did the next best thing and got him someone else who could fuss over all the little things he wanted.

I don’t know whether to be relieved or horrified that other hospitals have as many problems with getting meds from pharmacy as I do. I find that a neverending source of frustration (pharmacy and the diet kitchen both). It is also frustrating to feel appreciated no more than a waitress by patients such as the one you described. In my mind, they are obviously not sick enough to be in a hospital if they can imagine we have nothing better to do with our time than to be available for their every whim. Okay, I think I woke up on the wrong side of the bed this morning. Sorry to vent. I hear your frustratations in this post and they obviously resonate with some of mine.

BTW – this was an excellent post describing a day in the life of a nurse!

Thats my girl…I remember those days but to put into words like u do is amazing. When will your book be ready??

Do we work in the same ICU at the same hospital?? Sure seems like it!

have to say what a downer of a day, respect for knowing your limits, but imagine having four patients to ‘care’ for on a CCU and you can imagine the hassle we get in the UK. Nice blog, cheers for the reality check

it is truly amazing all that you packed into this post and day, and even more amazing to consider that this probably wasn’t so different than your everyday experiences. very well written!

That above comment “Do we work in the same ICU?” is so true – but where was I?? If I was there (as a CCU tech), I would have been there to run to the pharmacy, deliver food trays, transport patients off the unit, empty pt2′s urinal and change his sheets (and band-aid), and help you turn the 300 pound woman. Where’s your tech??!! You need some help up there!

You have just perfectly described my day on the floor, just add four more patients per nurse. Ortho post-op, all over 200 lbs, all needing turned and monitored and medications that are never there on time. Patients that can’t help you turn to the side to hit the bedpan. Numerous bed changes per shift. No assistants around to assist. Days like you described occurred everyday, and it makes me glad that I now work in case management.

You have just perfectly described my day on the floor, just add four more patients per nurse. Ortho post-op, all over 200 lbs, all needing turned and monitored and medications that are never there on time. Patients that can’t help you turn to the side to hit the bedpan. Numerous bed changes per shift. No assistants around to assist. Days like you described occurred everyday, and it makes me glad that I now work in case management.

I could only skim through your post, so I wouldn’t get angry. After 16 yrs. on Med/Surg., it’s the same crap I’ve expierenced, minus the outright need for a CCU bed & as others have commented, we get the increased patient loads. It seems to me over the years, the patients were not paying attention when everyone was telling them we are having a “Health Care Crisis” and there are not enough Nurses! I applaud your time management skills, which I know, is what saves your butt and I sincerly hope your superiors recognise your great work. In my Hospital they did not. Morale has been low for many years and turn over high. I know I couldn’t have relaxed enough after that one! Oh yea, and the customer/patient is always right, so the hits keep coming…Shields up!

Thanks for doing such a good job in letting others know what it is like to be a nurse in today’s work environment. Although, everyday isn’t like the one you just described, way too many days are! It is time for hospital administrators to listen to what nurses say and support their needs. Support means making sure the nurse has what she/he needs when she/he needs it. It is unacceptable to practice in environments where medications, supplies and auxiliary staff are not available when you need them. This just adds more stress to an already overburded system that is known to drive nurses away from bedside care.

Keep being the wonderful nurse you are and more stories please….

i can see why so many people die from staff errors in hospitals…diane

when my mom was in ccu there was a code vlue…a 30 yrold heart patient who had an aortic graft collapse and died …i heard the dr tell the mom that the stitches had come out…what an ass….diane

What a day. I’ve had many of those. It is frustrating when the least sick of your patients is the one who takes up all your time.

The parade to the CT scan is one of my all time favorite rants. We don’t have flex nurses so our staff has to go with the patient and leave all the other ones on the floor alone. They are covered by another nurse but nothing gets done and then you have to catch up when you get back. Sundays are MRI days and our hospital has figured out how to take ventilated and lined up patients in there. The only patient they can’t take is one that weighs over 400 pounds.

Reading about a day on the unit for you is Deja vu for me – from 18 years ago!!!
I guess things haven’t changed much in the nursing profession.
Just dont wait till you burn out to change jobs.
hugs

Geena, I found your blog thru Newsweek and have spent the last few nights laughing and crying thru the blog. You have a fine sense of style and can tell a yarn with ease. Please bless us with a book. It will be a NY Times bestseller. God bless you.

Ex-dialysis nurse considering getting into a nurse residency program and picking the adult critical care and emergency nursing specialty. Found your article very enlightening.

Pushin’ the library cart …
Tell me if you would; the volunteer coordinator at VicGeneral asked if I might be interested in trying Medical Imaging when I feel a change of assignment coming on.
What would I be dealing with?

Wow – that was like reading the story of my life. It’s a relief to know that I’m not the only one who has those days. I have been in that exact situation so many times. People think that a walky-talky patient is a breeze, but your entry clearly shows that is not always so. Just one question – when did you get to pee and eat? Just kidding!

Great Blog. I found it from the Thinking Nurse blog that links to yours. You have given me some ideas for my new blog.

I graduated from a small nursing school (Darton College) in Albany, Georgia about 12 years ago and have been a nurse ever since.

My husband talked me into starting a blog a little while ago. It’s about travel nursing. Check it out at http://travelnursingjob.blogspot.com/2006/08/travel-nursing-jobs-in-california.html. Let me know what you think. It is not as serious as your blog but I am just getting started.

Would you consider exchanging blog links?

Thanks,

Amy Robbins, BSN

I just found your blog, realize I am a little behind in commenting, but LOVE your stuff. I am currently a float tech in a large teaching hospital and I am a nursing student. I recommend this blog to all the young nursing students who have no idea what it is like to work in a hospital. They need to know.

I understand your frustration, just be glad you had a flex nurse to go on transport and someone to help with checking blood sugars. On our unit there is no such thing as a flex nurse so we have to go on all transports and hope that our other pt is being looked after by the rest of the staff. We don’t even have an aide to help with baths, I&O and blood sugars.

I totally understand. You know I cannot believe how inconsiderate can be. You know the ones that are really sick don’t complain. I work in the Er and we have those issues all night long. So everone who is septic or possilbly septic goes to the ICU???? WTF. That’s why we have so many holds in the Er. Well hang in there girl.

You know I could have written the daily routine, but usually on two of the comatose,vented patients, with every known med/lab protocol in place for the nurse to decide to use as indicated. Add to that being the charge nurse, with a 12 bed unit, and a 36 bed tele unit, so assingments, etc, and it DOES ADD UP to no lunck, no breaks, no BR breaks, and hopefully off within an hour of the time I should be. BUT even though the complaining patient did strike you wrong, I can see his point. HE ONLY saw you when he put on a light, and he saw that as hurry in hurry out, as the other patient is considered more important by you, and demanding most of your time. All patients need TLC, esp. lonely ones, and those that are too well to be in the CCU:/ICU and have time to watch the nurse come and go room to room. The comatose patient has no idea how much care they are receiving. IT works both ways, I never leave a room without making a couple of personal tasks, or at least asking if there is anything else they need for the next 30 minutes or so.

I am saddened that you and many of the nurses’ commnenting on this blog entry think it is appropriate to tell a patient that your attitude is becuase you have another patient to car eofr that is sicker. If you in fact were the patient – would you give a darn about anyone lese but yourself. Perhaps we have all forgottent hat we chose to work in this profession and if we cannot or do not like the stress of it than perhaps we need to make a change. We wonder why no one recognizes or appreciates us – if we act like whining children – we do not deserve praise or recognition.

To michelle:

So because I had one bad day and wasn’t able to keep it together for one patient, I should just bow out of nursing now?

I guess I don’t write about all the times that I’m on the ball because frankly it isn’t as interesting.

I’m glad you’re able to remain perfectly composed under stress 100% of the time. Seriously. That’s really quite a feat!
I myself can only remain perfectly composed 99.9% of the time. I am not ashamed to admit it :)

And because of that, I need to change my profession?

Maybe in the future we’ll be replaced by robots and can take the humanity of out the equation completely!

Thanks for the comment.

“People don’t remember much about our medicine but they remember how we make them feel.” -Thom Dick. I worked a too busy IIC for several years. I have learned that we are better nurses if once in a while we can put ourselves in our patient’s shoes. Hang in there!

I’ve been an inpatient frequently this past year, and have had several stays in ICU, twice on a vent. In fact, the last time was about a week ago. I am embarrassed to say that I made my nurse cry. I guess I could stand in for your patient with the toe issue. I was in pain, very scared, and angry that my nurse she seemed unable to answer any of my questions, or even to know what was wrong with me. This was the second day she had me, and she still did not know anything about a chronic illness of mine that made hospital life very difficult — CRPS/RSD. She kept putting charts and tubes, etc. on my very painful legs and would say, “Jeez. They are barely touching you, come on!” I was ready to kill her and told her so. I needed something for pain, and having had a great meeting with pain mgmnt, knew that I had been put, as requested, back on my home meds — I was polite when the nurse brought me a methadone tablet for breakthrough pain, and was trying to explain that that was a scheduled long-acting med, when she said, “You don’t want it, fine, I’ll write that you are refusing your pain meds” and walked out.

I wonder if ICU nurses become so used to working in the presence of patients who are either snowed, on a vent and out of it, or just plain confused, that human interaction sort of falls away. While on a vent, while being suctioned, or turned, I heard more intimate details shared between nurses, RTs, etc — when I was quite conscious and lucid!

One nurse made fun of me saying she was “sick of this one going ‘O! O! Don’t touch my legs! Ouch! Ouch!’” The nurse with her pointed out that I was awake, to which she responded, “She won’t remember anything…”

I guess, on a bad day, yours is a job I wouldn’t wish on my worse enemy… except that I know we’re talking about a *bad* day — and an unusual happening.

I think you did nothing wrong — being human in the midst of all the professional work ought to be a job requirement. Unfortunately, you were pushed to the breaking point. Thank you for sharing the details of a rotten day.

I know that as I reflect on what a bitch I was to the nurse who ended up crying — I am resolved to let more stuff just go… Most of the time, it was fear talking. I need information, and was not receiving any. Unfortunately, she wasn’t the greatest of nurses in terms of her knowledge base, but me going off on her wasn’t going to change that. So… nurse out there whom I made cry — I am sorry. I was scared and needy (ick, what a combo).

Keeping in mind I ve been nursing in critical care for 39 years—we ALL have had days like that. I find if I care for patients as I’d want my mother or other family cared for, it lessens the blow and guilt.

I understand ur frustration with the radiology tech staff but hanging up was only demonstrating she got to you and it was unprofessional. Human or not, if someone had done that to you, say the pharmacy staff, how would you react?

As far as your perceived attitude by #2 pt, I felt it from my side of the screen. I’ve been in your shoes so please don’t interpret this as a slam. It’s an observation. Your time management and critical thinking are spot on, but you admitted to being rushed and expressed it showed on ur face. How else would he be left to feel. The night shift pillow fluffer probably didn’t spend that much more time–it just felt that way to him.

Slow down a bit and apply all that great skill to your presencing and see what happens. God bless and God speed. <



So, what brought you to the hospital today?

Line and paragraph breaks automatic, e-mail address never displayed, HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

(required)

(required)

Your Progress Note



Author

  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

Find Me

Twitter Facebook RSS

Badge Blooms


Nursing


Med Blogs


Other Ways to Leave




Meta