When you care too much- A nurse’s Day

Soundtrack: “If everyone cared” by Nickelback

This morning I received a phone call from a co-worker who I see as a second mom. She is one of the biggest reasons I made it through my first year of nursing without breaking down. She was describing a situation that happened at work yesterday (it was my day off), we laughed, we shared “OMG” moments. An hour and a half later, we ended our phone call and went on with our day. Unless you are a nurse and work in a high stress environment, it is very hard to understand what we go through when we leave work. My fiancee listens when I do want to talk about it, which is not often. But he knows he will never be able to fully grasp what actually goes on. It is hard to imagine what we witness on a day to day basis unless you live it.

What I’ve heard before is, “I don’t know how you can be tired, you only work 3 days a week!” Yes, I do have a minimum work week of 3 days. Some weeks, I can work 4-5 days. Another thing to know about our profession, is we are ALWAYS short-staffed. It will always be short-staffed and that is the way of the profession. I work 13-15 hours per day, with no full lunch break, I’m lucky if I get 15 minutes to eat something without having to stand up. If I get to use the restroom at least twice in that time frame, it’s a decent day. Ever wonder why RN’s have frequent UTI’s and bladder infections? Now you know.  One more misconception of nursing- I don’t make GREAT money. It’s enough to live, but I’m not driving a brand new car and what’s a vacation?

In any given day, I can take care of up to 11-12 people. All coming from different walks of life, different diagnoses, different allergies, different past medical history. ALL of these patient’s require a different plan of care. Some patients are kind and appreciative, while others think we are the Hilton hotel and I am a waitress, drug dealer and short order cook. Others just have zero respect for anyone. It comes with the job. We are blamed for everything that goes wrong. Taking too long for transport to come get you to take you to a test? That’s my fault. You didn’t get a food tray? That’s my fault.  The doctor never called you to update you on your mother’s condition? You guessed it! That’s MY fault. Let’s not forget how we as “floor” nurses, get blamed by PACU (post surgery holding area) for taking too long to get report, ER for not responding fast enough to their call and of course, administration if the patient flow times are not within goal.

What really makes your day suck, is when you care. When you as a nurse, have compassion, care about each patient as if it was your loved one laying there, patient safety and if you are the BIGGEST patient advocate. When that happens, you get behind because we have a 6 patient to 1 nurse ratio. I love the nursing assistants, some are just absolutely wonderful but we barley have enough NA’s to go around. So NA’s can have 10-12 patients!

Now I switched to days in November 2016. Nights were killing me by a slow, painful death. Night’s are busy and you have less staff then during the day! Bless you night shift employees. During the day, you have more resources, but you have more admits/discharges, supervisors and managers almost breathing down your back, you can almost hear the sounds of “Budget”, “Patient flow”, “Watch the overtime…”. Then you have physical and occupational therapy working with patients, doctors/surgeons/NP/PA wanting you at the same time and expect you drop what you are doing to not hold them up (If I’m busy and a doctor needs me at the front desk, I don’t rush and I certainly won’t cut off my patient care, this is why I am a big B but I’m okay with that).  Let’s also not forget about documentation! EVERYTHING needs to be charted or it did not happen! I swear to y’all right now, I think estimated, I chart for 2.5 hours a day. Last, but not least, having people tell you how to do your job. I’m open to criticism, but you sir have zero medical background, now please quietly sit down, remove yourself from my bubble and let me finish your father’s dressing change, thank you much.

Now the day is done. I woke up at 0500, I left my house at 0545, pulled into the parking lot at 0615, I walked the half mile to the employee entrance in rain, snow, sleet or shine, then I went up the elevator, praying it didn’t stop working and I didn’t get stuck in it (But it worked, so first hooray for the day!). Arrived to my unit by 0625, attempted to breath, clocked in at 0638 and then endured the events listed above, then clocked out at 2000. I got lucky, I didn’t get slammed at shift change too badly, so I got to leave before 2100. I arrive home at 2030.

When I get home, I sit in my car, in the driveway, hearing my dogs lose their minds because mommy’s home. I take a breath. I recall the hardest parts of my day. “You have cancer…your parent is not going to make it, hospice has been consulted…your cancer has spread to 4 more places…you need to stop doing heroin or you will die…behavioral health consult…WHY CAN’T I GET MORE IV HYDROMORPHONE FOR MY EXCRUITING NECK PAIN AS I EAT THIS MCDONALDS AND TALK ON MY CELL PHONE AND REFUSE TO FOLLOW THE PLAN OF CARE?!….Jordan please come to this meeting about something that could just be an e-mail…” But I think about the positives as well. “You are C-diff negative YAY…you get to go home today…We cleared up the infection…yes sir,we got it all and you can go home tomorrow.” After I take my few deep breaths, I go inside and see my dogs losing their minds, going in circles and my fiancee handing me my protein shake. He takes my mug, after he kisses me, making sure to avoid my scrubs and sets up my coffee for the next morning. I feel my feet throbbing, even though I wear tight compression stockings, as I make my way upstairs, a dog on each side of me. I take my shower and hopefully get in bed by 2230. Then get up at 0500 and do it all over again.

I will have been at my job 4 years in August 2017. Why do I stay if this all sounds horrible? Because I love these patients, I love my co-workers. I do it for the people who really need care and patience. I do it for the daughter who cried because you took the time to speak with her mother, got her out of the bed shes been in for days. I do it for man that thanks you for just taking the time to speak to him because he lives alone and his wife recently passed. I do it for the patients who need to know someone cares about them.

So, I will continue to get up at 0500, 3-5 days a week, work 13-15 hours and continue my ritual of breathing in the driveway because this is what I do. This is my purpose in this world.

J.E

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