No Glamour in the Trenches…

Happy Nurses Day!!!

THANK YOU for all that you do!!!

Generally, a good number of people do not know what you do. I will try to enlighten the public about your job in this article.

It starts in nursing school. Most nursing instructors are pretty good. The nursing student receives what he or she came for, a good nursing education. However, I noticed a select few nursing instructors who were placed on this earth just to make the life of a nursing student miserable. They challenge the student. They hound the student. They confront the learner. They object. They question the undergraduate over and over until he or she double checks the fact for sure. They test how organized the learner is. The instructors test the nursing student for quick sequential critical thinking. They infuriate the new student. They effectively weed out the students who are not meant to be nurses. They beat you down until you are a little blob in the corner, and then, the instructors nurture you to a confident, knowledgeable, professional and capable nurse.

Here is a shout out for the nursing instructors! If it were not for you, we could not follow our calling, our dreams, and a decent financial future. Thank you!

Nursing school is similar to the military in my opinion. “Hell week” lasts for the duration of the nursing school program. If the nursing student makes it out alive from nursing school, then he or she has really accomplished something.  Pat yourself on the back if this implies to you!  

Taking the Nursing State Board Exam and anticipating a passing grade produces new levels of fear and anxiety.

In the olden days, graduate nurses had to wait 6 weeks for the positive or negative news from the State Nursing Board. Can you imagine what that much anticipation, fear, and anxiety, over such a long period of time, feels like? I can think of an answer, exhausting! Also, the graduate nurse was allowed to work in an RN role for the 6 week wait, however, if the graduate nurse fails the exam; the graduate nurse is immediately demoted to nursing assistant or fired if the hospital has no job openings for assistants.

I watched this system utterly wreck some new graduate’s lives if they happened to fail the exam. As I write these words down, I can see plainly, the system in the olden days really did not work very well!  For the newbie’s, be grateful you are in the techno-revolution!

The new nurse collects his or her shinny new scrubs, shoes, stethoscope, scissors, a pen light, hemostats, calibers, a pen, and other necessities depending on the specialty.

The new nurse arrives on the unit for his or her first day of work as a licensed nurse, full of energy, and ready to try out new skills. Usually, the first few weeks go along swimmingly. The new nurse is typically with a preceptor. As the newbie becomes a custom to the floor or unit the preceptor will give the nurse more responsibilities until he or she takes over the preceptor’s entire assignment. This is sink or swim time ladies and gents. The preceptor will observe all of the newbie’s decisions, correct mistakes before they happen, and grade the new nurse’s performance for the manager. When the nurse gets through this small initial hazing the newbie will go on to the next larger, more severe hazing.

The poor newbie’s, they are so abused! We, the nurses, as a profession, EAT OUR YOUNG! A new nurse will typically get the hardest assignment, or the patient no one else wants to deal with, or the empty hall which will be hit with tons of admissions. This type of assignment is repeated day after day. The person in charge will jump at the chance to make it easier on him or her self. Who wouldn’t in such an intense job? So the newbie’s run up and down the hallways of the unit, so that the nurses with seniority can get some rest. So smile as you run up and down the hallways with hunger pains, a full bladder, and sweat running down your brow! This part of the hazing will change soon enough.

If a nurse is fortunate enough to prove him or her self worthy during the orientation period, the experienced nurse’s, will then step in to teach the tricks of the trade. The good stuff happens in this phase. Patients are grateful to have a confident and competent nurse. The nurse is learning by leaps and bounds! Nurses will learn prioritization, organization, techniques, procedures, patho-physiology and so, so much more. Taking care of people while they are sick, vulnerable and in the hospital becomes a privilege and an honor. Nurses are happy to do the work because of these types of benefits.   

The hazing fades out soon after orientation, but will go on if the nurse messes up royally or consistently. Petty conflicts with staff continue throughout your career. In my opinion, some conflicts occur because of the preponderance of women in the profession. Women are ruthless while sniping at each other.

Nurses help sick patients and their families with love, compassion, and professionalism. The responsibilities nurses have are vast.

The minute the nurse listens to report and accepts the assignment, it’s on!  All nurses need to be prepared for ANY emergency at any time during the shift. This takes ultra-organization! Because the patient is so sick while in the hospital these days, emergencies happen frequently and are common place.

Nurses have to be attentive to the various sounds on the unit like the IV machine, the call lights, the heart monitor, the ventilator, and the cell phone the nurse carries in his or her pocket. Each one of these sounds will generate new tasks, which will need to be addressed immediately or in a timely fashion. Having polished time management skills becomes paramount when dealing with the copious interruptions.

A typical assignment will include (depending on the unit and shift) 1-15 patients. On occasion it is necessary to assign 2 up to 5 nurses on one patient.

Nurses are responsible for the wellbeing of each patient he or she agrees to care for during the next 8, 12, or 16 hours. Nurses are responsible for the administration of medications. Nurses will know the intricate details about each medicine he or she gives during a shift. In other words, the nurse will know the what, the when, the how, and especially the why to each medicine given throughout the shift. Nurses check for the benefits of the drugs and the adverse side effects to the medications.

A nurse will assess and re-assess the patient during the entire shift.

Nurses give updates to the patient’s family members frequently throughout a shift. Some times the family will need more care than the patient does.

Nurses will perform most treatments. Examples of treatments are, the nurse will assess, monitor, and maintain clear respirations while the patient is on a ventilator. The nurse will assess, monitor, and maintain adequate cardiac function and output. The nurse will assess, monitor, and maintain baseline neurological status. I could use the previous sentence for each system in the body and for each piece of equipment used to aid in healing of the body. The list would go on for miles! The nurses reading this article know that the words assess, monitor, and maintain translates into a whole bunch of work!

Other duties nurses perform include, maintaining IV access, keeping the line or lines patent and working properly through the shift. Nurses draw blood from central lines for laboratory analysis. Nurses keep track of tracings from the cardiac monitor. Nurses assess and treat various levels of pain, nutritional status, hydration status, and elimination status. Nurses assess, monitor, and maintain tubes, tubes, and more tubes! Tubes protruding from every orifice of the body and then some! Nurses monitor vital signs, blood sugars, and oxygen saturation levels regularly. The nurse will interpret various laboratory results, and share the information collaboratively. Nurses are able to iterate up to date info about their patient at any given point during the shift. These examples just scratch the surface of what a nurse accomplishes during any given shift.

Nurses alleviate the patient’s fear by teaching. In my opinion, teaching is the most important job the nurse has to accomplish. In this day and age the patient needs to know about their illness, medications and how to care for themselves at home.

Another important layer of nursing is listening. A nurse will actively listen to the patient’s concerns. Nurses get a lot of their information by observing. The nurse will check for congruency while talking with their patient’s. If the conversation does not match up with non-verbal communication; nurses dig deeper.

Occasionally nurses will get time to empty their bladder, but rarely will have time to eat. During and at the end of the shift the nurse will chart. Nurses must write down everything that happened to the patient during the shift. If the information was not written down then the assumption is made that the work was not done. Impeccable charting is a must! The last task the nurse will do is to give report to the next shift. After the transfer of patient’s is complete the tired nurse gets to leave. At this point I was usually limping home after a 12 hour shift! My body ached! I would go home, eat, shower, and sleep fast. After 7 hours of sleep I would go back and do it again.   

Nurses work hard. There’s no glamour in the trenches. Actually, it’s pretty gross when a nurse gets ‘slimed’ by a projectile mucous glob from a new tracheotomy!!! 

Nevertheless, nurses choose to be in this profession. Nurses are there because they want to be and to provide care to the patient.

It’s a dog-eat-dog world in nursing, but the benefits or gifts definitely out weigh the negative parts of the job. Our gifts include, watching a patient get better, watching a patient wake from a coma, watching a psychotic patient become lucid again, watching a patient survive a complicated surgery, or watching a patient fight an infection and win!, watching a child go into remission, Watching a mother give birth without complications, or watching a patient die with dignity intact. These are examples of the good stuff or gifts nurses receive everyday.

Happy Nurse’s Day to all you nurses in the trenches out there. I know what you do and how hard you work. Thank you!

Tags: Happy Nurses Day!!!, Nurse, nurses eat their our young, student nurse, trench