A Contradicting Career..

pulse-trace-163708_1282What constitutes a meaningful life? What defines you? Is it your career, your achievements, your fame, or your fortune? What makes you, you? What have you acquired that made you the person you are? Why is our self-worth tied to numerous things.. when it should all be within ourselves?

I am a nurse. I save lives. It’s an emotionally, physically, and mentally exhausting career. I’m constantly on edge at work, but little do people realize, it’s extremely hard work. I wake up at 4:30 to 5 a.m. every morning, hitting the snooze button as much as I could. When I finally am able to kick the covers off, I run to the bathroom and do the usual brushing of the teeth, shower, put on the scrubs, a little makeup to make me look undead, and comb the hair into a bun. I prep myself a bowl of cereal, make some coffee, and grab my cell phone, stethoscope, badge, keys, and head out the door.

There is always a possibility that there would be traffic, so I always leave around 5-ish to make it to my 7 a.m. shift. When they say nurses work 12-hour shifts, it’s not, it’s usually more. If you factor in from the time I wake up until the time I come home is a total of 15 hours a day, and most times, no lunch break in between. I get to the hospital around 6-ish.. then I begin driving around looking for parking in the garage. Once I’ve parked, I haul ass to the hospital so that I could clock in at 6:30 a.m. Once I’m in, I run and grab my assignment for the day and begin looking up my patients.

Our huddle begins at 6:45 a.m. Once the charge nurse is finished with the announcements, we break and go fight for the rolling computers because they are so few of them. I use a sticky note to claim my computer and the night nurses come and look for me for the handoff reports. We walk into each patient’s room, introduce ourselves, go over the plan of care, talk about why the patients were admitted, and what needs to be completed before the patient could be discharged. We do this for our four to five patients, depending on the census for the day.

By the time report is finished, it’s 7:30 to 7:45. There are a few things I have to do before I begin my day, I chart who I got my report from, and the time I received it. I usually get reports from a couple of different nurses.  I also begin my documentation of the patient’s status upon my first encounter of the patient in the room; this counts as my neurological assessment. Charting  for that goes somewhat like, “Received report from Anne, RN at 0720. Patient alert and oriented, with no signs of acute distress noted. Bed low, wheels locked, call bell within reach. Will continue to monitor.”

Medication passes begin from 8 to 10 a.m. Before I begin pulling medications, I look for any orders that have not been completed by prior shift nurses. If there were any labs, imaging studies, or procedures, there are different protocols in place that I have to carry out. If labs weren’t drawn due to the patient being a “hard stick” then I have to figure out another way to obtain labs. Either I pull labs from the IV.. or I have to call the PICC team, who are specially trained nurses that insert IVs using an ultrasound machine, to draw my labs.

Labs drawn early morning from night shift are sometimes available for me to see, other times, I have to wait a little later, around 8 o’clock. When the results are shown, I have to look at what is abnormal or not. If potassium is low, I replace it, same with magnesium. If the patient has a critical lab value, either too low or too high, I have to page an FYI to the doctor. I then look at the patients’ vital signs, which includes their blood pressure, heart rate, oxygen saturation, respiration, and temperature. If anything deviates from the norm, I have to correct them according to the protocol or order that’s in place.

Not only do I look at the vital signs and labs, I also have to look at the trends. I have to distinguish the patients’ baseline, what is normal for the patient, and if it deviates, then that’s a change in patient status. If the patient is a diabetic, I have to either correct the blood sugar with insulin or give the patient some glucose tabs to bring the sugar up if the patient is too low. After reviewing the patients’ chart, I begin to complete active orders that weren’t done.woman-3187087_1289

I call various departments to figure out if the patient is on the schedule for the different diagnostic tests, radiology imaging, or surgical procedures. I try to get a time frame so I could reassure the patient that they are on the schedule and if there are necessary steps that we had to do to prepare them. When everything is all complete, I begin my medication passes, which for me usually happens around 8:45 a.m. to 10 a.m. I pull up each patient’s chart and count the number of medications that I have to give to each patient. If there are any medications I am unfamiliar with, I look them up. I have to know the what and the why behind why I’m giving it, so I can explain to the patient the side effects and its purpose.

While reviewing the medication list, I would usually notice a few that aren’t in our medication drawer, so I then have to send a message to the pharmacy to tube it up to my unit. Usually, by the time I walk into the medication room, there’s a long line of every nurse on my unit in there trying to pull medications for their patients, too. I patiently wait until it was my turn. After pulling the medications, I either have to mix it with a certain dilutant, or with a powder. If I have to replace fluids or any electrolytes then I would go ahead and grab new tubing and a bag of fluids. I grab a medicine cup to make it easier for my patients and head straight to the nourishment room to grab some ice water.

I knock on the patient’s door, telling them who I am, and why I was there. It’s usually a Knock. Knock. “Good morning! It’s Evee, your nurse. I am here to give you your morning medications.” The patient is usually eating breakfast at this time, so the timing is usually perfect. I don’t wake up drowsy patients because they are usually grumpy when we do bedside reports at 6:45 a.m. in the morning. I try to cluster my care to avoid interrupting my patient’s rest because I know how hard it is to sleep in the hospital. I try to put myself in their shoes so I could understand where they’re coming from. This is where I establish rapport with the patient. I converse with the patient, ask them if they have any questions regarding the plan of care, and tell them the time frames that I have called about earlier.

What annoys me most of the time are the consults. When a provider puts a consult into a certain specialty, such as surgery or infectious disease, they take forever to follow-up with the patient. I usually tell the unit secretary to call the consult again. If there’s a cardiology or gastroenterologist consult, I have to keep the patient “NPO”, which means nothing by mouth, food or water. But most times, the order would say “NPO except for medications, which means I could give the patient their medications. I have to keep the patient NPO until the consult comes and evaluate them. That means that the patients have to remain hungry until the consults come. Sometimes, they don’t come until two or three in the afternoon. By then, the patients are angry and change their demeanor towards me, which is normal, I would be furious too if I had to starve for that long. hospital-840135_1284

In between all these events, I have to juggle questions from the family and answer phone calls from different providers, nurses, laboratory, technicians, guest services, dietary, environmental services, transporters, and so much more. My phone rings non-stop, I don’t think I’ve hated a phone as much as I hated this obnoxious one. I usually get a phone call from a fellow coworker asking me to watch their patients while they go grab some breakfast. I almost always never say no, unless I’m already covering another nurse.

By the time I send my patients to their planned destinations and wait for them to return, doctors are putting new orders in left and right. It would either be new medications or diagnostic procedures. I get new orders from a range of doctors and specialties. If a patient’s labs and radiology results come back, I usually page the doctor to update them on the patient’s status. The provider would either add new diagnostics or discharge the patient. If new medications are ordered, I have to print out education for the patient to read and teach them about the side effects, directions on how to take them, and the frequency. I look at more orders and I see a discharge note. I have to begin the discharge paperwork, see if any scripts were written, if so, does the patient want it filled here or closer to home. Almost all patients would like the scripts to be filled here. If the patient did not have insurance, I have to contact a social worker to see if they could help the patient obtain the necessary medication so that the patient could get better and not have to return to the hospital if the illness doesn’t go away.

Meanwhile, I glance at the clock, it’s past noon, I haven’t used the bathroom, have lunch, or even charted yet. When noon rolls around, I have to chart my second assessment, such as did the patient’s status change, are there any new symptoms, things like that. I choose to chart over lunch and the bathroom. My mucous membranes by this time are usually very dry, I haven’t hydrated myself at all. After I catch up on the charting, my patients are usually back from whatever test they went to and are usually calling me for random things, but most of all, food. I call down to food and nutrition and ask for trays to be brought up, now all of us play the waiting for the results game. By this time, my bladder is killing me, I run off to the bathroom.
It’s four o’clock, I’m starving, thank goodness for my charge for helping me with the discharge. She calls to tell me I have a new admission coming. Great, I haven’t eaten, now I have to take this call from the ED to get the report for my new patient. Will this ever end? I already knew the answer to that, it’s a firm NO. I could not have a lunch or else my manager will have a stroke, so I go clock out for lunch, but I didn’t really take one. This is what I do most of the time. I set the timer on my phone to 29 minutes, giving me time to walk back to the clock and clock in again. Sighing, I pick up where I left off and begin tying loose ends in preparation for the night shift. I hate leaving uncompleted tasks for other nurses to pick up. I know it’s not my fault, but not completing them made me feel inadequate.

It’s nearing the end of the shift when doctors discharge everyone and nurses get slammed with new admissions. I call five o’clock the hour of horror. I hated that time, it’s either you’re preparing a ton of discharge paperwork or receiving multiple calls from the ED for new admissions. Six o’clock rolls around, I summarize each patient’s chart to tell night shift what was still pending and what was completed. If there were any abnormals or special requests, I would be sure to let them know. Six-thirty rolls around and I’m stressing about what I haven’t completed and I still haven’t charted my afternoon assessments and other requirements. Jesus, I don’t think I can finish everything. I will have to tell nightshift that I am sorry, I tried my best. Six-forty five comes and its time to give report. When I finish giving the report, it’s seven-thirty. I have to sit down and finish my charting.

By the time I’m finished, it’s eight o’clock, sometimes a little over eight. I wash my hands, gather my belongings, and head out. I walk the five flights of stairs to get to my car because the elevator always gets stuck. By the time I reach my car, it’s a quarter before nine. I drive home, exhausted. All I could think about right now is that the bed is calling my name. I take my scrubs off, fix my bun, and jump straight into bed. Screw the shower, screw dinner, screw my life. I take a sleeping pill to help me fall asleep quicker so that I don’t toss and turn until the morning. I sleep like I have never slept before, like I was comatose. In the morning, I wake up and repeat everything all over again.medical-563427_12811

I chose to be a nurse, but my professors never told me how the reality of nursing wasn’t at all flowers and rainbows. I don’t just help other people and go home a hero. I exhaust myself for my patients, neglecting my well-being, my health, to help my patients get better. This scenario is one of my better days. The bad days are even more daunting, when patient’s statuses decline, when they code, when they yell and scream because doctors won’t put in orders that they want. When drug abusers want only Morphine and Benadryl every hour on the hour and to their dismay, the provider discontinues the order. I have to prepare myself every time this happens because disgruntled patients are usually verbally abusive. There are times when patients get so out of control that they swing at me, choke me, grab an IV pole and hit me with it, or make death threats. By the time I call security and they arrive, I am usually already hurt or I’m running away for my dear life. It is a very meaningful career, but at what cost?

Nursing affects not only my mental and emotional well-being, it also affects my relationships. I barely get to see my boyfriend or converse because by time I get home, I’m so exhausted that all I want is sleep. A relationship requires communication and intimacy, but this job wears me out to the point of near-death exhaustion. Of course they understand, but still, if you could have a choice to spend time with a loved one or be at work, of course it would always be family over work. I see my coworkers more than I see my family. This is the life I chose or that I was chosen to become a nurse for a reason and because I went through hell to become one, I sure as heck won’t disappoint my God upstairs. This is the story of my life…

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