I know its been awhile since I’ve written a post, but between recovering from a tonsillectomy and starting my first nursing job; I’ve been rather busy and plus I needed the time to gather my thoughts!
First, let me start by letting those of you who are not in the nursing field know that, nursing school and work in the field are two separate things. This might be true for quite a few fields, as we all learn to accommodate to the work environment but here is why nursing really sticks out like a sore thumb.
In nursing school we learn to be the patients backbone. Most patients are in a hospital nowadays because they are incredibly sick; hospitals these days are not keeping patients over night for simple post -op recoveries, they send them to nursing/rehab centers to recover, which is what scares me. In school we are taught to look at the patients perspective, to understand how they feel and what they are going through. To me, that is what a nurse is. We become advocates for the patients, we are their support system.
Now this is where things get tricky….; during my first few weeks, I was handling 15-30 patients on a single cart (med cart). And here are the rules:
1. Finish your med pass by noon (you start at 8am) + blood sugars and insulin
2. Answer doc questions; drop everything you are doing and get them the information they need
3. Stop what you are doing if there is a temp higher than 99 F or if someone is in pain
4. No electronic medical records; so make sure you remember to sign out the narcotics from their cardex. The count should not be off or your ass is on the line.
5. Gather vitals on who needs them.
6. Check off everything in the med book.
7. Know who takes their meds crushed or whole. (Crushing meds takes another 2 mins)
8. Find your patients if they are not in their rooms…. this requires an awfully fast walk to the other side of the building.
9. Finish morning med pass and start 2pm pass and hopefully finish by change of shift, which is at 3pm
10. Chart notes on your patients, do a monthly note, take off doc orders, fax pharmacy new med orders, report to the next nurse.
You get the point, I’m making here right? Now I am not complaining because this is the job I chose, my point here is that where do I have room to sit for 2 minutes and talk to my patient to see how they are doing? The truth is, you don’t have that time. The reason I chose nursing and the reason I actually fell in love with the profession during school was because I was able to uncover who I really was. All my life, I have seen myself tend to peoples feelings, putting myself behind them and I am okay with that. It is how I was built and it is how I am wired. But in the field where I cannot be who I want to be and I cannot give my patients the attention they need, how could I be the nurse I want to be?
I have met some extraordinary nurses while at my work place and they have years of experience. I have been told, once you figure out your routine and nook, you will be fine. Unfortunately, upon observing other nurses, I see them doing what the nursing field isn’t anymore. I encouraged one of my co-workers to further his/her degree, I saw their work ethic and I was amazed at how efficiently they dotted their I’s and crossed their T’s. They said “honestly, even though I wanted to, I wouldn’t do nursing again because nursing isn’t what it is used to be anymore”. As a new graduate I have quickly realized that.
I think I am more angry if anything at the system. I went to school in New England, where a nurses patient load did not exceed more than 5 patients. Here in NJ, it is 15-30 (in a rehab center) (7+in a hospital). I am the one these patients rely on throughout the time I am there to survive and to pick up on minor problems. If a patient is crying (even if I am told “oh she/he cries all the time”), I want to be there to comfort them, at the time they are feeling hurt and confused, so why not offer what I have? The answer is, “I can’t stick around sir and or madam because truthfully, I have 17 other patients just like you, to take care of and give medications to on time”. I mean, what kind of system is this?
I saw good nurses and bad nurses throughout my time in school. I vowed to myself that I do not want to become that cold nurse that ignores her patients because she needs to finish a med pass or write a couple words in a chart. I fear that most of the nurses that I am working with have changed. I do not want it to happen to me. I stuck with nursing because I became a shadow for someone in dire need of help, if my shadow can’t stick around what good am i? I refuse to be the one who is in and out with a paper cup of meds and yet that is all I find myself doing because I am rushing to move on to the next patient all the while triple checking my meds because I cannot make a mistake.
The list I wrote, looks simple to the untrained eye. But if you look at it, as everything being done in a cluster or some what simultaneously, the picture might become clearer. Being a nurse is hard work and I don’t say that lightly.
I would’t be a nurse if I did not pay attention to my patients, if I did not speak to them or have a simple conversation, if I didn’t do them little favors etc. I owe my professors the most gracious thanks because through them I learned to go the extra mile. Through them I learned I should listen to my patients speak for two minutes because that is what they need to do; they need to communicate. Most of my patients spend their time alone in a room or doing activities. The individuals who are alone, just want to have someone to talk to; after all no one wants to be alone.
I recognize that I am still being a nurse while I work. I give meds, monitor conditions, change dressings etc. What I am really upset at is that there is no room for therapeutic communication, which is something I believe it truly helpful to someone who is healing. The power of communication itself is such a grand opportunity, it should be woven into all walks of life.
So, what am I doing about this? I think, slowly during my day at work I am trying to integrate my own practice into something that is so set in stone. I am noticing, that it does set me behind schedule but only by 15 -20 minutes. Now, in nursing world thats like one hour… but I’ve received more information out of my patients through talking to them then by just walking in and out of their rooms. I am better able to control their pain because I ask them if they are in pain and how much and where it is hurting. I try to clean up what I can while I am doing their meds. The nursing assistants are just as busy as the nurses but I only wish that some could be more attentive. After all, no one wants to sit in a wet brief with food all over their face, I am sure you wouldn’t, I wouldn’t either. I am only standing up for what I believe in, whether it be quietly and on my own. I am one of the youngest and most inexperienced nurses in the field but I know what I have been taught and what I believe in should also be considered in the care of patients. I know I am doing the right thing for myself because when I am done talking to my patients, they thank me for listening, or give me a smile even if they are having an awful morning. Think about how many times you have had an awful day, where you wanted to quit…. then think about how many people you resided to… quite a few huh?! Now think, these patients do not have that. Some don’t even have a family to turn to, better yet friends.
So then, why not do what we can for people who cannot even raise their hands due to paralysis or because they forgot how to go to the bathroom due to Alzheimer’s?!
I am incredibly grateful that I became a nurse, I owe it to the family members that helped guide me in the direction and to the nursing school I attended and of course myself because I believe being a nurse not only includes what you learned to do in school but who you are as a person. I hope for change to occur, I know it is impossible to completely recreate something that is set in stone, but if us nurses are really in it for the patients & their happiness then bringing change little by little can’t be that difficult.
I will continue to work the way I was trained. Of course, I have remained fair to both systems presented to me, but I cannot stand for poor nursing just because your 9ams are behind schedule. I tried following the nurses’ lead…. the guilt of not reaching out to my patients came at me like a speeding 16 wheeler. I hated it.
As I may have mentioned before, I plan to go into humanitarian aide work. I want to travel to countries that do not have the proper medical means to survive. It is my ultimate dream and I plan on carrying it out 100%, I want to live in a country for a few months to become a part of a culture that is foreign to me. No matter where I am in the world, the greatest good I can do is helping another human being (and animals but thats a topic for another post 🙂 ) There is no such greater gratitude than the one you experience after you help heal someone and that is all I need.
“Sure, I’m for helping the elderly, I’m going to be old myself some day” – Lillian Carter
– TP ❤