A day in the life of a nurse

Well, as you all know, I am a new RN working in a big hospital. I thought that you all might enjoy knowing what exactly nurses have to deal with on a typical day. This week was a rough one for me. I work on the Respiratory Care Unit. Breathing is quite important. In nursing school and CPR you are taught the ABC's. Airway, Breathing and Cardiopulomonary are the most important in that order. Before you can fix anything else you need those things working. Your heart can't work unless there is oxygenated blood to pump and the lungs can't work unless there is an airway to get oxygen from. So where I work, number one and number two are usually what we are trying to watch and maintain.

Anyway the first thing we do in the morning, at 6:30 am, is get report from the night shift nurses. Then you look over morning labs and review all of the orders for each patient for that day. Then you go to each of your patients rooms and take morning vital signs and do morning assessments (listen to lungs, check pulses, check IV's, etc). While you are in each room you have to suction any trachs, change empty IV bags and find out who needs pain meds. You deal with all of that and then you go back and try to chart all that you did that morning. We do assessments at 8, 12 and 1600. You give meds as they are scheduled. 9:00 am is a big medicine time but some patients have meds every 1-2 hours. You also attend to any needs that the patients call you for. Sometimes your pager does not shut up. Sometimes trach patients need to be suctioned every 15 to 30 min. Sometimes people need pain medicine every 1-2 hours. Those things take time. Sometimes the patients IV stops working and you have to start a new one. There are also some patients that need dressing changes. The doctors come into the hospital throughout the day and order new things throughout the day. Sometimes you have to assist them with minor surgery at a moments notice, like the insertion of a chest tube or a indwelling IV. Fun! On those very special days you get to give an enema. You also discharge patients throughout the day and get new patients throughout the day. A good day is when you do not get new patients because they take a lot of time. You try to find time to eat lunch and then come 6:30 pm you wait for the night shift nurses to come in and you give them report again.

This week, I had two trach patients, and two end stage COPD patients that happened to both have a history of strokes, heart problems and demetia. Fun! Four patients does not seem like a lot but it is. First of all with trach patients you have to suction them if they are coughing up a lot of junk which they usually do. If you do not suction them then their trach (airway) gets plugged and you have lost their ability to breath. One of them was a 89 year old, crabby woman that was hard to please. The other trach pt was a 37 year old vegetable. At least he did not give me any trouble but it was hard to treat a person that is not there at all. He has no quality of life. He is basically a organ harvester. Still I had to suction his trach and feed him through a tube in his stomach. He had to be fed 3 times in the day on my shift. Of course in the middle of the day my old guy with COPD decided to start acting weird. He was very disoriented and did not recognize any of his family and did not know where he was or what was going on and plus he was not eating or drinking anything that day. I had to call the Dr. quick because that is a true sign that his lungs are not working properly and oxygen is not reaching the brain well. He was in bad shape according to all of the tests the doctor had me order so the doctor had me start and IV with fluids, put in a catheter, increase his oxygen and start antibiotics. This guy is not going to live much longer. He is in poor shape so I was not sure what was going to happen with him since all of his symptoms are also the same things you see when a patient is actively dying. The last patient I had that was the same way died within 12 hours. It was good to see him improved the next day. His wife was the sweetest woman ever and she hugged me and kissed my cheek when I left that day he was doing poorly and said thank-you for being so kind and for helping him. She did the same the next day when I left. That is the rewarding part. The thank-yous when you know you did some good for someone's life. Sometimes it is because it was an emergency situation and sometimes it was just because you took time to sit down and talk to a lonely patient or a stressed out family member or because you took the time to get a patient a snack or treat when they needed it or you sat with a grieving family member.

Of course throughout the day you help your fellow nurses in need. If another patient codes we all rush to that room. If another nurse's patient dies you stop for a moment and feel bad and then you move on with your busy day. If it was a patient that you have taken care of in the past then you go and tell them your condolences and give a hug or two.