When I was much younger, I didn’t think I will be a nurse, but I guess God has a better plan. My brother used to tease me before I took Bachelors of Nursing that I was so carefree and may end up harming a patient. But that carefree lifestyle didn’t last as I was thrown into challenges in life and had to mature fast for my family. It is true that God prepares you for what might be happening in the future as I became tougher and more resilient after those trials.
In nursing profession, one has to be tough to be able to survive the demands and challenges as it is not for the faint of heart. In my 26 years of being a nurse, I have experienced working all shifts. Back then, we used to only work 8 hour shifts, 40 hours a week for full time employee. Then shifts were extended to 12 hours.
I remember, it was in 2008, when it was started being implemented in the hospital where I used to work, a lot of nurses were against it as it is hard for the body and it is not good when you have kids or a family.
A lot of older nurses had to retire as getting used to that shift is not easy. I was actually working then as a 3 PM -11 PM in which later on became 7 PM- 7 AM. I hated that shift, it was not easy as I had no time for my family because I was asleep during the day when they are awake, on my days off. The body clock gets totally confused.
To Begin With
I mostly worked as day shift nurse even though it is busier because I have kids that I like to go home to while they are awake and the day goes by faster during day shift. And just like I said, I didn’t like night shift. Since I work 45 minutes to an hour away from home, I would wake up real early. If shifts starts at 7 AM we have to be there at least at 6:45 AM for bedside report. Since I have a long commute, I would drink coffee and have my breakfast while driving. Usually it’s toast or a banana, nothing fancy. I make it a point to eat and have something to drink before the shift starts as I didn’t know what kind of day I was going to have which may end up as no lunch and not even a snack kind of day.
As soon as I get to work I would gather the stuff that I need which usually is my pre printed lists of patients’ that I am assigned to. Taking report or waiting for a nurse to give report can be time-consuming especially in the Medical surgical unit where there’s a lot of patients’ with different cases and conditions. So, while waiting I would go and gather information that I can get about my patients’ by going over the charts.
And when the nurse is ready, we go to each patient room and goes over pertinent information of the patients’ with me. Some can be short and sweet but there are times that it would take longer depending on the cases as there are a lot to report about. During that moment is when I also introduce myself to the patient and if at all possible, I would fill in the board where we write our name, phone number and the plan for the day for his/her care, as that serves as patients’ guide for what to be expected and to remember who to call if in case she/he needs something.
Report Taking Is Done, Moving On
Either way, you can start going from one patient to the other to do the head to toe assessment but I make it a habit to scan and go through the lists of medications and doctor’s orders for each patient before assessing them so I can prioritize things. Some patients’ need to be seen first because they may have tests or procedures early in the morning or some has certain medications that has to be given prior to breakfast.
Prioritization is very important as it makes a nurse and patients’ life easier. There are times that a patient has to be prioritized over others because of pain, anxiety, blood pressure issues etc. When things that has to be done right away has been addressed then I go back to each patient to complete their assessment as thorough and quick as possible as I have to start preparing for each patients’ medications. Before I leave each patients’ room, I would see to it that I picked up any trash or dirty linens and towels that does not belong to the room. Each bedside table has to be cleaned and organized as possible.
Depending on the amount of medications each patient has, it can be time-consuming as it can be from pills to IV medications or some medications need to be crushed or should be given one at a time depending on the preference of the patient. With each medication patient has to be educated and be informed of the possible side effects so they would know what to watch for.
In between passing medications, there’s this care coordination rounds that each nurses has to go to in which we quickly have to discuss any barriers of discharges for a specific patient. Sometimes we need to answer call lights, phone calls which maybe from the patients’ family, doctors, labs etc. or some patients’ or another staff needs assistance. These are unavoidable tasks which are needed to be accomplished as well.
It is also a must, to coordinate with interdisciplinary personnel about patients’ conditions and goals so that everybody is in the same page. If doctors are rounding, if I am able to, I would pop in the room so I can listen to what the doctor has to say because most of the time, patient does not remember what they said.
Usually morning medication passing lasts until before lunch so if I still have time prior to lunchtime medications, I would at least start charting or documenting those assessments that I have done earlier but was unable to jot down. Or maybe squeeze in some care plan and other documentation that are needed to be done. But if not then I’ll usually do it after lunchtime medications has been passed.
Remember, this particular day that I am recounting is a regular and calmer shift. One has to understand that if there’re emergencies or other incidences like a code, falls or a patient becomes agitated then that’s a day when some usual process may get skipped or the nurse may not get to have lunch or any break at all.
So to continue, patients’ lunch has been served and so it is during this time when other medications are being given, especially those that has medications where its frequencies falls three times a day. Patients may also require assistance to eat. After lunch, it’s usually nap time so before they nap they need to be assisted to the bathroom or to be cleaned up as some maybe incontinent.
Although there are nurses assistants, nurses still need to assist a lot of times as not all patient can stand on their own and are heavy or the assistant is somewhere else helping another patient. Now and then, I would check the chart as doctors may have written orders which means there maybe procedures pending, lab draws or new medications ordered.
It is very important that a nurse take their lunch break. I used to skip lunch a lot, but not anymore as it is so unhealthy. I would usually take 30 minute lunch break but on a very busy day, I will take 15 minutes at least just so I would get something to eat and drink real quick.
This is the time that most patients’ are taking naps or are in tests/procedures so I would usually catch up on my charting, intake and output documentation and check my other documentation such as restraints (if I have a patient that are in restraints) pain assessment etc. But of course, during this time, it is very usual that we get up so many times to assist a patient or answer their call lights for concerns and questions.
Not to forget, that no matter what we are doing except if someone is getting compromised or in danger, we have to make rounds every hour to see if each of our patients’ are alright, needing to go to the bathroom or maybe needing some as needed medications. It is also during this time that I try to get to dressing changes and other extra stuff that patient needs. A lot of discharges happens during this time also and sometimes another admission would come in. Which would mean that I need to hurry and get through with my existing patients’ charting as I have a new one to chart on and to take care of.
Between four or five PM is when the last rounds of medication administration takes place and during this time is when I would check charts again to make sure that there’s no doctor’s orders missed and would also scan all the medication lists to make sure that they have all been signed.
Right before the next shift comes I make sure that all my bins are clean. I have gathered all the information that I will have to endorse and complete all my documentations which more often than not gets completed right after report as they are lengthy. If at all possible it is very important that they are done right before the next shift but distractions are unavoidable a lot of times.
It is every nurses goals to get through the shift on time especially if he/she is going to be on duty the day after. 12 hour shifts is not easy and can be so stressful especially to those that has young children as ones tasks resumes at home.
Do you have what it takes to be a bedside nurse? If you are a bedside nurse? What is your day usually like? Please share us your experiences and views. For any questions and comments, please leave them down below.