Life of a med surg nurse 2

We're in the midst of a very busy flu season and your friendly neighborhood hospital staff is finding themselves tired, overworked, understaffed, under-appreciated and underpaid.

In the light of recent changes to health care.  Hospital reimbursement is now based off of satisfaction scores and the survey results that people fill out after they go home.  So say you report back that there was a long wait in the emergency department and you found the staff noisy.  Or you report that the staff does not always immediately respond to your needs.  This means that for the price of your care the hospital is actually going to get back a certain percentage of what they spent taking care of you.

Add in the flu epidemic that leads to higher patient to nurse ratios and higher acuity patient and the misguided idea that we should jump immediately to your requests and you get plummeting scores.

Well I'm tired.  Tired of family members chasing me down in the hallway for the fifth time in 5 minutes because "Mom wants her gas-x."  Tired of the hearing that the "soup is tasteless and the bed is uncomfortable."  Tired of management calling after I've worked 50 hours in 5 days to ask if I can please come in on my one weekend off.  Tired of getting told "someone needs to stay and hold Mom's hand because that's the only way to keep her calm at night" and then getting told off when I ask which family member will be sleeping in the recliner to do so.

I am a nurse.  I am taking care of 6-8 patients at a time and the odds are you are not the sickest one.  This means that I will make you wait for your gas-x while I finish giving pain meds to the patient who just got out of surgery.  This means I envy you your tasteless lunch and your lumpy bed because I've been on my feet for 10 hours without a break. This means I will not be able to hold mom's hand all night because I'm busy keeping the 96 year old next door from pulling their oxygen off and having a heart attack.

I am a nurse.  I am assessing your body to see if the plan of care the doctors have decided on is working for you.  I am responsible for advocating for YOUR RIGHTS.  I listen to your lungs and heart and bowels to make sure you are progressing.  I will look at every inch of your skin and follow you into the bathroom to make sure you are going okay.  I will check on you at all hours of the night, I will interrupt your phone calls and ask your family to leave the room.  I have your life in my hand.   I don't just pass out pills and take orders.  I'm responsible for every single medication you take and acting on every change in your vitals.

But this is what I will do.  I'll keep the doctor who has been on call for 24 hours from forgetting your insulin and from ordering the wrong dose of fluids.  I'll work with the case manager to make sure you go home with help and I stand up for you when I think someone is trying to discharge you prematurely just to open up a bed.  I'll fight tooth and nail to get you more pain meds when you are suffering and I'll happily spend any spare moment with your mom if she's scared.  And I'll wish I had the time to sit with her all night.  I'll clean up your messes and offer a shoulder when you break down after bad news.  I'll teach you how to take care of mom when she goes home.  I'll work overtime to make sure that there are enough nurses to care for you.  I'll make small talk and joke with you and act ridiculous to make you laugh during difficult procedures.  And I'll happily be your nurse and treat you will all the respect and dignity you deserve.  All I ask is that you do the same to me. 

Nursing on a med-surg floor.

After walking past a room and noticing that the elderly patient is attempting to crawl out the bottom of their bed, seemingly heedless of their IV, chest tube and oxygen... 

"Ma'am, where are you going?  Is there something I can help you with?"

"Yes, I need my pants.  I'm supposed to catch the bus.  I'm going to the Big E!"

At this point I'm trying to gently guide her back into bed before she rips the chest tube from her body.

"Ma'am do you remember where you are?"

"I'm at the bus station, but I don't know where my pants are!"

"No ma'am, this is the hospital.  You fell and broke some ribs and needed surgery.  I don't think you are going to make the big E this year.  Besides, it's already November... the Big E is over."

A shocked look crosses her face and she appears to notice my uniform and the appearance of the room around her.

"Oh!  Well I guess I don't need my pants then." 

"No honey, you don't need your pants tonight."