Kristin's
College Blog
Typical Day
June 8, 2009
A nursing student shadowed me today.
She is about halfway through her training. Her task was to follow me
around for my shift, assist me where possible and learn about what my
job is like. She is supposed to get a glimpse into nursing in a
long-term care facility. This will help herdecide where she wants to
work, eventually.
We started off in a team meeting,
where I talked with the care staff, determined which residents would
stay in bed for breakfast, who would be getting a bath, what special
needs should be considered for the day. I ran through the residents'
charts from the night before and shared anything important with the
staff.
"This one patient didn't take her 0600
pain medication. I'll have to get down to her room right away and make
sure she gets some. Don't try to get her up for at least half an hour,
give it some time to kick in. The lab results are back for two others,
both negative. Another patient had some emesis in the night, I'll be
down to assess her." Emesis is a nurse-word for vomit.
I grabbed my cart, made sure I had the
necessary medications on it and all my supplies, and headed off. I
delivered the first round of medications, which is called the 0730
rounds. These are things that certain residents need before they start
the day -- meds that need to be taken on an empty stomach, for
instance, or nebulizers for those with asthma. I checked in with the
kitchen staff, made sure they knew who would need a tray in bed for
breakfast.
I started the 0800 rounds, the
heaviest round of medications for the day. While doing these, I popped
into one man's room to change a dressing, assess another man with liver
failure, deal with requests for pain medication from a few others. I
don't just hand out pills -- I carefully administer them. And give eye
drops, apply medicated patches, talk people through using their
inhalers, give injections, test blood sugar levels....
We had a fairly quiet day. Nobody
fell, nobody had a seizure. The man with liver failure was
deteriorating quickly. I made sure he was comfortable, arranged the bed
and the lighting in his room the way I knew he liked them, talked to
him a bit. He was not answering. I let the care staff know what I
thought, and one aide told me, "Last week he had a confused spell and
told me he needed to pack everything because he was going to leave on
Tuesday." It was Tuesday.
In the dining room, I almost finished
the 0800 meds by 0930. I fed a woman who was not able to eat by
herself. At 0945, I headed down the hallway to catch the last few
stragglers. I took my break at 1000.
At noon, we met my supervisor to sort
through all last month's empty medication containers. We were looking
for anything with remnants of narcotics in it. These need to be
separated from the rest and disposed of carefully. The student nurse
did one rack, while I did 12. It is a test of how well you can
recognize drugs! There were so many empty packages to dispose of that
there was a dumpster full of them. My manager climbed into it, business
skirt and all, to stomp them down and make room for more. I really like
her!
Then we had some other nursing tasks
to attend to -- dressings to change,
unstable residents to check on. I kept returning to the man with liver
failure. His breathing was difficult, but there were no physical signs
of imminent death. I wanted to keep an eye on him, make sure he was
comfortable. The student nurse was a little uncomfortable with this.
Then we had the 1100 rounds, the 1130
rounds, the 1200 rounds. More medications -- sometimes it seems like
endless medications. At 1300, I took my lunch break. I sat outside,
alone, for half an hour. It was so peaceful that I didn't want to get
up!
At 1330, I got my charting done and
attended to some paperwork. I did the end-of-shift narcotic counts with
the other nurses. We all have to co-sign for exactly how many
narcotics are in our carts at the end of every shift. My wing has a
lot of narcotics and it is a slow process. At 1400, I did another round
of meds. One of my residents was in tears. She was unhappy with her
medication schedule. We talked, I empathized, we negotiated. We came up
with a solution that would make her happy. I made a note to chart it,
so the oncoming nurse would know about our new arrangement.
At 1430, I was back in the report
room. The care staff let me know about the events of their day. We
discussed their concerns, come up with some solutions. They wanted me
to fill out the paperwork for three residents to have some changes to
their diet. I rushed off to do this, dropped the requests off in the
kitchen, and headed back to the med room. I restocked my cart and
cleaned it, so the next nurse would have a fresh work station.
At the end of the day, I asked the student nurse
what she thought. "I don't know. Wow, the time goes by so fast! And you
walk really fast... Thanks." And she was gone.
Dealing With Shortages
June 1, 2009
Just a few weeks after moaning about
not having any work, I am overwhelmed with work. Now that the weather
is nice, the regular nurses are taking turns going on holidays.
Apparently, this will continue until September or October.
When a nurse with full-time or part-time status takes a holiday, his or
her shifts are offered to the casual nurses. Where I work, there is one
casual nurse ahead of me on the list. She works through their holidays.
I get everything else.
Up until now, I've had two to four
shifts per week. Except in April, when I went three weeks without work.
But now I've worked nine days straight, and I am turning down shifts
for the next two days. I am booked to resume working again. I am taking
the place of a nurse who injured her shoulder.
There is nobody else to take other
shifts when a nurse calls in sick, or simply doesn't show up. That
happens surprisingly often.
So it is fairly common for us to be
working "short" -- which means we're short on staff. We will be missing
a nurse, so the rest of us have to work doubly hard to cover their
work. It is exhausting and busy.
I love my job, but I don't enjoy
working short. It is too hard on everyone. We get tired and frantic,
and everyone's tempers get short.