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Sun Apr 21, 2019, 12:14 PM

From a nurse's perspective...


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Itís 5:15 am and my alarm goes off. I sit up in bed and wipe my eyes and sigh. The sound of that alarm indicates the start of my 14 hour day. Time to wipe away any signs of grief from yesterdayís shift.

Yesterdayís shift, was something to grieve over. I started yesterdayís shift, just as Iíll start the one today. Alarm going off at 5:15am. Brushing my teeth and tucking my hair into a ďI can run a marathonĒ tight pony tail. A hair do I know will survive what this 12 hour shift ahead of me will entail. I slip my scrubs on. Then apply some eyeliner and mascara that is sure to be gone and never retouched in a couple hours.

I arrived to work. Read our assignment board and write my name down next to two numbers. These two room numbers signify the two lives I will have in my hands for the next twelve hours.

In yesterdayís case it was just one. Just one because this patient was so sick that she was in need of one to one nursing care. I walk over to the night shift nurse, who I am relieving, and instantly read the worry on her face. She is bent over the flowsheet writing. Every three minute vitals in this patientís case.

I take my gaze from the night nurse to my patientís room. I see a face. A face with a 7.5 mm/25 cm tube inserted in her airway. I follow the airway tubing to the machine on her right that is breathing for her. I hear the all too familiar whoosh of the ventilator delivering her every breath. In front of the machine breathing for her, I observe the device doing the job her failing kidneys can no longer do. I watch the circle of blood leave her artery, run through the circuit of the machine, then return the clean blood to her tired body.

Then a quick gaze to the left, I see the ten iv pumps neatly aligned on the pole. The ten medications that are sustaining her every organ, because the septic shock has made them all so weak.

I then hear the all to familiar sound of the monitor alarm. Then my eyes see the flashing numbers in red. BP 60/40. I take a deep breath and sigh. Thatís not good. Then most importantly my eyes gaze to my patientís hands. They are entangled with another set of hands. A manís hands.

I look at his face. I observe the tears rolling down his eyes and a box of tissues resting on a chair next to him. I take my second deep breath. Time to listen to report and find out what my next 12 hours will look like.

Septic shock. CRRT. Vented. Levophed. Vasopressin. Sodium Bicarbonate. Epinephrine. Zosyn and zyvox for antibiotics. Vitamin C and Thiamine. Heparin. Insulin. Propofol. Fentanyl. Then I listen to how this all came to be. That two weeks ago everything was fine. The woman in front of me was a healthy wife, mother, and grandmother.

Now a deadly bacteria is swarming through her bloodstream. Taking over every organ and body system.

I finish the bedside report and take my third deep breathe of the day. I know when I step into that room that I wrote my name down next to, I am starting a battle. A battle that I too often cannot win. A battle of life and death. A battle that ways heavily on my 24 year old shoulders.

So I put my battle face on and step in the room willing to give this patient and her family, my all. Now I must try to rely on my four years of education, two and half years of critical care experience, and my critical thinking.

I must do this all after I introduce myself to her husband and hand him a tissue to wipe the tears off his face. I must do this after hearing how he canít believe he just signed a DNR for his perfectly healthy wife as of two weeks ago.

I touch his shoulder softly. Explain how sorry I am that Iím meeting him under these circumstances but that I will do everything I can for his wife.

I quickly increase the dosing of my medications after my latest blood pressure. I approach the Resident almost instantly with a list of my concerns and needs to try to save this patientís life.

He agrees with me that an Arterial Line is needed. I am in the room as he gains consent from my patientís husband. I calmly explain to the husband that he will have to step out for this procedure but that I will grab him from the waiting room as soon as it is over.

I then quickly gather and ensemble the Arterial Line set up. Then I throw on a sterile blue hair cap, and mask. I bring my flow sheet inside the room as I know every three minute vital signs are still required to monitor my patientís every number appearing on all four of my machines.

In the midst of writing every number I see on all four machines, I now operate as a scrub nurse. Sterilely handing the doctor every tool he needs to successfully complete the procedure. We attach the arterial line and my head shoots to the monitor.

I take my fourth deep breath of the day and sigh as I realize the critically low cuff blood pressures correlate with the arterial line. The patient is now on 100 mcg of levophed. Her bp is still only 70/30.

I quickly clean up my patient. Wipe away the blood from her wrist and any sign of trauma that may alarm her family further. Then as promised I call her devoted husband back to her bedside.

I then start drawing the eight ordered labs from her. I quickly label them and send them to the lab as I know they will not be good. I then call my nursing assistant in the room to help me turn and bathe her.

My nursing assistant is my life saver. She walks in and instantly my anxiety is slightly relieved as I am reminded that I am not in this alone.

I look at every piece of skin head to toe on my patientís body. Making sure there are no signs of breakdown. Then we clean her naked body while preserving as much dignity as possible.

I call her husband back in the room. Iím now on 125 mcg of levophed. I comb my patientís hair and look at her pale skin. My fifth deep breath of the day is when I start to realize that she is slipping away despite my best efforts. And that time is not on my side.

I briefly step out of my room, only to be handed six slips of paper with critical lab values. PH 7.1, BICARB 8, WBC 50. I run to the MD to quickly report the values. I witness the first sigh from the doctor. ďSheís not doing well, we need to talk to the familyĒ. Those words that Iíve heard too often before.

I watch my attending go into the room. Her son from Georgia has now arrived. Suitcase still in hand. I watch my attending sit down and next to her family and deliver the news. I listen with a sinking feeling in my stomach as he states the words ďshe has a very little chance of survival, there is not much more we can doĒ.

But my heart cannot be heavy for too long. An iv pump is beeping that holds one of the life sustaining medications. I must quickly fix the pump before her blood pressure starts falling. Then, another alarm on the monitor. Blood pressure 59/35. I quickly titrate my levophed to 150 mcg. And max out my bicarbonate drip by the doctors order.

I take my sixth deep breath of the day, knowing that there is not much more room to go up on the life sustaining medications. I listen to the plea from her husband to try to keep her alive, so that her son from Ohio can see her. His flight gets in at 2:30. Itís 1pm.

My heart sinks as I know despite my best efforts, that may not be possible. Itís time for me to draw my next set of labs. I do my work quietly as more family members arrive and are faced with the horror of the illness that has taken over the person they love the most. I quickly run to the supply room to get more tissue boxes and chairs for family members.

Itís 2pm. I take my first sip of water since 6am . And quickly down a snack size bag of pretzels in front of my patientís room. Iím now on 200 mcg of levophed. There is no more room to increase the dosage. I am maxed out. My bp is 73/40. Not good, not good by any means. But I hold on to enough hope that it will be high enough to buy us time for her son to make it to the hospital.

My labs are back. Ph 7.0 BICARB 7, WBC 55. I am losing the battle, I was feared to lose. I look at my patient. I wonder what her eyes looked like when she was healthy and full of joy. I wonder how her mouth, now covered by a tube, looked like when smiling during her happiest moments. I wonder all of this while watching her skin fall even paler.

Itís 3pm. Her eldest son has made it to her bedside. He collapses over her almost instantly. He mutters words of disbelief and shock. His father, who is just as broken, lays a hand over his shoulder in an attempt to comfort him.

Itís 4 pm and I start to see my heart rate fall. My blood pressure is now 59/38. Itís time to get the doctor. Time for the discussion that no family every deserves to hear. I take my seventh deep breath of the day. I listen to the attending tell my patientís family that she is not responding to treatment and there is nothing more we can do.

I hear him talk about the all too familiar comfort care. And hear him say we will make sure she is comfortable and will go in peace with no pain. I watch her husband and sons shed more tears but shake their heads in agreement. I turn to make what feels like a very long walk to the desk to pull out a hot pink paper.

A paper that will be signed allowing us to stop life sustaining treatment. A paper that signifies the battle has been lost despite my best efforts.

I quietly walk into the room and start explaining how everything will happen. I explain how I will first hang the morphine drip and increase her fentanyl (pain medication). I then ask if they want the breathing tube removed. I go on to explain how I will turn off the monitor so nothing will alarm. No noises are needed. I then explain that I will turn off all medications that are sustaining her organs, as well as any machines.

ďHow long they askĒ, ďNot very I replyĒ. I go on to explain that it will be quick and peaceful because she is requiring so much medical intervention at this time. I watch her husbands face drop. I feel his heart rip into a million pieces as he has to say goodbye to the love of his life.A woman he built a home and family with.

I tell the family to take as much time as they need until they are ready. I quietly close the curtain and prepare myself.

Iím called in by the family a little while later. Weíre ready, they solemnly say. I instantly hang and administer my morphine drip and increase her pain medication. I have lost the battle but this I can do. I can make sure she leaves this world in peace without suffering.

I then turn off every alarm on the monitor so nothing will sound. I then blacken the screen, so my family does not have to see any numbers on the screen.

After delivering a morphine bolus, I then slowly shut down every life sustaining medication. My stomach drops. I know this will precede to her death.

I tell the family for the tenth time today just how sorry I am and that I wish I could do more. I offer to put on pandora to play some of her favorite music. Frank Sinatra is requested.

I close the curtain and step into the empty room next door to bring up my patientís HR and EKG. I watch as my heart rate starts to slowly drop. 80, 70, 55, 40... I watch as a normal heart rhythm faded into a course zagged line. I know what this means.

My patient is gone. I take my last deep breath of the day. But this time it is followed by a tear streaming down my face. I must now go tell the family the news.

I quietly walk into the room and utter the words ď Iím so sorry, but sheís passed awayĒ. I listen to the cries of disbelief. The horror as my family realizes they have just lost their wife, mother, and grandmother.

I tell the family they can spend as much time as they need with her to say their goodbyes. I then walk over to a physician to call time of death. I write the time of death on my flowsheet. And wrap up any other remaining notes detailing the circumstances of the shift.

I watch my tear covered family exit the room. They hug me and thank me for all my efforts. I once again tell them how sorry I am and that I wish there was more I could do.

I then grab my nursing assistant and start to wash my patient. I comb her hair and take out all remaining tubing. For the first time I get to see my patient as she is. Free from tubes and wires.

I see her green eyes. The way her lips fall. The heart shape outline of her face. I see her in that moment, for exactly who she was before entering my ICU doors.

I then wrap her body. I tie the toe tag across her red polished toe. I fill out all the necessary death paperwork. And for the first time at 5pm I sit down.

I try to absorb the reality of the devastation of the past ten hours but I canít for long. ďGrace thereís a RR being booked for your empty room next doorĒ.

And Iím forced to snap out of it. I put on my second suit of the day.

But now itís Tuesday at 5:15am. Itís time to get ready for my second shift. So I do what I always do. Iím out the door by 6:30 am and walk up to the assignment board and write my name down next to two more numbers, two more lives.

These lives canít know about yesterday or see any part of the damage I still feel. They canít know that I lost sleep thinking about my patientís family watching her slip away. No. These patients will not see that Nurse.

So I walk in with a smile on my face, an introduction to who I am and that Iíll be their nurse for the day, and write my name on the wipe board.

This is the reality of a day in the life of a Nurse, Senator Walsh. Anything but a game of cards.


*lab values, genders, medications, and other details were altered to protect patient privacy*ss

44 replies, 4017 views

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Arrow 44 replies Author Time Post
Reply From a nurse's perspective... (Original post)
babylonsister Apr 2019 OP
KT2000 Apr 2019 #1
UniteFightBack Apr 2019 #2
ck4829 Apr 2019 #3
uppityperson Apr 2019 #4
Karadeniz Apr 2019 #5
uppityperson Apr 2019 #6
ismnotwasm Apr 2019 #7
uppityperson Apr 2019 #9
ismnotwasm Apr 2019 #24
smirkymonkey Apr 2019 #8
malaise Apr 2019 #10
ancianita Apr 2019 #11
Stonepounder Apr 2019 #12
ck4829 Apr 2019 #25
TNNurse Apr 2019 #13
Iggo Apr 2019 #26
Iggo Apr 2019 #27
mcar Apr 2019 #14
Volaris Apr 2019 #15
Post removed Apr 2019 #16
mgardener Apr 2019 #19
WhiskeyGrinder Apr 2019 #20
liberaltrucker Apr 2019 #23
backtoblue Apr 2019 #22
pazzyanne Apr 2019 #17
BSdetect Apr 2019 #18
yonder Apr 2019 #21
Kurt V. Apr 2019 #28
Lifelong Protester Apr 2019 #29
MuseRider Apr 2019 #30
Maru Kitteh Apr 2019 #31
Sunsky Apr 2019 #32
riverwalker Apr 2019 #33
lostnfound Apr 2019 #34
Cousin Dupree Apr 2019 #35
Aristus Apr 2019 #36
BSdetect Apr 2019 #37
OxQQme Apr 2019 #38
EllieBC Apr 2019 #39
Duppers Apr 2019 #44
PoindexterOglethorpe Apr 2019 #40
ismnotwasm Apr 2019 #41
PoindexterOglethorpe Apr 2019 #43
Duppers Apr 2019 #42

Response to babylonsister (Original post)

Sun Apr 21, 2019, 12:54 PM

1. I so hope

that horrid woman reads this.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 12:55 PM

2. Thank you Nurses...the backbone of our healthcare institutions. And next time I want to complain

 

about my job, which will probably be tomorrow...I'm going to remember this and shut right the hell up.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 12:58 PM

3. Except for Maureen Walsh's name... K&R.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 01:56 PM

4. She is incredibly stupid. "Play cards all shift" my shiny butt

nurses

Spending Christmas day in ER with a trached special needs toddler with pnuemonia, moving repeatedly to bathroom to suction child so can breath, administer formula through feeding tube surgically implanted in belly for nourishment, changing multiple diapers, all the while monitoring status, dealing with other busy er staff, and reassuring parent and child.

"Playing cards"? Pshaw

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 01:59 PM

5. Thank you, Babylon, for posting this. Really poignant. ❤❤

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:02 PM

6. Sitting b the bedside of an actively dying person hours after shift ends so they won't be alone

when they die. Not family. Not friend. A random person you don't want to be alone, knowing the current staff has no time to do this.

No pay, no credit. Watching the hours pass knowing you are due back at work later and balancing the minimal amount of rest you can get by with with leaving someone alone for their final hours.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:11 PM

7. My union is involved in that rest break bill that she is trying to sabotage

She also wanted an amendment to leave hospitals with less than 25 beds off the bill. There is also an amendment limiting nurses to 8 hours days, which in many areas of nursing is not even possible. So Walsh is an epic ass not just for her comment,, but for her anti-union evil typically republican bullshit sheís trying to pull.

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Response to ismnotwasm (Reply #7)

Sun Apr 21, 2019, 02:22 PM

9. "If nurses get tired working 8 hours, they shouldn't work 12 hours". No, Waish, you uncaring

ignorant fool. We. Need. Breaks. During our shifts. We need, like you do, to use the toilet, to eat food, to clear our minds for a moment to be able to provide good care, no matter our job or position. Nay, we need it MORE than you do because it's literally life and death.

She is an ass. Thank you and your union from a 25 bed hospital area.

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Response to uppityperson (Reply #9)

Sun Apr 21, 2019, 04:36 PM

24. Can you imagine surgical nurses, or even clinic nurses

In some cases having to LEAVE in the middle of things? Iím a certified Med Surg RN and I work in solid organ transplant. And general sugary. And Plastic surgery. And vascular surgery. Plus overflow. Our hospital also does itís own hemodialysis so about a third of our RNs on our unit are also HD RNs, including me. We also do all the PD for the entire hospital.

My fondest wish us that she loses her political career over this. So insulting

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:20 PM

8. K&R

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:25 PM

10. I could not do that every day

Respect due

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:30 PM

11. K & R

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:43 PM

12. Nurses are the lifeblood of any hospital!

I've been in the hospital several times over my life. Nurses are the lifeblood of any hospital. I was in the hospital for some minor surgery earlier this year. It was the nurses who walked me around the corridors for recuperation, who came in night an day to give me my scheduled meds. It was the nurses who came running if I pressed my call button. It was the nurses who were always cherry, caring, friendly and were there for anything I needed. I might see a doctor once every day or so. I saw the nurses probably at least a dozen times a day. Anyone who dares to imply that nurses are lazy would never, ever get my vote, be they R or D, because they would have just proved to me that they don't have a freaking clue of what the hell they are talking about and probably just got a nice cash infusion from some damn lobbyist for the bigwigs at some for-profit hospital corp.

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Response to Stonepounder (Reply #12)

Sun Apr 21, 2019, 06:20 PM

25. Indeed

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 02:55 PM

13. I have been an ICU nurse.

This is real, if I were a better writer, I could have told this story as well.

That Senator is an awfully ignorant woman. Either that or she is just a hateful one.

I hope she never experiences this as a family member or a patient, but I assure you in spite of her words, she and her family would receive the same excellent and compassionate care.

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Response to TNNurse (Reply #13)


Response to TNNurse (Reply #13)

Sun Apr 21, 2019, 07:06 PM

27. On second thought, let me just say Nurses are saints and that job ain't easy. (n/t)

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 03:00 PM

14. Tears

😭.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 03:01 PM

15. valar dohaeris to whoever wrote this 😰

And you, more than most of us, damn well DESERVE our fucking respect.

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Response to babylonsister (Original post)


Response to Post removed (Reply #16)

Sun Apr 21, 2019, 03:37 PM

19. Are you kidding?

You last paragraph is out of line.
I visited a friend this week who is on comfort care. She is 58 and late stages of Alzheimers. I thank God for the nurses and all the staff that give her the care she needs.24/7. And then go on to the next patient and the next, doing what needs to be done for others.
Atheist and Jews can be nurses. And the fact that you assume somehow the above author is somehow deficient and use religion to prove your point is reprehensible.
Actually, your words disgusted me.

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Response to Post removed (Reply #16)

Sun Apr 21, 2019, 03:39 PM

20. What the fuck is this shit right here.

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Response to WhiskeyGrinder (Reply #20)

Sun Apr 21, 2019, 04:19 PM

23. He's dead, Jim

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Response to Post removed (Reply #16)

Sun Apr 21, 2019, 04:03 PM

22. W.T.F.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 03:13 PM

17. God bless these "Angels of Mercy" who work every day

with pain and suffering in the efforts to heal. They touch every family at some time. Prayers of thankfulness for these caring people!

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 03:24 PM

18. My wife was a nurse and midwife. That senator is a complete asswipe.

He would last two minutes actually working under the stress of nursing.

Not even two ER minutes.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 03:40 PM

21. Thank you for this as it sheds a lot of light on someone very close and dear to me.

My wife has been a CCRN for almost all of her long career with much of that time being spent in a PICU. She's fairly stoic and I occasionally get glimpses of just how difficult her day may have been. Over the years, I've learned lingo and some other things, however and of course, I'm never privy to any details. This is a very gripping account of what many of her days must be like and has given me a stark new awareness of the professional work she and others like her, perform every day.

Thanks again.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 07:20 PM

28. thanks for posting this. my stays in the hospital are usually 4-5 days. for the last 3 yrs

and all future yrs i need surgery annually. my last stay, i wasn't nice to my night nurse. we argued and she could give it as well as take it. the last night she came in and i only had to walk to the door for release and i was beyond ready to leave. we tried to walk to the door. Failed. she came back in couple hrs, we failed. she did this all night long. Morning came, we did it.

she could have easily said i walked on the first try. i would have backed her and she knew it. Instead she decided, no matter how a difficult patient is, her heart and profession compelled her to keep me going.

all my nurses in the future will have a much more understanding patient

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 07:58 PM

29. I say thanks to all who

Made my husband comfortable in his last hours. He had developed Alzheimerís and I know was very confused. I am most grateful for the hospice nurse. I donít know how you do it, but I am grateful you do.

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Response to babylonsister (Original post)

Sun Apr 21, 2019, 09:17 PM

30. This is exactly what it is

in the ICU except those of us on night shift had no assistants or doctors there with us. We would end up after a night like this spending several hours deciphering our notes that we scribbled on our bare arms and the legs of our scrubs because it was not possible to even fit a chart on a table or write in it. We wrote on bed sheets, ourselves and anything we could and held it all together with scribbles of times and amounts.

Playing cards?!? This woman should have to go spend a month shadowing nurses. It may be at times less exciting on the floors but they have more patients, more diagnoses to deal with, different meds per patient....I was never comfortable out on the floor with all those different patients. I liked my one or two in the ICU, I honestly do not know how floor nurses keep it all together.

All I know is that I worked a lot of different jobs but being a nurse was the hardest both physically and emotionally but by far the most rewarding (except for my music maybe).

Celebrate nurses, they are your life line.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 02:28 AM

31. And the writer left out the horror of your patient looking deep into your eyes, begging you to kill

them. Happens a LOT, even with the great advances made in comfort care.

That senator would NOT survive half a shift with any average nurse. What an asshole.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 06:59 AM

32. This is exactly what my shift in the ICU

feels like.
The writer doesn't even get into what it's like when all hell breaks loose. When you have multiple code blues on the unit. When you have one patient who is crashing and the other needs close observation. When you leave your 12 hr shift and realize you haven't used the restroom once (this is frown upon by our superiors), then pray you don't get a UTI over time. On my unit there are no nursing assistants, we groom our patients.
I've worked several different nursing specialties over the years, and I've yet to find one area where I can sit around doing nothing/play cards and keep my job.
Walsh is an ignoramus.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 09:34 AM

33. She describes it exactly

Iíve been retired from a 30+ year nursing career for two years now. I still get up at 4 am, from habit. I think back on those superhuman days and wonder how did I do it? The stress and constant adrenaline takes a toll, as does the physical wear and tear, my back is ruined, my feet constantly ache. The crazy thing is, I would do it all again, in a heartbeat.

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Response to riverwalker (Reply #33)

Mon Apr 22, 2019, 10:50 AM

34. That is crazy. No, what is crazy is that they aren't paid like pilots

And they donít get major vacation and sabbaticals fro doing such an important and difficult job.

Our society is so upside down.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 10:55 AM

35. Walsh's hostility shows she has a huge axe to grind with nurses. I wonder what her problem is.

PS this story is not embellished in any way. This is how it is.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 11:07 AM

36. Thank you for this, babylonsister. Nurses are the backbone of the medical profession.

I'm always in awe of the work they do, the dedication they show, the compassion they feel.

Work, dedication, compassion. Three things you never see out of Republicans anymore. Just a bunch of rich, lazy, entitled, smug, sanctimonious assholes. The sooner they've been consigned to the dustbin of history, the better for everyone, including and especially nurses.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 11:31 AM

37. k&r

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 11:39 AM

38. My eldest daughter is a nurse.

She has described days such as this as a hospice attendant.
She shouldered so much grief she had to find another way to use her training.
She also spoke of keeping terminal patients being kept 'alive' by the 'ties and suits' for obvious monetary reasons.

She now works as a nurse in an elementary school taking care of runny noses and skinned knees 'owies' and
finds it much more satisfying caring for others at the beginning of life's spectrum.

Kudos, though, to those Florence Nightingales who persevere with compassion, as the nurse's tale describes my mom's
last two weeks lying in a hospital bed. Alive, but not 'there' for ten days.

Who does, and who should, put the DNR request into reality?
The family?
Or the hospital?

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 11:46 AM

39. I am not a nurse, but my oldest child would not be alive without nurses.

She spent 4 months in the NICU and while the chief pediatrician and neonatologist would make their morning rounds, they only spent 5 minutes at each incubator. The RNs on the other hand, were with my daughter for 12 hour shifts. They responded to every alarm (which were many many in that first month - like once every 5 minutes), they knew exactly what position would most likely make her desat. They knew literally everything.

The doctors are highly intelligent but they aren't *with* the patients. They don't have as much hands on. They know that their book says XYZ should work 75% of the time. But the nurses? They knew that XYZ with maybe a little ABC and some extra DEF on this particular patient would work 90% of the time.

Without those neonatal nurses, my daughter would probably not have made it or have been given up on. Instead now I have a healthy, happy 9 year old daughter who is amazing. And that credit goes to her nurses.

ETA: The nurses were also there for me and my husband as well. I cannot think of how many times they broke things down into terms we could grasp, wiped away tears, offered me a coffee or tea, or just listened to us as we wept and worried.

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Response to EllieBC (Reply #39)

Mon Apr 22, 2019, 01:29 PM

44. Thank you for posting this.

Most nurses are angels.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 12:11 PM

40. What quite frankly horrifies me is that nurses work 12 hour shifts.

I honestly do not want to be in the care of someone who has already been on her feet for 10 hours.

NO ONE can can do a job well when overcome by fatigue. It's bad enough for, say, a grocery store cashier, or an airline ticket agent. But it's potentially deadly when operating a nuclear power plant or an oil tanker on insufficient sleep. And worse for a nurse.

Unfortunately, most hospitals seem to have gone to twelve hour shifts, and I wonder if that's driving nurses from the field.

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Response to PoindexterOglethorpe (Reply #40)

Mon Apr 22, 2019, 12:36 PM

41. I just switched back to 12 hours from 8 hour shifts.

I have a choice. There is even an option for 10 hour shifts. I used to work 16 hour shifts, with overtime, making as much money as I could as my husbands disability progressed and he could no longer work.

Itís hard, but doable with appropriate rest breaks, and lunch breaks and a culture that promotes this. Which is what this rest break bill is about.

Humans arenít robots, have a procedure and it will take this much time and no more. When people get major surgery, it takes hours at a time, starting with the pre surgical care all the way to PACU. Surgeons will switch sometimes to prevent fatigue, but in delicate points of surgery or in a emergency they canít. And the surgical nurses are right there. When someone is going septic, a healthcare team streamlines care to prevent disability and death. It still takes time. When someone is coding, or in a simpler example, when extensive discharge teaching is needed, it takes time. I recently had a patient that took almost 4 hours to teach them from a variety of factors.

Actually I had two discharges, both needing very different teaching that day. And then an admission. An admission needs a full assessment and history. This doesnít touch the rest of my day, wound care, patients with psychological issues, pain control. Each patient deserves not only excellent care, but time and attention.

So the time needed to provide the best care isnít always contained in an 8 hour day. Also, whether working 8 or 12, you need time to debrief. We see so much pain and suffering, nurses often need down time. We take up hobbies. Many of us (I am one of them) tend to withdraw from people, take no calls, socialize as little as possible, to clear our minds.

One good, even great, thing about 12 hours shifts, is that it ensure more days off. Itís worth it.

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Response to ismnotwasm (Reply #41)

Mon Apr 22, 2019, 01:26 PM

43. For years the justification given for the very long

intern and resident shifts was to be able to follow through with the patients. However, whether it's a 2 hour shift or a 36 hour shift, at some point the shift and patients need to be transferred.

And studies have been done that show patient care declines when the caregiver is fatigued. Mistakes start being made. In medicine those mistakes can be fatal. And yes, I under stand the debrief time and so on. My very first job out of high school was as a nurse's aid, and while I'm not about to claim that's very much like being a nurse, it was direct patient care.

Maybe if the 12 hour shift is worked one day on, one day off, one day on, one day off, one day on, two days off, the nurses would mostly be well rested at least at the start of the shift. But as you yourself say, humans aren't robots. In far too many jobs great pride is taken in being at the job for ridiculously long hours.

Here a couple of things to think about. Back when the 8 hour work day was instituted, business men and factory owners screamed bloody murder that they'd never get enough work out o the employees in 8 hours. Guess what? They quickly learned that the workers were far more productive in 8 hours than they had been in 12.

And this. Someone once looked at the development of the iPod, and concluded that it would have come to market two years earlier had the people working on it did normal, 40 hour weeks instead of the ridiculous 80-100 hour weeks. Because mental and physical alertness and productivity decline, not increase with longer time on the job. Two years. The problem with the tech industry is that the people running those business honestly have nothing else to do but work, and cannot comprehend having a life outside of the work. You at least have one.

I was an airline ticket agent for 10 years. On my feet, in high heels, on a concrete floor for at least 8 hours a day. If flights ran late or the weather was bad we usually had to stay. It was exhausting. And all we were doing was making reservation, writing tickets, rerouting passengers, and so on. We didn't have their lives in our hands.

Just taking breaks isn't the same as not working 12 or more hours straight.

It's long past time when a shorter work day and work week was put into effect.

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Response to babylonsister (Original post)

Mon Apr 22, 2019, 01:17 PM

42. Caring nurses are angels!

Thanks for posting this most touching account. It left me in tears.

One day while walking down the hallway with the super nurse who was attending to my son who had been hospitalized the day before with meningitis, I said "your wings are hidden." She replied, "pardon" but then she got it. 😇

This was a day after an attending ER nurse told me I was being hysterical because I told her my son had all the symptoms meningitis. I wasn't screaming or ranting but only wanting immediate attention for my son's life threatening illness. She had assumed we parents didn't know WTF we were talking about. An ER doc soon came in and confirmed my husband's diagnosis but only after that nurse had disappeared. Our son was immediately admitted. Never got an apology from that nurse.

There are all kinds of nurses but most are so caring that they deserve all the appreciation and respect afforded docs. They work so hard and care so much.

Hats off to all you hardworking, unappreciated nurses!



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