What do nurses do?
We’ve all seem the meme going around, you know, the one with ‘what my boyfriend thinks I do, what my mum thinks I do, what the public thinks I do, what I actually do’. If you haven't, then check out the one I've found below.
So I thought I would do a post on what I do on just a regular day in the rehab ward….
I get to work at about 6:50am for my 7am start because god-forbid a nurse is ever late for handover! Check out the allocations and hope that I have a nice group of patients and then start handover which depending on how the night before was and what happened with my patients, can last 10 minutes to 40 minutes!
After handover is when the fun begins…. (and for privacy and confidentiality purposes, all of these patients and their conditions are NOT an real people or events but may be based loosely on my experience as a nurse).
So I walk into my first room, do a set a vital signs on my orthopedic patient, assess his pain, check out his wound and get out some medications. First patient on my round – done.
I hear the nurse call bell going, I walk out of the room to check it and see that it’s my patient next door. I can hear the sound of someone vomiting as I walk into the room and know from handover that this patients has been experiencing nausea and vomiting since they had their anaesthetic a few days ago and have had everything that we can possibly give them for nausea already this morning. I check her chart and see that she only had a Maxalon injection about 10 minutes ago and I give her reassurance that soon she’ll feel some relief. I check her vitals and find everything pretty normal apart from a slightly elevated BP. I tell her that I’ll be back to check on her in 15 minutes.
I then move into my 3rd patients room. I am halfway through giving out his medications when I hear the buzzer again. I see that it’s my same patient who was vomiting before. I go into see her and she says that she can’t handle this anymore and its not settling. By this point she is hysterically crying and still vomiting. I decide then that I need to let the in-charge nurse know and then call the doctor. The doctor tells me to give the patient another injection of a different anti-nausea drug, which I do and after some more reassurance I move back into my 3rd patients room and finish his medications.
Ok, 3 patients down, 4 more to go and time is ticking on! Luckily for me, my 4th patient is an independent woman with MS who is here for some balance work so I’m onto my 5th patient before I know it.
I do my 5th patients vitals and see that the doctor has written 'withheld' on his hypertensive agent perindopril for today. This wasn’t handed over to me by night staff, so I have absolutely no idea why. Anyway I ask the patient and she tells me her BP has been low since surgery so she hasn’t been taking it. Her BP this morning is 160/92, not low anymore! So this means another phone call to another doctor to see what we’re doing about this medication (which we end up giving).
I pop my head back into my vomiting patient and she is resting on the bed with her eyes closed and says she is starting to feel a bit better. Now its time to see what patient number 6 is up to! He is a patient who has a glioblastoma, is a high falls risk and needs supervision and assistance with everything. He is still asleep in bed and by the time I get him out of bed and into a chair, his breakfast is starting to go cold, which a quick zap in the microwave fixes up. I make a mental note that I’m going to need a lot of time to get him up and showered this morning and am thinking about where I’ll fit this into my time planner, especially to get him ready for his physio at 9:30…
Patient number 7 isn’t in her room when I get there…. Has my patient absconded?? Then I see her breakfast is missing… Ahh breakfast group. I look at her meds and realized I need to be giving them with food, how am I going to do that when I don’t even know what the patient looks like? I go into breakfast group and like a teacher I call out ‘Mrs Smith, where is Mrs Smith?’ and thankfully she answers and doesn’t leave my looking like a crazy nurse who has lost her patient.
OK, my first initial round is done for the day, I’ve seen all my patients, I’ve got a few issues that I need to resolve (like what am I going to do about my lady with nausea), I still need to call a few people (why can’t the kitchen ever get diet codes right for patients lol), I’ve got 1 full assist shower and a few minimal assist showers, I’ve got A LOT of pain relief to give out before my patients see their physiotherapist, I’ve got 3 wounds to review, luckily for me I have no discharges which means no admissions (YES!!!), I have 7 beds to make and all of this on top of the care I need to give to my patients. And by this point of my day, it’s only 8:30am!! And as nurses know, a lot can happen by the end of a shift....
I know I said the blog post would be on what I do in a regular day, but after writing about what happens just in that initial morning round, I don’t think I need to write about everything that happens in a day, I think you get the picture :)