Well, my daily blogging aspirations for my 30 day reading was a fail, but I still greatly enjoyed the book and got a lot out of it. What brings me back to my laptop this beautiful spring afternoon is the answer to questions I get asked frequently. It comes in different forms, but always pertains to just what fills the twelve hours in my shift at the hospital. "What do you DO for twelve hours?" "Doesn't it drag on forever?" "How do you fill the time?"
Last week I took on the task of painstakingly chronicling my entire shift, minute-by-minute, to the best of my ability. This is a diagram of a fairly easy, average day. This is a GOOD day, simply because at most times I was only doing one task at a time whereas most days I'm usually working on two or three at a time. Sadly, easy days like this are in the minority. So for all of you who wonder what a day in the life of a nurse is like, enjoy. My fellow nurses, I'm eager to hear how this day compares to your own. This shift was in the PCU, our more critical section with a 3:1 patient/nurse ratio. Normally I'm on the floor, with 4 or 5 patients.
0635-0710 reviewing care plans, pre-shift huddle
0710-0735 report from night shift, meeting patients
0735-0745 reviewing clinical notes from previous day, coffee guzzling, inner pep talk
0745-0755 pull meds from pyxis
0759-0804 shake freaking vial of Zosyn trying to desperately get the medicine to dissolve in saline for IV administration. Ultimate test of patient and tenacity
0805-0831 Head-toe assessment, vitals, meds, chart on 1st pt (pt=patient)
0832-0853 assess, vitals, meds 2nd pt
0854-0911 chart, bathroom break, talk with family of pt in hallway about plan of care
0912-0934 assess, meds, vitals, 3rd pt
***0927remember I'm 1.5 hours late for a blood sugar on 3rd pt because I was in with pt #2. crap.
***0928 crush/dissolve meds for G tube administration
0935 receive call from pt 1 and 2 for pain medicine
0936 take bs (blood sugar) on pt 3, it's high and requiring insulin
0940 return to pyxis for insulin for 3, pain meds for 1 and 2. Pyxis is out of insulin, send order to pyxis on third floor.
0943 pain meds to #2, hang zosyn antibiotic
0946 go upstairs for insulin
0950-0955 give insulin to #3
0956-0959 pain/anxiety meds to #1
1000-1035 chart rounds, drink protein shake because at ten, like clockwork, I'm STARVING
1040-1045 change soiled bed on #2, receive call to replace O2 sensor on #1
1045-1100 nurse-led physician rounds, change O2 sensor when we go in for rounds
1100-1130 charting, bathroom, play turn on words with friends
1130-1230 lunch break
1230-1300 round on group, review new orders written during break
1300-1330 enact new orders, nothing complicated luckily
1300-1400 blood sugar, 2nd assessment, vitals, total clean-up/bed change for #3. BS is high requiring insulin
1400-1415 retrieve and administer insulin for #3
1430-1450 meds, prepare discharge papers, remove IV for pt #1
1450-1500 talk to family about plan of care, results, tests etc
1505-1510 chart, interrupted by call for #3 to bedpan
1511-1525 #3 to bedpan, clean up
1525-1537 chart, calls to pharmacy to arrange discharge meds for family pickup
1537-1557 Review discharge instructions, mobility limitations, med purpose/dose/time/precautions, wound care, follow-up appointments with pt #1 and family. Discharge complete.
1600-1615 bathroom, snack
1615-1630 chart, review/enact new orders, talk to family members
1630-1654 welcome #2 back from procedure, 2nd assessment, meds, hang antibiotic, give #2 ice from kitchen
1700-1713 Call doctor to restart the diet order for the #2 since procedure is completed, print new menu, call dialysis for pickup for #3
1715-1754 meds, 3rd assessment, blood sugar, complete bed change, redress wound for #3
1754 call from charge nurse about new transfer into my empty room
1756-1835 use time waiting for new pt to update pt info sheets for shift change, analyze and print cardiac rhythm strips for the paper charts
1836-1855 bedside report with nurse for safe hand-off for new pt. Assess, set up glucostabilizer program in computer for blood sugar monitoring, set up pump/new tubing for continuous tube feeds through gastric tube. Receive call from #2 for bathroom
1857-1900 escort #2 to bathroom
1903 review cardiac rhythm of new patient, analyze and print strips for paper chart
1906-1930 report to night shift
And another shift done, everyone safe and alive. BOOM.