Thursday, May 13, 2010



This is the number of steps that I took at work on Monday.  For nurses week we got these pedometers and I decided that I should see how many steps I take in one 12 hour day.  I did some calculating on the treadmill after I came home and figured out that I walked almost 4 miles!  Wow.

Also, many of you have asked what my day is typically like.  After working for two months I feel like I can give you a little taste of what those 8,680 steps encompasses.

Now, hopefully I don’t sound frustrated. This is literally how busy it can feel sometimes. You get moments of “how I am going to get everything done,” but you get through it.

5:20 get ready and eat breakfast

5:55 catch the train

6:20 catch the shuttle to the hospital

6:40 find the patient assignment list for the day, find a computer, look up the history on the kids, check orders, and the schedule of medications.

7:05 get report from the night nurse and peek in their rooms to say hello.

7:45 check in with your PCT (patient care technician) and give them report on your kids. Get a phone for the day.

8:00 check your meds; are they here for the day or do you have to start calling pharmacy early?

8:15 see your first patient. Assess them, get vital signs, bring 8am meds. Discuss plan of care with family.

8:30 second pt

9:00 go to “rounds” on the patient. (this is when doctors, nurses, pharmacist, nutrition, social work, etc) all sit down and talk about the patient. How are they doing, do we need to change something, and so on.

9:30 look for 10am meds. Get your meds out for the pyxis (locked chart with meds). Find someone to double check your narcotic pain med.

9:40 given 10am meds early to patient A. While you are in the room patient B calls saying they need their nurse now!

9:45 pick up patient B meds on the way. Find the right tubing to set up a new bag of IV fluid since the tubing in the room is expired. While you are doing this patient B calls again saying they need you.  Okay, I promise I am on my way.

9:50 you finally get to patient B room and the monitor tech calls saying that your patient in A (who is on cardiac monitoring) O2 saturation is down in 88%. Yikes! you run back into his/her room, but first you must don a gown, gloves, and mask because they have pneumonia.

10:00 Finally you give all your morning meds and no one is calling. Wait, you check the computer and there are new orders. Pt A will now need blood. But the resident put the orders in wrong so for the next 10 minutes you try to find them to change it.

10:10 You sit down at a computer to start charting. (Charting is our life. We chart vital signs, complete physical, pain score, skin assessment, nutrition. You also chart IV or central lines every hour. You chart education. You chart Intake and output. (And it is detailed. For example: You chart that your patient had a bm, what color it is, how loose it was…etc).

10:15 Patient C is now here and is ready for chemo. (Oh well, you got five minutes of charting in ). You get the orders from the doctor and find another nurse to go over them in detail, checking dates, doses, what time it will start. Is there something that has to be done before it starts? Is every order sheet signs by two doctors…

10:30 Patient A is screaming in pain. You call the resident and see if we can up the dose of pain meds. She agrees, orders it, and now you have to wait for the pharmacy to verify it before you can get it from the pyxis. You wait 5 minutes while listening to your patient still screaming. You call frustrated and finally you get it verified.

10:45 Patient C needs fluids, anti nausea meds etc before chemo.

11:00 Patient A now has a fever and is having increased respirations rates. She has sickle cell disease and this means blood cultures, labs, chest x-ray, and urine sample. The IV team comes to draw her blood because the patient has tiny veins. You set up all the supplies for him.

11:30 You call radiology and ask when they are coming to get your patient for the chest-xray. They say they don’t have anyone to come get her which means you take patient A down yourself. You ask your fellow nurse to listen for you other patients while you leave the floor.

12:00 The blood bank calls and says blood is ready. Great, right as you need to give noon meds and actually 11am meds that you missed for patient B since pt A’s fever was more critical. You get noon vital signs. Test the urine on patient C to see if we are okay to start chemo, give meds and finally get to blood bank.

12:30 Start blood. Try to chart on the computer on the room for your other patients so you aren’t totally behind. (You have stay in the room for the first 15 minutes to check for reactions to the blood anyways). Resident calls and asks why the patient doesn’t have any recorded output for patient B for the day yet. Are you kidding.  I haven’t even had a chance to sit down!

1:00 you sit down for lunch for about 20 minutes. 

You get the point. 

Obviously, not all days are this busy. But I would say many days are pretty similar; busy but manageable. Luckily, some days literally feel like I have been there for about 3 hours instead of 12 which is a huge blessing.

Hopefully this is some good insight into my life. peace.


Eyrealm said...

Julie, this it truly amazing! I just had lunch with my high school friends, one whose husband is a nurse and another who is a nurse but couldn't come because the person who was supposed to relieve her didn't show up. The demands on nurses are just unbelievable! Plus you have people's lives in your hands, which doesn't make it any easer!

About the better start eating more! My new little body bugg system counts steps and requires 10,000 steps to lose weight. If you keep going at that rate you're going to start losing weight and YOU don't need that! Maybe I should become a nurse. I've tried everything else.

Thanks for letting us know a little about your day. What time does this shift end. Eli says you're doing great on your sleep system, even though it is so very weird! Thanks for all you do for so many. Your patients are so lucky to have you!

shawni said...

Wow, Julie! Now THAT is a day! Can't wait to hear all about it in person next month!
Love, Shawni

Jonah and Aja said...

Holy cow Julie. You are so awesome. I would never survive.
See you soon!