All in a Day's Work
By Shannon Lee
**This article won a second place award in the Nurses’ Week Writing Contest and was published in the June-July issue of the MONA (Manitoba Organization of Nurses Association) in 1988. The author had been a nurse for less than a year.
“So you’re a nurse! Isn’t that nice,” the woman remarked while reaching for yet another hors d’oeuvre.
“I thought about becoming a nurse once, but I can’t stand the sight of blood!” she chuckled.
Blood? I mused. Blood is nothing. How about vomit? Or diarrhea? Bacteria-infested sputum? Infected wounds and draining ulcers? Or one of the most disturbing and sobering of images—burned and blistered flesh. All in a day’s work for a nurse.
“It must be fun being a nurse”, she continued. “Giving pills and taking temperatures; putting cold cloths on feverish foreheads—it’s rather romantic isn’t it?”
“Oh…yes….very romantic,” I nodded.
Romantic? Fun? Not exactly the first two words that come to mind. Challenging. Rewarding, perhaps. Exasperating at times. Certainly exhausting. Medication time is not just handing out a few pills. Yesterday I had eight patients for the duration of my 12-hour shift. Each of them required medication at breakfast, lunch and suppertime. Two of them needed insulin shots. One of the ladies always sheds a tear when you poke her—even though she’s been diabetic for seven years. Another patient needs her medication crushed up into a fine powder and hidden in a dish of ice cream—otherwise she won’t take it. She is convinced we are trying to poison her. One patient vomited up his medication. He’s only 19 years old and he truly resents being hooked up to a line and confined to bed.
Taking a temperature can be embarrassing for the nurse and uncomfortable for the patient when it has to be done rectally. A nurse has to be a great conversationalist. We talk a lot about the weather and who won the hockey game. Anything to make the patients feel at ease when performing intimate procedures.
“So, tell me. What’s a typical day like, for a nurse?” the woman persisted.
Typical? I hesitated. Was there such a thing? What about today? I shifted my weight from one tired foot to the other. Let me think.
I arrived on the ward at 06:45 hrs in the morning. The sun wasn’t even up yet. After reviewing my patient assignment and preparing a work list, I listened to 07:00 report taped by the night shift. At 07:15 I went to see my patients. Mrs. Bains wanted to get up to the bathroom. She has a fractured hip and needs two people to help her in and out of bed. Mr. Garrison wanted pain medication immediately and Mr. Pollack was incontinent of urine. I changed his bed and quickly showered him, giving myself a bit of a wetting in the process.
While preparing my morning medication, three of my call bells lit up. I went to see Mrs. Toews first, who is a confused patient. She was attempting to crawl out of bed; the call-bell, pinned to her gown, was pulled taut, alerting me to the danger.
Mr. Craig asked for his urinal to be emptied and Miss Lynn requested the bedpan.
As I finished passing out the breakfast trays, Mr. Keats became ill and vomited all over his tray, the bed, the floor and the unfortunate nurse standing next to him. (Which, thankfully, wasn’t me!) Get the mop and pail. Between the lifting and the mopping, my biceps are really starting to tighten up.
Mrs. Toews wanted toast. It wasn’t on her tray. I oblige. I took Mrs. Bains to the shower. Mr. Garrison refused to wash this morning for the third day in a row. Mr. Craig had lost his socks, would I get down on the floor and see if I could find them. Certainly. Miss Lynn was still on the bedpan. I glanced at my watch. It was 08:15!
When I finally got a chance to give out medications, another nurse asked for my help with a difficult patient. He was screaming and kicking. After we calmed him, we put him into a wheelchair. His leg darted out, kicking me in the shin. He grinned. The pain was excruciating. Keep smiling.
At 10:00 it was time to change the dressing on Mr. Keats foot. He has a half-inch thick hole covering his entire heel. It drains foul-smelling, green pus and has to be soaked in special solution three times a day. The procedure can be extremely painful. Mr. Keats never cries. He won’t allow it. But I’ve seen the tears well up in his eyes more than once. I wished I didn’t have to hurt him.
Between 10:30 and 11:30, I had just enough time to put fresh linens on the beds and tidy up the rooms. Of course there were interruptions. There are ALWAYS interruptions. Like having to phone pharmacy to track down a patient’s eye drops. Or speaking with family members about a patient’s deteriorating condition. At 11:15, I spent 45 minutes taking Mr. Craig down to x-ray and back. We were pretty short-staffed. No porters. Guess who has to pick up the slack?
After lunch, everybody had to go to the bathroom again. One patient who had been unable to pass her urine for some time needed to be catheterized.
At 14:00 hours (2 pm) we had a staff meeting. The head nurse said we hadn’t been hustling our “buns” enough. Call lights need to be answered more promptly. Concentrate on teamwork. Stop complaining about being tired. It’s not professional.
At 15:15 I was told that I’d be getting a fresh post-op patient. Mrs. Henderson, who just had a hip replacement, would need a lot of attention. Demerol every three hours for pain. Vital signs every 15 minutes. I.V. antibiotics. Drains coming from her wound. And be careful turning her!
When suppertime rolled around I was worried about Mrs. Henderson. Her temperature had been climbing. I couldn’t get her to breathe and cough to loosen the secretions in her lungs. I explained that she must breathe deeply to prevent postoperative pneumonia, but the poor lady was just too weak. I notified the doctor on call. He said keep an eye on her. Call him if her condition worsened.
Near shift’s end, after taping my report, I was able to sit down and glance at a mountain of charting that still lay ahead of me. Not a bad day’s work. Mrs. Henderson’s fever had gone down and she was taking clear fluids. Mr. Bains was feeling better after being disimpacted. He hadn’t had a bowel movement in five days. Miss Lynn was very teary and needed someone to talk with about being hospitalized for so long. Mr. Keats had been taught how to give himself insulin injections. At 19:45, I said goodnight. (Only 15 minutes late!)
A typical day? I thought to myself. No, actually. A quiet one.
“Well, what would you say WAS a typical day?” the woman was still awaiting my reply.
“Oh, you know. Giving pills, taking temperatures and putting cloths on feverish foreheads—the usual.” I smiled.