Today I woke up feeling like I had a hangover. I’m starting my 4 day break from the ICU, after working 6 of the last 8 days. I drug myself down the stairs and starting cleaning house as I normally do on my days off. I glanced at myself in the mirror at the bottom of my stair case. Horror. My face blatantly shows the pure exhaustion that I feel, and my hair looks a complete mess. “Thank god I’m off work today and my patients won’t have to see this worn out version of myself” is my first thought.
People who aren’t nurses always tell me, “You only work three days a week? Wow! That must be great. I wish I had your schedule!” ..Only three days a week? ONLY!? I wake up at 4:30AM, shake off my fatigue, drive an hour to work, and then begin my scheduled 12 hour shift. 12 often turns into 13 hours or even more depending on the patient load and if I were able to keep up with my charting. When I’m done and finally clock out, I drive home arriving around 8PM, where I strip out of my scrubs and collapse onto the couch where I snuggle my cats and tell my husband about my day until I pass out from exhaustion. I slip upstairs to bed, to the disbelief of my husband that I could possibly be so tired, and I set my alarm and prepare for my next shift.
ONLY 36 hours a week. But does anyone who’s not a nurse know what those 36 hours consist of? Juggling all my nursing tasks for each individual patient while also trying to communicate with the doctors, pharmacists, respiratory therapists, PT, OT, social work, our aides, the patients themselves, and their families?! Yes, that’s right, I communicate with all of these people on a daily basis. I am personal coordinator for my patients. I am their voice, their advocate. I must be aware of my patients needs at all times. Room 101 is going up stairs to cath lab at 0900. 102 wants their pain medicine at 0915. 103 needs to be turned at 0930. Got it. My mental check list is a never ending dynamic that I must prioritize and rearrange constantly.
My job is scary. Always thinking, always analyzing, ALWAYS aware of my actions. I could cause a patient to lose their life if I am not critically thinking about everything that I do and every medication that I give. Is this dosage appropriate, does this patient need this medication? It is all my responsibility to keep the patient safe.
Even when I am doing everything that I can it isn’t always enough. I’ve had family members displeased that I took a little longer to answer a call light. I’m sorry that I couldn’t get you a coke right away, I was busy titrating a lifesaving medication in the room right next to yours. I have been asked by a family member if I were qualified to even be a nurse, surely I was too young for that. I have been told that I am too weak to help lift a patient when in reality I can lift more weight that I weigh. Nursing is hard. I take all these comments and offer a kind response to remain professional even though it can make me feel really small at times. Not feeling appreciated is hard when all I am trying to do is help.
I have been there when a patient said their lasts words before being intubated and never being able to come off of the vent. I have been there as a patient has taken their last breaths on the earth. I have been there when a patient has decided that their body can no longer fight, and they would like to receive comfort care. I have provided comfort care as family members are silent, with tears streaming down their faces, as I turn the lifeless body of their once resilient family member. I have been there when a doctor has told a healthy, active patient in front of their spouse that they have stage 4 cancer, and will not survive. I have stood and held my tears to remain strong for family members who have had their hearts shattered by the news that their loved ones will not be coming home again. I have sobbed on my way home from work because my heart is shattered too. I am so sorry that you have to go through these things. I am so sorry that your loved one has cancer. I am so sorry that myself and the doctors couldn’t get your loved one to wake back up after being sedated on the ventilator. Nursing is hard. I am human. I care about my patients. How could I not? My heart breaks along with my patients and their family members. Then I go home and try to pretend that I have not been broken during my shift. I don’t want to burden my husband with my sadness, and I need to pull it together so I can go back to work in the morning and do it again.
So how do I do it? How do all nurses do it? How do we manage ONLY 36 hours a week? Because nursing is beautiful. I have been there as a scared patient on a ventilator has woken up so I held her hand and told her that everything would be okay. She could not speak as she had a lifesaving breathing tube down her throat. Somehow she managed to grasp a pen with her weak hands and wrote “I love you guys.” My heart exploded with joy. I have provided comfort to someone when they were far from comfortable. I have been there when a patient has come off of a ventilator after being on it for a week, and watched as they cried and said they were so happy to be alive. I helped bring that person relief. I have bought lip gloss for an elderly patient whose son forgot to bring in her lipstick. The smile on her done up face was priceless as she put on the lip gloss to complete her look. I have made a patient genuinely happy even though she is sick and in the critical care unit. I have been there providing comfort care to a dying loved one and family members have hugged me and thanked me for being the angel that their family member needs. Nursing is beautiful. Life is beautiful. I watch lives change, I watched lives end, and I watch lives get a second chance because of the care and medicine that I have provided.
Nursing is hard. Nursing is stressful. Nursing is exhausting. It drains me both physically and mentally. I come home tired, sweaty, and defeated. Not all days are good days. Nursing is not all sunshine and rainbows. But nursing is my life. I dedicate my life to saving the lives of others. Those break through moments when a patient miraculously recovers, when a patient holds your hand and tells you how thankful that they are for you, and the moments when myself and a patient can share in a good laugh. The feeling of pride I feel when my patient came in on a ventilator but walks out at discharge, makes it all worth it. All the wonderful, precious moments are why I love nursing. The great moments are what get myself and my coworkers through the long, difficult 12 hour shifts. Thank god for fantastic coworkers. My coworkers are like my family. I know that they understand the mental turmoil that I go through after a hard day. Only nurses understand truly what nurses go through.
So the next time that you want to tell a nurse that it must be great to work ONLY 36 hours a week, please be mindful of what those 36 hours are like. Give a nurse a hug today, and be thankful that we continue to do what we do, and don’t judge us when we drink a little extra wine. If it were easy, everyone would do it.
Sincerely,
the exhausted,
but still smiling ICU nurse.
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