Every Nurse Counts (every role counts)
“Tracing a patient”…Did one nurse work harder than the other?
7;14am (ER) Pt came in unresponsive, s/p MVA, you’re his nurse, you’ve barely put down your bag, or gotten a chance to look at the assignment for the day when the charge nurse yells, “yours!” So you follow the stretcher into the trauma room. You’re a bit irritated, as you didn’t have a chance to check the room first, but you’re sort of hoping the night shift took care of it..they didn’t, you later find out, they were slammed with back to back traumas, and you aren’t really annoyed, since you understand all too well that feeling, but your day starts off as hit the ground running. You work fast to get the patient stabilized, the room a destruction zone by the time you’re ready to roll to the OR - you don’t look back, you haven’t got time to clean and reset, you don’t have time to check off the miniscule details in the chart you know the OR, or ICU will give you a hard time for later. Your concern is with keeping your patient alive and getting them stable enough for transfer, and you breathe a sigh of relief once you hand the patient over to the OR nurse. Onto the next.
2:19pm (OR) Damn the ER. The patient has a central line that looks like it’s half hanging out, and none of the meds are signed. You’re the nurse assigned, you’ve just come in to help out since they were short staffed. You’re on trauma today, and you sort of wish you weren’t. These patients need more than the 1 nurse that’s assigned today, although if you ask any other nurse in the hospital you’re likely to get “OR nurses have it so easy, one patient.” You wish they would spend a day in the OR, see how many egos you’ve got to straddle here, the surgeon, the anesthesiologist, the residents, the students. It’s small room with everyone almost tripping over each other trying to work, or see. It’s a headache, on top of the responsibility of the patient. By the time the anesthesiologist is wheeling the patient out, you’re exhausted, and it was only your first case. You look back over the room of destruction, but you don’t have time to clean it, there’s another trauma being wheeled into the next ready OR.
Onto the next.
7:19pm (ICU) YOU’VE GOT TO BE KIDDING. What is wrong with the OR? You’re the ICU nurse assigned to the trauma patient, s/p MVA. You just walked in, and you spot the assignment which says first admission, you. So you throw your bag in the nearest filing cabinet, slug back your coffee, and you trail after the stretcher. Typical of the OR, the patient is in a damn mess. The lines are all tangled, the sheets bloody, the A line not secured, the dressing to the head already saturated. Plus the patient needs to go to CT in 30 minutes. Your coworker next door begins to help, but the charge nurse is yelling at her to move, since she has a transfer she needs to move fast to the med surg floor, who without a doubt will complain about getting a patient at change of shift - but she doesn’t have a choice, the second trauma from the OR is about to roll into her room, and she needs to move quick. You step back a moment, survey the destruction that has come to you from the OR, and you breathe in, moving fast to re-stabilize the patient. When you’re done, you pause to look down at the patient, cleaned, neatly tucked in the bed, intubated, sedated with propofol, pain controlled with fentanyl, three different vasoactive medications, Sodium bicarb, and, blood transfusing. Lines marked for clarity and in the event of an emergency you will trace what goes where. Central line and A Line sutured in place. You look down, and you breathe in again, and you move to help your coworker who just got an admission.
Onto the next.
The ER nurse worked hard, worked fast to save this life, and moved fast to save the next
The OR nurse worked hard, worked fast to save this life, and moved fast to save the next
The ICU nurse worked hard, worked fast to save this life, and will move fast to save the next.
One picture may look harder than the next, one may seem more organized than the other, but each discipline comprised speed of skill, speed of thought, and speed of action.
Each discipline comprised organization as best as they could, in the moment they could.
Each discipline is unique, each discipline has its strengths
Every minute counts. Every discipline counts. Every nurse counts.
pixelskylines
blakekathryn
kianamaiart
