AbstractI chose to write my essay on the work loadof nurses because it is something that seems to be over looked. From a youngage, I have been drawn to everything related to medicine and taking care ofothers. From the bottom of my heart, Ibelieve that nurses deserve the same recognition as doctors because at the endof the day, they are a team.
I recall a time when my sister, a registered nursemidwife of 15 years, saved a patient and her baby’s life and the doctor was theone recognized. A patient was brought inat 12:30 am at 3cm, and only moved 1cm since admission with a grade 3 meconium(the first feces of a new born), receiving 5l oxygen via face mask as the babywas in destress and needed additional oxygen. Upon reviewing the patient’snotes, she spoke to her gynecologist 2nd, explaining to her that she waspreparing the patient for an emergency caesarean. Doctor Gomez said, “wait tosee if she makes any progress because I am not interested in doing a caesareansection today.” After speaking to thedoctor, she examined the patient to find small clots at the introitus (vagina).My sister then bypassed the doctor’s decision, and took the patient into theoperating theatre for a caesarean section as she was noted to have placentaabruption (when the placenta is detached from the mother).
As for the infant,he came out with Apgar score (a physical condition of a newborn), and wasplaced in the nursery for close observation. If my sister had waited longer the infant would have died, but DoctorGomez got recognition for saving their lives. This particular incident mysister experienced, drove me to highlight a day in the life of a registerednurse, with hopes to enlighten my audience that nurses work just as hard asdoctors.
A Day in the Life of a Registered Nurse Tosay registered nurses are busy is a bit of an understatement. They spend longhours daily dedicating time and effort into their work. The determination isclear within the role of a nurse which includes leadership, assessment andtreatment, for each of their patients. Nurses are doers who work physicallyharder than doctors. They are not as well paid or respected as they deserve. Aswell, they have less autonomy and less credibility than they might. Finally, theyare wonderful patient advocates.
Nurse leadership assures that everyindividual does their part to get a job done. The individual that is in chargefor the entire nursing team is called the head of nursing, and that individual mustallocate each staff member to a task, they need to ensure that every patienthas received adequate care and debrief every individual on the team. Accordingto the American Nurses Association (ANA) Code of Ethics for Nurses withInterpretive Statement, the nurse is responsible and accountable for individualnursing practice and determines the appropriate delegation of tasks consistentwith the nurse’s obligation to provide optimum patient care (Kelly-Heidenthaland Marthaler, 2005).When the staff arrive to work, theindividual that is in charge has to assign each nurse to five-six patients and aclipboard (medical chart containing information such as: medical history, vitalsigns, diagnoses, treatment plans, laboratory and test results). Then, thenurse has to go into every patient room during morning assessments, set uppatients for breakfast, chart (medical chart), give medications, and assist patientswith following out doctor’s orders. Lastly, at the end of the shift the nurseand the nurse in charge must debrief the nurse on the oncoming shift. Duringthe handover, the nurse has to give details of every patient assigned. Thehandover of each patient is generally made up of three sections: Past:historical information.
The patient’s diagnosis, any information the team needsto know about the patient treatment plan. Present: current presentation. Howthe patient has been during that time of the shift and any changes to theirtreatment plan. Future: what is still to be done. For lots of reasons tasksthat need to be completed at a certain time may be handed over to the nextshift, simply because the team did not have time to complete the task (Daniels,2004).
Nursing leadership is vital not only to the long-term credibility of thenursing practice, but to achieving good patient and client care and effectivenursing leadership is very important in all nursing role.Clearly, nurse-patient encounter is thefirst encounter between a nurse and patient while assessing that patient. Nurseassessments focus upon the patient response to health problems, perceivedhealth needs, health practices and values. The goal of assessment is thecollection and analysis of data that are used in formatting nursing diagnoses,identifying outcomes and planning care, and developing nursing interventions.
Incomplete or inadequate assessment may result in inaccurate conclusions andincorrect nursing interventions. When entering a healthcare facility nurses arethe first person individuals will encounter asking them series of questionswhile checking their vital signs, it may not seem like a lot of work to some,but nurses do assessment from the moment an individual walk through the doorand at the beginning of every shift. There are three types of assessments carriedout by nurses, comprehensive, focused and an ongoing assessment. Firstly, the nurse must perform acomprehensive assessment which is completed upon admission to a healthcareagency. This assessment includes assessing the physical, emotional and mentalaspects of all body system as well as the environment and social issuesaffecting the patient. Next, a focused assessment, this assessment collectsdata about a problem that has already been identified. This assessment has anarrower scope and a shorter time frame than the initial assessment, the nurse determineswhether the status of the problem has change (improved, worsened, or resolved).
Finally, an ongoing assessment which is a systematic follow-up when problemsare identified during a comprehensive or focused assessment. This assessmentincludes the nurse doing systematic monitoring and observing related specificproblems, it also allows nurses to broaden the database or confirm the validityof the data obtained during the initial assessment (Daneils, 2004). “Themost important practical lesson that can be given to nurses is to teach themwhat to observe- how to observe-what symptoms indicate improvement- what thereverse- which are of importance-which are of none-which are the evidence ofneglect- and of what kind of neglect. All this is what ought to make part, andan essential part, of the training of every nurse” (Nightingale, 1860/1969,p.
105). Nurses provide care based on patient needs,working along with doctors to formulate a care plan. The nurse providespsychological support to clients with terminal illness. In addition, throughthe assessment process nurses individualized priority-setting, priorities willbe influenced based on the patient’s condition and the intensity of nursing carerequired by a patient.
Priority ranking of patients are characterized intothree levels: First level is where they treat patients with immediate survival,safety and high demand. Second level highlight concerns such as mental statuschange, acute pain, acute urinary elimination, abnormal pathology lab results,risk of infection and safety. Third level is where those that do not fit intothe above categories.
If there are no life-threatening situations, nurses used professionaljudgment to set priorities and planning. “Prioritization is defined as decidingwhich needs or problems require immediate action and which ones could be delayeduntil a later time because they are not urgent”(LaCharity, Kumagai, and Bartz,2006, p.4)Critical thinking skills is the core ofbeing a good nurse, in addition, they use these skills to provide effectivecare while coping with the expansion in roles associated with the complexitiesof current health-care systems. Nurses use critical thinking skills to preventmedication error.
In fact, they think in a systematic and logic manner with opennessto questions and reflect on reasoning to ensure safe nursing practice andquality care. Every day, nurses make decisions through critical thinking. Criticalthinkers are people who know how to think. They possess intellectual autonomy,in fact they refuse to accept conclusions without evaluating the facts andreasons for themselves. Critical thinking is process that allows nurses to seethe big picture instead of focusing only on details. Furthermore, nurses mustadminister numerous drugs daily in a safe and efficient manner. They administerdrugs according to the nursing standards of practice and agency policy. Beforeadministering any medication, the nurse must compare the medications listed onthe Medication Administration Record (MAR), other recording forms, or computerorders with the healthcare practitioner’s order.
When administering medication,the nurse must check the label when removing the drug container from thedrawer, check the drug when removing it from the container and before returningit to the patient’s medication drawer. The nurse should give only medicationthat they prepared and checked, because they are the responsible party shouldan error occur.As a result, long hours and dedicated timespent by nurses are their daily work routine. Everyone has a common goal, butthe nurses are not being recognized for their hard work. They deserve the samerecognition as doctors because nurses are the center of healthcare.
Societythink so little of nurses, but at the same time doctors rely on them so much.Doctors will see a patient anywhere from five to thirty minutes a day dependingon how sick they are, and the rest of the work are left to the nurses. They arethe ones making sure patients get their pills, check their vital signs toensure they do not drop, make sure patients do not fall and break something.
Ifa patient vomits, doctors will run out of the room while a nurse rushes in. Theychange patients wound dressings and start their IV line. They will cleandisgusting things off patients even if they are drunk, delirious or mean andthrough all of this they try to be friendly and positive. To say registered nursesare busy is a bit of an understanding. The determination is clear within the roleof a nurse which includes leadership, assessment and treatment, for each of theirpatients.
References Daniels, R. (2004). Nursing fundamentals: caring & clinical decision making. New York, NY: Thomson Delmar Learning. Delaune, S. C. & Ladner, P.
K. (2002). Fundamentals of nursing: Standards & practice (2nd ed.). Albany, NY: Thomson Delmar Learning.
Kelly-Heidenthal, P., & Marthaler, M.T. (2005) Delegation of nursing care.
Clifton Park, NY: Thomson Delmar Learning. LaCharity, L.A., Kumagai, C.K., & Bartz, B. (2006) Prioritization, delegation, and assignment: Practice exercise for medical-surgical nursing. St.
Louis, MO: Mosby Elsevier. National League of Nursing. (1997). Interpretive guidelines of standards and criteria 1997: Baccalaureate & higher degree. New York: National League for Nursing Accrediting Commission. Nightingale, F.
(1860/1969). Notes on nursing: What it is and what it is not. New York: Dover.