Modern Day Slave Trade

I have just watched the first part of the human trafficking documentary, Not My Life, created by Robert Bilheimer. It was shown on CNN. I have been remiss. I actually learned about human trafficking in a class I had during my Populations at Risk for Mental Health Disorders in nursing school. However, getting caught up in the NCLEX, finding a job, and surviving the first few months of the job I finally was able to bag, I lost sight of what is really important. How could I let myself become consumed by trivial challenges in my privileged life when there a tens of millions of people who are being starved, beaten, and exploited almost every single hour of their lives? Especially when the majority of these people are younger than me, many of them younger than me by 10-20 years (I'm 23). According to the documentary (which got it's facts from sources such as the US Government and many non-profit agencies) the human trafficking trades spans across all 190 countries in the world, even within our own. Many of the victims are exploited sexually and some people are forced to do physically crippling labor for 16-20 hours a day, 6-7 days a week. Many victims are forced to be soldiers and sent to the very heart of battle, are even forced to kill their own parents and family members to dehumanize as soon as possible. 


How is this possible? It's almost 2012 and this is happening in every country. It is because there is a market for these people and the abusers; the cruel, heartless, soulless individuals who profit from this sick industry; spend less than half the time in jail when caught, than they would if they had engaged in dealing drugs. Governments are effectively stating that selling drugs is worse than selling people. 


Please, please if you can, go to notmylife.org, watch the second part of the film tomorrow on CNN at 9 PM eastern time, and if anyone wants to help me join in the fight let's find a way to end this tragedy. Let's start a group, or travel the world and buy someone and give them a place to live and get them a job and help get them US citizenship or something. Please. 

Staffing Draft

As a person who may potentially be hospitalized, access a clinic, or need home health services, it is important that you have a say in how your health care should be delivered. The American Nurse's Association (ANA) is an organization that represents the nurses of the United States. They want nurses, other health care providers, and people who use health care services like the general public, to give their own views on the changes that need to be made in health care, specifically in the arena of nursing. One thing that is obviously close to my heart is nurse staffing! If you would like to add your input the ANA is more than willing to listen.

http://www.nursingworld.org/HomepageCategory/Announcements/Comments-Principles-for-Nurse-Staffing.aspx

A nurse's day

Foreword. I only wrote half of one of my days. There's just too much that happens, I would have to write a novella and I'd still not be done. This narration doesn't include the incidences of having to get the enterostomal nurse to change an ostomy bag 2 more times, and my returning patient coming back right after I received another admission exactly when 1800 medication are due.

Although this timeline seems fictional it is based on the truth and it is certainly not an exaggeration. These conversations and occurrences all happened that day. I have switched up the genders, ages, medical histories and principal problems, but all the events have occurred. Furthermore, this wasn't an anomaly, this is what my job is like every day. Most of the time I don't have a truly surly patient, but sometimes I do, and all of the time I have patients that are very demanding. As they should be. But this is just to illustrate how having a lot of patients can cause nurses to feel scrambled and overwhelmed. And keep in mind I have another nurse helping me since I just started. As a new graduate it's hitting me hard and I've already questioned whether this is truly what I want to do. All my fellow nurses say I'll get used to it but I don't think that this is something nurses should just get used to. This is the situation all over the country and it needs to be acknowledged not just because nurses are burning out and leaving the field, or that because of this our physical health is suffering (notice in the narrative how I can't pee for at least 5 hours and I actually didn't get to pee until my lunch that day which was at 1600), but because it effects the care that we can give to our patients. (Nurses leaving nursing means even less people to take care of you, not to mention there's still that nursing shortage the nation has to contend with). The more patients we get, the less time we have for them individually. 

I pray that people take note and see how this can effect their own time at the hospital and demand to be given more attention (but not in the way where there's just more pressure on the nurses and we still have the same patient loads). Or maybe we'll just start getting the respect we deserve. Either way, every little step counts. 

Explanation for the narration:

Italics - my thinking

"Quotes" - conversations

Bold - a little machine we wear around our necks called the Vocera.

                                       *                *                 *                  *                  *

My Day

0630 – Thank God I made it to work okay. I wonder how many patients I have...where's the assignment list? Whoo! Only 5: 309, 310A/B, 311A/B. And they're all in a row! I can keep my cart in one place and not risk crashing it, that thing is ridiculously heavy for being on wheels. Well cool I'll go print the work lists.

0700 - “Good Morning!!!” I'm a big brave dog, I'm a big brave dog, I'm a big brave dog. “You have my patients right? I'm ready for report, ______ says I can take it without her.”

0705 - “Attention staff, huddle time” Oops, forgot about huddle...

0718 - “***, you ready? “309 _______, ______. 68 year old male with a history of HTN (hypertension), depression, BPH (benign prostatic hyperplasia), brain aneurysm, gastric CA (cancer). No past surgical history. No known allergies. Contact for C. diff. Alert and oriented times three. Patient came in almost two weeks ago for partial gastrectomy and his B/P was very low after surgery so he went to step down. Now it's stable except for the HTN but he is on metoprolol and it's effective. He has a midline incision which had staples but were removed three days ago, c/d/i (clean/dry/intact) healing well. Bowel sounds hypoactive. He has a double lumen Hickman in right chest, TPN (total parenteral nutrition) going at 100. IV in right antecubital with 0.9% NaCl KVO (keep vein open), he gets esomeprazole and pain meds IV. He's NPO except for sips, he takes his other medications PO. He has a foley and it's been in for a while but GU (genitourinary) says to keep it in and he'll probably leave with it. He has a stage II (bedsore) on his sacral area, last dressing change was yesterday AM, still c/d/i. Generalized edema at 3+. Pt refuses flowtron boots....”

Okay one pt with c. diff., have to remember to wash hands at the sink, not just with hand sanitizer and has TPN which means fingersticks at 1200 and 1800, no dressing change due but gotta check it just in case; one pt going home today so I'll need to get paperwork ready; one patient has a PCA (patient controlled analgesia) so I have to tell my PCA (patient care associate) to take vitals at noon and who also has TPN and needs fingertsicks/potential dressing change; the other I have to make sure the ostomy bag doesn't leak; and finally one pt who's pain is out of control. God bless America...

0755 - “Okay *** let's start. We'll go see the pain pt first because pain is a priority remember. Good morning Mrs. ______. My name is ______ and this is ***. We're your nurses for the day. Can you tell us your full name and date of birth? Good and do you know what day it is? And where you are?” Okay good she's still oriented.

“We're just going to have a listen to your lungs and tummy and assess you okay? Hmmm, lung sounds are clear bilaterally and in all lobes. Her heart sounds are regular with no extra sounds. Her bowel sounds are hypoactive but she has motility issues so that's to be expected. She's been in pain since yesterday though, have to make sure the doctors know. ____ is asking if she's passed gas yet or had a bowel movement. Yes to gas, no to BM. Her IV still looks good and it was placed yesterday we wont have to change it. If we get her pain at a good level she'll need to walk today and do the incentive spirometer, oh no wait she didn't have surgery. Anyway she says she has 10/10 pain.

“***, check what pain medications she has and get the one for severe pain.”

Urgent message, patient call. Room 309 call back, yes or no.

“Call back. Hello, how can I help you?”

“Get this out of me!”

“I'll be right in okay?”

“Get it OUT.”

“Okay sir. Be right in.”

“Okay ***, I'll go to 309, you get the pain medication.”

So much for planning to do a quick assessment today. What am I supposed to do when I don't have my preceptor? I know I would have to go see 309, but pain is more important. What if 309 pulled something out while I was getting the pain meds? I'll ask ___ later, gotta go to the pyxis.

0805 - “Can I get a witness? I'm giving 0.8 mg of dilaudid. That means I'm giving 0.4 ml and so I'm wasting 0.6 ml. Thanks.” Okay I'm just going to grab a few needles and syringes from the med room...and now to clean supplies to get a bunch of piggy back bags...you know I might as well grab my tubings for secondaries and the TPNs so I have everything ready already.

“***, 309 wanted to have his foley removed but I explained to him why he needs it. Make sure when you give him his tamulosin to explain what it does so he knows it will help with removing the foley in the near future...”

0815 - “Okay Mrs. _____. What I have for you here is Dilaudid, it's the pain medication you have been receiving. Did any one explain the side effects of the medication? Okay good, so remember it may cause drowsiness so if you need to go to the restroom, please call us first so we can help you. We don't want you to fall. Okay I am -”

Urgent message, patient call. Room 310A call back, yes or no.

“Call back. (Sorry. Mrs. ___ one second.) How can I help you?”

“The doctor said I could leave today, can you let me know when?”

“Of course, it will be a while but I'll be in soon.”

“Sorry Mrs. ____, let me just scan your wrist. Okay great, now I'll scan the medication to make sure that everything matches up...perfect! I'm going to hang the medication now. It should work in a few minutes and I'll be back to see how it is working okay?”

Urgent message, patient call. Room 309 call back. yes or no

“Call back.” FRICK!! “How can I help you?”

“Give me ice chips.”

“Okay I'll be right in.”

I might as well assess him while I give him the ice chips.

Vocera

“Call _____ _____.”

I think you said, call Anjelino Jolie. Is that correct?

“No”

Okay, let's try this again. Vocera.

“Call ____ ____ on (my floor).”

I think you said, call Ina Garten. Is that Correct?

“NO!” Ugh, never mind!

Okay, let's try this again. Vocera.

I'll just turn it off. I'll assess 309 and tell ____ I already did it. Hmmm, I have to pee.

0825 - “Hello Mr. ____ here are your ice chips. Let me listen to your lungs and tummy first and then you can have some okay?... Everything looks good and sounds even better! I'm going to check your TPN rate. Okay good, going at 100 which is where it should be! Let me move your table closer so you can reach your ice chips.”

“I can't reach that there, where are your brains? Haven't you got any?”

“Mr. ____ what's upsetting you? I am sure you wouldn't say that if you weren't feeling bad.”

“I want this stupid thing out of me!! No one will take it out.”

“I'm sorry Mr. ___ -”

“You're sorry, you're sorry, you're sorry! Everybody's sorry but nobody does @#$&!! Do something, don't be sorry!”

“I know it's uncomfortable and I know you are angry that it has to stay in. But I can only assure you that you need it to help you. The GU doctors feel that it is better to keep it in or else your bladder will fill up and there will be more problems. They feel your BPH is not under control enough to have you use the restroom on your own. Please understand that it needs to stay in until the medication takes effect.” I thought ____ already explained all this! Calm down, he has a catheter in his privates for goodness sakes ***, calm down!!!

“Well then give me the medication!! And I'm thirsty and hungry! What are all you trying to do? Starve me?”

“Oh, no, no, of course not Mr. ____. We are only waiting to see if you can tolerate any food without feeling nauseous. I will speak with your doctor and see if you can have something else to drink or maybe even eat. I will be right back with your medications okay?”

Breath ***! It's not his fault! I'm going to get ______ and see if we can do the rest of the assessments. Oh dammit, its 0855 have to check on Mrs. _____ first and see how the pain medication worked.

“Hello again Mrs. ____. How is your pain now, if you could rate it from a 0-10: 0 being no pain and 10 being the worst you have ever felt. Well it helped a little but not too much if you're feeling a 7. I'll come back in another few minutes and if it hasn't gone down I'll let the doctor know.”

0900 - “Oh hey _____. Can we finish the assessments? I did 309 already.”

0935 – Okay everyone looked pretty good. The doctors removed 310A's JP's (Jackson Pratt drains) so she's definitely good to go home today. All the IV's, PCA's, and TPN's are running at all their right rates. I hope that 310B's ostomy stays sealed till I can change it later. Now that we have that done I'll go back to 311A and see how the pain is and give the rest of the meds. Let's see what she has....okay these are all compatible she can take them all together, and none are blood pressure meds so I don't have to take her B/P again.

0938 - “How is your pain doing now Mrs. _____? Still a 7/10? I'm going to call the doctor right now okay? First I have a few of your medications. Are any of these medications new for you? No? Okay do you need any information on any of them, like side effect information? Cool, let me scan your wrist band then. And I'll be right back, I need to go to the cart and scan the medications to check if they are all as ordered.” Good good, everything scanned right. “Okay everything seems to be in order, lets get you some water. Perfect. If you change your mind about the information let me know. I'll go call the doctor now.”

0945 – Need to call Team III and Team V. Let me check 311B's meds while I wait for the calls back. Okay we have this, this, this...frick! Why is her hydrocortisone not here? Let me run to the med cart and see if they brought it...nope, not here. Gotta get back to my cart and send a note to pharmacy. Missing dose: please send as soon as possible. Ahhh, the phone!!

“Good morning. Hello this is *** ******* the nurse for Mrs. ____ ____ in 311A. Her pain has been severe all morning. It was 10/10 and I gave her the 0.8 mg of Dilaudid however it only brought the pain down to a 7/10. I know she's impacted and she can't take too many narcotic pain medications but there really needs to be something done, can you prescribe toradol or another non narcotic pain medication? Okay I'll look for the order, thanks.” Okay Team III you're up next...call call call!! YAY!

“Hello good morning. Hi this is *** ******* the nurse for Mr. _____ in 309. He's tolerating ice chips and his PO medications and he says he's very thirsty. Can you come see him and see if he's ready to take sips, or clears? Great, I'll let him know.”

1000 - “Mrs. _____. The doctor is going to order you some pain medication that is non narcotic okay? We cannot give you anything stronger because of how you are suffering from impaction in your bowels. Narcotics can cause more constipation and we don't want that, we want you to be able to use the restroom. While you are waiting for the pain medication there are a few things you can do to try to help relieve the pain. Sometimes it helps when people think of a nice place that they have gone to and they reflect on their memories by going through all their five senses. For example - “

Urgent message, 309 rounding request reminder respond yes or no.

Oops forgot to press the rounding button..

“Yes”

“Sorry Mrs. ______. Anyway, you can think of the nicest beach that you have gone to. And you try to remember what it smelled like, whether you could smell the ocean water. And maybe there were palm trees so there was tropical fruit smells. And then you could try to remember what you heard at the beach, the ocean and waves, the birds and the wind. And you would do this with all your senses. Do you think you could try that for me? It can be very calming. Okay, well give it a try and I will be on the look out for the other pain medication order.” Okay now 311B.

“Hello Mrs. _____. I have some medications for you! Of course I can empty your drains for you., let me just scan your wristband so I can give you the meds and we can get them all emptied out. Okay let me scan the medications for a triple check okay? Okay great you want to take them with apple juice no problem. Here you go - “

Urgent message, patient call. Room 309 call back, yes or no

“Call back. (Sorry Mrs. ____) How can I help you?”

“I'm thirsty! When do I get to drink, I can't take it any more!!”

“I'll be with you in just a moment. I will explain everything when I come in.”

“Sorry my friend. Okay good, let's take a look at your drains.” Okay left Jackson Pratt: 10 ml. Right Jackson Pratt: 15 ml. Both have serosanguinous drainage, actually going more serous that's good, less blood in the drainage. “Okay - “

Urgent message, 309 rounding request reminder respond yes or no.

Oh God bless America...

“Yes.”

“Sorry about that Mrs. ______. I'm actually going to change the dressing around your left JP okay, it's a little soaked.” Does she have gauze here? Okay good, use a little alchohol here to loosen the tape. “I apologize, I know the tape hurts a little. It'll be over in a minute” Hmmm this JP is right on the crease between her leg and side...I'll fold the gauze a little bit more. Perfect. Tape annnnd done! “ Wonderful -”

Urgent message, 309 rounding request reminder respond yes or no.

Don't respond testily, take a deep breath and even out your voice when you respo -

I didn't hear you. 309 rounding request reminder respond yes or no.

OMG!

“Yes.”

“Okay, I'll be back to round on you in a little bit okay? That just means I'll come in and see how you are doing, if you need anything else, or have any questions.”

1035 – Fudge! I only have 25 min to give the rest of my patients their meds. Okay let's go!! Darn 309 has the blood pressure meds, let me get the blood pressure cuff. And don't forget to round, don't forget to round! “Hello Mr. ______. I spoke with the doctor and she said she would be up in a few minutes to determine whether you can have something to drink okay? As of now I have your medications. I need to take your blood pressure first. While that's going I'm going to scan your wrist band and then scan the meds okay?” Frick, this Dinamap isn't working! “Let me go get the other cuff Mr. _____.” Where are all the cuffs?? I just walked around the entire floor, where could they be? Oh here's one, why's it in this person's room...hope no one is using it, maybe it was just forgotten. “Excuse me, I just need this blood pressure cuff. Do you know if any one was using it? Good, thank you. Oh you would like a warm pack? I will let your nurse know.”

Vocera.

“Call _____ _____”

I think you said call _____ _____. Is this correct?

“Yes”

Calling ______ ______.

“Hey! You're patient in 303 would like a warm pack for her belly.”

Now back to 309. “Here Mr. _____. I'm just going to wrap this around your arm.” Good B/P is 135/76 and pulse is 89. “Here are your meds Mr. ____. This one is the Flomax. This medication is the one that helps with the urinating. This will help you with getting the foley taken out.”

“Who's going to get me washed up?”

“I will be back in a few minutes to help you with washing up, sir. I will come back with _____ he's the PCA.”

1055 – Dammit, I'm going to be late with my meds. AHHHHHHHHH. And I have to check up on Mrs. _____. Okay calm down, calm down. I'm a big brave dog! I'll check the orders and see if she has pain meds...okay good order is in. I'll get it ready and then finish the meds.

1100 – It's scheduled for 12 but I can give it now and have pharmacy change the time. “Okay, so I have the pain medication. Can you tell me your level of pain again? 8/10, so it's gotten a little worse. I will give it you now then. It's called toradol and it is an NSAID like tylenol. However it is given IV. Would you like any side effect information on the medication? No? Just let me know if you would like the information. I will be back in a few minutes.” 310A go!

Can you talk to _____ _____.

“Yes”

“Hello, ***? I'm going to help ______ do AM care for Mr. ______. Just go ahead and finish the medications.”

“Thank you so much, _____.”

She just saves the day, thank God. Thank you God.

1111 - “Hello! I have your medications for you. Yes, my dear of course I am going to get the papers ready. But we have to wait for the orders and the doctor's prescriptions before we can actually let you go, okay? Let me scan your wrist band there. Okay good, I'm going to just scan the meds. They all scanned, here you go. And how was your breakfast? Okay good, no nausea? Perfect. Now will someone be coming to get you? Okay, can I have his name? Let me just write that down...okay and do you feel like you would need a wheel chair? Or do you want to walk down. Of course we can get the wheel chair it would be no problem. Wonderful, I'll be back in a little to round on you and hopefully we will have the orders to send you on your way!” Yes, 310B and then I'm done with the meds whooo hoooo!

1120 - Good done with all the AM meds. Let me check orders and look at the labs. Hmmm 310B's H/H (hemoglobin and hematocrit) are low, even for having just come from surgery. Let me check what it was the last few days...oh no its trending downwards I'll have to tell the team, maybe she'll need blood. Everyone else looks good though. Potassium all good, H/H good, and platelets...okay nothing else too alarming. And orders for discharge are in great, I'll call the team and get paper work ready for 310A.

Can you talk to _____ _____.

“Yes. Hey _____ what's up? Oh no, really?...okay let me go take a look, I have to call the team first and I'll be right in.”

It was fine just a second ago when I was giving the meds. Poop...literally. Why now??AHH! Phone!

“Hello. Yes, this is *** ******* the nurse for Mrs. ____ ____ in 311B. Her H/H is a little low 8.2/24.1. And yesterday it was 8.3/24.4. Alright. Thanks.” THANK GOD she doesn't need blood!! And it was a slow trend but I just wanted to make sure, although it would have added more shiz to my day...mehhh don't think that way ***, be happy she doesn't need blood for her sake not yours. Meh, well let's go see 310B.

1135 - “Hello Mrs. ______. I heard that you're bag is leaking? Let me take a look. It looks like it's coming loose because it was wet underneath.” Hmmm, where are her extra ostomy bags. None?? Let me check her closet...none here either?? I'll have to ask-

Urgent message, patient call. Room 311B call back, yes or no.

“Call back. How can I help you?”

“Excuse me but I'm beeping here.”

“Oh no problem, I'll be right in to help you.”

Dammit!

“Okay Mrs. _____ I'll be right back. I have to find some supplies so I can change your bag. Let me place a this underneath the bag so you don't get any leakage on you.”

I'll go fix 311B's IV and then I'll ask. Oh shoot, and I have to ask Mrs. ____ about her pain.

1145 – “Hello Mrs. _______. I see you're IV fluid has run out. I will go and get you another one, I can turn this off for now though so the sound wont bother you.”

“And how are you Mrs. ______? How is your pain doing? Wow that really helped if it's down to a 5. I am glad. Now I can give you some more pain medication in an hour. If it's still a 5 then I'll get it ready for you if you would like it. Okay I'll round in a little bit.”

Okay on the way to _____'s office grab the fluid from the clean supplies. D5 and ½ plus 20 of k, got it! Now let's go see _____. Hmmm why is her door closed...ugh she must be on another floor!

Vocera.

“Call _____ ____.”

I think you said call Justin Bieber is that correct?

“No.” Banana nut muffin! What is wrong with this thing??

Okay, let's try this again. Vocera.

“Call ____ ____ on (my floor).”

I think you said call ______ _____ is that correct?

“Yes.” Thank you!

Calling _____ ____.

“Hey, 310B's ostomy bag is coming off. Yea the adhesive isn't sticking, but she hasn't any supplies and _____ isn't on the floor. Check the supply closet and then page her. Where do I find her number? Oh, okay. Thanks.”

Back to supply room...hmmm....nothing is here! Oh wait...no this is weird. I don't think this is an ostomy bag. I'll take one to show to ____ just in case. Okay write the label for the bag...good.

“Hi there. I'm back with your fluids. This is the same one you've been getting okay, it is almost the same make up of the fluid in your body but it has a little more potassium and sugar to help keep these at a good level in your blood. Let me scan your arm there, and I'll go scan this and hang it right up.”

Urgent message, patient call. Room 310A call back respond with yes or no.

Her paperwork!!

“Yes.” Oh frick, I forgot I have to say call back.

Okay responding with yes.

“Okay my dear, I'll be back to round on you in a little bit. Is there any thing else you needed before I go? Okay then, I'll be back in a little.”

1200 - Let me find _____ and have her look at this bag. If not I'll just call the ostomy nurse.

“OH, hey ____!!! Hi yea, this was the only thing. No I didn't think so. Let me call _____.”

Let me get this paper work done while I wait for the call back. No wait, there she is!!

“Hey! So 310B's ostomy is leaking from the bottom. The adhesive seems to have stopped working and we have no supplies. Do you mind taking a look? Thank you, thank you, thank you!”

Good, let me finish this paperwork up. Yes vitals are stable, leaving with ____ _____, leaving in a wheel chair, patient education is adequate for discharge, care plans are adequate for discharge, okay pt instructions....ab surgery and follow up care. Phew I'm like a marathon typer woot woot! Done let's call transport now, it'll take a while.

1217 – “Here we are Mrs. _____! Yes everything is ready! Let me take your IV out now and then we can go over a few things.” Disconnect all this IV fluid and I'll just throw it out now. “I have a few things to go over with you. This paper here is for us. We like to call our patients a few days after they go home to see if everything is alright. And then if you have any questions we can answer them. Yes, right here you place the best number to reach you and then check mark which part of the day. Mmmmhmmm, and any questions. Okay great. Now this is very important. This packet here informs you of when you need to return and a few things about how to take care of your self. So if you follow along here at the bottom it tells you which prescriptions you will be leaving with. This is a prescription for percocet. You may take one to two pills every four hours as needed. If you feel moderate pain take one, if you feel severe pain take 2. And again this is as needed, so if you don't feel pain you don't have to take - ”

Urgent message, patient call. Room 309 call back respond with yes or no.

“Call back. (Excuse me Mrs. ____, just on moment.) How can I help you”

Oh just kill me...

“The doctor said I can drink, get me some apple juice.”

“I will bring some to you in a minute okay sir?”

“Hurry up, I'm so thirsty, not giving me water or food or anything, stupid ---"

Ahhh, shut it off, the pts will hear!! ...kill me twice instead...

“I apologize Mrs. ______. Okay so...um...oh...umm...oh right yes if you don't feel pain you don't need to take the medication. To go on, these are the medication you were taking at home. Please continue to take them as prescribed. Now this is very important. Your diet is a mechanical soft diet. This means that you should be eating foods similar to the ones you have been getting here. Vegetables should be kept at a minimum, if you feel like you would like some they should be cooked until mushy. The fiber often causes discomfort and with the recent surgery it will help to stay away from them for now. That's right, like the pureed spinach or carrots. No salads! Any meat that you want to eat must be soft like ground meat. You should eat meat though, the protein will help with healing. Mashed potatoes are always good too, yes. This is - ”

Urgent message, patient call. Room 309 call back respond with yes or no.

“Yes.” AAAAARRRRGH.

Okay responding with, yes.

“This next bit is very important. No nuts or popcorn. These foods are very hard to digest and particles can get stuck in any other diverticuli. Do you have any questions about the diet? Okay, great. Let's move on to activities. You can participate in activities as you tolerate them. Walking is highly encouraged. One thing that you cannot do however is any pulling, pushing, or lifting of objects of more than five lbs. This is usually a gallon of water. It can cause pressure on the site where you got surgery and cause the wound to open. A lot of people don't think about it but pushing a vacuum is pushing more than five lbs so no doing that until the next time you see your doctor. Hahaha, yes, have your daughter do it! Okay so here's the information about when to follow up with your doctor. Are there any other questions? Yes you can shower normally, just don't put direct water on your surgical sites, let the water simply run down on them. Perfect. If you could just -”

Urgent message, patient call. Room 309 call back respond with yes or no

“Call back. How can I help you?”

“I WANT APPLE JUICE.”

“Yes, I'll be right in.”

“One more minute Mrs. ____.”

Vocera.

“Call _____ _____.”

Calling _____ _____.

Yay, got it at the first shot!

“Hey _____. Can you help 309? He says he can have clears and is requesting apple juice. No I didn't see if there was on order yet, can you check? Thanks.” Again, thank goodness for preceptors. What am I going to do when I'm alone...probably just go into a corner and cry...

“Okay Mrs. ____. If you could just sign right here...and here. Thank you! We're just waiting for the wheel chair, I'll let you know when they're here.”

1245 – Oh bananas, I have to do fingersticks. And I think Mr. ____ has a 1200 medication. I'll do his first and give him the medication then go to 311B.

“Hello Mr. _____, were you able to get your apple juice?”

“Yes, it took long enough.”

“Well I'm glad you were able to get some. I have another medication here and I have to check your blood sugar. Let me just scan you there and then the med. Okay the medication scanned perfectly so here you go. Now for your blood sugar. Which finger would you like me to check? Okay ready...good, it's 130. A little high but -”

Urgent message, patient call 310B call back yes or no?

“Can't you shut that stupid f****** thing off?”

“Sorry Mr. _____ I -”

“STOP SAYING SORRY!”

I didn't get that. Call back yes or no?

“Yes.”

“Turn it OFF.”

Okay responding with yes.

“I need to be alerted when other patients call Mr ______, I cannot shut it off. But as I was saying you just had the apple juice. We don't need to give you any insulin then. Is there anything else you needed before I go?”

“No just get out of here. And bring me my phone!”

“Here Mr. _____, I'm happy to help you.”

1305 - Okay I'll quickly do 311B's fingerstick.

1315 - “Hello Mrs. _____. I have to check your blood sugar. Which finger would you like me to test? Ready? One, two” poke. “Great, it's 103 thats right in the perfect range. Okay I'll round in a little bit.”

Okay no meds until the 1400 heparins, now I really need to pee.

Afterword: The rest of the day followed suit. Ostomy bags were flying off left and right and getting seriously bombarded with antipathy from one patient. Of course as nurses we're not allowed to say anything about his attitude because we need good patient satisfaction scores. It seems like you can never win. 

Two weeks after this day I was placed by myself and now I have started working on nights. I almost don't know how I survive except for nights are much easier. Pt's are trying to sleep and we don't have to send them off to locations for tests. We do get a lot of admissions but only until around 1200. 

I hope this sheds a little light on what we do as nurses. And if you are a nurse reading this please send me a transcript of your day. I will gladly post it,  and you can remain anonymous.