“I would submit to you that those (small hospital nurses) probably do get breaks. They probably play cards for a considerable amount of the day.”
– Maureen Walsh
For the first ten years of my professional life, I was an inpatient nurse, first on a surgery floor and later in an ICU. After working three shifts in a row, I learned that I’d need to to spend a day recuperating. I called it work hangover, and for ten years, it was normal.
When I was 22, I graduated from nursing school and immediately began work on a post-operative floor in Syracuse’s biggest hospital. My clientele were patients with polytrauma, burns, abdominal surgeries and kidney transplants, to name a few. I had between five and seven patients per shift, and usually there was a tech who was responsible for some of them. My duties included assessments, med pass, baths, blood sugars, assisting with eating, helping patients out of bed, transport to and from tests and procedure, bed changes, blood draws, IV maintenance, dressing changes, relating the plan of care to the families, and oh, of course, monitoring my patients for critical changes. Granted, I was new, but the immensity of these tasks, coupled with the consequences of my own actions (people could die!), made me feel completely inadequate. I could not keep up. I was often getting my 6 p.m. vitals at 8, when I could stop answering call lights. On a 12-hour shift, on a good day, I’d grab a 15-minute lunch at 2 or 3 p.m.
This floor was not the busiest one in the hospital and from what I’ve been able to gather from nurses who work at other local hospitals, I had it far better. One hospital routinely gives new graduate nurses ten patients at night, and punishes them if they stay past the end of their shift to finish charting. Later in my career, the ICU I was privileged to work in mandated no more than two patients for one nurse, but I’ve heard many nurses complain of having three patients; all on complex life support equipment, and for them this is normal. I’ve picked up patients from the ER, from a nurse on a 12-hour shift who noted that it was 10 hours into her shift, so she was going to call lunch a total failure.
Recently, Washington State Senator Maureen Walsh implied that nurses already have too much time on their hands and, furthermore, we spend it playing cards. Why did tens of thousands of nurses on Twitter become infuriated?
Because so many of us give our lives to this job and still feel we are failing our patients. We hate feeling inadequate. We hate it when our soiled patients have to wait, to lay in dirty embarrassment while we attend to something more important. We hate being late with our meds, knowing our patients are waiting in pain. We agonize over missing critical changes that tell us our patients are going downhill. We cringe when we turn a delicate elderly woman and find a new pressure sore, because we did not have time to turn her. When a family member comes in angry because no one is feeding his mom. All we want, all we’ve ever wanted, are the tools to do our jobs; to care for our patients and God forbid that involves hydrating ourselves.
We are historically and chronically understaffed and because of this, do not have the resources to do our jobs the way we want to do them. As a result, experienced nurses find work elsewhere, leaving the floors to new grads and creating a cycle of chronic inexperience.
There is no data on how many nurses routinely do not eat during their shifts and neither has there been research done on how long the average nurse will keep working without stopping to pee or to change a tampon. But if you ask us, we will tell you. It happens all the time. In Maureen’s view, forcing hospitals in Washington to mandate breaks is appeasing an already lazy, and apparently gambling-prone population, ushering us into further ineptitude. In a nurse’s view, it guarantees we can take a bathroom break.
A few years ago, I wrote a short story about a nurse. There’s a bit in there where the nurse sneaks into the med room to eat an illegal Clif Bar. When I read this at an awards ceremony, that part got a laugh. I was puzzled, and then I realized, my God these people don’t get it. They don’t know we actually aren’t allowed to eat in patient care areas. We might get a moment to sit down and chart, but some higher up entity has decided that it is dangerous for us to sip water or munch on a granola bar while we do so. Eating and drinking is required to take place in a separate area, and many nurses simply don’t get the time to go there.
Because patients always come first. In our quest to manage pain, stop hemorrhages, restart hearts, catch babies, comfort children and hold the hands of the dying, we put ourselves last. Wouldn’t you? Don’t demean our entire profession and all of the amazing things we do by saying we play cards at work.
All we’ve ever wanted is to be able to do our jobs; to take good care of our patients. We need intelligence, strength, teamwork and a whole lot of patience. Sometimes we need a water break. We certainly don’t need card playing skills, and we don’t need politicians who have no idea what nursing entails to make sweeping and derogatory generalizations about our profession. We need leadership who want what we want; good patient outcomes, and are willing to give us the tools to make that happen.
Emily Weston is a nurse practitioner who blogs at Nursing: A Confession.
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