My Bones are Weary

It's been one of those days (or nights). You hit the floor running and even had to stay late to catch up on charting. You never once had time for a lunch break, much less a bathroom break. You had three total-care patients with extensive dressing changes, two patients in severe pain, and one patient who could not stop vomiting, regardless of how many antiemetics you gave her. You finally made it home and all you want to do is use the bathroom and go to bed. But the kids and husband (or wife) are wanting to spend time with you. Do you, A) tell them you are too tired and fall over into your luxurious bed, or B) push yourself to spend some much-needed time with the family?

This is a question that many nurses (and nursing students) are having to ask themselves. With the onslaught of higher acuity patients, nurses are becoming more and more tired at work. One recent study found that more and more med-surg nurses are not as happy with their jobs as they were 10 years ago. Why is that?

Sicker Patients

The patients we are seeing in the hospitals are much sicker than in the past. People are waiting until they are deathly ill before they see a doctor due to the rising health care costs. Also, they are being discharged earlier, so there is an increased need for patient teaching in a short period of time.

Money is Tight

Money is tighter, so hospitals are forced to slack off on the amount of nurses on each unit. Even having one less nurse per shift can cause the amount of work to be done to increase for those left behind. I remember some years ago, when I worked on a med-surg floor. We were all scurrying around, trying to get everything done. We were all sweating, turning patients, cleaning patients, giving meds, giving patients cold washcloths, cleaning bed pans. We all finally got to sit down to chart and the CNO came around. She said that since we weren't doing anything, one of us would have to go home. We tried to tell her that we couldn't manage, but all she saw was us sitting down. One nurse had to go home and we would have to take up the slack. None of us sat down for the rest of the shift, which caused us all to stay late to finish up charting...which caused us all to have overtime. Was that overtime less than what the other nurse would have been paid, had she been able to stay? I don't know the answer to that, but I can tell you that our morale was zapped. We were unhappy campers.

More Demanding Patients?

Patients are becoming more and more savvy. That is a good thing. They know more about their health issues than ever before. However, some of these patients feel as though they should be treated like they are guests in a hotel. Is that so wrong? Maybe...maybe not. Patients do deserve to be treated well, with kindness and respect. So when you follow a nurse who hasn't been all that respectful and kind, the patients can already be in an uproar when you come onto your shift. It seems like an endless cycle. When I come across an angry patient, I try not to become discouraged. I see it as a challenge. Can I get this patient settled and happy before the end of my shift? If I can do that, I will have done my job.

All of these things, and more, all lead up to some very tired nurses. So what is the solution? Nurses should start thinking about the upcoming shift more. When you use the last of an item, replace it immediately. If you write on the last line of the nurse's notes, put in a new sheet. Keep your patients happy so the next nurse isn't land-blasted.

Another thing you can do is work in teams. Teamwork is so helpful on a med-surg floor because you can all share the work. When it is time to go bathe patients, get a cart ready with everything you will need and park it outside of the patient's room. Everyone can get in there, clean up the patient and the room, including placing new linens on the bed, in less than 10 minutes. Move on to the next patient, and before you know it, everything will be done.

When you work in teams, you begin to read each others' minds. I have had some great teams in the past, and I keep reinforcing teamwork with all of my students. Don't ever say you won't help someone, because you may be the one needing help someday. It MUST be a give-take relationship. If everyone gives, then no one has to feel guilty about taking from time to time. Just don't be the one who is always taking and never giving. Anger can grow quickly!

Start out your shift with a smile on your face. This may sometimes feel impossible, but studies have shown that if you force yourself to smile, your brain is tricked into thinking you're happy. In recent years, I have never seen more scowls as I have when I walked onto a med-surg floor. However, I smile at everyone, and before I know it, others are smiling back at me. Are smiles contagious? I don't know the answer to that, but I do know that one can certainly affect the moods of others...so why not have a positive effect?

Don't forget about your family or yourself. You give yourself over to your patients every day you are at work. But don't forget that you have a loving family at home. Make just a small effort to spend time with them. It doesn't have to be anything big. Come home, take some ibuprofen, and allow yourself to relax. Having a supportive family is crucial, but they won't be supportive if you always come home in a negative mood. Leave your work woes at work, and turn that smile on again when you walk through your door. You never know...you just might brighten your family's day as well.