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Nurses and Their Niches

August 27, 2013

Finding one’s niche as a nurse can be difficult. I’ve only been a nurse for 2-years and already feel pressure from within myself to find my specialty, to find my true passion that lies within nursing. Many of my coworkers know exactly where they want to end up in nursing. Some know they want to deliver babies, some know they want to work in clinics, others know they want to work in the ICU or the emergency room. Some want to be travel nurses, others are happy just where they are: in Cardiothoracic and Vascular surgery. For me, what I know is that I enjoy traveling. I also enjoy the adrenaline rush when patients are having acute issues. I also enjoy getting to know the patients and their families admitted for many consecutive days. I enjoy watching my patients  progress from their first day out of heart surgery, sweaty, with multiple chest tubes, pacer wires, in pain, often in rapid afib, to having all tubes removed, giving them their first shower, walking with them in the hallway and caring for them all the way through discharge.

The last time I wrote, plans were in full effect to start travel nursing this fall/early winter. My, how plans change. As many of you know I am a renter, have no children yet, don’t have a car payment (My 1994 Volvo that I purchased for $1850 years ago runs like a gem), don’t pay for internet, live sans cable television, bike to work, and live in a city where cost of living is relatively “cheap” comparable to other cities I’ve lived in. Aside from the thousands of dollars in student loan debt, I’ve managed to keep my monthly expenses quite low. My partner in crime, N.M and I try to live our life as simply as possible, our main priority: be good employees, save money to go on adventures and travel as much as our finances allow. That is why we thought travel nursing could be the secret to satisfying our passion for travel, while maximizing saving money.

In the many months of research spent scouring the internet, talking to recruiters, and fellow nurses who have worked as travel nurses, we have come to the conclusion that at this point in life, travel nursing is not the secret to making our passion for travel a reality. We realized travel nursing would be quite an experience, but would make our life over-complicated with the paperwork, the tax information, always searching for our next assignment, health insurance, trying to score similar schedules or at least similar time off, which we already have now. Travel nursing would make it more difficult to travel for “pleasure”  since we would be on the road so much for work. Also, travel nursing would mean leaving Burlington. Obviously. Somehow in all of the planning to leave, it didn’t occur to me how wonderful we have it here. We are easy traveling distance to family, have the ability to hike, bike, run, ski, swim, and camp all in one city. Travel nursing would not only be the opposite of living simply, but mean leaving my coworkers, some dear friends and a life I’ve worked hard to build for the past 2 years. Moving to Burlington changed my life and I’m not ready to give it up just yet.

Somehow in the midst of planning to travel nurse, to deciding not to travel nurse I had heard from one of our attending heart surgeons about a program that travels to Rwanda performing heart surgery to those with rheumatoid heart disease. I had applied to be part of this team back in May and hadn’t heard anything until, ironically the week we decided not to move out west to be travel nurses. N.M also had applied and we both found out we were accepted to go with the program in February/March of next year. I am beyond excited.

So for now I may not know exactly where my passion within nursing lies, but for now, staying just where I am feels pretty darn awesome and we’re going to Rwanda in February!

Will post more details about Rwanda as I learn them!

Thanks for reading.

Slouched and Sweaty

June 14, 2013

One of my biggest pet peeves in nursing is when providers (nurses, doctors, students, interns) do not pay attention to the hygiene needs of their patients. Even though there is sufficient evidence stating the positive benefits (lowers blood pressure/heartrate, and relaxes patients) of bathing, and we are taught to do this for our patients in school, we appear to be lacking in this very important aspect of patient care. I notice that more seasoned nurses are really good at helping with bed baths. I’m not sure why it appears that newer nurses often forgo this important task. Now, I am a day-shift nurse, I get how busy it is. Most of the time I feel like a human medication dispenser and mediator between family members, doctors and patients. There are days I don’t know how I will be able to accomplish the day’s tasks and take care of my patients in the ways that they truly need me to, let alone assist with bathing and/or bathe them!

When I was on orientation a long time ago I remember that one of the of the nurses told me to “forget” helping bathe my patients as I had more important things to focus on. Now, in retrospect I know she didn’t really mean that. She was just trying to take something off my plate as I was probably seeming overwhelmed with all that had to be done. That said, for the first many months of working as a nurse, I didn’t help my patients bathe, I completely ignored it subconsciously.  It wasn’t until one of the nurses aides confronted me about this issue that I truly realized what I had been “forgetting” to do.

Patients after heart and vascular surgery are very sweaty. Their bodies have been to hell and back. They’re emotionally drained, in pain, exhausted and sometimes stubborn. When I walk into my patient’s room first thing in the morning, my eyes immediately are drawn to that patient slouched down in the bed, sweaty, on wrinkled sheets, despite how many times the night nurses and aides diligently boosted and repositioned/straightened them all night. Not only are the patients uncomfortable when this happens, there is this pressure of knowing that a patient’s family members will be arriving soon and you don’t want their loved one to be slouched down in bed, with their feet dangling off of the foot-board, sweaty and miserable.

Because of this, I’ve worked very hard on changing my routine. As often as I am able when I bring meds into my patient’s rooms, I start to get the patient set-up to bathe. On a given day, out of my 4-patient patient assignment, there can be 1-2 “heavy” patients, meaning they require full assistance with bathing, taking medications, etc. It is much appreciated by the aides if you can assist with or completely do at least 1 of your “bed baths.”

Recently I had a bedridden patient, severely depressed, who often withdrew from staff interaction. That morning, she was as I referred above, slouched and sweaty. As I washed her face, back, hair and legs/feet I noticed a smile form. The smell of the soap permeated the room, causing the room to smell like flowers. When the aide and I changed the sheets and bedding and repositioned her in the bed she thanked us. This patient doesn’t often thank us for our work. On that particular morning she took her pills without a fight. Not only did we notice a change in the well-being of this patient, I felt more relaxed from taking 20 minutes out of my morning routine to wash someone.

Moments like those remind me of why I became a nurse. In my eyes, it’s not about administering the difficult-to-pronounce medications, or starting IV drips that make you a nurse, it’s the private interactions you have with patients that make them feel better. Those moments are what most patients remember, not that time you started a Dilt gtt (gtt is abbreviation for drip).

To this day when I precept new graduate RNs, I teach them to do at least 1 of their bed baths. I tell them it makes the patient’s feel good, the aides will appreciate them more (being that they’re new) and it will give them a good opportunity to fully assess their patient.

Thanks for reading!

42 degrees, Rain, Wind and My First Marathon

June 3, 2013

Two days before the marathon my sister flew in for the week. Not only was my adrenaline already on overdrive, I was ecstatic that I would get a week with her. The nerves for the marathon, paired with my excitement turned me into one jittery, little lady. Fortunately (for my sake) my sister is obligated to love me and it’s amazing that she put up with my crazy for the 2 days leading up to the marathon. She accompanied me to get my marathon henna and run all kinds of last minute errands in preparation. For example, the realization that the weather for marathon Sunday would be 40 degrees, cold and rainy sent me into a spiral of panic, assuming I didn’t have the “right” clothes (since I had already planned my marathon outfit several weeks prior). What didn’t help my marathon jitters was that my boyfriend, whom I’ll initial, NM (also running the marathon) was as cool as a cucumber. He kept saying, “you will do great,” while I wondered what was wrong with him that he wasn’t more nervous.

Fast forward to the night before the marathon: Carbo-load dinner was finished, and itunes playlist completed; race bib filled out and attached to shirt; clothes set out, and marathon fuel on the table; I was ready. When the alarm sounded at 0445 on Sunday morning I could hear the rain pitter-pattering on the roof, and feel the chill in the air. I remember thinking, “you’re crazy.” As the coffee brewed and breakfast prepared, NM and I kept looking out the window at the pouring rain, then at each other, shaking our heads. The weather couldn’t have been more terrible to run a marathon in, but I was ready and I was more excited than a kid on Christmas morning.

After a bowl of Raisin Bran, 16 oz of Gatorade, 1/c cup coffee, banana, a protein bar and some morning yoga, I was ready. By 0720 NM and I headed downtown to the start, clad in garbage bags (our makeshift ponchos). Upon reaching Battery street, our excitement began to rise, yet I also felt calmer than I had in the days prior. We looked at each other, we were ready. As we jogged down and then up the Battery street hill to warm up, laughing and joking, I had never felt happier. We had trained together and prepared together and there we were; it felt wonderful.

We lined up at the start, and after a few high fives and nervous smooches,  the race horn sounded; we were off! We had previously agreed not to run together during the marathon since we both kept different paces. Within the first 10 minutes, NM was out of sight ahead of me. The first things I remember feeling was such joy and utter calmness. Running up Pearl street, noticing the spectators for the first time sent chills up my spine. Around mile 4, I noticed I was running faster than I should have been (just behind the 3:15 pacer). It didn’t matter though, I was too dang excited. It wasn’t until mile 10 that I really began to focus, that the marathon became a true, mental “game,” requiring my full mental and physical capacity.

I knew I had run too fast for the first 10 miles, failing to pace appropriately. I knew I had a long way to go, but I also knew that I was in it, there was no backing out and the only way to finish was to keep running.  As I approached the halfway mark (mile 13) behind the 3:30 pacer at Oakledge Park and ran along the water on the bike path I remember my teeth chattering, the waves of the lake splashing over the path hitting some runners. I remember thinking, just pass this corner and you’ll start getting warmer once you run up Battery hill.

Rounding the corner onto the bottom of Battery street hill evoked feelings in me I didn’t know I had. The amount of spectators lined up on both sides of the road, the homemade signs, the screaming people, the rain, the music, the flags; it brought tears to my eyes. I ran right up the yellow lines in the middle of the road. I don’t remember much about the people I saw or what I looked like, or how sore my muscles were, or how fast I was running up the hill. But I do remember smiling, feeling intense joy, the tears rolling down my face and seeing my Mom, Sister and NM’s Mom at the top cheering and waving their arms wildly. The energy was contagious and it gave me a boost to finish the last 13ish miles of the race.

marathon yes

Now, I must tell you, the 2nd half of the marathon became a whole new race. I was tired. My left hip flexor was tight, my feet were soaked, I was cold and hungry and like I said earlier, I knew the only way to finish was to keep running. I don’t remember much about the streets I ran down or how fast I was running (I had since lost the 3:30 pacer). As I ran in and around North Ave and all the side streets I remember talking to myself every few minutes, sometimes saying, this is ridiculous, I’m never running a marathon again. Just moments later, I’d be thinking, this is awesome! I am so tired, but this is awesome! I wondered where NM was and how he was feeling. There is a long period of time somewhere between mile 15ish and 20ish where there aren’t as many spectators and that was hard for me. Somewhere around mile 19 my friend, LD, running on a relay team ran up behind me. I was hurting. I was a little dizzy and starting to get a little discouraged. She pumped her fist in the air and was like, “you got this, girl!” We ran together for a short time and she helped me get a little boost in energy. There are so many of those moments during the race, it’s amazing. All I could think was, you only have 7ish miles to go, think how far you’ve come. 7 miles is nothing!

As North Ave turned into the bike path I realized how close I was to actually finishing my first marathon and I felt a slew of emotion. I had biked and run on this portion of the bike path many times. I knew how close it was to the finish line, but I also knew it was just far enough. The sun began to creep out behind the clouds and the rain ceased for a short period of time. I jogged along, more slowly than I had the entire race, at this point I all I wanted was to finish the race in under 4 hours. I stayed as close to the 3:45 pacer as I could. My quads burned, my left hip was popping and throbbing, my hands were numb, and I just remember smiling and crying at the same time. As many of you know, the bike path is very narrow. Running alongside the several hundred runners, all packed in tight, was very inspiring and created a sense of camaraderie.

Somewhere around mile 22.5 ish I lost all chutzpah. I felt like my hip was going to explode and that I would surely pass out. Somehow, I allowed myself to slow my jog to a fast walk. I remember hobbling along the side, crying, feeling frustration, defeat and also some relief of discomfort. Out of nowhere, another friend running a 2-person relay, LR came running up behind me and put her arm around my waist, saying something like, “come-on Lil, you’re so close!” I started to jog again. I was so happy to see her. When we passed the 23 mile marker together, I knew I would finish. I told her to run ahead of me so I wouldn’t slow her down and watching her energy as she pushed forward was all I needed to get myself through those last 3 miles.

As the 4:00 pacer passed me around mile 24.5, I remember thinking, Oh no you don’t! Out of nowhere a surge of energy ran through my body and Flo Rida’s Wild One song came on my ipod. My hip went numb, my legs felt stronger and I sprinted ahead. Close to the finish, there were hundreds of people lined up on the sides, all screaming. I remember realizing that I did it, that I was about to cross the finish line of my first marathon in under 4 hours. As I ran across the finish line at 3:59:54, relief, excitement, exhaustion, pain, inspiration and many other thoughts and feelings flowed through me. When I found NM, I collapsed into his arms and cried (yes, more crying). I felt so proud of myself, and felt shock that I had done it (I never doubted that NM could do it).

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The marathon was an experience that even though I am able to write many paragraphs about, I will never be able to fully explain or articulate what it was really like. I can say that it made me realize how much I am capable of and brought out a confidence that was hiding deep within myself. It made me love strangers just a little bit more, and appreciate the togetherness of such an event. I can’t wait to run my next marathon and beat my time. Even though I was barely able to walk and was insatiable for the 4 days after the marathon, I will do it again.

Thanks for reading :).

Not Only a Nurse

May 30, 2013

This post won’t have a lot to do with nursing. In fact, it’s been ages since I’ve blogged and lately I’ve been writing less and less about nursing and more and more about mountain biking, running and yoga in my private journal. Then it dawned on me to write about these adventures on my blog because, not only am I a nurse, I am a nurse who mountain bikes, runs and practices yoga, therefore these adventures truly are Talesofanrn.

For those of you who actually read my blog and for those readers who are nurses, you already know how important it is to get outside, to breathe fresh air, to get exercise. 12 hours spent inside a large, brick building, beneath fluorescent lights, breathing in thick, stuffy and often smelly air certainly feels detrimental to one’s health. For me, after 12 hours spent caring for others, I feel like my mental and physical energy has literally been sucked out of every orifice of my body into an abyss far, far away from myself. For those of you who aren’t nurses you may be thinking, “but you only work 3 shifts per week.” That may be so, but 3-shifts in a hospital is comparable to a full week of work. Please do not misunderstand the above statement to mean I dislike my career as a nurse; I love being a nurse. I take pride in my ability to empathize with patients and to imagine they are my relative. Unfortunately that method of nursing takes its toll on the mind and body as it forces you to feel more emotionally connected to your patients.  I wouldn’t change how I do it because becoming a robot, and going through the motions is far worse.

Mountain biking, running and practicing yoga helps me to rejuvenate my mind, body and soul in order to return to work each week. If I remind myself that I am not only a nurse, I am an athlete; I feel strong, mentally and physically. When the going gets tough at work, or in life I repeat the following mantra, “I am strong, I can do this, I will do this. I will make it.” This mantra helped me through a tough time recently when my father was struggling with a health scare. All we can do is keep on keepin’ on, moving forward, and enjoying life.

Thanks for reading this stream of consciousness and please read my next entry about the 2013 Marathon!

12 Hours is Just not Enough

January 6, 2013

I started this blog in November, 2011 with the intent to show others what a day in the life as an RN was like. Looking back through previous entries, it’s interesting to see where I was last year at this time.  Lately I’ve been more motivated to write, and I’m hoping I can keep up with my blog again. Now, as I am home sick with pneumonia (2nd year in a row) I find the time to write.

As I write this entry,  I have been off of orientation for a full year and working as an RN for 16 months. By no means am I a seasoned nurse, but I am finally in a place where I feel as though I know what the fuck I am doing each day and don’t want to run for the hills if a patient rapidly declines requiring ICU transfer.

Now that I can no longer refer to myself as a “new grad” I feel I should write about what it’s like to not be a new grad. Perhaps some of the biggest lessons I’ve learned over the past 16 months is that, you can’t do it all and you have to take good care of yourself. Sure, they may seem like simple concepts, but I assure you that working full time in a stressful and disease-ridden environment tends to test one’s ability not to sweat the small stuff and to take care of oneself.

As the tasks and charting for each patient become increasingly time consuming it can make one feel incomplete if everything on the “list” wasn’t accomplished in the 12-hour shift. But I think it’s important to remember that the reason we have shift changes with new nurses coming to relieve the exhausted ones at 0700 and 1900 is to take over the care of patients and sometimes that means finishing up tasks from the previous shift. As nurses we become very task oriented, constantly checking off the little boxes on our sheets of paper when we complete one of the seemingly 1-million tasks of the day. Included in these tasks might be: Remove Mr. X’s foley, give meds to patient A, B and C, provide Diabetic teaching to patient D, give insulin to patient A, chart the above for patient A, B, C and D…you get the idea.

At times it seems as though there are not enough hours in the day to get things done and sometimes I have a hard time accepting this fact. Myself, along with many of my coworkers hate leaving things “un-finished.” For example, I recently had a fellow nurse say to me at shift change, “I am so sorry I just did not have time to put bacitracin on patient X’s incision…I can go do that now if you like.” My response was, “go home, it is OK” as I thought to myself, “Are you f-ing serious? It’s bacitracin, why do we feel guilty about leaving such a menial task left un-done?”

Clearly, nurses are superheros, I’m the first one to say it. But it’s okay to admit that you can’t do it all on occasion. No one will eat you alive, you won’t get in trouble. In fact, most nurses are wonderful people (except for the ones who aren’t),  are on your side and will understand. Don’t run yourself into the ground on a busy shift if you are unable to finish everything, despite delegating and utilizing your resources. Also, important to note that what I’ve said above is not excusing one to leave things undone on a regular basis, just that on occasion it is impossible to finish every single task and rather than beat yourself up over it, just pass it on. Though if you leave me a cordis to remove, a foley to remove and a plethora of meds to give I won’t be happy…just kidding.

Stay tuned for the next entry all about the relation of outdoor sports and mental well-being. Thanks for reading!

The Saga of Neverending Jaw Pain

April 17, 2012

The blogging has come to a halt over the past two months and not for lack of material, just lack of energy and inspiration to sit down and write. Now, as the weather gets warmer, the only thing I want to do is spend my time off outside for every second possible. Earlier, as I was sitting, zoning out at the lake I heard my inner voice practically telling me word for word what to write for my next entry. I had to rush to the nearest cafe with my laptop to begin promptly writing. And here I am.

I’m shocked I never thought to write of this sooner, but feel it is so relevant to what I do every day as a nurse that now is as good a time as any. Many of you are aware I had a pretty intense, 7-hour long jaw surgery exactly 2- years ago. The goal of surgery was to improve my breathing and chronic jaw pain by improving my bite/jaw structure. This was accomplished by removing my turbinates, surgically breaking the upper and lower jaws and rebuilding them by securing metal plates inside my chin, maxilla, and mandibular bones. I knew for 4-years I would need this surgery, but put it off for as long as possible because I would have to wear braces for a year leading up to the surgery, and let’s face it being a 20 something and braces are not a good combination. After having had a second opinion and 4-years of “should I’s and shouldn’t I get the surgery” I decided to get the surgery. After-all my surgeon in his own medical terms,  put the fear into me that if I didn’t have the surgery I would forever be in chronic pain and my jaw would look “funny” one day.

Nothing could have prepared me for what I was in for. During surgery I was intubated, had an NG tube, and foley–pretty standard as far as surgeries go, but for a 20 something not finished with nursing school, this was truly upsetting and terrifying. Post-surgery I stayed in the hospital for 4-days until I could sufficiently take in enough calories and had adequate pain control. Those 4-days were terrifying and a blur. I recall my head throbbing, my throat on fire from being intubated, my nostril chaffing and the bizarre feeling in the top of my throat when my Uvula would rub against the NG tube. I remember having the most intense cravings for salt and the fruity smell of the tube feeds.  I’ll never forget the first look in the mirror at my face that had swollen to 3X the size (no exaggeration) and bursting into tears of shock because I did not recognize myself. Those of you who have had wisdom teeth removed, think much, much bigger! I remember a night nurse coming into my room stating, “I’m going to hook up some suction just in case you know, you start choking on your tube feeds and I need to suction you out.” This statement kept me awake all night…and every hum and beep the tube feed machine made I wanted to freak out.

I remember feeling like I should be tough because after-all I was a nursing student, I could handle this stuff, but a huge part of me was so terrified and in so much pain all I wanted was my mother every minute of every night, fortunately they let her stay at my bedside all hours of the day/night, because had they not I may have had some sort of emotional breakdown. I was not myself those 4-days and I felt like I was out of my body looking down at my swollen, pain-ridden face the whole time. I’m telling you, it doesn’t matter how old you are, or how tough one is. When you have a big surgery, and are in pain, one often reverts to a younger age and I see this in my patients on a daily basis.

After those 4-days slowly went by, I was discharged home on a liquid diet for 6-8 weeks. Chewing was not a possibility. I remember having the biggest cravings for italian food, steak, cheeseburgers and salt. Anyway, to spare you every detail, I healed nicely. 8-weeks went by pretty quickly, the swelling came down quite a bit,  my follow-up appointments went well, and I gradually was able to eat more and more foods. Fast forward to 7 -months post-surgery I began having severe pain in both  tempomandibular joints (the two parts of my jaw the surgeon did not surgically open or mess with). When I called my surgeon to tell him about the pain, his response was, “Well you’re apt to be in some pain following such a big surgery. Your surgery was like a marathon, and you’re going to be sore.” I felt as though he punched me in the gut. As the pain increased and never went away I learned to live with it. I felt defeated, missed classes senior year due to being in so much pain and worst of all felt that the horrid surgery I went through was all a huge mistake. After a few more similar phone calls to the surgeon where he would claim, “just take some ibuprofen, you’ll feel better” I decided I would never contact him again and that something must be terribly wrong inside my jaw.

In a fit of desperation, I began seeing my orthodontist who so valiantly tried to help figure out the cause of my now, worse than prior to surgery pain. After many, many visits over the past 2-years with no reduction in my pain, I was referred to a jaw pain specialist. This doctor is brilliant…and did many scans which reveal I have many bone spurs and scar tissue inside my bilateral jaw joints as well as a slipped disc. There is no way to prove if this is from my surgery, but in my heart I feel it is since I never had this severe pain before the surgery. In the future I can look forward to physical therapy, a mouth orthodic (not sure how I feel about that one…), some arthroscopy and potentially a disc replacement further down the road, but it feels good to be listened to and taken seriously. This doctor was appalled that my surgeon didn’t feel it was necessary to see me after having such an extensive surgery. To quote the new doctor he said, “I’m surprised you’re not in more pain and are able to eat any foods at all with the damage inside your joints right now.”

If you’re still reading this saga, I can tell you the only good things that came out of my having this surgery is that I am actually able to breathe much better with my turbinates removed, and the experience has made me a more insightful nurse. Since I will never forget the feeling of having tubes invading my body, I am more sensitive to what my patients must be going through.

Perhaps the biggest lesson I learned from all of this, don’t just get a 2nd opinion if you’re told you need surgery. Get a 3rd or 4th opinion. Don’t assume because a surgeon has won many awards and published many articles that he will be the best surgeon to perform your surgery, because it’s possible, that like mine, his bedside manner will suck. If I could go back in time, I would have never gotten this surgery. Since I can’t go back and can only move forward I am in the process of writing the surgeon a letter explaining what I went through and the conclusion of the cause of my pain 2-years later. I don’t believe he made a mistake in performing my surgery, but I feel he recommended  a surgery I didn’t need. He also should have known to refer me to an appropriate doctor when my pain was getting worse. As my current doctor puts it, “it seems as though no one explored that your pain stemmed from the jaw joints and wasn’t related to structure of your bones” in which case the surgery I had wouldn’t fix the pain I had prior to surgery.

All in all, this was a huge learning experience and I will continue to share this story with others and try to turn a positive spin on it. I am hoping that I won’t have pain every day and that I can one day eat an apple without cringing with pain.

Revenge of the Afternoon Meds

February 20, 2012

A huge part of a nurse’s job is administering medications. In nursing school administering medications sounded so exciting, but truth be told…most of the time it’s just tedious.

I personally take a great interest in the medication management of patients. Too many older adults are suffering from poly-pharmacy (taking more drugs than needed). That’s where being a Nurse Practitioner, Doctor or Physician Assistant has it’s pros because you can prescribe medications to your patients, and also take away medications from the patient’s medication regime.

One of the patients I cared for recently was taking so many medications. Every morning when I handed out his medication, the pills would fill a medicine cup to the top. The patient would groan when I would enter his room and say, “ugh not those pills again.”

Most patients have a lot of medications due in the early morning. As a nurse, you can often look forward to the late morning/early afternoon and know that you will get a break from preparing/administering medications to your patients, which allows you to spend more time assessing, providing education and emotional support to your patients, which is truly what nursing is all about. With the patient I described above, I was unable to do such things. He had medications due every other hour and despite my clustering care and administering medications a little early or late in order to bother the poor man less, I still found myself in his room constantly giving pills that didn’t seem to make him any better (or any worse). It was at this time I found myself so extremely frustrated at the nurses station exclaiming to a coworker, “IT’S LIKE REVENGE OF THE AFTERNOON MEDS! IT NEVER ENDS!” Which subsequently gave me the idea for this blog entry.

It’s times like those where being an RN and not a Nurse Practitioner, Doctor or Physician Assistant has it’s cons. As an RN it is my job to look up and know the medications I am giving and to understand why I am giving a certain medication to a patient. It is even my job as an RN to question (respectfully of course) any medications I believe may be prescribed in error, but unfortunately it is outside my scope of practice (in many situations, not all) to claim a patient doesn’t need a medication. I remember speaking to the physician about the many medications for the patient, and the physician thoughtfully explained, that the medications were indeed necessary for the patient to take. Unless I felt the patient was in great danger of taking those prescribed medications (in which case there is a chain of command for dealing with such situations), I have to respect the knowledge of the person that prescribed the meds and carry out the orders to administer them.

In situations where you don’t see the immediate benefits of administering the medications or when you feel like a human medication dispenser, it’s easy to feel burnt out and wish that doctors handed out meds instead. But there are times when giving medications can be really satisfying. For example, I recently cared for a patient awaiting open heart surgery to repair three of the major vessels in his heart. When he began having acute chest pain and sweating profusely I knew I had to give him IV Morphine and sub-lingual Nitro really quickly in order to relax his arteries and decrease the workload on his heart to prevent permanent damage. In that situation, administering medications was extremely exciting as I was able to watch the medications do their job and work effectively,  if only for enough time for my patient to get to the operating room and have the emergent CABG (Coronary Artery Bi-Pass Graft Surgery).

I guess my point in all of this is there are times when medications are important and as a nurse you can see the benefits of a prescribed medication clearly, and there are times when you can’t see so clearly. All we can do as nurses is always understand why we’re giving a medication and making sure we ask questions when we don’t know.