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Jack of All Trades

November 14, 2011

If I had to find a phrase that best sums up good nurses in their entirety, Jack of All Trades would be at the top of my list.  One of my closest friends from nursing school first used this phrase to describe the nursing profession back in the days of 2nd-year Health Assessment class. I remember our professor had just finished teaching a particularly difficult lecture on assessing the cardiovascular system and he ends with, “I know these concepts are challenging to grasp, but in addition to the cardiac physical exam, you need to also still remember the other less exciting aspects of nursing.”

The so called, “other aspects of nursing” to which my professor was referring include, but are not limited to the following:  bathing patients, toileting patients and wipin’ butts, brushing teeth, walking (also known as ambulating), dressing, changing bed linens, measuring urine/feces, feeding patients, measuring the amount of food/ fluids consumed, and let us not forget the troubleshooting of hearing aids, glasses, dentures, canes, crutches, walkers and wheelchairs. It was after this comment my close friend turns to me and goes, “so really, nurses are just Jacks of All Trades?” We had a good laugh over this, but gradually realized over the remainder of nursing school how true her statement really was.

In the world of nursing we can so easily get carried away with whichever difficult skill we need to accomplish (i.e. removing central lines), that we can forget about the more seemingly “simple” tasks such as, getting our patients out of bed and into the shower down the hall.

Recently I had a patient recovering from a Coronary Artery Bypass Graft and they desperately wanted to take a shower. At first I thought, “Oh a shower, that’s easy, I can do that.” Then I discovered that my patient’s SpO2 would decrease to 89% on room air, and the BP would drop to 90/50 when standing. Those questionable vitals paired with my inexperience as a nurse did not make me feel comfortable. I’m going to confess something. Somehow I managed to get through nursing school without EVER having to ambulate a patient to the shower. I know…absurd. Truth is, the patients I cared for in clinicals either required bed baths because they were very critical from neuro disorders/trauma, or they had showers in their room and the LNAs always assisted my patients to their shower, 8 feet from the bed… So you can imagine that the last thing I wanted to do was walk my patient with low blood pressure 150 ft down the hallway to take a shower. But, my patient had a specific order to take a shower, and I had already checked with the doctor that, yes, my patient could go off the tele monitor for the shower. So truth of the matter was my patient needed a shower, and also, there is evidence supporting the taking of showers after cardiac surgery to improve patient outcomes. Really, my hands were tied. I had no choice but to bring my patient to the shower.

After staring at my patient’s tele-monitor and assessing blood pressure for a few minutes, I disconnected the telemetry leads, taped up the IVs and central line dressing, put plastic wrap around the IV pump because my patient was on a continuous Insulin infusion, which I embarrassingly learned can NOT be discontinued for a shower. Once this was complete which seemed like 30 minutes later (really only a few minutes later), I tested my patient’s O2 levels and with an “OK” from the charge nurse and MD, decided that with a SpO2 of 89-90% RA, could ambulate my patient to the bathroom without the O2 tank (thankfully), as bringing the O2 tank into the shower would have been even trickier. At this point, I was sweaty and nervous because I was scared my patient would drop down in the hallway on the way to the shower and I would somehow be responsible and look like an idiot. After pushing that fear back down, I handed my patient the heart-shaped pillow that all of our post-cardiac patients receive to hold tightly against those painful sternal incisions–this offsets the pressure to the chest when a patient stands up, and we were good to go…

Turns out, everything went great. My patient walked with great ease down the hallway (despite my internal panicking), and kept saying “wow, I feel great moving around!” I learned not to assume something will be easy or difficult before I try it, and getting my patient up and moving that morning improved their oxygenation status for the remainder of the shift.

In closing, I still say “yes, nurses are Jacks of All Trades,” we do so many different things to help our patients. Amidst all of the many aspects of nursing, like my professor said, we have to remember and practice the basic skills too. Want to know how to balance the stress of working as nurse with having a life outside of work? Stay tuned for my next entry, Keeping the Sanity to be posted soon.

2 Comments leave one →
  1. November 15, 2011 9:57 am

    Wow, a writer too! Well done. What a gift you are to the nursing profession, your patients and yourself. You have landed exactly where you can use all these extraordinary gifts you have. I loved the part about pushing down your fear and getting the woman to the shower. Terrific!

  2. November 18, 2011 7:48 pm

    Thanks Uncle Bob for the nice comments. I appreciate your support!

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