Rooming patients, giving injections, charting, answering the phone, taking messages. These are all listed in my job description with a whole list of other normal office nursing kinds of things.
Not listed, but also expected: picking up paperclips from the floor, trying to keep my piles neat, and telling someone when the Kleenex are running low. And really, truth be told, I probably spend as much of my day doing the things that aren't explicit as the things that are.
A couple of weeks ago I was filling in at the other end of the clinic. I took a phone call from a patient who was basically gasping for air on the other end of the phone. She had been in a couple of days earlier with bronchitis, but was worse. She wanted was another prescription. What I wanted was for her to call 911. Our compromise was an appointment at the clinic in about 45 minutes. I told her to call a cab because her husband was out of town and she didn't have any friends who could bring her.
In the end, she came in with lungs that sounded like they could be coughed up at any moment. The doctor called an ambulance to take her to the hospital. She hobbled out to the desk where I was sitting and started talking about her puppies. Her distress had much more to do with how they would be cared for than the fact she was about to be admitted. Before I knew what had happened, she was digging through her address book looking for names and numbers of people who might be able to check on them. And she wrote them down for ME to call.
Say what? She also wrote down her husband's email address because he was at a conference out of state and could not be reached by cell phone during the day, but would have his laptop opened.
Next thing I know, I'm emailing this poor man to let him know his wife is headed to the hospital via ambulance. Once that was out of the way, I had the task of finding those darn dogs a babysitter.
As I left messages on various answering machines, I realized the ludicrousness of the situation.
When I hung up for the last time I said to the doctor, "I don't remember this being in my job description."
But as I said, much of what happens in nursing isn't actually about the job description. It's the little things we do everyday that go above and beyond the expected that really speak to who we are. We are a helpful and caring lot. We see what needs to be done and we do it. We care about more than just the physical needs of our patients. At least that's what I hope we're about.
So what have you been asked to do lately that wasn't in your job description?
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August 20th, 2009 at 9:40 am
I agree, “much of what happens in nursing isn’t actually about the job description. It’s the little things we do everyday that go above and beyond the expected that really speak to who we are. We are a helpful and caring lot. We see what needs to be done and we do it. We care about more than just the physical needs of our patients.”
You have verbalized my convictions about nursing for me.
As a new nurse, I entered my profession after graduation with stars in my eyes. Only to find, sadly, so many nurses have long since left behind the “caring” part of caring for patients.
I implore us all to stop for a moment, remember our “patient” is a person – with deep needs (physical, mental, emotional, spiritual; real or imagined). Needs that require filling – often without that pill we want to administer, or that nurse’s aid we want to have deal with it (so we don’t have to).
Once we are completely skilled at the medical and technical aspects of nursing (we need that as a minimum!), let’s stop for a minute to hold a hand, to look into our patient’s eyes, to listen to a life story, to get the iced water, to bring a tube of lotion, prop a pillow, change a diaper, to make a concious effort to be present and available – let’s slow down, and stop for a minute to care!
It really is what Florence Nightingale believed nursing is all about – and modern evidence based research tells us everyone (patient and staff) does better when the RN is there and engaged!
Let’s be proud of our profession, and delight in going the “extra mile”!
August 20th, 2009 at 9:47 am
I’ve found that I am basically an IT person at work. Usually it’s just when we’re computer charting and the computer goes wacky, but I’ve also had patients hand me their laptops and say, “fix the internet, I can’t connect!”. Good thing I’m computer savvy!
August 20th, 2009 at 11:02 am
I bought a homeless man some new clothes,he was dirty and smelly.I,m not sure if he appreciated it but everyone around liked the clean man better!
i have given several people a little cash for the bus when we were not able to get a bus ticket for them.I also give them snacks and juice and clean slipper socks.I try to feed them before they leave,if I can.We have a lot of them,some of them got divorced and were down on their luck,a little compassion goes a long way,made me feel better too.I used to give patients rides home but it,s too risky now.I have also called insurance companies for them and neighbors to feed their dogs or cats.
August 20th, 2009 at 2:38 pm
It is late in the afternoon, and it has been an extraordinarily busy shift. My fatigue, along with that of my colleagues, is compounded by our worry for a much-loved coworker out on unexpected medical leave, our worth-her weight-in-gold unit secretary is out on a planned medical leave, and if all that isn’t enough, an important and well respected physician in our oncology community died suddenly in an accident. We received the news this morning. It is a horrible, no good, very bad day. And it is so busy, we can’t take time out to give one another a hug. You can see the tears we hold back in our eyes.
He is my last patient of the day. He needs a a blood test today, then he’ll return to the clinic tomorrow for his treatment. He tells me he feels horrible, no good, very bad today. He asks me if he can stay and begin his treatment this afternoon. I look at the clock. To honor his request means I will stay at least an hour over time. He may have seen me wince, or maybe I sighed, because I know I am going to do as he asked. A worried expression crosses his tired face, and he looks around the unit at the other patients. “It’s very busy here today? Lots of sick patients? You are tired?”
My heart was touched.
“Yes, we have many patients and they are very sick today, but you are sick too, and it’s my job to take care of you. I will start your treatment this afternoon. You need it.”
He smiles with what little energy he has. He holds my hand and says, “When you professional, sometimes you suffer.”
I squeeze his hand and walk away to send his blood to the lab, before he can see me cry.
August 20th, 2009 at 5:56 pm
Today I walked into a room on our busy med/surg floor to discover loads of cash pilled on a patient’s bed. She said she does not trust the banks so brought her cash to the hospital. Myself and two other staff members had the duty of counting out what totaled to be over $21,000 (mostly in small bills) to verify the amount before it could be handed over to the security department to be locked in the safe.
Talk about what a liability and a waste of time!
August 20th, 2009 at 9:26 pm
Well things I’ve done that I felt were not in my job description as an RN was clean patient rooms…I’m talking emptying trash, mopping, things such as that…oh and my favorite, running down to the cafeteria at 3 am to get the doc a cup of coffee from the machine b/c the coffee we made on the floor was too strong for him. Working the overnight shift, we had no housekeeping so anything that happened or messed up a room was to be cleaned by the nurse for that room….which oh yeah, if a patient vomited or soaked the floor with blood from a ripped out IV on day shift, they just called someone to come clean it..us night nurses, well they needed to add housekeeper to our job description
August 23rd, 2009 at 1:11 pm
I had a clinic client recently who needed to take Ibuprofen with something on his stomach. We all checked our spare change and bought some crackers from the macine in the hallway so he could eat them first. He didin’t know the behind the scenes effort to get him a bite of food, but he was able to take his pills and all of us felt that we had helped out caring for him. It’s the little stuff, like making a client a cup of decaf because we have double strength in our urn, or getting pepper when no salt is allowed that the clients remember. Not the pills or IV’s or other tests. The little stuff that’s not in the job description, but is a part of being courteous and ‘going the extra mile’, that makes us ‘good’ nurses.
October 17th, 2009 at 5:47 pm
clean toilets,emptying trash , not having a nurses aid we are short….every day …so doing two jobs for the price of one ( 3 if you add janitor on top of that) … sure the hospital doesnt mind
It also drives me nuts when family members ask me to go get them drinks or coffee from the kitchen. I am like uh… I am not your waitress . go to the kitchen yourself please . You are not sick!
October 17th, 2009 at 5:49 pm
calling patients
“client” has never caught on with me . I think it just perpetuates the idea that the patient is the one that calls the shots on everything, and the hospital is a hotel
October 19th, 2009 at 5:10 pm
i second that, anne!
not sure about anyone else here, but i certainly did not bust my ass in school or continue to bust my ass as a nurse to be treated like the hired help by “clients” (that said, i work in-patient, so they technically are still considered patients!)
WE. ARE. NOT. MAIDS. or your mother, waitstaff, or concierge, for that matter.
as the old saying goes, we are there to prevent doctors from killing you!
October 20th, 2009 at 3:33 am
It’s simple, we do go that extra mile. We do it when it’s needed. It’s the patients in real need that we do the extra bit for. We do it not because we have to but because we know it’s right, hell it even feels right.