Not too long ago we experienced what at the time seemed like an unusually busy day. (Worth noting it had been a full moon the night before.) One patient was out of specialty supplies and we had scrambled to get some only to find out that morning that it wasn’t all that urgent after all.. The caregiver had found some in another closet. OK we could stop and take a breath and not be rushing around so much.
However, about a half hour later we had a situation with a patient who was not scheduled to be seen that day. Suddenly this patient was reporting new issues with pain that wasn’t responding to her current scheduled and break through medications and had to added to a nurse’s schedule. The sooner she could get there the better. This required a few phone calls to push some visits later in the day and move one to the next day.
Within a half hour another patient was acting out and biting and punching staff at her assisted living facility. The new med tech there wasn’t about to get close enough to try to give any medications. So we had to find another nurse who had to also juggle his schedule around to go and assess the situation and hopefully get her symptoms under control.
Meanwhile the patient who originally needed the supplies was an urgent problem again. Apparently the caregiver found that the supplies she located were damaged and some were expired which is why she suspected someone had moved them to the other closet in the first place. So now we had to find someone to get supplies out to this patient ASAP as well.
And of course, we received a referral for a new patient being discharged from the hospital imminently to go home to die. They expected she might not last more than 1-2 days, if that, and the family was willing but very scared and needed a nurse as soon as we could get one there.
Well somehow we got everything covered, made all the visits necessary, and lived to tell about it. However, I wouldn’t doubt that someone had been commenting about how quiet things were the day before! Never say that word!!!
While this type of day may not be considered completely typical, it’s also not that unusual. A nurse’s life is never easy and flexibility is a requirement.
I often have students and new nurses ask about the meaning of prioritizing and re-prioritizing and how or why it’s so important to the nursing profession and the nursing process. This certainly was a day where those skills were essential and priorities kept changing from seemingly one moment to the next. It seemed as if patients were playing leap frog for who needed to be seen the quickest.
And how was your day??!
You make several valid points. In nursing school, the nursing process is so often emphasized in reference to patient care decisions and prioritizing patients, but it is not necessarily applied to the everyday task of nursing skills. Prioritizing patients, getting the appropriate resources to the right patient's and changing a schedule, changing the schedule again, reorganizing staff and changing the schedule again. It would be nice to put nursing students through the paces in "real life" scenarios to enhance their understanding of the real world in reference to critical thinking and the nursing process.