The pace of a day in the nursing profession can be hard to get used to. Thinking about nursing skills and remembering important information isn’t enough. Nurses need to update their knowledge of each patient’s chart, comprehend endorsements from the earlier shift, hand off important duties to qualified staff such as supervisors, certified nursing assistants and licensed vocational nurses. Case management responsibilities may fall to a desk nurse, but the medication nurse must serve as a conduit of patient wishes and advocates for patient care.
The pace of the shift takes its cue from the total number of patients the nurse is responsible for, and the frequency of calls to the bedside from each patient. If the patient needs accelerate and the number of calls spike, it is appropriate to notify the nursing supervisor or the Director of Nurses to staff accordingly. Specific chores such as giving IV medications, assessing new intake admission patients, recording vitals for special needs patients, and delivering special treatments such as dialysis and/or oxygen administration can fill a shift before you know it. (And then there is still the charting to do).
As in every job, timing in and out is important to maintain the integrity of the facility’s nursing acuity. Oversight agencies evaluate the timekeeping rolls to derive the accurate account of the nurses assigned at any one time. A nurse who regularly arrives late or misses an entire day of work creates a practical problem that may take hours to solve. In the case that no other staff are available, other nursing staff may have to increase their workload and absorb that nurse’s patient assignments and duties. This can have a negative effect on patient care and reduce the allotted time each nurse can regularly spend with their patients. Patients will notice and feel passed over or that their case has been “rushed”.
Timekeeping is an essential but irksome chore for every professional nurse. Arriving to work on a timely basis and staying after when needed are invaluable qualities in a career nurse. Flexibility in scheduling makes any nurse a prize who is very attractive in a competitive hiring market. Nurses who arrive constantly on time will be given priority and also will get preferred responses to requested time off. Nurse who regularly call in sick or miss work, for any reason, will find themselves short hours or written off the schedule altogether.
Nursing is not always just about medication or vital statistics. The term “bedside manner” is a joke in some circles, but a very real and desired trait in professional nurses. Each patient needs to feel as if their needs are being met. Positive statements, cheerful questions, and small jokes can brighten up a patient’s day. Nurses can easily underestimate how the smallest word or gesture can seemed magnified to a patient with little outside or family contact. This directly affects the quality of care offered by the hospital or facility. During surveys and in feedback sessions, patients often remark on these issues. Positive feedback, online or via word of mouth, is crucial to any organization today.
Patients prefer to rely on key staff and feel better when the routine of their day is supported. The welfare of the patients is the priority of the nursing supervisor. New staff should maintain the behavior and tone of the other nurses. Otherwise, patients can feel estranged. A proper evaluation of the nursing staff should be their flexibility to medicate and treat each patient in the facility, not just the “chosen few”. (And charting must be consistent as well). Puzzling out idiosyncrasies is not a skill every nursing manager has. An hiring institution bringing new nurses on board expects a concordance to facility norms. To do this cheerfully and in a consistent manner is what every nursing home, private patient, or hospital wants.
Encouragement of activities and interventions according to the care plans in the patient’s charts will help the patient feel supported and well cared for. This kind of goal can help patients handle pain, lessen anxiety, and improve their ability to communicate ills and problems some patients might otherwise feel embarrassed or discouraged from sharing. The duty of care falls to the institution and its staff to observe the entire range of symptoms and conditions noted for that patient, as well as known contraindications and/or medical risks.
If a clinical condition becomes exacerbated, the nurse must be able to note increases in pain, swelling, blood pressure, blood sugar, nervousness sleeplessness, and general well-being, all from exchanging a few words with the patient a few times a day. The investment of a few jokes or special inquiries about personal interest or hobbies can pay off in certitude that a patient can rely on the nurse to note variations in their condition.
Some hospitals and nursing facilities have incentive programs for cross-checking symptoms
The manifestation of certain symptoms can be easily missed unless the nurse has established a rapport with the patient. A nursing supervisor often looks to key nurses who can be trusted to “handle” patients who have special interventions indicated in their care plan. Patients need guidance and instruction how to do things good for their conditions. Even if the nurse thinks the patients already know, reminders keep the patient focused on best habits for their own health.
Nurse should encourage patients on how to best elevate legs, attend community activities, perform approved exercises, work well with therapy professionals and stretch their muscles. Some patients may get in a “rut“ and need to motivate themselves towards physical therapy. But some patients just droop and drift into a pattern of inaction. The pattern of interaction should not be allowed to fall static. Just asking a patient what they are watching on television or what they are reading can bolster a patient’s attitude.
Regular familiarity with the patient, good understanding of their conditions and medications, a working knowledge of how to relate verbally to the patient and make them feel at ease, and an ability to confront your own fears and deal with people in a respectful manner that meets their expectations of an institution are all the traits of a successful modern vocational nurse. It is each nursing student’s responsibility to evaluate their own strengths and weaknesses, and to critique themselves and their peers for the benefit of all.