One would be hard-pressed to find a career field that matches the personal, physical, and emotional toll that healthcare places on its employed. When I tell people I am a nurse, it is usually replied to with generalized, though very well-intentioned, comments such as “wow, so you have 4 days off every week”? Throw in a few comments about how long my shifts must be and how well-paid I am, and you now have an idea of how the general person replies to being told I am a nurse. I do not intend to sound cynical, because the truth is that these comments are accurate, common selling points to young men and women who decide to enter nursing. However, a large gap remains where healthcare workers are not often able to truly describe the hardships they face mentally and emotionally, shift after shift.
How do you explain this to a friend who calls on your drive home, asking “so how was work today?” You may answer, “it was fine”, or “it was a tough shift”. How do you vent about your day when you showed up at 0700 to find your unit understaffed again. You walk into your first patient’s room, a gentleman in his early 70s who is supposed to be discharging around 1400 today. We’ll call him Mr. A. He is pleasant and forces a smile out of you even though you’re sure the day ahead will be tiring and overwhelming. You tell him you must do a brief assessment, and he starts telling you how he feels so much better and is ready for discharge later. This is his second hip replacement, after all, and he swears it will be his last. Between listening to lung sounds, he can barely stop conversation to offer those good deep breaths, because he is excitedly telling you about how his daughters have flown in from out of town and will be in the car when his wife picks him up. He has not seen them since last Christmas. He tells you that he and his wife also have a small Yorkie at home- his wife’s dog, by all technical accounts- but he admits he can’t wait to see the little gal after 4 days in the hospital. You leave the room to grab his morning medications, and your spirit is already lifted. See, these are the small parts of your day that make things brighter. Meeting a new person, getting to know them and their families and even their pets, teaching them about new medications, making them promise to use that walker at home, and sending them on their way- healthier, happier, and reunited with family after a tough experience away from home.
That’s the easy story to tell your girlfriend when she asks, “how was work?” What about the hard parts? What about the part where, while you are pulling Mr. A’s morning medications, the door of the supply room abruptly swings open and you hear a frantic voice ask, “do you have Mr. A today?” “Yes, I do, why?”, you answer nervously. But nurses know. They know that voice… that tone. They know emergencies. “His oxygen saturation just dropped to the 70s and he says he can’t breathe.” You rush out of the room to find Mr. A clutching his chest, pale and diaphoretic, oxygen saturation continuing to drop. You look at the monitor and see a heart rate in the 50s. Then in a blur, amidst sounds of dinging alarms, concerned colleagues, and phone calls to the operator to page the physician, you see a flat line on the monitor. What proceeds after this can only be described as organized chaos. While you are working a code blue, you have about a million emotions existing at once. A span of 20 minutes feels like 2 hours, as you hold your beath while simultaneously putting your most important knowledge to work with each passing second. Ideally, it is successful and can be chalked up to a scary but effective change in patient condition. At its worst, it’s a devastating loss for someone’s wife, daughters, and small puppy back at home. The doctor calls time of death 0942. You have not been at work for 3 hours, and you are already staring at someone who has lost his life. The phone call with a physician to tell his brokenhearted wife, the preparation of the body, the clean-up of the room, the note you type into his chart- it all must happen while you take care of your four other patients.
So how do you prepare for this? I guess, you do it by remembering why you do it. You remember that conversation with Mr. A. You remember that you were the last person he saw, that he was smiling, and that you listened and laughed with him. You remember that death is a part of life, and it’s a part of your job. You remember that Mr. A’s family needs your knowledge and your compassion, and you offer that. You remember that you will be the first face they see when they arrive to the hospital, and you listen, and hug, and listen some more.
It is important for nurses to talk to each other. My girlfriend who called to ask about my day may not understand, but my charge nurse who alternated compressions with me does. My colleague who handed me syringes of Epinephrine does. And those nurses are your backbones and your confidants. And we need to talk. Because even though the next 9 hours of your shift will go on, a part of your mind and maybe even your heart will stay in Mr. A’s room. And instead of crying in our cars on the way home, we need to talk and to share our emotions. Carrying the weight of a hard shift alone is what’s exhausting. Nurses have each other, and that’s a unified force that can help carry you through a bad day.