To say registered nurses are busy is a bit of an understatement. But for those of us who are called to the nursing profession, each day is as reenergizing as it is tiring. While there’s really no such thing as a typical day in the eventful life of a registered nurse, here is one example from Samantha Narog, who works at Memorial Urgent Care in NYC.
5:15 am and my alarm clock goes off with a loud buzz. I roll over to turn it off and begin my day. Luckily, I laid out my clothes the night before, allowing me to sleep to the very last second possible (every little bit of sleep helps).
I pull on my compression socks, because at the age of 23, I am already concerned about the spider and varicose veins that are destined to come my way. Next my scrubs pants, followed by a quick trip to the bathroom to brush my teeth. Yes, I brush my teeth BEFORE putting on my scrub top. Otherwise, one drop of toothpaste and into the wash it must go.
Next stop—the kitchen to make my breakfast and my essential morning cup of coffee. Then, I take my hour drive into Manhattan, wait in line in the morning mayhem of the parking garage, and then walk my six blocks to the hospital.
Arriving on the Scene
7:30am and I am ready to take report. I exchange the usual AM banter with the night nurses while assessing how the day might go. Once the report is finished, we walk around together to say hello to all the patients, letting them know this is just a hello and to make sure they are not in emergent need of anything. I bid the night RN sweet dreams as I’m wiping down the computer desk.
7:50am and I’m signed onto a computer, reviewing doctor’s notes, reviewing orders I need to execute, looking at AM blood work results, and checking to see if anyone requires 8am medications. I determine who is the most critical and should be seen first, and I’m off.
Making the Rounds
If all goes well, I have patient assessments finished between 9 and 9:30am, allowing me some time to formally document in the computer before 10am meds are due. After administering medications, I take a few minutes to sit at the computer and see if orders have been updated. At this point in time, I find myself prioritizing new orders alongside the existing orders.
I begin by sending repeat AM labs for a patient whose labs hemolyzed. Naturally, they aren’t pleased at the thought of a second stick, but fortunately, they have plump veins. With a quick joke and a simple butterfly stick, I have my labs. Then, through the pneumatic tube system they go.
Next, I remove the foley catheter from my patient down the hall, sharing in his excitement to finally have the catheter removed. I inform him that post removal of a foley we like to see patients void minimally 200ml within eight hours. I ask him to measure his output, and mention that perhaps we will do a bladder scan later to confirm there is no residual volume in the bladder.
As I’m walking back to the desk, an Alaris pump beeps, alerting me that my patient needs a new bag of Normal Saline hung. This won’t be the last beeping Alaris pump of the day, but is a good opportunity to check in on a patient who has been requiring less attention throughout the morning.
At the computer, I document the foley removal as an event note and review the lab results from the specimen I sent confirming labs aren’t hemolyzed. I also take the opportunity to confirm my patient’s potassium is low and she will require repletion. Once that order is placed I will explain to the patient her plan of care and begin the medication infusion.
Before I break for lunch, I visit my patient with a newly placed pleurx catheter. I begin education on the catheter, step by step teaching the patient and his family member how they will drain the catheter at home. After 30 minutes of teaching and them demonstrating what I have taught, I inform them I will be back later for further review.
3pm and I return from lunch. My patient has finished her potassium repletion, and the doctors say she can be discharged. I quickly get her paperwork together and no sooner is she out the door, do I hear I’m getting an admission. I head down the hall before the new patient comes and bladder scan my patient whose foley was removed earlier. Wonderful! He reports he has voided 300ml and only 80ml remain in the bladder. He can go home home too!
I come back to the station to receive the report on my new patient. An older gentleman with EKG changes. He is monitored on telemetry and serial troponins will be done. I get him settled, placed on the EKG monitor, and perform an assessment.
Before documenting that assessment, I complete the discharge for my foley patient. I print his paperwork and explain the antibiotic he will be going home on. One last set of vitals, removal of his IV, a “safe home and all the best,” and he’s out of here.
Next, I stop in to see my pleurx catheter gentlemen who looks much calmer when discussing and demonstrating care of his pleurx catheter. My teaching was successful.
6:30pm and I get that new assessment in and complete follow up notes on my patients just in time to see the night nurses and give report to them. It’s a long day, but a successful one.
During these 12 hours, I was able to calm someone’s fears about their newly placed drain. I was also able to spend time getting to know patients and explain the steps of the day to them. Something that is often not done. Just because you know how the system works, you can’t take that for granted. The patient doesn’t always understand the system and why things take time.
Some of the most appreciative patients I have are thankful and calmer because I’ve taken the time to explain how things work to them. This keeps them from becoming frustrated because they now know things take time and they aren’t just forgotten. I leave with the feeling I did my best and I’m ready to come back tomorrow for another successful day.
Sam is a graduate of Pace University in Pleasantville, New York, and a graduate Oncology Nurse at Memorial Sloan Kettering Cancer Center in Manhattan. She is currently working in Memorial’s Urgent Care Center and 24 Clinical Observation Unit. Samantha is passionate about education and helping others enter the nursing profession. She hopes to eventually pursue teaching by returning to school and earning her MSN. In her free time, Samantha enjoys cooking, shopping, dancing, and spending time with friends, family, and her three-year-old bulldog.