Take A Walk In My Clogs

Take A Walk In My Clogs

The nursing profession varies from specialty to specialty and I often get asked what being a nurse includes and what I typically do during a shift at the hospital? SO here it is, a step by step of my typical day as an ICU nurse! 

0653 CLOCK IN. I get my caboodle out of my locker, get my patient assignments, copy my report sheets, print my cardiac strips, get my patient labels, and get my assigned phone for the day.

0700 Time to HUDDLE! We spend a few minutes getting updates from our charge nurse such as how many open spots we have, what surgeries are planned for the day, which patients are one to ones, staff shout outs, etc.

0700-0740 Bedside report. During this time I am in the room with the night nurse, getting report, meeting the patient (if they are not sedated or sleeping), quickly assessing them, looking at my drips and meds hanging (what doses, how much is left in the bag, etc.), asking questions, reviewing labs, and making sure my rooms have the supplies I need. 

0740-1000 To start, I assess both of my patients from head to toe. In addition to my assessment, I typically have labs to draw, blood sugars to check, notes to read, and orders to review. This is also when I give all my morning medications and participate in multidisciplinary  rounds. Rounds typically start around 0830, so I have to utilize my time wisely and organize my thoughts, updates, and needs before the intensivist comes to my rooms. I also make it a point to chart my initial assessments during this time. 

1000 If the morning is going pretty smoothly, I take a short break to eat some breakfast! 

1015-1830 During this time frame is usually when family members call or visit, I do my reassessments a minimum every 2 hours, I chart, chart, and then chart again, and I perform my nursing tasks. Honestly, each patient varies so I never really know what to expect, but typical tasks include:

• Closely monitoring blood pressures and titrating medications accordingly
• Taking patients for walks, getting them up to the chair, or repositioning them in bed every 2 hours
• Assisting with bedside procedures such as EGDs, chest tube insertions, central line insertions, trach placements, cardioversions, and more!
• Oral care, foley care, and everyone’s favorite changing poopy bed sheets 
• Changing wound dressings
• Going to other units when a code blue or rapid response is called
• Checking blood sugars every hour and adjusting insulin drips
• Going on an adventure to the MRI or CT machine
• Calling a code grey on that patient who’s in alcohol withdrawal and trying to hit me
• Admitting new patients and transferring out stable ones
• Giving medications to a patient who is passing, calling donor network, postmortem care, and supporting the family

Also, during this time frame I take lunch and use the restroom, that is if I have time haha. 

1830-1900 the end is near and I spend this time cleaning my rooms, emptying my linen and trash cans, making sure my patients are clean and positioned well, ordering back up medication drips, restocking the supply cart, emptying my foley/rectal tube, finalizing my I/Os, ordering labs or renewing restraints, and any last minute things that must be done. Something important I would like to emphasize is remembering to leave your rooms neat and ready for the next nurse. There’s nothing more annoying than starting your shift and the trash is overflowing, supplies are everywhere and half used, or your meds are low and there’s not backups! I always strive to be the nurse that other nurses are happy to get patients from! 

1900-1930 end of shift report and CLOCK OUT! 

This day is a pretty good representation of a typical shift, however no matter how hard I try to stay “on task” or stick to my “normal routine” there’s always those emergencies that throw you for a loop, the rapid response on the 4^thfloor, the code blue in the cath lab, the patient who needs to be rapidly intubated, the patient who accidently self-extubated, the patient who’s throwing up blood, or the patient with a sudden MAP in the 40’s. You just never know when or what will happen, and honestly the craziness of critical care is what I love most!