A Day in the Life of a Med-Surg Nurse

BY ISABEL MENDOZA, RN, DNP STUDENT | APRIL 2, 2018

0530

The alarm goes off, I’m tempted to hit the snooze button but I finally crawl out of bed to get ready for my day.

0600

Mentally preparing for the long shift ahead, I pack a peanut butter and jelly sandwich and other easily available snacks for lunch, I grab a quick protein shake and banana for breakfast and head out the door.

0630

Quick stop at Tim Horton’s for coffee. This is essential to get myself going, especially since it’s a Monday (they tend to be extremely busy).

0645

I walk into the break room. I fill my scrub pockets with all my favorite pens, bandage scissors, a pen light and a handful of alcohol swabs, grab my stethoscope, throw my hair up and I’m off to the floor.

0700

As I walk onto the unit I already hear the loud beeping of IV machines, call bells and notice the night shift nurses scramble to finish last minute tasks. I write my name next to my patient assignment. Hopefully I picked a stable group (alert, oriented and independent).

0710

The night shift nurse without hesitation is ready to give me a report. The first patient* is an 87 year old male, confused, incontinent and impulsive. Luckily, the rest of the patients seem stable.

0730

I pop my head into all my patients’ rooms to say hello before I check the computer to review orders. I then make a game plan on which patients I will see first.

0745

I decide to see my 87 year old patient first. I walk into his room and notice a strong smell. I pull back the blankets and find that he was incontinent of stool and urine. I find a nursing attendant and clean him up before I even have a chance to take vital signs.

0810

Now that the messy predicament is over and he is properly placed on a bed and personal alarm so he doesn’t fall, I head into the next room. I immediately notice the patient’s IV is infiltrated and she needs a new site for antibiotics. I grab the IV cart and attempt an IV on her small, roll-y veins. YES! It only took me one try! Fortunately, everyone else seems comfortable this morning and all vital signs are normal so I quickly chart them in the computer.

0900

I start my morning med pass. As I enter the first patient’s room, the unit clerk finds me to tell me one of my patient’s family member is on the phone. I politely excuse myself to answer the call.

1030

I finally sit down to chart; it takes me almost an hour and a half to finish passing meds because of various interruptions. I log into the computer, open up the first patient’s chart and start clicking away.

1035

I chart for five minutes until I hear a nurse attendant say, “Isabel, room 16 is asking for pain medication again and his IV machine is beeping.” I close out of the computer and head back into the med room to see which pain medication is due and grab a new bag of IV fluids.

1100

I return to my computer to check for new orders. I notice two of my patients have discharge orders in and one has STAT blood work. I grab supplies and head into the room. I hope this patient has big juicy veins!

1130

The charge nurse asks if I am ready to take a patient who is in PACU. I hesitantly say yes because I know I still have a lot to do.

1145

My post-op patient arrives, I assess him, make him comfortable and update his family members before I get ready to complete noon rounds.

1200

I round quickly, take vital signs and medicate anyone due for pain medication. My discharged patients are anxiously ready to leave and ask if I can bring in their paperwork. I head to the nurses station and scramble to get discharge paperwork complete.

1215

The wife of my post-op patient approaches the nurses station and says, “My husband is throwing up, please come check on him.” Noticing I am overwhelmed, the charge nurse jumps in and helps me with my discharges. I let her take over so I can check on my patient.

1330

The rush settles down; I hear my stomach grumbling. I ask my coworkers if they need any help before I take a break. I head into the break room to eat. Five minutes later the charge nurse comes in and looks worried. She says, “I am so sorry but everyone is extremely busy. Are you able to take an ED admission?” I scarf down my sandwich, chug the rest of my now cold coffee, run to the bathroom for the first time today and I head back onto the floor.

1400

My admission arrives: 66 year old, COPD exacerbation. I assess my patient, settle her into the room and take vitals. Uh oh, her SpO2 saturation is 85 percent with labored breathing. I increase the O2 from 2L to 4L, recheck her SpO2 and call the respiratory therapist for a breathing treatment.

1415

I am able to get my ED admission stable and comfortable. Luckily I didn’t have to call a rapid response! I call the doctor to update him on the patient’s status.

1500

I look at my Fit Bit; I have already walked over 8,000 steps. I sit down to complete more charting. I think to myself “Only four more hours to go!”

1700

The other nurses seem to be overwhelmed with their patients so I jump in to help. Teamwork is essential to get through the day.

1800

One hour left, I still have a lot of charting to do. I am sure to chart carefully so I don’t forget anything important!

1845

The night shift crew starts to arrive. I am exhausted, but I breathe a sigh of relief as I put on a smile and make a final lap to check on my patients. I like to make sure everyone’s pain and nausea are addressed, IV fluids are replenished and dinners are ordered.

1930

I finish giving report to the night shift nurse, telling her about the day I had and how busy the patients kept me.

1945

I put on my jacket, grab my still half full lunch box and head to my car. As I drive home, feet throbbing, stomach grumbling, mind still racing, I think to myself that as busy and crazy as today was, I can’t see myself in any other profession.

*All patients mentioned in this account are fictional but details have been written to describe patient experiences as they would be in a case study.

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