Tuesday, August 08, 2006

This is just like me!

Two-Minute Job

By Elizabeth Bussey Sowdal, RN

I go into a patient’s room with a specific task or three to perform. I want to give the morning medicines, do a dressing change and chart vitals.

In the process of giving the morning medicine, I notice that the IV tubing needs to be changed. I do that quick job, it only takes a few minutes after all, and, since I am right there anyway, I untangle all the monitor cables.

As I finish this job the feeding pump beeps and, since the bag is empty anyway, I decide to change the feeding tubing. As I start to connect the new tubing to the enteral feeding tube, I notice that it has slipped out a bit and must be replaced. No sweat: 2-minute job.

I explain it to the patient, remove the displaced tube, teach the patient about what comes next, and place the new tube. I check placement, call for an x-ray and comfort the patient.

Done. On to the dressing change…

But if I am going to change dressings anyway, I might as well get the bath out of the way, too. Besides, it will help the patient to feel better to have a warm bath and a little attention after the feeding tube placement.

And you cannot give a patient a bath and leave him on old linen. Plus, he will need fresh pajamas, a shave, help with his oral care. He might have a story to tell me after all of this, and that might remind me of a story to tell him. By this time he has more medicine due. But his IV has infiltrated. No sweat: 2-minute job.

Only it never, ever takes just 2 minutes, does it?

I spend more time than I really need to spend looking at the patient’s veins and reassuring him. It’s bad enough to be in the hospital and to have to be stuck and prodded and rolled and all, without having your arm flopped around and jabbed at like it isn’t connected to a human being.

So that 2-minute job takes 10 minutes. But when it is over, we are both happy and minimally traumatized.

Next I have to DC the old IV, maybe bring him a warm pack, dress both sites, date and initial the new one.

Finally, I am done for a little while. Now it is time to get my charting all caught up.

I leave the room, and just as I reach for the flowsheet, someone asks me to come and help them. Off I go to help with a linen change: a 2-minute job.

Only, if we are bathing part of the patient, we might as well bathe the whole patient. Since we are there, we might as well do wound care. And since there are two of us in the room anyway, it is the perfect opportunity to change the ETT tape. Done and done!

Time to chart...

As I leave the room, I hear my other patient’s call light. I go in, help with a bedpan, tidy up the room a little while I’m waiting, and then help her off the bedpan. Of course, I spill it. I always do.

I have helped one million and seven people get off the bedpan and the only time I have not sloshed it was when it came out empty.

So… bath and linen change.

One thing leads to another and I am not out of there for 30 minutes. But, now that my second patient is all squared away, I have time to chart on both of them before anything else is due.

I get both flowsheets, both charts, dig in my pocket for my jotted notes and sit down to document. At this point, the charge nurse comes to find me.

The visitors in my first patient’s room would like to see me. They tell the charge nurse that they have not seen a nurse all day. All day being the 30 minutes they have been there.

But that’s OK.

Two-minute job.

Then I will have time to chart.

Elizabeth Bussey Sowdal is a trauma ICU nurse and writer based in Oklahoma City.

This is soooo me at work! I'm sure that most will agree that it sounds like you as well. I get interrupted several times a day while trying to get one thing done. Nursing is all about multi-tasking. One day I will write down everything that keeps me from doing my nursing job and I'll post it.. My final exams are tomorrow for the semester and then some free time from the books for a couple of weeks. WHEW! Thanks for all the support and well wishes!

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