Health Care Workers in

the fieldExperiences of nurses

by: Diego

Vanessa

Yakie

Our Nurses

Theresa Brown.

Emily Burnham.

Katen NP.

Rachel RMN.

Michael D. Jackson.

Theresa Brown - RN

Clinical nurse in Pennsylvania.

Author of “The shift”. New from

Algonquin Books.

Author of New York Times column

“Perhaps Dead is Proud, More

reason to Savor Life”.

Katen NP

Barnard College Alumni.

Current alum at MGHIHP (MGH

Institute of Health Professions –

Boston, MA)

Twitter: @KatenNP

Rachel RMN

Mental Health Nurse.

Specialist in Community Public

Health.

Twitter: @rachelRMN

Emily Burnham

Community Nurse.

Resides in Toronto, Canada.

Passionate about Gerontology.

Twitter: @EmilyGGB29

Michael D Jackson - ER

Resides in Chula Vista, California.

Marine Corps vet.

ER nurse and educator.

Current candidate for Chula Vista

School Board.

1- How do you prioritize what tasks are more

important than others when dealing with

human lives?

“Usually I prioritize by level of distress. That is, respiratory distress trumps pain,

which trumps vomiting, which trumps emotional distress. A severely low or high

blood pressure is very important, too, as is chest pain, depending on the situation.

There are times when emotional distress is the most important thing for me to

address and if other more pressing physiological issues are presenting it can be

very hard to prioritize. The general rule of thumb, though, is to save lives first,

treat lesser problems second.”

Theresa Brown

1- How do you prioritize what tasks are more

important than others when dealing with

human lives?

Michael Jackson

“Prioritizing use ABC airway

breathing circulation, level of

illness and triage. Safety if

paramount”.

Emily Burnham.

“Manage ABCs first. But also

think about how long a task

will take. A leaky dressing

may be more pressing than

the patient wanting PRN

meds but one can be solved

a lot quicker than the

other.”

Common factors – Question 1

Airway

Breathing

Circulation

2- How do you handle the stress of taking

care of patients while being short-staffed?

Theresa Brown

“See my answer above--knowing your priorities is key, but if there are

too many times when you have to be in two places at the same time

the stress can be overwhelming. If you have two patients in distress at

once see if you can pull in another nurse to help. An involved charge

nurse can be a huge help in these situations”

2- How do you handle the stress of taking

care of patients while being short-staffed?

Rachel

“Again difficult & becoming worse,

we work through our breaks &

lunches. We stay late, take our

laptops home to write up

everything you couldn't manage to

fit into your working day. I balance

this out with quality family time

with my family when I can.”

Michael Jackson

“You have to care for the patients

and part of caring means

advocacy...holding management

accountable for staffing the units

according to the law. In California

we have mandated nurse: patient

ratios. If the ratios are not being

met then a nurse should be

documenting and reporting this to

management and regulatory

agencies”

Common factors – Question 2

3- What are the most common ways to de-

stress while working in such busy

environment?

Theresa Brown

“Talking to colleagues helps, as

does taking breaks when possible. I

rode my bike to and from work as a

way to beat stress.”

Rachel

“Playing with kids, glass of wine at

the end of the day, off loading into

a partner.”

Michael Jackson

“De stressing could involve exercise, talking with friends and colleagues, taking

trips and eating right.”

Common factors – Question 3

Colleagues.

Enjoy free time.

Exercising.

Eating.

4- Have you ever been in emergency? If so,

what was it, and how did you handle it?

Emily Burnham

“One patient murdered another.

Stay strong until help arrives and

then take care of yourself.”

Katen

“Of course I have been in

emergencies. I slow down and

think, you have to in my opinion.

But I have been doing this a long

time and experience helps a lot”.

Michael Jackson

“I’m an ER nurse. Remain calm and

work as a team.”

Common factors – Question 4

5- How did you adjust to the long-shifts

and abnormal schedules?

Theresa Brown

“Catch up on sleep when I'm not

working, drink way too much

Starbucks, try to believe that I'm

superhuman, which unfortunately

I'm not.”

Emily Burnham

“Coffee and other forms of

caffeine. However, I find if I'm busy

the shifts go by quickly.”

Common factors – Question 5

6- What is your opinion of the common belief

that nurses are doctor’s assistants?

Theresa Brown

“Ugh. This is just dumb. We are

doctors' colleagues, not their

assistants. An assistant helps,

whereas a colleague works with

you. If you look at the work nurses

do we are not helping doctors, we

are doing our own work, which

independently contributes an

extraordinary amount to patient

care.”

Emily Burnham

“Completely incorrect. Nurses and

doctors have different sets of

knowledge that when blended can

maximize patient care.”

Common factors – Question 6

I’ve got the

power!

7- Is there any liability for you as a nurse if

your opinion or diagnosis is incorrect?

Theresa Brown

“I always say that doctors worry

about getting sued and nurses

worry about getting fired. We don't

feel the liability threat the way

MDs do, but we often feel a fragile

hold on our jobs. The busier one is,

the greater the worry of making a

simple, but devastating, mistake.”

Katen

“Of course when a nurse is

incorrect or wrong there is liability,

that's the beauty and the

responsibility of the license. When

we make decisions we OWN

THEM.”

Common factors – Question 7

Fear of:

Liability.

Jobless.

8- What kind of actions does a nurse usually

takes to relieve the stress of patients?

Theresa Brown

“Listening is really helpful,

explaining the confusing

information they just received

from a doctor, passing on

important news to family

members, making clear exactly

what the next steps in the patient's

treatment are.”

Michael Jackson

“Give reassurance Keep them

informed Remain calm Allow them

to vent frustrations Seek help.”

Common factors – Question 8

Be informative.

Keep clear.

9- Off the top of your head, what is the most

disgusting thing you’ve had to do at work?

Theresa Brown

“Oh, I guess clean up all manner of

diarrhea. But that's an important

part of caring for people, so I

would clarify and say that while

poop is disgusting, people never

are. It's remembering that contrast

that's important for nurses.”

Emily Burnham

“Inserting a catheter into a GJ

tube stoma (the tube had just been

pulled out) while the patient was

throwing feces at me.”

Common factors – Question 9

10- What was the hardest thing you had to

face when you began working as a nurse?

Theresa Brown

“Fear of failing, of screwing up. As

your on-the-job knowledge and

confidence grow, the fear lessens

because you develop clinical

judgment and learn to trust

yourself.”

Emily Burnham

“Confidence. People don't know

how long you've been a nurse but

rely on you at their weakest

moments. You have to be strong for

them.”

Common factors – Question 10