A view from the bedside of fellow nurses one year into Covid-19.
I awaken after 6 hours of surgery in the PACU. My nurse sits at the head of my gurney with an assortment of recovery equipment. Skilled to offer medication and options with nausea and pain, "she was on it"! Not once throughout my entire three-hour stay did she leave my side.
Having recently been involved with developing the "CODE YOU" workshop, I was aware and conversing with my nurses about their work and self-care in their jobs during my 2-day stay. From the OR to surgery floor discharge, my care was attentive and excellent. All nurses were working 12 hour shifts, all had some involvement in the care of Covid patients over the last year, suggesting traumatic and stressful nursing situations recently. Observed all were not able or chose not to do basic, self-care within their shift.
The PACU nurse was in the last 3 hours of her shift. She had only eaten a piece of the cake made for her in honor of her last day before military transfer. As she transported me to the floor, I heard her ask her working partner to prep for a new patient coming from the overflow from ICU. (When ICUs fill, PACU remains open after 11 pm as overflow.) She will now push from 12 hours into unknown overtime. I left with these words following a brief conversation about her husband's desire for her to take a break from nursing for a short time after their move:
"I offer you thoughts and prayers for that decision and hope for a friend to walk with you in that break. I believe you have a 'self wisdom' to know what you need."
My night nurse, who arrived at her unit as her shift began, was just coming off a 10-day vacation. She was refreshed and "chirpy". "I have worked nights 15 years and love it." She said, "my three kids have learned to let me sleep in the day and so it works well". I mentioned how I always had personally struggled to work nights and I had decided a straight night shift nurse would likely also "walk on water"! While I was feeling extremely grateful for her rested body and sharp skills tonight, I was also aware from personal friends, as well as having been a nurse manager, the cost for a family when this is 7 pm-7 am is a lifestyle. Is there ever an invitation from their administration to take an extended break to another option for a season? Not likely! For those of us who are administrating learn quickly that "good night nurses are GOLDEN," and best to enable them to remain to keep that shift strong!
Waking up to my new day shift nurse, she also arrives smiling and eager to use her skills to aid in my recovery. Lots of moving me my 1st post-op day, pain medications, and working with catheters! At some point about 8 hours into the shift, she leaves me to attempt a self-care task on my own and says, "I need to run to the bathroom, as I haven't found my way there yet today. Just use your call button if you need anything."
Interestingly when she returned, we had a conversation about my surgery for my bladder. "You may know one of the factors that have influenced the need for the surgery I just had is that perpetual 'nursing delay' to not care for our kidneys and bladders. Do we still champion the hero nurse who can work their entire shift without a bathroom break?" She replied, 'Wow, I never thought how those habits might have causes later in life!" Of course, she had not thought of those factors at 30 nor was there a written (only unspoken) line in her job description that mentioned, bathroom breaks are not guaranteed. No breaks or meals will create a "Super Nurse" of you!
How do we break this cycle of years of these unrealistic expectations of our nurses? Nurses, who are the backbone that keeps the hospital running and patients alive and healing? The system is constrained and struggling under the weight of centuries of these expectations! Could we begin to break away from old expectations by giving nurses permission to acknowledge their own, physical, emotional, and spiritual needs? Maybe offer space for self-care, a few tools to ignite hope and vision from the inside of their profession?