What do you think nurses do?

[Felix01]

I've just been reading some of the threads over the past few weeks and I wanted to ask MNers, What do you think nurses do in their jobs on day-day basis ? Responsibilities etc how many patients they look after?

Preliminary checks before referring to a doctor
Blood tests
blood pressure
Ask questions about symptoms/medical history
Administer some medication
Assist doctors if necessary

Oh and I'm not sure how many patients they look after but If I had to guess I'd say maybe 5 at a time. Could be more depending on the case, some patients may need more attention.

5 at a time 🤣🤣🤣 sorry PP but that's tickled me.

As a student nurse, I am watching this with interest 🤣😬 (grabs popcorn)

I assume the general consensus will be people think nurses do a lot less than they actually do.....

Honestly I don't really know. Is it less? I suppose it could be depending on what nurse you are?

Depends on what type of nurse surely? I assume all types of patient care / triage / looking after patients / administration / giving medication / dealing with patients and diagnosing etc etc. Again not sure on how many patients, surely depends on the area eg NICU vs Post Op Ward will have different ratios?

Injections, monitoring of patients on wards, removal of drains after surgery, inserting/removing catheters. Setting up drips, inserting and removing cannula ( if HCA don't do it)
Calculating doses for medications, stitches and stitch removal, general patient support and care ( when HCA not available,

More like 15-20

Never mind nurses what about us NHS podiatrists - in my trust we don't cut nails. That's left to the private pods - we do epic and gruesome wound care.
But people still ask me why I need a degree to cut toenails 😡😫

Depends on their where they work and what type of nurse they are.

It would depend on the nurse, surely? The day of an ICU nurse is going to look different to one of a community nurse.

Also I was a nurse previously, I did burns - it became too much. Especially the children.

Ok I’ll bite: depends of course but what I’ve seen neonatal nurses do is phenomenal and non-stop. Constant tube feeds, changing babies, blood gases, referral to doctors, administration of medicine: in the neonatal units I was in there was 1 nurse for two children in GOSH, one nurse for 3 in Colchester and I think I nurse for two in UCLH.
In the children‘s wards and CAU I don’t know how many they have - they do hourly observations ( BP, heart rate, breathing check, temperature and run around at parents/doctors beck and call, initial assessment and taking details, administration of medication).
Adult wards - I’ve never had a good experience- tell new mothers off!, one showed me how to express milk, another helped me walk after my c-section, observations, bitch about patients if it’s overnight (I have heard this!).
They also have developmental progression and learning to do.
Updating notes on computer..
Probably 8 patients on a ward but 3 wards for about 6 nurses…???

In my department, take bloods, cannulate. give IVs, give complicated chemo regimes, prescribe medication, run their own clinics, insert PICC lines, do bone marrow aspirates and biopsies, dispense medications. Of course they also do observations and give personal care, though the HCAs also do this. I was horrified by the thread earlier about patients not being washed. All our patients are assisted with hygiene daily, though if you are the only chemotherapy trained nurse on duty, some of that will be delegated to HCAs. I also know nurses who do endoscopies and run ventilators. Modern nursing is not what it is perceived to be.

It depends on the area/type of nursing and current demands.

When I worked on the wards it was always between 8-12 patients per nurse depending on staffing levels. Medical ward, majority of patients on IVs, oxygen therapy etc. Majority had a high level of personal care needs/bed bound/incontinent etc.

When I worked in A&E anywhere from 6-10 majors patients was normal ie patients in for strokes/head injuries/acute chest pain. Double that if when your morrow nurse needs a break. Not counting anyone queing in trolleys in corridors waiting for a cubicle.

In resus..anywhere from 3 to 6 patients per nurse. That's cardiac arrest/seizures/vented etc if stable. Again depending on staffing levels etc.

Well, I assume they don't write surveys based on the pointlessness of this question?

This is not what most nurse do 🤦‍♀️

I work in the community, community nurses are responsible for wound care including complex wounds and dressings, palliative care and managing end of life symptoms so patients can remain at home, catheter care, management of pic lines, giving medications, injections, taking bloods as well as countless other tasks.

They have to give this care in the home environment which can be challenging in itself.

I'm a specialist nurse with my own caseload, I tell the Drs what needs to happen not the other way round!

It will obviously depend on what kind of nursing - a district nurse will do different things to a ward nurse will do different things to a scrub nurse will do different things to a CNS.

Our specialist nurses do independent clinics for patients with either transplants, or chronic kidney disease. They will see between 8-10 patients per clinic, and do blood pressures, examine them, check their medications and blood results, provide education on both self care and future management options, and change medications within a protocol. They work at the level of a registrar, can prescribe, etc.

Our ward nurses do full personal care for patients (along with the HCAs). Dispense and administer medications, assess and treat pressure areas/wounds, they are trained to carry out both haemodialysis and peritoneal dialysis on the ward, they do blood pressures, blood sugars, oxygen saturations etc and interpret these, they take blood and put cannulas in, they insert urinary catheters, they manage drains. Plus teaching other nurses and HCAs, discharge planning, liaising with families, physios/OTs/social workers and nursing homes/care agencies, infection control, investigating complaints/Datixes, and probably a tonne of other stuff I can’t think of right now. We have a fairly high intensity ward (a combination of very sick multi-organ failure patients, and some very short surgical admissions - so up to ten new admissions a day, and another 10-15 very sick patients). We have four nurses and two HCAs on a good day, but often only two nurses and 1-2 HCAs in reality, one of whom might be specialing somebody who is confused and on a DOLS.

They do a fuck of a lot.

So I work within brain injury/neurodegenerative/ LD in fact lots of things. Complex behaviours which mainstream settings cannot manage as well as physical health interventions. Some staff have had internal bleeding , broken limbs, bites . I do really like my job compared to NHS wards the ratios are a lot better, I find it less stress Vs NHS wards even with the risks.

This thread isn't going to be about minimising what nurses do, how easy their jobs are and how they definitely shouldn't be striking for better pay, is it? Of course it isn't.

No actually I was just curious about the public perception of nurses even HCPs as a whole.

@Felix01 I get you now, and I hope that this will be read by many people so that they can really see what nurses are up against.

I had to have a PICC line inserted a couple of years ago and the whole process was done by nurses. They basically turned a room into a sterile environment like an operating theatre, then made an incision in my arm, entered a vein and guided a line through it to my heart, using a monitor. It was very complex and as far as I was concerned, a mini-surgery. There wasn't a doctor in sight - it was all carried out by nurses.

In fact, for most of my cancer treatment, which included administering heavy-duty chemo and radiotherapy, I rarely saw a doctor - it was all nurses. It was eye-opening to me. They are highly qualified professionals and should be paid a fuck-tonne more, imo.

Coronary Care Unit
Greet patients & staff.
Answer call bells while waiting for handover
Take handover
Allocate patients/staff
Check emergency equipment
Observations / pump checks / fluid balance/ECGs
Answer the phone to tell A&E that I haven't got any beds.
Breakfasts, medicines, phlebotomy
Washes, bed making, assisting with toileting
Wardrounds
Answer the phone to tell A&E that I haven't got any beds
Assess patients with pain/other symptoms, arrange further assessment and intervention
Attend to any medical emergencies as part of crash team
Arrange transfers to tertiary centres as required including arranging nurse / Dr escort, transport, paperwork, drugs and equipment
Answer the phone to tell A&E that I still haven't got any beds
Make a coffee. Have 2 sips go and sort out a vomiting patient.
Patient lunches. Catch up on admin, medicines round
Observations etc
chase up pt investigations.
Assess patient in A&E and agree needs admission to unit.
Phone bed manager to badger them to prioritise a steep down bed so that I can transfer pt out & make room for poorly A&E patient.
Call Drs back for deteriorating patient. Spend time setting up additional treatments and extra monitoring.
Speak to patient's wife and explain patient is very poorly and see if she wants her children to come in.
Sort out a drink & a sandwich for patient who has been off the ward having investigations and missed lunch. Apologise to patient because there is no roast dinner left.
Organise transfer of patient to step down ward.
Admit patient from A&E who is having rhythm changes and is in pain.
Provide pain relief and discuss further interventions to keep stable.Agree to monitor closely for now.
And that's not all as any other nurse will tell you .