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?

Depends on their role? I wouldn’t expect the specialist diabetic nurse I see at the hospital to do my smear but then I wouldn’t expect the practice nurse to be able to fit my insulin pump and teach me how to carb count. My diabetes nurse said she hadn’t been on a ward in years and wouldn’t know what to do if she had to.

That sounds intriguing!

From what I gather, podiatrists are the only HCP that can call themselves surgeons.

I'd say it depends on the type of nurse- some are highly specialised and trained. I had breast cancer and my breast-care nurse had a lot of years experience- she had a masters degree. Her roles included giving information, explaining diagnosis and reassuring about symptoms, checking post operative healing, draining haematomas, prescribing painkillers, initial diagnostic examinations and referring patients to appropriate consultants, presenting at conferences etc. She was also responsible for managing more junior nurses and organisational duties.

The physician associates in my trust are band 7 static ward posts and they know the patients plan better than the consultants.

depending on level of qualifications and field of practice all of the above and then some.
Many nurses autonomously manage whole episodes of care including complex clinical interventions, image referral and interpretation and challenging prescribing without direct oversight from a doctor.
Some are researchers, some are leaders, some educate the next generation of nurses in those degrees that the Daily Mail sneer at. Some lead nationally on reviewing and developing those degrees and the underpinning capability frameworks that go with them.

Nurses are seriously undervalued and their contribution to society is unseen beyond direct physical patient care. Fundamentally though, nurses work with people and beside their people throughout all that life throws at them.

God, SO many tasks spring to mind. I've always been amazed by the amount Ive seen nurses do on the frequent occasions I'd gone into hospital to visit my late mum (loads of different wards).
I've met so many nurses in the last 5 years and they've all been so lovely, especially the ones working in ICU.

I'm no expert at all but from what I've seen I think:

• Settle patients, bring them drinks and meals / feed patients that can't do so themselves
• Checks vitals on a regular basis (hourly?) such as blood pressure, oxygen machine output depending on patient ailments
• Assist with incontinent patients /change if patients have had an accident or been sick

-take bloods/ samples

• conduct minor assessments
• help patients to be mobile
• administer medicine
• be the main contact for patients/ relatives of patients over consultants or drs

Tbh I think the list is endless as whenever I see nurses on wards they're always looking super busy. I would guess currently the patient ratio is 20 per nurse? (Way too high for one person to be managing I'd say).

As others have said- depends on the job.
My DD is a peadiatric intensive care nurse. Patient to nurse ratios are 1:1 each patient has a dedicated nurse.

Depends on specialty and where they work.

My DD has every other eye test at hospital done by a nurse. The follow up in the next room to decide if the prescription needed changing was then with a consultant ophthalmologist. On the other appointments she has a junior ophthalmologist doing the eye test.

In my GPs surgery one nurse does family planning appointments while two nurses deal babies and kids including weight-ins and vaccinations. Then there are other nurses who run the asthma clinics and diabetic clinics plus sometimes adult health checks. Though HCPs do the adult health checks as well. The nurses run the flu clinics at my GP, though at the pharmacy where I actually get mine they have a mixture of health practitioners giving the vaccinations.

In my previous GP practice there was a nurse practitioner who was better at her role than the GPs specifically the locum GPs. When they hired her, she ended up running her appointments late every single day for months as she was sorting out the mess left by the various GP locums the practice had.

I had an adult family member in ICU before Covid. They had a nurse doing the observations which were every few minutes, giving medication, helping to move the patient, communicating with the doctors and talking to the next of kin.

And I'm ignoring the nurses I know in pediatrics in different settings, mental health, A&E and minor injuries.

Endless. That's all I do. It's really quite similar to when I was a burns nurse.

ICU nurse here
care of surgical, medical or trauma pt who can be extremely unstable
top to toe assessment including chest auscultation with stethascope
care of ventilated intubated patient and those on non invasive ventilation
Hourly obs, monitoring and intervening as nec
Responsible for changing vent settings/modes depending on arterial blood gases
Administering very potent meds IV like noradrenaline which if done wrongly could kill a patient
interpreting blood gases and routine bloods,
passing a feeding tube, inserting an arterial line, catheterising,
Suctioning, extubating, bag and mask ventilation, chest physio if pt desaturating
Dialysis
holistic care of your patient, washing, eye and mouth care, pressure area care,
liasing with relsth
chatting to and laughing with your patient if they are awake
Calming delerious pts, may involve being spat at
or physically attacked (hence new pair of glasses funded by NHS ! )
monitoring for early signs of deterioration ......

Too much for not enough pay.

I am a nurse. I have my own clinics, I perform diagnostic procedures, I prescribe, I break bad news, I see, assess and treat patients in a&e, I admit and discharge patients, I run my own operating lists - as in it is me performing the surgery. No surgeon there, but somewhere on the hospital premises.

In a previous role, I ran theatre lists, I checked anaesthetic machines and equipment, assisted the anaesthetists and was a scrub nurse. Was responsible for over 100 staff and 10 theatres and millions of pounds of equipment.

Nurses and their role have evolved massively in recent years. And long may it continue.

Thank you this has been a really nice thread. I haven't heard sitting at the nurses station chatting once.

Sit chatting at the main desk for long periods (this is what I witness)
Take temperatures
Look at charts
Occasionally change pipes/tubes
Ignore bed baths because they don't have time.
Change dressings

Apart from that, I've no idea.

There we go spoke too soon .

@Felix01 agreed. Trolls sadly.

Shows you no nothing.

Definitely.

Answer questions from the family. Reassure the family. Make tea for the family. Explain things again and again.

Know nothing, that's what it should say.

I'm a mental health nurse.

It feels like what is missing from the replies is all the holding of responsibility and decision making as opposed to practical tasks. We all need to coordinate and prioritise a range of urgent tasks.

Lots of different nurses will have varied (sometimes extremely specialist) skills, but from my perspective is the sense of being responsible for x number patients and their care that really weighs. Very frequently I'll go home anxiously thinking over a decision I made, that's what I find most difficult.

5 acutely unwell patients. Or up to 8 if staffing low. Think very unwell.

Respiratory failures who need fine line nursing. Blood transfusions, platelet transfusions, end of life care, complex wound care, managing suicidal ideation patients, dementia patients, alcohol and or drug acute detox patients, big bleeds, cancer, seizures, new diagnosis of cancer, making up IV medicine, complex diabetes management sometimes including sliding scales so hourly monitoring and giving correction doses of insulin, heart attacks (trying to keep this simple so not using my big words), catheter insertion, bladder monitoring, delirium care, obs 1 to 4 hourly, admission paperwork, transfer of patients to other areas, ward rounds, liaising with medics, pharmacy, a multitude of referrals to DN, care at home, social Work, dietetics for NG or PEG feeds including placing NG.

Falls risk (soooooooo many falls risk patients) personal care, skin assessment, feeding those who need assistance, ensuring those not safe to eat normal diet can be kept safe and not choke and equally not lose weight by starving. Keeping confused patients from trying to sneak out, often with a dementia patient with me while I do a drug round. Controlled drugs sooo many controlled drugs that need 2 nurses to sign off... Try finding someone who can. Complex med regimes..... Picking up sooooo many tablets from those who insist they can take them independently.... Please please just put the pot of tablets to your mouth and not in your shaky hands... Please.... Ahhhh OK let me gather these and my thoughts 😂.

Bloods, cannulation, speaking to families.... Answer so many calls. Paperwork, way more paperwork than should be allowed. Charting, keeping track of who needs other tests, IVs that aren't standard there are some really complex meds out there.. I have had pharmacists on the line to talk me through really unusual meds despite there being a system you look at to see how to make them up, sometimes drugs are so new you need them to talk you through .... and that's all before I get someone who deteriorates and needs a rapid input and an alarm call put out. Frequently paging medics when someone is off and needs a review. Keeping patients safe can be overwhelming... Handing over to other wards can be difficult to.

That's just a tiny amount of what I do. I bank in other areas but I'm honestly burnt out. I don't think I actually want to be a nurse. I often get hit, punched, bitten. I have lost 2 pairs of glasses in as many years. Families are either so patient and kind or are trying to intimidate. Some shifts I couldn't pee or get breaks so the nursing assistants brought me coffee and a pack of biscuits.

Add into that I need to do continuous professional development, attend training sessions, read up on new research as I have to be up to date. I have missed things out. I know I have but if you make it to the end of my post I applaud you and you need a badge 😂

As I said on the other thread, in the hospital where I've been in and out for many years, a lot of the day-to-day care is done by health-care assistants and not nurses, so the HCAs do the washing of patients, bed changing, domestic tasks, blood pressure checks, monitoring, ECGs and so on. The nurses are far fewer, there was only two nurses on two full wards last time I was in and they manage the wards, do the medicines, do the admin and liaise with the other wards and patient families. All are busy. Catering do food and drink, HCAs do hydration and snacks if you need extra.

That's a ward nurse though, it's different in the community, but again mostly they do medical procedures, such as dress wounds, distribute medications, do checks, liaise with other HCPs and GPs and hospital.

It's quite different than what you think of when you stereotype 'nurse'- the nurses I met don't tend to do bedpans unless two people are needed and there's absolutely no-one else around, they are the medical professionals overseeing the wards as the doctors only come on a couple of times a day for ward rounds.

@Itstarts
I'm a nursing associate, basically the old sen rebranded.
We are band 4
I do everything that a band 5 nurse does with a few exceptions.

I work with dementia so every shift is different. Start of with hand over, put meds trolley together, give meds, do observations then start to help with personal care.
Take phone calls inbetween.
Do ward round highlighting any issues
Might is lucky get a luke warm brew.
More meds, more observation, referrals to various people. Speaking to social workers, irate relatives, splitting up fighting patients. Incident forms , helping to feed /fluids.
Ecg, catheters, bloods, cannulas.
More phone calls and splitting up fights.
Do some writing in documentation.
More meds and observation, wound dressings, care plans , admissions and discharges. Assessments for physio, salt - nurse led.
More phone calls.
Hand over and leave about 45 mins after my shift has finished.
My daughter works in a supermarket, get 2p and hour less than me.