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?

@MattHancocksWhiteBikini absolutely. As nurses we are really good at coordinating care safely. So we won't extubate a patient if there's lots of other stuff going on like sedation holds, tracheostomies etc On the other hand some consultants are blissfully unaware of this and a nice shift can rapidly turn the other way because they really can't see the unit wider picture.

Hello to fellow student nurses being nosey!! 👋
😂

Let me counter that with a friends recent experience. Her DH went to the advanced nurse practitioner at UTC due to excess wind. The brilliant ANP out this together with the fact he had swelling to the ankles and flagged up the fact it could be bowel cancer markers - it was. Thanks to her, they caught it incredibly early.
I've just finished a placement on UTC. The advanced practitioners were to a person incredibly knowledgeable, insightful and experienced people. I'm sorry you had a bad experience but there are good ones out there too!

Yes I think so...

We would only have five on a really bad day. Our ratio is 4:1 in paediatrics. When I was an inpatient, I was horrified to discover that the nurse looking after me had 10 patients. Though he also had two support workers with him.

Midwife here…

On postnatal ward:
Handover - basically a summary of each patient and their care plan, who needs what etc
Usually allocated 7 women and 7 babies, but quite often it’s more. Sometimes 14 women and their babies.
Carry out most, if not all, observations. Some women and babies can be on hourly obs. Lower risk patients might be daily.
Provide breastfeeding support.
Answer call bells.
Daily postnatal checks.
Discharge chats.
Chasing doctors to see patients and complete paperwork so that they can go home.
Administering medications.
Chasing pharmacy for TTOs.
Blood tests and reviewing their results.
Organising scans and other additional tests.
ECGs
Discharge paperwork (which takes an age).
Documenting any time a patient moves/breathes/asks for anything/does ANYTHING
Lots of seemingly pointless paperwork.
Liaising with social services.
Caring for post operative and unwell patients.
Making sure no one falls asleep and drops their baby.
Constant monitoring who has too many visitors, who’s sneaking in children that aren’t the baby’s siblings.
Keeping a close eye on potential safeguarding issues.
Blood transfusions.

On labour ward:
Observations
Providing emotional support
Delivering babies
Scrubbing in theatre
Administering drugs
Assessing progress in labour
Assisting anaesthetists
HDU care (frequent obs, monitoring blood loss, carefully measuring input and output, personal care, complex drug regimes etc)
Resuscitation (mostly babies, but we do obviously have maternal collapses too)
Breastfeeding support
Paperwork
Episitomies
Inserting catheters
Interpreting CTG traces
Suturing
Cannulas
…did I mention documenting everything as it is happening whilst trying to maintain some kind of sterility?
Oh and quite often you end up with two patients. Sometimes more.

Community:
Observations
So. Much. Urinalysis.
Parent education
Social services contact/meetings/referrals
Discussing and supporting mental health
Booking appointments
Taking blood
Interpreting blood results
Referring to hospital care
Postnatal visits
Checks for mums and babies
Breastfeeding support
Answering a million voicemails/emails
Being responsible for keeping track of 200 women, and their health and well-being throughout their pregnancy
Administering drugs and blood products
Newborn blood screening
About 6 million different pieces of paperwork, mostly duplicating from various shit computer systems

I’m sure there’s more stuff I’ve forgotten.

OMG if only that were true.

When DD was an inpatient I couldn’t BELIEVE how good the ratios in paeds were!! (Not saying it’s easy, they were still insanely busy and overworked!)

It's confusing in hospital because there are so many nurse-type roles. Like nursing assistants and HCAs & then there are trainees... As a patient, you haven't a clue who is who. They wear different colours which means... something.

I haven't read thread. I think nurses are basically parallel with the other Uni-trained HCPs (like paramedics or radiographers) in the responsibility stakes. The nurse's role is to take on a huge lot of patient care management; Nurses

review care plan for the day for each patient, each work area
give medication, sometimes draw up medications (dose per kg per time unit)
supervise process & procedure
supervise the other nurse-type staff
delegate or do the many types of care themselves

patient #s:
Can be in charge of (critical care unit/HDU) 1-200 (something like a vaccination clinic) patients in the same hour, just depends on the patient individual needs.

will read other replies after I post

Yes. Much better. Though we are very short staffed at the moment. We occasionally would have 6 on nights. My friend is convinced that the kids just sleep all night! They don't!

oh yeah... records management. Lots of that. part of process & procedure

god, amazing post OP

Nurse on a general medical ward:

Monitoring of patients’ condition (so bp, o2 sats, heart rate etc) and recording these in notes

Drugs rounds, with multiple nurses needed to sign drugs out of the controlled drugs cabinet - that would things like opioids, for example. Ensuring that dosages are correct because nurses are responsible for what they administer and can’t just say ‘a dr told me to do it’ if they make a mistake

Wound care where required. Changing dressings, cleaning and so on.

Checking on things like IVs, O2 supplies etc

Catheterisation

Possibly taking blood samples? I can’t remember if this was a nurse thing, needed extra training etc

Taking care of patient needs like walking to the toilet etc - HCAs are also there to help with this

Laying out deceased patients

Liaising with other HCPs like doctors, physios, OTs etc. Possibly being an advocate for their patients as they probably spend the most time with them and know them best

Recording all of the above properly in the medical notes

From what I recall you’d expect maybe two trained nurses with HCAs and student nurses on a medical ward of 20-30 patients per shift - although it’s been a while since I was in a hospital.

My mum is a retired nurse and I was a bank ward clerk in the medical directorate of her hospital when I was a student - these are things I’ve watched nurses do or that mum has told me about. I’m sure there’s more! But it’s a much more technical job than I think many people expect, with things like drug calculations and the like.

An amazing job, that is what I think nurses do!

Oh god yes, having read some other responses now - chasing discharges around. Wrangling TTOs, transport and so on could take forever!

And of course the ‘human’ side of it - talking to patients and their families. That’s really important and can be very time consuming. And draining - mum had some awful experiences with certain relatives, and it was a big factor in her decision to retire.

I watched my Mum nursed in ICU. One-to-one care and literally everything. Everything medical as well as support for us as the family in 12 hour shifts. She was in for 3 days before she died. The only doctor contact was to ensure her donor wishes were fulfilled.

Inpatient forensic mental health nurses (I am not one but have worked with them for decades):

Manage severely psychotic and aggressive people all day long. Get screamed and sworn at and threatened. On occasion get punched, kicked, spat at, stabbed or have bones broken if unlucky. Also, be with people at the darkest and most frightening moments of their life. Give medication, sometimes under restraint. Negotiate begavioual plans and de-escalation strategies. Listen to unbelievably stressful and distressing stories of violence, abuse etc without judgement. Talk to often hostile and abusive family members and have empathy while doing so. Search people for drugs, sometimes against their will. Counsel and comfort. Psychoeducation. Help people maintain dignity while in highly disturbed states. Understand side effects of medication and monitor for dangerous, even potentially fatal side effects. Understand suicide risk and monitor for this constantly. Maintain professionalism as a nurse while being regarded, even hated, as a jailer by some patients. Understand psychological processes including splitting and passive-aggression.

I could go on and on. They are astonishing people.

I want to know where these wards are with a 5 patient nurse allocation…. Sign me up!! Throw that application form my way!!
😂😂😂

Much less actual "nursing" than when I trained in the 1980's!

Since nurse training all became degree level it appears the job is much more medicalised. In my opinion new nurses now have limited ward experience in training, they all seem to be "specialised"from first qualifying rather than having the opportunity to get a good base - level understanding in general nursing care and patient awareness, while the basic "nursing care" seems to be the sole responsibility of nursing assistants.

The job has become too much paperwork and specialisms with too little commitment to actual hands on patient care and dignity.

This is not a post slagging off nurses more a sad reflection of how a historically caring profession offering a highly regarded patient led service has been turned into an underfunded, target driven, tick box exercise.

I have 8 but there's a trade off with their being regular assaults, restraints verbal abuse, my MIL who's a nurse on general medical ward calls it danger money 🤣🤣🤣🤣

I’m a MH nurse in the community. In practice, largely due to the severe shortage of psychiatrists (it’s something of a dying speciality as lots of medics don’t see it as “real” medicine), community MH is almost entirely nurse-led. We diagnose, prescribe, medicate and treat-sometimes with some psych input, but often not as a very large proportion of our nurses have done their non-medical prescribed qualification.
I specialise in seeing people with complex personality disorders. They self harm, take overdoses and have very high care needs. One of my ladies has overdosed on insulin (bought off the internet…) twice this week and I can’t get her a bed. My case load is 35.

Clueless

I'd love to know how nurses view unpaid carers.
Just genuinely curious to see if they have the same respect for us as we have for them.

I'm a nurse. I write educational programmes and teach. It's not one size fits all!

@Billoddiesbeard I suppose you also thought Hattie Jamie's in Carry on Doctor was your role model!