A day in the life... of a new graduate nurse September 2013

NAME | Rochelle Paice JOB TITLE | New Graduate RN | LOCATION | Acute Orthopaedics, North Shore Hospital, Waitemata DHB

5.30AM WAKE

The alarm sounds. A quick change into a swimsuit makes for a cold start to the morning. Driving down to the local pool, I anticipate the plunge. After a 2km swim, I smile. I am mentally prepared for the day ahead.

6.45AM WORK TIME

After handover and patient allocation, the day begins. In the acute orthopaedic ward I’m in, we deal mainly with acute bone injury, spinal injuries, and cellulitis.

The new graduate programme has been a perfect way to settle in and gradually integrate into the role of a registered nurse. Eight months into my first year and I love the work. You get to be a part of an extremely vulnerable stage in someone’s life and knowing you can make it that little bit easier is very rewarding.

7.30AM

Morning smiles, baseline observations, drain and epidural checks start the morning. A queue at the pyxis machines (medication dispenser) shows that everybody is waiting for pain relief.

After morning washes and some analgesia administration, I call out to my nursing partner to help me turn Mr S. He was admitted a day ago with a neck of femur fracture. We turn him onto his side and check his back and other bony prominences for signs of pressure. We wash and moisturise. While he is on his side, I get him to take some deep breaths and have a cough – it is crucial we assist the prevention of bed-rest complications such as pneumonia. With a quick change of the sheets, we roll him back. He smiles as I pass him his cup of coffee. No surgery for him today, another day of waiting … It’s time for my own cup of coffee, but this morning will just be a quick break. Before I go, I need to run through a pre-op checklist with Mrs J. I have been notified she will most likely go down to surgery this morning, so it’s better to get it done now. You never know how the day will unfold.

10.00AM Back after coffee break

We collect together in teams for a catch-up with the charge nurse. It gives the chance for an overview of the patients’ current condition and any new plans. Once up to speed, we head off in all directions to catch up on the workload.

Whilst dressing a post-operative wound, I chat to Mr H and he shares stories about ‘back in our day’. Banter flies across the room from those who have been in hospital a while. It’s a really enjoyable atmosphere. I can hear my name being called from the nurses’ station – a phone call waits. With the dressing finished, my name is called again. Down the hallway to dispose of the dressing trolley, hands washed, then “Hello…”

11.40PM THEATRE CALL

My patient has been called to theatre, so time to get moving. Thank goodness I had a chance to go through the pre-op checklist this morning. A standard procedure on the ward but very new for Mrs. J; she is nervous.

I talk to her about what it means to have a closed reduction of her fibula. Once I’ve finished going over the checklist with the pre-op nurse, I smile to Mrs J and with a short squeeze of the hand, I leave her on level one.

Sometimes it takes a nervous patient to remind me that hospital processes that are now everyday to me are not familiar to them. It makes me think about their journey and the anxiety and fear that they are experiencing.

12.45PM POST-LUNCH

As I walk back on the ward after a bite to eat, patient bells are ringing as nurses pace up and down the hallways. I get a handover from my nurse partner so she can go on her lunch.

Nothing major, she says, they should all be fine until I get back, can you just check on Mr J’s antibiotic? Antibiotics … a staple of nursing on the ward. I check my day planner. Two more antibiotics to give this afternoon.

1.00PM VITAL SIGNS AGAIN

A second set of vital signs to be taken and another round of analgesia thanks to the encouraging physiotherapists helping everyone to get back on their feet after surgery. It’s amazing what the body can go through.

2.00PM

I check on Mr C, who had a washout of his infected knee yesterday. He has spiked a temp of 38.7 degrees. His knee looks inflamed; it’s hot to touch. I send off a urine sample and some bloods. I page the house surgeon so they can review Mr C and decide on whether they want to get blood cultures or a chest x-ray.

2.20PM NOTES

I need to get some time to do notes but a 2.30pm antibiotic has me back into the medication area, where I double check the fluid a colleague is getting ready and she checks my antibiotic. I draw it up, 2g flucloxacillin, it’s quite harsh on the veins, so I grab a burette and a bag of saline and go down the patient’s bedside.

3.00PM Shift ending … nearly

An account of the daily cares and a double check of all documentation. The afternoon staff enter the ward and we head to the hallway to begin the bedside handovers.

3.45PM

With the next shift up to date, it is time to leave work, a little late today… I’m knackered; don’t think I will squeeze in a run after work. Home to walk the dog instead.

5.30PM DINNER

I love early dinners on work nights and especially pasta during winter. The dog is at my feet, hoping for a morsel to be dropped accidently. After a blob in front of the TV, I muster enough energy to squeak in a bit of postgrad work before heading to bed.

9.00PM BED

I climb into bed, trying to calm my mind. It never works, as I am quietly preparing for the next day ahead.