One of my favorite types of posts to read from other bloggers is “Day in the Life” posts. I thought it would be interesting for others to read about a
day night in the life of an oncology nurse.
A little background, I have been a nurse for 8+ years and have specialized in oncology for the last 5 years. My unit handles all types of cancer from blood cancers (i.e. leukemia, lymphoma) to solid tumor cancers (i.e. breast cancer, lung cancer). Within the last year, however, my unit has begun to focus primarily on blood cancers and bone marrow transplants. I have worked the night shift for the last 1 1/2 years.
6:10 PM: Head to the hospital. I typically skip out of the door because everyone is normally screaming or refusing to eat dinner at this time. I wave goodbye to my hubby and grin as the screaming fades into the distance.
6:40 PM: Clock in, put my stuff in the break room and check the board to see what my assignment is for the night. On this night, I have been assigned 3 patients with one empty bed. An empty bed is any nurses worst nightmare because you are guaranteed an admission from the ER and that could either go really well or be a straight up train wreck. What will it be tonight?! Spoiler alert. It was a train wreck.
7:00 PM: Go to huddle. Huddle is a time for both the day and night shift to get together to hear about any issues on the floor or be briefed on any changes that have occurred. Tonights huddle is quick. Praise hands.
7:00-7:45 PM: Get report on each patient, review the patient’s charts, orders and medications. Tonight, I have a trained nurse buddied with me while she waits for her unit to get up and running. She will not be here until closer to 8:30 so I plan on getting started ASAP because with my luck, the ER will call report on my patient sooner rather than later.
Tonight I have a patient getting chemotherapy in preparation for a bone marrow transplant, a solid tumor patient with fevers who is feeling much better and a sweet but confused patient on a bed alarm.
I put my skates on (figuratively speaking) and get the party started.
8:00-8:30 PM: Start passing medications and doing my head to toe assessments on each patient. My patient getting chemotherapy has his pre-medications scheduled for 8:30 so I make sure those are given right on time. I also prep his tubings and make sure everything is ready to roll for his 9:30 and 10:00 chemotherapy.
8:30 PM: The dreaded call from the ER comes. Bleh. The patient coming is a known patient of ours and he is vomiting blood.
8:30-9:00 PM: Pass the rest of my meds and finish my assessments. My nurse buddy is here and I give her a quick rundown of our patients. At this point, the ER is calling me back to inform me that the patient to come now has a fever. Arg!
9:10 PM : The ER patient arrives on the unit. He looks pretty rough but thankfully he is stable. He has a fever and we can’t give him any oral medications due to the vomiting sitch. We also can’t use other…ahem….routes because he has low platelets (aka he will bleed). We get him comfortable, give him anti-nausea medication, give him an emesis bag (aka puke bag) and place a call to the doctor.
9:25 PM: Thank God for my buddy nurse because I have to run over to the pharmacy to grab chemotherapy #1 for my pre-transplant patient. She is able to stay with our new patient and check his current orders while we wait for a call from the doctor.
9:30 PM: Chemo #1 is infusing! I have to pee but that will have to wait.
10:00 PM: Chemo #2 is up! The doctor has called back and we have a slew of new orders for our feverish/vomiting patient. Blood work to be done, urine to collect, calls to radiology for X-rays and IV tylenol to administer. A call is placed to the oncologist because the primary doctor does not want to order IV antibiotics yet. She is cray, he needs them, so we are going to nip that in the bud.
10-12:00 AM: My life is a blur. If my nurse buddy wasn’t with me I would literally be in a corner somewhere soiling myself. Dramatic? No. During this time, we are administering additional medications to our other patients, changing out bags of IV fluids, completing all of the orders for our new patient, talking to doctors, speaking to family members and answering questions. Basically all of the things.
12:00 AM: The calm after the storm. Thank you Jesus! I am literally sweating through my scrub and of course I would pick tonight to not wear deodorant. (I am looking at more natural methods. It’s a whole granola wanna be thing.)
12:00-1:00 AM: Charting. The bane of any nurses existence. I have to go into the computer and document everything that has happened tonight. The patients head to toe assessments, pain assessments, conversations with doctors, patient education etc. It’s super
1:30-2:00 AM: Lunch (breakfast?) time. My lunch this morning is a piece of wild salmon that my doll of a mother bought me. Unfortunately, it tastes like garbage. I baked it like I bake farmed salmon and it just doesn’t taste the same. The meat is too…..tough? I can’t quite decide. All that matters is that it was gross and made its way into the garbage.
2:00-4:00 AM: The night has slowed down considerably which is a perk of working the graveyard shift. Ain’t no one here! Also, people want to sleep and would like minimal disturbances. During this time, I start to drag and try a new caffeine infused chocolate treat. I am not a coffee drinker so I am hoping that this will keep me awake. It works and I will be buying a box for my locker. I pass the time by reading doctors notes, updating paper work, hanging random scheduled antibiotics and chatting with my co-workers.
4:00-6:00 AM: Time goes by quickly. Blood work is done on each patient, morning meds are given and any loose ends are wrapped up. My ER admission has spiked another temperature so he is covered in ice packs and given IV tylenol. The chemo comes down for my pre-transplant patient and my sweet little lady gets a diaper change. Our solid tumor patient has had a great night and should be able to go home today! Star patient alert!
6:00-6:30 AM: Stare at the door waiting for day shift to saunter in. They look so well rested and alive. I am pretty sure I have caffeine chocolate on my scrub. I’m sexy and I know it.
6:30-6:45 AM: More huddle. More information. Nothing has changed from huddle 12 hours ago.
6:45-7:20 AM: Give report to the day shift nurses. Skip out of the door, drive my little butt home and dive into my bed. Goodnight!