It’s morning huddle. The charge nurse is updating the floor on recent changes, new protocols, and high fall risk patients on the floor. The black circle next to the patient’s name indicates their high fall risk, and suddenly you realize 3 out of your 5 patients are marked with black dots, and the other needs a sitter, but there are none available in the hospital. The sighs fill the nurse’s station. We all know what that means - the tech gets pulled from the floor.
The nurses frantically start mentally preparing - finger sticks and assessment done immediately after this huddle, vital signs with medication administration, wound care after lunch. Somewhere between all of this you are suppose to plan for lunch, update the charge nurse, and keep doctors updated with changes throughout the day. Your phone starts vibrating. It’s the resident for one of your patients. “Are you the nurse for patient X?” They know, they just want to confirm. “Yes,” you text back. “The patient’s labs weren’t drawn. I’m not sure why it was ordered an hour ago. I need it NOW”. You review your brain sheets again and see that “difficult stick” was scribbled at the corner of the page by the night nurse. You text them back relaying the information, and still, “I need it NOW”.
With the patient load and limited assistance, the unfortunate reality is that “now” tends to be relative. There is so much more than meets the eye. As nurses, our patients are our #1 priority and we will never do anything to delay care. However, there needs to be more situational awareness and grace when it comes to language given to the staff on the floor. They have not walked in your shoes and don’t know the many challenges that are thrown at us. As a new nurse, it can be intimidating to defend yourself and speak up when faced with a miscommunication. Boundaries at work can look and sound different for other people. How can you empower yourself to be an efficient team player while setting important boundaries at work?
Be clear in your communication
When your workload is overwhelming, it may be difficult to clearly and succinctly describe your current situation. For example, if you have an EKG and troponin draw that needs to be done, but you also have another high fall risk patient that is verbally abusive and trying to leave AMA while simultaneously pulling out their IVs, indicate to the team that you have not forgotten but may need a little more time.
Speak up & notify the charge nurse
There may be instances where your communication has been crystal clear but the demands are still being pushed. You've clearly described your situation and still getting significant pushed back. You are only one person and can do so much at one time. If for some reason you feel the language being used against you is inappropriate, feel empowered enough to notify your charge nurse. Your charge nurse is another advocate and resource for you on the floor. They will know what the next steps to take and will be an excellent resource for you.
Delegate when appropriate
There may be times where too much is being asked of you at one time. The field of nursing is a foundationally teamwork-based occupation. When appropriate, ask for help. It may be that you're in a situation that may take longer than anticipated. There are techs, your co-workers, and even the charge nurse that could help you with your tasks.
As a nurse, the challenges we face vary day by day. It’s important that we stand our ground, speak up, and empower yourself to use your resources to be the best nurse you can be.
“For the sick, it is important to have the best”
- Florence Nightingale