A Day in the Life of a Registered NursePhew… What a relief! To say registerednurses are busy is a bit of an understatement.

They spend long hours dailydedicating time and effort into their work. The determination is clear withinthe role of a nurse which includes leadership, assessment and treatment, foreach of their patients. Nurses work physically harder than doctors. They areunderpaid and not given the respect they deserve. Finally, they are wonderfulpatient advocates.Nurse leadership assures that everyindividual does their part to get a job done. The individual that is in chargefor the entire nursing team is called the head of nursing, and that individual mustallocate each staff member to a task, they need to ensure that every patienthas received adequate care and debrief every individual on the team. Accordingto the American Nurses Association (ANA) Code of Ethics for Nurses withInterpretive Statement, the nurse is responsible and accountable for individualnursing practice and determines the appropriate delegation of tasks consistentwith the nurse’s obligation to provide optimum patient care (Kelly-Heidenthaland Marthaler, 2005).

Whenthe staff arrive to work, the individual that is in charge has to assign eachnurse to five-six patients and a clipboard (medical chart containinginformation such as: medical history, vital signs, diagnoses, treatment plans,laboratory and test results). Then, the nurse has to go into every patient roomduring morning assessments, set up patients for breakfast, chart (medicalchart), give medications, and assist patients with following out doctor’sorders. Lastly, at the end of the shift the nurse and the nurse in charge mustdebrief the nurse on the oncoming shift. During the handover, the outgoingnurse has to give details of every patient assigned. The handover of eachpatient is generally made up of three sections: Historical information. Thediagnosis of a patient, and information the teams needs to know about thepatient treatment plan. Current information. The condition of each patientduring that time of shift and any changes to their treatment plan.

Futureinformation. For lots of reasons tasks that need to be completed at a certaintime may be handed over to the next shift, simply because the team was unableto complete the task before the end of their shift. Nursing leadership is vitalnot only to the long-term credibility of the nursing practice, but to achievinggood patient and client care and effective nursing leadership is very importantin all nursing role.Clearly, nurse-patient encounter is thefirst encounter between a nurse and patient while assessing that patient. Nurseassessments focus upon the patient response to health problems, perceivedhealth needs, health practices and values. The goal of assessment is thecollection and analysis of data that are used in formatting nursing diagnoses,identifying outcomes and planning care, and developing nursing interventions.Incomplete or inadequate assessment may result in inaccurate conclusions andincorrect nursing interventions. When entering a healthcare facility nurses arethe first person individuals will encounter asking them series of questionswhile checking their vital signs, it may not seem like a lot of work to some,but nurses do assessment from the moment an individual walk through the doorand at the beginning of every shift.

There are three types of assessments carriedout by nurses, comprehensive, focused and an ongoing assessment.  Firstly, the nurse must perform acomprehensive assessment which is completed upon admission to a healthcareagency. This assessment includes assessing the physical, emotional and mentalaspects of all body system as well as the environment and social issuesaffecting the patient. Next, a focused assessment, this assessment collectsdata about a problem that has already been identified. This assessment has anarrower scope and a shorter time frame than the initial assessment, the nurse determineswhether the status of the problem has change (improved, worsened, or resolved).

Finally, an ongoing assessment which is a systematic follow-up when problemsare identified during a comprehensive or focused assessment. This assessmentincludes the nurse doing systematic monitoring and observing related specificproblems, it also allows nurses to broaden the database or confirm the validityof the data obtained during the initial assessment (Daneils, 2004). “Themost important practical lesson that can be given to nurses is to teach themwhat to observe- how to observe-what symptoms indicate improvement- what thereverse- which are of importance-which are of none-which are the evidence ofneglect- and of what kind of neglect. All this is what ought to make part, andan essential part, of the training of every nurse” (Nightingale, 1860/1969,p.105).  Nurses provide care based on patient needs,working along with doctors to formulate a care plan.

The nurse providespsychological support to clients with terminal illness. In addition, throughthe assessment process nurses individualized priority-setting, priorities willbe influenced based on the patient’s condition and the intensity of nursingcare required by a patient. Priority ranking of patients are characterized intothree levels: First level is where they treat patients with immediate survival,safety and high demand. Second level highlight concerns such as mental statuschange, acute pain, acute urinary elimination, abnormal pathology lab results,risk of infection and safety. Third level is where those that do not fit intothe above categories. If there are no life-threatening situations, nurses usedprofessional judgment to set priorities and planning.

“Prioritization isdefined as deciding which needs or problems require immediate action and whichones could be delayed until a later time because they are not urgent” (LaCharity,Kumagai, and Bartz, 2006, p.4)Critical thinking skills is the core ofbeing a good nurse, in addition, they use these skills to provide effectivecare while coping with the expansion in roles associated with the complexitiesof current health-care systems. Nurses use critical thinking skills to preventmedication error. In fact, they think in a systematic and logic manner withopenness to questions and reflect on reasoning to ensure safe nursing practiceand quality care. Every day, nurses make decisions through critical thinking.Critical thinkers are people who know how to think. They possess intellectualautonomy, in fact they refuse to accept conclusions without evaluating thefacts and reasons for themselves.

Critical thinking is process that allowsnurses to see the big picture instead of focusing only on details. Furthermore,nurses must administer numerous drugs daily in a safe and efficient manner.They administer drugs according to the nursing standards of practice and agencypolicy. Before administering any medication, the nurse must compare themedications listed on the Medication Administration Record (MAR), otherrecording forms, or computer orders with the healthcare practitioner’s order.

Whenadministering medication, the nurse must check the label when removing the drugcontainer from the drawer, check the drug when removing it from the containerand before returning it to the patient’s medication drawer. The nurse shouldgive only medication that they prepared and checked, because they are theresponsible party should an error occur.As a result, long hours and dedicated timespent by nurses are their daily work routine. Everyone has a common goal, butthe nurses are not being recognized for their hard work. They deserve the samerecognition as doctors because nurses are the center of healthcare. Societythink so little of nurses, but at the same time doctors rely on them so much.Doctors will see a patient anywhere from five to thirty minutes a day dependingon how sick they are, and the rest of the work are left to the nurses.

They arethe ones making sure patients get their pills, check their vital signs toensure they do not drop, make sure patients do not fall and break something. Ifa patient vomits, doctors will run out of the room while a nurse rushes in. Theychange patients wound dressings and start their IV line. They will cleandisgusting things off patients even if they are drunk, delirious or mean andthrough all of this they try to be friendly and positive.

To say registerednurses are busy is a bit of an understanding. The determination is clear withinthe role of a nurse which includes leadership, assessment and treatment, foreach of their patients.                   References   Daniels, R. (2004). Nursing fundamentals: caring & clinical decision making.

New York, NY: Thomson Delmar Learning. Delaune, S. C. & Ladner, P.K. (2002).

Fundamentals of nursing: Standards & practice (2nd ed.).              Albany, NY: Thomson Delmar Learning. Kelly-Heidenthal, P., & Marthaler, M.T.

(2005) Delegation of nursing care. Clifton Park, NY:               Thomson Delmar Learning. LaCharity, L.A., Kumagai, C.K.

, & Bartz, B. (2006) Prioritization, delegation, and assignment:               Practice exercise for medical-surgical nursing. St.

Louis, MO: Mosby Elsevier. National League of Nursing. (1997). Interpretive guidelines of standards and criteria 1997:              Baccalaureate & higher degree. New York: National League for Nursing Accrediting             Commission.

Nightingale, F. (1860/1969). Notes on nursing: What it is and what it is not. New York: Dover.


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