Facebook Instagram Twitter YouTube

Barely Swimming: Systemic Burdens that Ravage Nurses

A nurse recounts her daily experiences on the hospital floor.

Kyu Nam

November 21, 2017
Facebook Twitter Share
Image from Readers Digest

The floor is chaos.

Not enough nurses on shift. Julia* called out sick this morning and an RN from 7 West who put in for overtime ended up a no-show. Our manager isn’t around, in a meeting or at lunch after popping in at 10:00 with a dapper “hello” and calling us in for a mandatory 10:30 huddle (in the middle of our biggest medication pass) to tell us about the upcoming Christmas party. We throw each other looks when she mentions the $90 price tag to RSVP. She closes with grand rounds on “fascinating nursing research topics” that we’re all invited to; of course none of us will make it because we will be slaving away on the floor.

11:55: I’m mixing antibiotics for a patient who came in with neutropenic fever overnight. We push them over 2-5 minutes via IV because of a normal saline shortage caused by Hurricane Maria. Several weeks ago, management and infection control informed us that we had to be more sparing with the mini-bags and discontinue all “keep vein open” fluids because major Baxter facilities in Puerto Rico were knocked out by the superstorm.

I pull the antibiotics into a syringe, yellow and foaming, and my mind roves to the next items on my list: notify MD of critical lab for 7A, pull methadone for 7B, find IV pump and hang fluids for 10A, return phone call to 8A family member, find out hemodialysis slot for 8B, make sure 9A is chugging the go-lightly for her colonoscopy (and not pouring it down the toilet), fetch blanket for 9B…

“Shit. Forgot the flush.”

I spin around to grab a 10-cc saline syringe from my cart swoop into the room. Over the next two minutes, I hear about the patient’s work as a massage therapist, her maltese Rick and how she quite enjoys her newfound baldness after her last run of chemo.

Walking out the room, I glance over at my co-worker Elisa, two months into her first nursing job. She looks pale, her lips dry and cracked–dehydrated after 5+ hours without a sip of water. She catches my eye and timidly asks for my help setting up a tube feed. Dammit. To-do list on hold.

“You got all the stuff? Let’s go.”

We grab a few tins of the beige stuff and a new feed bag. The patient is on contact, so we gown up before going in. He’s inaudible after having his voice box removed; a few days ago, he had a mass the size of a golf ball lodged in his throat. I see a marker gripped in his hands and phrases scribbled on a whiteboard resting on his lap: “Soy de Cuba. Dolor. Donde esta el doctor. Llame al Victor.” We hang the feed, label the bags and tubing, show the patient how to swish and spit an anti-fungal and reposition him in bed.

Before leaving, I empty two urinals hanging off the bed rails and call out, “About 725 cc’s, babe. You okay with the rest?” Elisa throws me a grateful look and nods as I rip off the gown and walk out.

What’s next? Oh yeah, page doc.

I stop to pee on the way to the nurses’ station to page the doc. My movements are brisk, mechanical, and measured–nothing extra. I breathe as I relieve myself, Elisa’s stricken face is on my mind.

I feel for her and the newer ones. This is not a place to ask questions and learn. No one is there to guide you gently by the elbow. This is a place to survive, hustle and grind.

Later in the break room, I shared my thoughts with a co-worker who’s been on the unit for over eight years. He shook his head, “I know. I’m barely swimming.”

They say the old eat the young in nursing, but that’s not the whole story.

We depend on each other. When the floor’s empty cuz we’re chronically short staffed, we pair up to do cares, dressing changes, and ambulate patients. When a nurse breaks down sobbing in the supply closet because she feels overwhelmed, we hug her, change her assignment, and say, “You’ll get through this.” When a patient crashes, it’s everyone’s. We depend on each other to eat, sit, stay emotionally intact.

Even still, we end up feeling abandoned or unsupported. The overwhelming demands of the job don’t give us much breathing room to jump in when someone else is in the weeds. It forces us to get tunnel-visioned. We all know teamwork is necessary, but oftentimes we come out looking more like lone wolves calling out into the wild: “Anybody out there? Can someone help me?”

The real beast ripping into our flesh and breaking our backs are the hospitals and healthcare system itself. I reach a point almost every shift where I tell myself, “This is insane. We need more support. I hate this shit.” Probably a useless meditation.

But it boils down to conditions being brutal and unsustainable for nurses. Unlike what they said to reassure us in nursing school, it doesn’t just get easier with experience.

At my last job, I remember coming home with ankles swollen, back and calves throbbing from a night shift of hauling hundreds of pounds in essentially dead weight. We were chronically short of nurses, patient care technicians, housekeeping, clerks – every department was stripped to skeletons. Being a public hospital, I guess we had De Blasio and Cuomo to especially thank for that. I would clock out two, three hours past shift to finish minimal charting for up to 12 patients.

One morning, I bumped into a veteran nurse I knew in the hall. Miss James was old school as old school gets: wore her nurse’s hat, crisp knee-length skirt, white stockings, and Guyanese accent proudly. I floated to her unit a few weeks back and she looked out for me, gave me the code to the bathroom, showed me where they kept the hypos. She wore a mini portable fan around her neck “to keep me cool when it heat up” and carnival beads as a lanyard. Her back was straight as a rod and she stalked through the unit like someone who handled it.

That morning, she looked wrecked. After a tight hug, she looked into my eyes with her tired ones.

“Nam, I can’t do this. This killing me. Eleven patients. It’s getting worse and they don’t care.” She threw a dark look toward the office we just walked out of – the managers sat inside, television on, watching as nursing staff clocked in and out.

*Names and personal details have been altered.

Facebook Twitter Share

Kyu Nam

Kyu Nam is a nurse in New York City. Pictured: Aiko Hamaguchi, Manzanar Relocation Center (Japanese internment camp), 1943.

Labor Movement

“Our Big Push Was for Union Democracy and a Plan to Win”: An Interview with the Amazon Labour Union Democratic Reform Caucus

Two years after the historic victory at JFK8, Amazon workers voted in a referendum in their union. They want to hold new elections and revise the constitution, as part of a struggle to make ALU more democratic and militant. Left Voice spoke with two organizers to discuss the struggle in ALU.

Luigi Morris

March 20, 2024
A banner reads "Real Wages Or We Strike" at a rally for CUNY, which is experiencing cuts from Mayor Eric Adams and Governor Kathy Hochul.

CUNY Faculty and Staff Have Gone One Year Without a Contract — It’s Time to Strike

CUNY workers have been without a new contract for a full year and the university has yet to make any economic offers. It's time to take action.

Olivia Wood

February 29, 2024
Florida governor Ron DeSantis stands at a podium that reds "Higher Education Reform"

U.S. Higher Education Is Being Gutted, but We Can Fight Back

Across the United States, higher education is being gutted through program eliminations and budget cuts. We must prepare to fight these attacks with everything we have.

Olivia Wood

February 28, 2024
CUNY workers at a demonstration hold a banner that reads "STRIKE TO SAVE CUNY."

CUNY Workers Launch New Strike Campaign

As Governor Hochul proposes another $528 million in cuts, workers at the City University of New York are fighting back.

Olivia Wood

February 12, 2024

MOST RECENT

A square in Argentina is full of protesters holding red banners

48 Years After the Military Coup, Tens of Thousands in Argentina Take to the Streets Against Denialism and the Far Right

Tens of thousands of people took to the streets across Argentina on March 24 to demand justice for the victims of the state and the military dictatorship of 1976. This year, the annual march had renewed significance, defying the far-right government’s denialism and attacks against the working class and poor.

Madeleine Freeman

March 25, 2024

The Convulsive Interregnum of the International Situation

The capitalist world is in a "permacrisis" — a prolonged period of instability which may lead to catastrophic events. The ongoing struggles for hegemony could lead to open military conflicts.

Claudia Cinatti

March 22, 2024

Berlin’s Mayor Loves Antisemites

Kai Wegner denounces the “antisemitism” of left-wing Jews — while he embraces the most high-profile antisemitic conspiracy theorist in the world.

Nathaniel Flakin

March 22, 2024

What “The Daily” Gets Right and Wrong about Oregon’s Move to Recriminalize Drugs

A doctor at an overdose-prevention center responds to The Daily, a podcast produced by the New York Times, on the recriminalization of drugs in Oregon. What are the true causes of the addiction crisis, and how can we solve it?

Mike Pappas

March 22, 2024