Nursing is an incredibly complicated job that combines so may different elements in to a single role. You don’t have to be great at everything, but you have to be a good all-rounder. One thing you can’t be lacking in is team work. Don’t play well with others? Can’t accept help? Don’t seem to be able to find ways to get out of your own way to give some else a hand? You may not cut it as a nurse.
Working in a busy hospital setting can be stressful, it can be busy and sometimes, despite all your best efforts, everything goes to hell and you never get to your break. Or you don’t finish what you were planning to do. Or you miss home time and have to stay back to finish your notes. Or you realise you haven’t been to the toilet for six hours. It happens. When it starts happening all the time, then something is up. When it starts happening to others all the time – you have to start looking at the workplace, the staff and the culture.
A large responsibility falls on senior nurses. Their role is two fold: to lead from the front in setting the tone for teamwork; and to set the example when it comes to self-care. Graduate nurses and students will always look to the example set by the most senior staff on the ward. If you are coordinating a nursing shift, you are often under the pump. Bed managers want you to clear your decks, theatre are always wanting to clear their recovery ward and get patients off their hands, the emergency department are desperate for you to clear their beds, families want information, your boss wants your time and your nurses want leadership. It can be stressful. There is a lot to coordinate. There can feel like no time to think. What there is always time for, is time to help.
The more you can get around your staff, the better. Just because you were in the right place at the right time to score some epaulettes, a red collar or a clipboard doesn’t mean you can’t muck in and help. Your coordinating a shift – you aren’t above helping with the most basic of nursing tasks. I’ve seen Director’s of Nursing treading the lino of a busy hospital in a crisis stripping beds and taking observations. Get over yourself. Where this is critical is when it comes to helping graduate nurses and new staff. Desperate to seem like they are on top of it, they will refuse help or view it as an acknowledgement of their lack of ability. The more normalised helping is, coming form the leaders on a ward, the easier it is for graduates to accept help. This will help them from floundering, build the culture of helping and guide them on what is expected when they aren’t the new graduate.
The next key thing a leader on a ward MUST do is take meal breaks. We’ve all seen coordinators eating al desko while sorting out transfers, paperwork, admissions or the like. That’s great. Its really inspiring to see their dedication. Their refusal to step away from the fray. Their reluctance to hand over the reigns to another profssoinal, to admit that they are expendable to the machinations of the ward. We’ve paid witness their inability to manage their time effectively. Their lack of awareness of OH&S legislation and patiently negotiated Enterprise Bargaining Agreements outlining their entitlements. Their lack of leadership when it comes to setting a correct example in ensuring that you have taken the appropriate steps for maintain your own well-being. We’ve seen them ignore patient safety by taking an allotted break; and fail to show the new nurses and graduates that one of the most important things you can do as a nurse is look after your most important resource – yourself.
Now, if it is UNSAFE to leave your ward environment due to a change in condition, a catastrophe or inappropriate staffing, then you still have a major role to play. You need to call nursing management above you and demand they come and relieve you so that you can take your break. If this is a regular problem due to workload, you need to show leadership and ensure that all nurses working through breaks apply to be paid for that time. Unless you are in a senior hospital management position that prohibits you from leaving the facility during your shift, your break is probably not paid for. Which means it is your time.
Now, if you feel like donating your time to your health service and government department, on top of your contribution through taxes, that is noble – because that is what you are doing. It is also crazy. You are not helping your patients or your fellow staff by not taking a break. If anything, you are undermining them by suggesting they should stay on the ward too, or suggesting they aren’t as “dedicated” as you are. You are also undermining your Enterprise Bargaining Agreement and giving management no reason to improve staffing as you always seem to “manage”. you are cutting your nose off to spite your face. No body likes that.
Taking your breaks and helping other professionals may seem like small things, but when you are working in a high-pressure environment, they mean big things. Helping those around you, if you are a senior nurse or not, helps morale. It helps the professionals around you know that you think beyond your workload, your six patients. It points out that your not so absorbed with your own workload that you can’t lend five minutes to someone to help with a turn or a wash or some post-operative observations. It points out that you are a team player.
On the flip-side – don’t exploit people that do offer you help. I worked a shift recently where I did more work with a group of patients than the nurse that was allocated their care. I wasn’t the only one that noticed this – my fellow colleagues on the shift and the manager did too. Its not a good look. It hinged somewhere between a lack of time management and a keenness to reduce a workload beyond what is reasonable. Don’t be one of those people that refuses to accept help when it is offered – but don’t be one of those people that tries to get others to do the tasks you aren’t that interested in or are less than great. Acting like that puts you well offside with your colleagues to the point that come the day you really need some help, and you are really under the pump – they might just blow you off. Professionally, of course.
The reason it is so important to embed such small concepts in to ever day practice is that in nursing, when things go really bad – they can go REALLY bad. If you’ve got a strong, committed and engaged team that genuinely respects each other; when things go badly, there will be no question that the team will kick in to gear.
When you’ve instilled in all nurses that looking after their own well-being is more important than paperwork or six hourly observations being thirty minutes late – then you’ll have well balanced, well rested, well fed individuals who will work harder and more efficiently because of their breaks, not in spite of them.
When graduates know that taking their coffee break is critical to managing their time, because their supervising nurse does it – they won’t baulk at doing it.They won’t learn the bad habits of eating meals while writing notes or skipping breaks to provide care.
When a nurse knows that they can help a colleague who is under the pump without being exploited, or shooed away – they’ll keep offering.
When everyone is working together and playing on the same team with the same rules, goals and expectations – those busy, pressurised environments become fun, engaging professional challenges.
When you’ve got a great group around you that values team work – you enjoy your shift and have great patient outcomes. There is no place for individuals, egos or selfishness when nursing is a team sport.