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Why Are Healthcare Workers So Tired? The Exhaustion No One Sees · Banter At The Bedside

• 0:06
  SPEAKER_00: Hey everyone, and welcome back to Bantuette's Bedside.
• 0:10
  SPEAKER_00: This week we're coming at you with a bit of a mini episode.
• 0:13
  SPEAKER_00: It's just me, Abby, one of your main co-hosts, a nurse practitioner of eight years, and Kaylee, our other main co-host, an ICU nurse of 18 years.
• 0:24
  SPEAKER_00: Hey everybody, welcome back.
• 0:26
  SPEAKER_00: We're giving the rest of our group some time off for the summer.
• 0:30
  SPEAKER_00: And so it's just gonna be us two for this week.
• 0:33
  SPEAKER_00: And we decided to talk about why we are so tired.
• 0:36
  SPEAKER_00: But before we dive into that, let's get through our disclaimers.
• 0:40
  SPEAKER_00: As always, this is not medical advice.
• 0:42
  SPEAKER_00: Please seek the care of your own medical professional.
• 0:45
  SPEAKER_00: All of our thoughts and opinions are our own.
• 0:47
  SPEAKER_00: We don't represent any entity at all.
• 0:50
  SPEAKER_00: This is for entertainment purposes only.
• 0:52
  SPEAKER_00: And we are recording from the safety of our own home because we are tired.
• 1:01
  SPEAKER_00: Normally, you know, Kaylee, I have my like banter at the bedside mug or the mug that you got me.
• 1:06
  SPEAKER_00: But today I switched it to my alpaca mug, and it says, A wise woman once said, F it, I'm getting an alpaca, and she lived happily ever after.
• 1:17
  SPEAKER_00: I love that.
• 1:18
  SPEAKER_00: And I feel like that that's the mood of today's episode.
• 1:22
  SPEAKER_00: Like, why are we so tired?
• 1:24
  SPEAKER_00: Why do we all just want to be like, I'm done.
• 1:26
  SPEAKER_00: Bye.
• 1:27
  SPEAKER_00: It's a good one.
• 1:27
  SPEAKER_00: It's a great one.
• 1:28
  SPEAKER_00: I think a lot of people can relate.
• 1:30
  SPEAKER_00: Let me just go have my alpaca farm and I'll make some wool and knit some things.
• 1:34
  SPEAKER_04: Yeah.
• 1:35
  SPEAKER_04: Yeah, you definitely could.
• 1:36
  SPEAKER_04: I don't know.
• 1:37
  SPEAKER_04: I'll dig stuff or something, whatever the manual labor is involved.
• 1:41
  SPEAKER_04: I don't know.
• 1:42
  SPEAKER_04: I'll dig stuff.
• 1:44
  SPEAKER_04: Yeah.
• 1:44
  SPEAKER_04: Be a farmhand.
• 1:46
  SPEAKER_04: You can help me with my yarn.
• 1:48
  SPEAKER_03: Yeah.
• 1:48
  SPEAKER_03: I don't get it.
• 1:49
  SPEAKER_03: Like, why why are healthcare workers so tired?
• 1:52
  SPEAKER_00: What's what's the deal?
• 1:54
  SPEAKER_00: I mean, it's so multifactorial, but I just feel like it's just constant for me.
• 2:00
  SPEAKER_00: Like, I don't know about you, but sometimes just driving home, just the silence is all I need.
• 2:07
  SPEAKER_00: And everyone's always on me about my hour commute, and they're like, I can't believe you do it.
• 2:12
  SPEAKER_00: How do you do it?
• 2:14
  SPEAKER_00: I couldn't do it.
• 2:14
  SPEAKER_00: And I'm like, I'm telling you, that hour after a long shift sometimes is like the most peaceful thing.
• 2:21
  SPEAKER_00: Like, I I drive home in silence a lot.
• 2:25
  SPEAKER_00: Because all day it is just stimulation, questions, buzzing, beeping, phone calls, alarms, like it is nonstop.
• 2:35
  SPEAKER_00: And getting into my car and having the silence.
• 2:38
  SPEAKER_00: I'm just like, this is so peaceful.
• 2:40
  SPEAKER_00: Complete silence.
• 2:41
  SPEAKER_00: Complete silence.
• 2:43
  SPEAKER_04: Ooh, that I rarely do that.
• 2:45
  SPEAKER_04: When I do that, it's been a day for sure.
• 2:48
  SPEAKER_04: Which I don't have the hour commute, but dang.
• 2:51
  SPEAKER_04: When when we were talking about this idea, one of the first things that I thought about, which I think probably a lot of nurses will relate to if you work in the hospital, but Abby is like, talk about why we're so tired.
• 3:01
  SPEAKER_04: And it's like that phrase that everybody will always say, like, I don't get it.
• 3:04
  SPEAKER_04: You only work three days a week.
• 3:06
  SPEAKER_04: Why are you why are you so tired?
• 3:08
  SPEAKER_04: Like, why can you not get up?
• 3:10
  SPEAKER_04: I don't get it.
• 3:11
  SPEAKER_04: And it's like that buzz phrase or buzzword that everybody will just be like, immediately set you off.
• 3:16
  SPEAKER_04: If you're a nurse or somebody who works shift work, maybe.
• 3:20
  SPEAKER_04: Oh yeah.
• 3:20
  SPEAKER_00: And the it's only three shifts.
• 3:23
  SPEAKER_00: Okay.
• 3:24
  SPEAKER_00: I like to like when people say this to me, I'm like, but you don't get it.
• 3:28
  SPEAKER_00: One, when you hit eight hours, like we all have that like three, it's literally like three o'clock clock lull.
• 3:36
  SPEAKER_00: Like you walk around the unit and everyone is like, we need coffee, we need caffeine, we need to go for our afternoon walk, like I need a break.
• 3:46
  SPEAKER_00: Like you hit that eight hours and it is done so.
• 3:51
  SPEAKER_00: Actually, there's a study.
• 3:55
  SPEAKER_00: I'm shocked.
• 3:57
  SPEAKER_00: Are you shocked?
• 3:58
  SPEAKER_00: No.
• 3:59
  SPEAKER_00: It was it was done.
• 4:00
  SPEAKER_00: It's old, it's old, but it was done years ago.
• 4:03
  SPEAKER_00: And they looked at it at nurses on these 12-hour shifts, and it was like after eight hours, between eight between hours eight and ten, the exhaustion from that is the same as if someone drank one beer.
• 4:19
  SPEAKER_00: And then between hours 10 to 12, that exhaustion that nurses have is the same as if you drank two beers.
• 4:27
  SPEAKER_00: So like people just don't it the exhaustion of it is so tiring.
• 4:32
  SPEAKER_00: But also on top of that, when people are like, it's just three days, yeah.
• 4:36
  SPEAKER_00: But I can't leave the unit and I can't leave the hospital to do other things.
• 4:41
  SPEAKER_00: So like normal businesses, like or normal jobs, like people step out for an hour and go to the dentist and come back.
• 4:48
  SPEAKER_00: Like people go and run an errand quick.
• 4:51
  SPEAKER_00: But when you're getting to the hospital at 7 a.m.
• 4:54
  SPEAKER_00: and you can't leave until 7 p.m., you don't get a doctor's visit in that day.
• 4:58
  SPEAKER_00: You don't really get to run any errands.
• 5:00
  SPEAKER_00: Maybe you can do a grocery pickup after work.
• 5:02
  SPEAKER_00: So it's like, yeah, it's only three days, but then on my days off, I'm having to do everything that other people do on a work day.
• 5:12
  SPEAKER_00: And so it's just like you don't really get like a day off because you can't sprinkle things in the same way.
• 5:19
  SPEAKER_04: Yeah.
• 5:20
  SPEAKER_04: And there's, you know, we've talked about this before.
• 5:22
  SPEAKER_04: There's pros and cons.
• 5:23
  SPEAKER_04: Yeah.
• 5:24
  SPEAKER_04: Your day off is at least like in the middle of the week when everybody else is still working.
• 5:29
  SPEAKER_04: So when you are cramming it all in, usually it's a little bit easier than on the weekend when everybody's going to the grocery store or something.
• 5:35
  SPEAKER_04: Right.
• 5:36
  SPEAKER_04: This is not a competition, everybody.
• 5:37
  SPEAKER_04: We're we're not sitting here saying our job's worse than yours.
• 5:39
  SPEAKER_04: We're just explaining our perspective for people who can't who can't understand.
• 5:43
  SPEAKER_04: Let's say okay, your sit your shift is seven to seven.
• 5:46
  SPEAKER_04: You're not getting there at seven because you have to clock in by six forty-five or whatever it is.
• 5:52
  SPEAKER_04: And to do that, you have to get to your parking spot, which might be a long ways away by I mean, six thirty, six thirty-five, depending on how fast you walk.
• 6:01
  SPEAKER_04: So then even if you live in town, you gotta leave your house by probably six fifteen.
• 6:06
  SPEAKER_04: So your 12-hour shift has already turned into a 13-hour shift immediately right there.
• 6:13
  SPEAKER_04: Then there's no guarantee you'll get out on time.
• 6:15
  SPEAKER_04: If you've had a hard day, you might have to finish up some stuff.
• 6:18
  SPEAKER_04: You might have a long report, then go back and chart.
• 6:20
  SPEAKER_04: Then you're walking back out.
• 6:21
  SPEAKER_04: So sometimes you might not leave until 7:30.
• 6:25
  SPEAKER_04: You're not getting home till eight.
• 6:26
  SPEAKER_04: So it stacks up.
• 6:27
  SPEAKER_04: Okay.
• 6:28
  SPEAKER_04: So, and even on a good day, you're still probably going to be gone from your house for 13 hours, right?
• 6:33
  SPEAKER_04: Best case scenario.
• 6:34
  SPEAKER_04: And if you commute, I mean, even more than that.
• 6:37
  SPEAKER_04: And then if you're doing those three days in a row, maybe like a lot of people like to space them out.
• 6:41
  SPEAKER_04: A lot of people like to do them back to back times three, right in a row.
• 6:44
  SPEAKER_04: And then you're talking about in your afternoon, you're as tired as you would have been if you were drinking.
• 6:49
  SPEAKER_04: Mm-hmm.
• 6:50
  SPEAKER_04: That first day off, it's like I am hungover.
• 6:53
  SPEAKER_04: Like, oh yeah.
• 6:54
  SPEAKER_04: Physically and mentally, I do feel like I have been partying or beat down or something.
• 6:59
  SPEAKER_04: It's like getting up is an effort.
• 7:01
  SPEAKER_04: And then physically getting up and getting my brain to work is like a whole other thing.
• 7:05
  SPEAKER_04: So maybe you maybe you take that day and you're like, I'm just gonna lay.
• 7:08
  SPEAKER_04: I'm just gonna lay here.
• 7:09
  SPEAKER_04: I'm not gonna do anything.
• 7:10
  SPEAKER_04: So then you do cram it all into one other day.
• 7:13
  SPEAKER_04: And that's maybe if you're single and young.
• 7:17
  SPEAKER_00: Don't have kids.
• 7:18
  SPEAKER_00: Don't have kids or other responsibilities.
• 7:20
  SPEAKER_00: Like when I lived alone, I don't have kids.
• 7:24
  SPEAKER_00: But when I lived alone doing the nurse schedule, it was so much easier because I wasn't like sharing the space or had other responsibilities.
• 7:32
  SPEAKER_00: Like I could just feel like I could lay and binge watch TV all day and it didn't really matter because if the dishes weren't done, it only affected me.
• 7:43
  SPEAKER_00: But once you add other life things in, especially kids who are dependent on you and you have to do everything for them for a long time, like I can't imagine like just zero days off, zero breaks.
• 7:58
  SPEAKER_00: Yeah.
• 7:58
  SPEAKER_04: Yeah.
• 7:59
  SPEAKER_04: Um, so you know, it's just like the schedule itself, it's only three days a week, but it's a full-time, so like if you work five days a week and you're working 40 hours, we're essentially working 40 hours just condensed into a certain smaller, you know, window of time.
• 8:13
  SPEAKER_04: Yeah.
• 8:15
  SPEAKER_04: Which does have its benefits, like we've said, but it does make for very long exhausting days just from the amount of time itself.
• 8:24
  SPEAKER_04: We're not even talking about the actual job, right?
• 8:27
  SPEAKER_04: But the actual work.
• 8:28
  SPEAKER_04: Um, so it's just something to keep in mind, like when you have maybe a friend or a family member and you're you're like, you don't get it, like just if you can just start thinking about that in and of itself, it might you know some clarity.
• 8:42
  SPEAKER_00: Not yeah, not even touching on like the work itself that we're doing, but just like uh like how uncomfortable it is.
• 8:50
  SPEAKER_00: Like you can't you have two options in terms of like how to sit at or like how to get comfortable at work.
• 8:58
  SPEAKER_00: You're standing and you're walking, or you're sitting in an office chair.
• 9:02
  SPEAKER_00: And that's it.
• 9:03
  SPEAKER_00: Like there's no couch to put your feet up on, there's no bed to go and take like a quick nap in like the the physicians have an on-call room.
• 9:12
  SPEAKER_00: Me as a nurse practitioner, I don't have an on-call room, but like the physician the physicians do, but even like on our team on day shift, we have two physicians and they have one bed.
• 9:23
  SPEAKER_00: So like the can't what are they going to do?
• 9:25
  SPEAKER_00: Bunk up, like there's nowhere, like I get so physically uncomfortable because humans, this is evidence as well.
• 9:35
  SPEAKER_00: Humans were not meant to sit as much as we do.
• 9:38
  SPEAKER_00: We're supposed to be either standing and walking or laying.
• 9:41
  SPEAKER_00: Sitting really isn't how our bodies are made.
• 9:44
  SPEAKER_00: So that's why like we have all of these chair, like all the office people.
• 9:48
  SPEAKER_00: Now I know you guys are sitting in those chairs and you feel us on that.
• 9:52
  SPEAKER_00: Oh, yeah.
• 9:53
  SPEAKER_00: But that's tough.
• 9:54
  SPEAKER_00: I mean, yeah, sitting on to sit at your computer all day is not comfortable.
• 9:59
  SPEAKER_00: So I mean, there's also just like that.
• 10:01
  SPEAKER_00: Like there's it's just 12 hours of I can't get comfortable.
• 10:05
  SPEAKER_00: Yeah.
• 10:06
  SPEAKER_00: Oh my god.
• 10:06
  SPEAKER_00: My little my little legs dangle all day in these chairs because they're so high and I can't touch the ground.
• 10:13
  SPEAKER_00: Oh my god.
• 10:14
  SPEAKER_03: Poor that's poor Abby.
• 10:16
  SPEAKER_03: She's too short.
• 10:17
  SPEAKER_00: I'm too short.
• 10:19
  SPEAKER_00: Look, this is the struggle that I have every shift.
• 10:22
  SPEAKER_00: This is maybe why I'm like, I can't get comfortable at work and it sucks.
• 10:27
  SPEAKER_00: Because either I raise the chair so my arms can rest on the desk so I can type appropriately, or I have to lower the chair so my feet can touch the ground, and then my arms are like little T-Rex arms onto the desk.
• 10:42
  SPEAKER_00: That's that's tough.
• 10:44
  SPEAKER_00: So my little legs, my little legs stankle all day, and that's why I wear Converse because it's like the lightest shoe I can find that I can wear for 12 hours.
• 10:55
  SPEAKER_04: Yeah, I mean, we finally got some new chairs at work because for a while there, every time you sat down, I felt like it was a 50-50 chance of you're getting knocked back, it might break.
• 11:05
  SPEAKER_04: No armrests, no armrests, chairs cracked, won't go up and down, which I mean generally I don't get to sit down for long periods of time, I think, um, as a bedside nurse.
• 11:16
  SPEAKER_04: But when I do, I don't like that either.
• 11:18
  SPEAKER_04: I mean, it's not none of it.
• 11:20
  SPEAKER_04: Like you said, none of it's good for your back and your posture.
• 11:22
  SPEAKER_04: It needs to be mixed up.
• 11:23
  SPEAKER_04: And it's not like we're just getting steps in for the sake of it at work.
• 11:27
  SPEAKER_04: Like if I'm getting my steps in, I'm walking, it's because I'm pushing a bed somewhere, probably with a patient in it and a bunch of stuff attached to it.
• 11:34
  SPEAKER_04: And when I'm standing, standing and like standing over the bed or over the patient, which you have to do it, but like it wears and tears on you.
• 11:43
  SPEAKER_04: You know, you go home and you're a young person, even if you're like 20 or something, you're like, my back's my neck hurts, my knees hurt, my feet hurt.
• 11:50
  SPEAKER_04: Because I just stood there all day.
• 11:52
  SPEAKER_04: Yeah.
• 11:52
  SPEAKER_04: It's like I just stood there over the patient's bed like all day, you know, doing whatever.
• 11:57
  SPEAKER_04: But yeah, it's not a comfortable place.
• 12:00
  SPEAKER_04: And even if you go take your break and you actually get a break where someone is watching your patients, you don't feel like you can get comfortable.
• 12:08
  SPEAKER_00: No.
• 12:08
  SPEAKER_00: You know?
• 12:09
  SPEAKER_00: I don't anyways.
• 12:11
  SPEAKER_00: I also I also feel like there's no like at work I'll have the wicked song like the or not the wicked song, uh, but I'll be like, there's no rest for the wicked.
• 12:23
  SPEAKER_00: Like you just even when you get you go on break, like you're so focused in on your patients that if they're not doing well, like you're not actually resting.
• 12:34
  SPEAKER_00: And for me, I'm such a control freak, like, especially when it comes to my patients.
• 12:39
  SPEAKER_00: Not that I'm like controlling my patients, but I don't like I never like other people to do my stuff.
• 12:47
  SPEAKER_00: Like no offense, but you're just not going to do it the way that I want you to do it.
• 12:53
  SPEAKER_00: And I appreciate people yeah, and like I appreciate the help, but like, or the attempt at help, but like just don't go in my room.
• 13:00
  SPEAKER_00: So when I was a bedside nurse, it was like like my breaks were pretty non-existent because I'd be like you're gonna touch my pump.
• 13:10
  SPEAKER_00: I don't want you touching my pump.
• 13:12
  SPEAKER_00: Yeah, yeah.
• 13:13
  SPEAKER_04: I mean, if if my patients are fine, that's one thing.
• 13:16
  SPEAKER_04: They're if they're if they're not doing good, I'm not gonna go take a break.
• 13:20
  SPEAKER_04: I can't I mean you just can't.
• 13:23
  SPEAKER_04: If they're one of those ones where I'm like, I just something don't feel right, sometimes even then, I'm like, I don't want to go because that's when something's gonna happen.
• 13:31
  SPEAKER_04: But yeah, your breaks are not always breaks at the hospital.
• 13:35
  SPEAKER_04: So maybe it's different if you work in a doctor's office where like the whole place closes from 12 to 1 or something.
• 13:41
  SPEAKER_04: That would be awesome.
• 13:45
  SPEAKER_04: Um, and then if you are, say, like having a break in like a common area and you do like I'm gonna put my feet up for a minute because my legs hurt.
• 13:52
  SPEAKER_04: If somebody sees you, oh that lazy nurse sitting there with her feet up on a brain.
• 13:59
  SPEAKER_04: That there's no work ethic.
• 14:01
  SPEAKER_04: It's like it's like that TikTok I made about like the nurses just sitting at the desk and it's like this never stops.
• 14:08
  SPEAKER_00: It never stops.
• 14:09
  SPEAKER_00: And I also feel like when people sometimes come online and they're like, they're out there laughing, and it's like, like, yeah, like that.
• 14:18
  SPEAKER_00: I yeah, like you, you have no, there's so much context, and like that's why I really like our section on like real versus real, and really what inspired it was like when people are filming us and then they put it online because of HIPAA laws, like none of those healthcare workers can come on and provide additional context to the situation.
• 14:40
  SPEAKER_00: Are healthcare workers always right?
• 14:42
  SPEAKER_00: Absolutely not.
• 14:43
  SPEAKER_00: Are there bad ones out there?
• 14:44
  SPEAKER_00: Absolutely.
• 14:45
  SPEAKER_00: Are there times that those videos being put online are probably justified?
• 14:49
  SPEAKER_00: Yes, not arguing any of that, but there's also times when there is pro I'm guessing that there's a lot of context missing.
• 14:58
  SPEAKER_00: And sometimes as healthcare workers, we can read into it.
• 15:01
  SPEAKER_00: But yeah, I just like when we even do get like that moment of like getting to laugh and giggle and have a little bit of fun.
• 15:09
  SPEAKER_00: I do feel like sometimes people take it away.
• 15:11
  SPEAKER_00: It's like we're human, we're human too.
• 15:14
  SPEAKER_00: Yeah.
• 15:15
  SPEAKER_04: It really online, it does seem to be a thing that people really hate to see healthcare workers or and nurses.
• 15:24
  SPEAKER_04: When I say nurses, I just mean anybody out there at the nurse's desk.
• 15:27
  SPEAKER_04: You know, it could be anybody hate to see us laughing.
• 15:30
  SPEAKER_04: They it really does seem to hit some nerve that we are laughing.
• 15:35
  SPEAKER_04: It's I guess because they feel like, you know, they're here and they're sick and they're having like a terrible day.
• 15:40
  SPEAKER_04: But we're here all day long.
• 15:41
  SPEAKER_04: Like you said, it's just like we get a chance to something good, or maybe it's not good, and we're just let me laugh because this is all this whole day has been awful.
• 15:50
  SPEAKER_04: And what else can I even do?
• 15:51
  SPEAKER_00: Yeah.
• 15:52
  SPEAKER_00: Right.
• 15:52
  SPEAKER_00: People, it really does seem to bother people.
• 15:54
  SPEAKER_00: It really does.
• 15:55
  SPEAKER_00: And that in itself is exhausting.
• 15:58
  SPEAKER_00: And I think, well, I do believe that like having positive online communities where we can come together and resonate together and be like, yes, I experience that too, which is like, you know, what you and I are trying to do here, that's helpful and that's been shown to help burnout for um healthcare workers.
• 16:16
  SPEAKER_00: What doesn't help and what contributes to my tiredness is when I am, you know, doom scrolling because I do it too.
• 16:24
  SPEAKER_04: Yeah.
• 16:24
  SPEAKER_00: When I'm doom scrolling and then I see people just like bashing healthcare workers for no for like laughing, and it's just like Yeah.
• 16:33
  SPEAKER_04: And I do it, it does give me like a little bit of peace when I go through the comments, and it's not just healthcare workers defending us.
• 16:43
  SPEAKER_04: It's yeah, you know, everyday people being like, you should be ashamed, or they there's nothing wrong with that, and they're people too.
• 16:51
  SPEAKER_04: Um, but yeah, it can be very dis disheartening.
• 16:54
  SPEAKER_04: Is it just me or does it always seem to be in an emergency room?
• 16:56
  SPEAKER_04: It does.
• 16:57
  SPEAKER_04: It does, which is really just not a good snapshot of what it's like to be a patient in the hospital.
• 17:02
  SPEAKER_00: No.
• 17:03
  SPEAKER_00: And I also feel for the emergency room staff because like you don't have the time down there to bond with the patients like we do.
• 17:12
  SPEAKER_00: Like, and I feel like that that does help us on the inpatient side and maybe why there aren't so many inpatient videos, because it's like, ooh, I I actually really, really, I really like this one nurse.
• 17:27
  SPEAKER_00: So I might not post it online.
• 17:29
  SPEAKER_00: Instead, I'm going to if if I don't like this person, I'll just file a report quietly.
• 17:36
  SPEAKER_00: I don't know.
• 17:37
  SPEAKER_04: That's how I think part of it's the setup.
• 17:39
  SPEAKER_04: They're all in like, well, hopefully in a room or they have a curtain.
• 17:42
  SPEAKER_04: And I don't even know where the nurse's desk is in the emergency department, honestly.
• 17:46
  SPEAKER_04: They probably don't ever sit down.
• 17:48
  unknown: No.
• 17:48
  SPEAKER_04: But in a in a regular inpatient, most of the time you can see like a desk somewhere, whether it's central or like in a pod, and you can see like the staff.
• 17:57
  SPEAKER_04: So I feel like you can see your nurse and your care partner and the doctors like walking back and forth, zooming back and forth.
• 18:02
  SPEAKER_04: Maybe the setup is different in the ED.
• 18:05
  SPEAKER_04: But yeah, I always feel bad.
• 18:06
  SPEAKER_04: I'm like, these people can't catch a break.
• 18:09
  SPEAKER_04: And truly, like the stuff that they're doing, if you can't find them, like in these traumas, I'm like, if you're able to put this video up, you're probably fine.
• 18:18
  unknown: Yeah.
• 18:18
  SPEAKER_04: Not saying that you don't need to be there, not saying that you don't deserve your treatment.
• 18:24
  SPEAKER_04: Context can be everything.
• 18:26
  SPEAKER_04: And you can context can be everything.
• 18:28
  SPEAKER_00: And you don't know, even if you are in the ED and you're like, you think you know what's going on with the patient, you just don't know.
• 18:36
  SPEAKER_00: And we see that sometimes on our unit where Or you're just choosing to ignore the context.
• 18:42
  SPEAKER_00: People choose to ignore the context.
• 18:44
  SPEAKER_00: Like you see the code cart, like you see the code card, and you're coming and you're walking into this room and you see us doing chest compressions, and you're walking into the room asking for a glass of water.
• 18:55
  SPEAKER_00: True story.
• 18:56
  SPEAKER_00: True story.
• 18:57
  SPEAKER_03: Literally true.
• 18:58
  SPEAKER_00: Literally true on multiple times.
• 19:00
  SPEAKER_00: Multiple times, not single occasion, multiple times.
• 19:04
  SPEAKER_00: Can I get a cup of water?
• 19:06
  SPEAKER_00: Yeah.
• 19:06
  SPEAKER_00: When when we're done here, and that's yeah what is tiring is and it's never the patient.
• 19:15
  SPEAKER_00: It's never the patient.
• 19:17
  SPEAKER_00: It's never the patient.
• 19:19
  SPEAKER_04: Enrages me.
• 19:20
  SPEAKER_04: Honestly.
• 19:21
  SPEAKER_04: I'm always on the cart because nobody wants to run the cart or record.
• 19:25
  SPEAKER_04: So I do feel like you know, like that has happened a lot because a lot of times I end up like out by the cart or whatever.
• 19:32
  SPEAKER_04: Yeah, people walk up and there's like, I know you're busy.
• 19:35
  SPEAKER_04: And it's like, honestly, I know this is terrible.
• 19:37
  SPEAKER_04: Probably people are gonna judge me.
• 19:38
  SPEAKER_04: Sometimes I literally won't acknowledge them.
• 19:40
  SPEAKER_04: I don't care if they're talking to me one foot from my face.
• 19:43
  SPEAKER_04: Because you're number one, you're fine.
• 19:45
  SPEAKER_04: Number two, like, how dare you?
• 19:48
  SPEAKER_04: Like, are you fing kidding me?
• 19:51
  SPEAKER_04: Right.
• 19:51
  SPEAKER_04: Somebody is literally dead, and we are trying to save their life.
• 19:56
  SPEAKER_04: So I just won't even look at them.
• 19:58
  SPEAKER_04: So I act like I don't hear them.
• 20:00
  SPEAKER_04: And if they persist, I'll be like, no.
• 20:02
  SPEAKER_04: Somebody I'll check on you in a little bit.
• 20:03
  SPEAKER_00: One of, you know, you reach a certain age and you kind of get to say whatever you want without people really making a big fuss about it.
• 20:13
  SPEAKER_00: And the first time that I ever experienced that situation as a nurse practitioner, one of our very, very senior nurses just the family came in and was asking for water.
• 20:25
  SPEAKER_00: And she just looked and was like, sure, let me stop saving this man's life to get you some water.
• 20:34
  SPEAKER_00: And I was just like, did she just did she just say that?
• 20:38
  SPEAKER_00: And I was like, I mean, you're not wrong.
• 20:43
  SPEAKER_04: Like, you want people to get his water.
• 20:47
  SPEAKER_04: I do.
• 20:48
  SPEAKER_04: Right.
• 20:49
  SPEAKER_04: But literally, life and death, like, come on.
• 20:53
  SPEAKER_04: It's insane.
• 20:53
  SPEAKER_04: And I think that there are people who are gonna hear this and still be like, they're being dramatic.
• 20:57
  SPEAKER_04: Nobody did that.
• 20:58
  SPEAKER_04: I'm like, no, they do.
• 20:59
  SPEAKER_04: That's why it's so bad because you can't imagine that because you're like a normal person.
• 21:04
  SPEAKER_04: And it happens a lot.
• 21:07
  SPEAKER_04: So much.
• 21:09
  SPEAKER_04: Even when there's not a crash cart per se.
• 21:12
  SPEAKER_04: But you I think most people can tell when people are like tense and something's going on.
• 21:16
  SPEAKER_04: If there's a lot of people kind of moving fast and lots of alarms, and there's you know, you see everybody on their phone, and there you can still tell that there is something.
• 21:24
  SPEAKER_04: And you know, because people are how they are, they'll like look in, yeah, they'll walk by and look in like it's a show or something.
• 21:30
  SPEAKER_04: And then they'll still decide to go ahead and ask that question.
• 21:34
  SPEAKER_04: And it's like, no, I don't have time.
• 21:37
  SPEAKER_04: Hit the call bell, or or sometimes I'll just close their door.
• 21:39
  SPEAKER_04: I'm like, no.
• 21:42
  SPEAKER_00: Like this it just it really does my mind.
• 21:47
  SPEAKER_00: I do um I have one time where I I reflexed a little bit role, and it was another one of these situations in the family.
• 22:00
  SPEAKER_00: Went into other patients' rooms during emergencies to ask for not important stuff.
• 22:05
  SPEAKER_00: So I went over with the attending physician as well, and I said, you can't keep doing this.
• 22:12
  SPEAKER_00: It's not appropriate.
• 22:13
  SPEAKER_00: It's not safe.
• 22:14
  SPEAKER_00: And it's not fair to those patients.
• 22:16
  SPEAKER_00: One family actually was very upset about it and filed a complaint that we allowed it to happen, which I under also understood.
• 22:24
  SPEAKER_00: And I just was like, I was like, you can hit the call bell if you need something.
• 22:29
  SPEAKER_00: Call bell?
• 22:30
  SPEAKER_00: What?
• 22:31
  SPEAKER_00: I've never heard of a callbell.
• 22:33
  SPEAKER_00: And I said, I was like, it's right here and here.
• 22:36
  SPEAKER_00: They're like, I didn't know that this was a thing.
• 22:38
  SPEAKER_00: I was like, well, Florence Nightingale invented the callbell, actually.
• 22:43
  SPEAKER_00: And I can see that you're here.
• 22:45
  SPEAKER_00: So your mother at least has been in the hospital for giving birth.
• 22:49
  SPEAKER_00: So like I think you know what a call bell is.
• 22:51
  SPEAKER_00: You're choosing not to use it.
• 22:53
  SPEAKER_00: The nurse button.
• 22:54
  SPEAKER_00: They know what it is.
• 22:55
  SPEAKER_00: Oh, I know.
• 22:56
  SPEAKER_00: And he he was flabbergasted.
• 22:58
  SPEAKER_00: I didn't know when was this invented?
• 23:00
  SPEAKER_00: Florence Nightingale.
• 23:01
  SPEAKER_00: Literally, Florence Nightingale invented what became the callbell.
• 23:05
  SPEAKER_00: A callbell system.
• 23:06
  SPEAKER_00: And it's on the sign in the room.
• 23:09
  SPEAKER_04: I'm like, what?
• 23:12
  SPEAKER_04: That says P now this is not the majority of people.
• 23:17
  SPEAKER_04: No.
• 23:18
  SPEAKER_04: Yeah.
• 23:18
  SPEAKER_04: No.
• 23:18
  SPEAKER_04: I can I can stand with that family who filed the complaint of like these people are coming into my family member's room during this emergency.
• 23:24
  SPEAKER_04: I mean, it's so rude.
• 23:28
  SPEAKER_04: And it's like we can be prosecuted for like a HIPAA violation.
• 23:32
  SPEAKER_04: Yep.
• 23:32
  SPEAKER_04: Yeah.
• 23:33
  SPEAKER_04: It's stuff like that.
• 23:34
  SPEAKER_04: That's why we're tired.
• 23:35
  SPEAKER_04: I miss the curtain.
• 23:37
  SPEAKER_04: Because it could just be like, pull the curtain.
• 23:38
  SPEAKER_04: Yes, it's it's stuff like that.
• 23:40
  SPEAKER_04: And I think what it is, like once again, not even talking about even if you're not talking about the actual job or like the work, you're trying to explain something like this to like your significant other or your partner or your parents.
• 23:56
  SPEAKER_04: And I on top of like maybe like the technical stuff that you did, like the actual medical stuff, and they they don't understand.
• 24:01
  SPEAKER_04: And so it's like just like when someone's telling me something like mechanical or something with finances, I'm like, okay.
• 24:08
  SPEAKER_04: Whatever you supplicated.
• 24:12
  SPEAKER_04: And they just they can't understand maybe why stuff is so hard.
• 24:16
  SPEAKER_04: And so then you feel like like I might feel they're not gonna get it anyway, so I'm just not even gonna talk about it or complain about it.
• 24:24
  SPEAKER_04: They don't want to hear me complain, or they'll just be like, Well, at least you're making good money.
• 24:28
  SPEAKER_04: Or at least it's only three days a week, and it's like three days.
• 24:32
  SPEAKER_04: So then I don't maybe talk about it, and I just have to like keep all that in.
• 24:40
  SPEAKER_04: Or it's like you say something super traumatic and like you you're something that was really bad, and they're like, Oh, okay.
• 24:46
  SPEAKER_03: Well, what do you want for supper?
• 24:47
  SPEAKER_03: It's like okay.
• 24:48
  SPEAKER_04: Nothing now.
• 24:51
  SPEAKER_04: You know, it so it can be a little disheartening sometimes, I think, just because it's such a it's not anywhere near as like first responders or like people in the military, but I'm sure they feel like a lot of people don't understand their jobs and they probably just don't even waste their breath talking about it.
• 25:10
  SPEAKER_00: Yeah.
• 25:10
  SPEAKER_00: It's it is exhausting sometimes talking to non-healthcare people.
• 25:15
  SPEAKER_00: And I think that's why a lot of partners of healthcare people that are not in healthcare will complain about like, well, I don't want to go to your parties because whenever you guys get together, all you do is talk about the hospital.
• 25:28
  SPEAKER_00: And it's like, yes, partially because that's some of our common ground, but it's like when we're at work, we're talking about like real housewives and what's happening in the world or our hobbies.
• 25:38
  SPEAKER_00: But it's like outside of work, we need decompression, and sometimes it's like family and friends, as much as even if they try, they just can't get it.
• 25:46
  SPEAKER_00: And so sometimes when we do get together, I feel like outside of the hospital, it's where we get to be like decompressed.
• 25:53
  SPEAKER_00: And it's like, yeah, like I couldn't talk about this in that moment, but I gotta talk about it now.
• 25:59
  SPEAKER_00: Or we didn't even have a chance to talk about it because we were so busy the rest of the shift.
• 26:04
  SPEAKER_00: So now that we're together outside of work, I need to talk about this.
• 26:09
  SPEAKER_04: Yeah, absolutely.
• 26:10
  SPEAKER_04: Um, and I think that's something that's maybe like special about working together in the hospital.
• 26:15
  SPEAKER_04: Because I don't know that like I don't know if other professions or like people at offices, like, do you want to go out for drinks after work and like my gosh, can you believe that happened today?
• 26:24
  SPEAKER_04: And like you could talk about it for hours.
• 26:27
  SPEAKER_04: Hours.
• 26:28
  SPEAKER_04: Um and we will be that dead horse.
• 26:30
  SPEAKER_04: To to the ground.
• 26:33
  SPEAKER_04: To the ground.
• 26:36
  SPEAKER_04: But yeah, I've had to do that a lot of times where it's like, we'll gotta eat after work.
• 26:40
  SPEAKER_04: It's like I'm gonna go sit in my dirty scrubs after I worked all damn day and I gotta work tomorrow because I just need to vent about this.
• 26:46
  SPEAKER_04: I need to like talk about this and like get some some of this out a little bit.
• 26:51
  SPEAKER_00: Oh yeah.
• 26:52
  SPEAKER_00: Like you just have so much adrenaline that you need to go and sit and decompress with other healthcare people immediately after work.
• 27:01
  SPEAKER_00: Sometimes you need space, but sometimes you're like, no, right now, let's go.
• 27:06
  SPEAKER_00: Uh huh.
• 27:06
  SPEAKER_00: Oh yeah, absolutely.
• 27:08
  SPEAKER_00: I had so I have always wanted to open up a bar restaurant like right across from like a big hospital and call it the nursery and cater to the hospital hours.
• 27:23
  SPEAKER_00: Ooh, that's a great idea.
• 27:25
  SPEAKER_00: Like alcohol at like 8 a.m.
• 27:27
  SPEAKER_00: for those night shift people, but like you don't not just breakfast food at 8 a.m.
• 27:32
  SPEAKER_00: Like we'll have like burgers and stuff too.
• 27:34
  SPEAKER_00: So like you get off work or you're coming off day shift, and that that's always been my idea.
• 27:42
  SPEAKER_00: It's a great idea.
• 27:43
  SPEAKER_00: Why hasn't anybody done that?
• 27:45
  SPEAKER_00: Now someone's going to take it.
• 27:47
  SPEAKER_04: Yeah.
• 27:47
  SPEAKER_04: I mean, there's some places that'll serve you um breakfast drinks, which you know is fun.
• 27:53
  SPEAKER_04: I used to do that a lot when I was younger after getting off night shift.
• 27:56
  unknown: Yeah.
• 27:57
  SPEAKER_04: And that's the other thing.
• 27:58
  SPEAKER_04: Like when you get off, you're home for like what?
• 28:01
  SPEAKER_04: Home and awake for like two hours before you like have to go to bed and do it all again.
• 28:05
  SPEAKER_04: Like it really is like three straight days of work.
• 28:09
  SPEAKER_04: Of just and sleep if you're lucky.
• 28:12
  SPEAKER_04: And you know, like if you want to space it out, the upside of that is that you're not like I think probably as physically exhausted.
• 28:19
  SPEAKER_04: But then there is something nice about going to work multiple days in a row and having your same patient assignment because you know when you get there, you've got the history, you've got the background.
• 28:28
  SPEAKER_04: It's harder to start over from scratch every single time you go to work, don't you think?
• 28:31
  SPEAKER_04: Yes.
• 28:32
  SPEAKER_00: Oh, yeah.
• 28:33
  SPEAKER_00: It's so much harder.
• 28:34
  SPEAKER_00: And to build the rapport every time.
• 28:37
  SPEAKER_00: Like I know some people that would do like I worked with one girl and she liked to do Monday, Wednesday, Friday.
• 28:43
  SPEAKER_00: And I just was like, but you have to like build rapport back with the with a new set of family and earn their trust sometimes.
• 28:51
  SPEAKER_00: And it's just like that's so exhausting.
• 28:54
  SPEAKER_04: And I think it's probably even better for you, like you know, you guys, because you work half oh yeah, five days in a row.
• 29:03
  SPEAKER_00: Yeah, so it should how we're contracted, it really should be like seven on seven off.
• 29:08
  SPEAKER_00: That's not what my team does, but we will try to do like five or six in a row.
• 29:13
  SPEAKER_00: I will say there's no and I've done seven in a row.
• 29:16
  SPEAKER_00: I've done ten.
• 29:18
  SPEAKER_00: I think ten is the longest I've done in a row.
• 29:21
  SPEAKER_00: I'll say after day five, this the level of exhaustion is about the same.
• 29:26
  SPEAKER_00: Like you kind of hit like a plateau of like day six and seven.
• 29:31
  SPEAKER_00: Like, I'm exhausted, but it doesn't get like worse, whereas like day one to two to three to four to five to six.
• 29:38
  SPEAKER_00: Like every day I'm like, oh god.
• 29:41
  SPEAKER_00: Oh gosh.
• 29:42
  SPEAKER_00: That makes sense.
• 29:43
  SPEAKER_00: But yes, it's so much harder to come on with like a scattered schedule as a provider because like you're managing everything, and there's stylistic things, like there's more than one way to skin a cat, definitely medicine.
• 29:59
  SPEAKER_00: So there's like stylistic things, like medicine-wise, that sometimes you're like, I don't like that, like I might fix it, but then it's like, well, I'm only here one day.
• 30:07
  SPEAKER_00: Should I really tinker?
• 30:09
  SPEAKER_00: And then the notes, like the notes are exhausting.
• 30:13
  SPEAKER_00: I try for the most part, I will restart the note.
• 30:17
  SPEAKER_00: I don't like copying my notes forward anymore from other people.
• 30:22
  SPEAKER_00: So I'll start a note from scratch, and that in itself is a lot of work to like go through the whole chart on every patient.
• 30:30
  SPEAKER_00: And then if I'm doing that on six patients and then I'm leaving the next day and then coming back and getting potentially all new patients, but I I'm less likely to get a new patient assignment as a provider.
• 30:43
  SPEAKER_00: Like the way we split it up, I'm more likely to keep my patients.
• 30:47
  SPEAKER_04: So you're saying like on your first shift of your like coming stretch, you're gonna you're gonna make your own note.
• 30:55
  SPEAKER_04: But then if you keep those same patients for the rest of week, then you will build on the yeah.
• 31:00
  SPEAKER_04: Whereas some people just come in and they're just straight building off the other person's note, which is fine.
• 31:05
  SPEAKER_00: It's fine.
• 31:06
  SPEAKER_00: I mean, you guys write great notes.
• 31:08
  SPEAKER_00: It's so and sometimes if it's busy and I don't have time to start a note from scratch on a patient, I I just don't have the time.
• 31:16
  SPEAKER_00: And so I still copy some forward, but it is still exhausting.
• 31:20
  SPEAKER_04: Okay.
• 31:21
  SPEAKER_04: So speaking of charting and documentation, do you think which one's worse?
• 31:25
  SPEAKER_04: Like, is it more stress or less stress for you now as a provider versus when you were a bedside nurse?
• 31:32
  SPEAKER_00: Uh like most things, there's pluses and minuses to both.
• 31:35
  SPEAKER_00: I miss I miss the Excel sheet of um of nurse documentation of Epic.
• 31:43
  SPEAKER_00: I miss the flow sheets being able to I miss the flow sheets just being able to plug and chug.
• 31:48
  SPEAKER_00: Okay.
• 31:49
  SPEAKER_00: And I will say I did more, there was more required documentation for me on my unit.
• 31:56
  SPEAKER_00: So we did two Q2 hour neuroassessments, and we had to chart all of those, and we did Q4 hour full body assessments on our start downs.
• 32:06
  SPEAKER_00: So we were charting a ton.
• 32:08
  SPEAKER_00: So I missed that.
• 32:10
  SPEAKER_00: It's much harder to like cognitively think of like a sentence and like thinking about this and like the documentation I know much more now as a nurse practitioner.
• 32:21
  SPEAKER_00: I'm not just documenting to convey what I did, what I'm going to do to the nurses, to other teens.
• 32:28
  SPEAKER_00: It's also communicating to potentially myself in the future if I get pulled into a law case, into a court case.
• 32:38
  SPEAKER_00: And nurses are less likely to be pulled in.
• 32:40
  SPEAKER_00: I'm more likely now.
• 32:42
  SPEAKER_00: That's the risk that you inherently take when you become a provider.
• 32:46
  SPEAKER_00: Right?
• 32:47
  SPEAKER_00: Physicians even more so.
• 32:49
  SPEAKER_00: To cognitively have to like think about all of that and like what my future self would need to know is a lot.
• 32:57
  SPEAKER_00: Now, on the other side though, I don't have people auditing my charts like the nurses do.
• 33:04
  SPEAKER_00: I don't get a scorecard.
• 33:06
  SPEAKER_00: I don't, you know, if if I choose to not put a hundred percent effort into a note for a day, that is my choice, and I'm taking that on.
• 33:18
  SPEAKER_00: And no one's going to come at me about that.
• 33:22
  SPEAKER_00: No one's going to potentially pull that chart and be like, you're, you didn't document this.
• 33:28
  SPEAKER_00: And even if someone did, it would be like, Oh, sorry, I forgot, because we have to type everything up.
• 33:33
  SPEAKER_00: Whereas I feel like as a nurse, the chart audits they get so intense and they're tied to your raises.
• 33:39
  SPEAKER_00: If you don't get a certain percent, then you don't get a raise, and then it like it has a lot more downstream effects.
• 33:45
  SPEAKER_00: So in some ways there's more pressure, and other ways there's less pressure.
• 33:51
  SPEAKER_00: Does that make sense?
• 33:52
  SPEAKER_04: And you have to chart certain ways for billing too, right?
• 33:55
  SPEAKER_00: Yes, I have to chart certain ways for billing, but it's also combined because I'm an acute care nurse practitioner, we do combined billing in the hospital.
• 34:04
  SPEAKER_00: So I also don't take a hundred percent of that charting on.
• 34:09
  SPEAKER_00: It's split between me and my physician on that shift.
• 34:12
  SPEAKER_00: So like if I don't, you know, if I chart a kidney injury and it's a kidney injury on CKD, we're more likely to get it because two of us are documenting the same thing and combining our billing.
• 34:26
  SPEAKER_00: Whereas like you're the only one charting the nurse's charting.
• 34:30
  SPEAKER_00: So if you miss that pulse ox rotation, you miss that pulse ox rotation.
• 34:34
  SPEAKER_04: I think so, like, it does not take me long to chart.
• 34:39
  SPEAKER_04: Like, it just doesn't.
• 34:40
  SPEAKER_04: I hate having a whenever I go to like neuro or I do have patients like that where I have to do Q2 hour stuff that's like, but like in general, for me to sit down and chart a full ICU assessment and all my flow sheet stuff for eight, 10 o'clock, it don't take me long.
• 34:55
  SPEAKER_04: The problem I have with it is that like we have to double document so many things.
• 34:59
  SPEAKER_04: And if you do it one place but not the other, you're still gonna get dinged for it.
• 35:04
  SPEAKER_04: Like I have a medication I gave under my PRNs for the perfectly worded, you know, PRN reason that I gave it.
• 35:12
  SPEAKER_04: So I documented that.
• 35:14
  SPEAKER_04: But I still have to go to the flow sheet and say that I gave a PRM medication, why I gave it and what the outcome was and then in the right time frame.
• 35:21
  SPEAKER_04: It's just stuff like that.
• 35:22
  SPEAKER_04: Um, and they don't want us to write notes, they want everything to be in the flow sheet.
• 35:26
  SPEAKER_04: It's that's what's tiring.
• 35:28
  SPEAKER_04: And then also like if you've had a really tough day and you've just been so busy because it's been you have like a really critically ill patient and you do miss like charting your pulse ox rotation, even though you've probably moved it a thousand times because you couldn't get it to pick up, right?
• 35:40
  SPEAKER_04: Or something like that.
• 35:41
  SPEAKER_04: And so you get like a bad like chart audit, and it's like, damn it, I worked my ass off.
• 35:47
  SPEAKER_04: And then I just get this back, and it's so frustrating, but we have to do it because of the quality things because of the way that insurances are, and it's this whole it's still a lot of pressure, I guess.
• 35:58
  SPEAKER_04: Yeah, you're right.
• 35:59
  SPEAKER_04: If I get so many of those, I can get a bad e bowl and not get raising or get written up.
• 36:05
  SPEAKER_00: Mm-hmm.
• 36:06
  SPEAKER_00: Yeah.
• 36:07
  SPEAKER_00: Or stuff like that.
• 36:08
  SPEAKER_00: So yeah, I feel like there's a little bit more eyes immediately on nursing documentation, whereas as a provider, some of it's a little more downstream.
• 36:20
  SPEAKER_00: As a nurse, I've been pulled into two different court cases, so I think I might have a little bit more vigilance than other people because I can kind of see what they've nitpicked.
• 36:30
  SPEAKER_00: Um, not that I was sued, I was just a nurse that documented, so the lawyers had to talk to me.
• 36:39
  SPEAKER_03: That's scary.
• 36:40
  SPEAKER_03: Not fun.
• 36:40
  SPEAKER_00: It was not fun.
• 36:41
  SPEAKER_03: Scary.
• 36:42
  SPEAKER_00: That's so scary.
• 36:43
  SPEAKER_00: And I didn't I didn't do anything wrong.
• 36:46
  SPEAKER_00: Um and it's just like saying one of them, it very much was thank God I charted what I charted.
• 36:52
  SPEAKER_00: Like, thank God.
• 36:53
  SPEAKER_00: Yeah.
• 36:54
  unknown: Yeah.
• 36:54
  SPEAKER_00: I charted what I charted.
• 36:56
  SPEAKER_00: Yeah.
• 36:56
  SPEAKER_04: The the other thing that bothers me too is that I chart so much.
• 37:00
  SPEAKER_04: And there's certain things that we can go back and chart, but there's certain things that like they drill into us to keep them like updated as much as we can, like our vital signs, our medication rates, like our drips and our eyes and os.
• 37:11
  SPEAKER_04: Because in my mind, if I've got somebody on like a LASIK strip or CRT or whatever, like the eyes and O's are really important for you guys because you want to know.
• 37:20
  SPEAKER_04: So I try to stay very digital diligent about real time my vital signs, my medication rates, my eyes and O's.
• 37:27
  SPEAKER_04: So it's really frustrating sometimes when I'm doing that.
• 37:30
  SPEAKER_04: And then a physician or a provider or maybe a consulting people will come up and ask, Well, okay, so how much leave are they on?
• 37:36
  SPEAKER_04: I'm like, oh, but I need to.
• 37:37
  SPEAKER_01: Just in the chart.
• 37:38
  SPEAKER_04: Like and so it's like I get asked a bunch of questions that I've already like made sure that I had in for everybody that wanted to see it.
• 37:45
  SPEAKER_04: And that's like they didn't even look.
• 37:46
  SPEAKER_04: And it's it's so it's like, why am I why am I trying to stay not?
• 37:52
  SPEAKER_00: I appreciate when you stay on it.
• 37:54
  SPEAKER_04: I know, I know.
• 37:55
  SPEAKER_04: That's not everybody, but there's just so many things that because it's all so like documentation centered with the patient care, and everything is available in the chart.
• 38:06
  SPEAKER_04: If you're not gonna use that as your resource and you're still just gonna come ask me everything, it can be very defeating.
• 38:12
  SPEAKER_04: And then I'm I, you know, I feel kind of like that's like asking me when we're both we're both three feet away from the vent, what vent settings are they on?
• 38:18
  SPEAKER_04: I'm like, turn your head this way and look.
• 38:21
  SPEAKER_00: I don't have to read it to you.
• 38:23
  SPEAKER_00: Right.
• 38:24
  SPEAKER_00: Stuff like that.
• 38:25
  SPEAKER_00: Yes, and it's all of these little things, right?
• 38:28
  SPEAKER_00: Like that in itself, if that's all the only annoyance you had every day, like it wouldn't be so exhausting.
• 38:35
  SPEAKER_00: But it's like that on top of all of the documentation, on top of all the things that you have to keep in your head, on top of you know, families be coming in during a code and asking for water and all of these not being comfortable, things happening at home that you can't address because you're here, like you can't get comfortable, like all of these things add up.
• 38:59
  SPEAKER_00: And then it's like by the end of the day, you're like, I've given all of me.
• 39:05
  SPEAKER_00: And I think for me, the final layer of what tires me is I can't I don't always feel like I can fully express my frustration or my emotions.
• 39:15
  SPEAKER_00: Like I have to stay on, I have to be like, that's okay.
• 39:20
  SPEAKER_00: We got it.
• 39:21
  SPEAKER_00: And it's like sometimes I am like internally screaming in my head, like just internally, like WTF is happening.
• 39:32
  SPEAKER_04: Yeah, like maybe the call bell has gone off now for the 500th time and I'm physically like vibrating, but I have to go in there and be like, What can I get you?
• 39:44
  SPEAKER_04: Hello again.
• 39:46
  SPEAKER_04: I just left.
• 39:46
  SPEAKER_04: You're right.
• 39:47
  SPEAKER_04: It's hard to verbalize sometimes to people.
• 39:50
  SPEAKER_00: Why?
• 39:51
  SPEAKER_00: The the layers, like it is a lot of layers.
• 39:55
  SPEAKER_00: Like, I think people can get like you take care of dying people, they're really sick.
• 40:00
  SPEAKER_00: It's really hard work, but there's so many layers to it that it's just like, yes, it it is that, but like being with my patient and being with a family and connecting with them, even if the patient dies, if I have that connection, if I can help them die peacefully, like that that is what keeps me from quitting.
• 40:22
  SPEAKER_00: Like, like as bad as it sounds, like I just still remember I had this one patient's daughter, and they pass the patient passed when they weren't even on my team, but I went in just to like give my condolences.
• 40:34
  SPEAKER_00: And as soon as I walked in, the daughter like ran into my arms and hugged me and was like, Oh, thank God you're here.
• 40:41
  SPEAKER_00: And it's like, I'm sad that this patient passed, but it it warms my heart that I know that when they were there and under my care, I could still provide a sense of comfort for them.
• 40:53
  SPEAKER_00: And even in the patient's passing, I could still provide a sense of comfort for that family.
• 40:58
  SPEAKER_00: Those things don't drain me, they warm me to why I do what I do.
• 41:03
  SPEAKER_00: But other things are so draining.
• 41:07
  SPEAKER_00: For me, my biggest trigger is I go in the room and there's no gloves.
• 41:10
  SPEAKER_00: And if I've had a bad day, and if I've had a bad day and I go and reach for my that, and when I open up the trash can and there's no trash bag, my head my head will smoke.
• 41:22
  SPEAKER_04: I will so let's just let's just paint a picture.
• 41:26
  SPEAKER_04: It's first thing in the morning and come in.
• 41:28
  SPEAKER_04: You're tired because you didn't sleep good.
• 41:30
  SPEAKER_04: No big deal, right?
• 41:31
  SPEAKER_04: That's like everybody in America or in the world.
• 41:33
  SPEAKER_04: I come in, I'm getting report.
• 41:35
  SPEAKER_04: That's not a great report, whatever.
• 41:37
  SPEAKER_04: I'll read the chart.
• 41:38
  SPEAKER_04: It's fine, right?
• 41:40
  SPEAKER_04: Both my rooms are a mess.
• 41:41
  SPEAKER_04: Okay, cool.
• 41:42
  SPEAKER_04: I'll clean them up.
• 41:43
  SPEAKER_04: I go to assess my patient, grab a glove.
• 41:45
  SPEAKER_04: There's not any.
• 41:46
  SPEAKER_04: So now I'm starting to get irritated.
• 41:48
  SPEAKER_04: And it's it's like 7, 10 in the morning, right?
• 41:52
  SPEAKER_04: Okay, well, let me go out.
• 41:53
  SPEAKER_04: I'll grab and I'm gonna grab all the gloves, probably.
• 41:55
  SPEAKER_04: Uh come and restock them all.
• 41:56
  SPEAKER_04: So then I come in, I'm doing some stuff.
• 41:58
  SPEAKER_04: My Pixis hasn't been stopped.
• 42:00
  SPEAKER_04: There's no flushes, so I can't flush these IVs, flush these lumens.
• 42:03
  SPEAKER_04: So now I gotta go back out.
• 42:06
  SPEAKER_04: And it continues on.
• 42:07
  SPEAKER_04: And this is not an exaggeration.
• 42:09
  SPEAKER_04: This is a an extreme of normal.
• 42:13
  SPEAKER_04: And then when I am done, there's no trash bag or uh the lift team's not here today.
• 42:17
  SPEAKER_04: I need to turn them.
• 42:18
  SPEAKER_04: But we don't have a care partner.
• 42:20
  SPEAKER_04: I'm in a pod by myself.
• 42:21
  SPEAKER_04: I don't have a pod buddy.
• 42:23
  SPEAKER_04: I go to do it.
• 42:24
  SPEAKER_04: Well, now they need to be cleaned up.
• 42:25
  SPEAKER_04: So let me start over.
• 42:26
  SPEAKER_04: Let me look in my cabinet.
• 42:28
  SPEAKER_04: There's no chuck, there's no wipes.
• 42:30
  SPEAKER_04: Let me go back out again.
• 42:32
  SPEAKER_04: So now it it something that should have taken 10 minutes has turned into an hour.
• 42:36
  SPEAKER_04: And this patient's probably not even like critically ill.
• 42:38
  SPEAKER_04: And I haven't even gone to my other patient's room to start, and it's the same BS.
• 42:42
  SPEAKER_04: And it's just stuff like that that happens every day.
• 42:46
  SPEAKER_04: But then, you know, you finally get, let's say you finally get it all straight.
• 42:49
  SPEAKER_04: You're stocked, you're good.
• 42:50
  SPEAKER_04: I bitched about it for a little bit.
• 42:52
  SPEAKER_04: I feel a little bit better, right?
• 42:54
  SPEAKER_04: Yeah.
• 42:55
  SPEAKER_04: Then the actual stuff starts.
• 42:56
  SPEAKER_04: Now people are coming around around all the orders, you know, going down for like a video swallow at the worst time.
• 43:03
  SPEAKER_04: The patient gets excavated.
• 43:04
  SPEAKER_04: So now they are on the call bill all the time and they're thirsty.
• 43:06
  SPEAKER_04: They can't have anything to drink.
• 43:08
  SPEAKER_04: Can I get something to drink?
• 43:09
  SPEAKER_04: Why can't I drink something?
• 43:10
  SPEAKER_04: I'm hungry.
• 43:11
  SPEAKER_04: I'm thirsty.
• 43:11
  SPEAKER_04: Then the family comes in.
• 43:12
  SPEAKER_04: Well, why can't they have anything to drink?
• 43:14
  SPEAKER_04: And you have to say it over and over and over again.
• 43:16
  SPEAKER_04: I'm like, okay, oh yeah, let's get them out of the bed.
• 43:19
  SPEAKER_04: Great.
• 43:19
  SPEAKER_04: Let's get them in the chair.
• 43:20
  SPEAKER_04: There's nothing in here to get.
• 43:21
  SPEAKER_04: There's no supplies.
• 43:22
  SPEAKER_04: Let me go get all the supplies to get you up to the chair.
• 43:24
  SPEAKER_04: Then I can't get the chair alarm to pair with the fucking controller.
• 43:28
  SPEAKER_04: So I'm trying to get him up.
• 43:30
  SPEAKER_04: I get them up.
• 43:30
  SPEAKER_04: And guess what?
• 43:31
  SPEAKER_04: We finally got up situated.
• 43:33
  SPEAKER_04: Now they show up.
• 43:33
  SPEAKER_04: It's time to go to the video.
• 43:34
  SPEAKER_04: So while I'm like, cool, let's let's do that instead.
• 43:37
  SPEAKER_04: And so on and so forth.
• 43:39
  SPEAKER_04: Yes.
• 43:40
  SPEAKER_04: All day long.
• 43:41
  SPEAKER_04: And it's it is exhaust.
• 43:42
  SPEAKER_04: It is just it's exhausting.
• 43:45
  SPEAKER_04: And that's like your patients are doing well.
• 43:47
  SPEAKER_04: Yes.
• 43:48
  SPEAKER_00: They're making these strides forward.
• 43:49
  SPEAKER_00: And it is your job.
• 43:50
  SPEAKER_00: It is.
• 43:50
  SPEAKER_00: And then it's exhausting.
• 43:53
  SPEAKER_00: And then if you have someone that's not doing well and you keep doing all the things to try and make them well and it's just not working.
• 44:00
  SPEAKER_04: And it's just like, oh my God.
• 44:02
  SPEAKER_04: Yeah.
• 44:02
  SPEAKER_04: And they're usually paired with each other.
• 44:04
  SPEAKER_04: Yes.
• 44:05
  SPEAKER_04: So it's like, you know what?
• 44:06
  SPEAKER_04: There's an emergency here.
• 44:08
  SPEAKER_04: This person's gotta get up, go to the bathroom every 30 minutes because they can't pee laying down.
• 44:13
  SPEAKER_04: And they can't have fully.
• 44:14
  SPEAKER_04: And they don't want to wear the whatever device we have for them to wear.
• 44:17
  SPEAKER_04: The urinary device.
• 44:19
  SPEAKER_04: I said it collection.
• 44:20
  SPEAKER_04: I don't want to say the wrong thing again.
• 44:22
  SPEAKER_04: Oh yeah.
• 44:22
  SPEAKER_04: Lectured.
• 44:23
  SPEAKER_00: The urinary collection device.
• 44:26
  SPEAKER_00: Yes.
• 44:27
  SPEAKER_00: Um.
• 44:28
  SPEAKER_00: So that's the job.
• 44:30
  SPEAKER_00: It's just the job.
• 44:31
  SPEAKER_00: It is.
• 44:31
  SPEAKER_00: And you know, I'm always going to bring it back to some science.
• 44:35
  SPEAKER_00: Yeah.
• 44:36
  SPEAKER_00: But that was this exact thing, is what tires nurses out.
• 44:41
  SPEAKER_00: And we've known it since about the 80s.
• 44:43
  SPEAKER_00: Like we know it because there is no workflow.
• 44:47
  SPEAKER_00: There's no workflow for nurses.
• 44:48
  SPEAKER_00: There's no workflow for healthcare workers.
• 44:51
  SPEAKER_00: As a provider, as a nurse practitioner, I have a little bit of a workflow to my day now.
• 44:57
  SPEAKER_00: Like I come in, I go through my charts, I start rounding at nine, but and then I do my notes, but that can be interrupted at any point for any reason.
• 45:07
  SPEAKER_00: I don't have quite as much like, you know, someone's my room's not ready, this isn't done, this isn't here.
• 45:13
  SPEAKER_00: Like I I just need a computer and my stethoscope and my brain, and that's about it.
• 45:19
  SPEAKER_00: And but back to the evidence.
• 45:21
  SPEAKER_00: So in the 80s, like it was discovered, and that's why the woman that created Purposeful Grounding created it was to add, try and get a workflow to the day, trying to get that like give us a little bit of normality to how your day looks.
• 45:38
  SPEAKER_00: But even then, it things happen and you can't.
• 45:43
  SPEAKER_00: And that is something, and it it's every shift.
• 45:47
  SPEAKER_04: Every.
• 45:47
  SPEAKER_00: It's not just like the thing that I've been coding, like computer coding, you know, crashed and I gotta like start over, and that happens to you like once a month or once a quarter or whatever.
• 45:59
  SPEAKER_00: Every shift you come in and the unexpected happens.
• 46:04
  SPEAKER_00: And you can't plan your you don't even have lunch at the same time every day.
• 46:09
  SPEAKER_04: And if you do have like great patients, they both get moved out and you get two new one.
• 46:16
  SPEAKER_04: Yep.
• 46:17
  SPEAKER_04: And it's like I do feel like I have always ended up doing a little bit more work than maybe was my quote unquote job.
• 46:24
  SPEAKER_04: Because if I'm in there, let's say it's 1145, I'm not gonna leave and wait for like the care partner or who the tech, if we have one, then to come back in 10 or 15 minutes to go back in there to do mouth care turn, get my eyes and nose, get my finger sick, because I'm just gonna do it now so I can go ahead and get all of it done.
• 46:44
  SPEAKER_04: Like you said, it's like purposeful so that I can have a chunk of time to maybe sit down and document, go through my orders, look at my lab results, call the family back.
• 46:53
  SPEAKER_04: So I'm not constantly in the room doing this, this, and this.
• 46:56
  SPEAKER_04: And that's how you get your time management skills.
• 46:59
  SPEAKER_04: But you're right, there is no workflow really.
• 47:01
  SPEAKER_04: There's no workflow.
• 47:02
  SPEAKER_04: There's um until you spend your whole day be bopping around and you learn the hard way that, like, I'm just gonna go ahead and do that.
• 47:09
  SPEAKER_04: I'm just gonna go do it now.
• 47:11
  SPEAKER_00: And I'm I was a guest on another podcast, and I said this, like I said this there as well.
• 47:17
  SPEAKER_00: But nurses get so frustrated at providers, doctors, nurse practitioners that go in the room and like the patient asks for the cup of ice and they come out and they're like, Can you get them a cup of ice?
• 47:28
  SPEAKER_00: And it's like, you are a hundred percent capable of doing that, and you should.
• 47:33
  SPEAKER_00: And it's like the same for nurses sometimes with the with the nursing assistants.
• 47:39
  SPEAKER_00: Like I've seen so many times where it's like, so you were just in the room, you were just drawing blood off the A-line, which is a lot easier, and you didn't get that sugar, you just waited 10 minutes till the NA came around to get the sugar.
• 47:52
  SPEAKER_04: Like, no, and as a person, I don't getting your fingers stuck is awful.
• 47:56
  SPEAKER_04: I don't want a patient to have to get their finger stuck.
• 47:59
  SPEAKER_04: It's the worst.
• 48:00
  SPEAKER_04: If they saw while I'm in there, I'd be like, Yeah, can you just get the machine set up real quick?
• 48:03
  SPEAKER_04: I'm gonna get the blood.
• 48:04
  SPEAKER_04: Like, let's let's work it out together.
• 48:05
  SPEAKER_04: And I be turning these patients all the time by myself, and I think the care partners probably could.
• 48:12
  SPEAKER_04: But once again, I value having some dedicated time to do something.
• 48:18
  SPEAKER_04: So, like if I can just knock it all out, even though it's more on me, like I'd just rather go ahead and do it.
• 48:25
  SPEAKER_04: That's how I am.
• 48:27
  SPEAKER_04: But yeah, I think like you said, it's hard to sometimes verbalize because then if you if you say too much, I feel like people will be like, well then why do you why do you do it or why do you do that?
• 48:36
  SPEAKER_04: Just go work in the office, and it's not that easy as you know.
• 48:41
  SPEAKER_04: But I will say if you are like living with somebody who has this type of job, I think the best thing that you can do, the best advice I could give you is to not put any decisions on that person.
• 48:53
  SPEAKER_04: Like I don't want to order their shift.
• 48:55
  SPEAKER_04: Don't ask me what I want for supper, just make it.
• 48:58
  SPEAKER_04: I'm gonna eat it.
• 48:59
  SPEAKER_04: Now I'm I'm gonna eat it.
• 49:00
  SPEAKER_04: I'm not gonna be like unless unless somebody's like being ungrateful, you know, right?
• 49:04
  SPEAKER_04: Whatever.
• 49:05
  SPEAKER_04: If I come home and you have like made something, if I don't want to eat it, I won't, but I'm gonna say thank you.
• 49:09
  SPEAKER_04: Don't ask me what I want to do, what do I want to watch?
• 49:13
  SPEAKER_04: Don't ask me anything about the the schedule for tomorrow.
• 49:15
  SPEAKER_04: Don't ask me anything about did you see what the teacher said about like I'll it would just it's so nice like to come home and not even that you're taking care of me, but like just you've taken care of everything else, and I don't have to think and I can turn my brain off.
• 49:27
  SPEAKER_04: I think just taking care of it, just take care of it.
• 49:30
  SPEAKER_04: Yeah, that's the best advice I can give.
• 49:33
  SPEAKER_00: It is, especially and that's where I just don't I don't understand how two healthcare workers can be together because I'm like, who's doing it?
• 49:42
  SPEAKER_00: Who's doing it?
• 49:43
  SPEAKER_00: Like you're gonna have to have opposite schedules, and then if you have opposite schedules, you're not seeing each other.
• 49:47
  SPEAKER_00: Like, I'm just like, who's doing it?
• 49:49
  SPEAKER_00: Because that is, yes, if you are not in healthcare doing that, just not the and it's not in every day, it's just the days that they work, it's just like it just helps so much.
• 50:02
  SPEAKER_04: Because guaranteed, while I've been at work, stuff has gone down.
• 50:06
  SPEAKER_04: And you go eat lunch.
• 50:08
  SPEAKER_04: If I choose to check through all of the messages from like the kids' teachers and stuff, you know, I choose to do that because I don't want things to get missed, but it would be really nice to not feel like I had to do that.
• 50:20
  SPEAKER_04: Right.
• 50:21
  SPEAKER_04: Um and you know, it's a trade-off.
• 50:23
  SPEAKER_04: So then, like you said, when you're off, you know, it's your partner's turn or your roommate, whoever's turn, to like, okay, now I'm gonna take care of it.
• 50:31
  SPEAKER_04: And you can chill because every job is stressful.
• 50:34
  SPEAKER_04: I'm just speaking about my job.
• 50:35
  SPEAKER_04: This is what I do.
• 50:36
  SPEAKER_04: Yeah.
• 50:37
  SPEAKER_00: Everyone has their own stresses.
• 50:39
  SPEAKER_04: And having a bad day at any job, like even if you're not saving people's lives, like you have a job that impacts a lot of people, right?
• 50:45
  SPEAKER_04: If you make a bad mistake and people lose their job or like something bad goes down, like that's a lot of responsibility.
• 50:51
  SPEAKER_04: I do think it's really just a different thing for us where it's like I've had a really bad day or I've had a really bad personal day, and now I get to go to work.
• 50:58
  SPEAKER_04: And if I mess something up, I could cause a patient harm.
• 51:01
  SPEAKER_04: Right.
• 51:02
  SPEAKER_04: There's just always that underlying, like a little bit more, I think, high level of stress with that.
• 51:07
  SPEAKER_00: But yeah.
• 51:08
  SPEAKER_00: It's just, yeah.
• 51:09
  SPEAKER_00: Cause some of it, a lot of what if we do something wrong, most of the time we can't undo it is the problem.
• 51:17
  SPEAKER_01: Yeah.
• 51:18
  SPEAKER_00: And it's not let's, you know, move this around and we can save this job this way.
• 51:23
  SPEAKER_00: It's literally like we make a mistake and someone might die, and you can't you can't always undo that.
• 51:29
  SPEAKER_00: Yeah, you're exactly right.
• 51:30
  SPEAKER_00: So, or if I miss something and someone gets harmed, like you can't undo it.
• 51:34
  SPEAKER_00: So and that's that's the inherent risk.
• 51:38
  SPEAKER_00: Well, I think we've scratched the surface on why we're so tired.
• 51:41
  SPEAKER_00: It is literally just like the first little Yeah.
• 51:46
  SPEAKER_00: Just layer upon layer upon layer of what it takes to be a healthcare worker in this day and age.
• 51:52
  SPEAKER_04: But and I do think it's just getting worse and worse with the way that the system is set up.
• 51:58
  SPEAKER_04: Yes.
• 51:59
  SPEAKER_04: It wasn't always like this.
• 52:00
  SPEAKER_04: It wasn't like this when I started.
• 52:02
  SPEAKER_04: Not to this level.
• 52:03
  SPEAKER_00: No.
• 52:03
  SPEAKER_00: And I think all of these like corporates coming in and buying up hospitals and hospital closures, like it's all contributing.
• 52:13
  SPEAKER_00: But well, let us know your thoughts.
• 52:15
  SPEAKER_00: Are these the things that tire you?
• 52:17
  SPEAKER_00: Do any of these things surprise you if you're not in healthcare?
• 52:21
  SPEAKER_00: And had you never thought that someone would come in and ask for a cup of water during a code situation.
• 52:28
  SPEAKER_00: Let us know your thoughts.
• 52:30
  SPEAKER_00: Hit the like button, follow along, leave us a review.
• 52:33
  SPEAKER_00: We are reading them.
• 52:34
  SPEAKER_00: Otherwise, from all of us shift talkers here at Banter at the Bedside, until next time.
• 52:39
  SPEAKER_00: Bye.
• 52:40
  SPEAKER_00: Bye.
• 52:40
  SPEAKER_00: Tootaloo.
• 52:41
  SPEAKER_00: If this felt your kind of conversation, make sure you're following, leave us a review, and we'll see you back here soon.
• 52:47
  SPEAKER_00: Bye.
• 52:49
  SPEAKER_01: Step into the light where the stories come.