As nurses and their families mark International Nurses Day by marching for better work conditions,

nurse Caitlin Francey opens her diary to share what goes on during a regular shift at a hospital
ward.

07:00: Night shift handover is finished. The night nurse looks knackered, but she guides us around
our pod and introduces us to each of our patients for the morning. I will work with a new graduate as
well as oversee a final year student on the busy paediatric ward. We meet our nine patients and wish
the night nurse "good night".

07:30: We have worked out our plan for the day, and now have 11 patients. I take the student with
me to prepare the first child for surgery: vital signs, weight, pyjamas and pre-op questions. The child
is anxious but we have bubbles to distract him – thank goodness for bubbles. The next child is more
relaxed; she's been here before and is very excited to have the metal plate removed from her leg.

08:00: The orderlies arrive to take both patients to theatre. My new grad buddy is doing well and he
has already done morning vital signs on four of our nine remaining patients. I let him know I'm off to
theatre before leading the two-bedded conga line.

08:30: I'm back from theatre and the burns team doctors have appeared to say they will be back at
09:30 to see their patient with his dressings down. Sedation will need to be given at 09:00 and I'll
start taking the dressing down at 09:20. I've called the play specialists to help by entertaining and
distracting the child, the physiotherapist knows to pop in and assess the child's movements and the
occupational therapist will also come in to see the wounds and plan the child's ongoing scar
management.

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09:30: The dressings are down and the doctors are running late…

09:45: The doctors have given me a dressing plan. The child is ready to be bathed and then the
dressings can go on after. I run the bath, bathe him and reapply the dressings. One area of the burn is
not quite healed and looks a bit deeper than the rest. The doctors have left and will likely be too busy
to come back so I call clinical photography and, with the parent's permission, I get photos taken that
the doctors can look at later to assess. I then dress the wound.

10:45: I'm finally out of the burns bathroom. My new graduate buddy hasn't had morning tea so I
send him and my student off for a break. In-between vital signs I go to check if the 15-year-old with a
broken leg has gone to surgery yet. He hasn't. And he's had no food or fluid since 0200. I page the
doctors on his team to chart some IV fluids.

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11:00: I finally get a cuppa.

11.15: The doctors call me back regarding the IV fluids and I take a verbal order over the phone. I go
in to start the fluids and the mother is getting upset. "The boy next to us has been to surgery and has
already come back, when will my boy go?" "I know it's frustrating, but they prioritise younger
children first. I'll call theatre and see if they can give us a rough estimate," I reply. The theatre
coordinator can't give me a time, someone else has come in needing more urgent surgery. I explain
this to the mother but it's little consolation.

11:45: There's an IV antibiotic due for the little girl with a skin infection. The student mixes and draws
up the antibiotic under my supervision, the mother gives my student permission to give the
antibiotic while I observe. As she flushes the IV luer, the girl screams and recoils into her mother's
arms. The luer has dislodged and isn't working anymore. I remove the luer, apply some numbing
cream and explain to the girl and her mother that the doctor will be back later to put another luer in.
I page the doctor about the IV luer.
12:15: There are six more sets of midday vital signs to do, we split them to do two each and set off
with a blood pressure machine each.

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12:45: A child has an abscess on the sole of her foot and the dressing has completely come off from
walking around and playing. As my student cleans the wound, I teach her how to take a wound swab
and ask her why I would do that. She answers correctly and does a great job with the dressing.

13.30: I'm about to walk off the ward for my lunch break when the ward clerk asks "New patient,
where do you want them?" I glance at the screen, I look at the patient board. "I'll have them in B17
please." I get downstairs to the staff cafeteria, two of the three microwaves are broken. It's cold pizza
for me today.

14.00: I'm back from break and start thinking about the handover. I hear the patient lifts open, it's
our new patient, fresh from having his tonsils removed at a different surgical centre and he is here to
be observed overnight. I follow them to B17 to take his vitals and get him comfortable in the room.
He looks pale, I think he might be about to... vomit. Carton, IV anti-nausea, new sheets, pyjamas and
an iceblock.

14.45: I update the last few patients and print handover sheets for the afternoon nurses. I hand out
the sheets, close the door to the nursing station and hand over all the patients on the ward. The
afternoon staff look fresh and cheerful, kind of like what I looked like at 07:00.

15.00: I sit down with five sets of patient notes in front of me to write. The new graduate buddy has
already written three notes, now on to his fourth note and the student has written two. I read,
critique and sign the student's notes. I get my notes down in-between answering questions from the
afternoon nurses. "Has B16 peed today?", "When is B14s next dressing change?", "Did the doctor say
when they would come do the luer for this patient?"

16.00: My shift ended 30 minutes ago and finally, my notes are done and I'm out the door.

Caitlin Francey is an NZNO delegate. The names of rooms are not the actual rooms used on this day
to protect patient privacy.
`ach interaction, each task, was a stepping stone towards becoming the nurse I aspire to be.
Tomorrow is another day of learning, and I am excited to continue this journey. I am grateful for the
incredible team I am working with and the opportunity to make a difference in the lives of others. As
this day comes to an end, I can't help but feel hopeful and inspired. Until tomorrow, dear diary.
Yours, A Student Nurse

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So I arrived nice and early, thanks to my super girlfriend lending me the car! I wasn’t sure about
parking so I had to park a bit out and then get the train to the hospital. Found my ward really easily.
Walking through the halls of the hospital that time in the morning is so dark and creepy. I walked
onto my ward and declared myself as ‘Student nurse, first day, first placement’. Everyone loves a new
student haha.

My mentor seems lovely, all the staff were lovely! My mentor wanted me to follow a healthcare
assistant round the wards for the day to get the feel of what the ward is like, the routine, patients,
etc. Which was a good thing 🙂 This ward is mainly a abdominal surgical ward, so a lot of stoma bags.

 7am: Handover, to find out about the patients and what they need today.

 7.30am: Get all clean bedding ready to make the beds. Check what patients are due pressure
relief.

 8am: Any patients that are awake and wanting to get up, assist them and change all
bedding.

 8.30am-9am: Breakfast time. Host comes around with all the breakfast for patients. Assisted
patients to sit up and get comfortable to eat.
  9am-10.15am: Continue to assist patients with washing and dressing if needed, if not just get
them fresh hot soapy water ready to have their wash independently.

 10.15am: have a break for 15mins.

 10.30am: head back and check all beds have been done in other bays or if anyone needs
assistance. Got called to assist the staff nurse do a dressing which was fun!

 11am: assist with measuring the urine and documenting it all. Giving patients pressure relief.

 12pm: lunch time. Assist to get the lunches out to the patients and ensure everyone is sitting
up comfortably.

 1pm: Check all patients notes, write in food diaries, fluid charts, pressure area charts. Ensure
patients have moved every 4hours.

 2pm: 45 minute lunch break. Absolutely starving and a pounding heading. Just occurred to
me that I’ve had 1 cup of tea all day! Whoops.

 2.45pm: I got my practice placement document folder ready for my mentor and our first
initial interview.

 3-4pm: First initial interview competed. Checking patients paper work is all up to date, give
pressure relief.

 4-4.30pm: Reading over ward information and printing my student guide to the ward. And
breathe.

 4.30 – 5pm: Watched the nurse remove some staples from a wound and remove a drain!
Exciting stuff! Yay! Call me morbid but I really love wounds and the nasties haha.

 5pm-6pm: Assist with getting the diners out and serving deserts. Documenting food plans,
fluid charts, reposition charts.

 6pm: checking all patients are ok, assisting with any personal care needed.

 6.40pm: My mentor says I can go home!! Yay!! Thanks! 😀 Nice early finish and a lovely
almost 2 hour journey back home.

My first day all in all was so busy, tiring, non stop. But the time went by fast and I learnt how this
ward runs and the type of surgery that went on. Arrived safe and sound back home and fast asleep
by 9.30pm!! Zzzzzzz. A few days off now and back at 7am-7.30pm on Sunday. Until next time……