Nursing is an amazing career to have. I have endless possibilities stretching out in front of me. I can change jobs every 3-4 years and have that work in my favour.  I make a difference in people’s lives, and inspire people to take care of themselves.  I am in a career where the education opportunities are endless, and learning will be life long.  My job however, sucks balls on a regular basis. We are in a huge bed crunch on a daily basis, and I feel like my voice is lost in a sea of everyone else. Someone else’s area is always the focus of the day, and making sure they have beds is always more important. We’ve had our overflow beds (our overflow beds are 8 beds, btw. Other wards are 1-2 beds) open for a year solid. Nobody seems to notice anymore.  But every day I see;  I see my staff struggle with the weight they are carrying, the strain of these eight extra patients.  I see my nurses burnt out because we are constantly asking them to work extra shifts, stay a few more hours. I see my PT, OT, Dietitian, SW, CML and rehab assistant working tirelessly, thanklessly to make sure that the patients are taken care of.
I do not work in a flashy critical care area. I do not work with young people. We do not get donations from private organizations. We are an afterthought, generally speaking.  Everyone assumes will get by, because we always do.  

Yet every day I go to work and smile and laugh and try and make sure the team I work with know I see them, that I see the difference they make. 

 
 
I work closely with doctors on my ward. Most of them are wonderful, caring people who understand and respect my role in patient care. They understand that they are looking after a small percentage of the patients on my ward, and I always have to look at the big picture. Some of them, however, think that I do nothing but their bidding. 
A young woman came in with a palliative brain bleed. I only had a ward room available. This is far from ideal. In a perfect world, these patients would always get a private room so the family can be with them and grieve in private. In reality, all my privates had people with some pretty serious infections that could pass on to everyone if they were in ward.
The doctor promised, in this order:
A bed on the palliative care unit (not gonna happen, they take from the community first)
A private on my ward (again, not possible)
After admitting to my ward, promised palliative care would come see them today (consults usually take 48h to happen)
A private on my ward because he "just sent someone home from a private, so you should get it. I wrote an order for it" (has no bearing on where I put patients, and we had a patient with diarrhea and vomiting that needed to be moved to a private)
So now I have a distraught family on my hands, cleaning up his mess and essentially being the bad parent, telling the kid he can't have a pony. In the meantime, I had been talking to the other charge nurses trying to secure a private room. I also was having a discussion with the family, who said "so, what you're saying is my mother dying isn't a priority" I almost burst into tears. 
I eventually did some moves, thanks to the other amazing charge nurses I work with, and got her a private room. 
Where was the doctor when all this was happening, you ask? I have no idea, but not backing me up, that's for sure. 
 
 
So, I'm on days on a stroke ward. Patient A hasn't had a BM in 6 days or so, and has obstructed. NG inserted, rectal tube inserted, gas and fluid coming out, IV fluid going in. All is well. Radiology phones, the NG and rectal tube decompressed the abdomen enough they could see a perforation. STAT page to neuro and Gen Surg. Patient goes to the OR in about 5 minutes, has a hemicolectomy. I take care of him for a few days, start TPN for him, and carry on. 
Fast forward two years later, I'm the charge nurse on a geri-med ward. Stroke is consulting on a patient, turns out he's got massively blocked carotids (90% L, 100% R). The stroke attending and R5 come up to take the patient to CT. The R5 recognizes me, gives me a hug and says to the attending "don't you remember her? She looked after that guy who's bowel perforated, We were so lucky she was looking after him, he could have died"
Made a shitty day a little better
 
 
Dear ER Nurse,

Your job is hard. I hear about it all the time.  I read the blogs; I see the news reports on pts being admitted to coffee shop’s because there is no space anywhere.  If you expect me to take pts as quick as possible, then you need to respect my job as much as I respect you and your role in health care. And I do have utmost respect for ER nurses. You guys rock, and often make the difference between dying and dead. You save lives. You fix people and then send them off to the wards. But let’s get one thing straight. These people are not fixed, they are broken. You have only placed a band aid on a haemorrhage. 
I do not appreciate being told that a pt has no isolation requirements only to find that they have MRSA. When I call down to ask to hold the pt while I make a private (note-not saying the pt can’t come up, just saying I need to make a private), saying “that’s your problem, not mine” and then hanging up is not going to work in your favour. It is also going to make me LESS likely to accept pts from you.
If your patient has a hip fracture, do the ward a favour and put a catheter in. It is VERY hard to try to it quietly at 0300 in a ward room.  
Stable in the ER does not translate to stable in the ward. You have everything you need at your fingertips.  Often in the ward, we have...nothing. The doctor is over the phone, grumpy and possibly not answering my pages.  A nurse with two years experience might be the most experienced nurse on the ward. We have no care aide, no unit clerk, possibly one lab tech for 4-5 floors.
Be honest. If the pt is a train wreck, give me a heads up.  It’s not your fault.  If the pt’s family needs more care than the pt, tell me. I will be glad you did.  If the “slightly confused” 90 year old will bite me/punch me/donkey kick me, TELL ME. I need to know these things. It will not change how fast I take the pt from ER, I promise.
It all comes down to that rule we learned in kindergarten “treat others how you want to be treated”
I'm sorry you've had to deal with shitty ward nurses in the past, but let's not take it out on every ward nurse you meet, okay?

Sincerely,
A ward nurse