How I Know that I Love my Dirty Job

Practice Makes More Practice
3 min readJan 30, 2024

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For some reason, Mondays are almost always crazy in the emergency department. Yesterday, I started my shift at 11AM with an ambulance. My patient arrived soaked from head to toe in urine. The EMS crew reported that she had fallen. We also found her to be febrile, tachycardic and tachypnic — i.e. very sick.

Starting the day like this is tough. There many things about this patient’s situation that need to be investigated. Why did she fall? Why does she have a fever? What are her potential sources of infection? Is she safe at home? Our team works together to try to answer these questions and more. Some questions just lead to more questions.

As I was doing all of the tasks to get this patient triaged and cleaned up, I received a call from my charge nurse. My next ambulance would arrive momentarily and my float nurse would settle the patient for me.

When I arrived in the room to assess my new patient, I found that she was not as physically ill as the first, but that she needed attention. She was struggling with feelings of depression and anxiety and needed someone to listen.

Patient after patient yesterday, I struggled to keep up. I received another ambulance about half way through my shift. This patient was on blood thinners and had a huge hematoma. The patient’s blood pressure was low and she was in uncontrolled atrial fibrillation, which meant our team needed to figure out how to slow her heart rate and maintain a good blood pressure. I stayed by my patient’s bedside and carefully monitored her as I gave medications and fluids to strike the delicate balance.

By this point in the day, I was absolutely exhausted. I needed a break. My float nurse covered me and I inhaled some food. I immediately felt better and bounced back onto the floor.

I’m not a great nurse at this point in my career. I work hard and I try my best to learn as fast as I can. I still ask a lot of questions. I still rely heavily on more experienced nurses. I take on as much responsibility as I can, but I know it’s in the best interest of my patients to defer to more experienced colleagues for many things. Sometimes I let my insecurities get the best of me, but nursing constantly pushes me to check my ego and think about what’s best for my patients.

What makes me feel good is how I feel at the end of a really hard shift like yesterday’s. I may be physically exhausted, but I feel intellectually and spiritually energized. I feel like I learned a lot and I made good choices for my patients. I feel like I conducted myself with integrity and humility. I find myself singing out loud on my drive home. That’s how I know that I love my job (despite all of the challenges and encounters with bodily fluids).

My Journal entry from yesterday.

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Practice Makes More Practice

A newly minted emergency department RN in my late forties, here is where I share what it's like.