One of nursing’s dirty little secrets

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Yep, I had one of those shifts recently. One of those shifts that tested my resolve, my will, and, of course, my patience.

One of the dirty little secrets of nursing is that we sometimes become babysitters – literally. It’s no one’s fault, it’s just reality. And no matter how much you want to place blame or get angry, you have to be vigilant in caring for your patient. Anger won’t get the job done.

You can’t blame the patients themselves, because for the most part, they have no control over their illness or the disease process. You can’t blame the family and/or caregiver – they’ve been “babysitting” for years, with no complaints. Oh, and they don’t get paid to do the job. You sure can’t blame the licensed provider; they’re trying to accomplish the same goals as you.

You can’t blame anyone. Period.

ICU nurses sometimes get the “unsafe” patients because we have the ability to increase observation. It’s a crude but true statement. Our ratio of patients is anywhere from 1-3 patients per nurse depending on the required level of care and just how darn sick the patients are.

And sometimes those lines get blurred when it comes to caring for the confused patient. You as the nurse have to figure out how to keep them safe while at the same time corralling their care, progressing their care and keeping things moving forward. All while caring for them and your other assigned patients. Yep – not enough time in the world.

Personal resolve becomes trying when you find yourself repeating the same phrase to the confused patient. Not a couple of times, but close to hundreds of times. Sorry, that’s not an exaggeration. I lost count how many times I repeated the phrase, “You have a catheter in your bladder” to a recent confused patient who adamantly desired to empty his bladder.



Over and over again.

Running into the room too many times to count to stop him from falling out of the bed or chair.



Over and over again.

Securing invasive lines and tubes to keep him functioning and not allowing your confused patient to remove those things he perceives as foreign.



Over and over again.

Explaining to the confused patient that he really is in the hospital and not back home. Also losing count of how many times you repeat these conversations.



Over and over.


And you wonder why we nurses proclaim not everyone can do our job.

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4 Responses to One of nursing’s dirty little secrets

  1. This is so very true, not only in ICU but Med/Surg as well. Sometimes it can be overwhelming. It’s difficult sometimes to manage juggling the safety of a confused patient with the care of the others under your care. Compound this with two or three confused patients and things really get fun!

  2. applebean

    I work in a residential Alzheimers facility. This is how ALL my shifts are. Almost everyday I hear from our residents’ families, “You have the patience of a saint.” Deep breaths! They do work.

  3. Candace RN

    I always love it when a family member “drops off” poor confused mom or dad at the ED and then goes on vacation with no contact numbers while they’re away or don’t answer their cell phones. Hospitals are not respite care.

  4. Smithteamracing RN

    The confused patient can be trying, but at least you know they can’t help it. I find the the whining demanding patients to be even more trying. The ones who don’t work & spent all their available funds on booze, cigarettes, tattoos & street drugs. They expect/demand the hospital pay for everything…feed their family, provide gas vouchers so they can visit, buy their discharge meds. It does get old.