Each patent's cancer experience is unique and cannot be managed with a one -size -fits -all approach. Good pain management is mostly about listening and then applying evidence based modalities and treatments. I would argue that pain is not the fifth vital sign. Unlike a temperature or a blood pressures, pain is subjective and has deep meaning and emotions linked to the sufferer.
Please read The Ethical Responsibility to Manage Pain and the Suffering that it Causes as well as Improving Nurses Attitudes Towards Patients with Substance Abuse Disorder. Both articles deliver the message that nurses as well as other health care providers can act as change agents, or as barriers to successful pain management.
Questions
- In your own words explain what a multi-modal approach to pain management is. At our hospital, what options are available for patients with cancer related pain?
- In your opinion or professional experience, what are some of the greatest barriers cancer patients face when trying to receive adequate pain control?
Discussion Question
It is a joke in our office that we often eat " al desko". Our crumb covered keyboards are sufficient evidence of our choice to eat while we work at our desks. One of the most frequent Journal Club New Year's resolutions for 2019 was to take a thirty minute lunch, or at least a break during the work day.
The following link can be read or listened to, "What Happened to Lunch?" It is from one of my favorite pod casts, and references nurses and their lunch habits not once but twice! Please share your pleasure or pain regarding why it is so hard to give yourself a precious thirty minute daily opportunity to relax, refresh and re-boot. For those of you who do take their thirty minute break, please share the positive benefits you receive from it.
Here is a great link for anyone needing some lunch time inspiration! #nosaddesklunch
This is the fourth of five Journal Club posts for 2018-19, please send your answers to melissa.luebbe@ctca-hope.com .
It is a joke in our office that we often eat " al desko". Our crumb covered keyboards are sufficient evidence of our choice to eat while we work at our desks. One of the most frequent Journal Club New Year's resolutions for 2019 was to take a thirty minute lunch, or at least a break during the work day.
The following link can be read or listened to, "What Happened to Lunch?" It is from one of my favorite pod casts, and references nurses and their lunch habits not once but twice! Please share your pleasure or pain regarding why it is so hard to give yourself a precious thirty minute daily opportunity to relax, refresh and re-boot. For those of you who do take their thirty minute break, please share the positive benefits you receive from it.
Here is a great link for anyone needing some lunch time inspiration! #nosaddesklunch
This is the fourth of five Journal Club posts for 2018-19, please send your answers to melissa.luebbe@ctca-hope.com .
I think it would be nice in theory to be able to take a break away from the desk to have lunch. But it does not seem like a feasible option. And technically because I sit in a patient area I'm not suppose to eat at the desk. So basically my fear of being caught by the bosses forces me to eat in our tiny work room because there is no break room that is not a good walk away from the clinic. I then eat in like 5 minutes time. During lunch we have to be available to hear with the MD comes out of a room and gives us report. Does not matter if we're in the middle of eating or not. It's almost frustrating when we're encouraged to take time to eat lunch as if its not something we would like to do. In order to even make it happen we would need to stagger our lunches and find coverage to be able to eat by ourselves.... Vent over. I think the video had great suggestions but I don't think they are realistic for most nursing staff..
ReplyDeleteStephanie,
DeleteI feel badly for you. The nice thing about my department (operating room) is that we almost always have a "floating" RN that takes over an operating room for the circulator nurse so that nurse can take a 30 minute, uninterrupted lunch. The float nurse has many other duties, but much of their time is devoted to giving lunches and breaks. I don't know why this can't be implemented in other departments. It is so wonderful to know that you have a guaranteed lunch to look forward to. Besides the obvious need to satisfy hunger/thirst, it is such a nice way to simply relax and have no responsibility for 30 minutes. It is sad that there are so many stakeholders who don't get this opportunity. Thanks for sharing your experience.
Unfortunately, the idea of a floating nurse to help us take breaks would probably not happen, since they've got us staffed pretty tightly these days. On nights we usually can get everyone a lunch break of some sort, but we almost always eat with the door to our break room open. Since there are only a few of us on the floor I actually find it harder to relax if the door is closed, like I'm shut off from the floor. It can be said over and over that we should be able to take a lunch break or take a break away from the floor, but the reality of staffing makes that nearly impossible to have happen all the time. I'm not really sure what the solution is, it's just one of those things that I kind of shrug and say "It is what it is."
DeleteMy reply is to John and Stephanie. I am in complete agreement with Stephanie as we always need to have someone to answer the phone and since we do not have at this time a CC that means the RNs or the PCT have to be present to answer the phone and manage the staff/ patients who are currently back in the clinic. In addition we currently have our usual provider who we work with, that primary provider occasionally will have a break in their schedule for lunch but we have to also cover ancillaries (cardiology, nephrology, neurology, pre-op clinic and infectious disease) These providers more often than not start at 12 noon ...allowing no lunch for us. At our last staff meeting we discussed this and we are now again starting to put "no lunch" on Kronos in the hope that we will get help....stay tuned for that. Lastly to speak to John, I was an OR nurse at Northwestern and in my 30+ year nursing career that is the only department when I truly received my breaks and lunch. Way to go surgery!!! You truly are rare in the clinical setting. Thanks for allowing me to vent as well....
DeleteJohn- that's really nice that there is a floating nurse. I think on inpatient it would be nice to reutilize a "floating/swing nurse" to help cover lunch/breaks as well as do other duties. (Audits, projects, committee coverage, etc).
Delete"Al-desko" it's unfortunate that we aren't able to take a lunch together with co workers or even take a 30minute lunch alone. We are not able to eat at our work stations and have no room available close to our work station to eat a lunch. Lunches are brought in by vendors and everyone rushes to fill their plates at that time and returns to their work stations with full plates not having anywhere to eat them together or slowly and enjoy eating. We are told by management that we should take our lunch, but are not afforded the time to take it. In the clinic the lunch time break of patients has been eliminated so there is no break of pts arriving, so I ask when are we suppose to take the lunch break to eat? It's nice to say you should all take a lunch and regroup, but when and how? It's not really feasible for someone to step in and assist in the midst of the flow of pts and tasks being done. I think it's a nice idea, but not a practical one or one that is truly offered by administration.
ReplyDeleteI agree I think the problem of finding coverage is huge. It'll take longer to try to explain to someone what is needed than it will to just do it yourself. Also as we all know in clinic the schedule timing can change so planning ahead is very difficult/impossible. You may think you have a break at 12 but then we're asked to bring patient in early or something comes up
DeleteI agree with Laura and Stephanie. It is hard to find coverage.
DeleteThese comments are so sad. How can we tend to patients when we cannot tend to ourselves? It is more than food, although I do enjoy a yummy lunch, it is about down time, distraction, calming and healing from the morning difficulties in cancer nursing.
DeleteSo much truth and wisdom in your words Donna!!
DeleteLaura, it sounds really awful not to be able to sit and eat lunch. I know that if I don’t eat I’m really annoyed and can’t focus . It is very challenging to function as a care giver if you neglect your own needs. I personally would like to have a nurse that is happy and nourished so they could perform at their best. It is no secret that when people are hungry and tired, productivity decreases.
DeleteFor me it depends on the night. I try to take a break and eat - but other times when no one else is in the break room and the cafeteria is obviously not an option... I just go back. When I was in PCU - I used the renewal room all the time. However the renewal room on 2nd floor is always so cold and the temperature can not be adjusted like the one in PCU. Other times, it's nice just to walk laps around the floor for a "break".
ReplyDelete-Danyel Scharff RN
Although many times haphazardly, we typically do get a lunch of some sort and can get away from the department for a little bit. I was just saying today that it will be nice when the weather finally breaks and we can eat outside in the fresh air. The staff cafeteria is not very clean, even the naked eye anymore, in fact it is kind of disgusting:-( I am concerned about eating in less than sanitary conditions, but maybe that is just me?? Nevertheless, getting outside for a break would be a positive on so many levels!!
ReplyDeleteI agree Julie. Since the closing of the serving area of Ricardo's the cleanliness has gone so far down. Which I do not get. It is still an area of the hospital, so I'm unsure why it is not assigned as an area that needs to be maintained.
DeleteI'd like to add to this comment. As others have stated that many departments are short staffed, maybe our environmental services department is as well. I agree that it's still an area of the hospital and cleanliness should be a top priority. Old Ricardo's no longer a highly populated area in which may be why it's no longer a top priority. This is great that its has been brought up and maybe we can pass this information along. Thank you
DeleteIt's unfortunate that we have come to feel this way about an area that has had many great days. I know that may of us are frustrated because of how short staffed departments may be, but keep in mind that we are all doing our best to keep up with the hospitals needs. Hopefully, environmental services will be notified and try to get to it more often than they are doing now.
DeleteThe thought of going outside to eat lunch or go for a walk sounds delightful! A little vitamin D will help us all and make us much happier.
DeleteI work in the operating room. The greatest perk that I enjoy about this department is that every nurse gets a 15 minute break and a 30 minute lunch. There are rare times when we must forego our 15 minute morning break. However, in my 11 years in the surgical department, there has only been a couple of times when I did not get a lunch break. Even better, this is a "real" guaranteed, uninterrupted, sit-down lunch. I appreciate this so much. I have worked in different departments where nurses eat standing up, when they can, or don't get a lunch at all. Having a set routine is so important to me. Even though we have to take call, I would not ever want to work in any other department. This seems like a small benefit, but it is one that I am not willing to forgo. There are other departments under the "surgical services" umbrella which do not have this perk. I find it so valuable to be able to have that personal, me time to eat in peace, rest and re-charge for the rest of my shift.
ReplyDeleteGood for you John:-)
DeleteI am so happy for you that you have this opportunity, John. It is quite apparent how this has increased your work satisfaction. I hope other departments will get this same opportunity!
DeleteI hope we will have this perk here in PACU too..
DeleteJohn, is your unit hiring? (LOL)
DeleteIt sounds like you have set a precedent in your unit John, to take lunch. I applaud you. In my unit it has become difficult to take breaks as we have so many tasks and details to attend to, and it has become easier to skip lunch and unfortunately a lunch skipping culture has developed. However, it is absolutely achievable to take breaks, and I think you have to make it a priority and unacceptable not to take a lunch
ReplyDeleteI have worked many depts/units and rarely have I had the opportunity to sit down with my co-workers or by myself to take a full 30 minute break. There is always an add on, a patient needing further help with something or the doctors needing the nursing staff to follow-up on something. I have been going without a full 30 minute break for so many years that I really have a difficult time eating slow. I figure at this point in my life I will take a lunch break when I retire. lol Funny but, not funny. Maybe we can take a deeper look a John's unit to figure out what they are doing right.
ReplyDeleteI have the same problem-eating slow that is....30 years of inhaling food while you had the chance.....
DeleteOh my gosh Mary I totally am on the same page as you about eating fast! I honestly feel like I have GI issues because I am always eating so fast. I get anxiety when I have a lunch break because I get worried about orders or things I’m missing while I’m eating. Therefore I shove my face as fast as I can to get beck to the computer. I need to change that!
DeleteI totally agree about needing to eat fast, Mary! Because if you don't eat fast then you don't get to eat!
DeleteWe are very fortunate that most of the time we do get our lunch breaks. They may be staggered, but usually it is possible. The nurses stopped eating in our department break room and started going to Ricardo's because we would be continuously interrupted for questions that can wait until we are back at our work stations. If we do not get a lunch, it is expected that we try to leave 30 minutes early sometime in that week. There are so many pros for getting away from your work area. For the areas that are unable to make this happen, it is a problem and I feel that their management team should be figuring out a way to make this happen for them.
ReplyDeleteIn rad onc, we work as a team, so if I finish a consult at 1230 and need to start a new consult at 1230, someone usually will either finish first consult or start following consult so I can get away to lunch. I rarely miss a lunch. In the spring/summer, we often sit outside in lawn chairs to eat, staring at the pond, birds, and trees. I am rejuvenated. I realize how lucky we are to have back-up and departmental support recognizing lunch is more then food. I hope this topic is brought to many department meetings so it can be fixed, as it needs to be fixed.
ReplyDeleteWow, that sounds like a dream! I'm glad your department has found a solution to this issue and that you are able to cover your coworkers for much needed breaks. I hope the clinics eventually work this out as well. Thanks for sharing.
DeleteDonna and Rad onc team - I find it inspiring that you all find time to take lunches everyday. I can imagine it would be rejuvenating. Good for your team!
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ReplyDeleteAs I said above, the reality of staffing right now means that getting in a lunch can be really tight and sometimes downright difficult. After having another string of days of not getting a real break, I finally said enough and have been trying to utilize the supervisor/house resource more at night to get a break, if there are only 2 RNs on stem cell. It doesn't always happen, but I'm trying to be better about taking what is truthfully ours by law. It's so hard to work that in, but it should be necessary. I think the podcast had a great discussion about the need to get back to a lunch break, but the realities are sometimes much harder to deal with.
ReplyDeleteHi Katrina,
DeleteI agree with you with staffing the way it is, it is almost impossible to take a lunch. For instance, it would be incredibly inappropriate to expect a nurse to cover at least 8 patients with sometimes no tech while I take a 30 minute break.
I certainly agree seeing that we work in the same unit. I think when you work together you have more empathy toward one another and as much as possible, help each other out.
DeleteKatrina, I truly agree with you. REALITY VS EXPECTATION.
DeleteMost of us (I think) is not that "I didn't get a lunch". As I believe all of us chose nursing to be there for our patients no matter what...but my frustration is lunch breaks are automatically taken out of our pay and we are made to feel it is "our fault" if we are not taking a lunch. This lunch debate has been going on for years, I hope some day it will be acknowledged that in reality many RNs are not getting a lunch and it is not "their fault, or "poor time management skills". If we take a good hard look at the temp plates with our current staffing, how could one take a 30" break over the course of the day and how could we avoid OT. In my mind, It is truly not realistic.
ReplyDeleteI would be very frustrated too if I didn't take a lunch but the time was deducted from my hours. It is not the nurses who created the "no lunch" work environment. Unfortunately, the only way I could see this being rectified is by having an additional nurse who could cover lunches. This would probably mean that it would take 45 minutes to cover the 30 minute lunch so that a hand-off could be exchanged.
DeleteThe issue of pay is really a big concern. It truly isn't fair that you are docked 30 minutes in compensation regardless if you actually take a break or not.
DeleteOperating rooms can be a fast paced environment. It's easy to feel burnt out, and providing these breaks gives someone the time to possibly feel refreshed, energized and overall relaxed for a moment in time. On many days my role as a floater is to provide 15 minute morning and 30 minute lunch breaks to 2, or sometimes 4 techs as well as myself. There is rare days were some may have not get their morning break, but we do our best as a team here to make sure that those 30 minute lunch breaks are offered. Most people here in the OR, will adjust based on the scheduled cases, and can see that they might have time to get their own lunch break, grab a small bite to eat, or run to the bathroom anything to help our day go a smooth as possible. It's easy for a schedule day in surgery to change at any moment, cases go longer, orders may change and procedures just don't go as planned. If you are offered a break, to either eat or use the bathroom it's best to take that offer if possible because you never know what can happen here in the OR.
ReplyDeleteI work in the operating room. Not getting a lunch break is not usually questionable. Our charge nurse tries to have lunch assignments by 11 am. Our lunch times start at 11:30 am. If we are shorter staff usual we may start sooner, just to make sure that lunches don't go too late. We work in a very stressful environment, and need a break to decompress. Plus, people cant focus and do their job well,if they are hangry. We are fortunate if we don't have enough staff our charge, manager or FA will step in and help with lunches. I believe that breaks are important not just to eat and decompress. They are good to create bonds with our coworkers and strengthen teamwork.
ReplyDeleteRosa Bastean
Oh boy.....a lunch break. Not possible. We cover at least two providers any given day in Internal Med Clinic, one of which is an ancillary provider, and they can be in the morning, at noon, or afternoon. They are often double-booked with our primary provider. So there's that. In addition, we also cover office tasks, such as calls, Right Fax, add-on patients, etc.
ReplyDeleteWe would love to find a way to have a lunch break. As mentioned by another nurse above, handing off to someone else is just too complicated, especially when that person is already juggling several patients, phone calls, Skypes, and emails.
So for us, the problem isn't a lack of space to eat, but a way to carve out time to step away.
Totally open to suggestions!
Hi Jennifer,
DeleteI feel the same way. There aren’t enough hours in the day or enough bodies to create coverage for breaks. Handing off is hard. We used to have a swing nurse that came in at 11 am to help cover lunches and settle admissions and that was absolutely amazing. However, that is no longer, so lunches have pretty much gone extinct for us too. We all are juggling a lot during our days as nurses and we often just keep the juggling act going til it’s time to go home.
I remember when I used to work inpatient at a different hospital, the AM charge nurse would cover the nursing staff while they went on break since the charge nurse didnt usually take an assignment it would be easier to cover. Perhaps this could be started here where a nurse who is not seeing patients would cover but with the shortage I know it isn't possible. Maybe one day.
DeleteNinfa L. Bontes 2/19/19
ReplyDeleteYes, the phrase, "Al desko" is a perfect description at my desk. I eat on the run and I often shake off my keyboard and sweep my desk with all the crumbs, sometimes pick some up from the floor:) No matter how you start the day determined that I am going to take a decent lunch break today, most of the time it will never happened. Just supporting not one or two but three providers at the same time and luckily if no overlaps or what we normally call double-booking is challenging scenario. But, we manage to grab little bites here and there just so we can nourish our mind and body in order to function efficiently. It is just the nature of nursing career ever since we open our eyes to it. Patients are always our priority no matter what. When at a crunch schedule, healthy finger foods serve well in those times.
Hi everyone,
ReplyDeleteAfter reading everyone’s comments, I feel like we are all kind of in the same boat with lunches. They’re not a likely occurrence in our day. My unit has so many admits and discharges and procedures that there is no way to ever be able to be away for 30 minutes. Our charge nurses always have full patient loads themselves, unable to cover for anyone. We really do our best to help each other out and cover as best we can when our peers are taking a break, but it can become overwhelming quickly. I feel guilty if I get a lunch sometimes because I feel horrible if I everyone in my unit doesn’t get a full 30 minutes. One thing I’ve been doing to try to make eating easier is packing my own lunch. I make sure I have a high protein snack for the morning and one for the afternoon and then a main lunch, and a little sweet treat for if I need a pick me up. It sounds like a lot, but I’ve gotten in the habit of it. My husband will do it for me sometimes before he goes to bed if he doesn’t see that I’ve prepared something the night before. Having quick options while I’m at work has helped a little bit. It also helps if I get out late and get home too late for dinner.
Hi Stephanie, That is great that you prepare and have meals and snacks from home while at work. It sure can make eating less stressful and less time away from patients.
DeleteSarah
Stephanie - will you pack me snacks, lunch and a sweet treat? After 22 years of making school lunches I went on strike and now buy my lunch. Lets rephrase that - I can afford to buy my lunch and peanut butter and jelly sandwich's are low on the food chain now!
DeleteHi everyone,
ReplyDeleteIt sure is hard to get away from patient care and get a lunch. It seems to be the ongoing struggle we each face and with more work force reduction, it definitely is not improving. For myself, I have had to bring my own food due to other reasons, but it has made lunch and snack time a little easier. Making food/snacks ahead of time, like others have mentioned, has really improved my time to sit and eat, no matter the place.
I think having the swing nurse position would definitely help give some relief, but it looks like that is not an option at this time for a lot of areas.
That's great, Sarah, that you can bring in food and prioritize your needs. I'm glad you make the time for yourself. I know it can't always be easy.
DeleteI am definitely guilty eating lunch at the desk more often than not. My struggle is that, even though I can schedule a time to eat lunch, I find that I need to continue to work in order to get all my tasks done and follow up on the many patient issues and tasks that are not on my schedule each day. I don't like eating at the desk, but dislike staying over in order to get everything taken care of even more.
ReplyDeleteI could not agree more with you,if someone look at schedule in SCM or on paper it looks like we RN in out pt clinic has enough time to get lunch. But in reality that is not the truth. i might have only few patients on schedule but there other things going, we supporting multiple providers, phone calls, Right fax.. list can go on and on. all we do because we love our patients
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ReplyDeleteI don't remember the last time I took a lunch break with coverage. It is not feasible on the inpatient units. We all certainly help each other out with call lights, but I would not be able to go phone free during lunch. I don't think the "staffing laws"...the grid, quadramed, etc. take lunch breaks into consideration. I'm not sure how this could be fixed as we don't have house supervisors. The managers that cover the house don't have time to cover for breaks.
ReplyDeleteVery true Krista. I feel like on inpatient resources are so limited it is hard to take a break without feeling "guilty" or feeling that the patients on the floor are adequately covered
DeleteWorking on nights isn't always easy getting a break, its pretty much your own initiative to take one. Usually there is only one tech. And some times its so busy, you just cant take one. If I read a newspaper or go get a bite to eat I am happy with that, it changes from person to person depending on ones needs.
ReplyDeleteVery rarely do we get an entire 30-minute break. If we get a break at all, it is usually consist of a whopping 10 minute of stuffing our faces. Last week, 3 of the 4 days I worked, I didn't get a proper break. Two of the days were without eating and one day was eating at my desk while charting for a quick 5 minutes (which is frowned upon). In our unit, it isn't even realistic for us to cover each other for breaks as we all are working nonstop. Hopefully, we can eventually solve this issue as not only do lunch breaks provide much needed nutrition for energy so we continue to be productive throughout the day, it also provides a mental health break to walk away from unit to gather our thoughts and take a deep breath. Given the environment we work in, mental health breaks (even 5 minutes) are much needed.
ReplyDeleteAmanda, I agree with you that it is usually the mental break that is needed and that involves removing ourselves from the desk and walking away is more important to me to regroup. It is not just at work that I sometimes have to eat on the run. Even home life involves eating quickly to get somewhere whether for an appointment, picking up kids, dropping off kids, ect. I think you get the idea. After dealing with a difficult patient or a sad situation you have been focusing on the mental break is often what is needed most.
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ReplyDeleteLunch breaks? At work? What's that? It is disheartening that in my outpatient clinic, we rarely ever get a lunch. If we do, it's only to grab food and eat at our desks. The problem is the clinic functions at a fast pace. At times, there are anywhere between 2-4 patients in the clinic waiting for something at the same time. It takes more time to handoff what is happening in the clinic than to do it yourself.
ReplyDeleteI would love to see if the outpatient clinic could somehow arrange something that would work, just like surgery and radiation do.
I agree with Sheila what is a lunch break when your at work? I can count in my hand the days I was able to actually sit down and enjoy a full 30 minutes lunch break. through the years of working I'm able to master to chow down my lunch in 10mins or less.
DeleteI tell new nurses that until you can savor the salty taste of cold potatoes you have not become a full fledge nurse! LOL!
DeleteI agree, Sheila!!! Our outpatient clinics are very fast paced! Taking a lunch break in the middle of clinic just doesn't work. I would love to see the outpatient clinic arrange lunch like the radiation department has! Now that would be Nice!
DeleteI have been RN in out patient clinic, and I do not remember getting full 30mins lunch break,it never bothered me as long as I was able to eat, forget about fifteen minutes breaks. But, lately I do not even get that. It is not only me my team members too. we support multiple providers in clinic so many times you have two different patients, with two different providers at same time not because we do not know how to manage out time. week before no lunch for 3 days at all. last week out of four weeks no lunch at all 2 days, i do bring my food but clinic was so busy I could not even eat at my desk. There is a no way my team member can cover for me because they are going through same thing.I am trying to stay positive that this might be a phase and will get through it as a team. We are really open for suggestions.
ReplyDeleteLike many areas in the hospital, it can be challenging to sit for a full 30 minutes for lunch. Depending on how the surgical day is, is what determines if we can eat, let alone have a lunch break. We do our best to look out for each other when we can cover so one can eat lunch. But can be impossible at times if we have multiple cases coming out at once. For me personally, sometimes it is hard to not think about the tasks that are waiting for me once I get back to PACU. So then I tend to speed up eating so I can finish up where I left off so I don't have much to do at the end of the day.
ReplyDeletetrue story Camille, but for now, we will just do everything in our power to give the safest care possible and still able to finish charting and eat lunch anytime during our shift.
DeleteI agree with you, it is hard for us to have a complete a full 30 mins because of how our cases come out, but in the end of the day a full 30 min meal would not give me satisfaction if I feel like I did not give the best care to my patient because of having a full stomach.
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ReplyDeleteAfter reading the majority of these post, it is disappointing to see that most of the nurses do not get very many breaks. This is an unfortunate trend that is not heading in the right direction. Statistics have proven that productivity decreases when staff is tired and hungry. Job satisfaction will also decrease as a result. There doesn't seem to be an easy answer to this dilemma. Hiring more help does't seem to be the solution due to the trending reduction in our numbers. I am one of the few that work in surgery and take it for granted that breaks are still considered necessary for staff morale and productivity. I feel fortunate and hope that they don't disappear. I hope we can find a way to keep our staff happy and refreshed soon. (In Maslow's Hierarchy of Needs, it states that our basic needs include food, water and rest. Just saying.)
ReplyDeleteFood, water and rest..haha! Lucky to have time to pee some shifts. Would be nice if all staff got their 30 min break not to even mention an additional 10-15 min break for those of us who work 12 hour shifts. Yup, sure would be nice.
Deletegetting an adequate break on the unit is definitely a struggle. on inpatient, many times there can be only two of us on our unit, so it would not be realistic to leave one nurse by themselves without adequate coverage. it is unrealistic to have our manager cover everyone for lunches as well as still get her own lunch and get their own work done. I wish we would be able to come up with a solution to solve this. it is important for well being of staff to get breaks.
ReplyDeleteHow I wish I can have at least 30 minutes of uninterrupted lunch break every single day. But most of us knows that this isn't happening especially with our recent staffing levels and cut-backs. In PACU just like the other departments, my lunch breaks are not guaranteed. We try to help and cover each other but you are not really free of responsibility and most of the time I am rushing to eat and come back as fast as I can and be ready for the next patient that might come out. But to be honest, some days are slow and I can fully enjoy my full 30 minutes lunch break and maybe more like 31 minutes... and I am grateful for that for it won't happen everyday.
ReplyDeleteAlex, I think the idea of "grab it when you can" is always applicable for us doing bedside nursing.
DeleteThere is a sense of guilt when I am able to eat lunch away from my desk because I think about the work that still needs to be done, that time could be used to prepare for the next patient/next day, etc. I feel as though when I am at work my brain is constantly thinking about what else needs to be done and every "quiet" moment we have should be used for productivity instead of taking a moment to deep breath, stretch, or step away from the clinic. In our clinic we do have lunch provided by drug reps quite often so at least there is food available for a quick bite, but I would much rather be able to step away without the quilt or my mind to calm down to regroup.
ReplyDeleteI agree about feeling guilty!
DeleteWe all need lunch break but it depends on the surgical schedule of the day. Most of the time its a quick bite just to eat something. Its unrealistic to cover each other because we are all running around.
ReplyDeleteHi Vilma, I've been there in SDS I agree, It's hard to get lunch when no tine to stop what you are doing. But you're correct we need a 30 minutes lunch break.
DeleteWhen I was in China, my husbands work company, mandate all the employee to take lunch breaks for an hour. Either you eat, naps or shopping. Well I guess it would be nice to get an hour break. And the kind of job you have will also determine that you can stop/pause of what you're doing. Working as a nurse, it is really hard, as our excuse is patients first or I have no time. Literally we have a choice. We can always call our manager/USL to cover so we can take a break. If we keep that as a habit then we can work and focus better.
ReplyDeleteI can not remember the last time I took a 30 minute break not even the 15 minute break they said in between. Working in a surgical floor can be very hectic most of the times. And now that we are doing primary care for some of our patients, I think breaks has become a "luxury" more than a necessity. Just like what other nurses said, they eat, pee, or drink when they can. In my honest opinion, I think as nurses we become guilty when we do not finish our work or we have not done things to our patients first that is why we tend to not go for a break and I myself is guilty of that. I guess Fides is right, we have a choice and breaks are our choice. We just need to get that habit of having someone to cover us so we can do it when we are working. Just like feeling thirsty is our body's way of begging for water, taking a break when we are exhausted is our body begging for downtime. There are benefits to stopping before we are completely exhausted that is why we have to be proactive and look for each other as nurses.
ReplyDeleteI have been a nurse for 20 years now and have only on a rare occasion got to take a 30 minute break for lunch. When I was a RN working the floor it was a matter of finishing tasks and meeting the needs of my patients. Now in the outpatient clinic it is a different type of busy and I feel that if I take that 30 minutes it may cause overtime if I do not get my work done. I just find it easier to keep working and eat my lunch as I work to get out on time and to finish my work so that I don't have it waiting for me when I return the next day. With that being said sometimes I do take a 5 minute walk just to get away from the desk and refocus for mental sanity. If it is possible to have coverage I am happy to take that 30 minutes but when we are all feeling overwhelmed I just cant do it. I can not ask a co worker who is overwhelmed to now cover me so that I can take a 30 minute break.
ReplyDeleteAgreed! We all have so much to do each day, it's hard to think about absorbing someone else's duties while they take a break. As a team, I think we function pretty well but it would be nice to be able to take an actual break.
DeleteOur patient's are scheduled every 20 minutes in the clinic, most days our providers schedules are very full. The nurses that work in the clinic are constantly in and out of patient rooms and providing patient care. The nurses that work in our office and on phones are just as busy. The nurses that are working at the clinic desk are not allowed to eat at their desk. Our breakroom has 4 chairs for our entire floor, which is about 25 people. Our nursing team eats quickly when able in between patients, taking just a few minutes, never anywhere near a 15 or 30 minute lunch. If a nurse did decide to take a 30 minute lunch there would be consequences. The time that nurse was away would impact/delay patient care and dump on another nurse who already has a full plate.
ReplyDeleteWe do the same but very seldom put in no lunch as that is OT. Many of us - probably 90% of us donate our 30 minute lunch to the hospital.
DeleteIt is extremely difficult as a nurse to take a 30 minute break. There are too many patients in a day and too many tasks to get away. You are left with either “do I take my 30 break now and be here late or work through my lunch break and leave on time?” For most people it would be the second option. Yes a break in the middle of the day would be great to get a mental break and to take a few deep breaths but in reality it is not possible. If you decide to take a break then you worry about finding coverage while being away. I’ve worked both inpatient and outpatient and it is just not that easy. Sometime you're lucky to get a bathroom break.
ReplyDeleteIt seems as this is now the norm rather than the exception which is really sad. It is the law to allow your employees to take a 30 minute lunch break if working over 5 hours. Take your lunch break, and whatever consequences follow will follow. You are just as important as your patients you serve. If we don’t take care of ourselves, there will be no one left to take care of our patients.
DeleteBrenda Chiappetta
My husband works in the corporate world and he takes a "lunch hour". He goes to Starbucks, gets a cheese and fruit tray and reads his book. Sometimes they all go out but more often this is his time to recharge or when the kids were at home he did the lunch runs, pick kids up early, go the bank...he could take his lunch most times when he wanted to.
ReplyDeleteWhat happened to the days that we all went down to the cafeteria? I think those days went out the door when we were mandated to eat our lunch and take our breaks on the unit so we were readily available to the doctor. I always took my lunch break down in the cafeteria and recharged (I know that will surprise many of you) but it did make a difference. Now in wound care we give up many of our lunches - does not matter what time you take it - to add patients. We are nurses and the compassion overrides the brain. I do try to take a moment to stretch and breathe even when I am eating on the run.
Pat,
DeleteNow you have my crazy little brain spinning. Nursing is mostly a female- dominated field. Your husband works in the corporate world which is mostly male-dominated. So, now I am starting to think nurses should think more as the corporate world does. We do work at a place of business; dollars and cents, they need to balance the budget. We might be happier in our jobs and function more efficiently if we took our breaks. We should also mark it down on the Kronos sheet when could not go to lunch. Maybe if we were honest about not getting a break, they could determine how much more staff is needed or at the very least try to cover our lunch breaks. It is interesting that the male-dominated world gets a break away from their desks and even away from the office but the female-dominated world doesn't get a break or eats at their desk while working. Women tend to sacrifice and put everyone else first even if it means not eating or if it means working without pay by not going to lunch or reporting that we didn't get a lunch break.
Agreed Patricia. We need to start putting in Kronos when we do not take a lunch. The only way things will change is when the truth is known.
DeleteWe see patients in clinic every 20 minutes, and at times have seen 20 patients in a day. The providers schedule is usually completely booked, and we have times slots we double book. I work in clinic, and move very quickly in and out of rooms from rooming patients, to injections, to letting the patient go after their appointment, to then cleaning the room once they have left clinic. We are not allowed to eat while working in clinic at our clinic desk. Our breakroom is super tiny with maybe 2 to 4 chairs and usually at lunch time is filled with food from Drug Reps. I am appreciative of the drug reps and bringing food in. At times, I am able to eat quickly between patients for just a few minutes. If we didn’t have the drug reps coming to the floor with food, I find it very hard to go to the cafeteria because there is NO time for break. I would just go without eating. Taking a 30 minute lunch, let alone (2) 15 minute breaks in a work day here is unheard of. There is simply no time. I would hate to ask anyone, because then that would put them behind if they have to cover me.
ReplyDeleteBrenda, this is all so true. When I worked in radiation a loooong time ago, I both had to be prepping a patient (before a doctor) while teaching another (after the doctor). One can't be in 2 places. I always tell my husband, "it's no wonder I'm not a size 2."
DeleteWorking in the outpatient clinic, I have found it difficult to walk away for 30 minutes to take a lunch. Clinic is very fast paced and very often we eat at our desk while charting in between seeing patients. I feel guilty when I walk away for any sort of break, knowing there is work to be done.
ReplyDeleteWe are lucky in the clinic that we often have drug reps cater in food. We go into the break room, make a plate, and head back to our desk to eat it then get back to work. Sometimes we let our food sit there while we go about our tasks then we come back to a cold plate of food.
At my previous clinic job, the whole clinic would close for one hour. We could sit in the break room, eat our lunch and decompress for that time. Some would run errands or take a walk outside. Being able to do this gave us the chance to recharge our batteries and prepare for the remainder of the day, without feeling guilty about not getting work done.
I agree fully with your comment. It's a guilty feeling when I take time to break away and someone else is drowning. I do miss the days when we could go for a walk in the middle of the day. Once around the hospital building and back to work only took less then 15 minutes.
DeleteTheresa Minniear Clinical Research
ReplyDeleteThis discussion comes at a perfect time. I was just thinking today that for weeks now, every time I have looked up at a clock, I realize it's 2-3pmish, and I haven't eaten. In my dept there are only 4 of us to shoulder every research pt in the hospital. We're absolutely overwhelmed. As Melissa mentioned, we scarf down lunch at our desk...while working. I know we're not unique bt I do feel like it's getting worse. It is so hard to break away for 30min because we're constantly "on call." Our phones, skypes and emails constantly light up with last minute consults, and we have to adjust when patients are seen early or late. Honestly, unless we're scheduled as "providers," I don't see how to fix this. It saddens me. Also, we're on our own...no drug reps come to our neck of the woods, and we're as far away from the cafeteria as it gets.
That’s really sad. Maybe if everyone stopped doing this, administration would realize that maybe more staffing is needed in certain areas. Sooner or later the stress and lack of self care will catch up to us and it will affect our health. Take the time...even if it means you have to not finish something.
DeleteBrenda Chiappetta
Theresa that is sad, you need to make sure to take care of yourself as well. Skipping meals is not ideal and maybe try to reach out to co-workers to better cover for you to grab a bite to eat! Important to take care of yourself!
DeleteThere are many days I still try to eat at my desk while charting or whatever. Sometimes we give up our lunch to see a patient add on in the clinic. I have tried to make it a practice at least 3 days a week to not eat at my desk and eat in the break room for 10 minutes, and then take a 20 minute walk around the hospital. The days I do this I feel more relaxed, rejuvenated, and ready to tackle the second half of the day. The saying goes, you make time for what is important to you. We all need to come to the realization that we are just as important as our patients, and take that 30 minutes for our own self care. Find a way. 😊
ReplyDeleteBrenda Chiappetta
Wound Care
We often skip lunch or else eat at our desks on a regular basis as it is hard to pull ourselves away from tasks that need to be complete as well as the ongoing patients needs throughout our day. Recent months have been a lot worse as far as trying to stop and take our time to eat as the phone is always ringing or an email comes through with patient needs. Hoping to get better at just getting up and walking away for a second without feeling guilty that you left your co-worker to take care of everything while your stepping away, but we all have to do that in order to take care of ourselves.
ReplyDeleteI have worked with different facilities and all of them have different policies about having lunch/breaks. Some they do require employees to clock out and back in for 30 mins uninterrupted, some employers just deduct 30 mins on your total time. I do eat fast because I want to get things done on time and I always think that patients will ask for me , we do hand off but still our patient's expectations with our availability for them is very important to me and I feel like If i am the nurse assigned with a patient, I am still responsible with everything for them the whole time.
ReplyDeleteI work in surgery and We do get lunch breaks every day. I am grateful and appreciate the 30 min away from work when I can sit and eat in peace. I think it is very important to have that time to rest and recharge. There is less tension and more productivity when people are fed and not stressed out by the fact that they cannot eat.
ReplyDeleteWhile I'm reading all your comments, I believe we all share the same experiences, we can't break away to take our break, we are groomed the same way, We are very passionate & very dedicated to our work & patient that we forgo our privilege to have a 30 minute break for lunch. We work in SDS & start very early in the morning, I usually eat my breakfast at 3:15 am, when we are very busy in our department, we may have lunch at 1200 or later & eat in our department standing up. For our snacks we try to do it in between patients. We all know this is not right but because our love for our patients & profession is our priority we still continue to do it. When we are not busy we try to eat in our lounge. Our relaxation technique is laughter & singing in our department. I am very fortunate I am working with bunch of excellent nurses & team that I love very much. So I guess it compensate for not going out of the department to have a break. And by the way we bring our lunch to work, otherwise going to cafeteria is not an option 'coz it requires more time out of our department.
ReplyDeleteAll of these comments are overwhelming! Makes me realize how many of us don't get the opportunity to step away from work.
ReplyDeleteDespite making it be my resolution this year to step away from my desk, I think I may have only successfully done this maybe twice. I know I am putting these pressures on myself to be available at ALL times for a call from a patient or a communication from a doctor. In the span of 30 minutes a situation can implode, which could have been handled easily if I'm available to handle it right away. I need to prioritize myself as much as I prioritize my work.
There was a time, a couple of years ago, where I made a point of taking a break away from my desk to eat even if it was for only ten minutes. My day seemed to go faster and I felt refreshed when I returned to work. Stepping away helped me focus and multitask better. The challenge now is that if I am working with the provider, if I am assigned to phones, or if I am in the office, there is no time for lunch. In my opinion, the restructuring has impacted MRMC. We were profitable and I believed staffed according to the number of patients we serviced. By working to balance and support the entire enterprise as one, the decrease in staff at MRMC has affected many staff members abilities to take a break. There are days that I am away from my workspace for a total of five minutes and that is because I couldn't suppress the need to use the bathroom any longer. I have thought about trying to sneak a quick lunch away from my desk but that means that I might end up accruing more over-time which is frowned upon. Sometimes I feel like it is a vicious circle.
ReplyDeleteI work the night shift so I may not always take a break away from my desk, but I do have a chance to enjoy my meals uninterrupted most nights. Generally I sit at my computer and chart while I eat dinner. Our break room in stem cell is unusually loud. It sounds like a crazy loud wind tunnel so it is far from relaxing to sit in there. Besides I get lonely! Seriously tho, it saddens me to read about the staff that does not have the time to take a well needed and deserved break. Hate to hear of staff donating their break to the hospital, please put in the time. It is yours and you earned it. Take your break or take your money.
ReplyDeleteMy previous manager at CTCA told out clinic staff that we could not leave the unit to take our breaks. This started the downward spiral for me that I would just work through lunch and quickly shove food into my mouth while standing in one of the patient treatment rooms. Then the providers were told that they could change the templates to see patient's continually through the day. The 30 minutes allotted for lunch was taken away. So now we all just hover over our lunch, shovel it in and keep going. Sometimes my food hangs out till 3pm where I've been picking at it and then it goes into the garbage. It is very sad and I miss the days when we could go for a walk or just sit and chat with coworkers. The work is overwhelming and there just is not enough staff to allow for even one person to walk away for 30minutes. BUT we keep going and we keep serving because we are hard working nurses who strive to be the best for our patients.
ReplyDeleteTaking a 30 minute lunch break is something that I have ALWAYS struggled with since I became a nurse. I feel that there is something that always needs to be done. I would rather just keep working to get it done, than take 30 mins and stress that entire time about all of the time I am wasting being unproductive. I pains me to the core that I cannot eat at my desk. So instead, I will take 5 mins to shove my food down my throat away from the desk or I just don't eat. I know that I need to do better for myself, but if only there was more time in the day it would make taking a lunch break a little easier! :)
ReplyDeleteI could say that I have come a long way to enjoy my lunch break. I am taking my 30- minute lunch break most of the time now. I decided to do this to get up and walk away from my desk. It's a way to keep my sanity intact. Our secretary would compliment us when she sees us in the break room or in the hallway at lunch time. She will also remind us if it's lunch time. The downside of it, have to go home later than my time. I'm on salary so I won't accrue overtime.
ReplyDelete