BOSTON, MA – Nurse Shannon Wilkens on floor 4 West thought she saw someone she knew in scrubs walking into room 414. “He was tall, I swore he looked familiar. Our charge nurse informed me he was recently hired and volunteered to work nights,” Wilkens recalled. “So being that it was slow and I had only 3 patients as opposed to the usual 5, I went over to see if the new guy needed help.”
“No, it’s Nurse Charlie tonight,” he responded before she could question any further.
Dr. Charles Fritz, an internist at Mercy Hospital, went back to school to get his RN. “The job market is tough these days. Having an RN degree and being able to moonlight as a nurse for this hospital, really put me above the pack,” Dr. Fritz told reporters.
Mercy Hospital recently let 2 hospitalists, an infectious diseases doctor, a cardiologist, and an orthopedic surgeon go over the past 3 months to save on costs. These recent layoffs ignited a fire under him to go back to night school to get his RN.
Nurse Charlie is taking vitals, giving medications, responding to 10/10 pain, calling doctors for orders, and of course, charting, and charting, and more charting. “I’m really doing everything that is expected of a nurse here on 4 West, and to be honest I’ve never been more tired,” he said.
“We are definitely over-worked. I don’t know how [the other nurses] do it,” he continued solidifying his decision. He also hopes he is able to keep up next week when he will be covering two patients.
“When I round as a doctor I just enter orders into the EHR computer, but I never really knew how it actually got done. I would notice that it would get done but didn’t really know how. And now,” he continued with a snarky attitude that only a nurse possesses, “some of these orders are just pissing me off. I mean giving high-dose Lasix without a Foley catheter and q1 hour neuro checks… Who do these interns and residents think they are?”
“It’s pretty clear at night I’m Nurse Charles, but during the day I’m Dr. Fritz. I don’t mix the two.” Nurse Charles loves to call his colleagues in the middle of the night for Chapstick and other PRN orders that were forgotten.
“Hello, Dr. Lennerson, Nurse Charles here, I was calling about your patient in 401, Ms. Johnson. Can I get an order for Ativan. She’s having trouble sleeping.”
“Chuck, is that you? Order it yourself! It’s 2 a.m.!”
“Dr. Lennerson, I can’t. I’m a nurse. I’d lose my nursing license if I went around just ordering medications.”
At times it has been a little confusing and difficult to keep the two separate. “On rounds the next morning I’ll ask my residents what the patient’s Is & Os were. They will tell me the nurse didn’t chart them appropriately. So I’ll wander over to the charge nurse and say who was taking care of Ms. Johnson last night and, of course, it was me…”
Charles has never been more in love with Haldol than he is now.
“Haldol? Yes, that drug gives me time to do what I love most about nursing: charting!”
Dr. Fitz may be a pioneer but he is not alone. Dr. Carl Nelson, a cardiothoracic surgeon, is 1 month away from getting his nursing degree. “I hope they don’t put me on telemetry, those patients are sooo sick! Plus, who will I blame if the patient dies in the middle of the night? It is me the whole time!”
There has also been a new trend of nurses obtaining their Doctorates of Nursing Practice (DNP). In response, many anesthesiologists are getting their CRNA degrees just to stay up-to-date and competitive.
“Being an anesthesiologist and CRNA really helped me get the position,” said Dr. Michelle Dubins. “Depending upon how much the hospital wants to pay a particular day, they either have me work as a CRNA or other days when the budget isn’t as tight, they plug me in as an anesthesiologist.”
Dr. Fitz sees a not-too-distant future where everyone at the hospital has many degrees and can be easily interchangeable. “I plan on getting my pharmacy degree next, if I don’t get a spot in neurosurgery residency or accepted to acupuncture school.”
