Opinion: ‘Busy’ Can Overwhelm Nurses with the Best Intentions

It had been a particularly grueling day on the med/surg unit. Anne and I gazed at each other in weary frustration as we sat down to catch up on hours of documentation. The day had proved particularly distressing for Anne, who recently had lost a beloved family member to an acute myocardial infarction. Tears of frustration and helplessness pooled in her eyes as she began to verbalize just how tired she had grown of being perpetually busy and stressed while caring for patients.

When and why had the word “busy” grown so powerful that it had the ability to summarize and shape her day, Anne wondered.

Hours earlier, Anne barked at her husband over the phone when he called to inquire about her day. “I’m too busy to talk right now,” she snapped, although she appeared more distressed than ever when she hung up. Later, she appeared equally distraught as a novice patient care technician asked for more personal protective equipment to stock an empty isolation room. “I’d be happy to get that for you, but I’m too busy right now,” she was overheard telling her peer. As a harried physician arrived to the floor, worried about time, chronically late to the office, Anne greeted him with additional words about the unit being “extremely busy.” The physician grew even more stressed, as if he alone assumed an additional burden for the unit’s acuity.

As Anne and I sat down to chart, we began to wonder if this was the kind of attitude (or care) we wanted to be providing. Had kindness and empathy toward our patients (and loved ones) fallen by the wayside, victim to the ascendancy of “busy”? We worried about how/when/why we might have lost the essence of nursing, and how we could get it back.

We had little time to reflect or wonder, as several call lights began to flash in urgent synchrony. Anne hurried to the first one as I left in search of the next.

My patient had accessed her bell by mistake, and was heartily laughing at her “misdemeanor.” Anne’s patient, however, was distraught and restless. Newly diagnosed with brain metastases, and a potential infarct into the basal ganglia, the elderly man appeared saddened and puzzled to be alone in a strange room, with both hands secured by mittens, and no one he recognized to soothe the worry lines from his brow. “I couldn’t find my dog,” he cried, growing more distressed by the minute. “Everyone seems too busy to help me find my dog,” he wept in a soft and helpless voice.

Anne immediately went into action, pulling a chair to the bedside as she soothed and quietly embraced the frantic patient. “I’m never too busy to help you find what you need,” she assured the man, holding his mittened hands until he began to relax and breathe ever more slowly. As she spoke to the gentleman about his surroundings, and reassured him that we cared and would help keep him safe, I saw the beginnings of a smile twitch on his face. He didn’t quite understand what was happening, but he recognized words of compassion, love and respect. Anne didn’t see this man as another “busy” interruption to her day; she merely saw a frail man in distress, someone who needed a hand to hold and a kind voice to respond to his worries.

As Anne gently secured her patient in for the night, she served to remind me that nurses, although frustrated and distressed by endless demands on their time, also can be empowered by the challenges facing healthcare. If we refuse to fall prey to the excuse of being too busy, as Anne had proved with her patient, conceivably the word would lose its dominance and become forgotten or passe.

“Wouldn’t it be wonderful,” Anne mused, “if nurses everywhere could expand and grow in their practice, utilizing empowering and nurturing words until they, too, became habit?”

Diane Goodman, RNC, APRN, BC, CCRN, is a clinical nurse specialist at Advocate Condell Medical Center in Libertyville, Ill.

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