Impaired Nursing Habitat

by Lu Ann Wahl, RN, BC-HN

I arrived to work 15 minutes ahead of clock-in to recon my PRN mission. Friday night; there would be shift change incoming. Self-prepped with “before shift” prayer, meditation (with intent, to keep a calm environment and efficiently attend workload so I could, take a full lunch break), by ambush, I discovered altered terrain. My thought? “adapt, improvise and contain the situation.”

Entering the med room I saw a new refrigerator? Hmm, it replaced “the under counter” end table used to keep the neb machines, fan, and other homeless items… no intel, no memo, no directives…no heads up… nada. Surprise change, just a more congested floor space.

The med room was already “tight.” It stores the med dispensary machines, med cart, counter refrigerator and misc. supply bins artfully hung on the wall, to the side, in the back, and above the existing counter top refrigerator… On top of the fridge is the fishing tackle box of lab supplies, and the glucometer. There are locked cabinets under the sink.

On limited counter space sits books, manuals, log binders and miscellaneous drug info pamphlets. Cables, phone cord lines, and power strips are all together in a nice dusty clot of electrical spaghetti – on the floor, behind the med cart, in front of the new fridge… The upper wall space encompasses a layering of posters, memos, drug info, protocols, announcements and updates on bulletin (not one but two) boards.

There’s other wall items such as the towel dispenser, foam soap dispenser, liquid soap dispenser (drips like molasses from a tree) and clip boards times three to log IT malfunction calls. (As if we don’t have enough documentation of logging the logs of logs of log entries -YEEESH). Even the equipment has its own display of posted notes, memos, and handwritten directives taped to their surfaces, all necessary says the powers that be.

Well, here’s the deal. In my nursing history of 20+ years, I am still not accepting that nursing workspace areas need to become the depository of the lifeless debris or unannounced additions, otherwise known as “clutter.”

Non-functioning equipment, BP machine bits and pieces, “mistakenly ordered” stock not returned, carpujets, dated PDR’s , screws, washers, old hospital bed parts… bla, bla, bla, litter the habitats of nursing units’ workspace or report/lunch/break/education multi-purpose rooms.

As I paused for a breath to release my vasoconstricting frustration and flush off my co-occurring hot flash to seek inner Zen, I am once again determined to practice self care. As many times before, my inner Zen prevailed, and with new eyes, in my own Virgonian way, I embraced the adrenaline rush of having eight minutes before clock-in, salivating over the challenge to execute a quick re-organization of “my turf.” I wiped things down with disinfectant, (added a few drops of Lavender essential oil to the sink drain), refilled my water pitcher and emptied the overfilled trash can to begin fresh. I lifted the end table out of the med room and placed it with “other don’t know where to put it” carcasses that get dumped in the report room.

After checking supplies, loading my fanny pack, and reviewing my checklist, I was ready for duty. Just then, ambushed again, I was given a new assignment. I would be charge that night, not meds; the med nurse (agency) staff would be arriving shortly after 1900. (Report was to start @ 1845P). Thus, the nightshift began.

Although a bit cortisol elevated, and one “code white” later … I remained flexible. I led a PM reflections group on awareness and breath, finished charting, admits, and even helped my agency comrade, covering some of her tasks so she could address audit issues. Even though I missed lunch, (I was prepared, I brought finger food quick nutritional snacks and a protein smoothie) I had our Psych team clocked out exactly at 0715, just the way management likes.

Mission accomplished, I believe the nurse is the first line intervention. Centered presence, attention, and ability to connect with patients are strategic priority #1. I think if nurses wish to utilize their energy optimally then we must hold consciousness of Florence’s philosophy. “The hospital shall do no harm to the patients.” Explore one’s inner work of self care first, meanwhile… form a focus group to take measurable steps to clear clutter – be it physical, mental, emotional or spiritual clutter that impedes the flow of Nursings’ energy benefit to patients.


Lu Ann Wahl, RN, BC-HN and Certified Healing Touch Practitioner, promotes energy balance. Enrollment in the “Integrative Nurse Coach Certificate Program” has inspired even more energy to facilitate wellness within and around her.


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  1. rkamen says:

    That is beautiful and so true!

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