Joshua Arruda, a 27-year-old nurse with a degree in Master of Arts, has been working in the medical system for many years. Through the interview, he gave us insight into the responsibilities that a nurse holds and the improvements that he would like to see in the healthcare system.
He "started working in a hospital at 18 as a housekeeper." At the time he attended community college, he "didn't have a major yet." "[He] had moved up to a transport position which entailed much more patient contact. [He] realized [he] tremendously enjoyed not only the social aspects of dealing with the patients but of working with all [his] colleagues also. That fact and the vast amount of growth, traveling opportunities and competitive pay offered led [him] to choose nursing."
As a nurse, he has many roles and duties to fulfill.
"Nurses are charged with continuing the nursing process (ADPIE) throughout the patient's stay. This includes being able to [...] assess, manage and intervene accurately and relevantly to the patient's condition, and be able to work collaboratively with the entire health care team, including doctors, respiratory therapists, and OT/PT, just to name a few."
"Generally, on a regular day, we are charged with daily assessments of patients and administration of medications. I am also charged with taking general information from my daily assessments and my research from patient charts and being ready to daily round with the floor MD and Case Management to establish the next phase of the patient's plan of care. Throughout the day, it is up to me to continue to collaborate with all of the providers on each patient's health care team and make sure specific tasks and treatments are completed."
What motivates him to complete his tasks first and foremost each day is "to make money so I can achieve all the goals I have in life (house, family, travel, etc.)." Besides, He "also just really [enjoys his] job and what [he does]."
"The facility I work for is the best I have worked at, and very appreciative of staff. Generally, I enjoy learning about the many health conditions and continuing to grow my knowledge and refine my skills. Taking care of patients and making a positive impact in their life gives me great incentive to continue this work."
Joshua's feelings are closely related to his patients' conditions.
"My favorite part of my job is face-to-face patient care. I really love having the same patients for days at a time and building a strong rapport with them. It's a great feeling to see the patients' conditions improve and essentially grow with the patient for that short period of time."
"My least favorite part of my job is having to inform patients about negative health news or seeing a patient progressively deteriorate. It sucks to have a relatively young adult come in with abdominal pain and later be told they have stage 3 liver cancer. This is a situation that has become too prevalent in my line of work. Seeing people with the will to live and fight being ravaged by illnesses is one thing I'll never get used to."
Of course, being a nurse can be stressful at times even though he is "a very hard person to become stressed out."
"Even when managing 6-7 patients a shift, I still usually manage to organize care and tasks. The work can become stressful when my patients as a whole require a lot of care. For instance, a majority of my patients may be diabetics, require wound care, or just a few difficult patients who may require more time. Having to round up with doctors, provide care to multiple patients, and chart can be a lot at times; but at the end of the day, I prioritize providing actual care to my patients, and knowing I've done that gives me peace of mind."
Despite the numerous tasks he has to complete every day, he often feels rewarded.
"As cliche as it may sound, I feel rewarded when I actually make a positive impact on the patients' quality of life. It's very nice to hear from patients that "you're a great nurse" or "thank you so much." Also, the paycheck is quite rewarding, especially with all the incentives currently offered!"
By trying his best to relate to patients, he helps them feel less anxious, but at the same time, he understands that healthcare professionals will never know how they actually feel.
"I never minimize feelings and really just try to be as calm and supportive as possible. Making it a point to check on your patients multiple times and not just during assessments and medication passes makes a big difference and helps them feel like more than a patient. Also, PRN Ativan helps."
Joshua thinks that a good nurse is someone who maintains humility.
"Understanding that above all, we are here to give the most appropriate patient-focused care. A good nurse never judges a patient based on their past or current situations. I couldn't tell you how many times I have been told a patient is difficult or disrespectful only to take over the care and have a much different experience."
"Compassion and understanding are the two most important qualities. Compassion, to be able to have sympathy and actual concern for the patient's situation. Understanding how the situation can be affecting not only the patient health-wise but the impact it has on their life."
Working with many different people of different backgrounds each day, he thinks a common stigma around healthcare is that "you do find many personnel that judge patients."
"Many times you see patients that are recurrent visitors or have a history of drug abuse. Situations like these lead nurses or other providers to devalue patients and minimize their illness, pain, or feelings in general. I think in this profession we have no place to do any of that. I don't care if a patient comes in weekly; they will always receive quality care and have all their considerations taken into account."
In current healthcare, the greatest change that he wants to see is improved equality.
"Generally, I want to see a system where care is provided the same for all. Universal healthcare is something I greatly support. There are too many providers who require too much coordination to give patients current and follow-up care. I want to see a system where placement for rehab isn't difficult, and a patient isn't denied equipment needed to manage their illness."
"There are a few changes I'd like to see in healthcare that I've seen issues with not only in my current medical-surgical assignment but especially in my time as a psych nurse. Health-care, I've noticed is very much so about stabilizing a patient, getting them to baseline function, and sending them on the way. Healthcare needs much more emphasis on preventive care and sustained follow-up care."
Knowing that "healthcare offers so much growth and opportunities for the future," he would suggest anyone who would like to pursue a career in healthcare "to do it."
"In nursing alone, the number of specialties and travel assignments available are abundant and only growing. At times, while it can be repetitive and tedious, nursing always provides stimulation with ever-changing populations with various illnesses. One thing that I've grown to love is not only does nursing allow you to grow your career, but working with the public and speaking with so many different people from all walks of life really grows you as a person!"
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