They're not the days with three codes and a couple near-misses. They're not the days when some idiot resident decides now is the time to scream at you in the nurses' station. They're not the days when big things go wrong; they're the days when a multitude of tiny things don't go quite right.
Mostly, it's because of people. Not patients--people. Patients are, though we tend to forget it, basically people just like we are; they just happen to feel like shit and need good drugs.
There's the patient who has a dozen excuses for why he simply can't walk right now. There's the patient who is inexplicably rude to you, or the one who's offensively rude about you in front of a doctor or family member. There's the patient who, for some reason, you just can't do anything right for, no matter how hard you try. They're all people, and most of 'em aren't as big of assholes as they seem while they're in your hospital.
Some days it's easy to channel your inner Cherry Ames and just keep on plugging. Other days, the sorts of days I'm talking about, you get frustrated and have to stop yourself from running screaming out into the night (or dawn) as soon as your shift ends.
I once had a patient who had a big, nasty brain tumor in her frontal lobes. It turned her from a bearable, if brusque, person into the sort of alkaline bitch you wouldn't want your worst enemy to meet. For a week, I had no problems at all dealing with her, and could even sweeten her mood a bit--all while getting charts open on time and handling five other patients with varied (and more pressing) needs.
This has not been one of those weeks. When a patient was insulting about a resident to me, I snapped back, "Keep a civil tongue in your head" and handed her off to my (angelic) charge nurse without a backward glance. When a patient gave me yet another reason why she simply couldn't turn over in bed just now, I growled "You're turning, and that's final" and then hauled her over on her side before she could protest. When one other patient said to me, after I finished starting a particularly tricky IV, "I bet you don't have a boyfriend; it hurts to hold your hand," I had to get out of the room quickly in order to hide the ridiculous tears that started in my eyes.
That's what they don't tell you in nursing school: that dealing with people is hard. It's rewarding and satisfying, yes, but it's also really, really hard at times. You get lessons on how to handle the really difficult, insane people, but nobody prepares you for the exhausting, grinding, disillusioning work that makes up some days.
What's worst about those days is how lonely you feel during and after them. It feels like, no matter how much your coworkers sympathize, you're the only person who's ever had a day this bad in the history of nursing. You feel inadequate, you wonder what the hell is wrong with you that you can't manage to take care of four or five sick people without nearly losing your mind by noon, you think seriously about applying at Starbucks.
The good news is that those days, those weeks don't last forever. Eventually something turns around: the surgeon who's known as a stickler compliments you spontaneously, or the raving bitch in room 9 decides you hung the moon. Sometimes it's as simple as having all your meds and equipment there when you need them, and avoiding the running-around that characterizes so much of the average nurse's day.
So: If you're a new nurse, or a more experienced nurse, or an old, old, old nurse (and, believe me, after a week like the one I've had, you feel old-old-old), don't lose heart. Eventually the moon will move out of Klutz and things will stop sucking as much as they do now.
In the meantime, you still have the end of the shift to look forward to.