Herding Cats and Nursing

Some days nursing has felt to be to be synonymous with “herding cats”. Trying to create order within an environment of chaos and unpredictable behavior can be quite the challenge. Being a nurse who prefers to work with foreseeable and anticipated situations I was always a bit frustrated while working in a hospital setting. Nursing in a hospital has often seemed like “herding cats” to me.

Wikipedia describes “herding cats” as being “An idiom denoting a futile attempt to control or organize a class of entities which are uncontrollable or chaotic.” While Wiktionary defines it as a verb (idiomatic) To attempt to control the uncontrollable.

Yes, nursing can feel like an attempt to control the uncontrollable. Working on a surgical unit involved getting patient’s ready for surgery, getting their rooms ready (clean, organized, set up to accommodate the surgery stretcher next to the bed for transfer, a place to hang IVs) while getting the next patient’s prep and ready for surgery, then controlling the symptoms, pain, and other potential side effects of those who had returned from surgery. Implementing new orders from physicians as they made their rounds also had to be incorporated. Patients being human beings are not predictable in their behavior, their tolerance or pain, their ability to be assertive, their willingness to express discomfort and pain, and reaction to medications and procedures.

As nursing students we were taught all about various conditions, illnesses, surgeries, recovery from surgery as if these were all stable, predictable situations. But that is not the case and it can be quite a shock for the new nurse just starting out. Nursing involves unexpected situations and endless changes.

There are all sorts of attempts to incorporate standardization into nursing care. However, when we are caring for actual individuals this introduces all sorts of scenarios into the mix. Then take into consideration patients that don’t follow directions such as not getting out of bed unless they call for assistance. Patients also come from various backgrounds with different values, beliefs, and understanding related to health care and health care procedures. In some cultures families and elders are involved in health care decision making so you may have a whole room full of people while you are trying to work. When you introduce a wide variety of different elements into the health care environment it begins to become unsystematic and messy. This results in the chaos that feels like herding cats.

If some days feel chaotic and disorganized know that this is normal. You are not alone in feeling your work is out of control. It is out of control. Sometimes nursing is like herding cats.