How to be a Nurse in America
Welcome to the USA! My name is Maddie. I have been a registered nurse in the midwest for about two years now. Let me take you through a day in my life going to work!
It's 5:15 on a Monday evening. My alarm goes off and I get up to make my 'morning' coffee, get dressed in my scrubs, and take my dog out for a walk. I pull up a podcast to listen to so I don't get too sleepy, as this is my fourth 12 hour shift in a row (picking up overtime to pay off the debt I have from going to school to be a nurse! More debt than if some European students went to college for 20 years). I head out the door with my dog on his leash to take him on a short walk in the brisk, cold winter air. I pause halfway down my stairs, and listen to a round of gunfire going off in an adjacent neighborhood. After a moment, I continue my walk with very little anxiety. This gunfire is a typical part of my day, as in many US states, owning a firearm is an opportunity open to anybody. During my walk I realize that during the gunfire, I was distracted from my podcast and rewind about two minutes to review the part that I missed. This morning I am listening to the news. I muse on the stories the reporter tells, wondering if the information she is passing on about our current administration is really reliable or not. She mentions that the president commented on how "we don't have inflation." (CNN, August 2025) I quickly google the inflation statistics since his election in 2024 while my dog sniffs a holly bush.
I finish up my morning routine and hop in my car to head to work. It's a short commute, and the shuttle bus driver plays one of those radio shows where someone pretends to catch a cheater on the air in a highly dramatized confrontation. I clock in at work just in time! At the morning huddle, I check to see what area I am working in today, and chat with my coworkers. Our charge nurse comes out and reads off several names, stating that we should skip our morning huddle and go to our care areas now, as we have a high census today and extra hands are needed ASAP.
I walk with my things back to my area and look around for the day shift nurse who I am getting report from. I spot her, but before I can wave hello, the ambulance bay doors are thrown open and a stretcher surrounded by medics comes barreling around the corner. A nurse shouts "5 left!" and I throw my bag into a corner, whipping off my jacket. The patient, per report, sustained six gunshot wounds to the chest, abdomen, and thigh. As we pull the patient from the EMS stretcher onto our own stretcher, my work phone dings with the page alerting us to the upcoming arrival of this patient, signed "here now, sorry." A lot of pages are signed this way.
My day passes in a regular fashion. This first patient who came in is mine. We give him fifteen units of blood, I hold pressure on a gunshot wound on his leg, and collect the clothes that we cut off of him in an evidence bag. Because he died in the operating room and that makes it a homicide. My next patient is a woman who was attacked by her boyfriend and jumped out a second story window to escape him. She broke both her legs, but luckily the baby she is 20 weeks pregnant with is doing well. While I give her pain medicine, I get a page that my next patient arriving is combative. I prepare by putting my hair in a clip to keep it out of reach of hands that might try to grab it. This patient arrives in restraints with EMS and police. We move him from one stretcher to another, but in the process, he jumps up from the stretcher and breaks the nose of a public safety officer with his fist. He is tackled to the floor, and I give him a shot in the leg to subdue him. We tried his arm first, but he bit me. I spend an hour filling out paperwork about this.
Patients come in and out. I help my coworkers where I can. I draw up and administer medications for a patient with a stroke. I monitor the sedation of a patient who was given ketamine for their broken leg reduction. I access the port of a sickle cell patient and give 2 mg of Dilaudid for their pain while they cry about how badly it hurts. I perform chest compressions on a cardiac arrest patient and sing Pink Pony Club to get the rate just right. I try not to look at their face. Shift change arrives and I give report to the oncoming day shift nurse. I use the bathroom since I haven't been able to since I left my house this morning. I grab my lunch from the fridge because I never had time to eat it. I hunt around the nurse's station for the coffee cup I accidentally left yesterday, and head home as the sun rises in front of me. I pause walking from my car up to my apartment, noticing that I have blood on my shoes and should probably not wear these inside, so I take them off and walk up the stairs in my socks.
It's 6:30 in the morning, so I call my boyfriend who is a physician assistant. He has been rounding on patients for about an hour, and we talk for a few minutes before I go to bed and before he heads into the clinic where he will work until 4:30 pm. He does this five days a week. I shower, eat some dinner, take my dog on another walk, and fall into bed in my dark room where I have worked diligently to shut out all the daylight. This is shift four of four, and I cannot wait to sleep my entire day off.
I know what you may be thinking right now, because it is the same response I often get when I reluctantly tell stories of what happens while I'm at work. What a crazy day, right?! But in a way, this is one of the least stressful kinds of days I can have at work. Let's think about it: I didn't get to eat, I didn't get to use the bathroom, I worked twelve hours straight without a break, I was physically assaulted by a patient, I experienced a death, and I didn't get to finish my morning coffee. But here are three highly possible things that I worry about, and remain thankful that I have yet to confront in my job as a nurse in the USA:
I have not had to protect a patient from state-sanctioned brutality! Donald Trump rescinded the policy which protected patients in hospitals from being detained by ICE, once designated as a sensitive location. (National Immigration Law Center, Physicians for Human Rights) When I read this in the news, I began to think about what actions I would have to take to protect my patients if these people were to barge into the hospital and try to harm them. And of course, things became a little more complex this week when the physician who attempted to check a pulse on the woman who was shot by ICE in Minneapolis was barred from doing so by ICE. Just a little confusing because may I remind you, at work, if he does not check a pulse on his patient he can be prosecuted for a crime. But on neighborhood streets, in ICE's words, they "don't care." Luckily, I am not one of the nurses who has had to confront this in reality. Only in my mind.
Another silver lining: I may have been assaulted at work, but I haven't been murdered! When I was starting nursing school in 2022, I had no clue how bad things would continue to get since COVID when it came to workplace violence against nurses and other medical staff. Some studies show that the prevalence of verbal abuse against healthcare workers in the US is as high as 67.8%; even as high as 44.4% for physical abuse. (O'Brien et al. 2024) The same literature review found that one of the biggest barriers to reporting, and why the actual numbers are certainly higher than the reported numbers, is because workplace violence is an expected part of the job. Apparently, "One in four nurses face workplace violence, a rate that is higher than police and correctional officers." (American Nurses Association) I think sometimes about how these other two professions operate at work with the expectation that they may be armed or wear protective gear. I am not armed and I wear Figs.
The third and final thing I am thankful for about my job: (I know, I know, but try to come up with something)
I wanted to write something so I can be a part of the conversation about why our country is so dysfunctional, to put it mildly. And the best way I can do that is by shedding light on my corner of the chaos. I think that in the grand scheme of our global pandemonium, the USA certainly couldn't be at the bottom of the list for half-way decent places to live. Really, when you subtract the gun violence, the higher rates of chronic illness, the lack of access to healthcare, childcare, maternity leave, food assistance programs, rent assistance programs, homeless shelters, reliable dissemination of information, reliable public safety organizations, and some basic human rights, it's not all that bad! Especially for an RN making $30 an hour! I mean, nursing has a great reputation. It's been ranked as the most honest and ethical profession for 23 years running. (Nurse.org) We are given the privilege to care for vulnerable people and take fragile lives into our hands, and we do our best with that immense responsibility. Especially considering the conditions were have to carry this responsibility in. But anyways! There may be all this going on, but at least I only face a 1 in 4 chance of being physically assaulted at work, a mildly low chance of being the victim of gun violence, a 99% chance of being lied to by the government, and a 100% chance that there is very little I can do except for try to just... get through it!
Everything is fine, right?
Sources:
https://www.cnn.com/2025/08/29/politics/fact-check-trump-ukraine-inflation
https://pmc.ncbi.nlm.nih.gov/articles/PMC11152903/
https://nurse.org/articles/nursing-ranked-most-honest-profession/
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