Nurses "Play Cards For a Considerable Amount Of The Day"

[Mormolyce]

Ah yes, nurses, those notorious layabouts who have a lot of free time.

Fucking lol.

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Comment and profile pic matched up, bravo

Would it ruin the effect if I said the cat lost an eye and is actually just yawning?

[Celista]

Nurses do work long hours.

Lately I've been losing a lot of respect for the nursing field, particularly because of new nurses and nursing students. I find that a lot of women enter this field because they think it's the quickest way to easy money and a respectable job. Like you only need a two year degree to become a registered nurse. Because of this, you rarely encounter someone who is actually passionate about nursing and helping the patients, and you hear their constant whining about either the coursework or the work itself. It's highly annoying and I really wish the requirements to be a registered nurse were increased. Really need to weed out the people who don't deserve to be there, and are only in it purely for the money grab.

Social workers have earned far more respect from me for that reason.

Have met/worked with a lot of great nurses but noticed the same, with friends and relatives who went into nursing it was always about the money. A couple of them weren't even very good with people, luckily working in a helping field softened that a bit in one of them.

One friend from WoW, who is an RN/BSN and getting his nurse practitioner degree, told me very seriously that he got into a major argument with his husband for making a joke about killing his black patients. He was upset because he thought his husband would know he was clearly joking but apparently the joke went on far too long and it was definitely not clear to the husband in the end.

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Cutting shifts from 12 hours for the majority of nurses across an entire state would be a logistical nightmare. Many nurses (from my experience, most) who work 8 hour shifts hate it and would prefer to work 10's or 12's, and those who work 12's wouldn't give that away. You know what would be of more benefit to nurses?

Ensure proper staffing, in general but specifically so that we all can actually get the rest breaks we should (by law) be afforded (hint, this is a huge problem and is likely under exaggerated by nurses)

Reduce the nurse to patient ratios of most departments

Prosecute those patients who assault/threaten/injure/kill healthcare professionals (not just nurses)

Ensure proper staffing of support staff in medical facilities-e.g. security, housekeeping, CNAs, transporters, etc...

the list goes on. I submit, having worked 8, 10, 12 hour shifts, with a number of hours of overtime on any one of those aforementioned lengths of shifts, that it is less about the time total at work and more about the lack of support to do our damn jobs the way they should be done.

ps and screw patient entitlement and satisfaction. You come to the emergency room and you're alive (or at least better than when you arrived, for legitimate reasons)? You're satisfied.

Yeah I don't think it would be as difficult as you state, although there would be a lot of whining from the mommy nurses who chose the profession so they could work long shifts and have more family time.

I agree about other factors influencing health care professionals' QOL though.

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@gaymer77 I've read the studies, long shifts by health care staff increases burnout and has other negative effects on care. This isn't limited to nursing btw. Clearly there are other things contributing but I have seen the effects of long hours on my boyfriend and friends who work as RNs/MDs.

[Vash The Stampede]

Read. The. Fucking. Article.

I mean, could you get much more low effort? They literally explained it right in the quoted text: The nurses themselves specifically requested the 12 hour schedule. They work 3 12 hour shifts a week, usually with a decent amount of additional over time, which in their profession is much more efficient and viable than working 5 shorter shifts in a work week.

I get they want to work 12 hour shifts... but why? Instead of working 3 days a week for 12 hours, why not 4 days a week for 9 hours? The math works the same plus you get time to relax. I wouldn't want to be in a hospital that has a nurse that has worked for 12 hours and is probably very tired.

The medical and care industry is kind of fucked though. A lot of places don't give staff enough down time or retain enough workers (turnaround can be high, everybody poaches each others staff) or wages (all workers from maybe LPN and below) too low so people put in crazy hours.

So if nurses had better pay then they'd wouldn't need to work those crazy shifts? I get nurses are overworked and need more nurses to offload the stress.

[Celista]

I get they want to work 12 hour shifts... but why? Instead of working 3 days a week for 12 hours, why not 4 days a week for 9 hours? The math works the same plus you get time to relax. I wouldn't want to be in a hospital that has a nurse that has worked for 12 hours and is probably very tired.



So if nurses had better pay then they'd wouldn't need to work those crazy shifts? I get nurses are overworked and need more nurses to offload the stress.

RNs get excellent pay. A lot of health care professions pay excellently, dental hygenists(2 year degree) average 72k a year now which I think is similar to nursing. X-ray techs are also similar.

The problem is gatekeeping by nursing programs and an aging/sick population. Local community college here accepts less than 10% of applicants and the average gpa for admission is like a 3.85 and most applicants have a previous degree.

They want the 12 hour shifts so they get 3-4 days off. Really popular for young moms.

[Kasierith]

Ah, misconceptions about overnight jobs and long shifts and the like... get them all the time with night pharmacy.

"So, you pretty much just sit around all night just waiting, right?"
"Ya, sure. I definitely don't have 7ish hours minus ER patients to do 240+ prescriptions solo. Corporations love paying heavy salaries for people to do nothing."

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They work 12 hour shifts so they don't have to work every day of the working week.

Also for continuity of care and fewer shift transitions. If you have 8 hour shifts with a single rotation it means that you're spending time handing things off half again as much as with 12 hour shifts.

[Vash The Stampede]

RNs get excellent pay. A lot of health care professions pay excellently, dental hygenists(2 year degree) average 72k a year now which I think is similar to nursing. X-ray techs are also similar.

The problem is gatekeeping by nursing programs and an aging/sick population. Local community college here accepts less than 10% of applicants and the average gpa for admission is like a 3.85 and most applicants have a previous degree.

They want the 12 hour shifts so they get 3-4 days off. Really popular for young moms.

That shows that a lot of people today need more free time. I know Amazon does something similar with a 10 hour work day for 4 days. At some point we really need laws that limit the work week and pays better, so that people have more free time like young moms spending time with their children.

[Captain N]

That shows that a lot of people today need more free time. I know Amazon does something similar with a 10 hour work day for 4 days. At some point we really need laws that limit the work week and pays better, so that people have more free time like young moms spending time with their children.

I wish you the best of luck with this. We currently live in a society where people view one another's worth by how much money they have and how many hours a week they work. You've seen it right here on MMO-Champion where individuals mock those who only work 40 hours a week as lazy and make excuse after excuse as to why we can't increase wages.

[ZazuuPriest]

So we are for or against nurses working 12 hour shifts? That seems excessive to me. I get that they should hire more nurses so they aren't doing the job of three nurses but do you guys want to work 12 hours?

i think youll find that most nurses prefer 3 12 hour shifts to 5 8 hour shifts

[Thage]

Maureen Walsh is a failed lobotomy given human form, I'm not surprised she'd spout some ignorant shit like this.

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Everyone understaffs tbh. The difference being that in healthcare understaffing can cost lifes. And while I am unsure of the situation in the US in much of Europe there is a clear nursing shortage.

Medical degrees in general in the US are so prohibitively expensive there's definitely fewer than we need, to say nothing of nursing programs having a serious problem with gatekeeping (as mentioned by another poster).

[Vash The Stampede]

I wish you the best of luck with this. We currently live in a society where people view one another's worth by how much money they have and how many hours a week they work. You've seen it right here on MMO-Champion where individuals mock those who only work 40 hours a week as lazy and make excuse after excuse as to why we can't increase wages.

There's a price to pay with that work ethic. You may get paid more but you risk effecting your health and in my opinion your health is far more important than monetary gain. We don't exactly have the technology yet to fix arthritis or heart failure. Working more hours doesn't mean you're more productive either as its been proven. I personally would rather have a hospital who has nurses that work less hours so they don't make mistakes like giving me the wrong medication or falling asleep from exhaustion. It isn't good for the nurse and it isn't good for the patient. Nurses don't want that cause they get paid less, and they want the 12 hour work shifts so they have 3-4 days of free time. But if we paid them more and they worked less I don't think the nurses would have an issue with that, plus the hospitals can hire more nurses to cover the shifts, hence more people are employed.

[Captain N]

There's a price to pay with that work ethic. You may get paid more but you risk effecting your health and in my opinion your health is far more important than monetary gain. We don't exactly have the technology yet to fix arthritis or heart failure. Working more hours doesn't mean you're more productive either as its been proven. I personally would rather have a hospital who has nurses that work less hours so they don't make mistakes like giving me the wrong medication or falling asleep from exhaustion. It isn't good for the nurse and it isn't good for the patient. Nurses don't want that cause they get paid less, and they want the 12 hour work shifts so they have 3-4 days of free time. But if we paid them more and they worked less I don't think the nurses would have an issue with that, plus the hospitals can hire more nurses to cover the shifts, hence more people are employed.

You'll get no argument from me that the American populace works far too many hours for far too little pay and often at the expense of our health. We've just been fed so much propaganda for so long about how we need to work hard and put in long hours in order to be successful that it's become part of our culture.

In terms of short-staffing nurses you have to remember that healthcare in America is a for-profit business. Hospitals are in it to make as much money as possible and that involves treating as many patients as possible with the bare minimum of required staff to do so. Like everything else in most American business it's shareholders before anything else...it's easier to replace an employee (often times at a cheaper rate of pay) than it is to care for those you already have.

[Dudenoso]

From someone who grew up with a nurse, FU lady.

If the Republicans get to be any more of a cartoonish villain party they will need scary organ music when ever they enter a room.

While I don't have anything to do with 'muricans or their politics, I have to wonder: who in their sane mind WOULDN'T want scary organ music whenever they enter the room?

You have to be pretty badass to have ominous music play whenever you show up.

[medievalman1]

Yeah I don't think it would be as difficult as you state, although there would be a lot of whining from the mommy nurses who chose the profession so they could work long shifts and have more family time.

I agree about other factors influencing health care professionals' QOL though.

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@gaymer77 I've read the studies, long shifts by health care staff increases burnout and has other negative effects on care. This isn't limited to nursing btw. Clearly there are other things contributing but I have seen the effects of long hours on my boyfriend and friends who work as RNs/MDs.

As an example of the logistics... The hospital I work for has a nurse labor union. According to the contract (which is a huuuge deal. the hospital can try to make decisions that, if they violate the contract, can be overturned by the union, otherwise risk severe legal action) if a nurse wanted to switch from 12 hours shifts to a different hours the hospital would have to open an entirely new position (they could keep it to an internal-only position and not have to worry about external applicants). Again, according to the contract, that new position would be entirely affected by seniority of the nurse at the organization assuming the basic requirements are met (Bachelor's degree, ACLS/BLS certifcation, etc.) If the original nurse had 10 years of experience and some other nurse had 11 years of experience (in a completely different department) and both applied, the nurse with 11 years experience would get the job, no questions asked, no appeal, no other option.

Now, even if you were to be hired as a variable start time, it can only vary by approximately 4 hours. Each start time would have to be covered and follow the same restrictions on seniority and opening new positions. Most floors work on a 0700-1930 and 1900-0730 rotation. Switching everything from 12's to 8's would likely have to transition to 0700-1530, 1500-2330, 2300-0730 shifts. The day starts would likely be less of an issue but the other 2 shifts are now going to be staffed by nurses who have become accustomed, according to the families, schooling, etc.. to specific start times, and expand that from 3 days a week to 5. The hospital I work at employees approximately 1200 nurses. So now, if this law passes, you'd have to rearrange over 1000 nursing positions, according to seniority, and it would have to be done as the nurses want (a good number would likely cross state borders to avoid this kind of a fiasco) and you'd have to do it all according to a brand new nursing contract. Contracts at my specific hospital have sometimes taken an entire year of negotiating. Now do it for every hospital-which likely all have their own unions with their own bargaining teams and their own individual contracts. I think you're grossly underestimating the logistical nightmare doing this for literally 10s of thousands of nursing positions and nurses across the entire state. And this would just be for hospitals.

[Stormspellz]

So I'm confused... is this a support the nurses thread, or bash the Rs thread?

in this case its one in the same, and deservedly so.

[Celista]

As an example of the logistics... The hospital I work for has a nurse labor union. According to the contract (which is a huuuge deal. the hospital can try to make decisions that, if they violate the contract, can be overturned by the union, otherwise risk severe legal action) if a nurse wanted to switch from 12 hours shifts to a different hours the hospital would have to open an entirely new position (they could keep it to an internal-only position and not have to worry about external applicants). Again, according to the contract, that new position would be entirely affected by seniority of the nurse at the organization assuming the basic requirements are met (Bachelor's degree, ACLS/BLS certifcation, etc.) If the original nurse had 10 years of experience and some other nurse had 11 years of experience (in a completely different department) and both applied, the nurse with 11 years experience would get the job, no questions asked, no appeal, no other option.

Now, even if you were to be hired as a variable start time, it can only vary by approximately 4 hours. Each start time would have to be covered and follow the same restrictions on seniority and opening new positions. Most floors work on a 0700-1930 and 1900-0730 rotation. Switching everything from 12's to 8's would likely have to transition to 0700-1530, 1500-2330, 2300-0730 shifts. The day starts would likely be less of an issue but the other 2 shifts are now going to be staffed by nurses who have become accustomed, according to the families, schooling, etc.. to specific start times, and expand that from 3 days a week to 5. The hospital I work at employees approximately 1200 nurses. So now, if this law passes, you'd have to rearrange over 1000 nursing positions, according to seniority, and it would have to be done as the nurses want (a good number would likely cross state borders to avoid this kind of a fiasco) and you'd have to do it all according to a brand new nursing contract. Contracts at my specific hospital have sometimes taken an entire year of negotiating. Now do it for every hospital-which likely all have their own unions with their own bargaining teams and their own individual contracts. I think you're grossly underestimating the logistical nightmare doing this for literally 10s of thousands of nursing positions and nurses across the entire state. And this would just be for hospitals.

Perhaps but it sounds like most of the challenge would be with union issues and state/federal law supersedes established employment contracts, which negates a lot of your post. The point is that there is no good reason to have such long nursing shifts when all of the evidence (that I have read) regarding longer shifts for nurses points towards increased burnout/fatigue, more nursing errors, and more on the job injuries, and that long hours have shown to have an adverse impact on nurses' health. Those studies adjust for all other factors that confuscate data outcomes, like number of patients under a nurse's care.

We don't need to prop up bad practices because it's convenient and people like four day weekends. I would really love it if the data showed otherwise, I think everyone likes the idea of longer hours at work and longer weekends and I include myself in that statement. But in places like health care that practice can be dangerous.

Again...1000% aware that the problem in nursing/health care isn't just long workdays.

[medievalman1]

Perhaps but it sounds like most of the challenge would be with union issues and state/federal law supersedes established employment contracts, which negates a lot of your post. The point is that there is no good reason to have such long nursing shifts when all of the evidence (that I have read) regarding longer shifts for nurses points towards increased burnout/fatigue, more nursing errors, and more on the job injuries, and that long hours have shown to have an adverse impact on nurses' health. Those studies adjust for all other factors that confuscate data outcomes, like number of patients under a nurse's care.

We don't need to prop up bad practices because it's convenient and people like four day weekends. I would really love it if the data showed otherwise, I think everyone likes the idea of longer hours at work and longer weekends and I include myself in that statement. But in places like health care that practice can be dangerous.

Again...1000% aware that the problem in nursing/health care isn't just long workdays.

The only thing that a legal change like this would change with regards to a union/contract would be the change in shift hours. Nothing to do with the way that the positions would be filled. So again, and in short, a logistical nightmare.

[Celista]

The only thing that a legal change like this would change with regards to a union/contract would be the change in shift hours. Nothing to do with the way that the positions would be filled. So again, and in short, a logistical nightmare.

Again--don't prop up bad practices because it's easier to maintain the status quo.

At least you'd only have to do all that work once.

P.S.: I think a significant amount of the issue here is that we have had a nursing shortage for so long, and nurses were able to negotiate from a position of real power. Not necessarily a bad thing, but when nurses themselves want to prop up bad practices because they don't want to give up their 4-day weekends, that really makes me wonder about their motivations for practicing nursing. Because it's not in the patient's best interest and their desire for long weekends even causes harm to themselves.

[gaymer77]

Perhaps but it sounds like most of the challenge would be with union issues and state/federal law supersedes established employment contracts, which negates a lot of your post. The point is that there is no good reason to have such long nursing shifts when all of the evidence (that I have read) regarding longer shifts for nurses points towards increased burnout/fatigue, more nursing errors, and more on the job injuries, and that long hours have shown to have an adverse impact on nurses' health. Those studies adjust for all other factors that confuscate data outcomes, like number of patients under a nurse's care.

We don't need to prop up bad practices because it's convenient and people like four day weekends. I would really love it if the data showed otherwise, I think everyone likes the idea of longer hours at work and longer weekends and I include myself in that statement. But in places like health care that practice can be dangerous.

Again...1000% aware that the problem in nursing/health care isn't just long workdays.

This is where I have to correct some things you touched on. The burnout/fatigue you're referring to has nothing to do with the number of hours a nurse works. It has to do with the amount of patients the nurse has to care for during his/her shift without being able to take a break because they are understaffed (Rogers & Hughes report from 2008). Nursing errors typically happen because that nurse is having to deal with numerous patients in a very short amount of times because their load is huge. In a home-health setting, it is normal for a nurse or nurse's aid to work a 12 hour shift and errors are extremely low because the patient to nurse/aid ratio is 1 to 1. Same goes for ICU and the OR which also typically have a 1 to 1 ratio (again as I mentioned in other posts to you, California is the ONLY state in the USA to mandate ratios and has since 1999).

Same can be said about injuries on-the-job for nurses and aids. These happen more because of time cutting measures the nurse or aid uses so they can get done with the patient they are caring for and get on to the next one in a timely manner. The studies you are referring to that show longer shifts impacting a nurse's health are referring to the work load a nurse goes through during his/her shift not the amount of hours per say. Higher the work load/patient load then the higher the fatigue. In fact, in a study examining the relationship between health care errors and work breaks, researchers found a 10% decrease in the likelihood of error when nurses were given an additional 10 minutes for their meal and break periods per work shift (report from Rogers, Hwang, and Scott in 2004). It isn't the time a nurse is working that is an issue but the amount of time a nurse is working without being able to take a break and the amount of patients the nurse has to care for during his/her shift that is the factor for errors, injuries, and fatigue. A study published in The New England Journal of Medicine found that the risk of death increased two percent each time a patient was exposed to shifts with below target RN staffing (report by Needleman in 2011).

Again--don't prop up bad practices because it's easier to maintain the status quo.

At least you'd only have to do all that work once.

P.S.: I think a significant amount of the issue here is that we have had a nursing shortage for so long, and nurses were able to negotiate from a position of real power. Not necessarily a bad thing, but when nurses themselves want to prop up bad practices because they don't want to give up their 4-day weekends, that really makes me wonder about their motivations for practicing nursing. Because it's not in the patient's best interest and their desire for long weekends even causes harm to themselves.

Another thing I must correct you on is this. It isn't an issue of nurses wanting to give up their 4 day weekend (most don't get 4 days off in a row anyway because it is typically 3 or 4 days on and then 2-3 days off or they schedule it 7 days on 6-7 days off because of back to back work weeks). The issue for nurses is that we know a patient is getting better care when they only have to deal with 2 nurses per day than 3 nurses per day. Only changing who is responsible for the patient twice per day means that less information about the patient is lost during change of shift report and this leads to better care for the patient. One nurse looking after a patient for 12 hours can notice and measure better changes in condition than a nurse who is looking after the same patient for only 8 hours in the day. Yes it sounds like it shouldn't matter but small changes in a condition are easier noticed over a longer period of time even with those extra 4 hours by the one nurse.

The problem with the number of nurses out there who can take care of a patient is that hospitals are a for-profit company. Since there is only 1 state that mandates a minimum number of nurses on charge per day (again California is the ONLY state that has mandates) that means that the non-nursing staff determines what is "cost effective" in terms of how many nurses will be on shift that day. If a hospital decides that the ER only needs 8 RNs for peak hours and suddenly they get a rush of patients come in, the hospital doesn't suddenly call in nurses to pick up the slack. The 8 RNs who are there simply have to take on more patients which translates into higher work load which translates into more than likely no breaks for that nurse which translates into increase of nursing errors. I've seen it first hand even here in California where we have mandated minimum ratios where at the start of a shift the census is low so they send home a nurse or two only to get bombarded with patients a couple hours after the nurses leave. Happens daily here.

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snip

In fact, if you care to read the article by Philip Tucker where he discusses the research about nursing fatigue over the course of their shift while increasing the number/length of breaks you can read about it HERE

[Linkedblade]

So we are for or against nurses working 12 hour shifts? That seems excessive to me. I get that they should hire more nurses so they aren't doing the job of three nurses but do you guys want to work 12 hours?

Three days on and four days off is a great schedule. And that leaves four hours for extra time if you're busy on a shift. And that's not mentioning anything about being called in, because nurses are per diem regardless of scheduled time.

And yes the nurses prefer that, so why bother changing something that they are fine with

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This is where I have to correct some things you touched on. The burnout/fatigue you're referring to has nothing to do with the number of hours a nurse works. It has to do with the amount of patients the nurse has to care for during his/her shift without being able to take a break because they are understaffed (Rogers & Hughes report from 2008). Nursing errors typically happen because that nurse is having to deal with numerous patients in a very short amount of times because their load is huge. In a home-health setting, it is normal for a nurse or nurse's aid to work a 12 hour shift and errors are extremely low because the patient to nurse/aid ratio is 1 to 1. Same goes for ICU and the OR which also typically have a 1 to 1 ratio (again as I mentioned in other posts to you, California is the ONLY state in the USA to mandate ratios and has since 1999).

Same can be said about injuries on-the-job for nurses and aids. These happen more because of time cutting measures the nurse or aid uses so they can get done with the patient they are caring for and get on to the next one in a timely manner. The studies you are referring to that show longer shifts impacting a nurse's health are referring to the work load a nurse goes through during his/her shift not the amount of hours per say. Higher the work load/patient load then the higher the fatigue. In fact, in a study examining the relationship between health care errors and work breaks, researchers found a 10% decrease in the likelihood of error when nurses were given an additional 10 minutes for their meal and break periods per work shift (report from Rogers, Hwang, and Scott in 2004). It isn't the time a nurse is working that is an issue but the amount of time a nurse is working without being able to take a break and the amount of patients the nurse has to care for during his/her shift that is the factor for errors, injuries, and fatigue. A study published in The New England Journal of Medicine found that the risk of death increased two percent each time a patient was exposed to shifts with below target RN staffing (report by Needleman in 2011).



Another thing I must correct you on is this. It isn't an issue of nurses wanting to give up their 4 day weekend (most don't get 4 days off in a row anyway because it is typically 3 or 4 days on and then 2-3 days off or they schedule it 7 days on 6-7 days off because of back to back work weeks). The issue for nurses is that we know a patient is getting better care when they only have to deal with 2 nurses per day than 3 nurses per day. Only changing who is responsible for the patient twice per day means that less information about the patient is lost during change of shift report and this leads to better care for the patient. One nurse looking after a patient for 12 hours can notice and measure better changes in condition than a nurse who is looking after the same patient for only 8 hours in the day. Yes it sounds like it shouldn't matter but small changes in a condition are easier noticed over a longer period of time even with those extra 4 hours by the one nurse.

The problem with the number of nurses out there who can take care of a patient is that hospitals are a for-profit company. Since there is only 1 state that mandates a minimum number of nurses on charge per day (again California is the ONLY state that has mandates) that means that the non-nursing staff determines what is "cost effective" in terms of how many nurses will be on shift that day. If a hospital decides that the ER only needs 8 RNs for peak hours and suddenly they get a rush of patients come in, the hospital doesn't suddenly call in nurses to pick up the slack. The 8 RNs who are there simply have to take on more patients which translates into higher work load which translates into more than likely no breaks for that nurse which translates into increase of nursing errors. I've seen it first hand even here in California where we have mandated minimum ratios where at the start of a shift the census is low so they send home a nurse or two only to get bombarded with patients a couple hours after the nurses leave. Happens daily here.

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In fact, if you care to read the article by Philip Tucker where he discusses the research about nursing fatigue over the course of their shift while increasing the number/length of breaks you can read about it HERE

That's true for any type of work. I'd much rather work through my shift without a break and leave early or get the extra pay.

[kneehidude]

So we are for or against nurses working 12 hour shifts? That seems excessive to me. I get that they should hire more nurses so they aren't doing the job of three nurses but do you guys want to work 12 hours?

As an RT (think of a nurse, but a specialty that deals with heart and lungs only) I like 12 hour shifts. I work 3 days a week and have 4 days off. In all actuality, 12 hour shifts aren't that bad. You hit a lull period around the 8 hour mark, but as soon as you start moving again, it's a breeze making it to the 12 hour mark.

I like having more days off to recuperate after working my 3 days, and can even pick up a fourth day if I want to and still have more days off than most people.

Nurses (and the like) aren't tired because we work 4 more hours per shift than everyone else. We're tired cause we deal with bullcrap on a constant basis. And comments like this senator made are a prime example.

We need breaks, and yes we know patient care comes first and foremost (no one was arguing that). But can I at least eat a sandwich and use the restroom before fetching someone ice? As if that is an emergency that can't wait 30 minutes?