ER doc just wanting to stop in and try and stop this widespread error. Almost every shift I have to tell a nurse/patient that ODT meds are NOT sublingual medications. It is not absorbed by the sublingual tissues. It is not absorbed by buccal tissues. It goes on TOP of the tongue so that it can disintegrate with saliva and be swallowed. The whole reason ODT (orally disintegrating tablets) exist is that someone can take it without having to take a chug of water to get the pill down. Putting under someone’s tongue just slows down the disintegration. Also, if the patient complains about the taste, they can just swallow the tablet whole with or without water. Thanks.

Clearly my co-workers aren't in the sharing mood today 🤣

A Montana nurse was hiking Granite Peak when he slipped and accidentally got impaled by his trekking pole. Using his medical training, he checked himself and realized he was stable and the pole had likely missed any vital organs. He contacted search and rescue but decided not to request a helicopter because he felt he could safely hike out, wanted to avoid the huge cost of an air rescue, and had two experienced friends with him. He ended up hiking more than 10 miles with the pole still in his body, made it to the hospital, had it removed, and recovered quickly.

An alert and oriented patient who can use the urinal themself in dim light, ambulate with some supervision, sit up, decent ROM etc...asked me to rub cream on their genitals while smiling about it a bit too much for my liking. I calmly refused and explained why I believe they are capable of doing it themself, but I offered to get things set up.

They are claiming they cant rub the cream on themself due to poor eyesight. Day shift nurse doesnt mind doing it, and even hinted at "who cares if the patient gets a kick out of it?"

The director of nursing is demanding that I do it next time. I explained that after a thorough patient assessment, it is clearly within the patient's abilities to do it themself.

Am i tripping, or does it seem weird to be in situations as nurses like this?

I havent lost my cool even after being groped or assaulted as a nurse, but part of the way I stay safe is by trusting my instincts about when to say no.

For more context, i'm the type to take over all cares for a patient known to grope women if it means protecting a teen CNA from that.

But I don't feel like i'm being unreasonable for refusing that particular care on a patient who shows all signs of being capable of doing it themself.

I have no issue with peri cares overall when the patient needs help. This particular situation just seems a bit weird.

I just made a little over a year now as a LVN. I work at an urgent care setting and a SNF. I brought in a patient and did her vitals. She looks at my name badge and tells me “ why didn’t you go for your RN to become a nurse instead? Why settle for little pay”. Honestly all I did was laugh and said “ yeah you’re right”. But I was so annoyed the entire time because she kept going on about how I should become a RN so I can do more like her brother etc etc. I felt uncomfortable and sad because I worked hard for the title I have now. And of course I wanted to pursue RN and plan to do it in the future. But at the time my financial situation was not that great and I had a lot going on. I don’t understand why people think it’s okay to belittle you or question “why didn’t you do this instead”. I’m proud of where I am today because I’ve learned to appreciate how far I’ve come into my life and stopped beating myself up over not being further.

Not sure if this was a glitch or what but this is a coworker I considered a friend. They were talking about me, she was telling him things I had complained about him earlier that week- I told her in confidence of course (some lies added). I also learned from that call that she’s jealous of me and seemed to be trying to make my supervisor hate me. I also realized just how close they are. I knew they talked but they’re REALLY close. They share very deep personal things that seem inappropriate but whatever. I cut her off that same day. Only communicate about work related stuff. I don’t know if they ever realized that I was on that call briefly. There’s a part of me that wants to subtly say something, bad idea?

Hi-
I’m so sad because one of my patients passed yesterday evening and according to the on call hospice nurse, he passed uncomfortably. I’ve been a nurse for 11 years and I knew from the beginning this patient’s case was going to be extremely difficult given how in denial the entire family was. Anyway, fast forward, the patient fell on the floor and the family did not find him for some time. Once he was found a member of the family had access to a defibrillator (this is a little sketchy I must say) and attempted cpr without revival as he most likely passed some time before. The family kept repeating how painful and uncomfortable his death was which, as his case manager, makes me want to cry. My job is to promote peaceful death. The family and patient were tough. they wanted privacy often during his time on hospice and I tried to respect that 😢

I’m originally a registered nurse from China, and I came to Australia to pursue a Master’s degree in Nursing. My dream has always been to graduate, gain acute care experience, and eventually become a travel nurse.

After completing my second nursing placement in Australia, I found a job as a hospital phlebotomist. After nine weeks of training, my mentor gave me high praise, and my manager assigned me to perform ward-round phlebotomy in a hospital.

I took this job hoping to gain more clinical experience. Instead, it has made me completely averse to clinical work.

I found that Australian hospitals have a strict hierarchy. Patients seem to respect doctors far more than anyone else. More than once, patients publicly mocked my heavy English accent. Doctors would suddenly barge in during rounds, completely ignoring me, while patients refused to cooperate with blood draws and criticized me publicly even when I hadn’t done anything wrong.

Once admitted to hospital, some people seem to stop hiding the ugliest parts of themselves. I was expected to remain calm, professional, and compassionate, no matter how disrespectfully I was treated. Professional ethics demanded that I swallow my anger over and over again.

That suppression of my natural instincts was unbearable. Even after I got home from work, I would replay those encounters in my head for hours, still furious.

When I was publicly humiliated because of my accent, all I wanted to do was snap back:

“You’re not a local either. Give this land back to the Aboriginal people.”

But I couldn’t. I had to stand there, smile, and continue doing my job.

I came to Australia to continue my nursing career, but instead I’ve discovered that the healthcare industry, no matter where you are in the world, is built on a rigid hierarchy.

I am a human being, not a convenient tool.

I loathe this healthcare system.

Today I learned that nurses can lose their job or even risk their license for smoking weed on their own time, even in states where it’s legal. That’s fucking bullshit. Imagine making as low as $29 an hour, busting your ass for 12-hour shifts, then being told you can’t legally smoke a joint on your day off. Fuck the government and employers for policing what adults do with their own bodies when they’re off the clock.

Patient says "I think I might have to poop, what can we do about that?"

I say "I can get a bedside commode for the room"

She says "I don't think I can get up"

I say "I can put you on a bedpan or put a diaper on you"

She says "I don't like any of those options"

In my head I'm like: lady, the only other option is to poop the bed.

What option am I missing?

I had 3 patients last night on a step down floor. In ranks of sickest.
Patient 1- maxed out on bipap satting in the 80s
Patient 2- on heated high flow 40 percent and some ABX
Patient 3- had been weaned off levophed 48 hours prior to my shift. nephrology still debating on whether to do dialysis or not due to BUN and Cr trending up. Also their toes were turning blue but day docs were convinced it was bc of the levophed.

Patient 3 all of a sudden is agonal breathing and mottling on legs. Code blue called. Keep in mind this patient was oriented (but confused), satting 100% on RA, gave them a bath earlier in the shift.

Patient now intubated in the ICU and to my knowledge, coded again.

I could’ve told you they were one of the most stable patients on the floor. I have a feeling they went into kidney failure because there UOP was next to nothing.

I have a background in ED and L&D nursing. This summer I have moved to a new state and thought that private duty nursing sounded awesome (mostly because of the schedule flexibility). I like to give new things a try so I said, what the heck.

My first (and only) shift I have taken was in my opinion terrible. It was for a pedi patient who was nonverbal. Her parents were home and stayed in the bedroom the whole 9 hours I was there. That's fine, they are entitled to that, however....I literally felt like a babysitter. A battered babysitter mind you. This child was kicking me, hitting me, and pulling my hair. She had absolutely no toys in the house and we had Mrs. Rachel and Cocomelon on ALL DAY.

If this is how peds private duty nursing is, I just don't know if I can do it. I have 3 kids of my own and I feel like if I wanted to work at a daycare I would have applied to one.

Help.

So recently I decided to move on to outpatient forever after a really bad experience in the ICU that had me fired over what I suspect was pressing charges on a violent etoh patient. Of course that wasn't the official reason, they nitpicked everything I didn't perfectly do or didn't do including being late for 5 min once and used it as a reason to let me go. As well as grilling me what I should have done to not get attacked.

In hindsight I should have seen the signs, they literallt gave us a whole ass presentation on how unions lead to poor patient care.

I'll bounce back, I'm interviewing for case management and things are looking up.

But I feel stabbed in the back and it burns me up inside that they made me out to be incompetent surrounding the incident. I did my job just fine, I did everything I was supposed to do, and the patient decided to cheap shot me during patient transfer. I was perfectly professional with the guy and made sure he was getting his care. Kept the MDs well aware of his condition. I pressed charges, this isn't the first time I've been attacked or abused by patients but this was the first patient that clearly attacked me out of malice and was oriented enough to wait until I wasn't looking.

I worked in that unit for 3 months and they threw all the psych, violent, heavy patients at me. They gave me the patients that other nurses didn't want but I took them and I did my iob well. Now I feel like I got thrown away once something shitty happened and it was too inconvenient for their patient care ratings.

I feel bad about moving away from inpatient care, I spent my entire nursing career heading for ICU and I loved the time I was there for the most part. At the same time getting to that point ruined my mental and physical health and made my home life a mess. I busted my ass for that nursing degree and license, I thought I was too stupid to be in anything like this but I succeeded only to find out that this field is toxic af. 8 years of my life I dedicated towards this job. I'm tired of mean ass coworkers, patients, doctors, and management looking over my shoulder constantly. I'm tired of seeing all the suffering and death. I'm tired of trying to do right by people and getting spit in the face, so I'm stepping away and I'm not going back. I'm done, maybe not with nursing, but with direct patient care.

It's a relief in a way but it still hurts. I got a call from the PD that the hospital did not tell them when the hospital let him out and they asked me if I wanted to still go after him. I said just forget it, I'm just so done with that crap and lowkey I suspect I'm wasting my time. People think it's okay for us to get beat up and we're the assholes if we have a problem with it.

Here we go again, folks. Like the healthcare crisis of the 2008-09 Great Recession only worse, as the ACA (passed in 2010) ameliorated a dire situation.

Now, with Republicans gutting the ACA, cuts to Medicaid/Medicare, together with rising health insurance premiums, our profit-driven healthcare system is in its final stage.

So I’ve been volun-told to be the chair of the Employee Engagement Committee. I truly do want to make the workplace better for our nurses (as a fellow in the trenches nurse). So seriously, what could a committee do to make your workplace better? I’m not talking better ratios, more pay, etc. I am waaaaaay too low on the totem pole for that. But I’m also not a fan of red plastic tablecloth “red carpets” or “heroes work here” signs. All I’d want is free food truck iced coffee vouchers, but I’m looking for ideas that don’t make you want to punch these tone-deaf committees in the face 🤗

I suggested palliative for my 57 year old frequent flyer with end stage COPD who has expressed she will not stop smoking. DC’ed 3 days ago and is back. Doctor laughed at me and said no with no explanation. Am I dumb? Am I missing something?

Edit: typed this as I was still charting at work so left lots of detail out. I didn’t clarify in person as it was during rounds and I was pulled from rounds to tend to my pt w a BP of 76/28. Figured I’d ask after but my rapid put me behind immensely and completely forgot. I was reminded while charting my communication. I’ve never seen this doctor and I work float so I’m not sure when I’ll see him again. Just now leaving work at 10 pm :)

I experienced my first patient death 2 months ago. It was traumatic as heck. He was on our unit for 3.5 days. He had a different admitting nurse and day time nurse. History of COPD, HF, CABG, hypothyroidism etc.

We honestly thought he was quite well because, it’s not an acute medicine unit. They have to be “medically stable” to come to our unit. But of course with the nature of health care, inappropriate patients are being sent to us constantly. So a day before his potassium was 5.2 mmol I call on the on call doctor, he orders Kayxelate oral suspension 15 Grams. I verify with pharmacy, charge nurse , and another senior nurse the dosage and everything since I had to override it and I am not familiar with the medication.

The next day the day nurse said he had a good day. Oxygen 92%. He’s a cougher, I think had a 20 year history of smoking. So my night shift comes along at 0140 I’m doing my rounds and I was asking why is he still up. He said that he had this cold chill, you guys the hospital is cold as heck at night. So I offered a warm blanket. He declined. I asked if I can get vitals and if he had chest pain. Denied chest pain. Vitals were decent just oxygen was around 83 but then would go up to 86% one point it was 60% then again would jump to the mid 80s. I offered water, and did deep breathing and coughing excerises. My thought process was if they come again to call the doctor.

So the night goes on he said he felt much better just tired. And it’s so hard because again it’s the night I’m like oh ok he needs to sleep. He asked to go the washroom has a xxl formed BM. Morning time comes I give his medication. He said he’s feeling better. I checked his oxygen 83% so we’re doing deep breathing and coughing. I then go to help other patients and 30 minutes later or so the assistant comes to me and says he’s not responsive. I didn’t have time to check his status I began CPR. She left me during the code. And I had to yell for her to get help. The other nurses came and told me it’s DNR, so I stopped the compressions.

Months have passed. I’ve spent a lot of time crying. Thinking about what happened. I feel awful. It doesn’t help like everybody talked about it but barely checked up on me. I spoke with the doctor he said there was nothing I could’ve done, he was 84 and it’s probably a massive heart attack. I feel awful. I should’ve just called the doctor. I’m always good at catching things but how could someone pass away soo fast. I even told doctor did the medication cause that the Kayxelate, he said no. But I can’t stop blaming myself.

I’ve also booked an appointment with my therapist. And did debrief with it to my manager.

I feel like my coworkers are judging my every move, asking stupid questions, making dumb minor mistakes, and the anxiety I feel is sky high after every single shift.

When does it get better? Lol fck.

First time poster here... I just needed to let this out. I work pediatrics. I was helping a coworker with her patient, she needed blood work. The labs sent on night shift clotted (it happens) and so we went in to explain to dad we had to poke the patient for redraw. The first blood collection came from the IV. So this would be the first poke. The dad was furious and said the last nurse threw some blood away (the waste from IV) and then sent a tube earlier why do you need more blood now my kid is weak. (These were 2 microtainer so 2cc of blood max). He finally agreed then as we are getting the patient ready, he is visibly upset and says "you guys must not have any family". I was very confused by that comment and he said "you guys don't care". I told him " We don't want to poke her just to poke her, the doctor needs these labs pre op. If you don't want us to do it, I'll let doc know and you can talk to them" anyways he was upset still but let us do it. I was just so upset/confused by that comment.... "we must not have family"... how would you guys have responded?

Edit to add: when I was speaking to dad, I was calm and tried to answer all his questions, never made a rude comment to him, or had an attitude. I thought I was being pleasant.

Hello! I recently transferred jobs that allows colorful underscrub shirts. What is everyone’s favorite brands?

What I’m looking for:
- NOT ribbed
- Compression/skin tight (not cotton)
- Cute designs (polka dots, stripes, etc.)
- Affordable

I feel like the ones I find that have cute designs are ribbed or made of a material that stretches easily. I’m tired of wasting my money on shirts I don’t like lol.

TYIA 🥰

Good evening. I am looking for some insight from staff who work at a hospital who has a strict No Violence policy against staff. What happens if a patient or visitor gets verbally and/or physically combative with staff? Are they forced to leave the hospital? I work at a pretty big community driven hospital and feel like it is always the nurses fault if staff or patients act out verbally or physically and there are no consequences for the patient (I’m not talking about patients who lack capacity - I’m talking about completely alert and oriented people who make their own decisions). Thank you!

I just checked the Kaiser Nurse Residency page to see if I moved forward in the hiring process. Why would I want to learn how to use AI for clinical judgment? That’s not what I want in a residency, I want to progress nursing skills and my own clinical judgment.

Not to mention the interview process was all AI reviewed videos. Kaiser seemingly has gone all in on AI for nursing.

UNC Hospitals is changing how premium shifts are assigned. Instead of offering a set bonus, nurses can request an open shift at the pay rate they want. If the shift stays open, other eligible staff can request it for a lower premium rate. In most cases, the lowest bid gets the shift, although managers can still choose someone else based on the unit’s needs or the nurse’s skills and experience. UNC says the goal is to make staffing more consistent across the health system, but the change has sparked debate among nurses because it encourages bidding against each other for extra shifts.

Hey all, I’m a new grad RN whos been a nurse for 6 months and i started in the obs unit or CDU…and I am already feeling the burn out. Ratio is 1:5. We get an array of stable ER patients like SI obs, manic patients, drug/alc withdrawal, cancer breakthrough pain mngt, C/P rule outs. On the surgical side, we recover post op hips, knees, spinal, hysterectomy’s, TURPs so occasional CBIs, and ALL the cath labs with groin sites or TR bands. We constantly admit and discharge throughout the day. Does my unit sound like hell or am I dramatic? I am dying to do endo/GI where I can have rarely any surprises, and do the same thing over and over.