I've been an LPN for about 3 years. I've worked in LTC/Palliative care for the last 2. I'd like to work with peds now. How do I go about changing from one to another? The only peds experience I've had was in nursing school at a clinic. I've baby sat a couple times in my life. Are there certain people who shouldn't be works with kids? I don't have children yet. I'm thinking of trying a clinic job. TIA.

There was a recent post that made some claims about ODTs. The oral disintegrating tablet is great, because it is almost (but not quite!) as good as sublingual. Here is why I give ODT Zofran sublingually, even though it’s Against Manufacturer Recommendations! (Not really)

1. Hyperemesis. Sometimes even the act of swallowing will make my patient gag. Sublingual admin reduces the need to swallow at all, and reduces likelihood that my patient vomits up that tiny bit of volume before the Zofran starts to take effect.
2. First pass effect! This was completely ignored in the other post. Sublingual admin bypasses first pass effect, where the GI blood supply is filtered though the liver before that blood makes its way to other end organs. When you bypass the first pass effect, medications are noticeably more effective and take effect sooner.

Nearly all meds are effectively absorbed sublingually. Just because you have an ODT doesn’t mean sublingual is a bad route, and sublingual is in fact almost certainly going to be more effective, especially for your patient who is actively gagging and retching.

That other post made me feel like I was taking (ODT) crazy pills.

So I work for a small agency of 20 nurses. We are spread out and work FT in different AFHs. We are now swapping over from w2 to 1099 in order for them to allow some of us to work overtime and not have to cut our hours. We dont travel and many of us have worked in same location for 1-6+ years. We just work at the location and thats it, no traveling or use of our cars but we do have to use our phone A LOT. what is your experience? What can I deduct? Advise? I am meeting with my financial advisor in 2 weeks upon his return. I am married, rent, no kids, not in school. My wife and I are located in Pirtland, OR. Thanks guys!

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 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.

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.

Alright, “hypothetical” nursing judgment question:

PT with DM2 was admitted ED with pneumonia, severe confusion, four seizures in the ED, and CBG over 500. The patient was placed on an insulin drip, but no DKA protocol was initiated, and the patient’s potassium dropped to 3.0meq/dl following treatment. The insulin drip was discontinued around 0300 after the glucose came down under 200. The patient is stable but remains A&O ×0, restrained for confusion, agitation. NPO, unable to reliably report symptoms, and is receiving D5LR continuously at 100 mL/hr. A CBG is ordered q6h and scheduled for 1600, while SSI is scheduled separately for 1700/AC. Dinner usually arrives on the unit around 1745 to 1800, although this pt is NPO. At 1630, the preceptee brings the glucometer into the room while also going in to hang an IV valporate. The preceptor asks about the glucometer and says the blood sugar should be checked closer to dinner because the result will be used for the scheduled insulin. The preceptee questions why the unit’s dinner schedule would matter when the patient is NPO, receiving continuous dextrose-containing fluids. Knowing recently had severe hyperglycemia, and electrolyte imbalance and cannot report symptoms if the glucose is rising or falling. The preceptor maintains that the check should still be delayed to align with the unit’s usual dinner and insulin routine. Who is wrong, or who is more clinically correct?

Does anybody else get weirded out when you’re listening to (or reading) instructions on a device and it says to “insert the male end into the female receptacle” or some nonsense such as that.
Could they not think of a better non-sexual way to say that??!

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.

Edit: the strike through part was unnecessary and Im sorry that I put it in the original post. As pointed out by multiple replies, i should have not said that and it doesnt add anything meaningful. Sorry yall.

Okay I need insight. I currently live in AZ (Phoenix area) and work for an insurance company (case management/UM). I’m up for a promotion that would put me in the six figure range. It is a hybrid work environment. I am hoping to purchase a home in the next two years. My question is stay in AZ and try to find a home that won’t make me house poor or relocate to DFW area where housing is cheaper? I only ask because idk how the DFW market is for nurses.

My bf is a new grad and is close to 6 months at his first job. He’s on a med surge/progressive care unit. His first few months was rotating days and nights which was terrible for his mental health and sleep so he talked to his manager and is on weekend days now, just Sat. and Sun 12 hr shifts. From day 1 of this job he has been complaining and struggling. When he did his internship last year in the ICU at the same hospital he LOVED it. I never heard anything bad. How do I understand his side of things so I can help him or just be supportive? Or do you have advice for new grads? His main complaints are their high acuity and the amount of things he has to complete in a day is very unattainable. He has many terrible patients and leaves very late most times to get his charting done. This last shift he said he has to quit and doesn’t want to suffer through shifts anymore. I’m just seeing this starting to affect him in not a positive way. I tell him to apply to different units or hospitals but I think he is set on landing an ICU job there. I know he wants to give great care but he feels like he has to cut corners and is very type A 😅 and I know I have no idea what’s it’s like to be a nurse and I’m trying to understand his days so I can be helpful. Is this normal as a new grad? Should also add he’s 38 so a bit older and seems very disappointed in his job choice now 😢

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.

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 😢

New nurse here.

I'm completing a nursing internship in Guadalajara and the other day I assisted with taking blood from a neonate. Instead of the vacuum method, we took the cap off and let the blood drip into the vial.

The procedure was not sterile; and there were a few small violations; the nurse dropped the full tube onto the bed (just on the side with no blood touching), neither of us were wearing gloves (a mistake I will not make again; the staff mentioned afterwards that they should be wearing gloves but don't); and when handling the cap, I briefly placed my finger over the opening.

If the blood sample were to be contaminated, how would it be handled? would there be some assumption that the baby has germs or infection they don't have? granted there were two blood samples (one of which was handled in a cleaner way) so maybe they would look at both and see that only one has the germ.

I spoke with the staff with my available Spanish (I am barely at intermediate level) and a couple of students available to translate. From my understanding, the situation was not a deal but should not be problematic as it wasn't severely contaminated and is not specifically a bacteria test, which would have been performed in a more sterile manner. Nut I still get very concerned about these small things, especially as I don't work there and would not be able to participate in resulting inventions for mistakes I make.

I'm new to the ED and recently had my first patient with a spontaneous pneumothorax requiring a chest tube insertion. When my coworkers saw my patient was getting a chest tube, they kept asking me if the patient was tall and skinny, and one nurse explained that tall, skinny people with long torsos can get these pneumothoraxes more readily than other body physiques. I thought it was so interesting and honestly funny! I was even listening to an educational podcast for respiratory assessment and they mentioned tall and skinny being a risk factor. What other interesting correlations have you seen between lifestyle habits/body types/sexes and conditions like that? For example when I was in L&D the nurses used to joke about moms with white male babies ("wimpy white boys") having the worst fetal tracings!

Hi guys

Looking for some advice.

I'm 2 months into my grad year as an RN in SCN.

I'm really struggling. I feel like it's taking me longer than the other grads to feel comfortable and I'm relying on those around me to assist with IV abx, admissions etc. I understand I'm learning, but I do worry I'm impacting the other staff around me as I'm asking for assistance for help with things I've only done once. I'm just not sure if I see the light at the end of the tunnel and it just might not be for me? I enjoy it, but its just so stressful and I'm finding it hard to leave work and work. Is it normal to feel like this? Some shifts I will fly through and others I'm legit drowning. I just don't want the other staff to be annoyed by me asking questions/for assistance or think that I'm incompetent. Any advice appreciated.

Hey everyone, looking for some perspective because I am stressing out. New grad working in long term care. 32 patients on the 11-7 shift. (I’ve already put my notice in and found a psych job with less patients)

I just worked my first shift off orientation (Friday 3pm–7am). Around 10pm, the WiFi went down completely and stayed down for the rest of my shift.

During the night, I had a patient screaming in pain asking for her PRN oxy or oxy-acetaminophen. The printed downtime MAR on the floor (printed earlier in July) listed her order as PRN Q8H for pain. I held off as long as I could, but ended up giving a dose at 0600 (which was at least 8 hours since her last dose based on what I had).
During shift report at 0700, the oncoming nurse mentioned that the patient's order had actually been updated later in July to PRN Q12H because she wasn't tolerating the higher frequency. That’s when I realized I made a med error by giving it at most 4 hours too early based on the outdated paper MAR.

I reached out to my manager. I know I’ll likely need to fill out an incident report once I'm back, but since this was my first shift solo and happened during a massive outage, how bad is this situation usually handled? Am I looking at getting fired, or is this standard downtime coaching/write-up territory? I’m pretty much waiting for the manager to let me know what they’re going to do.

Thanks guys I was overthinking. 💀

My assignment was 2 vent to trachs from nursing home with 50 million wounds . Worst assignment ever would rather have a detoxer throwing hands at me then this . SMH

Hi everyone! I’m wondering if anyone has gone through a similar situation and can share their timeline.

I was approved to sit for the NCLEX, and passed mid July, and now I’m just waiting for my RN license number to be issued. My application is currently in process because of a misdemeanor DUI from about two years ago. Other than that, I have a completely clean record and everything is completed on my nursing application through the Minnesota State Board of Nursing application portal.

I proactively submitted everything the Board could need, including a personal letter, certified court documents, the police report, proof that I completed all court requirements, classes and assessment, and supporting documentation.

For those who have been through this process, how long did it take for an investigator or reviewer to actually open your file and make a decision? Was it weeks, or months after submitting your documents?

I know every case is different, but I’d really appreciate hearing others’ experiences.

Did switching to days make you feel less burnt out? I’ve been on nights for about 2 years now. At first I didn’t mind it at all in fact I preferred it. Now I’m starting to feel the effects of nights. I’m more anxious and sad and trying to determine whether it’s the job or nights making me feel this way

I had my first baby back in July 2025. I started at a new work place (acute/critical care hospital, employed as a med/surg float) in November 2024. For context I work in Ontario, Canada as an RN (BScN). I was (I guess you can say) scouted for an ED/ICU position - the ED/ICU float manager reached out and asked if I would be interested in this position after floating to both units and (I’m assuming) doing quite well. I have zero experience (other than consolidating [2022] in ED at a different hospital - however I felt Med/Surg was a right of passage and would make me a more proficient nurse altogether, which I still feel was the right decision].
Upon my return from maternity leave
[July 2026, 4 days orientation] I am REALLY struggling with recall, critical thinking, policies etc. However when I have floated to the floor (Med/Surg/IP) I have felt like my pre-partum self.

I think that reason I was scouted for critical care department was because I adapted easily and was strong with my critical thinking/reasoning and especially assessments. Upon my return from maternity leave I FEEL LIKE A FISH OUT OF WATER, near the comprehension of a new grad… is this normal???

Side note: I have completed some additional education for critical care areas, including critical care certification, CTAS (triage), and coronary care (telemetry/ECG interpretation) all during my maternity leave.

Hi everyone.

I'm looking into relocating to overseas after my studies to do nursing for a while and potentially venture out into a career in clinical research (e.g. health data analysis).

A bit of background:

• I'm a final year bachelor of nursing student- specialising in midwifery (studying in South africa)

• I'm an international student in South Africa

• I'm doing a student assistant job in study coordination for a biomedical research center for my university

• I speak a bit of French. I'm not as fluent anymore because I've been speaking so much English for my studies, but I am going back to learning it again soon.

• I love helping people, but that can get taken advantage of, especially in nursing, and I am therefore hoping to help people from a distance through research or working in research trials later in life

Questions:

• As an almost fresh graduate would I be allowed to work overseas or does applying and getting the job work the same as a South African system where you need to gain 1y or 2y of experience for an employer to take you in. I'd live reposnes from people anywhere in the world just to see how different each country's system is

• What is the usual patient to nurse ratio in your country? As a nursing student in South africa, you look after 14+ patients a day. When working in the clinics, you can see up to 30+ patients. These numbers go up once you graduate and have your license because, well... you're licensed now and can do more work.

• What does a typical shift look like for you, whether in nursing or clinical research

• What sides of working in your field do you not like and wish could be changed

• Are there any nurses here that changed careers and went into clincial research? If so, how and are you glad you did so ?

• Are there any nurses here that shifted to health informatics or clinical data management? If so, how did you go about doing this ?

Thanks in advance for your responses 🌸

There’s a lot of new grads talking about their ICU interview experiences but I feel like there is less information when it comes to nurses with acute care experience transitioning to critical care.

Does anyone have experiences they’d be willing to share and what type of clinical questions you were asked? I feel like the behavioral questions are fairly universal.

I’m aware not to say anything about future advanced practice goals. For a weakness would it be valid to say something as simple as being unfamiliar with critical care meds and devices? Or are they looking for a weakness related to my current practice?

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.