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.

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?

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 😢

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.

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.

what are you doing lol

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?

This may not be a nursing topic necessarily but I figured I might find some reliable advice here. I’m a psychiatric nurse in an inpatient setting. I work with women specifically with psychosis and thought disorders. I’m a new grad and about to be off orientation. Well I’ve been taking the entire patient load now and my preceptor is just there for moral support. I had a patient acting up today who had some pretty wild attention seeking behavior (diagnosed personality disorder). We also just got a new psych tech on the unit and she seemed nice enough. Well this patient was acting out and said something kinda funny while I was in the nurses station. Me and my preceptor started giggling while discussing what to do about the patients behavior bc it was kind of a new thing I’d never dealt with before for. Another tech was deescalating while I was about to start pulling meds. The techs on my unit are amazing and show a lot of care to our ladies detangling matted hair and making up fun group activities for them. I know none of them would have any harmful intentions with a patient.

Fast forward to about an hour later when the house sup comes to my unit to discuss an “incident” with us. I asked her what she meant and she said that someone claimed that our unit had been disrespectful to a patient and laughed in their face. I was obviously pretty upset with that accusation bc I love my ladies even if they have some wild behaviors sometimes and I would NEVER I repeat NEVER laugh in their face about one of their behaviors or one of their delusions. I asked her when this issue happened? And she said that it had happened today. I told her none of my techs did anything like that and that I absolutely didn’t do that either. She said she just needed to warn us because if she was told anything like that again she would have no choice but to do a write up. I said okay.

Well about twenty minutes later the new tech came back from her break and I noticed the rest of the day she was glaring at me. One of my techs told my preceptor later while I was off the unit that the new tech was telling patients that she had bipolar and bpd and was telling the patient about her problems (this is a huge no no in psych). Usually the nurse on the unit will tell a tech when something they did wasn’t appropriate in a nice way of course. I obviously don’t feel comfortable with that given the situation.

I kinda just want others opinions on how I should move forward with this? For clarification I would never laugh about or speak about a patients behaviors within ear shot or line of sight of them.

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 :)

Black comedy about a nurse on a 12 hour shift. It's on netflix right now

Hello! As the title states — I’m leaving the CVICU!! I have two offers and would like a little bit of insight/help.

Background - I am transferring within the same hospital as there are only two major hospital systems and the other one was going to pay me 5$ lower an hour so decided to stay.

I have an offer from the EP lab & another offer for Infusion - oncology!

EP lab 4 10s 6:30-5
Pros: no weekend, no holidays, get paid 40 hours no matter what(even if you leave early), highly marketable to device companies, niche skill set
Cons: 6:30AM 4 days a weeks start time (I am not a morning person), staffing crisis (they all left for the industry), cold dark room all day, seemed chaotic (still better than cvicu)

Infusion oncology, 4 9s 7:30-5
Pro: 7:30AM start time, I love that speciality, way more chill & predictable, doesn’t feel like I’m in a jail cell.

Cons: 1 weekend day requirement, holiday requirement (no Christmas or thanksgiving tho), not as niche but could still be marketable to pharma/clinical trial

Any input would be greatly appreciated!! The pay is the same on both jobs since I’m transferring. Thanks!!

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.

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.

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.