u/ren23_

My first thought is always small bowel obstruction 😭but really any severe GI condition / complication in general. I’m definitely influenced by the fact that I work on a superrrr GI heavy med surg floor at a hospital that specializes in a lot of complex colorectal surgeries and bariatric surgeries (including revisions) 😅.

The misery on a pts face after enduring the trauma of an NGT insertion so they don’t aspirate on their own poop haunts me more than anything else… Or the pts who end up having an abdomen stitched up like Frankenstein with every type of drain imaginable, a problematic ostomy, TPN & lipid dependence, opioid & antiemetic dependence, etc.

Every chronic and high acuity GI pt I encounter at work reminds me how much I take for granted. It’s so humbling to realize that being able to eat, drink, and poop is such a privilege.

Anyways, I’m curious to hear other ppls worst nightmare based on what they’ve seen at work. Do u think it’s biased towards ur specialty or is there a general “yea, just kill me if ______” consensus amongst nurses😂? I’m only a year into being an RN and only worked on a med surg floor so I’m sure I’ll probably develop a million more “greatest fears” as I move around lol…

How many other nightshifters always respond to this question @ 2am with, “na, I got night vision” 😂? I saw a tiktok talking abt this and thought it was funny how we collectively agree that the big light is only necessary for certain circumstances haha.

Genuine questions:
What is the reason someone would ask which nare a NGT is in? And what is the reason someone would ask which side the foley stat lock is on? These are 2 questions during report I have always found a bit silly bc it is easily answered by just looking at the pt. I understand asking what cm the NGT is supposed to be at , and I often ask this question myself. But these 2 questions are a little strange to me and I’m wondering what I’m missing lol.

I’ve been a bedside RN for a year and I’ve concluded that the main thing that has contributed to my burnout is charting / documentation. I work on medsurg and although the pt care alone can be so mentally / physically / emotionally draining, I still hate charting way more than anything else. I honestly love being nurse and I love taking care of ppl, even with the chaos of my busy 5-6:1 med surg floor. But the longer I work, the more I realize how much the whole “if u didn’t chart it, u didn’t do it” thing is true. And I hate that. It genuinely has affected the way I work so much and I think that’s so sad.

Before I do ANYTHING, I always subconsciously think about how it will look “on paper”. It’s kinda hard for me to put into words exactly what I mean but I guess I just feel like I can’t even take care of patients the way I want because I’m so focused on making sure it lines up with the specific way it has to be documented in the chart.

Every abnormal assessment u chart needs come with a documented intervention and communication w a doctor, which is a lot of extra charting when u have 5/6 pts. ***obviously it’s necessary to communicate abnormal assessments to doctors and make interventions , im just saying that it gets exhausting and tedious to constantly document all of this for several pts***. This never ending cycle of documentation has definitely scared a lot of nurses into charting less detailed / accurate assessments bc it can be used against them if they didn’t chart the follow-up intervention / physician notification. For instance , let’s say a pt’s urine is amber. Some ppl just don’t chart the urine color at all bc it’s abnormal and should come with “proof” that they did something abt it. This is a hindrance to pt care because when I have the pt, I can’t tell if this has been baseline or new (if the pt can’t answer for themselves).

I’m not insinuating that other nurses r being neglectful for not charting certain things, bc most of the time they actually did do something abt it (aka tell a doctor, bladder scan, etc); they just didn’t chart any of that either. And I don’t really blame them bc honestly I’m starting to see that sometimes documenting less is better bc it means less to pick apart and use against u in the future.

They say charting every time ur in a pts room helps cover your ass, but they also will say “well u charted that the last time u were in their room was 2134 and they fell at 2235. So if u did ur hourly rounding, you could’ve prevented that. You also charted that u had 3 bedrails up instead of 4 so it’s also ur fault they fell out of bed.” Oh but then if u chart that 4 bedrails are up it’s actually considered a restraint and u can get in trouble for that too. Like omg!! Nothing will ever be the “right documentation” so I see why some ppl chart very minimally. Also, ppl definitely chart things they DIDNT do all the time. So I don’t understand how it actually “proves” anything. It’s crazy to me that someone who worked their ass off all night to provide amazing pt care can be punished but someone who scrolled on tiktok and didn’t go into in a pts room for 6 hrs but charted their “hourly rounding” will get awarded.

I also hate that a big reason why hospitals have gotten so anal about charting is because it makes them more money -_- . It just makes me laugh so much when someone in admin says we need u to chart xyz so they can make sure to bill them for that. Like omg that’s literally the last fucking thing I care abt 😭. They started making us scan the 3000ml CBI bags and we all thought it was so we could more accurately document Is&Os but nope! it’s just so they can charge the pt for each one used…

I want to clarify that I understand that documentation is important. I take it very seriously and often stay late to make sure every little assessment, I&O, etc is charted bc I know it matters and makes a direct impact on pt care. I just wish it wasn’t so punitive. Increased surveillance and nitpicking on documentation is promoting dishonest and inaccurate charting, ultimately contributing to worse patient outcomes.