r/nursing

We are being inundated with anti-vax parents at our clinic and it is beating the compassion out of me with a stick.

Parents who laugh at us, accuse us openly of trying to kill children and profit off of the “system” all while they are demanding that we write letters to schools and sport teams exempting their children from vaccine requirements. Parents who say that we are out to get them and their kids and then are flabbergasted when our providers ask “If you believe that I am not a trustworthy practitioner and am trying to harm your child, why did you make the choice to schedule an appointment with me and drive an hour to be here today?”

Maybe what we need is a massive outbreak.
An outbreak of an illness we have a vaccine for.
Maybe we need PICUs that are full, death rates on tv, anti-vax parents having to get notifications of deaths and funerals of friends and family.

Maybe these parents need to see the complications of these diseases and be told “your child developed measles induced swelling of the brain. We cannot be certain that they will return to their baseline. The measles infection can cause damage that we cannot repair.”

Even then, I dont think anti-vax parents will be able to comprehend that these illnesses are a direct result of not vaccinating, I dont they most would care.

Guys what mascara are yall wearing to the hospital? Im talking not bleeding onto my eyebags half way through my shift but also not ripping my lashes out at night trying to wash it off. Also preferably not very expensive, but if it’s worth its worth it yaknow. Thanks in advance!!!

"We've been told it happened in the pharmacy where instead of putting an anesthetic called bupivacaine into the syringes used in these procedures, somehow they were filled with potassium, which can be lethal.

In fact, potassium is one of the drugs often used in lethal injections because it stops the heart."

Seems deliberate !

I got blackout curtains and I thought that would be my answer but it has helped exactly 0%

I'm especially curious for those who've been psychiatrically hospitalized. (Because I've had three psych admissions at a different hospital, but I occasionally wonder what it would be like to be psychiatrically hospitalized at my own hospital - which will hopefully never happen but I wonder just out of morbid curiosity.)

I was taken aside yesterday at work and told that I made a patient cry after our correspondence via MyChart. I work clinic side and I field hundreds of messages and phone calls every day from patients, and sometimes I do get frustrated by patients who don’t seem to…..get it?

This patient had two recent UAs. One came back with trace non-hemolyzed RBC and the other came back with trace hemolyzed RBC. This patient, a woman in her late 50s-60s, had a lot of questions about what these results meant - specifically what the difference between hemolyzed and non-hemolyzed RBCs in her sample meant.

I did my best trying to explain in lay terms what this meant but over the course of our correspondence she was just not grokking it. The provider even stepped in and sent a message to the patient explaining the difference. We gave her resources and links to articles explaining what these words meant.

Finally (after about 6 messages back and forth) I sent her a message saying that she may be better off researching the topic herself and that we had no further information to give her.

Additional info- this is a relatively healthy older adult female patient who had an acute UTI, this is not related to an ongoing chronic illness which I would have handled with more care.

It was my final message, my manager explained, that caused so much upset and apparently caused the patient to cry.

Yes I understand that it should not have gone on for so long. I should have offered her an appointment to discuss this with her PCP. But it had already taken so much of my time and effort that I didn’t see that as an option at the time…

Has anything like this ever happened to you? Where you were too direct with a patient and they got upset? Should I just learn to let go of these things??

This is my rant post for nursing certifications. Nearly $400 for initial BCEN certification is insane and a total money grab from these certifying bodies. Plus eventual renewal fees and associated CEUs and also costs for licensure renewal that is essentially a "licensure tax". add multistate licensure and multiple certifications in there and there goes the vacation fund. Looks like more overtime for me.

Curious the fastest you ever quit a toxic nursing position?

This is definitely a record for me. I accepted a job as dispensing nurse at an outpatient MAT facility (methadone/suboxone). I ignored some red flags in the hiring process.

First off, I wasn’t contacted for about a month after applying. I was gearing up to accept a job elsewhere that I really wanted even though it was a long commute but then at the last minute I changed my mind to pursue the dispensing position instead because it was so much closer to my home.

Once I interviewed and was offered the position and accepted it, the interim director could not keep straight what parts of the onboarding process I had/hadn’t completed. I chalked this up to her being overwhelmed by managing 2 facilities. But I didn’t get confirmation about my start date until the Friday afternoon before. When I emailed her basic questions about my first day (ie: what time are they expecting me, what entrance, should I make sure I bring anything, etc) it was ignored. Twice.

On my first day I show up at 4:30am thinking that someone is bound to be there, I’m knocking, nobody is coming, I call the office, phones aren’t on so it’s forwarded to an answering service of some kind and that person messages someone in the office to let them know I am there but apparently that message wasn’t received until hours later. Finally someone inside happens to hear me knocking but they almost didn’t let me in because they thought I was a client looking to dose early.

There is no formal orientation process, so I spent the next 2.5 shifts kind of just watching my preceptor. Instead of taking downtime to walk me through things, she spends the time either sharing stories about her personal life (I know everything about her ex husband, current husband, previous jobs, every grievance she has ever had, every shred of gossip she had ever heard, every outdated opinion she holds, etc) or gossiping with coworkers who come up to her window about other coworkers or clients. All I could do was sit there feeling invisible while everyone around me just spewed toxicity. It was really uncomfortable. They were bullying one lady who works there. You knew this has been going on for a long time.

The interim director called me today to let me know that I hadn’t clocked in yet. The reason that I hadn’t done this is because she told me to use the computer in a co-workers locked office and she expected me to pick the lock with a credit card in order to get in. When I told her I wasn’t comfortable doing that so I refused, she actually got defensive.

I grabbed all my stuff, took my break, and sent my resignation email. I’ve been a zombie all day since. Going into this job, I was warned that the clients can be difficult. But in 2.5 shifts, the staff proved to be the ones who made the job impossible. I couldn’t sit there and listen to their shit another second. I’m exhausted.

/rant

I haven’t told anyone at work about my miscarriage, or even that I was pregnant in the first place. I’m a fairly private person/ I hate bumming people out. It was very early, <12 weeks. but today, a dementia patient asked me “how’s the baby?” 🥺🥺🥺🥺

So I’ve been an RN for 6 years and a home health nurse for 1.5 years.

Today I had a suprapubic catheter change due for a patient at an assisted living home. I went to remove the old catheter and I noticed upon pulling it out it got stuck. I managed to wiggle it around and it loosened up a little. When it came out there was a soft pop but there wasn’t any blood or anything on the catheter tip or on the SP site.

When I went to insert the new catheter I swear the canal must’ve closed up or the patient was having a bladder spasm because when I was trying to insert it wasn’t going in. I tried to insert it straight, at an angle, and also downward toward the pubic bone but nothing worked. Then the SP site began to bleed so I stopped. I spoke with the patient’s resident care coordinator and she looked really irritated when I told her the patient will need to go to the ER to have his catheter changed.

I called my clinical manager and notified her and she seemed pretty nonchalant about my decision.

Did I make the right decision to send the patient to the ER?

Sorry if it seems like I’m worried over something petty. I’m just pretty hard on myself as a nurse when things don’t go smoothly.

I’ll go first: Family didn’t want baby to receive vitamin K or CHG wipedown prior to a major surgery. Post-surgery didn’t want baby getting labs or TPN. Didn’t want kid to get vec to put in PICC for long term access despite kid was already intubated and on a fentanyl gtt (which they weren’t keen on either).
Dad says he doesn’t like unnatural things. Covered in tattoos. Mom drinks hella diet coke every day.

Before getting into everything, I should mention that I already put in my two weeks, and this week was supposed to be my last week at this job. Long story short, I work in the ICU and recently had two patients with pacemakers. One of the pacemakers was doing some funky things, which made me realize I was a little rusty with EKGs. I had a tab open with different EKGs and practice questions and was reviewing them periodically while taking care of my patients.

My charting was up to date, and my patients were stable. One had already been downgraded to step-down.

I went to lunch around 2:30PM. When I came back around 3 PM, my manager pulled me aside and told me that I had been looking at EKGs "all day" instead of taking care of my patients. She then claimed my charting wasn't up to date and that there was something wrong with my notes. However, her main reason for sending me home was that I had been doing EKG practice questions and looking at EKGs "all day."

I asked her to show me where in hospital policy it says we aren't allowed to study or review educational material during downtime. She couldn't show me a policy. Instead, she said she had a witness who also saw me studying and she doesn’t have to show me any policy that says we can’t do that.

She then pointed out that I hadn't documented my 3 PM vitals yet as an example of my charting being behind. The problem was that I had literally just returned from lunch at 3:05 PM, and I was in the process of doing my 3 PM vitals when she interrupted me. She then proceeded to say that I have been doing anything, and I took her through all of my charting the whole day to show her that I have been charting every single thing up until 3 PM and that both of my patients had all of their stuff done for most of the day. They were up in their chairs (cardiac patients), had worked with therapy, had received their medications, and everything that needed to be monitored/documented was being handled. I was simply using some downtime to review EKGs because I wanted to improve my knowledge.

She basically told me that it was against "her policy" and sent me home. She then took me off the schedule for the rest of the week without really giving me an explanation. I've already emailed whoever I could about what happened.

So, Reddit, I'm curious: Am I actually in the wrong here? Is studying EKGs during downtime something that could reasonably be considered inappropriate, even if patient care and charting are up to date? Or does this sound like management looking for a reason to send me home because I'm already leaving? Is there anything else I should be doing to protect myself/document what happened?

I'm honestly just glad I'm almost out of there, but I'd appreciate some outside perspective. Thanks

I work in hospice and tend to keep things professional. Since COVID I tend to avoid personal contact, though a handshake or a hug occasionally can mean a lot. Hand holding, rubbing someone’s back or shoulders is completely acceptable and hand hygiene to follow. I care so much about our patients and their families, however I see staff especially of some local assisted living facilities swoon over a dying patient, hugging, kissing, etc. and I can only think of how many other staff have done the same before and after them. Families have mentioned to me how many women are kissing their husband, etc. and it’s sometimes a little off putting in that way and concerning when I think of infection control. And I’m not a stickler by any means.. these places I visit take strong precautions once there’s an illness going around, but then I see this sort of thing.

I'm curious about this because I'm an older nurse (12 years in). How often do you write a nursing note?

When you page a provider to the bedside to assess a patient for a concern you have, do you write a note summarizing the encounter? ie, "dr smith at bedside at 1330 in response to page at 1315." Drain with 100cc bloody output in one hour, previously straw colored. Per MD continue plan of care, if output becomes more than 200cc/2 hours notify team. At this time vitals are WNL, pt resting in bed, A+Ox4 with no complaints.

Or for example if a patient seems like they have a behavior issue (rudeness, risk of violence, noncompliance with instruction" do you write a note (A SOAP note - subjective, objective, assessment, plan)?

I spent some time auditing charts and most newer nurses don't write nursing notes, but I feel like they help paint a picture in a way charting by exception does not. I don't want to over chart, but I also know my memory isn't what it used to be and the cases in the news right now with documentation being ripped to shreds I know I need to be able to paint a bigger picture.

What do you do in your practice?

I have 6 years and 5 jobs.

I’m self conscious that my resume makes me looks like a job hopper lol.

From a RN, tech, MD, anyone in the field, thoughts on the Clancy trial? I’m not looking to start an up for I’m looking for professional and experience based perspective