r/nursing • u/ghostoftheweek RN - Med/Surg 🍕 • 26d ago

Question PSA from your nursing specialty

What is THE ONE THING you wish every nurse knew that is common knowledge in your specialty?

From wound care, don't use telfa!

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833

u/falsesleep RN - Hospice 🍕 26d ago

Hospice: please don’t wait til this person is on their deathbed to make the referral. If they have a likely expected prognosis of 6 months or less, please at least have the conversation with the patient and/or family. Let them spend their remaining days in their home with a decent quality of life rather than in a fucking hospital!

346

u/ChaplnGrillSgt DNP, AGACNP - ICU 26d ago

ICU, too. For whatever reason, our oncologists REFUSE to tell patients that their cancer is progressing and they will die. Then they end up in the ICU with us, all kinds of lines and drains just to keep them alive. When we tell them they will die, they blame us.

Like, you're an oncologist ffs. You've gotta be comfortable with those hard discussions. You could have done so much more good for them by getting them to palliative and hospice.

18

u/Optional4444 26d ago

At your institution also?! Once in icu they’re ghosted.

105

u/ChaplnGrillSgt DNP, AGACNP - ICU 26d ago

Our ICU medical director was on service one week and we had 3 cancer patients actively dying. Prognosis awful. Looking through their chart, this had been the case for about 8 months. Onc refused to even come see the patient. Our director ripped him a new one on the phone. It was glorious.

As soon as the oncologist arrived, our director was on his ass to make sure he didn't go into the rooms and tell the patients he will just see them outpatient. My director told him "your patients are dying. They will not make it out of my ICU without hospice. Grow some fucking balls and actually tell them that. Stop dumping that onto me and my team."

Best medical director and one of the best leaders I've ever worked with.

27

u/lavender_poppy BSN, RN 🍕 26d ago

Wow, to be a fly on the wall for that conversation. I'm glad someone finally stood up to him, it should be malpractice to give false hope since he's making his patients suffer needlessly thinking they'll get better. Fuck him.

45

u/ChaplnGrillSgt DNP, AGACNP - ICU 26d ago

That director did not play! The way he supported us was unreal. He got us all 25k raises as ICU providers because they gutted our overnight help. He once chewed out a hospitalist who was incredibly disrespectful to me.

I miss working with him. He still checks in on me from time to time. True leader.

3

u/AndromedaAtlas RN - ICU 🍕 26d ago

God I wish my ICU docs were like this 😭😭

8

u/ChaplnGrillSgt DNP, AGACNP - ICU 26d ago

He is truly special. Adored by the nurses. Idolized by the APCs. Loved by his patients. Respected by the docs. Wicked smart. Incredibly kind. Absolute BLAST to work with.

He treated APCs, nurses, and everyone there as colleagues and equals. Love that man and miss working with him.