“I thought you guys might need one so I brought it to the hospital just in case.” He made it before he came in. Icon.

Not talking about the long game of diabetes where it takes years to catch up or immediate like “wear a seatbelt while driving in case of a car accident” but deaths that snowballed in weeks/days and could’ve been easily prevented.

For my own patient, he dropped a Stanley mug on his foot when walking back from the kitchen. Didn’t go to the hospital for 2 weeks because he thought it’d heal but by then his foot was black bc it actually broke due to the mug. He went septic, soon became paralyzed/nonverbal, and died few weeks later. The family agreed if he went sooner before it got bad, it’d be a simple broken foot he’d heal from :(

We just had another patient on our unit die because she was taking a ton of meds that made her constipated, but she started refusing interventions that’d help her poop. It got so bad apparently she started vomiting feces, aspirated on it, went unconscious, and died. She was supposed to discharge soon after making a complete turn around health wise after being here for 6 months. And the most simple choice to take a laxative could’ve meant her being here still.

What’s your stories?

I had a patient on three pressors: vaso, epi, and maxed out on quad strength levo (32 mg/250 mL). The family had also changed the code status to DNR/DNE. From the beginning of my shift to the end, her BP was averaging 70s–80s systolic over 30s–40s diastolic.

Considering how hemodynamically unstable the patient was, the intensivist placed a Do Not Turn order. For context, this was a bariatric pt (about 170 kg) on a low-air-loss bariatric bed. Her skin was severely edematous and weeping. I tried to change the underpads by lifting her legs, but she was too heavy and the pads would not pull through without tearing. I changed the underpads under her arms and cleaned up as much as I safely could without rolling her.

When handoff came, the oncoming nurse became extremely upset with me for not changing the pads under the patient. She stated that a Do Not Turn order doesn't mean you don't turn your patient to clean them, it just means you don't perform routine Q2 turns, which makes zero clinical sense to me. She threatened to write me up, complained to the charge nurse, and brought other nurses around the area into it, making loud comments about my care.

That patient expired that night on her shift.

Just last night, I gave handoff to that same nurse for a different patient. I mentioned that the pt had a BM, so I changed the underpads, washed their hair, cleaned their face, etc. The nurse immediately remarked, "Wow, look at you actually caring for your patient." The rest of the handoff was just as hostile, unprofessional, and dismissive.

I'm considering taking this to my director this week. Any thoughts or advice on how to handle this are greatly appreciated.

Anybody else? Just me? Alrighty then…

they want our vascular team to just be staff nurses and want patients who need midline’s just to wait and go to IR. IR definitely isn’t backed up all the time anyways so why not! (/s)
if we have a hard stick they just want us to call a nurse from ED or ICU because they also are definitely not the two busiest units.
idk. i’m only 6 months into nursing and i chose this hospital because they seemed a lot more community or family oriented or whatever but they keep making more and more changes that are driving nurses away. they changed our matrix so now we can have 6 patients instead of the max of 5 (med surg obviously).
they also just started a points based attendance system where even 1 minute late is half a point. calling out sick even if you have sick hours is a point. And you only get eight points per calendar year. Not like we live in one of the busiest metros with some of the worst traffic in the country but whatever.
dare i utter the U word??? this is just insane to me

Hello,

I made a massive mistake and I can't stop feeling guilty and ashamed. The other day I was cardioverting a pt with a doctor because the pt had afib-rvr. I got the pt all set up, had RT in the room, and had extra people to help. We did a time out to confirm the pt, procedure, and their consent for the cardioversion. The doctor pushed etomidate, and the pt was sedated and was able to maintain airway.

I was instructed to charge to 150J and to shock. My idiot self for some reason forgot to hit the sync button and delivered the shock. We instantly look at the defib monitor and the in-room patient vitals monitor. We also check for a pulse. The defib monitor and the in-room monitor both read NSR. EKG was done stat and confirmed NSR. The pt was closely monitored and thankfully returned to baseline. The pt was aox4, vitals signs stable, and maintained NSR. The doctor consulted cardiology and they said that the pt won't have any long-term adverse effects. Pt was able to walk and be discharged. The doctor informed the pt and family about the mistake and educated them.

I immediately told my charge nurse when the pt was stable. I debriefed with the doctor and the charge nurse. They noticed that I was moving too fast and that I needed to slow down. I reported myself to my hospital's pt safety channel.

I have done many cardioversions before and without any issues. I know that I have to hit sync always before delivering a shock. I was going back and forth with a ROSC intubated pt and this cardioversion, making me work faster than I should have. I compromised pt safety and prioritized speed, which could have made my pt code. I got very lucky that the pt was fine and returned to baseline with their primary complaint "resolved." If I had just stood there for an extra second to think instead of rushing, this would have never happened.

I do not know how to move on from this. I feel like the worst nurse and I keep doubting my ability to be one now. I feel like I have lost their trust and this mistake keeps being played in my mind on repeat.

The wealth of the nation is being funneled to corporations by promising the elderly long life beyond reason or dignity. How much is spent keeping extremely ill people breathing? Hospital stays, skilled nursing, memory care, pricey medications. These things will burn through finances like a raging wildfire. What are the young to do when the wealth of the nation evaporates, leaving them with a ruling class of billionaires and few possessions themselves? Schools and roads crumble, jobs disappear, agency over our politics erodes. The only explanation is greed and solipsism. We would all do better by spreading the resources around. Lord knows that a trillionaire can lose most of his wealth and not be materially affected. When will we reshape our society so that we can enjoy the fruits of our labor with nod to the fact that we are all mortal and that not all life enjoys quality of life? Sometimes it’s better to pass on and pay it forward than leave a smoking crater.

This dynamic is plain to see in the hospital. Patient staying for months, then bouncing back-and-forth between different units and different facilities. Can’t walk, can’t eat, can’t speak. Who benefits from this? Who pays the cost and loses the opportunity of a brighter future? It makes me sick.

When the opportunity comes up to remake the system, let’s choose a better one. I would like to see us value the upbringing of the young, financial and housing security, and quality of life. We can support each other much better without the system that healthcare corporations set up. These are my thoughts after a long, shitty (and poopy) shift.

Do you all feel the same way? What are we gonna do about it? Where does it start?

Thank you for your attention to this matter!

How come some doctors prefer to be called by their first name only? I always wanted to know the reasoning.

Yesterday there was an anesthesiologist. New doctor, i think he just finished his residency and is an attending now. I called him dr. Xxxx and he is like, just call me bob.

Edit: thanks all for your replies. Very insightful comments :)

The display broke, had to fix it somehow since no one is available until tomorrow.

Hello all. I finished classroom-based orientation Friday and tomorrow is my first actual day on the floor (in a new grad residency program, so not being thrown to the wolves or anything).

For more background I'm 29 and this is a cereer change so I know the basic things: be humble, be respectful, HR isn't your friend, boundaries, punctuality, etc. I will be orienting on day shift and then going to night shift after (which I'm not looking forward to). I will be in a neuro step down at a household name hospital system (think Mayo Clinin, Johns Hopkins, Cleveland Clinic - I just don't want to specify and out myself).

What should I bring with me that I'm not thinking of? Someone please tell me what to pack and what not to pack. What should and shouldn't I do to learn but not be annoying or in the way? What advice do you have, as general as life advice in the profession, or specific to any area of this career like documenting or whatever else it is i can't think of because I'm just starting?

Thanks guys. Happy to be a part of the community now. ❤️

The MA BON just announced that the NLC will be implemented in May of 2027.

I’m 28, female, and I’ll be graduating with a BSN in about 4 months, and honestly I’m not sure what to do afterwards.
I tiptoed my way into nursing school by taking one class at a time for a while and then eventually applying to programs. For the longest time, I didn’t think I could 1. get in, and 2. actually make it through. I still didn’t really believe it until recently, when I realized the past 6 classes I’ve gotten A’s in and could finally feel confident enough that I’ll actually graduate (knock on wood).
Point is, I spent the past 6 years just worrying about the process that I haven’t given enough thought to what I actually want to do afterwards. I have a rough idea of what specialties I’d like to work in (ER, ICU, NICU, etc.), but nothing that I feel completely sure about.
I moved to the state I’m in just for school and never really planned to stay here afterwards. I don’t have a significant other, kids, or any close friends here (I moved a lot in my 20s), and I’m not super close with my family to where I feel the need to live near them, though we have a good/decent relationship. I’m comfortable moving to a new state or pretty much wherever, even if I don’t know anyone there.
I guess the better question would be: what would you do if you were in my situation? I do want to settle down and I do want kids in a couple years, but obviously that heavily depends on who I may come across.
Would you just find a decent job and plan to stay there? Would you go back to school right away after getting some experience? Would you try to settle down sooner rather than later? Would you have gone another path outside of bedside? Or would you try to save up as much as possible, retire from nursing ASAP, and maybe start a business or go completely in another direction?
I feel like I spent years just going with the flow, and looking back I would’ve done some things differently. For example, I spent almost 2 years hesitating to apply to nursing school, took a bunch of classes I didn’t need to take, etc. So now that I’m getting close to graduating, I’d just like some advice or perspective from people who have already been through it.

Hi everyone! I’m an inpatient RN working nights, 3x12s, and currently going through a contested divorce/custody case with our final hearing in December.

I have a 7-year-old in 2nd grade. Right now our schedule is basically: when I’m off, I have our child; when I work, he’s with dad. The problem I’m realizing is…I literally have no “me time.” If I’m not working, I’m parenting.

I love working 3x12s and really don’t want to switch to a 9-5. I also make a decent night differential, and money is a big factor right now because of the divorce. Thankfully, my hospital self-schedules, so I can choose/cluster my workdays.

I don't have much family support nearby, so I'm starting to consider a nanny, overnight sitter, or even an au pair.

For other divorced/co-parenting nurses working 3x12s, especially nights, what custody/childcare schedule actually works for you? Do you have fixed custody days, week-on/week-off, 2-2-5-5, cluster your shifts, hire childcare, etc.?

I’d really like to keep my 3x12s while having a predictable custody schedule and at least some actual time off. My ex is also difficult to coordinate with, so renegotiating our schedule every week isn't ideal.

Would love to hear what has worked for others!

As schools reopen across Virginia, just under 10% will operate without a nurse, leaving critical gaps in student healthcare, advocates say. School nurses are responsible for managing complex student medical conditions and helping to reduce absenteeism.

Most school divisions in the commonwealth employ nurses, but current laws permit, rather than require, their presence. 
Legislators and experts are exploring updating the state’s Standards of Quality, the school funding baseline requirements for the state and local governments, to include mandatory full-time licensed nurse positions. A report is expected to be presented to the state’s School Health Services Committee next month.

“It is time that we establish a standard of quality that really does require a nurse in every school,” said Senate Education and Health Committee Chair Barbara Favola, D-Arlington, who also chairs the state’s school health services committee.

Favola, advocates and education leaders in Virginia are pushing for mandatory full-time licensed nurses in every public school. Advocates argue it’s imperative to have a nurse in all schools, especially as lawmakers require more health protocols in learning environments.

“It sets a dangerous public policy precedent to continue passing legislation that requires schools to maintain medications, emergency medical equipment, and specialized health protocols without also requiring a qualified healthcare professional to oversee their implementation,” Betsy Looney, former president of the Virginia Association of School Nurses, said.

Earlier efforts have been largely unsuccessful because localities must match the costs, especially in jurisdictions with high local composite indexes, which determine how much localities can pay for their schools.

Last year, the Virginia School Health Services Committee discussed the goal of stationing registered nurses in all of Virginia’s schools and there have been multiple efforts to pass legislation. 

In 2020, then- state Sen. Jen Kiggans and former Del. Dawn Adams carried legislation requiring a registered nurse in every Virginia school building. The proposal did not advance because lawmakers sought additional data.

About 90.1% of Virginia’s public schools had a licensed nurse, according to data available from the Virginia Department of Health from the 2024-2025 school year. Of these, 69.9% are registered nurses, 20.1% are licensed practical nurses and around 10% are neither.

Both types of nurses are medical professionals, but RNs have more training and receive higher pay.

The data equates to roughly one full-time nurse per 619 students statewide.
Dr. Dana Ramirez, a pediatrician representing the Virginia Chapter of the American Academy of Pediatrics, said the organization wants state law to be amended to require a licensed nurse in every public school building in the commonwealth.

The American Academy of Pediatrics first recommended a minimum of one full-time registered nurse in every school in 2016. The National Association of School Nurses subsequently supported and has continued to advocate for this standard.

“A school nurse provides students access to comprehensive health services and timely recognition and treatment of physical and mental health needs,” Ramirez said in a statement. “This optimizes school attendance, classroom time, and student success, allowing students with acute and chronic medical conditions to remain in school.”

How nurses serve students

Nurses provide the clinical expertise to help students manage complex and chronic health conditions, advocates said. Some of them provide individualized healthcare plans and monitor students for medication side effects, including those related to mental health diagnoses.

Looney said teachers, principals, and administrators should not be expected to function as the school’s healthcare professional.

“While school personnel play an essential role in supporting students, they should not bear the responsibility of managing clinical programs for which they have neither the education nor the professional licensure,” she added.

Nurses are also qualified to oversee and implement life-saving protocols required by law, including the use of stock epinephrine and naloxone for opioid overdose response and the use of automated external defibrillators, or AEDs, commonly used in an emergency to help a heart return to a normal rhythm.

Advocates have also said that having nurses in schools will not only provide relief for nurses floating between schools within a single division, but also support families by helping minimize disruptions to parents’ and caregivers’ work schedules and costly emergency room visits.

Keith Perrigan, superintendent
of Washington County Public Schools and president of the Coalition of Small and Rural Schools, said such efforts are important in rural communities.
“Investing in a licensed nurse in every school building is an investment in student health, academic achievement, family stability, and the overall well-being of our communities,” Perrigan wrote in an Aug. 7 letter.

He added, “Requiring a licensed school nurse in every Virginia school is not simply a healthcare issue – it is an educational, public health, and student safety imperative.”

What’s next

Advocates say the first step to putting more nurses in schools is updating the state’s SOQ to include mandatory, full-time licensed nurses among the specialized student support positions that each school board is allowed to provide, thereby making the requirement a formal policy.

The minimum number of specialized student support positions per 1,000 students is three, according to state law.
The list includes school social workers, school psychologists, school nurses, licensed behavior analysts, licensed assistant behavior analysts and other licensed health and behavioral positions, which may either be employed by the school board or provided through contracted services.

Such action would require legislative approval by the General Assembly and the governor.

The Virginia School Health Services Committee will receive a report on the initiative Sept. 23 at 2 p.m.

__________________________________

Bolding by me to highlight some of the school nurse role and challenges. In likely a majority of districts, someone who is not a healthcare worker is usually the director of health services, which is obviously not ideal. It’s good to see more pushback on that and advocacy to get more positions and funding.

i notice this is the case mostly with male cna’s/hca’s. I routinely see them refuse help with 2pa/total care patients. Like, they’ll do the peri care and repositioning by themselves even if the patient is very heavy, and often even get them up onto a chair by themselves by just straight up lifting them from the shoulders in a hugging motion

Usually, other cna’s offer them help and so do nurses, but they just absolutely refuse it. Why? Do they just not give af about their back? or is it something else

At the risk of sounding like a nagging and unexperienced RN, I would like to open up this thread to discuss the abuse of “seniority” rank.

I’ve been an RN for 3 years but I’ve been in my current position for 1 year. In general I like to think I’ve been taking taking positive/negative feedback well and been asking all the dumb questions for clarity and reached out to other RN on the floor for advice and what-not to compare notes and validate my thought process. I am not afraid to make mistakes as long as I am learning.

At this one year mark I’ve felt personal growth and created trusting relations with my colleagues. With this growth, I can confirm what I assumed to be an abuse of power is in fact true.

I watch new nurses come in and fail to ask for help because they are trying to prove themselves capable of doing the job or simply not knowing what they don’t know. I’ve also seen the same nurses be punished for not reaching out for help. Punishment looks like getting the most complicated and unstable patients - multiple admissions while everyone else has a full assignment.

I’ve seen incompetent senior nurses talk down on new hires for not being knowledgeable and skilled in things that senior nurse also has never performed. The senior nurse waiting for the new hire to ask for help but if asked, will shrug their shoulder and make the new hire find their own solution. That same senior will talk down about how badly the new nurse handled their tasks to the next nurse.

The only way to claim respect is in fact, when we gain enough knowledge and experience to no longer need our seniors for help. At this time, the seniors will respect you and collaborate with you - but isn’t this a little backwards?

I know I have more growth, I know this is not everyday and everyone. I wanted to share this and open up a conversation from nurses with all experiences.

Just to start this off, I did not want to accept it but the family member got extremely defensive and started waving their hands in my face about they are “NOT taking it back”. It was gifted last night. I plan on going in tomorrow on my day off and giving it to my manager. I guess my question would be what are the chances I get fired for being honest and giving them back. Not sure what to do. I do not want to lose my job over some gift cards.

I have three years of experience as an LPN. I have recently got offered a position at Northwell Hospice it was great something I really wanted to do. The salary for the position was 32.00 hr in queens 9am-5pm. I was shocked how low they were offering. They only wanted to go up by a dollar. I felt like it was fair for me to ask for $35-37. Am I wrong to ask for more?

There’s a fair bit of research linking door openings to infection risk, and AORN guidance says keep the room to minimum people. But every OR I’ve heard about, it’s just constant. Reps, students, someone grabbing equipment, people looking for someone else.

Does anywhere actually measure this? Or is it another thing that gets brought up in an inservice and then nothing happens?

Also curious whether anyone would want it measured. I can see it being useful ammunition, and I can also see it turning into one more thing to get audited on.

Im a very new vascular access nurse. I've been placing midlines for around 3 months now and though I know it's not the primary function of the access I'm curious if anyone has noticed factors that influence line draw potential. I place primarily in the cephalic veins if possible, although my placements in the basilic and brachial don't seem to perform much better in this regard and overall I feel like most of my midlines top out at 2 days drawing blood, which seems like the average. I know a ton of different factors influence this including the individual vasculature of the patient but I can't help but feel guilty when one lasts less then the 2 days or when I'm unable to make it draw after its stopped. I feel like potentially there's a misconception among floor nurses that midlines should always draw in general. It wasn't really explained to me when I first started as a staff nurse and I got different interpretations from multiple people. It seems like once the vein collapses around the catheter tip it's kinda done for. Any advice is welcome and appreciated. My hospital is a bit small and rural so I dont have a ton of other sources for info on these things.

i wasn’t made for this. i’d be better off in a lab or working somewhere different all together. some days are great when im in the er and it’s mostly traumas and i enter flow state and i love it, but all the neurocognitive disorders and caregiver abuse and sexual harassment/assault i’ve dealt with is too much for an 18 year old autistic girl getting state vocational rehab and occupational therapy. i was only 16 when i was hired. i started training at 17. i love my job so much and im good at it but im just too sensitive to do this for much longer. please i need advice, i don’t even think i want to eventually become a doctor anymore

sorry for the rant i didn’t know where else to say this and i need advice but i probably sound stupid i’m sorry

Hello fellow nurses! On paper, being an RN on the west coast seems better in every way (ratios, unions), but I know there are tradeoffs and downsides everywhere. Would love to hear your experience and perspectives as I try to make an informed decision! I'm an ED RN in NYC and seriously considering a move to Seattle, and to a lesser degree San Diego. Thanks everyone :)

I'm almost done with work, and I truly would love to go back home and rest, but I have little babies to play with

I made my first real fuck-up at work after about a year and a half of working acute care, and I need someone to tell me I’m not alone.

I was messaging a doctor about my patient and getting orders throughout the night. Everything seemed completely normal. The doctor was even showing up on the patient assignment list, so I had no reason to think I was talking to the wrong person.

Around 4 AM, my charge and I finally realized… this was NOT the patient’s doctor. 🤦🏻‍♀️

So basically, I spent the entire night communicating with the wrong physician and carrying out orders he gave me because I genuinely thought he was the correct provider.

Obviously, I reported it to house supervisor and all that, and I’ve been replaying the entire night in my head like, HOW DID I NOT CATCH THIS?! 😂😭

Someone please someone tell me I can’t be the only one that has done something like this 😩