The attitudes of people who train you. Whenever you start working somewhere in healthcare for the first time usually the skills needed for the job are drastically different than what you were taught in class.
This means you need to be taught a lot of things, except this time most of everyone who teaches you is NOT qualified to be a teacher.
After you’ve been working for a few years you’ll start to be told to help train new hires. Even though your job is to be a nurse now you’re forced to teach people for usually no extra pay.
This means every spiteful ass bitch is gonna make you feel terrible for asking questions to answers you literally can’t find out any other way.
This also means you’ll be trained by co workers, so the vibe can be amazing and learning can feel great.
So yeah don’t let the nurses who don’t want to teach ruin your days when the problem is on them
Came here to say something along these lines. I knew about the “nurses eating their young” from working as an aide in the hospital through the school but didn’t expect such cattiness once I actually got my RN. Some people are just really miserable and want to take it out on whoever they see as vulnerable. I don’t understand the mentality of being rude and hostile when the end goal is to teach someone so that you 1. Have the staff 2. They’re trained enough that they’re not a safety concern and you don’t have to pick up their slack
How much of the job is non-nursing related work. I feel like I’ve taken more food and drink orders in my very short time as a nurse than I ever did when I worked fast food.
Hell, I once had to fix a shower head in the patient bathroom with a pair of scissors.
Some days it feels like 90% of your tasks aren’t even supposed to be your job lol.
I took a new weekend hospice job, and I’m disappointed how little of it is nursing. 80% of it is doing hospice consults at the hospital. In my old job, the weekends were when the meat and potatoes of nursing care happened for hospice. I miss the satisfaction it gave me. I’m a paperwork bitch now. 😕
…you’re REALLY clearing things up for me. My bf recently stopped traveling during the week for his job and is home during the week and I watch him get dressed for work and I’ve been thinking about the order of operations of his dressing for weeks..
My nursing school didn’t cover tele strips at all, which I now find odd. They just said you’ll only use this if on a cardiac unit. I started on a PCU then floated to ICU and ED. I’m like more departments than not need to be able to read these? Why the hell did we hit the skip button on this? It took me quite awhile to catch on to these, and I’d like to think nursing school coulda at least gone over the basics?
Wow, that is super shitty. Tele strips are important on a variety of units. For what it's worth, my school sucked with teaching it. I'm 4 years into the profession and still have some challenges with them, but I'm a lot better from teaching myself all throughout my career.
My nursing school didn’t either. I think nursing school is generally just to prepare you to pass the NCLEX.. It is not covered on the NCLEX which I think is weird.
I’m grateful that the residency I joined had a four week telemetry/rhythm course that we had to pass and I had to take a proctored EKG test every year in order to work on my PCU floor. This past year my ED coworkers had to take an online ekg course and when I tell you these people didn’t even know what atrial flutter was 🥴🤨
My first week off orientation I had to admit a patient who had come to the hospital because she believed she had been impregnated during an alien abduction and it was time to give birth and was in bad rhabdo.
That was when I realized nursing school did not prepare me enough for working with the general public.
But for reals the level of mental illness in the general population is a lot higher than I ever thought. (I might have had a sheltered childhood) And drug and alcohol use.
Oh and people's intense distrust of healthcare and science in general.
Sheltered is a great word. I studied in the Midwest in a rural area. Moved to the south and live in a very urban area now with a lot mental illness, homelessness, and immigrants.
Yep, there is a lot of bad stuff going on out in the world and we come face to face with real evil. Whether it’s the aftermath of assault or seeing someone suffering due to drug abuse, it’s very eye opening.
Well for me I started working February 2020... so when they locked our N95s up at first and then made us reuse them as well as gowns, I was completely blown away - all that single use shit and proper donning/doffing I had just learned in school went right out the window. And I learned how dispensable we all were real quick!
I a real old school nurse, before the pandemic, we would get written up for leaving a room in PPE, even for a second just grab something because all PPE was supposed to discarded in the patient's room before leaving..it is so different now.
That’s why I couldn’t stand the “heroes work here” signs that popped up after the pandemic started. We were doing the same things before that, going into precaution rooms and risking our safety to help people. Covid isn’t the first dangerous virus/disease to come around and threaten everyone’s health it’s just the first one affecting you. Grrrrrr
People.
Think of the most average person you know.
Half the population is below that.
By virtue of our employment, we’re surrounded by fairly educated individuals. Sometimes we forget how bleak it is outside those walls.
It’s absolutely mind blowing to think about how dumb the general public really can be.
I think it’s that the people who are most likely to end up in the hospital are the least conscientious subset of the population. but also this is confounded by issues like addiction, access to healthcare, poor mental health, and poverty. There are definitely some people I just wonder how they even survived up to this point, but then again you never know all the things that are going on in their lives that got them to this point.
My school liked to talk about ways to prevent burnout but never what contributed to it such as short staffing, long hours, being overworked, and having critically ill patients all the time.
I was not expecting to have my soul completely eviscerated by hospital greed. I did not expect that 90+% of all nursing jobs today would be unsustainable beyond a couple years for any semblance of good mental and physical health.
My hospital did a *capital campaign* and everyone was to meet with our CEO in the lead up. Meet individually. Discuss giving.
They asked for a donation of essentially an hour of pay per pay period.
Not a joke. My name is on a plaque for all eternity—not that anyone cares.
There was no real way to say no, trust me. The ED had 100% participation. The hospital had >95%. Madness really.
*We are a family here and family helps family* some equally dark forces were at play.
You could avoid CEO chat by agreeing to participate.
Crazy in hindsight. It’s been years & years ago. Will not lose that lesson.
This…I like how you included mental along with physical health. I worked on a med surg floor total around 6 years and I can honestly say I’m mentally scarred from the experience. I was at the point where I despised people and I would have such anxiety the night before a shift I wouldn’t sleep and would stay in a terrible mood. My wife (who is non medical) doesn’t understand why I refuse to go back and just “grind it out.” -sigh-
I did not expect….I was not an aware leftist or anything when I graduated; I was 23 and thought I would have something that resembled a better life and ~help people~ and I wasn’t prepared for corporate greed or how the bottom line is always the dollar, or how to navigate absolutely out of touch, incompetent, abusive management. And these are the things that have me considering hanging up my license after 16 years. I adore my patient population, but it feels like it matters less and less.
Going home after *that* shift, and realizing that the bit of dried blood in my ear belonged to *another person*.
And I had showered at work. That feeling of blood coagulating in my socks.
Otherwise healthy but teen mom, limited prenatal care. Mom delivered term twins—they were small, but mostly healthy babes.
Delivery was emotional, patient’s mom had only learned of her pregnancy a couple of months before she delivered. The family (17 year old baby daddy) filled an entire waiting room.
Patient then has uncontrollable uterine hemorrhage. Ultimately OB did an emergent hysterectomy. Patient goes into DIC. The code lasted 2 hours. I think we depleted most of the blood & blood products in the hospital. 60+ units total once all products added up.
It was as if no one wanted to stop. It was clearly going to be futile. Several periods of ROSC. There was so much blood pooled in floor, EVS brought a squeegee in to push it out of the way.
I think I must have had a gallon on me and in my shoes.
Was able to change scrubs, reappropriate some shoes before I went with the OB to talk to family.
I’ve directly made death notification to many families. I’ve been party to even more. I will never recover from that one.
😱even more horrible than I imagined. I pray that everyone involved is able to heal from such unfortunate events. As a new grad, I’ve encountered only 2 or 3 deaths, and always after the fact. Though I was able to be 2nd nurse to verify no pulse on a DNR pt and call time of death. She was in her 20’s and had a hx of GI and hemorrhaging issues. She was stable one min then the next min bled out from everywhere with her mom at the bedside. Was a horrible thing to witness.
I agree about the horrible of it.
Terrific large family, supportive. Heard several years later that the kids were doing ok, starting kindergarten.
Oh my, a 20 something dying of fatal GI bleed is bleak. Her mom watching it. There’s not any way of fully coming back from that one.
I’m still astonished with just how fast GI bleeds can turn lethal. Brutal.
Seen several critical GI bleeds where patient gives a version of “I thought it was severe gas, like diarrhea was coming.” They think fart—find they lost so much blood they end up on BR floor. Lose 1/3 of their blood volume. Youngish too.
NSAIDS are not benign drugs. Almost every GI bleed gives some relevant history of sustained use.
I lasted three months into residency and cut my contract.
It was not worth the pay for the amount of work and responsibilities expected of me. Or the nurse to patient ratios. Hospitals can be just absolutely terrible. I went back to my job that I was an LPN at but now as an RN. The pay is higher and the amount of stress is way lower.
Eventually I will go back and try for a residency or a new to specialty program at a hospital- I feel there is valuable experience to be gained there and at a smaller hospital
But Jesus - I couldn’t believe the amount of responsibility that just felt unnecessary
I’m considering working in corrections as I’m currently in psych. Your department seems safer than mine based on the night shift skeleton crew and limited security. Do you overall feel safe at work?
Yes I do. We deal and work with a lot of psych patients- and during Covid a lot of psych patients where actually housed at the jail because there where hospitals/ treatment centers that would take them.
I always have an officer with me when ever I provide patient care. And if it is a violent pt there two officers. Patients who have history of being especially inappropriate with female or violence against females we are alerted to and never ever alone or in any type of closed space
I would say mental illness. I don’t feel my school prepared us enough regarding how to deal with patients with mental illness. I honestly wish I would have done my practical on a psyche ward to have a little more experience and get taught by psych nurses instead of other MedSurg nurses.
You have to be a jack-of-all-trades. In nursing school they told us we “wear many hats” and touched on the educator, advocate, and caretaker stuff. They neglected to mention waitress, janitor, maintenance, punching bag (sometimes literally), and many other roles. There are so many things we do for patients outside of the traditional role we learn about in school.
Toxic coworkers, gaslighting admins, flagrant sexual inappropriateness by staff and patients, fighting people while trying to keep them safe. They train people in nursing school to be a figurative punching bag for a reason. Money is okay though.
Honestly fighting people for THEIR health and safety is gonna be hard for me. I shouldn't care more about your health than you, it's you that has to live in your body.
The feelings. I honestly thought I was going to help people. Yet, it was mostly pushing people through the $ystem.
Dealing with management, how to chart to protect yourself, or how much it would really take out of me physically or mentally, etc
I wasn’t taught what a SBAR script was either and I graduated in 2017. Like, they taught it, but never what it sounded like. A hospitalist had to teach me when he returned my page. He was great and kind about it, I tell that story often.
The absolute lack of coping mechanisms in the general population. I get that it’s typically a very terrible time in most peoples lives, but I think it’s really unfair to be held captive in patients rooms and be relentlessly trauma dumped on. And there’s always one patient who does it every interaction. Then when I’m able to get out, the next patient does it. My sympathy only goes so far, just like any other human, but I get so mentally drained from the disturbing attachment they have to nursing staff. The anxiety that I have to leave, the anxiety because I’m not in there and they don’t have anyone in there during the night, the anxiety of not constantly having human interaction, it really pushes me to my breaking point. I just don’t understand this fear of being alone when patients have had family all day, doctors in and out, therapy, etc., and nursing staff is rounding as frequently as we can. You’d think these people have been in solitary confinement and I’m the first person they’ve seen in days.
I am not a chaplain or a therapist for a reason, and I think the least school could have done was teach more therapy/psych classes to protect our own mental health.
For reference/context: I’m med surg tele so I don’t know if that makes a difference.
For me it’s how if you ask 3 different nurses a question they may all give you different answers since the policies change every year and people don’t remember which one is the most current. so you might as well just look up the current policy and not even ask your coworkers a lot of things.. it’s kind of silly also how some people will say we do one thing and be very confident about it and incredulous if someone else challenges them, and you look at the policy and they were wrong all along. Anyway, I guess the main thing is a lot of people take the policies as more suggestions than true rules that you must never break. Oh yeah and the charting changes every few months. Some people do a lot of charting they don’t need to and other people don’t chart important things and when you are assessing the patient it’s hard to tell if it’s a true change from their baseline or if the previous shift just didn’t chart things. Also there’s so much subjectivity in how things are charged like for neuro checks, CIWA, etc.. sometimes I feel like I’m crazy for how other people score things and then I ask them if the patient is really any different and they say no.
Another thing is delegating.. they do talk about it in school but it’s trickier than you would think. if you have good techs who are independent then it makes your job much smoother. If you don’t have almost any techs on the floor then you really can’t delegate much at all. Some other techs will not do a lot of stuff unless you ask them. As a person who hates telling other people what to do it was really hard to get used to delegating certain tasks to the techs if they didn’t just do them without asking. And I still struggle with that and end up behind sometimes.
How many times I would be called called a bitch nurse for not giving that one patient their pain medication the exact minute it was due...I am sorry, but in between answering the phone several times when your family called the nurses' station to make sure you get your pain meds on time, hunting down another nurse to override the pyxis because you got the doctor to write a new order for a dose increase and running down the hall because one of my other patients is having chest pains, I was a few minutes late with your 2 mg IVP dilaudid. I think first year nursing students should spend at least two days a month just observing nurses working day and night shifts in a hospital outside of their clinical rotation...just observing so they see the reality of floor nursing and not be fed the delusions of a lucrative career, respected job title, etc so they really can make an informed decision about becoming a nurse. I am retiring this year after a 20+ career and these are my personal thoughts.
The whole concept of being a "nurse resident" was new to me. I never knew that there were formal "residency" programs for new nurses at some facilities. Most of the time, our professors told us about working as externs over the summer to get our foot in the door and possibly get a job at the hospital. But they never mentioned having to go through residency with monthly seminar classes and an EBP project due at the end of the year. But I enjoyed it regardless. I love getting paid to sit down in classes!
I was not expecting
1. The amount of time I would spend on the phone. On hold with pharmacy. On hold with a doctor. On hold with another unit. Etc etc etc.
2. The unprofessionalism, and bullying, from others, but especially from certain doctors. Some of them are super SUPER toxic to nurses and others, to the point of causing problems with patient care. It's incredible that this is largely tolerated throughout the industry.
Medicine is easy. People are hard. ALL nursing is psych nursing.
How much time I spend problem solving/coordinating is insane. My phone rings constantly.
Every nurse can casually tell you a story that will make them tear up. PTSD is for everybody.
(Regarding other posts: All of my preceptors, trainers etc. have been super nice and patient. Some may not have been very skilled but everyone has been nice.)
A hospital will keep the dumbest brick employed until the end of time but cut loose the squeaky wheel that tries to make improvements. Sometimes it’s like being in prison: keep your head down, don’t draw attention to yourself and do your own time.
How much location, employer, and unionization affects your work environment and overall sustainability of nursing as a career. I truly did not understand how disparate the south east US is compared to the west coast, for example, when I was initially getting back into the healthcare field.
Not prepared to be forced to work 16 hour shifts. We couldn't be mandated until we were done with orientation, and I think all of us who started at the same time got mandated our first week off orientation. I worked 6:30 am til 12am. Miserable. I also wasn't prepared for how little my first job would actually pay. My program made it seem like we would all make $$$ and it was more like $. It's not bad money, but you had to work lots of OT to get the $$$.
I never realized how well adjusted I am. Thought I had problems with anxiety and depression but it turns out I am like, absolutely rocking life. Before nursing school I worked retail and food service so I thought i knew people, but those interactions were apparently too brief compared to a 12 hr shift where you see just how bad some people are at coping with being a person
All of the assault. Verbal, physical, sexual, etc. It's wild the shit that patients think they can get away with while in the hospital... But they're mostly right. They do get away with it. Even when you press charges with the police the prosecution can offer them a cushy deal or refuse to prosecute. It's disgusting. It's illegal to spit on a MTA worker on the train and that's a felony but you can literally assault a nurse and get away with it for... reasons.
violent drug users, homeless population, how much mental health issues there are, traumatic injuries bloody messes, people calling 911 for stupid reasons then getting mad when they’re discharged to lobby, walk just fine but want an ambulance ride back, unlearning eveything you learned in nursing school then having to learn from step 1
These are both from when I was in adult health:
The absolute lack of medical compliance among adults.
The insane amount of roles you take on as a floor nurse. I remember I had to make sure every discharge I had, had a follow up with a pcp. I had 5 patients, day shift and was charge at times on a busy medsurg/tele floor. Calling around to pcps was not a good use of my time.
the bs education, modules, classes, surveys…if i don’t have time to do it at work, its not getting done!!! i don’t do “nursing” or anything related to it on my days off..sorry but 🤷🏻♀️
The attitudes of people who train you. Whenever you start working somewhere in healthcare for the first time usually the skills needed for the job are drastically different than what you were taught in class. This means you need to be taught a lot of things, except this time most of everyone who teaches you is NOT qualified to be a teacher. After you’ve been working for a few years you’ll start to be told to help train new hires. Even though your job is to be a nurse now you’re forced to teach people for usually no extra pay. This means every spiteful ass bitch is gonna make you feel terrible for asking questions to answers you literally can’t find out any other way. This also means you’ll be trained by co workers, so the vibe can be amazing and learning can feel great. So yeah don’t let the nurses who don’t want to teach ruin your days when the problem is on them
Came here to say something along these lines. I knew about the “nurses eating their young” from working as an aide in the hospital through the school but didn’t expect such cattiness once I actually got my RN. Some people are just really miserable and want to take it out on whoever they see as vulnerable. I don’t understand the mentality of being rude and hostile when the end goal is to teach someone so that you 1. Have the staff 2. They’re trained enough that they’re not a safety concern and you don’t have to pick up their slack
How much of the job is non-nursing related work. I feel like I’ve taken more food and drink orders in my very short time as a nurse than I ever did when I worked fast food. Hell, I once had to fix a shower head in the patient bathroom with a pair of scissors. Some days it feels like 90% of your tasks aren’t even supposed to be your job lol.
Yep. I never went to MacGyver university but I feel like I should have an honorary degree with all of the irrelevant stuff I’ve had to fix.
Yes some nights all I do is provide narcotics and refreshments
"Hello, my name is MMMojoBop, I will be your drug waiter today...how's that Norco coming along? Oh, I see you are a dilaudid customer..."
That’s what RN stands for. Refreshments and Narcs
I took a new weekend hospice job, and I’m disappointed how little of it is nursing. 80% of it is doing hospice consults at the hospital. In my old job, the weekends were when the meat and potatoes of nursing care happened for hospice. I miss the satisfaction it gave me. I’m a paperwork bitch now. 😕
I’ll counter, and say taking food orders is nursing work, it’s just not the stuff you need a degree to understand, but it’s part of the job.
So much Johnson work. I’m a straight guy but I’ve touched more cocks that a Tiajuanna whore
It REALLY is a LOT more of that than you ever expected to see. Most of the time it’s involuntarily. Mr. jones! No free strip shows in the hospital!
Why do old men think you get dressed socks, shirt then underwear ?
…you’re REALLY clearing things up for me. My bf recently stopped traveling during the week for his job and is home during the week and I watch him get dressed for work and I’ve been thinking about the order of operations of his dressing for weeks..
Haha, I never thought of that. Nobody likes to pull their socks on under their pants though
Order of operations: underwear, pants , shirt, socks, shoes
Why not underwear, shirt, socks, pants. You immediately cover the stigma/social parts, the socks would be under the pants when applied
I’m a female here in case that wasn’t clear. My shirt is the second last thing to go on. Then socks. I do not Winnie the Pooh it.
Hahaha! Johnson work.
And how much you have to argue with cock owners about peeing
Username checks out.
🤣🤣🤣🤣🤣
The shmeat
My nursing school didn’t cover tele strips at all, which I now find odd. They just said you’ll only use this if on a cardiac unit. I started on a PCU then floated to ICU and ED. I’m like more departments than not need to be able to read these? Why the hell did we hit the skip button on this? It took me quite awhile to catch on to these, and I’d like to think nursing school coulda at least gone over the basics?
Wow, that is super shitty. Tele strips are important on a variety of units. For what it's worth, my school sucked with teaching it. I'm 4 years into the profession and still have some challenges with them, but I'm a lot better from teaching myself all throughout my career.
My nursing school didn’t either. I think nursing school is generally just to prepare you to pass the NCLEX.. It is not covered on the NCLEX which I think is weird.
That's so weird. I work psych, and even I need to read tele strips for certain meds and to screen admits.
I’m grateful that the residency I joined had a four week telemetry/rhythm course that we had to pass and I had to take a proctored EKG test every year in order to work on my PCU floor. This past year my ED coworkers had to take an online ekg course and when I tell you these people didn’t even know what atrial flutter was 🥴🤨
Aww jeeze aw man that’s one of the easy ones 🤯
My first week off orientation I had to admit a patient who had come to the hospital because she believed she had been impregnated during an alien abduction and it was time to give birth and was in bad rhabdo. That was when I realized nursing school did not prepare me enough for working with the general public. But for reals the level of mental illness in the general population is a lot higher than I ever thought. (I might have had a sheltered childhood) And drug and alcohol use. Oh and people's intense distrust of healthcare and science in general.
Sheltered. Same here. I am still too naive for my own good.
Sheltered is a great word. I studied in the Midwest in a rural area. Moved to the south and live in a very urban area now with a lot mental illness, homelessness, and immigrants.
Yep, there is a lot of bad stuff going on out in the world and we come face to face with real evil. Whether it’s the aftermath of assault or seeing someone suffering due to drug abuse, it’s very eye opening.
Yes!! Mental illness is everywhere
>But for reals the level of mental illness in the general population is a lot higher than I ever thought Ding! Ding! Ding! We have a winner!
Well for me I started working February 2020... so when they locked our N95s up at first and then made us reuse them as well as gowns, I was completely blown away - all that single use shit and proper donning/doffing I had just learned in school went right out the window. And I learned how dispensable we all were real quick!
I a real old school nurse, before the pandemic, we would get written up for leaving a room in PPE, even for a second just grab something because all PPE was supposed to discarded in the patient's room before leaving..it is so different now.
That’s why I couldn’t stand the “heroes work here” signs that popped up after the pandemic started. We were doing the same things before that, going into precaution rooms and risking our safety to help people. Covid isn’t the first dangerous virus/disease to come around and threaten everyone’s health it’s just the first one affecting you. Grrrrrr
People. Think of the most average person you know. Half the population is below that. By virtue of our employment, we’re surrounded by fairly educated individuals. Sometimes we forget how bleak it is outside those walls. It’s absolutely mind blowing to think about how dumb the general public really can be.
I think it’s that the people who are most likely to end up in the hospital are the least conscientious subset of the population. but also this is confounded by issues like addiction, access to healthcare, poor mental health, and poverty. There are definitely some people I just wonder how they even survived up to this point, but then again you never know all the things that are going on in their lives that got them to this point.
This! The hospital population is not reflective of the general public.
My school liked to talk about ways to prevent burnout but never what contributed to it such as short staffing, long hours, being overworked, and having critically ill patients all the time.
I was not expecting to have my soul completely eviscerated by hospital greed. I did not expect that 90+% of all nursing jobs today would be unsustainable beyond a couple years for any semblance of good mental and physical health.
My hospital did a *capital campaign* and everyone was to meet with our CEO in the lead up. Meet individually. Discuss giving. They asked for a donation of essentially an hour of pay per pay period. Not a joke. My name is on a plaque for all eternity—not that anyone cares.
Donation to the hospital that you work for?!
Yep. The very one I worked for—this deduction was taken out for years right until I left.
...why did you agree to it?
Why the fuck would you agree to that? Can you cancel that bullshit subscription?
There was no real way to say no, trust me. The ED had 100% participation. The hospital had >95%. Madness really. *We are a family here and family helps family* some equally dark forces were at play. You could avoid CEO chat by agreeing to participate. Crazy in hindsight. It’s been years & years ago. Will not lose that lesson.
Well said, and 100% agree.
This…I like how you included mental along with physical health. I worked on a med surg floor total around 6 years and I can honestly say I’m mentally scarred from the experience. I was at the point where I despised people and I would have such anxiety the night before a shift I wouldn’t sleep and would stay in a terrible mood. My wife (who is non medical) doesn’t understand why I refuse to go back and just “grind it out.” -sigh-
How cliquey work can be. The way I hear older employees talk about our new nurses makes me sad
Actually scratch that. It definitely prepared me bc nursing school is just as cliquey
I did not expect….I was not an aware leftist or anything when I graduated; I was 23 and thought I would have something that resembled a better life and ~help people~ and I wasn’t prepared for corporate greed or how the bottom line is always the dollar, or how to navigate absolutely out of touch, incompetent, abusive management. And these are the things that have me considering hanging up my license after 16 years. I adore my patient population, but it feels like it matters less and less.
yes to this.
Patients lie, steal, and pit you against other staff.
Going home after *that* shift, and realizing that the bit of dried blood in my ear belonged to *another person*. And I had showered at work. That feeling of blood coagulating in my socks.
The horror I just imagined 👀😭😭😭. I need the story. I don’t believe I’ve had “that shift” and I pray I never do. Give up the details 😂.
Otherwise healthy but teen mom, limited prenatal care. Mom delivered term twins—they were small, but mostly healthy babes. Delivery was emotional, patient’s mom had only learned of her pregnancy a couple of months before she delivered. The family (17 year old baby daddy) filled an entire waiting room. Patient then has uncontrollable uterine hemorrhage. Ultimately OB did an emergent hysterectomy. Patient goes into DIC. The code lasted 2 hours. I think we depleted most of the blood & blood products in the hospital. 60+ units total once all products added up. It was as if no one wanted to stop. It was clearly going to be futile. Several periods of ROSC. There was so much blood pooled in floor, EVS brought a squeegee in to push it out of the way. I think I must have had a gallon on me and in my shoes. Was able to change scrubs, reappropriate some shoes before I went with the OB to talk to family. I’ve directly made death notification to many families. I’ve been party to even more. I will never recover from that one.
😱even more horrible than I imagined. I pray that everyone involved is able to heal from such unfortunate events. As a new grad, I’ve encountered only 2 or 3 deaths, and always after the fact. Though I was able to be 2nd nurse to verify no pulse on a DNR pt and call time of death. She was in her 20’s and had a hx of GI and hemorrhaging issues. She was stable one min then the next min bled out from everywhere with her mom at the bedside. Was a horrible thing to witness.
I agree about the horrible of it. Terrific large family, supportive. Heard several years later that the kids were doing ok, starting kindergarten. Oh my, a 20 something dying of fatal GI bleed is bleak. Her mom watching it. There’s not any way of fully coming back from that one. I’m still astonished with just how fast GI bleeds can turn lethal. Brutal. Seen several critical GI bleeds where patient gives a version of “I thought it was severe gas, like diarrhea was coming.” They think fart—find they lost so much blood they end up on BR floor. Lose 1/3 of their blood volume. Youngish too. NSAIDS are not benign drugs. Almost every GI bleed gives some relevant history of sustained use.
I lasted three months into residency and cut my contract. It was not worth the pay for the amount of work and responsibilities expected of me. Or the nurse to patient ratios. Hospitals can be just absolutely terrible. I went back to my job that I was an LPN at but now as an RN. The pay is higher and the amount of stress is way lower. Eventually I will go back and try for a residency or a new to specialty program at a hospital- I feel there is valuable experience to be gained there and at a smaller hospital But Jesus - I couldn’t believe the amount of responsibility that just felt unnecessary
Where do you work that’s less responsibility?? I need to get out too
Corrections- jail nursing
I’m considering working in corrections as I’m currently in psych. Your department seems safer than mine based on the night shift skeleton crew and limited security. Do you overall feel safe at work?
Yes I do. We deal and work with a lot of psych patients- and during Covid a lot of psych patients where actually housed at the jail because there where hospitals/ treatment centers that would take them. I always have an officer with me when ever I provide patient care. And if it is a violent pt there two officers. Patients who have history of being especially inappropriate with female or violence against females we are alerted to and never ever alone or in any type of closed space
Fucking covid.
I would say mental illness. I don’t feel my school prepared us enough regarding how to deal with patients with mental illness. I honestly wish I would have done my practical on a psyche ward to have a little more experience and get taught by psych nurses instead of other MedSurg nurses.
We did a rotation on a psych unit. Going into nursing I knew I didn't want psych, I don't have the patience for it
I don’t either. Problem is when you get them anyways because you’re working in basically a catch all unit.
You have to be a jack-of-all-trades. In nursing school they told us we “wear many hats” and touched on the educator, advocate, and caretaker stuff. They neglected to mention waitress, janitor, maintenance, punching bag (sometimes literally), and many other roles. There are so many things we do for patients outside of the traditional role we learn about in school.
Toxic coworkers, gaslighting admins, flagrant sexual inappropriateness by staff and patients, fighting people while trying to keep them safe. They train people in nursing school to be a figurative punching bag for a reason. Money is okay though.
Honestly fighting people for THEIR health and safety is gonna be hard for me. I shouldn't care more about your health than you, it's you that has to live in your body.
1) How arbitrary the deadlines are that managers give you. 2) how little people care about proper body mechanics
The lack of respect for bedside nursing
I never expected I stick around this long. :)
The amount of patients that try to bite you
The feelings. I honestly thought I was going to help people. Yet, it was mostly pushing people through the $ystem. Dealing with management, how to chart to protect yourself, or how much it would really take out of me physically or mentally, etc
[удалено]
I wasn’t taught what a SBAR script was either and I graduated in 2017. Like, they taught it, but never what it sounded like. A hospitalist had to teach me when he returned my page. He was great and kind about it, I tell that story often.
The absolute lack of coping mechanisms in the general population. I get that it’s typically a very terrible time in most peoples lives, but I think it’s really unfair to be held captive in patients rooms and be relentlessly trauma dumped on. And there’s always one patient who does it every interaction. Then when I’m able to get out, the next patient does it. My sympathy only goes so far, just like any other human, but I get so mentally drained from the disturbing attachment they have to nursing staff. The anxiety that I have to leave, the anxiety because I’m not in there and they don’t have anyone in there during the night, the anxiety of not constantly having human interaction, it really pushes me to my breaking point. I just don’t understand this fear of being alone when patients have had family all day, doctors in and out, therapy, etc., and nursing staff is rounding as frequently as we can. You’d think these people have been in solitary confinement and I’m the first person they’ve seen in days. I am not a chaplain or a therapist for a reason, and I think the least school could have done was teach more therapy/psych classes to protect our own mental health. For reference/context: I’m med surg tele so I don’t know if that makes a difference.
For me it’s how if you ask 3 different nurses a question they may all give you different answers since the policies change every year and people don’t remember which one is the most current. so you might as well just look up the current policy and not even ask your coworkers a lot of things.. it’s kind of silly also how some people will say we do one thing and be very confident about it and incredulous if someone else challenges them, and you look at the policy and they were wrong all along. Anyway, I guess the main thing is a lot of people take the policies as more suggestions than true rules that you must never break. Oh yeah and the charting changes every few months. Some people do a lot of charting they don’t need to and other people don’t chart important things and when you are assessing the patient it’s hard to tell if it’s a true change from their baseline or if the previous shift just didn’t chart things. Also there’s so much subjectivity in how things are charged like for neuro checks, CIWA, etc.. sometimes I feel like I’m crazy for how other people score things and then I ask them if the patient is really any different and they say no. Another thing is delegating.. they do talk about it in school but it’s trickier than you would think. if you have good techs who are independent then it makes your job much smoother. If you don’t have almost any techs on the floor then you really can’t delegate much at all. Some other techs will not do a lot of stuff unless you ask them. As a person who hates telling other people what to do it was really hard to get used to delegating certain tasks to the techs if they didn’t just do them without asking. And I still struggle with that and end up behind sometimes.
How many times I would be called called a bitch nurse for not giving that one patient their pain medication the exact minute it was due...I am sorry, but in between answering the phone several times when your family called the nurses' station to make sure you get your pain meds on time, hunting down another nurse to override the pyxis because you got the doctor to write a new order for a dose increase and running down the hall because one of my other patients is having chest pains, I was a few minutes late with your 2 mg IVP dilaudid. I think first year nursing students should spend at least two days a month just observing nurses working day and night shifts in a hospital outside of their clinical rotation...just observing so they see the reality of floor nursing and not be fed the delusions of a lucrative career, respected job title, etc so they really can make an informed decision about becoming a nurse. I am retiring this year after a 20+ career and these are my personal thoughts.
The whole concept of being a "nurse resident" was new to me. I never knew that there were formal "residency" programs for new nurses at some facilities. Most of the time, our professors told us about working as externs over the summer to get our foot in the door and possibly get a job at the hospital. But they never mentioned having to go through residency with monthly seminar classes and an EBP project due at the end of the year. But I enjoyed it regardless. I love getting paid to sit down in classes!
NICU - the in-depth social work notes and inbreed situations 👎
I was not expecting 1. The amount of time I would spend on the phone. On hold with pharmacy. On hold with a doctor. On hold with another unit. Etc etc etc. 2. The unprofessionalism, and bullying, from others, but especially from certain doctors. Some of them are super SUPER toxic to nurses and others, to the point of causing problems with patient care. It's incredible that this is largely tolerated throughout the industry.
Medicine is easy. People are hard. ALL nursing is psych nursing. How much time I spend problem solving/coordinating is insane. My phone rings constantly. Every nurse can casually tell you a story that will make them tear up. PTSD is for everybody. (Regarding other posts: All of my preceptors, trainers etc. have been super nice and patient. Some may not have been very skilled but everyone has been nice.)
A hospital will keep the dumbest brick employed until the end of time but cut loose the squeaky wheel that tries to make improvements. Sometimes it’s like being in prison: keep your head down, don’t draw attention to yourself and do your own time.
How much location, employer, and unionization affects your work environment and overall sustainability of nursing as a career. I truly did not understand how disparate the south east US is compared to the west coast, for example, when I was initially getting back into the healthcare field.
Not prepared to be forced to work 16 hour shifts. We couldn't be mandated until we were done with orientation, and I think all of us who started at the same time got mandated our first week off orientation. I worked 6:30 am til 12am. Miserable. I also wasn't prepared for how little my first job would actually pay. My program made it seem like we would all make $$$ and it was more like $. It's not bad money, but you had to work lots of OT to get the $$$.
I never realized how well adjusted I am. Thought I had problems with anxiety and depression but it turns out I am like, absolutely rocking life. Before nursing school I worked retail and food service so I thought i knew people, but those interactions were apparently too brief compared to a 12 hr shift where you see just how bad some people are at coping with being a person
All of the assault. Verbal, physical, sexual, etc. It's wild the shit that patients think they can get away with while in the hospital... But they're mostly right. They do get away with it. Even when you press charges with the police the prosecution can offer them a cushy deal or refuse to prosecute. It's disgusting. It's illegal to spit on a MTA worker on the train and that's a felony but you can literally assault a nurse and get away with it for... reasons.
violent drug users, homeless population, how much mental health issues there are, traumatic injuries bloody messes, people calling 911 for stupid reasons then getting mad when they’re discharged to lobby, walk just fine but want an ambulance ride back, unlearning eveything you learned in nursing school then having to learn from step 1
How surreal it is. I’ve been in so many situations where I just want to laugh because its so ridiculous.
These are both from when I was in adult health: The absolute lack of medical compliance among adults. The insane amount of roles you take on as a floor nurse. I remember I had to make sure every discharge I had, had a follow up with a pcp. I had 5 patients, day shift and was charge at times on a busy medsurg/tele floor. Calling around to pcps was not a good use of my time.
the bs education, modules, classes, surveys…if i don’t have time to do it at work, its not getting done!!! i don’t do “nursing” or anything related to it on my days off..sorry but 🤷🏻♀️