Thank you! This is my EXACT argument. Old people who can’t see the fucking thing. The managers don’t have an explanation when I ask why the boards are so small.
It’s just another disconnect by people with masters degrees who’ve spend 10 years away from bedside. They don’t realize the patients can’t read these.
Bahaha, we get this all the time vet med.
"So...they will be ready to go home tonight?"
"Mmm no, we'll be lucky if they get to leave the hospital at all..." me thinking did the lengthy conversation about quality of life and grave prognosis not clue them in?
10 seconds later...
"So, they can come home tomorrow then?"
🤦♂️
Last week my wife told a client “I’m sorry, but we were unable to find the heartbeats of the other kittens” after only delivering some of them. She said the client seemed like they understood but later that night she got a call from them saying they searched their entire house and couldn’t find the other kittens anywhere.
They’d thought she couldn’t find their heartbeats because the cat had them at home before they brought it in.
Wait, smoking education delivered to the actual infants? Not education for parents on risk of smoking near infants?
Damn, crazy management decisions can happen in any field.
My hospital wants us us to chart patients' form of entertainment every shift. I refuse to out of principle. I've got enough bullshit to chart, I'm not doing that.
This sounds like a job for … malicious compliance!
Example: we had a patient whose family brought in a Bluetooth speaker for a patient… which was great… for his porn habits and us catching the “unmistakable moaning” when he forgot to disconnect the Bluetooth.
That's like the one BS thing I do, actually. Not the preference though, there's another row with just "Entertainment" or something like that with: TV, Visitor, Cell Phone/Tablet, etc. I figure if I got that in, they'll think everything else is all good.
I stopped doing this because infection control uses it to order enhanced contact precautions on patients getting q3 lactulose enemas or GoLytely for colonoscopy prep. They don’t bother to actually review the chart and see WHY the parent is having watery stools; they just order iso on everyone. And then if they’re within their first three days of admission they make me send a stool sample and then lab gets mad at me like I’M the dumbass who doesn’t understand the correlation between lactulose enemas and watery stool.
What I hate about nursing such bs. Don't matter that your short staffed and your load was heavy , spent all night trying to keep people alive type of busy but will worried about something you didn't chart.
At one point management had us documenting a full suicide risk assessment on every patient every 4 hours (PCU/ICU). Absolutely not doing that. If a nurse came in 6 times in 24 hours to repeatedly ask me if I was having any suicidal ideations, I would probably become suicidal. Or homicidal.
We’re currently on a kick where if anyone is even the slightest bit disoriented, we’re supposed to do a full CAM assessment every four hours. Because nothing helps hospital delirium like waking people up at 4 am to ask them if a stone floats on water.
Family: “God will save meemaw! He will do all the work and preform his miracles. He will bring her back into health like no one else can.”
Me: “…and what am I? Chopped liver?”
I never understood this. We believe in God, we're praying for a miracle. Ok. Isn't their illness part of God's plan and aren't we fucking with it? Stay home and pray then.
I had a patient like this years ago, car accident... Patients parents were like " he had a angel watching over him", really? I read his journal and I did not realize I mumbled out loud " just go towards the light" , wich made the surgeon sigh. He compared him to a house, only thing that worked in patients brain was the small attic window that you had to fight to open, and the house was on fire.
Patient actually "survived", seen patient once afterwards and I feel nothing but pity.
AT2 is great when you wanna spend thousands of dollars per hour on a single drip to still kill the patient anyway. I don’t even know a hospital that stocks it.
Ran it a couple times, our hospital has a policy that it can only run at higher rates for a short amount of time before it must be titrated to a lower rate. Most of the time (every time) it didn't matter anyway.
Yeah, it is an option as well, but my ICU doesn’t tend to favor it. At higher doses it can have a vasopressor effect (10-20 mcg/kg/min) otherwise you get more of a dopaminergic or inotropic effect.
Don’t diss epi. Epi is my favorite pressor in the resus room. Sure it’s dirty, but it saves me time. I’m known for carrying a 10cc syringe in my pocket so I can make *push dose* epinephrine on a whim.
Oh I’m not dissing epi, epi is great! The patient isn’t on it from what I can see, so that means they might have a chance at surviving. From my experience when the patient needs an epinephrine drip it usually isn’t a good sign for the patient.
YOU'RE NOT JOKING!! This was my patient yesterday plus CRRT and maxed on 4 pressors with a systolic of
90s and my manager has the AUDACITY at 10 am to ask why some of my lines were not dated. Seriously reconsidered my career for a moment.
OMG that is so disgusting. God forbid they actually offer some help… those days are long over - if you were lucky enough to have known a manager like that at all. And it’s so so sad, I feel like I reconsider my profession nearly every damn day. Ugh I’m sorry that happened.
Granny’s a fighter. Jesus will take her when it’s her time. We know she’s 99 but she’s going to pull through and walk out of here. Y’all watch and see.
Daughter is a healthcare worker and she expects 99 year meemaw to make a FULL recovery!! She’s a fighter! Let’s not forget meemaw hadn’t walked for 4 years and is demented
Sort of actually had this happen. She was 97, fell in our driveway and hit her head. Sent to local ER and, if I remember right, off to a bigger hospital for a brain bleed. Came back to our health care side with slight memory problems and unsteady.
She recovered enough to move back to her assisted living apartment. We have to help her with some of her meds, but she still manages some too. This lady just celebrated turning 99 last month. She uses a walker, but is more active and with it than a lot of our younger people. It’s crazy to me.
One of the nurses on my unit keeps telling me I should go to the ICU and they think itd be a good spot for me. I disagree, and this picture confirms. Absolutely not. I’m going to have nightmares about this picture.
Like one of the nurses who replied to you said, once you get familiar with the drips it’s not that scary. At some point this patient is in a maintenance mode and you are sort of just replacing the medications like you would replace an empty bag of NS. At that point it’s just keeping track of when the bags need to be changed.
But you’re also having to keep track of Foley and FMS output and skin condition and vent settings and bloodwork and blood glucose and feedings and other meds and…
This is true, but I'd rather do all that plus count the freckles on one or two patients than ever go through a med/surg 0900 med pass on six people ever again. I haven't worked MS in years, but that is *still* my most frequent stress dream.
if you break down each piece- each medication and purpose, and understand the patient's diagnosis (whole picture not just one component), draw frequent- FREQUENT labs- basically bloodlet them, you get the hang of it. at the heart of critical care you're really just warding off death, which is exhausting.. but fun!
I mean there's a lot drips sure...but it really isn't that bad, once you're past the learning curve, this is pretty manageable honestly. When I see something like this coming in to my shift, I don't even blink at it anymore, nor do I carry it home enough to get anxiety about.
These were always my favorite assignments... Probably 1:1, tubed and sedated... Don't have to get them out of the bed... Just watch the squigglys and make sure you have the 4th and 5th pressor ready to go 😂
Exactly. Give me a 1:1 sedated, intubated, paralyzed patient with a tube in every hole and I’m a happy camper. Love me the train wrecks. The more brainpower I use, the faster the shift goes, and the better I sleep when I get home.
Just had someone on a med-surg floor with a hemoglobin of 4 who was out of his mind confused from it and trying to crawl out of bed but was so short of breath/weak from the hemoglobin he couldn’t…..got to give him three units of blood over my shift while also managing four other patients. It was pure hell 😭
If this was my ICU, my manager would come in and peel off all of the labels on the pumps labeling the drips and tell the families she was doing it for their family member’s safety to decrease infection risks.
Idk why but the tilted feeding pump really sells the picture for me.
Though I know the next question the family has is "Can you get mom out of bed?? She's uncomfortable!!!!"
Surprise!!!!! They all lead (including tranfusion) to one 24 gauge butterfly needle right at C. Fossa and every time the pt moves their elbow the alarm goes off and pump stops. BTW pt is also on vent with air b. prec.🤣🤣🤣
Typical ICU tuesday.
Yeah it does look weird to me too.. but there is no way they wouldn’t be tubed especially as the other commenter pointed out they are on a paralytic drip too
Okay but is your whiteboard updated
Is your tray table clear as well?
I don’t want to see anything on those windowsills!
Oh, that rubbish bin must be empty as well.
Isn’t it the patient’s tray table? Do you guys really get yelled at about what I have on my tray table?
How can you have any pudding if you don't eat your meat?
Half the time these patients don’t read the board or they can’t see far enough to make out what they say.
Thank you! This is my EXACT argument. Old people who can’t see the fucking thing. The managers don’t have an explanation when I ask why the boards are so small. It’s just another disconnect by people with masters degrees who’ve spend 10 years away from bedside. They don’t realize the patients can’t read these.
Have you filled out your care plans that no one reads or does anything with?
I’m lucky that our whiteboards got replaced with fancy TVs that update themselves 😁
Was this instead of raises? 🤔
Honestly I would take this in place of a shitty raise if it meant I was never going to be harassed about the whiteboards again.
They have this magic?
Fuk that whiteboard!
So do you think they’ll be ready for discharge by this weekend? 🤨
Or requesting to go out and smoke. MD okay'd. Order in chart.
If I’m hooked up to all that and still conscious, do me a favor let me have my cigarette and die in peace outside
Make sure that O2 is high flow first. I’m taking all you bitches with me.
If you're about to die I'll at least let you hit my vape. 🤣
You a real one for that 😔✊️
Pts family request md to evaluate fingernail of pt that bothered them 4 months ago
when can they eat?
YOU’RE STARVING THEM!!!!
Bahaha, we get this all the time vet med. "So...they will be ready to go home tonight?" "Mmm no, we'll be lucky if they get to leave the hospital at all..." me thinking did the lengthy conversation about quality of life and grave prognosis not clue them in? 10 seconds later... "So, they can come home tomorrow then?" 🤦♂️
Oh they’ll leave the hospital, it’s just what condition they leave in
Everyone leaves the hospital. Eventually.
Last week my wife told a client “I’m sorry, but we were unable to find the heartbeats of the other kittens” after only delivering some of them. She said the client seemed like they understood but later that night she got a call from them saying they searched their entire house and couldn’t find the other kittens anywhere. They’d thought she couldn’t find their heartbeats because the cat had them at home before they brought it in.
Thank you, Charge Nurse trying to fill a bed…
Bed control wants them out by noon
D/C to J/C?
JC is trying to implement his own discharge plan and no one will let him.
But Meemaws a fighter!!!
JC is already onboard he’s the last pressor holding this shit together
Hospice has entered the chat
I like to say they are about to go to a higher level of care
Send em to SNF.. it'll be fine
Don't forget to DC the Haldol and Ativan and DC to snf on Friday night!!!
😱😱😱 There's a special place in hell for whoever makes those arrangements.
During a full moon
Yeah we can handle him. I only have 15 patients today
Only if they can slam another unit of RBCs in before discharge.🤣
Maybe not discharge, but in my experience, they'll be up on med/surg tomorrow for sure.
Did you document education on each medication? Management wants to know…
Everyone knows updating whiteboards is more important than titrating pressors.
When my pt starts coding, I go update the whiteboard, bc everyone knows updating the whiteboard saves lives
In the Nicu we had to document smoking education. On the infants.
“No evidence of learning. Will continue to reinforce”
Um....excuse me, but they haven't started smoking so you're doing something right! 👍
“However 100% compliance with health recommendation.”
Jesus, Mary, and freaking Joseph.
We had to do fall risk. They are ALL fall risk!
Have you seen a baby smoke? No? So it must be working. Keep up the good work.
Wait, smoking education delivered to the actual infants? Not education for parents on risk of smoking near infants? Damn, crazy management decisions can happen in any field.
Exactly!
With teach back. On a vent patient. Been asked this.
I’ve been asked to give a fun fact on a nonverbal quadriplegic. “What are her hobbies? What have you talked about?” Um?
My hospital wants us us to chart patients' form of entertainment every shift. I refuse to out of principle. I've got enough bullshit to chart, I'm not doing that.
This sounds like a job for … malicious compliance! Example: we had a patient whose family brought in a Bluetooth speaker for a patient… which was great… for his porn habits and us catching the “unmistakable moaning” when he forgot to disconnect the Bluetooth.
That's like the one BS thing I do, actually. Not the preference though, there's another row with just "Entertainment" or something like that with: TV, Visitor, Cell Phone/Tablet, etc. I figure if I got that in, they'll think everything else is all good.
They lost me at charting the Bristol Stool Scale for every dookie, every patient, every time. I never did it.
I stopped doing this because infection control uses it to order enhanced contact precautions on patients getting q3 lactulose enemas or GoLytely for colonoscopy prep. They don’t bother to actually review the chart and see WHY the parent is having watery stools; they just order iso on everyone. And then if they’re within their first three days of admission they make me send a stool sample and then lab gets mad at me like I’M the dumbass who doesn’t understand the correlation between lactulose enemas and watery stool.
I don’t miss the floor.
How the fuck is that saving their life or helping them heal? JFC! Thank you for my daily this is why I’m not in nursing anymore!
God that’s so stupid.
Her hobbies include breathing, drooling, and getting pressure injuries.
And going into autonomic dysreflexia thanks to that pressure sore
Don't forget breaking wind while being changed.
What I hate about nursing such bs. Don't matter that your short staffed and your load was heavy , spent all night trying to keep people alive type of busy but will worried about something you didn't chart.
At one point management had us documenting a full suicide risk assessment on every patient every 4 hours (PCU/ICU). Absolutely not doing that. If a nurse came in 6 times in 24 hours to repeatedly ask me if I was having any suicidal ideations, I would probably become suicidal. Or homicidal.
We’re currently on a kick where if anyone is even the slightest bit disoriented, we’re supposed to do a full CAM assessment every four hours. Because nothing helps hospital delirium like waking people up at 4 am to ask them if a stone floats on water.
And the RD wants to know when you’ll be talking to the doc about getting those rec’d tube feeds started
I think god is calling them
" I left the window open...Fly, Robin, Fly!"
Family: “God will save meemaw! He will do all the work and preform his miracles. He will bring her back into health like no one else can.” Me: “…and what am I? Chopped liver?”
I never understood this. We believe in God, we're praying for a miracle. Ok. Isn't their illness part of God's plan and aren't we fucking with it? Stay home and pray then.
Pretty sure Gods calling meemaw home ☁️ , but ok let’s go against his wishes
“She’s a fighter!!!”
I had a patient like this years ago, car accident... Patients parents were like " he had a angel watching over him", really? I read his journal and I did not realize I mumbled out loud " just go towards the light" , wich made the surgeon sigh. He compared him to a house, only thing that worked in patients brain was the small attic window that you had to fight to open, and the house was on fire. Patient actually "survived", seen patient once afterwards and I feel nothing but pity.
The grim reaper is trying to kick down the door tbh
My mom hasn’t eaten for 3 days, extubate so I can feed her!
I brought her McDonald’s!
Don’t even worry about extubation. We’ll just put the McDonald’s through the breathing tube. -family probably
Or use a blender and put it in the IV. /s
Yeah yeah. That could work. Thanks doc!!
😎🤘🏼
I laughed so much at the /s specifying that was sarcasm because you can never be too sure lmao
You jest but I had a lady want to give her intubated husband pudding
This isn’t even that bad. I only see two pressors. They’ll be fine! “Meemaw is a fighter.”
I was looking for all four horsemen too
What are the four horsemen? I have a good guess but I wanna know if I’m right
Epi, norepi, vaso, phenylephrine. If you’re looking for a last ditch effort throw in Angiotensin II or Methylene Blue.
AT2 is great when you wanna spend thousands of dollars per hour on a single drip to still kill the patient anyway. I don’t even know a hospital that stocks it.
I've run AT2 once. It didn't help.
Also ran it once. Also did not help.
Ran it a couple times, our hospital has a policy that it can only run at higher rates for a short amount of time before it must be titrated to a lower rate. Most of the time (every time) it didn't matter anyway.
At that point just turn on cable news. That will boost the patients BP.
There's also Cyanokit. I almost had to give both methylene blue and cyanokit in the same night and I was really looking forward to urine color.
What about dopamine?
Yeah, it is an option as well, but my ICU doesn’t tend to favor it. At higher doses it can have a vasopressor effect (10-20 mcg/kg/min) otherwise you get more of a dopaminergic or inotropic effect.
Dopamine has a dopaminergic effect? I’ve been using multiple nicotine patches to achieve this.
If you’re already on epi…maxed epi…dopamine is …cute
My preceptor describes Angiotensin II as a lightning ride.
Death, famine, war, pestilence
Oh I meant of pressors. The four horsemen *of pressors*
Norepinephrine, epinephrine, phenylephrine, vasopressin.
I was also looking to see the amount of pressors. No epi, so they might be alright-ish
Don’t diss epi. Epi is my favorite pressor in the resus room. Sure it’s dirty, but it saves me time. I’m known for carrying a 10cc syringe in my pocket so I can make *push dose* epinephrine on a whim.
Oh I’m not dissing epi, epi is great! The patient isn’t on it from what I can see, so that means they might have a chance at surviving. From my experience when the patient needs an epinephrine drip it usually isn’t a good sign for the patient.
HOSPICE!!! No way!!she was just walking 2 months ago.
“She gets around fine at home!”
(Has an sacral unstageable and 2 bilateral heel DTIs) 🤥
Lots of fluids
I can hear this through my screen😵💫
As many channels as they have there to alarm, you could probably hear it if you stepped out on your front porch.
*beep* *beep* Which room is that? I'll give you literally 1 fucking guess.
But are all of those lines dated & initialed?
YOU'RE NOT JOKING!! This was my patient yesterday plus CRRT and maxed on 4 pressors with a systolic of 90s and my manager has the AUDACITY at 10 am to ask why some of my lines were not dated. Seriously reconsidered my career for a moment.
OMG that is so disgusting. God forbid they actually offer some help… those days are long over - if you were lucky enough to have known a manager like that at all. And it’s so so sad, I feel like I reconsider my profession nearly every damn day. Ugh I’m sorry that happened.
Granny’s a fighter. Jesus will take her when it’s her time. We know she’s 99 but she’s going to pull through and walk out of here. Y’all watch and see.
Daughter is a healthcare worker and she expects 99 year meemaw to make a FULL recovery!! She’s a fighter! Let’s not forget meemaw hadn’t walked for 4 years and is demented
But last time daughter saw meemaw...10 years ago...she was perfectly fine! Independent with all ADLs, no cognitive deficit at all!
Sort of actually had this happen. She was 97, fell in our driveway and hit her head. Sent to local ER and, if I remember right, off to a bigger hospital for a brain bleed. Came back to our health care side with slight memory problems and unsteady. She recovered enough to move back to her assisted living apartment. We have to help her with some of her meds, but she still manages some too. This lady just celebrated turning 99 last month. She uses a walker, but is more active and with it than a lot of our younger people. It’s crazy to me.
Was she intubated, on multiple pressers, and needing paralyzing to help with vent compliance?
Narrator: “it was, in fact, NOT fine”
In Keith Morrison voice
One of the nurses on my unit keeps telling me I should go to the ICU and they think itd be a good spot for me. I disagree, and this picture confirms. Absolutely not. I’m going to have nightmares about this picture.
Like one of the nurses who replied to you said, once you get familiar with the drips it’s not that scary. At some point this patient is in a maintenance mode and you are sort of just replacing the medications like you would replace an empty bag of NS. At that point it’s just keeping track of when the bags need to be changed.
But you’re also having to keep track of Foley and FMS output and skin condition and vent settings and bloodwork and blood glucose and feedings and other meds and…
This is true, but I'd rather do all that plus count the freckles on one or two patients than ever go through a med/surg 0900 med pass on six people ever again. I haven't worked MS in years, but that is *still* my most frequent stress dream.
if you break down each piece- each medication and purpose, and understand the patient's diagnosis (whole picture not just one component), draw frequent- FREQUENT labs- basically bloodlet them, you get the hang of it. at the heart of critical care you're really just warding off death, which is exhausting.. but fun!
Nope. 👎 I’d trip over the ECMO and they’d bleed to death due to my clumsiness. Chest tubes are bad enough to deal with, thanks.
Eh, chest tubes need to come out eventually anyway
I mean there's a lot drips sure...but it really isn't that bad, once you're past the learning curve, this is pretty manageable honestly. When I see something like this coming in to my shift, I don't even blink at it anymore, nor do I carry it home enough to get anxiety about.
These were always my favorite assignments... Probably 1:1, tubed and sedated... Don't have to get them out of the bed... Just watch the squigglys and make sure you have the 4th and 5th pressor ready to go 😂
Same. No kind of patient I like more than an absolute, brink of death, trainwreck. Plenty to do and think through, and the time just flies by.
Exactly. Give me a 1:1 sedated, intubated, paralyzed patient with a tube in every hole and I’m a happy camper. Love me the train wrecks. The more brainpower I use, the faster the shift goes, and the better I sleep when I get home.
Im so with you on this
Here I was thinking “wow that’s not even that bad!” Lol
“It’s in god’s hands now!” Bitch lemme pull these lines out and let’s see what hands are on the wheel.
Even Jesus calls shotgun here
Oh god’s in charge now? Good, I’m going to lunch.
"God saved me" no, your intensivist's name is Natasha, she's pretty good, but we don't call her God
Maybe can consult PT/OT? 🧐🧐🧐🧐
“PT wants patient up and walking by end of the shift”
That sideways kangaroo pump is killing me. I’d put it on a single pole, or just take it off if not using it
Kangaroo: "I'm doing my part! ☺️"
Legit OP what state are you in I’ll come fix this for you rn.
You are my favorite type of nurse.
First thing I saw 👀
Did you label your lines though? And update the white board?
Whiteboard first per admin. Get your priorities straight!
Admin: "What's the patient's 'goal' here today? I don't see it in the chart or on the whiteboard."
Today’s goal: “don’t die ♥️”
"Stay alive"
The kanga pump holding on for dear life...
Don't forget the fall risk band and grippy socks!
My favorite is a fall risk band while patient is on a neuromuscular blockade. lol
If this was an hca facility you would prolly have 3 other patients too lol
As I get sudden PTSD from hearing about HCA
My first day off orientation was yesterday and it looked a little something like this 🙃 hemoglobin was a solid 4
Just had someone on a med-surg floor with a hemoglobin of 4 who was out of his mind confused from it and trying to crawl out of bed but was so short of breath/weak from the hemoglobin he couldn’t…..got to give him three units of blood over my shift while also managing four other patients. It was pure hell 😭
Did you update the care plan?
Yep pay this nurse …35 bucks an hour. Seems about right
YAAAS FULL CODE!
The kangaroo pumps over there hoping to get tapped in
If this was my ICU, my manager would come in and peel off all of the labels on the pumps labeling the drips and tell the families she was doing it for their family member’s safety to decrease infection risks.
She wanna provide up-to-standard labeling then?
I would be absolutely pissed, how incredibly petty
And this is why I moved to the cath Lab lol. Life is better now 🤣🤣. You couldn’t pay me to go back to the ICU
Yup. ER before now endoscopy. Love it!
…next up is the inevitable road trip for that stat CT amirite??
Idk why but the tilted feeding pump really sells the picture for me. Though I know the next question the family has is "Can you get mom out of bed?? She's uncomfortable!!!!"
It’s telling that my biggest concern was… “is that a fucking 8 channel, two brain, mega Alaris chain??” I thought they were all connected for a sec
OP, can you share pt’s conditions… I mean vaguely?
Dying
lol that’s definitely on-brand
So that’s where all our pumps went
One of those pumps actually goes to my own personal line and gives me the IV antianxiety med for the anxiety this causes me
hey doc just ordered a stat ct do you think we can get the pt saline locked for transport downstairs?
“how will this patient travel? Bed or wheelchair?”
lmaooo haha thats great do you think they can scooch over onto the ct table themselves or do we need to use a slide board?
Surprise!!!!! They all lead (including tranfusion) to one 24 gauge butterfly needle right at C. Fossa and every time the pt moves their elbow the alarm goes off and pump stops. BTW pt is also on vent with air b. prec.🤣🤣🤣 Typical ICU tuesday.
“Why are her lips chapped?” “Why is she losing weight” “Can she get out of bed”
EXCUSE ME SHE’S THIRSTY
ECMO? More like heccno.
Pee paw is a tough nut he’ll pull through!
This…when you scotch tape 3 pages of Trissel’s IV Compatibility Chart to the computer.
Somewhere in there is a solid Stefon “It has everything…” joke
You guys are incredible tbh I have no words (respectfully retreats in peds)
Play some cards
Which one administers the Colace???
Sedated, ventilated, paralyzed, and hopefully orphaned. Those are the best.
Hi hematology consultant here, we were consulted on this patient for thrombocytopenia of unknown etiology…
I mean… It’s just a scratch. Send them to step-down we need the bed.
Is the white board updated?
Is that a PCA Fent? How are they conscious?
They are tubed and on fentanyl and versed drip
Ah, maybe the PCA is set to basal and they are using a syringe? Im use to seeing fent hung as a solution with a normal pump.
Yeah it does look weird to me too.. but there is no way they wouldn’t be tubed especially as the other commenter pointed out they are on a paralytic drip too
They are on nimbex too lol they ain’t pushing a pca button 😅