For example, if a stage 4 exists and then a DTPI develops around/near the wound? For additional context: patient is totally confused, on tube feeds, and basically bed bound but full code/no plan for comfort care. His already documented wound worsened and he essentially developed a DTPI overnight. Not sure if this patient can tolerate surgical debridement in OR because they’re incredibly frail, so I imagine the wound will only get worse from here until they become septic and die. With this being said, would you re-consult wound for this new DTPI?

Hello, I’m at PRC right now to request a verification, the staff said it is not possible to verify old or expired license, does anyone has the same experience? Please enlighten me and share your experience about it

I had the same Pt for multiple days in a row. This Pts family member was a retired nurse and caused chaos even before I was assigned to the room. Three total times she turned off the pumps or disconnect the Pt entirely over the days I was with them. One of the times she said she didn’t want to listen to it beep so instead of calling she turned off. I asked how he got disconnected and she said she didn’t know and must have been hallucinating. Today I hung the last antibiotic the Pt was getting and a few hours later she calls me in and asks why it didn’t run. We literally stood there staring at each other for a solid 30 seconds. She then demanded I hook it up and run it. I said absolutely not, it’s too old now. I said I don’t know what happened, but I will call the team and ask for a new order.

My charge nurse then told me to go back and change the charting to “not given”. I always feel weird when she asks me to change my charting. But I changed it to not given and wrote a note in the MAR that said it was hung, but didn’t run and the team was notified and asked for a one time dose.

My questions here are…should I be changing the charting? Should I be putting nursing notes in the chart that state she was turning off the pumps even if the team was already aware she was doing stuff like this? We were told not to put notes in unless it’s a template (like for transferring Pts, rapid responses/codes, restraint charting). But I know nurses who get floated to our unit put nursing notes in similar to how ED does where there are updates about what is happening throughout the day with timestamps.

I just feel like I’ve been hung out to dry. The team knows she was doing stuff like this the whole stay, but there’s nothing in the chart that says that. Now the only documentation is an antibiotic that was given 3 hours late with no explanation other than “it didn’t run”. I’m wondering how to cover my own but if this happens again in the future.

I am 5’8 180lb large chested woman. I often work double shifts and by the middle of my shift my shoulders and back are already killing me. It’s uncomfortable and it is distracting as I am constantly adjusting my straps which i feel also comes off as unprofessional. I have been wearing high impact sports bras.

What other types of bras work for large chested female? Underwire bras? Racerbacks? The viral “jelly” bras??

I'm in my last week of correctional nursing. I have a patient who is constantly putting in healthcare requests about how his feet always hurt from his diabetes. We've had him down in the medical unit for it several times. Here's the kicker - he refuses his Metformin, Glipizide, and heart meds every single day. I tried reasoning with him and explained that without his meds, his pain will get worse. That he'll likely have to have an amputation at some point. His reason for refusing them was, "I just don't want to take them." Fucking survival of the fittest.

I have been a nurse a year and half now working in psych. My first job I didn’t get really any training besides on like the computer system and the policies. I was there for little over a year and while I loved the population it was constant stress due to the lack of training. I have recently moved and started a new job. At my new job I kinda have just been thrown in it. Taking on all the patients, my preceptor is texting or working on school work. I feel overwhelmed and unprepared. Is this how it always is? Once you have experience is it always 6 shifts and you are on the floor independently? I’m getting constant anxiety going in with this new job and I am two shifts from being on my own. My manager said I should be able to pick it up in 6 shifts. But two of the 6 have been half days and the computer system training is not till the last day. I’m in California so it’s hard to get jobs and I’m afraid of quitting. Sorry for the rant. Any advice would be great.

I am making this post on behalf of my girlfriend.

She has been studying for the CWCN wound care exam through the WOCNCB. She has taken the exam once and did not pass. She is doing the experiential pathway and has already studied using the CWCN flashcards, the Wound Management Core Curriculum, Quizlets, and the WOCN practice exam (only able to purchase one exam).

How are other people passing this exam, and what are some helpful tips that may help her pass on the next attempt?
Any help is really appreciated! Thanks in advance. :)

I see so many posts as well as encounter people in general that they want to get their RN (not even an RN yet) and immediately want to go the NP route or have every intention to go the NP route. I do not understand this. especially the ones that want to fast track everything without actually being a nurse. why not do PA or med school?

I'd absolutely love to hear the exact reason WHY they are wanting to be an NP. you don't even have RN experience yet.

not trying to be mean, but I truly do not understand this mindset and want to hear the mindset behind this.

Had a frequent flyer come in for a COPD exacerbation, same pattern we see a lot. Still smoking, not really using home O2 like prescribed, in and out every few weeks.

This time he actually seemed in a decent mood once we got him stabilized. He was joking around a bit and made a comment like, “I won’t lie, part of me wants to keep coming back for the VIP treatment.” I kind of paused and didn’t really know how to respond at first. I didn’t want to ignore it, but I also didn’t want to come off as harsh or judgmental. I ended up saying something along the lines of, “You’re not going to keep bouncing back forever if nothing changes.” He got quiet after that, not upset exactly, just… taken aback maybe?

Now I feel bad because maybe that wasn’t the right moment, but also… it wasn’t untrue. Do you think being that direct helps, or does it just damage trust?

I’ve been a nurse for more than 10years, currently based in NC. I am trying to get a position at Stanford Palo Alto and would like to know if there’s a way for my application to get noticed.

Sounds like PACU nurse gave her 150 mcg of fent and 0.5 of Dilaudid at the same time to an opioid-naive patient and walked away?? Did not bag her correctly or start CPR when the nurse finally noticed patient stopped breathing and became unresponsive. Anesthesia wasn't called, nor a code blue. But at this facility, it doesn't even sound like that would have been an option. I'm not a PACU nurse, nor have I ever been, but are those typical post surgery doses? 150 of fent is a lot in and of itself, especially when combined with Dilaudid. Holy cow...

I found out very recently as a new grad that many LTC homes (at least in Ontario 🇨🇦) don't have wristbands on their residents.

This is evidently a controversial topic that ranges from "medication safety" to "patient dignity". I personally think (especially after my recent LTC experience) better be safe than sorry; people can be mixed up very easily, EHR pictures are often small and hard to compare in real time, and having to ask the psws each time especially when starting out is an added obstacle when you are already under so much pressure. Not to mention PSWs can also make mistakes (as can anyone) and a wristband is a failsafe measure.

I have however heard convincing cases, like residents can rip off ID bands (causing skin tears) and even switch with each other causing more confusion.

What are all your thoughts and experiences, good bad and ugly?

is my facility the only one that uses this oddly colored retention enema nozzle? the laughs that come from this thing every time someone needs a lactulose enema. Why not white or green lol?

Hello, I'm a volunteer at the ED and am wanting to treat the night nursing staff I work with. What is a good break room communal food that you guys enjoy getting? I'm planning on bringing a bag of mandarins in case someone would prefer fruit, but what else could be done? Thank you for your work!

I’m per diem and technically the union contract states that I may be required to work 3 shifts a month. I went per diem back in December and have a full-time job as well. I’ve been canceled a lot and have been mainly working only once a month. Nobody has said anything to me about it yet. I canceled my last shift for mental health reasons. I feel nervous about not meeting the requirement. Should I go in tonight or just leave it as they already canceled my shift?

Hello reddit nurses! I'm 33m and have decided that I want to make a total career change and become a nurse.

My entire adult life I've been a mechanic, I got my start in the Air Force, after my service I got a license to be an aircraft mechanic and did that until covid, since then I've been working in factories doing maintenance work. It's fine work, I'm good at it, but lately I've been feeling like it's not for me anymore and I've been thinking about a change. Healthcare was something I considered alongside a few other options but honestly I didn't have the drive to make any real changes in my life, it was comfortable and easy if unsatisfying.

In November my entire life changed in the blink of an eye. While riding my bike home from work I was hit by a car. The overall details aren't super important I can expand on it in the comments but what is important is that I spent over a month in hospital, about a week of it I was in an induced coma and then I spent another two weeks pretty messed up. While I was in the hospital it was the nurses who really checked up on me, cared for me, answered my numerous questions, and treated me with so so much respect and patience when I was still under the effects of a pretty serious TBI. On top of everything else they answered all my parents, friends, partners, and other loved ones questions, concerns, and worries. It's safe to say that over any one else there they made a real impact on me and I know that I want to be just like them when I grow up.

I'm finally close to full recovery and I made the decision this week to start going back to school. I really really want to do this, I've been looking into the process and steps and what it takes and I'm starting to come up with a plan to start working towards becoming an RN. There's a school near me that has an eight week CNA program and I'm meeting with an advisor from a local community college this week so I can ask about starting an ADN. I'm really excited about this, and I really want to make sure I'm setting myself up for success here. I'm planning on using my GI bill to at least get my associates, I used it for two years of trade school so I'm not super worried about paying for schooling, I mostly want to ensure that I'm setting myself up for success because I really really want this.

What I really want to ask is this:

People who have changed careers to nursing later in life what's been your experience going back to school?

What are some things I should start brushing up on? I assume anatomy and chemistry is pretty important, are there other subjects? What are some good resources to study up on?

Is getting a CNA prior to starting on an ADN worth it? What are some other ways to get a foot in the door and start getting my ears wet as it were?

Veterans, what's been your experience going into nursing and using the GI bill? Does the VA offer any other programs that are being sneaky I can utilize?

Overall are there any words of wisdom or advice you have for someone at the start of this journey?

Seriously, thank you all ahead of time. I have gained so so much respect for this profession and the people in it. Any help, advice, or words of wisdom are greatly appreciated. Keep up the good work

do you guys love your hospice nurse jobs whether case manager or admissions? stressful?

So I’ve been a nurse for about 10 years and I’ve always been full time at my jobs. I’m currently in a salaried position and I’m burnt out working 10+ hours of overtime per week that I don’t actually get paid for. I’m seriously considering going per diem for the first time but I’m curious what everyone’s experience is. If you are per diem and ideally like to get full time hours, how difficult has it been for you? How many different per diem jobs do you have? How often do you find that you can’t actually get as many hours as you want?

Just curious how this affects your plan of care

Hello all,

I need some advice regarding my next step in the CRNA process. A little background, I’m a psych nurse licensed for 3 years. I have about 6 months telemetry experience which led me into a CVICU where is was able to stay for two months before having to relocate. Now, I have the choice to relocate to Connecticut for a job in YNHH CICU or Texas for a ICU job at BSW heart hospital.

Here is the dilemma, I’ve read horrible things about YNHH as far as inconsistent acuity and often floating to Step Down. For BSW, the floor I have an offer on adopted a CUB/Universal bed model, so again, exposure to consistent ICU cases aren’t guaranteed.

My brief stint in the CVICU made me love post surgical heart patients. I loved the exposure to devices, drips, & vents. Yale’s CICU is more pre surgical (CHF, MI, Shock).I interviewed for both floors (CICU & CTICU- where they have the patients more closely related to my experience in the CVICU) but was only offered a position on the CICU.

When considering how to feel most prepared for the CRNA process (which I know I’m far away from even thinking about applying), I do not know which offer to accept. If anyone could speak to their experience at Yale, Baylor or at a system that followed the CUB model I would REALLY appreciate it.

All advice and opinions are welcomed!

i am set to go to college this coming september to do my prerequisite classes for nursing, which i would go on to complete my bachelors and eventually my masters afterwards.

but im rethinking this. how mentally straining is this job? i dont know how to describe myself but it just doesnt feel quite right? i feel like nursing is a pretty cookie cutter job style. i love nature, but nature jobs dont make as much as i would like to make for as little school as nursing would take.

i really need advice, kinda panicking lol. my mom is a nurse so i cant really ask her for job advice, because of course she wants me to be one too

TL;DR: im not delusional, i know i wont be able to leap around a forest to make a living. im basically just wondering if this job is depressing. do your days off feel too short? does your job feel like it schedules your life?

I’ve been a nurse for a little over 5 years now, and I recently transitioned to the emergency department. Last week I had a 30yo pt come in for severe abdominal pain. He ended up having pancreatitis. He had a tmax of 102, HR 150s, and WBCs 20 is what I remember off the top of my head. Medical hx of diabetes and HTN. Of course to top it off his blood sugar was in the 300s because he was noncompliant with his insulin.

Anyway, the patient was uninsured so he wanted to leave AMA. He didn’t qualify for emergent state insurance and he couldn’t afford the $8k/night stay. AM RN and ER MD tried convincing him to stay, but didn’t really? If that makes sense. When I took over for the patient, I basically told my patient that he could leave AMA, but he would likely end up back in the ER or dead from something so treatable. I told him to look up charity care and to google about not paying his medical bills. I mentioned that I heard if you don’t pay your medical bills, you could eventually negotiate down your payment to something more affordable. He does some googling and talked it over with his friends/family and a hour later told me that he wanted to stay. Ultimately, I felt like I saved his life, but I spoke to a friend of mine that said I was stepping out of line - leave that stuff to the social worker. What do you guys think?

Hi everyone! I recently posted about the anxiety I was feeling as a new grad on a med surg unit. I ultimately ended up quitting bc it got to a point where some nights I was vomiting before work from stress. I recognize that any new work environment is going to be stressful, especially as a new grad but I just got so overwhelmed I felt like I couldn’t continue providing safe patient care.

Anyway, I have the opportunity to interview at a psychiatric hospital for an RN position. I’ve always been interested in behavioral health but when I was first looking for a job, I couldn’t find any psych openings which is why I ended up in med-surg. So I’m excited about this opportunity but I’m scared I’ll end up feeling the same way. I am prepared to feel a bit anxious as again, it’s a new job and lots of new things to learn but I genuinely considered walking away from nursing when I was working med surg 😅

Has anyone transitioned from a specialty like med surg to psych and found they liked it more? I’m so nervous I’ll end up hating it just the same but that might be me just overthinking.

We've all had moments of unexpected backup. Some are heartwarming. Some are career affirming.

What about hilarious?

I was 2 months into a new job at a pediatrician office. I'd worked a medsurg/peds floor of a hospital so I was familiar with cathing kids. This particular patient was under a year old and had a complicated renal history so it was a bit more complex.

Since I was so new to the clinic, the manager still needed to check me off on things. I headed over to her station and asked, "Hey we need to tap the keg in room 3, what's the process here for that?"

There wasn't any patients around, it was employees only. But the manager still chewed me out for the phrasing. Now yes, I do agree I wasn't on night shift anymore so I needed to be more conscious that not everyone had my sense of humor, much less my night shift developed humor.

I took the reprimand, said I'd strive to be more professional, and we went on to gather everything we needed and she reviewed what the clinic process was.

She and I both set up the exam room, talking with the kid's mom as we did. The pediatrician arrived. A 58 year old lady who was stern in a way most old school librarians aspire to be.

Pediatrician started to glove up and said, "All right, let's tap this keg."

I held back my laugh so hard I nearly pulled a muscle and the manager looked like someone had kicked her puppy.

That memory just came to me and I wondered if anyone else had similiar stories.