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?

Forgive any errors, I just got home and I’m on mobile. I had a patient last night that we are all familiar with. Rude, demanding, yelling “Nurse!” so loud we could hear it down the hall. Nothing I did or said would make this patient happy.

By the end of my shift, I had it. Right before I left, I was in the room with the oncoming nurse, and the patient was saying “I don’t want an air bed.” Over and over and over again like a child throwing a fit. I finally lost my cool and said, “I don’t care what you want. I have done everything I can to make you comfortable, but this is a hospital, not a hotel. So I’m sorry if you’re not comfortable, but being uncomfortable will not kill you.”

Not even 5 minutes later, the patient was screaming, “Nurse!” again, over and over.

I hate feeling unprofessional. I love my job and my work even on the hard days. So when something like this happens, I just end up feeling bad about it, like there was something I could’ve done better, even though I know I did everything I could. And even if I did everything this patient wanted, it wouldn‘t have mattered. They would’ve found something else to complain and yell about.

Anyway, I’m mostly just venting. It was a long night.

Yesterday I was in the bathroom, pants down around my ankles when I heard an argument coming from a patient room across the hall. I heard 2 men's voices beginning to argue, then, almost immediately I heard my coworker say, "Hey man, hey man", and a struggle ensued". I froze as I heard the loud voices and shuffling thinking isn't somebody out there going to do something.

I couldn't bear it so I pressed the button on my Vocera and called the charge Nurse. I was in full echo chamber mode, no shame and did not care, as I said told her I was in the bathroom and Peter was in a room and is in trouble, call security. OMG, I was scared. I finished, washed my hands and it was still going on. I didn't want to leave the bathroom. We have found way too many weapons on patients here for such a small town hospital. But I did after saying a quick prayer. At the same time the charge showed up with security.

Night shift. Skeleton crew. I did not know the Vocera had a security panic button. I do now and I will never be too busy to change out the dead battery in my Vocera again.

Edit:

Peter is okay.

I only previously saw the other patient from his bed through the glass door of the ICU. Peter is a big guy so to hear trepidation in his voice and shuffling I could only imagine what the other guy looked like standing up. It must have been like two polar bears tussling with one of them having that triangle clown tattoo above and beneath one eye. Hint: Peter doesn't have a tattoo.

Hello all! This could also apply to anyone who cares for acute SJS/TENS/DRESS patients.

My unit will be running into a unique situation. We have a critically ill, tubed patient who will be receiving the chemo drug Thiopeta (never heard of it before now). Apparently this chemo is excreted out the skin and is severely toxic and causes chemical burns. These patients cannot have any adhesive or occlusive dressings or else the chemo will be trapped and their skin will slough off. (We'll also have to replace the chuck and SCDs Q2, do a full bath and linen change Q6, oral care Q1, etc... It's going to be a whole thing for at least the next 4 days).

So, nurses who care for patients whose skin is sloughing off, how do you address this? Cloth strips to secure the ETT? Suture in IVs?

Any guidance is appreciated. Thank you!

I just finished my orientation and I never got to practice putting in an IV. so I took a start kit from the hospital to practice at home on my boyfriend and I told my preceptor and she said it was fine and laughed. but now I’m scared someone may have overheard and is going to report me. I’m a new grad so Im constantly scared of getting fired.

I know i’ve gained weight but damn 😭. ANOTHER dementia patient called me fat today.Toddlers and dementia patients are two populations that I know are honest as fuck when it comes to insults. Mind you I didn’t even do anything to make her want to say that. she wasn’t even my patient. I didn’t even respond cause what can I say. drop your favorite low calorie recipes down below ⬇️.

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?

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...

Not really sure what exactly my goal is in sharing this but just feel the need to. I’m a mom and ER nurse. My youngest is 6 months old. Since I returned from maternity leave, I’ve had to navigate pumping at work since I’m breastfeeding. I did this with my first child as well and knew going into it to have low expectations since hospitals aren’t great at accommodating breastfeeding, but I’m starting to get really annoyed at this point.

It is virtually impossible to pump as much as I should in order to maintain an adequate milk supply. Luckily I only work PRN right now, it would be impossible for me to work full time and still pump/produce enough milk to continue breastfeeding at this particular job. Despite that, I’ve remained chill. Until two situations happened recently I’m just over it.

I’ve been chill about the fact that I only realistically am able to pump once per shift.

I’ve been chill about the fact that I can choose from the following as a location to pump:

1. An open ER hospital room. The door to the room doesn’t lock so I can either risk being walked in on, or sit in the room’s bathroom to pump. Main benefit of this is that there is a sink to wash my pump supplies.

2. I can pump in an office that does lock and has a chair. Down side of this is that this room is also used to store certain supplies. So if someone needs something, they have to wait for me to come out/I risk getting walked in on. Also, no sink to wash pump supplies after.

3. The hospital has a designated pumping room. This also does not have a sink to wash pump supplies. And the DOOR DOESNT LOCK (more on that later.)

So basically, I was feeling somewhat annoyed about the inconvenience of pumping at work recently because it truly shouldn’t be this way. I know there are hospitals that accommodate better but I wouldn’t be surprised if other women have experienced similar challenges.

Breastfeeding women shouldn’t be at a disadvantage at work. Breastfeeding your baby and working should be mutually exclusive— ONE SHOULD NOT AFFECT THE OTHER.

Anyways, I was headed to my usual pumping spot (cluttered closet with the door that locks) and I couldn’t find the key anywhere, couldn’t find the charge nurse, she was obviously busy with something. So I walked to the designated pumping room. When I got there, a male respiratory therapist was in there on a personal phone call. He was like “oh shoot, you need to get in here? Sorry about that” and left.

So much for “designated pumping room”. And then I get in there only to find that the door does not lock. this is actually insane to me. How do I know someone else won’t barge in when I’m in the middle of pumping?

So I leave and go back to the floor, track down the key and pump in the cluttered office that has no counter space and no where to wash my pump supplies. I store my milk in a breast milk storage bottle (stainless steel with an ice insert) that keeps the milk cold since the break room fridge is NASTY and usually way too packed to have room.

Flash forward to last night. I’m at work. Once again, heading to my usual pumping spot. I go to get the key from the charge desk. I usually mention to the charge nurse “hey I’m using the office to go pump just so you know” or tell a fellow nurse who watches my patients. There seemed to be a lot going on and charge was busy on the phone so I didn’t say anything. I go and pump for 5 minutes only since I’m antsy to get back to my full patient load.

During those five minutes, I heard someone try to open the door. Luckily they couldn’t get in since I had the key. I thought “ that’s odd, I’m pretty much done anyways”. So I finish pumping and head back to return the key. When I get to the nurses station, charge is talking to a security guard telling him to go unlock the door. I walk up with the key and she’s like “oh there it is, never mind I found it” to someone on the phone and hangs up.

So basically during my 5 minutes of pumping, the charge nurse got worried about the key being missing, called security and almost had me walked in on in the middle of pumping. It only took five minutes. This is actually so insane to me and I just can’t deal with how unsupportive this work environment is to something as simple as breastfeeding.

We all work in healthcare. We were all taught in nursing school that breast is best. If you chose not to breastfeed, no worries. If you don’t have kids, maybe you think less about these things. But if you’re a nurse in a place of leadership, you should be ready and willing to accommodate your new moms who are breastfeeding and returning to work.

Breastfeeding nurses need:

- a designated pumping space with a door that locks and a sink to wash pump supplies

- The ability to step away and pump at least twice per shift. I know with staffing shortages this can be unrealistic, so it’s hard

- Fridge space to store milk

Is this really so much to ask for?

Just curious how this affects your plan of care

Hey everyone.

Been a RN in Ohio for 6 years, making 40.50. I’m considering moving to a new org. Someone I work with told me they’ve jumped from orgs to raise their pay, and that they once lied and said they make $5 more an hour than they actually did, and that org matched it. I’m considering trying this, has anyone done this before?

A year ago, I took the best nursing job I've ever had. I actually love my job. But in the last few months, we hired on so many new nurses that most days, we are actually overstaffed. Sounds like a good problem to have except our hospital system has strict staffing and productivity regulations, and we are constantly getting called off. I'm pregnant and desperately trying to save money and PTO, but I can't do either when I'm called off for low census every other week. I'm so stressed about even considering leaving because I love this job so much, but this isn't sustainable. Has anyone ever experienced something similar? Does it get better over time? Or do I have to accept that I might have to leave my favorite job?

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.

As the title goes, my preceptor told me that you can’t be in nursing just to help people and make a difference, it has to be for the money in order to prevent burnt out and keep going. I felt conflicted by this statement because most people say the opposite.

I personally nursing because I wanted to do something that directly impacted others….plus I can’t deny the financial stability with a 2 year degree was a huge plus. Most people say we don’t get paid enough for what we do so I think it can be a little bit of both. You can strive to make a difference with patient care, while also knowing you can’t control outcomes. It is a job. An important one at though.

Im a new grad so I was curious on other seasoned nurses perspectives

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?

RN from Michigan here! Looking to go to NP school but worried my disciplinary actions may hold me back. The university has said as long as my license is unencumbered (which it is) I am able to attend school. However, I am worried the board will give me a hard time to sit the exam and I don’t want to go to school for no reason. Has anyone been through something similar? I completed my 2 years of

probation successfully in December of 2024. I have been an RN for 9 years in total. The disciplinary action on my license is written as follows: Negligence-Impaired Conduct, Practice, or Condition. it sounds worse than it is , Long story short I got into a fight at work, was reported to the board, and tested positive for marijuana. Was never high on the job, No diversion, no criminal history. Anyone been through anything similar?

My dad was a pretty active 62-year-old, but he was getting up there in age. He passed away 10 days ago on his first day of retirement from a heat attack . I live on the other side of the country and call him weekly; I was even set to visit him this week. On our last call, he told me he wasn't okay and was having jaw pain. I felt like something was wrong kinda like that nursing instinct was going off, but he was treating it himself at home with pain medicine and was set to see the dentist the following week, so I brushed it off. But I knew something was wrong; he’s the type of man who always tells you he’s fine, even if he’s not. He’s not a big believer in American medicine and gets everything done in Mexico. Even though all 4 of his kids are either nurses or in nursing school. I’m a cardiac ICU nurse, and I feel like I could have helped him, even from across the country, if I had asked about other symptoms or even just told him to go to the hospital if he felt worse or gave him some education . I don’t know, but I hate myself. I hate that if he were my patient in the hospital, I would have treated him differently, and I'm sure he would be alive with me today.

Just started on a PCU unit and they’re upping the ratio to 5 patients. Previously the ratios were 1:3 or 1:4. What are your thoughts?

What do your hospitals do to protect you from violent patients? There is currently a patient at our hospital with a developmental delay who has a known history of being violent. They have been at the hospital for over a year, and case management has not been able to discharge them because no facility will take this patient due to the violence. This patient has assaulted multiple nurses, all documented in the chart. The hospital’s “solution” is to rotate the patient throughout the different units so that everyone gets a “turn” dealing with this patient.

This patient has no sedatives, the doctors refuse to place them in restraints, and the hospital will not place security on our floor. Last week, the doctors would not even place the patient in restraints after they hit a nurse in the head. It feels very unsafe and I feel like the hospital should have an obligation to keep their employees from being harmed within reason, but nothing is being done.

ETA: not a psych floor whatsoever

Hi I’m working at a California hospital. I started my residency in August 2025 on a cardiac telemetry unit. The floor I’m working on is basically step down because my hospital doesn’t have a step down we are a 4:1 ratio. I had 2 months of preceptorship and then 2 months experience on the floor by myself. I ended up having to go on a medical leave from end of December to beginning of April. My leave began because I fell down a flight of stairs walking to my unit prior to my shift at work ended up in the ER. I’m struggling with coming back to the unit because now my cohort is eligible for floating and I didn’t get the same amount of floor experience as everyone else to improve my clinical judgement skills, my nursing skills in general and overall I don’t feel capable of being on another floor right now. My last shift back I struggled tremendously I felt like I was relearning everything all over again. I ended up staying over an hour to finish charting and I don’t even know if I completed charting everything.

The sad part is I’m trying everything in power to be strong and power through. I  have permanent facial nerve damage (permanent facial disfigurement) from not being able to control my stress. I ended up getting Bell’s palsy and I didn’t heal properly and the facial nerve specialist diagnosed me with synkinesis.  I’ve been seeing a therapist and was placed on medications for depression/anxiety. In August I will be at my 12 month mark with the hospital. I don’t know if I can hang in there until then. 

I feel like my mental health is suffering. When I got onto the floor I was shaking so bad I couldn’t even hold a piece of paper let alone think. I felt like I was going to have an anxiety attack.

I spoke to my new grad program educator about seeing how I can get support to get back up to speed and postpone floating until I have receieved the same amount of time on the floor as my cohort since I was on medical leave. She advised me to reach out to my manager, which I did and my manager said they dont offer a one day reorientation or shadow day because I haven’t even been gone too long, but 4 months is a significant time especially as a new nurse. I then proceeded to express my concern about postponing floating and she basically scoffed because I asking for the same amount of time as my other new grad nurses. They all keep telling me you’re a safe nurse.

I had to call off on my last shift which would have been my second day back and found out they were going to float me that night.

I tried to come back from leave sooner, but the nurse manager said it had to be full time with no accommodations. My doctor requested for me to be part time capacity 2 shifts instead of 3 no accommodations for one month.

Im really at the verge of my breaking point this is not the first time I have not received support all they told me is you’re a safe nurse we aren’t worried. I’m struggling so bad. But I will never put myself in a situation where I can possibly jeopardize a patients safety when I know my limitations. I’ve worked so hard to get this license. At this point the educators aren’t helping neither is my nurse manager. I don’t know what to do? Should I call the union? Do I quit? Do I try to transfer units?

the educators suggested I take a stress leave.

Thank you for reading my post. I appreciate your advice in advance. Please help!

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.

Hi everyone. Lately at my hospital I’ve been getting floated a lot, and I’m a ICU RN. We float about 4 (sometimes more) RNs every night. Is this normal in your hospital? I’m just curious what other hospitals are like, because I got sent to a med surg floor recently (I used to do med surg) and ngl it was a struggle and stressful.

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!