Fuck ICE and this administration.
I realize this image is graphic, Mods can remove if they feel it necessary.

I have no idea what it is. I think going up to the nurse’s station while they give report is the best move, because my grandpa NEEDS a ginger ale and he needs it NOW. I thought I heard them talking about a “rapid response”? But nothing in this hospital is rapid. My grandpa ran out of his ginger ale .5 seconds ago and it’s DISTURBING that I can’t find a nurse in a timely manner. How else am I supposed to relay this extremely urgent request if I don’t physically enter the nurse’s station? /s

Long story short I work in a private surgical hospital, no doctors onsite overnight. Patient load 1:5.

The pm handover nurse handed over what seemed to be a routine spinal fusion on a morphine PCA, handover had nothing unusual to report, she said the patient was sleeping most of the shift and was low maintenance. I went to see the patient after report and their resp rate was 4. I got it verified by two other RNs as I wasn’t sure if I was missing some shallow breaths but no, it was fucking 4. Last recorded observation was half an hour earlier and the resp rate was 14 and the patient recorded as ‘asleep’. Patient rouses upon sternal rub quickly drifts off. You can imagine how the rest of my night shift went. Never have I seen a patient’s respiratory rate on a PCA deteriorate like this in a matter of half an hour, but hey, maybe it’s a possible. Total use was 43mls between 2100-2300hrs which made me say something along the lines of ‘that’s a lot’ at handover which the pm nurse said ‘yeah she’s fine though and not nauseas’.

I naturally want to speak to the handover nurse about this, but she can be quite defensive and arrogant from my previous interactions with her. My colleagues have told me not to bother as she will just report you for ‘bullying’, as this has happened recently with another colleague.

Unsure how the fuck this got missed with her, but my usual practice before doing an incident form is speaking to the nurse first, to make sure the facts are straight. Should I just skip that conversation and report?

ER RN was fired from Trinity Health in Ann Arbor after showing a patient the exit after they wanted to leave AMA after a head CT. A man was brought in by ICE who claimed he tripped while fleeing and hit his head on the curb. His face was bloody when they brought him. After imaging, the nurse removed his IV as it was no longer needed and showed him the door near the ambulance bay. After review by security footage, the hospital fired her as there were no formal discharge orders. Charges are being brought against her for interfering with a criminal investigation.

Background: I completed my nursing degree and lived in a blue state for the last 10 years. Due to unforeseen circumstances I had to move back to the town I was born (a smaller >250,000k city). When I moved here I was afraid of how the patients would treat me but it has actually been my coworkers that are causing me to be uncomfortable.

I am having trouble connecting with my coworkers in the sense that I cannot believe some of the things they say. They frequently make comments about gay /transgender people “going to hell”, asking how I feel about them, horrible comments about POC, looking at patients addresses and saying they “are probably this way because they live on the bad side of town”, “God is my God, Trump is my president”, laughing at parents who CHOOSE to vaccinate their kids. I’m sure there are people like this everywhere (im sure even where I came from..but they wouldn’t dare say these things out loud) so I have never been around so many outright hateful people. I genuinely have only heard of people like this on TV. Everyone says you just “get used to it” but as a new grad who is trying to learn, it makes it hard when I don’t understand or want to understand the people I work with.

Should I quit and try to find a new unit…? I am afraid it might be like this at other hospitals in the area.

Eta: I do value their expertise within the field & know I can learn a LOT from them but at what cost?

A pt I had given me this card a few months ago. I just rediscovered it and it reminded me that despite how burnt out I am because of MSurg nursing (mind you I haven’t even been a nurse for one year), that some pts really value nurses. They see us, they see how hard we work, how we still manage to tend to their needs while trying to keep track of a million things, not even counting charting, writing notes, or any acute events. I can’t even recall what I did that was so special to the point where I received a card. In any case, it makes me feel good and appreciated all over again. I suppose the pt has forced my hand (/j) and I will stick through being a nurse 😬

Fool proof phrases to use in your patient notes, admissions, discharges, etc?

Hi. OP onc nurse here. Had a patient for the first time today that was given blood labeled as incompatible. Called the blood bank and there is an entire protocol for administering. An order needs placed by the physician to acknowledge. I can’t remember what it said exactly, but something along the lines as the patient has some type or lacking some type of protein, and only about 5% on donated blood could be an exact match. I was on edge the whole time they were there, but they got through the transfusion with no trouble. Has anyone else witnessed this? No other nurses at my work, including managers, had seen this before.

My hospital does this a lot. They arrange a lot of self-congratulatory daytime events or “lunch time celebrations” that most nurses are unable to attend due to unit acuity. So it’s 99% administrative staff strolling down there with their suits and Starbucks to shake hands and pat each other’s back for succesful projects and initiatives that would honestly, be a nonexistent flop without the contribution and hard work of bedside nurses. We recently had one “celebrating x years of rapid response.” I work nights, the unit was an understaffed mess so likely nobody went besides management. We nurses are run off our feet and rarely have breaks in the 12 hours when we’re assigned to do rapid response. Yet management is there congratulating each other and having hors d’hoeuvres in our name. At least, sometimes we get the leftovers.

I’ve been a nurse for 2.5 yrs so far, moved from Med surg to the ICU and been here for about 7 months thinking a change might help my mental .I love it so much ! But I realized that I’m still struggling. It doesn’t help that I rotate.
I’ve been struggling so badly that I am going to start IOP soon (intensive therapy) and currently on meds. I’m hoping that it helps, I love my job so much and I hate that it takes me so much to
do it. How do other depressed nurses do it?
Any tips?

Prove me wrong.

I'm looking for some opinions from fellow nurses, especially anyone who has been in a similar situation or has experience with nursing management.

A few months ago, I transferred internally to the Emergency Department at my hospital. During the hiring process, I discussed my scheduling needs with the hiring manager because I have a young child with a serious medical condition, and childcare can be challenging.

I was very upfront about the fact that I wanted to work in the ED but that night shift would not be sustainable for me long-term.

Typically, nurses in this department have to complete six months after orientation before being eligible to join the waitlist for day shift. However, the hiring manager specifically agreed to place me on the day-shift waitlist immediately upon hire, rather than making me wait the usual six months.

This was a significant factor in my decision to accept the position. I also have the agreement documented in emails.

Unfortunately, the hiring manager left shortly after I was hired, and we now have new leadership.

I recently reached out to my new manager to confirm that the original agreement would still be honored. During our conversation, I was told that my original waitlist date would NOT be honored because it "wouldn't be fair to other employees."

I completely understand the importance of fairness and consistency in scheduling policies. However, I also feel that it's unfair to change an agreement that was made during the hiring process, especially when that agreement influenced my decision to accept the position.

To clarify, I'm not asking to be moved to day shift immediately or to jump ahead of anyone already on the waitlist. I'm simply asking that the original date I was placed on the waitlist be honored.

I also requested some flexibility with my schedule because I consistently work every Saturday and Sunday and have difficulty arranging childcare on Fridays. I asked whether an exception could be considered regarding the requirement to work every third Friday.

I genuinely enjoy working in the ED and want to stay in this department. I'm not trying to create conflict with management, but I also feel like I should be able to advocate for an agreement that was made in writing.

I'm torn because I don't want to start off on the wrong foot with new leadership, especially in a department where I hope to stay long-term.

My questions are:

1. Am I being unreasonable for expecting the original agreement to be honored?
   
2. Is it common for new nursing leadership to disregard agreements made by previous managers?
   
3. Would you escalate this to HR or higher nursing leadership, or would you let it go to avoid damaging your relationship with your manager?
   
4. How would you approach this professionally without coming across as difficult?

I'd really appreciate some honest perspectives from other nurses!

Hey all,

I started work in 2020 as a new grad, burnt out hardcore and officially left nursing about 4 months ago. I took an extended break last year (about 7 months) to try and recover from burnout but I just never did.

I'm sure many here know the feeling of something just breaking inside them during COVID. At some point, I think in early 2025, it's like my brain snapped and I just stopped caring entirely. I felt no care or compassion towards any patient and I knew I had to step back immediately.

However, my empathy and compassion has not seemed to return. I hardly feel a thing towards family, friends, or anyone else I know who is going through a hard time. I've removed myself from a lot of situations I usually wouldn't in my personal life, and I've stopped supporting my family pretty much entirely. I just don't care anymore. And that is SO unlike me - I spent my whole life up until last year almost overflowing with empathy and compassion. I felt so deeply for people around me, I never had any issues putting myself in people's shoes. And now, like I said before, I just don't care. I want people to leave me alone. I hardly feel a thing if i hear about someone having a rough go of it in whatever capacity that may be. I have the bandwidth for interacting with and caring for about 3-4 close friends and that's it.

Anyone else who has gone through this? What would your advice be? Did you gain your compassion and ability to care for others and the world back?

EDIT: Just to add, I'm on meds, I see a psychologist and psychiatrist, I have a great GP. Medically/treatment wise I'm doing all the right things :)

Hey everyone.

I know this sub is usually for venting, so I promise I’m not here to drop any "toxic positivity" on you.

I work in healthcare in France (LTC, previously ER).

Reading your posts, it’s wild to see that despite the different countries, we all fight the exact same battles: understaffing, heavy ratios, and exhaustion.

In this field, we’re surrounded by chaos all day. Yet, it’s incredibly easy to feel totally isolated once we clock out, the adrenaline drops, and we’re back in our quiet living rooms..

I just wanted to offer a safe space tonight. If you're trying to decompress from a brutal shift, or if you just feel lonely and need to talk to someone who gets it without having to explain the jargon... my door is open.

Whether you want to vent about management, or just chat about absolutely nothing to take your mind off the call bells, feel free to drop me a message.

Take care of your backs tonight ☀️

I work in skilled care. We just had a resident who was ACTIVELY dying. He has been like this for about two weeks. I came in yesterday and apparently he is eating and talking.

He was all of the things. How does this happen?! Am I losing it? Have you ever seen this and how was that like?

Used to be the occasional phone out during a code or a birth. Now it feels like every third visitor has the camera rolling before I even introduce myself. Not even stealthy about it. Had someone propped on a windowsill last week trying to get angle on a dressing change through the door glass.

The policy is fuzzy. Management says "discourage politely" but nobody wants the TikTok complaint. I find myself rehearsing sentences in my head before entering rooms, like I'm on stage.

This is not a post about HIPAA. I know what HIPAA is and is not. This is about the ambient pressure of being watched, and whether anyone has found ways to address it that do not turn every interaction into a negotiation with three people in the room: patient, family, and lens.

What actually works where you are? Or are we all just adapting around it in silence.

I know we've all heard horror stories of nurses with 6mo experience having to become charge in a pinch. I'm curious: how much experience should a nurse have before being charge? Does it differ depending on the specialty? 🎤

Okay so I’m new to ICU, and the last 2 shifts I’ve had I’ve unfortunately left the night nurse with one access. First one she came around 1700, which sucked lol. She was a hard stick and her husband was telling me she’s usually needs ultrasound. I tried but I was just unsuccessful. I asked one of my coworkers who can do ultrasound IVs but he ended up getting busy.

Today the patient I had, had a triple lumen picc but unfortunately patients fungal cultures came back positive and the MD ordered to remove it. The patient had +3 edema in both arms, skin was weepy, and both arms had wounds that made access extremely limiting. Vascular access came back to put in a midline and I damn near begged for two midline’s but the nurse said no. The only other place he had for access was his upper arm and only vascular access can do that.

Moral of the story is I feel terrible for leaving them with only one access. And even when I try to explain why I couldn’t get another access, they look at me like I’m lying :(

An overcooked CVPCU RN here… almost burnt out!

Been looking into what specialty could offer me an “escape”, i know every specialty is hard in its own way. Coming from heavy cardiac 5pts to psych, what should i expect?

Why do I always stay hungry all day long post night shifts. Like literally I feel like a cow. I work on my diet the whole week then comes post night shifts I ruin everything in one day. I literally had 2 burgers, fries, lunch, a doner and I still feel hungry 😅😅

I passed my test this week and wanted to share my experience since I used reddit to keep me sane while I was prepping! This will be lengthy so I'll tl;Dr at the end.

Background:

16 years RN

7 years RN circulator in hospital setting with 8 ORs

Started studying in July planning to test in October

I had already asked to start cross training over to PACU so my employer assigned me 40+ ASPAN learning modules to do online. That helped because it covered pre- and post operative material that isn't normally in my wheelhouse and also reinforced things I do know like thermoregulation, operative risks, and anesthesia modalities. Bonus: it came with a big 100 question test at the end that I had to pass, so it got me in that retain-for-test mindset.

I signed up for an AORN membership ($125) for the first time so I could take their CNOR prep course (free with membership.) It broke the material down week by week and gave me a study plan to follow. On the days I wasn't very motivated or interested, I could just tell myself, "You have to get through this week's material so you don't get behind." Since I was following the plan, I didn't have to wander aimlessly through different topics. Definitely would recommend. (This also gives you access to AORN Guidelines+ which I used while studying.)

I had access to Drain's, Alexander's, and B&K textbooks, but only ended up using Alexander's. When I finished my AORN course, I took the big practice exam at the end twice - once closed book like a real test, then a few weeks later open book so I could test my recall and immediately look up topics I wasn't as familiar with like ophthalmology.

I downloaded the CCI pocket prep app. I paid $20.99/month for 3 months and worked through the 1500 question test bank plus 2 of the 200 question mock exams. I liked how the app tracked how much time I had spent and showed trends in my scores - it helped build my confidence and show that even though it felt like playing a little Quizlet game, I was actually banking serious study hours doing it.

I read so much about the Zander course and strongly considered it, but I really didn't want to spend the money. I'm a pretty good test taker at baseline and wanted to see how I did without it before I coughed up that money. I told myself if I didn't pass the first try, I would invest in Zander and try again.

Between my ASPAN modules, the AORN course, and the 3 months of pocket prep, I felt prepared enough to test and chose to take it in person at a testing center. I mentally took the test 50 questions at a time - answered 50, flagged the ones I was unsure of, revisited those flagged, then did the next 50.

When I reached the end, I felt confident I was going to pass. I had 2 hours of time left so I went back through each question individually to read more slowly and thoroughly. I did end up changing a couple answers that I think I would have initially gotten wrong. This is something I learned with pocket prep - that I had a habit of answering wrong because I wasn't reading CAREFULLY enough.

Here's my takeaway:

--ASPAN modules - very helpful if you don't float to pre/post/PACU - a lot of this was new knowledge to me and ended up being pertinent to CNOR exam

--AORN course - excellent for a framework to keep you on track and motivated to push through the times you are losing steam - a lot of review of things I already knew but more detailed, good reinforcement of OR knowledge, plus access to guidelines helped

--Pocket Prep app - the best for improving your actual test taking skills, being able to work through a non-knowledge question and come to the best answer, but I don't think it would have been enough had I not also been using the other modalities as well

--Textbooks - use as reference only. I really thought I was going to read them cover to cover lol no.

For what it's worth, I didn't study every day. I had days and weeks where I didn't get much done. I would say on average I actually studied with my laptop and books out for about 1.5-2 hours/1-2 days a week, plus an average of 1.5 hours a week answering practice questions on the app. If I was dragging my feet to get started, I would set a one hour timer on my phone and give myself permission to quit then. Usually my timer would go off and I'd feel motivated enough to keep going until a stopping point in the course.

I'm proud that I set this goal for myself and achieved it. I hope this post is motivating for anyone else looking to do the same. I am preemptively rooting for you!

TL;DR: Passed CNOR exam on first try with a combination of work-assigned ASPAN online modules, AORN prep course, plus Pocket Prep app, textbooks for reference only. Was too cheap to pay for Zander course and passed without it.

How would you feel if your unit was floating like 2 or more nurses a day. Basically, you're constantly floating on a weekly basis or twice a week. Hospital has a internal float pool but they don't wanna pay $$$ and so they are just encouraging us to float and pick up.

So I basically think I wanna transfer.

Professionally- how would you tell you your boss?

It's just like burned me out along with other things like there's some favorites around. I was picking up alot of slack for certain techs or a particular nurse but I stopped.

Its a big hospital system so there's options around. I have talked to other nurses who work and this hospital is the one that's doing it the right now. I feel like we are the trial.... its just an internal feeling.

Job hunt advice

Well friends. Anyone who’s seen my other post can see that i was in a tele job that ran me into the ground.

Proud to say that at this morning I put in my resignation. I was initially going to just resign and stop showing up because this job physically makes me sick and I think it has permanently affected my relationship with nursing for the worse. But I am putting in my 2 weeks instead and if I feel like I need to I’ll just call off my remaining shifts or say I’m not coming in…. Burnt bridge be damned.

I was only in this job for 2 months (I’m right at the 3 month mark almost) but I wanted to know for future job applications, is this job appropriate to put on work experience?? I’m planning on telling my manager plainly I’m burnt out and cannot do this any longer and I need a permanent change of pace in the nursing I do, and asking if she’d be willing to help me find that. She either says yes or no. But while I hate this job it did teach me a lot of nursing skills that transfer over to other jobs I may want. So pls lmk if 2 months is something I should even put on work experience??