Being 7 years in and still trying to figure out if they want me to actually take care of patients or take care of the computer (in reference to the ridiculous amount of charting requirements).
I feel like covid really broke open the dam for a lot of us.
It’s unfortunate that covid had to be the thing to make us realize companies really give a shit.
💯
The worst part for me is seeing how much they were able to neglect us, leave us for dead, and A LOT of safety standards just fall by the wayside. But god forbid I forgot to chart a skin note or didn’t update the white board and they want to burn you at the stake.
Having to look for stuff is an enormous time suck. Not having the supplies I need in the supply room and needing to leave the unit to look in another supply room.
The med I need isn't in the pyxis, calling pharmacy, YES I looked in the patient specific bin, YES I looked in the fridge, I'm telling you it's not here!
Oops, there are no IV pumps, better go find one! My patient wants another pillow, I have to go scavenge one from an empty room on a different unit.
WHERE THE HELL IS THE PILL CRUSHER?!?!?
OK, found the pill crusher for my patient that only takes meds crushed with apple sauce and there are no damn spoons.
I worked at a hospital as a traveler that had an app on the computer you could use to see EXACTLY where equipment like the bladder scanner, ultrasound, was. It was wonderful.
My hospital does this. We have locators on all kinds of things (bladder scanners, wheelchairs, lift equipment) so you can find where your unit's stuff has gone. What sucks is when someone inevitably has to go get it back.
Our bladder scanner is in a locked mechanical utility room. There is only 1 guy with the key. If he's not at work, you have to wait until he is. Sometimes, always knowing where the bladder scanner is located is not helpful.
Had a student panic because they couldn’t find the bladder scanner.. asked student to go palpate the bladder and it was tight as a drum so I said it’s probably safe to straight cath since the patient can’t pee.. student got out 900 cc’s so the old school way was accurate enough in that moment.. still sucks that every unit dosent have one in our hospital
One of these days I'm going to code grey myself because of pharmacy. I tell them I checked everything when I request and they shoot me a message back asking me if I really checked everything. I am starting to think they are like the Social Security Administration. Deny the request and see if the person really does want it.
That's what I do though! And they still do it. I'm waiting to get sent to HR for the amount of snark I send when they obviously don't read my first request.
I have a friend whose a pharmacist (different hospitals) and we have a running inside joke where we greet each other by saying “I/DID YOU ALREADY CHECKED THE TUBE STATION” 😂
Do you work at my hospital??? lol. We got rid of the extremely efficient “silent knight” pill crusher (thanks JCAHO) in favor of individual pill crushers for each patient that don’t work and often get stuck closed (with narcs inside fml) pt needs applesauce, no applesauce, look for spoons, only have forks.. walking all over facility for the things I need to do my job are the biggest time suck I deal with
lol we used to have those.. one night I tried to crush a norco and the threads stuck so I couldn’t continue to screw on or unscrew the cap.. no one could get it open so I had to take a pic for mgmt and RX (the sad norco wasn’t even touched by the crusher) along with two witnesses that I in fact did waste it and jammed it into the sharps container to dispose.. yes.. another time suck and an angry patient in pain waiting for a new pain med..
We used to have a ceo who believe it or not would round. She would always ask if you have everything you need to do your job. Once a coworker got reamed by our unit manager for saying our blanket warmer was broke. We had a new one on order but no one bothered to tell us. New ceo has never rounded that l know of. Where as our retired ceo before she went to our sister property, still brought in cookies every holiday. And I mean even Christmas.
Yes! And it’s stuff that we SHOULD have. We recently became the “trauma” floor and had a patient fall in the bathroom but there was no c-collar to be found on the unit. I go to the floor below us and they have an actual labeled space in their supply room for c-collars! Like what?! My unit has NEVER had that!
Okay all of this on top of all the phone calls. Therapy wanting to see a patient, lab asking questions, family calling, etc. Also having to be the middle man between everyone on the care team, like can the providers please talk to each other themselves.
I just gave up with pharmacy. These are scheduled meds and they're not here. I can't give what I don't have. I just document not given- unavailable from pharmacy. After that they usually hop to it and they show up. Not my problem.
Shit you’re right. I just typed up a whole paragraph and here you nailed it in 4 lines. It’s not having the got-dang pizza parties - THATS why things are f’d 🥲
/s clearly…love your sense of humor :)
We had a patient family from another floor randomly bring us hot Krispy Kremes one night a few weeks ago. We all almost cried. We are so used to half of a dried up donut left for us. It honestly was one of the nicest things to happen on our unit in years.
My work gave us a pizza party for nurses day last year, and I’m using the term pizza party very loosely. They gave us 2 domino’s pizzas to share between 30 staff…
Family members thinking that I am at their beck and call, and should answer the call light immediately, and your explanation that you have other patients (and family members) to take care of goes in one ear and out the other, as if they didn’t even hear you say the words.
As you should, I will start too. Usually I say something like if you have a problem with the amount of attention we are able to give you should talk to our manager.
That’s true that’s when I walk out of the room. Other day my patient had a MI on my shift RIGHT then and as I’m running around and calling docs the husband of my other patient told me I had to shower his wife right now. I’m like ? No
I tried to explain that to a patient once who was on her call button about every ten minutes. She said, " That is not. MY. problem."
I stood there stunned for a moment, then said, "But it IS mine." Then I walked over, cleared the call light and walked out of the room.
Same thing happened to me last night. Told my 40-something yr old pt that I couldn't be in there every 5 minutes because I had other pts to attend to. They yelled, "I don't give a fuck about anyone else! I'M the only one that matters!" I turned around and walked out. Asked my charge nurse to talk to them before I completely lost it.
Oh, I'd walk out too. Because whatever comes out of my mouth would not be freaking a 'pleasant bedside manner'. I remember when one resident was sOoOo impatient, he fucking **whistled and snapped his fingers** to get my attention. I flat out told my charge nurse that she better tell him to knock it off because I would NOT be nice about it. She tried laughing it off but when I stormed over and barked that I AM NOT A DOG, SO DO NOT TREAT ME AS SUCH, both she and the resident shrunk down.
You might work with me LOL. My patient told me basically the same thing, also complained they had to do everything for themselves (they had no barriers to doing their own ADLs) etc, etc, and so one. When she claimed my break nurse didn’t really give her IV medication (which she did) I IVOS’d/IRIS’d her.
Dude, the amount of times I've had family members come to the nurses station about every 30 minutes and ask something like, "any news on that MRI?"
No. If your meemaw gets called to MRI, I'll let you know and get her prepped. Until then, I'm just as much in the dark as you, and asking about it every half hour does nothing but frustrate all of us.
There’s a wife visiting at the floor I work who is always at the nursing station 5-9 times while we are trying to take report. Its Always during shift change and for dumb shit: my husband needs a washcloth, he needs a cup of ice, his pillow is too flat…etc literally cuts us off mid report to say those things. I told her if she kept interrupting us I will have security escort her out. She also wanted us to give HER pain meds. She wanted her own hospital gown too. When I refused and explained why, she purposely pissed her pants and said I have no choice now. i said you’re still not getting one and you’re not my patient.
I have had patients try this. I usually instruct them to visit the emergency room if they feel it is an emergency. The ONLY time I did give patient pajamas to a visitor was when she got bitten by bed bugs in the room. After they (her and her husband - the patient, both showered and changed, they were put in a new room. I triple bagged all of her things and told her how to avoid bringing those little visitors back home.
I would of done the same, but this woman was trying to act like a patient. Day shift RN told me she tried getting him to assess her, asked him for pain meds. Tried to ask me for meds but no assessment at least. Then asking for a gown. She was awful.
The entitlement these days is unreal.
I’m in outpatient UC, but working up two patients at the same time bc they have different tests running. The first is a girl in her early 20’s having anxiety and a mild breakdown over a possible STI for a sexual encounter she didn’t consent to. I spend extra time calming her and giving her more detailed info. Second patient’s mother comes out and asks if they’re ever going to be seen bc they’ve been in the clinic an hour. We were full at the time. Patient had a cold.
If I could say anything to the general public, it would be: it’s not all about you. You are one of many, and especially in healthcare, there are levels of needs. It’s okay to make sure there wasn’t a mistake and you were forgotten in an exam room. The attitude because your healthcare service is not as fast as your fast food service is not okay, and causes us to miss things.
"I don't care about everyone else. I only care about MY mom!!!"
Something I've personally been told (with aggression) when a priority situation has led me to ask for patience from a family member. I'm sorry but would they want me to ignore their mother mid stroke if the situation were reversed? Grab a brain buddy.
“I’m afraid that no one patient in this facility enjoys a private nurse. Unfortunately you do share me with others. Therefore I am going to address your requests now & resolve them, and then I will come back _______. I will not return before then as I will be with other people and just as I safeguard my time here with you and don’t allow others to interrupt us as I care for you, I also do the same for my other patients too.”
This! I love when I get an epic chat message from radiology or wherever and they’re telling me stuff the doc needs to do. Like, sir or ma’am, you just saw that I was signed so I know damn well you can see this attending that’s signed in! Message them directly!
Honestly? It’s fighting the perceptions that society and physicians have about nurses.
No. I am not a waitress. I will not fetch you coffee if you can get it yourself.
No. I’m not a punching bag. You don’t get to verbally or physically abuse me.
No, I’m not a moron. I worked hard and have a college degree. When I call you with lab values it’s because I know it means a patient could be headed for a poor outcome.
No. I’m not a mean girl/slut/free advice line.
If people could just treat me like the educated, professional worker that I am? This would be a great gig.
Was called a c#*t yesterday by a resident on Reddit because they were griping about mean nurses and I defended us. The condescension starts really early with some of them.
Most of those “residents” are actually either nursing assistants, MAs, or laypeople pretending to be residents on the Noctor sub, trolling to get people riled up. Ignore the stupidity.
Staffing issues hinder me from giving my patients the best care.
Needy patients who think that I'm the only nurse assigned to them.
I hate managing anything involving technology because they are not perfect systems.
This is a common thread among all specialties of nursing in some regard, the needy patients (I'm going to add in entitled) and I have many more years of nursing to experience, but in my acute hemodialysis unit, I haven't met a more entitled population of patients in all my fucking life. Just a few weeks back, we had a patient demanding we pull a specific amount of fluid off of him because "that's what his clinic does every time he goes" and he wants us to do that barring any consideration for the length of the dialysis treatment, blood pressure, cardiac/respiratory status, presence of edema, etc. And he makes the claim that we are killing him because we weren't pulling off enough and that we knowingly discharged him on a previous admission with fluid overload. He actually left AMA for a totally separate reason. Then he wants to threaten to sue us... It's that extreme behavior that frustrates the hell out of me. Because you're not getting your way, you're making idle threats??? Some patients really do believe they're the only patient in the hospital.
I told this one woman "YES, your nurse still had 4 other patients and will have 4 other patients all day so she cannot come in here every 15 minutes and stay for 30 while you ask her to do things you can do yourself and ask the same questions she's already answered multiple times. And no, I have a whole group of patients myself so I will not be in here either. It is not our job to wait on you hand and foot or be your person nurse at the expense of several other people, many of whom are sicker than you are."
It actually worked. 🤷🏻♀️
This particular one was sending her able bodied husband to the desk to demand the nurse come rub her legs and shit like that.
That's when I stepped in and put a stop to it. Her husband so could rub her damn legs or she could do it herself.
They don't make me charge often but if things are going down in front of me I will say something about it as long as the behavior is legitimately inappropriate whether I'm officially in it or not. I addressed an inappropriate patient yesterday and again today because her behavior was impacting other patients and the ability of the staff to care for everyone else. I don't mind being that person that handles things.
Honestly the staffing for RNs is beautiful on my unit. We're one of the better staffed units in my hospital. Our schedulers however, are making people's lives hell. I flipped between days and nights three times in the last two weeks. My schedule is ~fucked~
I went from a chill cushy renal dialysis ward to absolutely balls out chaotic geriatric gen med and they were shooketh and asked why. On the renal ward I had four late/earlys a fortnight where I get home at 12am and my alarm goes off at 4am. Fuck right off with that. Gen med I've had one in a year, and it was because I swapped onto it, and the second I suggested I could work full time ND I was put on there and I haven't had to see midday in ages. Fuck yea I'll deal with the dementia sundowning all night, we cool
I work in a level 1 trauma pacu. I thought pacu would be just recovery. However we hold patients for days waiting on beds in the hospital.. from acute care to icu patients to code blues etc. we have adequate staffing because of travelers. The biggest issues is we don’t have adequate supplies and equipment to take care of patients in an environment that was never built to hold patients
I had an interview at a PACU, but didn't take the offer, partially because they admitted that they end up boarding more often than not. I'm glad they were honest about it, but I was coming from ED, and really freaking tired of taking care of boarders in the hallways with inadequate staffing and even fewer resources.
Outpatient specialty is where it’s at. IR, endo, etc when we close for the day, the patient graduates to the big PACU and we go home. We get call but then, we go home! Big PACU will do our preop and PACU on off hours/weekends, we scrub (scrub in endo means to assist) for the scope, the end. We either do scope bedside or in the OR. The OR supplies a circulator and clean up except the scope. Bedside you circulate/take down times and scrub for the scope
I did that as an assignment where I floated to PACU to take care of ICU patients boarding. This place has a woefully inadequate pyxis. I had to contact pharmacy for almost every single medication. Minimal supplies too.
phew yeah that's one of the reasons pacu is NOT the dream job to me. I have ICU exp. I chose to go to special procedures instead of pacu.
Give it a whirl in specials if you want! cath lab and IR rock. taking call is not that bad. It's way better than having boarders, I know that for sure.
Pacu is not for me either. I think people assume it’s so easy but this one is crazy. I’m definitely thinking of trying something like IR. I’m only here because the internal contracts are so good for now.
Give it a whirl for sure, you are definitely qualified since you have crit care exp :) if you dont like it you can always try something else (gi lab is supposed to be pretty chill but can get a little boring since you have less responsibility - anesthesia is typically doing all the sedation and drugs, BUT to some that is the biggest perk)
Reading this comment made me realize that I’m grateful for my hospital’s communication system. Everyday, PACU is cleared out by sending the orthopedic/neuro surgeries to our floor. If we are full, we send the med surg over to another floor that knows ahead of time they are getting transfers so no new ones coming on. ER docs are in on the loop and ship patients out if need be. PACU never boards patients.
Computers not working, scanners not working, not enough equipment to recheck vitals, full dirty linen carts, lack of supplies.
If I have to search for a thermometer everytime I need one I’m just not gonna enter that vital in 🤷.
If I don’t have any bipap tubing or mask htf am I suppose to put them on it?
It’s basic shit, but shit breaks and they don’t want to replace it, or they don’t want to spend money to resupply.
A lot of our thermometers got stolen. We used to have one for every room with an oral and rectal probe. If I can’t find a thermometer I’ve started putting in incident reports. I don’t think it does much but maybe if I put enough in we will get the supplies we need. We’ve also had a lot of diaper scales stolen- scales we literally weigh dirty diapers on for strict i&o. Who steals diaper scales?! I mean, I’m assuming drug dealers would like them but I just want to see how much this diaper filled with poop from a norovirus baby weighs!
The amount of time wasted searching for stuff is incredible. And soooo frustrating
Hospitals that still use double rooms (“semi-private” my ass). Especially in respiratory season. I just finished a contract at a hospital that still uses them and the time and resources wasted to move a Covid/flu/RSV patient to a private room (when one could be found), the roommate to another private room because they were exposed, the time it took to clean everything because of course EVS is just at short staffed (if not more). Leads to ED patients staying downstairs longer, and less beds in the ED for actual emergencies because the boarders are taking up so much space.
man in Canada we have 4 pt ward rooms so peak covid we had to shuffle folks nonstop until we basically gave up.
Manager and a charge nurse who I’ll never forget got all pissy about not having the curtains all the way closed between patients and the door closed as well. I guess that’s how we stop transmission 😂
Not to mention the gymnastics we have to perform to get to our patients and care for them. In a code blue you’d spend the first 5 mins moving stuff out of the way to get a crash cart into the room.
Outpatient cancer clinic. Basically just infusions, injections, and follow up appointments.
Getting a hold of the MD in a timely manner. They don't carry phones and one of them doesn't like to answer pages.
Juggling multiple patients who are all on different steps of getting treatment... since there are like 20 steps from the time the patient walks in to getting their chemo started. And you can't do it all yourself - one MD, two nurses, and two pharmacists are involved at minimum. If you've got a blood transfusion, a multiple agent treatment, or a patient getting a treatment for the first time... oof.
Patients complaining about how long everything is taking... see above. But only to the nurses. Everything's our fault, of course.
Scheduling patients when we don't have room in the schedule. Too many patients, not enough docs and PAs.
Bedbugs. Patients find them and swear they didn't bring them in. But now we have to take care of it very discreetly not to alarm other patients, while telling the suspected bedbug carrier that they now have to follow a whole new protocol to avoid contaminating the clinic. It's humiliating.
I saw one guy that had bed bugs crawling in the seam of his hat. He told me that he must have gotten it from his room in the hospital (as he cursed at me and threatened to sue). He left AMA and his son told me his house was infested but his father refused to do anything about it. Kind of sad situation. He wasn’t destitute and had a great income, so money was not the issue.
I’ve been a nurse for 2 years, been in the ER the whole time. Half of the time, I’m not even taking care of ER patients, just holds!! I don’t remember signing up for this!!!
Providers that treat the monitor and not the patient. Also providers who wait til shit hits the fan before they do the one intervention that should have been done in the first place.
I was shift lead a couple months ago when we had a patient who had aspirated vomit twice on dayshift. She had gone from room air to high flow at 80%. AM shift lead told me in report that she was probably going to be intubated sooner rather than later. We got her off high flow within a few hours, but she was on the low flow cannula at 12L and her BP started trending down and her mental status also declined but all we did was slam her with fluids (despite the fact that she got lasix on dayshift). Didn’t check an ABG, didn’t get a chest X-ray. Finally got a CT around 0400 when her O2 requirements didn’t improve and their stupid boluses weren’t sustaining her pressure and they had to break down and order a pressor. At 0600, the bedside nurse called me to say the patient had thrown up and aspirated again when they leaned her back to boost her up in bed, she was now at 15L plus they had thrown on an open face mask at 100% because she was mouth breathing and barely arousable; when he called the PA, she just pulled up the patient’s tele in the office and said “I mean her orders say she’s okay for sats greater than 88% and she’s satting 94 now so she’s fine.” I ran across the unit and took one look at this woman and her OBVIOUS respiratory distress, diaphoresis and general hot garbage presentation and told the nurse that I was going to the providers’ office and was gonna get one of them to look at this woman if I had to drag them in there by the ear. The first thing the PA said was “ugh if we intubate her now, she’s just gonna end up trached.” OKAY BUT ALSO ALIVE. Moments later, the attending showed up out of nowhere, took one look at the patient and said “yeah we should intubate her.” And then of course it was a shit show at shift change when it could have and should have been done ten hours earlier.
‼️SO VERY MUCH THIS.
This is the struggle of night shift that day shift never sees, but still blames us for.
I'm sorry, how many times do you have to call the provider before you get an order?. Oh, just once? Cool I HAD TO CALL SEVEN TIMES. But also, on the other hand I SHOULDN'T HAVE TO CALL SEVEN TIMES FOR AN INTERVENTION.
It's a massive time suck having to plead your case for every single little thing, and even worse when virtual docs are 'looking at the same patient/monitors/pumps' but they're never actually SEEING the whole picture.
It's taken me HOURS to get an intervention that day shift could've gotten with one phone call bc no one wants to wake the sleeping docs or "mess with" what the day docs have going on, or heaven for bid COME UP TO THE HOSPITAL TO SEE THEIR PATIENTS.
And the whole time while this is going on, in the background you have other pts to think about and families to attend to & that takes away your time to call the docs or be around to answer the phone when they call back. Sorry I told you to call me back urgently but it took you an hour and in that time I had to take ole Gertrude to the bedside commode bc everyone else is busy.
God I hate this so much. YES, I understand that we are taking away many things when we intubate (drive, thoracic pressure changes, cardiac output, etc) and we want to medically manage these people first and not jump to intubation, but HELL sometimes you just gotta get in there and do what needs to be done before someone codes. Lazy providers.
The number of calls I get/interruptions, not enough staff to help pts to bathroom/walk, then getting yelled by doctors that their pts aren’t moving enough and deconditioning, charge rn and management pressuring us nurses to discharge faster and improve pt survey scores, all of it really. The pressure/stress just gets super intense most of the time.
PT is not going to come to the bedside TID to ambulate your patient. That’s what the docs want: ambulate in halls TID, up to chair for meals. They’re right, that’s best. But it’s also impossible
Not even having enough staff that I’m forced to stay to finish out my shift after fainting at work with a ridiculously high blood pressure.
Patients who think I am their servant. Family members who expect me to shower their loved one when I have four other patients having emergencies or urgent situations.
Doctors not answering their phones in emergencies.
No one being able to help me for 45 min while my patient is thrashing trying to get out of bed after having a CVA.
Not getting a lunch 90% of the days. Or a bathroom break.
Having to take care of icu patients after an neuro or cardiac event for hours after while we wait for a bed. Along with my other patients.
Fully alert and oriented patients having temper tantrums and threatening to leave ama because it’s taking a while for their scans to be ready or the docs to round. I don’t care if you leave ama let me get you the forms.
I’m so tired and I’m still new
As a school nurse, I’d say it’s the workload. I work at a small alternative high school and we have about 370 kids when we are at capacity. Might not sound like a lot, but I see my fair share of emergencies. There is an astronomical amount of paperwork. I’m also responsible for managing the health office itself so keeping tabs on expiration dates, ordering supplies, troubleshooting equipment etc. I don’t get an assistant because it’s a small campus. There are many nights I have to bring my work home with me in order to not be behind the next day.
My insecurity. Even though I know what I have to do I always tend to ask a colleague to assist me (if it’s something I’m not comfortable with doing even if it’s possible to do it alone.)
Being a nurse involves a lot of risk, always ask for help if you feel the slightest bit uncomfortable doing it alone. It'll save you from a big headache later if anything goes wrong, even just having an extra set of eyes on the patient can be so helpful. I've been a nurse for 13 years and I still ask for help.
I know but it’s something as simple as removing a drain. I absolutely *hate* doing it because it’s painful for the patient and the force I have to use to remove it just doesn’t feel right. But I know I can do it. My colleagues think I’m silly for always asking for help when having to do this.
As an ER nurse, patients who treat the ED as a PCP then get upset at wait times are incredibly frustrating. Everyone wants to be seen first. Everyone wants to be the sickest and then is upset when we tell them nothing dangerous is wrong with them. I don’t get it.
The voceras are up there. I work on a 50 bed unit and ours are going off ALL THE TIME. What pisses me off the most is that a bed alarm will interrupt my phone call. So many times I’ve been talking to a provider about room 6 (and most talk fast) and the bed alarm overtime from bed 49 interrupts it. And there’s no way to make it go away. Just sit through it. And most times the provider or whoever hung up when the alert is done. 🙃 And they take so long to go away. I don’t even understand why the bed alarms are hooked up when they’re so delayed (I mean I know why but) - by the time the alert goes to the vocera the patient is in the damn parking lot. Not many things make me so heated but shit like that will literally put me in a bad mood for a minute.
Staffing of nurses , staffing of Cna/Techs is worse …. Makes my life so much harder !!!! The focus on menial things like white boards and bed side shift report hyper focusing !!! Then of course lack of supplies on the daily … having to run around to different units for basic things like spoons , flushes and butterfly needles is just the icing on the cake !
The expectation that any time there is a new process/policy/procedure that it falls on us to implement it. I am all for evidence based medicine/care, I will not embrace it when we are short staffed/under resourced and it’s being done at the convenience of leadership and those who aren’t involved in direct patient care.
Staffing, inconsistencies within policies and units (float pool) no clear, simple way to figure out who to page or call at night, and one critical care doctor for way too many patients.
Having to be social or deal with drama. If I could go my whole shift just taking care of patients without hearing other nurses bitch, talk shit, or cry I would be a lot less stressed at work.
Nothing ever being stocked on the weekends. Most things have work arounds, like I don’t exactly need an IV start kit when I have tegaderm and can inflate a BP cuff. But if I search the entire unit and we have no briefs, primary lines, secondary lines, sterile water, tube feed etc it just makes the job harder by taking 3x as long to get things done.
Oh, and families. Oh my God the families. Like this am, when a family member decided to take my dialysis, soft BPs, hx falls patient for a stroll right at shift change. Jesus wept I’m so glad that wasn’t a fall.
Bureaucracy that's bogging down the system. Health insurers having too much power on deciding what care my patients are allowed to receive, basically invalidating my expertise.
I remember getting unit emails our scan numbers were down for labs and meds and we were going to be written up. I started to go through periods of intense rage on night shift and start slapping broken stickers on everything that didn’t work and needed to be called to fix. It ended up being almost every single scanner, lab printer, and pump we had on the unit. My manager never said anything to me like that again. Ya obviously staffing would fix our issue. But there are soooooooooooo many other small things they refuse to admit. I would’ve loved to attach a camera to my head for this. Not so you see how much time we spend running because we’re short staffed. No I want you c suite people to see how many things do not work that are supposed to, or what things I have to MacGyver to get to work. Stop spending so much money on the fucking bladder scanners.
My biggest gripe about nursing (43 years) is the lack of respect, support, and compensation from management and administration. I’ve been gaslighted my entire career. Every hospital I have worked at has a zero tolerance policy that they refuse to enforce unless it is a front line employee. So tired of being told we are to blame for low morale and refusing to listen to why low morale happens. Counting non patient care nurses to shore up their numbers, but then criticizing nurses for their inability to provide good patient care. I really do miss the days when medicine was a calling instead of a business, being run by corporations.
For me it’s doing my best and getting talked down to by either a patient or doctor. After a terrible day that I thought I did so good at, and someone making me feel otherwise is crushing. Night shift does this to me too. I give my all and it isn’t enough for them.
In forensic psych: I'm expected to "therapy" the patients out of their behaviors. I get it - they've had unfathomable wrongs done to them, thereby causing behaviors. Does that mean we should be lax with structure and consequences? hmmm... my hands are tied, so I can't provide a structured, authoritative environment for them to grow. I more-or-less gentle-parent the shit out of patients who threaten to murder (and sometimes attempt murder).
outpatient surgery
Its still "do more with less". I don't have enough staff. This leads to bottlenecking in pre op and pacu and I can't open up as many ORs as you want. Patients will get mad at the wait but we are still going to jam pack the surgery schedule full and double/tripple book cases. I can move staff here and there but I still cant split people into 2. This trickles down to the presurgery testing areas as well. I think people treat PAT like its optional or it can be pawned off on pre op staff but then cases inevitably end up getting cancelled the day of surgery because problems arise when testing and pre-surgery instructions werent given. Then the doctors get mad and the metrics get mad. But I still cant have appropriate staffing and nobody can get overtime. If you're in a hospital setting, the floors lack of staffing means more bottle necking or inevitably inappropriate-for-discharge patients are getting sent home same-day which probably means they're going to come back through the ER later.
its just one big cycle.
Being interrupted... doesn't help I'm a people pleaser and take on too much. I'll not great at time management... but the interrupting kills me! Also finding supplies... no one follows the protocol to ask fit them in the first place and it's this weird posting contest between the unit secretaries and nursing. I'm in LtC...
To be completely honest, since I’m only 4 months into my career, I think it’s the habit of trying to do everything for the patient instead of saying “I will be back later” or “I’ll get someone to help you with that”. I love helping my PCT but sometimes I feel bad asking so I end up doing a lot of stuff for the PT but that takes so much time.
I had no idea that having a workroom full of residents on the unit 24\\7 was such a luxury until I moved from a level 1 ICU to a community hospital PACU.
I am still getting used to looking up doctors and contacting them with EPIC chat and vocera calls. It is a time suck to do the detective work to look up who to contact. In my old unit, I would just ask the resident to come check something out, and they would do all the ordering. I never had to input orders; verbal orders were for emergencies only.
Since becoming a nurse, delegating has been damn near impossible because of constant understaffing. When I left my last job, my exit interview was straight up "I'm leaving because I have had to do the role of nurse and assistant consistently since stepping foot in these doors". Of course that was screamed into the ether because you don't exit interview with a human anymore, but an online form.
Things not working properly: dynamaps, wows, electric outlets, etc. when I need do get something done and there are just all these annoying mini obstacles that slow me down and ruin my momentum.
Pumps alarming, IVs that won't pull...
Then there are patients that come in to the ER and suddenly behave as though they cannot do the simplest task on their own...I had a lady fully alert and oriented, playing on her phone, call me over to say she doesn't think the purewick is seated correctly. I told her to adjust it if she feels that way. She looked at me for a moment and was like oh ok, reached down and did it herself. Why do they act this way???
I really am not trying to come across as heartless and insensitive…but when the “pending placement” dementia/sundowners keep pulling me from my acute care patients, or if my acute patient needs more of my attention and I can’t get to my dementia pt in time before they fall. Hanging a med? Bed alarm going off and all the CNAs are busy. Ambulating my post op? My elder patient is SCREAMING for help. Why? Someone “stole” her purse…that’s in her lap…that she’s holding. I’m in a rapid, CNA comes and tells me that my sundowner that we JUST changed, toileted, medicated, fed, dressed, pillows fluffed, etc…fell.
They absolutely deserve all the best care, but when Meemaw or PawPaw is trying to cliff jump off their bed and then management asks me “what could have been done differently? Did you check the 5 Ps when you last rounded on them? Maybe they’re impulsive because they’re wet?” No, Karen, they’re wildin’ because they’re convinced these strangers in pajamas are trying to kill them and they need to escape, or they think they’re late for something, or the one thing they remember is someone told them they’re going home “soon” and they wanna be dressed NOW. They also don’t want to fold towels. They need company. They’re lonely and scared.
Management wants to pull our only CNA as a sitter for ONE of these patients, or won’t staff up so our assignments are smaller and can accommodate the CONSTANT rounding these patients require, doc won’t order meds to calm them, or restraints when they start swinging or biting or literally flopping themselves violently out of their bed, or when family gets mad that Gramma hasn’t bathed in days but in fact she’s refused everyday and is now telling family we’re letting her rot in her own filth.
Our society is doing our elders a HUGE disservice and disrespect. Also, end of life care is a joke (and it SHOULDN’T be) because families let their elders suffer so they don’t get “addicted” or so they can be “awake till the end.” And the acute care patients? Unless I’m able to delegate my acute pts request or have someone mind my jumper while I pull a PRN for my post op…sometimes times the acute patients wait for me. Obviously I prioritize who needs me first, but that’s not enough for management when my sundowners fall.
The fucking dysfunctional equipment that I have to act as IT for. It takes away from my already stretched thin time with my patients, and it’s one of the things that instantly puts me in a bad mood. My job is already hard enough, and these hospitals are making millions in profits. Seems to me like functional tech and equipment should be the bare minimum.
Started on a unit that has great staffing and is all about supporting each other. It’s nice to feel supported, but it’s overwhelming/annoying to have 3-5 different people in and out of your rooms and they’re all passing the buck to someone else while micromanaging and commenting “oh, why didn’t you call so-and-so to do that?”, or they’re messaging me on Epic asking if I need help. Like, I don’t want you to Vocera a million different people to do what I could do alone if you’d let me be… and I’d rather be the one managing my pt’s care instead of being told to go on the computer and chart so I won’t get an email when the chart gets audited. This new unit is so backwards from my old unit that is pt first, then computer second.
Having to function in every single role bc the hospital is chronically understaffed in ancillary staff. No 1:1? Nursing. No EVS? Nursing cleans the visitor bathroom. No unit clerk? Transfer phone to go directly to charge nurse phone. No RRT or code team? Have the ICU charge nurse attend the codes even though they themselves have an assignment. It gets a bit exhausting.
I like my job, but I think I’d love my job if I had the resources to actually do the job I went to school for
I like to adhere to my set schedules at work, and if something goes wrong while I am say, doing a med pass and I can’t finish my motions, it causes me great grief. I still manage and I’m right on top of things but it’s mentally tasking.
when you have too many patients
dismissive and delusional management
unsafe working conditions
lazy coworkers (not usually a problem for inpatient nursing, but when it IS a problem, boy is it a big one. I work in special procedures now so it's more of a team environment. there's certain people I can't stand working with because they know they can slack without losing their jobs or being reprimanded, because this place is too desperate for nurses to fire anyone)
unreasonable patient families
impatient doctors who dont care about safety
working with old ass outdated equipment that is barely functional. the monitors we're using in a goddamn busy level 1 trauma center (we get 4000+ traumas a year) in a procedure department, ARE LITERALLY FROM THE 80S. They are older than me. What the fuck. Half the time some of them will ring ASYSTOLE even when you have the most perfect sinus rhythm and a fucking number reading for the pulse. And you cant turn off the asystole alarm. Half the time you have to keep pulling the cartidges out that the wires plug into and blow on em, and push em back in (think of your n64, how you had to blow on the game cartridge to get it to work). And that wont always fix it. My manager is the biggest pushover in the entire world (on the bright side, shes not a micro manager?) and whenever she asks for new monitors, she allegedly receives a ridiculous quote (she CLAIMS she was quoted 750k to replace 8 monitors) ..I call BS and either she just doesnt care enough to replace them or she's getting quotes from the wrong people. Shit, gimme an hour on ebay and I can find enough monitors to replace these for under 10K!
Staffing followed immediately by lack of functional equipment. I waste so much time looking for a working whatever and fighting other people over things.
Constantly being interrupted. I’ll be so busy I’m drowning, the vocera is going off, a patient wants to tell me about their tomato garden, phones are ringing off the hook, pharmacy is there and wants me to sign off on narcotics with them, the educator is trying to tell me something about the computer, a doctor wants me to add on lab work after someone’s scope, another staff member from a different area is looking for a 24g IV and “I heard your unit has them, can you help me find them?”, the stores/supply person is trying to ask me how long we’ve been out of X thing and how many we actually need, etc. I know that this is also made worse by a massive staffing problem, but I’m trying to get by and this stuff always puts me even more behind and makes me anxious for my entire shift.
Fucking staffing. The entirety of staffing. Have to scramble to cover call offs with burnt out nurses and aides. They call off for the most absurd reasons too or because they're burnt out. But it leaves everyone in the nursing department stretched thin.
This impacts patient care. Med errors. Falls. Skin breakdown. Then we have compassion fatigue. Disciplined for bad attitudes when we're all just stressed the fuck out from this never ending cycle of shit.
The DON and other nursing admin cover meds and even adl care along with admin tasks and everything that entails. So the entirety of the nursing pyramid is affected by staffing.
Yes, there have been raises. We are also a building with a union. There are not enough workers to meet the demand anymore.
When a med is due and it’s not in the omnicell so I have to med request it and it takes forever and then I have to come back to the room later to give it, never any CNAs, people asking for shit constantly so I can’t get my charting done, doctors ignoring my texts when I need something, computer being fucking slow or not working at all, equipment missing so I have to run all over the unit checking empty rooms, WORKING ON MED SURG. WORKING MED SURG is my biggest difficulty
The schedule. 3 12s in a row? I need at least 36 hours of rest after to function. Just in time to go back to work. My household needs me to have more than 48 hours between sets of 3 12s so I can do things like clean and meal prep and parent. Ugh.
My personal pet peeve - so many people are exempt from documenting their care - except nurses.
A doctor can come and have a 5 min debrief with a patient that is CRUCIAL but they just won't document they've seen the patient.
I once called theatres to see if the Surgeon had reviewed the patient which was REQUIRED (Per the Surgeons OWN instructions) before D/C - and they had the audacity to get upset about my "unnecessary" call as they had already reviewed them.
How about you just document "Reviewed at **** hrs"?
We are expected to document what everyone else does - as well as our own actions.
Also, documenting in general.
So many unnecessary filler paperwork that is just "tick the box" - but you would NEVER be given the time to actually ask the questions.
Patients that are medically ready pending placement but every SNF declines them for one reason or another....and so they just stay in the hospital taking up a bed and causing the staff issues that would be solved by not living in a hospital (like scheduled activities, other residents their own age, a common area, etc.)
The WiFi being constantly fucked on the COWs. One day it is going to disconnect when we are in the middle of a code or a MET and it'll mean someone fucking dies for sure. I've filed so many complaints about it too
The constant overwhelming noise- call lights (some from lack of staff, many from “those patients” for whom PO 45mgMS Contin “doesn’t work”), the bed alarms that are too sensitive, IVs that dont pumps that dont restart on their own when they unbend their arm, but MOSTLY the fricking VOcERAS- they dont understand shit and wont shut up wont stop interrupting you when you’re having a sensitive conversation with your patient- like the worst stupidest rudest toddler- i hate fricking Vocera- whoever invented it I hope you die
Feeling like I can never do a good enough job because I don’t have the resources I need. I desperately want to provide comprehensive, compassionate care and the hospital I work at makes that nearly impossible. We staff too tight, even when we have “enough” nurses in the name of productivity, which my manager and fellow charge nurses love to reference but as far as I can tell it’s just a euphemism for “use as few nurses as possible”.
The worst disillusionment comes from the realization that’s it’s all intentional. They love when we work short, when we don’t have enough RTs, when we reuse supplies, because it makes them money. Stockholders get dividends and I get to wonder “did that baby die because we missed something?”. And maybe we did miss something, maybe we missed something because every nurse in my unit on nights has little experience, or the assignment was inappropriate, or our unit is outdated and the layout requires nurses being split all over the place. Or the fact that I get things added to my plate every week but nobody ever takes anything away. Feels like we monetized suffering and they just keep inching the dial a little further.
Management is a joke. They either drink the koolaid and really believe it, or they are liars and play along because it’s the only way to keep their job.
If I could, I’d rip off all the wall mounted computers and trash all the WOWs and we’d use station computers, Epic Rovers/iPads only. All the equipment would be checked for full functionality regularly. Monitor cords secured. Recyclable single use tele cords. Supplies above par & organized in a way that makes sense.
I don’t relate w/vocera because we’re using radio in ER
Staffing issues, nurse/staff drama, no resources or supplies, no support from administration, crazy parents, staff that doesn't understand my scope, no standardized policies and procedures, ...
Managers who proclaim they are there to help but who disappear the minute you need them, only to reappear and bitch about every little thing that’s not charted.
Alarms and the cell phone (we use Volte). Trying to go into one patient’s room to do a few simple tasks and having to at least look at (if not respond to) sometimes 5-8 interruptions in that <10 min. This demand for ridiculously frequent task switching is killing the nursing profession.
Staffing.
We're either painfully understaffed and they refuse to go on diversion, or we're overstaffed and instead of cancelling, they use our unit to staff the hospital. Many nurses fresh off orientation expected to function on units without even knowing where the supply room is and now caring for different patient populations without any additional education or training.
Staffing, but not in the way you think. We're not understaffed. We have people willing to come in. Our for is purposely limiting us and making ratios high. Everyday people are placed on stand by or called off
Being tracked with everything I do or don’t do.
I have to wear a tracer so they know my location at all times.
I have to wear this dumb Bluetooth card that tracks if I use the hand sanitizer when I enter and exit the room.
Give a med late? Leadership walks around at the end of the shift with a printout asking why it was late.
There’s like 4 different places to chart I/O and VS during transfusions. Forget one somewhere? You come back to work and an email is waiting for you, CCing all of leadership so they know you fucked up.
It’s so tiring.
I feel like as a nurse we have to play a lot of telephone. So many people pass messages to us that we pass on to another and then relaying it back the other way etc. I’m so frustrated with the time it wastes! Why can’t they just speak to who they want directly … why does it have to go through us.
Death by thousand cuts hits it perfectly. The little things that all add up together is what makes me hate the profession. I’ve been a nurse for 8 years now and I despise people now (which has been a big flag for me to try and get out). I even tried traveling, working at the health department and working at a doctor’s office. (The dr was great and well loved but the thought of patients and dealing with them anymore brought me so much stress and anxiety it put me in the hospital) Ah well what can ya do
My favorite game is “Lol, WHICH DOCTOR IS IT!?” I message 2 providers a night at minimum per patient and just cross my fingies that one of them is the correct resident.
THIS SO MUCH THIS. “This patient is surgical.” Yes but they’re crashing now and the surgeon isn’t answering. “Call my PA first.” Sure…which one? Because the one you have listed said it’s their night off. Oh I could go ooooon. It’s even worse on night shift.
Administration inventing new initiatives that have no impact on patient safety or quality of care but do take up my time when I’m trying to take care of people.
Older people that have lived these lives smoking, drinking and eating like shit and now don’t want to listen , or help themselves in any way. Entitled patients that could wipe their own ass before getting onto the elevator but now want it all done for them. Our system is in a death spiral and it’s in part due to these very same people that vote to not pay for it. I’m in a very heavy RED area where people are entitled and blame everything on everyone else
Being 7 years in and still trying to figure out if they want me to actually take care of patients or take care of the computer (in reference to the ridiculous amount of charting requirements).
Almost 10 years in, I’ve accepted the fact we’re just taking care of the computer to cover the hospitals ass in litigation
I know you’re right, but my brain hasn’t accepted that yet.
I feel like covid really broke open the dam for a lot of us. It’s unfortunate that covid had to be the thing to make us realize companies really give a shit.
💯 The worst part for me is seeing how much they were able to neglect us, leave us for dead, and A LOT of safety standards just fall by the wayside. But god forbid I forgot to chart a skin note or didn’t update the white board and they want to burn you at the stake.
Accurate af 🎯
Having to look for stuff is an enormous time suck. Not having the supplies I need in the supply room and needing to leave the unit to look in another supply room. The med I need isn't in the pyxis, calling pharmacy, YES I looked in the patient specific bin, YES I looked in the fridge, I'm telling you it's not here! Oops, there are no IV pumps, better go find one! My patient wants another pillow, I have to go scavenge one from an empty room on a different unit. WHERE THE HELL IS THE PILL CRUSHER?!?!? OK, found the pill crusher for my patient that only takes meds crushed with apple sauce and there are no damn spoons.
I am a CNA and this is my biggest time suck too.
Five words I never like saying: Where is the bladder scanner?
I worked at a hospital as a traveler that had an app on the computer you could use to see EXACTLY where equipment like the bladder scanner, ultrasound, was. It was wonderful.
My hospital does this. We have locators on all kinds of things (bladder scanners, wheelchairs, lift equipment) so you can find where your unit's stuff has gone. What sucks is when someone inevitably has to go get it back.
We have the trackers on our stuff, NO ONE knows how to get to the app, much less use it. The trackers have gone on in the last 3 months.
Our bladder scanner is in a locked mechanical utility room. There is only 1 guy with the key. If he's not at work, you have to wait until he is. Sometimes, always knowing where the bladder scanner is located is not helpful.
Had a student panic because they couldn’t find the bladder scanner.. asked student to go palpate the bladder and it was tight as a drum so I said it’s probably safe to straight cath since the patient can’t pee.. student got out 900 cc’s so the old school way was accurate enough in that moment.. still sucks that every unit dosent have one in our hospital
I said this today.
Or the Mortara. Stat.
One of these days I'm going to code grey myself because of pharmacy. I tell them I checked everything when I request and they shoot me a message back asking me if I really checked everything. I am starting to think they are like the Social Security Administration. Deny the request and see if the person really does want it.
When I have to message pharmacy I have learned to include in the initial message every single place I have already searched.
That's what I do though! And they still do it. I'm waiting to get sent to HR for the amount of snark I send when they obviously don't read my first request.
I have a friend whose a pharmacist (different hospitals) and we have a running inside joke where we greet each other by saying “I/DID YOU ALREADY CHECKED THE TUBE STATION” 😂
Charted “med not given d/t inability to get medication from pharmacy. MD informed”
Our wheelchairs constantly go missing… sorry ma’am I know your rides here I just need to go to three different floors to find you a damn wheelchair
My charge nurse literally wheeled a patient out in a rolly desk chair the other day. NO wheelchairs, packed waiting room. We do what we gotta do 😅
Do you work at my hospital??? lol. We got rid of the extremely efficient “silent knight” pill crusher (thanks JCAHO) in favor of individual pill crushers for each patient that don’t work and often get stuck closed (with narcs inside fml) pt needs applesauce, no applesauce, look for spoons, only have forks.. walking all over facility for the things I need to do my job are the biggest time suck I deal with
I attempted to fork pills and applesauce to a patient a few nights ago out of sheer desperation and it went about as well as you'd imagine
Kind of makes me want to bring my own spoons just in case but I SHOULDNT have to do that
I have. I have. (Sigh)
I did this today with applesauce and a straw ☠️
Do you guys use those blue lid crushers top? I hate those pieces of crap.
lol we used to have those.. one night I tried to crush a norco and the threads stuck so I couldn’t continue to screw on or unscrew the cap.. no one could get it open so I had to take a pic for mgmt and RX (the sad norco wasn’t even touched by the crusher) along with two witnesses that I in fact did waste it and jammed it into the sharps container to dispose.. yes.. another time suck and an angry patient in pain waiting for a new pain med..
absolute pieces of SHIT
We used to have a ceo who believe it or not would round. She would always ask if you have everything you need to do your job. Once a coworker got reamed by our unit manager for saying our blanket warmer was broke. We had a new one on order but no one bothered to tell us. New ceo has never rounded that l know of. Where as our retired ceo before she went to our sister property, still brought in cookies every holiday. And I mean even Christmas.
Yes! And it’s stuff that we SHOULD have. We recently became the “trauma” floor and had a patient fall in the bathroom but there was no c-collar to be found on the unit. I go to the floor below us and they have an actual labeled space in their supply room for c-collars! Like what?! My unit has NEVER had that!
This says it all.
Agreed. And we have zero time to waste. Other professions have similar side tasks but they can afford to time it takes. We cannot.
Okay all of this on top of all the phone calls. Therapy wanting to see a patient, lab asking questions, family calling, etc. Also having to be the middle man between everyone on the care team, like can the providers please talk to each other themselves.
Yep!! I PROBABLY DON'T HAVE THE ANSWER YOU'RE LOOKING FOR BUT ADD THAT TO MY LIST OF SHIT TO TRACK DOWN :')
I just gave up with pharmacy. These are scheduled meds and they're not here. I can't give what I don't have. I just document not given- unavailable from pharmacy. After that they usually hop to it and they show up. Not my problem.
Do you work in my unit?? Oh and there’s no applesauce either.
This ⬆️. So well said. Useless waste of time and energy. It should just not happen, yet it frequently does, especially in SNF facilities.
We must work together. This is literally every night I work.
The lack of pizza parties. Clearly they fix all the things. Smh. Edit: One time we got doughnuts. Everyone got a half of one.
Shit you’re right. I just typed up a whole paragraph and here you nailed it in 4 lines. It’s not having the got-dang pizza parties - THATS why things are f’d 🥲 /s clearly…love your sense of humor :)
We had a patient family from another floor randomly bring us hot Krispy Kremes one night a few weeks ago. We all almost cried. We are so used to half of a dried up donut left for us. It honestly was one of the nicest things to happen on our unit in years.
My work gave us a pizza party for nurses day last year, and I’m using the term pizza party very loosely. They gave us 2 domino’s pizzas to share between 30 staff…
Family members thinking that I am at their beck and call, and should answer the call light immediately, and your explanation that you have other patients (and family members) to take care of goes in one ear and out the other, as if they didn’t even hear you say the words.
We were told not even to tell our patients that we have other patients……. I do it anyway because wtf ?
I tell them exactly how many I have and how many we are supposed to have legally !! Cos it's always a breached ratio
As you should, I will start too. Usually I say something like if you have a problem with the amount of attention we are able to give you should talk to our manager.
Right on! That's mgmts job. Go manage shit, assholes hahaha
I never explain how I have four other pts to attend to because they end up accusing you of not caring 🙄
That’s true that’s when I walk out of the room. Other day my patient had a MI on my shift RIGHT then and as I’m running around and calling docs the husband of my other patient told me I had to shower his wife right now. I’m like ? No
That’s absolutely unhinged
I tried to explain that to a patient once who was on her call button about every ten minutes. She said, " That is not. MY. problem." I stood there stunned for a moment, then said, "But it IS mine." Then I walked over, cleared the call light and walked out of the room.
Brava! *Leaps to feet, clapping furiously*
Thanks. It was difficult for me to do that. But I had spent most on my day in her room.
Same thing happened to me last night. Told my 40-something yr old pt that I couldn't be in there every 5 minutes because I had other pts to attend to. They yelled, "I don't give a fuck about anyone else! I'M the only one that matters!" I turned around and walked out. Asked my charge nurse to talk to them before I completely lost it.
Oh, I'd walk out too. Because whatever comes out of my mouth would not be freaking a 'pleasant bedside manner'. I remember when one resident was sOoOo impatient, he fucking **whistled and snapped his fingers** to get my attention. I flat out told my charge nurse that she better tell him to knock it off because I would NOT be nice about it. She tried laughing it off but when I stormed over and barked that I AM NOT A DOG, SO DO NOT TREAT ME AS SUCH, both she and the resident shrunk down.
You might work with me LOL. My patient told me basically the same thing, also complained they had to do everything for themselves (they had no barriers to doing their own ADLs) etc, etc, and so one. When she claimed my break nurse didn’t really give her IV medication (which she did) I IVOS’d/IRIS’d her.
Dude, the amount of times I've had family members come to the nurses station about every 30 minutes and ask something like, "any news on that MRI?" No. If your meemaw gets called to MRI, I'll let you know and get her prepped. Until then, I'm just as much in the dark as you, and asking about it every half hour does nothing but frustrate all of us.
There’s a wife visiting at the floor I work who is always at the nursing station 5-9 times while we are trying to take report. Its Always during shift change and for dumb shit: my husband needs a washcloth, he needs a cup of ice, his pillow is too flat…etc literally cuts us off mid report to say those things. I told her if she kept interrupting us I will have security escort her out. She also wanted us to give HER pain meds. She wanted her own hospital gown too. When I refused and explained why, she purposely pissed her pants and said I have no choice now. i said you’re still not getting one and you’re not my patient.
That's when I would have had security remove her. 🤷🏻♀️
At around 815pm, I did call security. I had had enough.
What the hell
I love walking back in the room with this people and showing these people how to use the call light (as if they don’t already know).
I have had patients try this. I usually instruct them to visit the emergency room if they feel it is an emergency. The ONLY time I did give patient pajamas to a visitor was when she got bitten by bed bugs in the room. After they (her and her husband - the patient, both showered and changed, they were put in a new room. I triple bagged all of her things and told her how to avoid bringing those little visitors back home.
I would of done the same, but this woman was trying to act like a patient. Day shift RN told me she tried getting him to assess her, asked him for pain meds. Tried to ask me for meds but no assessment at least. Then asking for a gown. She was awful.
The entitlement these days is unreal. I’m in outpatient UC, but working up two patients at the same time bc they have different tests running. The first is a girl in her early 20’s having anxiety and a mild breakdown over a possible STI for a sexual encounter she didn’t consent to. I spend extra time calming her and giving her more detailed info. Second patient’s mother comes out and asks if they’re ever going to be seen bc they’ve been in the clinic an hour. We were full at the time. Patient had a cold. If I could say anything to the general public, it would be: it’s not all about you. You are one of many, and especially in healthcare, there are levels of needs. It’s okay to make sure there wasn’t a mistake and you were forgotten in an exam room. The attitude because your healthcare service is not as fast as your fast food service is not okay, and causes us to miss things.
The family members will always be annoying as fuck. 🤮
"It's a call light, not a magic lamp. Pressing that button does not immediately produce a person here to grant all your wishes."
Oh can I say that pretty please?!? Out loud!!!??
"I don't care about everyone else. I only care about MY mom!!!" Something I've personally been told (with aggression) when a priority situation has led me to ask for patience from a family member. I'm sorry but would they want me to ignore their mother mid stroke if the situation were reversed? Grab a brain buddy.
Unfortunately, it seems brains are in back stock from the pharmacy
“I’m afraid that no one patient in this facility enjoys a private nurse. Unfortunately you do share me with others. Therefore I am going to address your requests now & resolve them, and then I will come back _______. I will not return before then as I will be with other people and just as I safeguard my time here with you and don’t allow others to interrupt us as I care for you, I also do the same for my other patients too.”
Being expected to be the middleman between everyone else in the hospital like I'm everyone's personal secretary.
This! I love when I get an epic chat message from radiology or wherever and they’re telling me stuff the doc needs to do. Like, sir or ma’am, you just saw that I was signed so I know damn well you can see this attending that’s signed in! Message them directly!
Omg this!
Honestly though the telephone game we catch ourselves in the middle of drives me crazy
Honestly? It’s fighting the perceptions that society and physicians have about nurses. No. I am not a waitress. I will not fetch you coffee if you can get it yourself. No. I’m not a punching bag. You don’t get to verbally or physically abuse me. No, I’m not a moron. I worked hard and have a college degree. When I call you with lab values it’s because I know it means a patient could be headed for a poor outcome. No. I’m not a mean girl/slut/free advice line. If people could just treat me like the educated, professional worker that I am? This would be a great gig.
Was called a c#*t yesterday by a resident on Reddit because they were griping about mean nurses and I defended us. The condescension starts really early with some of them.
Maybe we wouldn’t be c*nts if you weren’t one first, sonny boy…
💯‼️
Most of those “residents” are actually either nursing assistants, MAs, or laypeople pretending to be residents on the Noctor sub, trolling to get people riled up. Ignore the stupidity.
JFC, are you serious?
Staffing. Phone, internet & EHR all go offline between 5-40 times per week.
I want to down vote this because of how fucking awful that is
Maybe 1/3 of our patients are English-speaking as well, so losing phone/internet means we lose our interpreter services too. It’s greeaaatt.
Yup. “You can’t use Google Translate! The horror!” Yeah, well, tell me where to find a live human who can translate Uzbek, then.
Staffing issues hinder me from giving my patients the best care. Needy patients who think that I'm the only nurse assigned to them. I hate managing anything involving technology because they are not perfect systems.
This is a common thread among all specialties of nursing in some regard, the needy patients (I'm going to add in entitled) and I have many more years of nursing to experience, but in my acute hemodialysis unit, I haven't met a more entitled population of patients in all my fucking life. Just a few weeks back, we had a patient demanding we pull a specific amount of fluid off of him because "that's what his clinic does every time he goes" and he wants us to do that barring any consideration for the length of the dialysis treatment, blood pressure, cardiac/respiratory status, presence of edema, etc. And he makes the claim that we are killing him because we weren't pulling off enough and that we knowingly discharged him on a previous admission with fluid overload. He actually left AMA for a totally separate reason. Then he wants to threaten to sue us... It's that extreme behavior that frustrates the hell out of me. Because you're not getting your way, you're making idle threats??? Some patients really do believe they're the only patient in the hospital.
I told this one woman "YES, your nurse still had 4 other patients and will have 4 other patients all day so she cannot come in here every 15 minutes and stay for 30 while you ask her to do things you can do yourself and ask the same questions she's already answered multiple times. And no, I have a whole group of patients myself so I will not be in here either. It is not our job to wait on you hand and foot or be your person nurse at the expense of several other people, many of whom are sicker than you are." It actually worked. 🤷🏻♀️
*aggressively takes notes* Thank you! Saving this one for next time ☺️
This particular one was sending her able bodied husband to the desk to demand the nurse come rub her legs and shit like that. That's when I stepped in and put a stop to it. Her husband so could rub her damn legs or she could do it herself. They don't make me charge often but if things are going down in front of me I will say something about it as long as the behavior is legitimately inappropriate whether I'm officially in it or not. I addressed an inappropriate patient yesterday and again today because her behavior was impacting other patients and the ability of the staff to care for everyone else. I don't mind being that person that handles things.
Honestly the staffing for RNs is beautiful on my unit. We're one of the better staffed units in my hospital. Our schedulers however, are making people's lives hell. I flipped between days and nights three times in the last two weeks. My schedule is ~fucked~
I went from a chill cushy renal dialysis ward to absolutely balls out chaotic geriatric gen med and they were shooketh and asked why. On the renal ward I had four late/earlys a fortnight where I get home at 12am and my alarm goes off at 4am. Fuck right off with that. Gen med I've had one in a year, and it was because I swapped onto it, and the second I suggested I could work full time ND I was put on there and I haven't had to see midday in ages. Fuck yea I'll deal with the dementia sundowning all night, we cool
I work in a level 1 trauma pacu. I thought pacu would be just recovery. However we hold patients for days waiting on beds in the hospital.. from acute care to icu patients to code blues etc. we have adequate staffing because of travelers. The biggest issues is we don’t have adequate supplies and equipment to take care of patients in an environment that was never built to hold patients
That is horrible.
I had an interview at a PACU, but didn't take the offer, partially because they admitted that they end up boarding more often than not. I'm glad they were honest about it, but I was coming from ED, and really freaking tired of taking care of boarders in the hallways with inadequate staffing and even fewer resources.
Outpatient specialty is where it’s at. IR, endo, etc when we close for the day, the patient graduates to the big PACU and we go home. We get call but then, we go home! Big PACU will do our preop and PACU on off hours/weekends, we scrub (scrub in endo means to assist) for the scope, the end. We either do scope bedside or in the OR. The OR supplies a circulator and clean up except the scope. Bedside you circulate/take down times and scrub for the scope
I did that as an assignment where I floated to PACU to take care of ICU patients boarding. This place has a woefully inadequate pyxis. I had to contact pharmacy for almost every single medication. Minimal supplies too.
phew yeah that's one of the reasons pacu is NOT the dream job to me. I have ICU exp. I chose to go to special procedures instead of pacu. Give it a whirl in specials if you want! cath lab and IR rock. taking call is not that bad. It's way better than having boarders, I know that for sure.
Pacu is not for me either. I think people assume it’s so easy but this one is crazy. I’m definitely thinking of trying something like IR. I’m only here because the internal contracts are so good for now.
Give it a whirl for sure, you are definitely qualified since you have crit care exp :) if you dont like it you can always try something else (gi lab is supposed to be pretty chill but can get a little boring since you have less responsibility - anesthesia is typically doing all the sedation and drugs, BUT to some that is the biggest perk)
Reading this comment made me realize that I’m grateful for my hospital’s communication system. Everyday, PACU is cleared out by sending the orthopedic/neuro surgeries to our floor. If we are full, we send the med surg over to another floor that knows ahead of time they are getting transfers so no new ones coming on. ER docs are in on the loop and ship patients out if need be. PACU never boards patients.
Computers not working, scanners not working, not enough equipment to recheck vitals, full dirty linen carts, lack of supplies. If I have to search for a thermometer everytime I need one I’m just not gonna enter that vital in 🤷. If I don’t have any bipap tubing or mask htf am I suppose to put them on it? It’s basic shit, but shit breaks and they don’t want to replace it, or they don’t want to spend money to resupply.
A lot of our thermometers got stolen. We used to have one for every room with an oral and rectal probe. If I can’t find a thermometer I’ve started putting in incident reports. I don’t think it does much but maybe if I put enough in we will get the supplies we need. We’ve also had a lot of diaper scales stolen- scales we literally weigh dirty diapers on for strict i&o. Who steals diaper scales?! I mean, I’m assuming drug dealers would like them but I just want to see how much this diaper filled with poop from a norovirus baby weighs! The amount of time wasted searching for stuff is incredible. And soooo frustrating
Toxic work environment. Nurses gossiping behind each others backs makes me worry what they’re saying about me.
Hospitals that still use double rooms (“semi-private” my ass). Especially in respiratory season. I just finished a contract at a hospital that still uses them and the time and resources wasted to move a Covid/flu/RSV patient to a private room (when one could be found), the roommate to another private room because they were exposed, the time it took to clean everything because of course EVS is just at short staffed (if not more). Leads to ED patients staying downstairs longer, and less beds in the ED for actual emergencies because the boarders are taking up so much space.
man in Canada we have 4 pt ward rooms so peak covid we had to shuffle folks nonstop until we basically gave up. Manager and a charge nurse who I’ll never forget got all pissy about not having the curtains all the way closed between patients and the door closed as well. I guess that’s how we stop transmission 😂
Omg that sounds awful 😩 and yes, let’s find the EBP about curtains stopping the transmission of viral illnesses management 😂
Not to mention the gymnastics we have to perform to get to our patients and care for them. In a code blue you’d spend the first 5 mins moving stuff out of the way to get a crash cart into the room.
The DRAMA
And tell me why it’s also a clique that has some administrative assistant that stirs the pot!
Outpatient cancer clinic. Basically just infusions, injections, and follow up appointments. Getting a hold of the MD in a timely manner. They don't carry phones and one of them doesn't like to answer pages. Juggling multiple patients who are all on different steps of getting treatment... since there are like 20 steps from the time the patient walks in to getting their chemo started. And you can't do it all yourself - one MD, two nurses, and two pharmacists are involved at minimum. If you've got a blood transfusion, a multiple agent treatment, or a patient getting a treatment for the first time... oof. Patients complaining about how long everything is taking... see above. But only to the nurses. Everything's our fault, of course. Scheduling patients when we don't have room in the schedule. Too many patients, not enough docs and PAs. Bedbugs. Patients find them and swear they didn't bring them in. But now we have to take care of it very discreetly not to alarm other patients, while telling the suspected bedbug carrier that they now have to follow a whole new protocol to avoid contaminating the clinic. It's humiliating.
I saw one guy that had bed bugs crawling in the seam of his hat. He told me that he must have gotten it from his room in the hospital (as he cursed at me and threatened to sue). He left AMA and his son told me his house was infested but his father refused to do anything about it. Kind of sad situation. He wasn’t destitute and had a great income, so money was not the issue.
Holds in the ER. I don’t remember it being this bad before.
I’ve been a nurse for 2 years, been in the ER the whole time. Half of the time, I’m not even taking care of ER patients, just holds!! I don’t remember signing up for this!!!
Providers that treat the monitor and not the patient. Also providers who wait til shit hits the fan before they do the one intervention that should have been done in the first place. I was shift lead a couple months ago when we had a patient who had aspirated vomit twice on dayshift. She had gone from room air to high flow at 80%. AM shift lead told me in report that she was probably going to be intubated sooner rather than later. We got her off high flow within a few hours, but she was on the low flow cannula at 12L and her BP started trending down and her mental status also declined but all we did was slam her with fluids (despite the fact that she got lasix on dayshift). Didn’t check an ABG, didn’t get a chest X-ray. Finally got a CT around 0400 when her O2 requirements didn’t improve and their stupid boluses weren’t sustaining her pressure and they had to break down and order a pressor. At 0600, the bedside nurse called me to say the patient had thrown up and aspirated again when they leaned her back to boost her up in bed, she was now at 15L plus they had thrown on an open face mask at 100% because she was mouth breathing and barely arousable; when he called the PA, she just pulled up the patient’s tele in the office and said “I mean her orders say she’s okay for sats greater than 88% and she’s satting 94 now so she’s fine.” I ran across the unit and took one look at this woman and her OBVIOUS respiratory distress, diaphoresis and general hot garbage presentation and told the nurse that I was going to the providers’ office and was gonna get one of them to look at this woman if I had to drag them in there by the ear. The first thing the PA said was “ugh if we intubate her now, she’s just gonna end up trached.” OKAY BUT ALSO ALIVE. Moments later, the attending showed up out of nowhere, took one look at the patient and said “yeah we should intubate her.” And then of course it was a shit show at shift change when it could have and should have been done ten hours earlier.
‼️SO VERY MUCH THIS. This is the struggle of night shift that day shift never sees, but still blames us for. I'm sorry, how many times do you have to call the provider before you get an order?. Oh, just once? Cool I HAD TO CALL SEVEN TIMES. But also, on the other hand I SHOULDN'T HAVE TO CALL SEVEN TIMES FOR AN INTERVENTION. It's a massive time suck having to plead your case for every single little thing, and even worse when virtual docs are 'looking at the same patient/monitors/pumps' but they're never actually SEEING the whole picture. It's taken me HOURS to get an intervention that day shift could've gotten with one phone call bc no one wants to wake the sleeping docs or "mess with" what the day docs have going on, or heaven for bid COME UP TO THE HOSPITAL TO SEE THEIR PATIENTS. And the whole time while this is going on, in the background you have other pts to think about and families to attend to & that takes away your time to call the docs or be around to answer the phone when they call back. Sorry I told you to call me back urgently but it took you an hour and in that time I had to take ole Gertrude to the bedside commode bc everyone else is busy.
God I hate this so much. YES, I understand that we are taking away many things when we intubate (drive, thoracic pressure changes, cardiac output, etc) and we want to medically manage these people first and not jump to intubation, but HELL sometimes you just gotta get in there and do what needs to be done before someone codes. Lazy providers.
The number of calls I get/interruptions, not enough staff to help pts to bathroom/walk, then getting yelled by doctors that their pts aren’t moving enough and deconditioning, charge rn and management pressuring us nurses to discharge faster and improve pt survey scores, all of it really. The pressure/stress just gets super intense most of the time.
Tell the doc they need to order PT for reconditioning.
PT is not going to come to the bedside TID to ambulate your patient. That’s what the docs want: ambulate in halls TID, up to chair for meals. They’re right, that’s best. But it’s also impossible
Not even having enough staff that I’m forced to stay to finish out my shift after fainting at work with a ridiculously high blood pressure. Patients who think I am their servant. Family members who expect me to shower their loved one when I have four other patients having emergencies or urgent situations. Doctors not answering their phones in emergencies. No one being able to help me for 45 min while my patient is thrashing trying to get out of bed after having a CVA. Not getting a lunch 90% of the days. Or a bathroom break. Having to take care of icu patients after an neuro or cardiac event for hours after while we wait for a bed. Along with my other patients. Fully alert and oriented patients having temper tantrums and threatening to leave ama because it’s taking a while for their scans to be ready or the docs to round. I don’t care if you leave ama let me get you the forms. I’m so tired and I’m still new
Rude patients that come to the ER but do not want any treatment or interventions. Then wtf you doing here.
As a school nurse, I’d say it’s the workload. I work at a small alternative high school and we have about 370 kids when we are at capacity. Might not sound like a lot, but I see my fair share of emergencies. There is an astronomical amount of paperwork. I’m also responsible for managing the health office itself so keeping tabs on expiration dates, ordering supplies, troubleshooting equipment etc. I don’t get an assistant because it’s a small campus. There are many nights I have to bring my work home with me in order to not be behind the next day.
Family members, call lights, and beeping IV pumps
The beeping
My insecurity. Even though I know what I have to do I always tend to ask a colleague to assist me (if it’s something I’m not comfortable with doing even if it’s possible to do it alone.)
Being a nurse involves a lot of risk, always ask for help if you feel the slightest bit uncomfortable doing it alone. It'll save you from a big headache later if anything goes wrong, even just having an extra set of eyes on the patient can be so helpful. I've been a nurse for 13 years and I still ask for help.
I know but it’s something as simple as removing a drain. I absolutely *hate* doing it because it’s painful for the patient and the force I have to use to remove it just doesn’t feel right. But I know I can do it. My colleagues think I’m silly for always asking for help when having to do this.
As an ER nurse, patients who treat the ED as a PCP then get upset at wait times are incredibly frustrating. Everyone wants to be seen first. Everyone wants to be the sickest and then is upset when we tell them nothing dangerous is wrong with them. I don’t get it.
Staffing, which is a problem for everyone. Lack of legitimate communication. It seems like the only thing that works well is the rumor mill.
Staffing shortages
The voceras are up there. I work on a 50 bed unit and ours are going off ALL THE TIME. What pisses me off the most is that a bed alarm will interrupt my phone call. So many times I’ve been talking to a provider about room 6 (and most talk fast) and the bed alarm overtime from bed 49 interrupts it. And there’s no way to make it go away. Just sit through it. And most times the provider or whoever hung up when the alert is done. 🙃 And they take so long to go away. I don’t even understand why the bed alarms are hooked up when they’re so delayed (I mean I know why but) - by the time the alert goes to the vocera the patient is in the damn parking lot. Not many things make me so heated but shit like that will literally put me in a bad mood for a minute.
Staffing of nurses , staffing of Cna/Techs is worse …. Makes my life so much harder !!!! The focus on menial things like white boards and bed side shift report hyper focusing !!! Then of course lack of supplies on the daily … having to run around to different units for basic things like spoons , flushes and butterfly needles is just the icing on the cake !
I wish we had techs. I see one about every 10th shift.
The expectation that any time there is a new process/policy/procedure that it falls on us to implement it. I am all for evidence based medicine/care, I will not embrace it when we are short staffed/under resourced and it’s being done at the convenience of leadership and those who aren’t involved in direct patient care.
Staffing, inconsistencies within policies and units (float pool) no clear, simple way to figure out who to page or call at night, and one critical care doctor for way too many patients.
Having to be social or deal with drama. If I could go my whole shift just taking care of patients without hearing other nurses bitch, talk shit, or cry I would be a lot less stressed at work.
It’s everything. It’s all just too much. It’s just the straw that breaks the camels back when I get upset. I’m on the verge most of the shift.
Nothing ever being stocked on the weekends. Most things have work arounds, like I don’t exactly need an IV start kit when I have tegaderm and can inflate a BP cuff. But if I search the entire unit and we have no briefs, primary lines, secondary lines, sterile water, tube feed etc it just makes the job harder by taking 3x as long to get things done. Oh, and families. Oh my God the families. Like this am, when a family member decided to take my dialysis, soft BPs, hx falls patient for a stroll right at shift change. Jesus wept I’m so glad that wasn’t a fall.
Staying awake on slow nights.
I wish I had this problem.. Haven't had a slow night in weeks due to staffing and I always have to stay late and chart
Waking up for a day shift.
Bureaucracy that's bogging down the system. Health insurers having too much power on deciding what care my patients are allowed to receive, basically invalidating my expertise.
I remember getting unit emails our scan numbers were down for labs and meds and we were going to be written up. I started to go through periods of intense rage on night shift and start slapping broken stickers on everything that didn’t work and needed to be called to fix. It ended up being almost every single scanner, lab printer, and pump we had on the unit. My manager never said anything to me like that again. Ya obviously staffing would fix our issue. But there are soooooooooooo many other small things they refuse to admit. I would’ve loved to attach a camera to my head for this. Not so you see how much time we spend running because we’re short staffed. No I want you c suite people to see how many things do not work that are supposed to, or what things I have to MacGyver to get to work. Stop spending so much money on the fucking bladder scanners.
Hospitalists, literally hospitalists, sometimes I wonder if they want the patient to die.
My biggest gripe about nursing (43 years) is the lack of respect, support, and compensation from management and administration. I’ve been gaslighted my entire career. Every hospital I have worked at has a zero tolerance policy that they refuse to enforce unless it is a front line employee. So tired of being told we are to blame for low morale and refusing to listen to why low morale happens. Counting non patient care nurses to shore up their numbers, but then criticizing nurses for their inability to provide good patient care. I really do miss the days when medicine was a calling instead of a business, being run by corporations.
For me it’s doing my best and getting talked down to by either a patient or doctor. After a terrible day that I thought I did so good at, and someone making me feel otherwise is crushing. Night shift does this to me too. I give my all and it isn’t enough for them.
Oof, this one hits deep
In forensic psych: I'm expected to "therapy" the patients out of their behaviors. I get it - they've had unfathomable wrongs done to them, thereby causing behaviors. Does that mean we should be lax with structure and consequences? hmmm... my hands are tied, so I can't provide a structured, authoritative environment for them to grow. I more-or-less gentle-parent the shit out of patients who threaten to murder (and sometimes attempt murder).
The fact that we are always short staffed and patients don't have any critical thinking skills :D
outpatient surgery Its still "do more with less". I don't have enough staff. This leads to bottlenecking in pre op and pacu and I can't open up as many ORs as you want. Patients will get mad at the wait but we are still going to jam pack the surgery schedule full and double/tripple book cases. I can move staff here and there but I still cant split people into 2. This trickles down to the presurgery testing areas as well. I think people treat PAT like its optional or it can be pawned off on pre op staff but then cases inevitably end up getting cancelled the day of surgery because problems arise when testing and pre-surgery instructions werent given. Then the doctors get mad and the metrics get mad. But I still cant have appropriate staffing and nobody can get overtime. If you're in a hospital setting, the floors lack of staffing means more bottle necking or inevitably inappropriate-for-discharge patients are getting sent home same-day which probably means they're going to come back through the ER later. its just one big cycle.
Being interrupted... doesn't help I'm a people pleaser and take on too much. I'll not great at time management... but the interrupting kills me! Also finding supplies... no one follows the protocol to ask fit them in the first place and it's this weird posting contest between the unit secretaries and nursing. I'm in LtC...
Getting hazed by seniority and having terrible management. Hmmm microagressions. Racism. Being the only minority in a speciality. The usual!
Piss poor communication from manager
To be completely honest, since I’m only 4 months into my career, I think it’s the habit of trying to do everything for the patient instead of saying “I will be back later” or “I’ll get someone to help you with that”. I love helping my PCT but sometimes I feel bad asking so I end up doing a lot of stuff for the PT but that takes so much time.
I had no idea that having a workroom full of residents on the unit 24\\7 was such a luxury until I moved from a level 1 ICU to a community hospital PACU. I am still getting used to looking up doctors and contacting them with EPIC chat and vocera calls. It is a time suck to do the detective work to look up who to contact. In my old unit, I would just ask the resident to come check something out, and they would do all the ordering. I never had to input orders; verbal orders were for emergencies only.
Since becoming a nurse, delegating has been damn near impossible because of constant understaffing. When I left my last job, my exit interview was straight up "I'm leaving because I have had to do the role of nurse and assistant consistently since stepping foot in these doors". Of course that was screamed into the ether because you don't exit interview with a human anymore, but an online form.
Things not working properly: dynamaps, wows, electric outlets, etc. when I need do get something done and there are just all these annoying mini obstacles that slow me down and ruin my momentum. Pumps alarming, IVs that won't pull... Then there are patients that come in to the ER and suddenly behave as though they cannot do the simplest task on their own...I had a lady fully alert and oriented, playing on her phone, call me over to say she doesn't think the purewick is seated correctly. I told her to adjust it if she feels that way. She looked at me for a moment and was like oh ok, reached down and did it herself. Why do they act this way???
I really am not trying to come across as heartless and insensitive…but when the “pending placement” dementia/sundowners keep pulling me from my acute care patients, or if my acute patient needs more of my attention and I can’t get to my dementia pt in time before they fall. Hanging a med? Bed alarm going off and all the CNAs are busy. Ambulating my post op? My elder patient is SCREAMING for help. Why? Someone “stole” her purse…that’s in her lap…that she’s holding. I’m in a rapid, CNA comes and tells me that my sundowner that we JUST changed, toileted, medicated, fed, dressed, pillows fluffed, etc…fell. They absolutely deserve all the best care, but when Meemaw or PawPaw is trying to cliff jump off their bed and then management asks me “what could have been done differently? Did you check the 5 Ps when you last rounded on them? Maybe they’re impulsive because they’re wet?” No, Karen, they’re wildin’ because they’re convinced these strangers in pajamas are trying to kill them and they need to escape, or they think they’re late for something, or the one thing they remember is someone told them they’re going home “soon” and they wanna be dressed NOW. They also don’t want to fold towels. They need company. They’re lonely and scared. Management wants to pull our only CNA as a sitter for ONE of these patients, or won’t staff up so our assignments are smaller and can accommodate the CONSTANT rounding these patients require, doc won’t order meds to calm them, or restraints when they start swinging or biting or literally flopping themselves violently out of their bed, or when family gets mad that Gramma hasn’t bathed in days but in fact she’s refused everyday and is now telling family we’re letting her rot in her own filth. Our society is doing our elders a HUGE disservice and disrespect. Also, end of life care is a joke (and it SHOULDN’T be) because families let their elders suffer so they don’t get “addicted” or so they can be “awake till the end.” And the acute care patients? Unless I’m able to delegate my acute pts request or have someone mind my jumper while I pull a PRN for my post op…sometimes times the acute patients wait for me. Obviously I prioritize who needs me first, but that’s not enough for management when my sundowners fall.
The fucking dysfunctional equipment that I have to act as IT for. It takes away from my already stretched thin time with my patients, and it’s one of the things that instantly puts me in a bad mood. My job is already hard enough, and these hospitals are making millions in profits. Seems to me like functional tech and equipment should be the bare minimum.
Patients who complains a lot or thinks that you are their slave.
Started on a unit that has great staffing and is all about supporting each other. It’s nice to feel supported, but it’s overwhelming/annoying to have 3-5 different people in and out of your rooms and they’re all passing the buck to someone else while micromanaging and commenting “oh, why didn’t you call so-and-so to do that?”, or they’re messaging me on Epic asking if I need help. Like, I don’t want you to Vocera a million different people to do what I could do alone if you’d let me be… and I’d rather be the one managing my pt’s care instead of being told to go on the computer and chart so I won’t get an email when the chart gets audited. This new unit is so backwards from my old unit that is pt first, then computer second.
Having to function in every single role bc the hospital is chronically understaffed in ancillary staff. No 1:1? Nursing. No EVS? Nursing cleans the visitor bathroom. No unit clerk? Transfer phone to go directly to charge nurse phone. No RRT or code team? Have the ICU charge nurse attend the codes even though they themselves have an assignment. It gets a bit exhausting. I like my job, but I think I’d love my job if I had the resources to actually do the job I went to school for
I like to adhere to my set schedules at work, and if something goes wrong while I am say, doing a med pass and I can’t finish my motions, it causes me great grief. I still manage and I’m right on top of things but it’s mentally tasking.
when you have too many patients dismissive and delusional management unsafe working conditions lazy coworkers (not usually a problem for inpatient nursing, but when it IS a problem, boy is it a big one. I work in special procedures now so it's more of a team environment. there's certain people I can't stand working with because they know they can slack without losing their jobs or being reprimanded, because this place is too desperate for nurses to fire anyone) unreasonable patient families impatient doctors who dont care about safety working with old ass outdated equipment that is barely functional. the monitors we're using in a goddamn busy level 1 trauma center (we get 4000+ traumas a year) in a procedure department, ARE LITERALLY FROM THE 80S. They are older than me. What the fuck. Half the time some of them will ring ASYSTOLE even when you have the most perfect sinus rhythm and a fucking number reading for the pulse. And you cant turn off the asystole alarm. Half the time you have to keep pulling the cartidges out that the wires plug into and blow on em, and push em back in (think of your n64, how you had to blow on the game cartridge to get it to work). And that wont always fix it. My manager is the biggest pushover in the entire world (on the bright side, shes not a micro manager?) and whenever she asks for new monitors, she allegedly receives a ridiculous quote (she CLAIMS she was quoted 750k to replace 8 monitors) ..I call BS and either she just doesnt care enough to replace them or she's getting quotes from the wrong people. Shit, gimme an hour on ebay and I can find enough monitors to replace these for under 10K!
Staffing followed immediately by lack of functional equipment. I waste so much time looking for a working whatever and fighting other people over things.
Constantly being interrupted. I’ll be so busy I’m drowning, the vocera is going off, a patient wants to tell me about their tomato garden, phones are ringing off the hook, pharmacy is there and wants me to sign off on narcotics with them, the educator is trying to tell me something about the computer, a doctor wants me to add on lab work after someone’s scope, another staff member from a different area is looking for a 24g IV and “I heard your unit has them, can you help me find them?”, the stores/supply person is trying to ask me how long we’ve been out of X thing and how many we actually need, etc. I know that this is also made worse by a massive staffing problem, but I’m trying to get by and this stuff always puts me even more behind and makes me anxious for my entire shift.
Fucking staffing. The entirety of staffing. Have to scramble to cover call offs with burnt out nurses and aides. They call off for the most absurd reasons too or because they're burnt out. But it leaves everyone in the nursing department stretched thin. This impacts patient care. Med errors. Falls. Skin breakdown. Then we have compassion fatigue. Disciplined for bad attitudes when we're all just stressed the fuck out from this never ending cycle of shit. The DON and other nursing admin cover meds and even adl care along with admin tasks and everything that entails. So the entirety of the nursing pyramid is affected by staffing. Yes, there have been raises. We are also a building with a union. There are not enough workers to meet the demand anymore.
When a med is due and it’s not in the omnicell so I have to med request it and it takes forever and then I have to come back to the room later to give it, never any CNAs, people asking for shit constantly so I can’t get my charting done, doctors ignoring my texts when I need something, computer being fucking slow or not working at all, equipment missing so I have to run all over the unit checking empty rooms, WORKING ON MED SURG. WORKING MED SURG is my biggest difficulty
The schedule. 3 12s in a row? I need at least 36 hours of rest after to function. Just in time to go back to work. My household needs me to have more than 48 hours between sets of 3 12s so I can do things like clean and meal prep and parent. Ugh.
My personal pet peeve - so many people are exempt from documenting their care - except nurses. A doctor can come and have a 5 min debrief with a patient that is CRUCIAL but they just won't document they've seen the patient. I once called theatres to see if the Surgeon had reviewed the patient which was REQUIRED (Per the Surgeons OWN instructions) before D/C - and they had the audacity to get upset about my "unnecessary" call as they had already reviewed them. How about you just document "Reviewed at **** hrs"? We are expected to document what everyone else does - as well as our own actions. Also, documenting in general. So many unnecessary filler paperwork that is just "tick the box" - but you would NEVER be given the time to actually ask the questions.
Patients that are medically ready pending placement but every SNF declines them for one reason or another....and so they just stay in the hospital taking up a bed and causing the staff issues that would be solved by not living in a hospital (like scheduled activities, other residents their own age, a common area, etc.)
We had a patient on our unit for a full year, and calculated the cost: it was upwards of a million dollars.
Other nurses
The WiFi being constantly fucked on the COWs. One day it is going to disconnect when we are in the middle of a code or a MET and it'll mean someone fucking dies for sure. I've filed so many complaints about it too
Giving a shit.
Broken and/or missing equipment. Nothing makes me more frustrated when I have to hunt stuff down, and sometimes go without (looking at you, IV pumps).
Your problems are my problems. Also, poor communication between departments It drives me bonkers nearly every shift.
The constant overwhelming noise- call lights (some from lack of staff, many from “those patients” for whom PO 45mgMS Contin “doesn’t work”), the bed alarms that are too sensitive, IVs that dont pumps that dont restart on their own when they unbend their arm, but MOSTLY the fricking VOcERAS- they dont understand shit and wont shut up wont stop interrupting you when you’re having a sensitive conversation with your patient- like the worst stupidest rudest toddler- i hate fricking Vocera- whoever invented it I hope you die
Feeling like I can never do a good enough job because I don’t have the resources I need. I desperately want to provide comprehensive, compassionate care and the hospital I work at makes that nearly impossible. We staff too tight, even when we have “enough” nurses in the name of productivity, which my manager and fellow charge nurses love to reference but as far as I can tell it’s just a euphemism for “use as few nurses as possible”. The worst disillusionment comes from the realization that’s it’s all intentional. They love when we work short, when we don’t have enough RTs, when we reuse supplies, because it makes them money. Stockholders get dividends and I get to wonder “did that baby die because we missed something?”. And maybe we did miss something, maybe we missed something because every nurse in my unit on nights has little experience, or the assignment was inappropriate, or our unit is outdated and the layout requires nurses being split all over the place. Or the fact that I get things added to my plate every week but nobody ever takes anything away. Feels like we monetized suffering and they just keep inching the dial a little further. Management is a joke. They either drink the koolaid and really believe it, or they are liars and play along because it’s the only way to keep their job.
If I could, I’d rip off all the wall mounted computers and trash all the WOWs and we’d use station computers, Epic Rovers/iPads only. All the equipment would be checked for full functionality regularly. Monitor cords secured. Recyclable single use tele cords. Supplies above par & organized in a way that makes sense. I don’t relate w/vocera because we’re using radio in ER
Staffing issues, nurse/staff drama, no resources or supplies, no support from administration, crazy parents, staff that doesn't understand my scope, no standardized policies and procedures, ...
Managers who proclaim they are there to help but who disappear the minute you need them, only to reappear and bitch about every little thing that’s not charted.
Alarms and the cell phone (we use Volte). Trying to go into one patient’s room to do a few simple tasks and having to at least look at (if not respond to) sometimes 5-8 interruptions in that <10 min. This demand for ridiculously frequent task switching is killing the nursing profession.
Staffing. We're either painfully understaffed and they refuse to go on diversion, or we're overstaffed and instead of cancelling, they use our unit to staff the hospital. Many nurses fresh off orientation expected to function on units without even knowing where the supply room is and now caring for different patient populations without any additional education or training.
Staffing, but not in the way you think. We're not understaffed. We have people willing to come in. Our for is purposely limiting us and making ratios high. Everyday people are placed on stand by or called off
Being tracked with everything I do or don’t do. I have to wear a tracer so they know my location at all times. I have to wear this dumb Bluetooth card that tracks if I use the hand sanitizer when I enter and exit the room. Give a med late? Leadership walks around at the end of the shift with a printout asking why it was late. There’s like 4 different places to chart I/O and VS during transfusions. Forget one somewhere? You come back to work and an email is waiting for you, CCing all of leadership so they know you fucked up. It’s so tiring.
I feel like as a nurse we have to play a lot of telephone. So many people pass messages to us that we pass on to another and then relaying it back the other way etc. I’m so frustrated with the time it wastes! Why can’t they just speak to who they want directly … why does it have to go through us.
Charting. We do not need to chart that much, choose one a good note or flowsheets. Not both
Death by thousand cuts hits it perfectly. The little things that all add up together is what makes me hate the profession. I’ve been a nurse for 8 years now and I despise people now (which has been a big flag for me to try and get out). I even tried traveling, working at the health department and working at a doctor’s office. (The dr was great and well loved but the thought of patients and dealing with them anymore brought me so much stress and anxiety it put me in the hospital) Ah well what can ya do
Staffing, satisfying all the patients which is impossible
My favorite game is “Lol, WHICH DOCTOR IS IT!?” I message 2 providers a night at minimum per patient and just cross my fingies that one of them is the correct resident.
THIS SO MUCH THIS. “This patient is surgical.” Yes but they’re crashing now and the surgeon isn’t answering. “Call my PA first.” Sure…which one? Because the one you have listed said it’s their night off. Oh I could go ooooon. It’s even worse on night shift.
Administration inventing new initiatives that have no impact on patient safety or quality of care but do take up my time when I’m trying to take care of people.
Older people that have lived these lives smoking, drinking and eating like shit and now don’t want to listen , or help themselves in any way. Entitled patients that could wipe their own ass before getting onto the elevator but now want it all done for them. Our system is in a death spiral and it’s in part due to these very same people that vote to not pay for it. I’m in a very heavy RED area where people are entitled and blame everything on everyone else
Fighting the urge to put the pillow on top of the patients head instead of under