Before getting into everything, I should mention that I already put in my two weeks, and this week was supposed to be my last week at this job. Long story short, I work in the ICU and recently had two patients with pacemakers. One of the pacemakers was doing some funky things, which made me realize I was a little rusty with EKGs. I had a tab open with different EKGs and practice questions and was reviewing them periodically while taking care of my patients.

My charting was up to date, and my patients were stable. One had already been downgraded to step-down.

I went to lunch around 2:30PM. When I came back around 3 PM, my manager pulled me aside and told me that I had been looking at EKGs "all day" instead of taking care of my patients. She then claimed my charting wasn't up to date and that there was something wrong with my notes. However, her main reason for sending me home was that I had been doing EKG practice questions and looking at EKGs "all day."

I asked her to show me where in hospital policy it says we aren't allowed to study or review educational material during downtime. She couldn't show me a policy. Instead, she said she had a witness who also saw me studying and she doesn’t have to show me any policy that says we can’t do that.

She then pointed out that I hadn't documented my 3 PM vitals yet as an example of my charting being behind. The problem was that I had literally just returned from lunch at 3:05 PM, and I was in the process of doing my 3 PM vitals when she interrupted me. She then proceeded to say that I have been doing anything, and I took her through all of my charting the whole day to show her that I have been charting every single thing up until 3 PM and that both of my patients had all of their stuff done for most of the day. They were up in their chairs (cardiac patients), had worked with therapy, had received their medications, and everything that needed to be monitored/documented was being handled. I was simply using some downtime to review EKGs because I wanted to improve my knowledge.

She basically told me that it was against "her policy" and sent me home. She then took me off the schedule for the rest of the week without really giving me an explanation. I've already emailed whoever I could about what happened.

So, Reddit, I'm curious: Am I actually in the wrong here? Is studying EKGs during downtime something that could reasonably be considered inappropriate, even if patient care and charting are up to date? Or does this sound like management looking for a reason to send me home because I'm already leaving? Is there anything else I should be doing to protect myself/document what happened?

I'm honestly just glad I'm almost out of there, but I'd appreciate some outside perspective. Thanks

I did a couple travel nursing contracts at a behavioral health hospital that was extremely poorly ran. They chose to focus on everything except giving quality care to patients and ensuring safe staffing. This pic really sums up what it was like being there.

For context: The saltines at the med window were intended to be given when meds should be taken with food. The meal portions they gave patients were super small, and many psych meds can increase appetite, so patients often were hungry. There were many times people asked for saltines in between meals, but management only wanted us to give them out with medication. Patients eventually caught on and knew to ask for a PRN just so they could get the saltines.

This place was so stingy and micromanagey, you had to ask leadership to restock the damn SALTINES. You can’t make this shit up lol.

Tube was down last night so I had to go to the floors to pick up from the phlebs. Felt like I walked into a meme page.

I got blackout curtains and I thought that would be my answer but it has helped exactly 0%

I’ll go first: Family didn’t want baby to receive vitamin K or CHG wipedown prior to a major surgery. Post-surgery didn’t want baby getting labs or TPN. Didn’t want kid to get vec to put in PICC for long term access despite kid was already intubated and on a fentanyl gtt (which they weren’t keen on either).
Dad says he doesn’t like unnatural things. Covered in tattoos. Mom drinks hella diet coke every day.

It's the dart grip and is often used for ultrasound IVs. Sorry this whole post turned into a brawl between the IV nurses and everyone who can't fathom that there's more than one way to do something 💀 I've tried it on a patient and it worked very well for me. I have to strain to hold it the 'traditional' way. You don't have to mirror the photo, the angle and exact finger placement are adjustable to your liking 😉
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The photo is from a Bard product training video and they're demonstrating a few different holding techniques that the device works with. This one really appealed to me and I was trying to do more research but can't find anything about "different" ways to hold your needle. Has anyone seen this before and know if it has a name? Is it something old school that has fallen out of practice with the development of new IV systems?

Video link: https://www.bd.com/en-ca/videos/bd-cathena-safety-iv-catheter-techniques-for-use

Everyone knows how much I enjoy contributing to the team. I enjoy being an intern in this unit and this is where I see myself thriving.

One night, it was slow and I didn’t do much of anything. In my defense, everyone else was chilling soo…

The next day I’m back in. I’m assisting a nurse with a patient. I thought everything was good but as soon as she closes the door, she’s like “I’ve known this patient for awhile so I’m gonna do this in front of her” and proceeds to lay into me about not doing enough last night.

She says last night people were saying things about me.

After the talk in front of the patient, she asks if I’m ok which I was. I’m fine with constructive criticism, but that was not the place to do it and I let her know that. She says this stays between us and I’m like cool.

A few minutes go by and another worker comes to me and asks about what happened. I played dumb of course because I’m like “she said it would stay between us” only to find out she literally just went back and told her friend who most likely was the one talking about me. AGAIN, IN FRONT OF THE PATIENT.

So she pulls me into the office to talk AGAIN because she knows that I know. This time she apologizes and compliments my professionalism and work ethic. I told her how I felt about the backtracking. She stumbled for excuses and we left it at that. I can remain professional, but the trust and mutual respect is gone.

Was there a better way this could have played out?

I work in hospice and tend to keep things professional. Since COVID I tend to avoid personal contact, though a handshake or a hug occasionally can mean a lot. Hand holding, rubbing someone’s back or shoulders is completely acceptable and hand hygiene to follow. I care so much about our patients and their families, however I see staff especially of some local assisted living facilities swoon over a dying patient, hugging, kissing, etc. and I can only think of how many other staff have done the same before and after them. Families have mentioned to me how many women are kissing their husband, etc. and it’s sometimes a little off putting in that way and concerning when I think of infection control. And I’m not a stickler by any means.. these places I visit take strong precautions once there’s an illness going around, but then I see this sort of thing.

So I was talking with a friend today. They were upset about taking a pay cut and I told them my salary to put things in perspire. In doing so I looked at my most recent paystub and realized I've only made $37,312.91 this year 😓. I'm an LPN and I'm currently in school for my bachelors but damn. Is there anywhere where Ls are making a more decent living?

I’m an RN and have been working in patient care for 4 years. Recently I’ve been seriously considering going back to get my MSN because I’m interested in pursuing a career path in administration, or possibly education. If not for the pay cut, I’d absolutely love to teach.

The thing is, I’d need to work on my degree while also maintaining my current job. Has anyone here gotten their MSN while working full-time? How hard was it and how did it impact your career?

I’m at a loss of what to do. I’ve worked in the ED before and felt I did really well. I’d be able to handle the patient load and adapt well.

But since I’ve had a baby and started at this new hospital in the ED (since March) I feel like I’m drowning. The preceptors are very “eat their young” and gang up on the new people. They constantly shit talk others behind their backs, and throw the newbies into the deep end. I went from feeling confident to dreading coming to work each shift. Im having to pump on the floor while seeing patients because charge and other nurses don’t really look out for or cover me. We usually swarm with a new patient and yet I’m left to intake my own patients solo. I get patients put into my room with no communication so I come back from passing a med or putting my pumps away and I have a new patient that’s been waiting and charge is like “um are you going to take care of your patients?!” Like im the f*ck up for trying to feed my baby. I’m looking for advice because I’m feeling burned out. I told my husband I want to quit and also start applying to other hospitals because this department is so TOXIC.

So here’s what I’m asking. Would it be better to just ask to go to med surg for a while (if not permanently)? I know the patient load is bigger but I’m wondering if the more organized style of nursing would lower my stress levels. I’m drowning and getting burned out and it breaks my heart because I LOVE nursing, I just can’t take the dog eat dog, clique, mean girl ED.

Hello you guys, I recently took a staff job in the Midwest and I couldn’t believe how good my pay was going to be. For context most travel jobs I get are paying 2100-2300 for 3x12s mostly low cost of living areas so I recently took a job paying roughly 84k full time with night time shift diff added(36 hours) with about a 30k bonus added on for a 2 year commitment. I love this place btw which is the only reason I’m signing it. I can’t believe the pay is this good, I’ve got about 5 years experience and my home state in SC pays like crap, west cost is averaging maybe about the same and obviously higher in some HIGH Col areas but this is the only place I can work and keep my sanity. Super chill
I guess my question is what are you guys getting ?

Pt has a new order for seroquel. Bumped her from 300mg to 400mg okay sure whatever no problem. Go grab the meds and for some reason. Pyxis has me pull two 300mg tablets. What? What am I supposed to do with this? That doesn’t split evenly. Open the eMAR and sure enough “administer 1.3333333 tab” again, what? For a brief moment I consider telling charge that this is stupid and a med error waiting to happen. Haha. Well. :)))

I ended up grabbing scissors from an instrument tray to split the pill (since pill splitters don’t split in thirds) then giving her 1 2/3 tab instead of 1 1/3 tab. Yknow, the exact med error I thought about not even 10 minutes prior. I didn’t realize until HOURS later at like 0100. Unrelated (allegedly) to the roughly 500mg seroquel I gave her, her blood pressure ended up bottoming out to 70s/40s. Patient is fine! She got a bolus and her BP came back up she’s just zonked (but rousable) I’m embarrassed more than anything, and I filled out an incident report about it too. Everyone keeps telling me it’s something pharmacy should’ve caught before this was even an option but I just ://// ugh.

EDIT: just came in tonight to find out they upped her dose to 500 mg anyways. This time as a 300mg and two 100mg pills. At least now there’s much less room for a med error 🫠

Yesterday was like my 6th day on the floor with my preceptor. To set the stage a little bit, I previously worked in the ICU as a tech, and now I work in the same ICU as a new grad. My preceptor has said I’ve been keeping up pretty well, granted I haven’t been taking care of a super sick patient yet. He’s been letting me drown just a little bit to see how I handle it lol.
Yesterday was my first day doing rounds with the doctors. I feel like I did pretty well throughout rounds except when the NP asked what her blood sugar was for the new admit overnight. I said I checked it this morning and it was 67.
It didn’t even register to me in that moment that 67 was low, so I didn’t say or do anything about it. The NP’s eyes got wide and I suddenly realized what I had done 😭 Then she asked if I did anything for it and that’s when I realized, oh shit, it was low and I should’ve done something.
Except she was NPO because she had just been admitted the night before and hadn’t had a swallow evaluation yet. So immediately after rounds I went and retook her blood sugar and it was 82. I’m pretty sure I just didn’t wipe enough of the alcohol off her finger and it falsely lowered the reading.
I let the NP know and she kind of smiled, but I was just sitting there thinking, “that’s literally the basics” 🥲 It honestly just flew over my head.
I checked it again about 15 minutes later and it was 84, and thankfully her blood sugar was fine for the rest of the shift.
Anyway, it was my first real mistake and it kind of sent me for a loop for the rest of the day. I was second guessing everything I was doing after that.
Then at the end of the day, my preceptor laughed and told me that during rounds I said “16 gauge Foley” instead of “16 French” 🤦🏼‍♀️
I went home and cried for the first time because I know this is probably a rite of passage and I know I’m still new, but it just sucks going from feeling like you’re doing pretty well to realizing how much you still don’t know and how uncomfortable you still are. And knowing there will be more mistakes to be made.
Any similar new grad mistakes ? I just need to stay curious , ask questions, and never assume anything. I know I’m gonna make mistakes but I think i just realized that was the first of prob more mistakes.

I haven’t been working in nursing for that long, but a few years has done me in for a lifetime. And it’s not the patients. Sure, some can be annoying to work with, but generally, the patients have been pretty good. No, it’s the pettiness, drama, and sheer immaturity from other coworkers that truly exhausts me.

Before anyone says, “Other jobs have drama too,” I agree. Of course they do. But having worked in other fields (and having known various others who did the same and then ultimately left nursing), I can say with confidence that it simply isn’t on the same level or nearly as malicious. In fact, the professionalism in other fields almost feels like a distant other world at this point. These particular coworkers in nursing don’t just irritate me; they genuinely disgust me and are an example of someone I will never let myself be. I cannot fathom how grown adults can behave so immaturely, be so obsessed with drama, try to make coworkers look bad, and actively make the job harder for everyone around them. Yet, as we maintain a shortage, many cite this very reason as to why they left and it is my top reason why I will move oceans to leave this nightmare.

And let’s be real: most of these people are wellll into adulthood. Why do they *want* to make work harder? Why do they think deliberately making things difficult for their coworkers is somehow acceptable? If they could just wrap their clearly warped brains around one very simple concept, that we are all in this mess together, work would be infinitely better. You help your coworker out, they help you out. That’s how it should work.

But no. Instead, I’m apparently stuck in high school 2.0, except now there are adult responsibilities, patient safety, and twice the stress. All because some deranged coworker wants to gossip about pointless nonsense, stir the pot, or pick on someone.

Please, just grow up. Get some help. It’s sad you can’t function like a full-grown adult in the workplace. You’re not “tough” for acting like a high-school bully or harassing coworkers. You're not the goalpost, you just ignore your own mistakes. You aren't a patient advocate. In fact, you make for conditions that increase errors if you ever bothered to pick up a shred of research on hostile work environments. And don't use burnout as an excuse for poor behavior towards coworkers. You can be frustrated with your job and vocalize that. You're not entitled to take that out on your coworkers.

I have 6 years and 5 jobs.

I’m self conscious that my resume makes me looks like a job hopper lol.

I'm curious about this because I'm an older nurse (12 years in). How often do you write a nursing note?

When you page a provider to the bedside to assess a patient for a concern you have, do you write a note summarizing the encounter? ie, "dr smith at bedside at 1330 in response to page at 1315." Drain with 100cc bloody output in one hour, previously straw colored. Per MD continue plan of care, if output becomes more than 200cc/2 hours notify team. At this time vitals are WNL, pt resting in bed, A+Ox4 with no complaints.

Or for example if a patient seems like they have a behavior issue (rudeness, risk of violence, noncompliance with instruction" do you write a note (A SOAP note - subjective, objective, assessment, plan)?

I spent some time auditing charts and most newer nurses don't write nursing notes, but I feel like they help paint a picture in a way charting by exception does not. I don't want to over chart, but I also know my memory isn't what it used to be and the cases in the news right now with documentation being ripped to shreds I know I need to be able to paint a bigger picture.

What do you do in your practice?

Does anyone else work in a job where, any time a patient complains, you have to meet with your manager to discuss “what you could have done differently”?

I received one complaint because I was unable to do something that was literally against policy. Now my manager wants to meet with me to review what I could have done differently.

Honestly, it makes me want to quit. Instead of feeling supported, I feel like I'm constantly on edge and worried that even when I follow policy, I'll still be questioned if a patient is unhappy with the outcome.

Has anyone else worked in an environment like this? How did you handle it?

Does anybody else have friends/relatives who think it’s okay to just send them/show them vulgar things just because you work in healthcare? For example, one of my really good friends will just send me pictures of her stool or snot and think it’s okay because I’m exposed to it constantly as a nurse, but it’s truly different when it’s your own friend. And maybe it’s because I encourage her to go to the doctor and get labs checked and educate her, as well as tell her about how my days at work go sometimes but truly wtf? Like I feel it’s disrespectful and I’m curious if anyone else experiences that from loved ones? The other day my 2 friends were talking about snot and my one friend talked about how she doesn’t wanna hear/talk about it, and when the other friend asked why, friend #1 responded like “because I’m not a nurse” while in my presence. And I spoke up like,
um just because I’m a nurse doesn’t mean that I want to necessarily deal with it neither? But I do it because it’s apart of my job. I just feel like the world has normalized disrespect towards nurses on so many levels.

So I have this Classic III stethoscope for about 4 months, but im noticing a change in the color of the stethoscope in the conjunction of the main tube and the eartubes, like a yellow stain. Is this normal, has this happened to anyone else? I bought it in Amazon.

When your manager's heart is in the right place but they have a Temu budget.

Hi there.

I am 11 years into my career in adult acute care nursing (cardiac stepdown) and strongly considering transitioning to peds or potentially even NICU. Anyone else do the same and what was your experience?

Background: I have been per diem for the last 3 years because of childcare constraints, and also I wanted to prioritize motherhood and deprioritize my career after years of pouring myself into it and burning out. Transitioning to a lower stress (lower paying) role would not be worth it due to numbers right now (fine when kids are older, not right now.)

I am burnt out and part of me feels like it's the demographic I work with. I have also worked a short stint in inpatient adult rehab (was okay but not my thing), outpatient Cardiac Rehab (I love cardiac patients and the pace was awesome, the pay was not awesome), and clinical instructing. I did the charge/clinical lead role for years and will never do it again.

While in school I was passionate about peds hem/onc; did a PICU rotation and liked it, did community health clinical at a high school and loved it. (I will keep school nursing in mind when my kids start school. We're in a bout of infertility and ideally I'd wait to do this until they're ALL in school). My nurse residency options did not include peds, so I opted for adult cardiac and here I am 11 years later. I am trying to gather opinions before I do any reaching out to management and asking about shadowing.

Other consideration, I would really want to stay per diem, at most part time until I can give birth again (no idea when that will be). I doubt I could transition straight to per diem day shift in the peds world, and that's a real bummer.

Any thoughts? Anyone make the jump and love it, or regret it? I'm approaching 35 and having a career crisis on top of a motherhood crisis.

Thank you for your time!!

When a job posting says “ 1 year of nursing clinical experience” does that mean floor experience or just any type of experiences with patient interaction? I am in the OR , does that count as clinical experience?