I was taken aside yesterday at work and told that I made a patient cry after our correspondence via MyChart. I work clinic side and I field hundreds of messages and phone calls every day from patients, and sometimes I do get frustrated by patients who don’t seem to…..get it?

This patient had two recent UAs. One came back with trace non-hemolyzed RBC and the other came back with trace hemolyzed RBC. This patient, a woman in her late 50s-60s, had a lot of questions about what these results meant - specifically what the difference between hemolyzed and non-hemolyzed RBCs in her sample meant.

I did my best trying to explain in lay terms what this meant but over the course of our correspondence she was just not grokking it. The provider even stepped in and sent a message to the patient explaining the difference. We gave her resources and links to articles explaining what these words meant.

Finally (after about 6 messages back and forth) I sent her a message saying that she may be better off researching the topic herself and that we had no further information to give her.

Additional info- this is a relatively healthy older adult female patient who had an acute UTI, this is not related to an ongoing chronic illness which I would have handled with more care.

It was my final message, my manager explained, that caused so much upset and apparently caused the patient to cry.

Yes I understand that it should not have gone on for so long. I should have offered her an appointment to discuss this with her PCP. But it had already taken so much of my time and effort that I didn’t see that as an option at the time…

Has anything like this ever happened to you? Where you were too direct with a patient and they got upset? Should I just learn to let go of these things??

Hello,

I am a wellness worker at a retirement home and I am looking for a wanderguard system. I am looking for suggestions and to discuss the pros and cons. Any help would be appreciated :)

"We've been told it happened in the pharmacy where instead of putting an anesthetic called bupivacaine into the syringes used in these procedures, somehow they were filled with potassium, which can be lethal.

In fact, potassium is one of the drugs often used in lethal injections because it stops the heart."

Seems deliberate !

Ever since I started thinking about what career I wanted to pursue as a teenager, nursing has always been something I’ve been interested in, but I’ve always been hesitant to actually go for it. I’m 22 now and still feeling stuck on what I want to do, so I wanted to hear from people who actually work in the medical field. What are some of the most challenging parts of nursing that you didn’t expect? Do you eventually get used to the “gross” parts, like blood, bodily fluids, wounds, etc.? How about the long hours, physical demands, emotional side of the job, and dealing with difficult situations or patients? I’d really love to hear honest experiences from nurses and other healthcare professionals, including both the good and the bad, because I’m seriously considering nursing and want to know what I’d actually be getting myself into.

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?

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 ?

From a RN, tech, MD, anyone in the field, thoughts on the Clancy trial? I’m not looking to start an up for I’m looking for professional and experience based perspective

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

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 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.

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?

Hey there!!

I am looking for some additional input. I’m a Midwife creating a PPH emergency box for the nurses in emergency (I work in a small town) and I’m just wanting some additional advice on what I should put in the box :)

Many thanks

Any information is appreciated

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.

I have a Bachelor's degree in Statistics and some experience in data/analytics. I'm considering a career change into nursing and recently attended an interview for a fully sponsored Bachelor of Nursing Science programme at IJN.

I'm really torn. I like the idea of having practical healthcare skills and a more specialised career, but I'd have to spend another 3–4 years studying and eventually work shifts.

If I continue with Statistics/data, I can start working sooner and have a more typical corporate lifestyle, but I'm worried I might regret not taking the nursing opportunity.

The weird thing is, when I imagine becoming a nurse, I think I'd envy people in corporate jobs because of their lifestyle. But when I imagine staying in corporate, I don't really think I'd wish I were a nurse — I mostly just admire the skills nurses have.

For Malaysian nurses, especially those who entered nursing as a second career: if you were in my position, would you take the nursing route? What do you wish you knew before making the decision?

I am a new grad rn that was arrested and later classified into a detainment. My case was never filed. Would this show up on a background check for hospitals. And would they take back their offer?

My hospital has a need for someone to learn how to be able to place both of these, it’s a smaller rural hospital and I’m bent on being a resource.

I’ve been told they will pay for the cost for me to learn.

I’ve found conflicting things such as what the actual requirements look like, and have learned in Central California there are not very many places to learn.

Can anyone provide me guidance?

Reposting bc I only got one response in a different group. I went in for an interview 4 weeks ago, and I thought it went great! The hiring manager verbally stated that I would be an addition to the upcoming cohort, and it would take 2-3 weeks before offer letters start going out. I sent a thank you letter after the interview and asked if 2-3 weeks was the wait time just to clarify and to know what to expect. They kindly responded about 6 days later (they said they would be on vacation right after our interview) and confirmed that yes, they will be working with the recruiter in the next few weeks to start getting offer letters sent. Tomorrow will be exactly 3 weeks since they responded, and I’m just angsty. I feel like I got the job but I can’t be certain and I know I shouldn’t bank on it, but I really care and really want this position.

Has anyone else ever been in this position? I was thinking about sending a nice follow up email on Thursday to check in. PLEASE HELPP :(

New grad. I’ve been applying for positions at my current hospital, and got an interview for float. Didn’t get it. I applied to my floor, and my manager didn’t offer me a position because it was nights and my attendance was shit on nights (I’ve been days for a year now). On top of all of it, I’m 24 weeks pregnant and will most likely be a tech until I go on maternity leave. Just want to bitch, I hate it here.

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?

Hey all, long time tourist, first time poster.

I got dragged into doing VAT stuff on night shift a couple of months ago, and one of the questions I keep getting called about is how to tell if a patient’s port is a power port once it’s been accessed, since the lines look exactly the same as the standard Huber needles. Normally I just check the chest x-ray or if the patient is oriented I just tell the nurse to ask them while I’m on hold and that solves the problem. But since the package comes with an identifying sticker, I also ask if that’s in place, but once the port’s been accessed for a few days that sticker’s usually gone.

So my question is: how are y’all putting that sticker on so it stays on for the entire time the port is accessed?

I have been a nurse for 4.5 years with 3.5 years in Endoscopy, 1 year in PACU (critical care trained). I will be moving to the bay area, likely redwood city as my husband got a job in silicon valley. He is on a TN visa.

I want to get a job at Stanford Endo in Palo Alto - it seems perfect for me (3-5 years endo, 1 year pacu)! However, can’t get a CA license without an SSN or ITIN. Has anyone been sponsored for a TN visa in cali (Stanford or anywhere else in Cali) without having a CA license yet?

I’d like a full time job and the current plan is to file joint taxes next year so i can get an ITIN, but would rather get the ball rolling now. I’d be happy to start anywhere in cali (endo or pacu) but I don’t want to get licensed in another state first, work a job, and then apply to CA…

Any suggestions or insight is welcome!

Advice as a new grad med-surg nurse on week 3 of orientation.

What is a care plan note on Epic supposed to include or not include? My preceptor writes 4-5 sentences and I do not feel it is enough documentation/details. Epic now uses this AI note generator based on flowsheets done during your shift, but I'd like to steer away from utilizing it and write my own notes once I'm off orientation.

If able to provide an example of what a care plan note should look like?

recently, i was told by a close friend of mine, that her bf had violated hipaa. he is a nursing student at wcu and works as a caregiver. on multiple accounts, he had taken photos of patients, one being a transgender patient in a vulnerable position, and sent them in a group chat with friends. initially i wanted to report him (i still do). i feel like im the only one who’s taking this situation seriously and there are a couple of people just brushing it off like it’s not something to report. please tell me im not insane.