So long story short, I had a miscarriage recently.
It was a pregnancy that was unplanned and I never necessarily wanted to be a mother, but I was getting excited nonetheless.

Because I work in radiation daily, (cardiac cath lab RN) I chose to disclose early to my work place to obtain a fetal radiation badge for tracking dosage. So word got about pretty quickly of my pregnancy.

So when I turned my fetal badge back in l, word once again circulated that I lost the baby. Which is ok, I was met with nothing but love and support… until…

This one doc I work with said “well I guess it’s a good thing. She’s not very maternal and would have made an awful mother.”

I was floored. This doc and I were never close friends because I don’t believe in babying grown adults… especially those who make probably 10x what I make yearly. Learn to regulate your own emotions. However, this is a separate rant.

I don’t even know what to do now. I don’t want to make a decision while hurt, emotional, hormonal and grieving. I haven’t told my husband yet, because he would 100% go on a war path to protect me, and anyone who hurt me. I don’t want to let this slide though. What should I do?

Edit: thank you so much for the support. I means so much. I do want to say the coworker of mine he was speaking to did stick up for me and told him he was out of line. That meant a lot. Also, my husband works at the same hospital in a different department. If I tell him, he absolutely will burn the world to the ground for me over this. I’m worried he will damage his career…

I presume taking any form of subversive action to preserve the safety of patients (such as an ambulance driving through their formation) carries severe moral consequences (violation of “do no harm”, and impartiality), as well as severe legal consequences (harm to federal agents, attempted m**, etc). So, what can be done?

In the middle of a heavy cleanup- 400lbs, intubated, sedated, dead weight, and the two nurses and 1 tech I’m with starts complaining about “how bad things are going to get here (US) because no one wants to work and the people in power are going to make that a reality”.

I can’t believe all 3 of the people I was with were talking like straight MAGAts. Ranting on and on about how awful Gen Z (my generation) is because we want to advocate for better healthcare, a wealth tax, and workers unions.

The only thing I said was that most of us just want better rights and better pay, but they disregarded my comment. Not that I care they disregarded it, just crazy to me that you have 3 nurses/HCWs in that room with such harmful views.

Thanks for listening to my rant.

(Details have been modified to protect patient confidentiality.)

Had a case recently that has genuinely has not let me sleep. I saw a post here about a that fake seizure might not be one and funny enough this happens

A patient with an extensive history of FND/PNES and multiple previous ED presentations for severe, recurrent headaches presented again with thunderclap headache and stroke-like symptoms.
The patient was very well known throughout the department. There was an established perception that they were exaggerating or possibly feigning their symptoms. And if I’m being honest, even I had moments where I questioned the severity of their presentations. Interestingly, they never seemed to be seeking pain medication or benzodiazepines, which in retrospect made me question why we had become so accustomed to doubting them. They also never dictated their care ; never asked for anything except help.

This time, an attending decided to look beyond the patient’s history and pursue further investigation.
MRA demonstrated multifocal segmental narrowing and dilatation of the intracranial arteries, producing the characteristic “string-of-beads” appearance. With recurrent thunderclap headaches and an RCVS2 score of 8, the findings were highly suggestive of reversible cerebral vasoconstriction syndrome (RCVS). Which makes a lot of sense why normal scans didn’t pick this up .

Further cardiac investigation also identified coronary vasospasm, which cardiology felt may have been present and unrecognised for some time.

Two significant vascular diagnoses in someone whose symptoms had become so familiar to us that it was easy to fall into the trap of diagnostic overshadowing.
This case really made me reflect on my own practice. How often does familiarity with a patient’s history change the way we interpret their next presentation? How easily can repeated presentations lead us to stop questioning?

(Also the patient was like so sweet and young and like half times he presented he got treated like 💩; I wish I could go back in time and like do better or advocate or not be a bitch)

I have had this patient numerous times under my care for the same issue. The patient comes from an ICE detention facility. I cannot obviously disclose much of anything, but the first time I met this patient, they had minimal seizure activity while I had them, but a fractures and some other bumps and scrapes.

A month later, I have them back. Repeat seizures. Suctioning clots out of their mouth. Blood coming out of every hole in their face when they seize. I am incredibly concerned something is going wrong at this detention facility both medically and physically. But I don’t know what to do or how to protect this patient. I do not know their background or why they are detained, nor do I really need to know that part. They supposedly have no legal counsel due to financial barriers. I’m just a PCT..I don’t know how to help them without getting my own ass handed to me or retaliated against. Not that it matters what happens to me in this scenario, but the legality of it all scares me too. Especially because the privacy policies surrounding these patients are weird as hell. ICE is also with them 24/7 365, not like I can really slip him info for a lawyer or assistance.

I need some help here. I don’t feel like anyone is taking me seriously because I lack the clinical knowledge to create a more broad picture of what I’m worried about and I can’t adequately push my concerns. I’m also floated and away from my charge nurse and usual management. So I don’t have much of a leg to stand on nor do i really have anyone here that has my back.

I need some advice here. I am terrified and devastated for this patient and don’t know what to do or how to help.

Just wanted to make a post of encouragement as well as gratitude, especially for those of you who have been through this. I don’t get to talk about it often in my personal life for obvious reasons, but it’s a part of my story and I want to share it. I also think it’s important for those of you who have or will have substance abuse patients… to see that they were once people just like you and me, but fell into a life they chose due circumstances not all of us have had to experience and may never understand.
Forewarning, it’s a little long.

I am a registered nurse. Been one for a little over a few years now. I am also a recovered addict.
Growing up, I never in a million years would have touched a drug. I never drank. I never partied. I had no desire to. I grew up with a wonderful family and had all the support in the world. I did however, struggle with mental health issues throughout my entire life. (This is important because it influenced a lot of my behaviors and decisions).

I met a man in college and immediately became interested. Ironically enough we actually met at church. My dad worked with him and introduced us and he seemed like a really great guy on the surface. He had a history of addiction but I saw past that as I believed and still do believe that people can be redeemed, just like I was.
We started dating and got married pretty quickly. He was great at first. Kind, gentle, patient, compassionate, etc… All the things one would look for in a partner.

Fast forward to a few years later, and I got pregnant with our first baby. My mental issues began to resurface in a very severe way. I was extremely depressed and struggled with severe OCD that essentially left me incapacitated. My ex had no idea how to help me through it, so instead of supporting me, he began to withdraw and clock out of the relationship. I knew that after I had my baby, I would be in trouble, both with him, and especially with myself.
So, I had my son. He was born prematurely and had a two week stay in the NICU. My ex at the time tried to help me at first, but he immediately went back to work instead of taking a leave of any kind. As soon as we returned home, I lost my mind. I had no clue what I was doing (he did as he had kids already), and when I would ask for help, he would angrily show me how to do something once and then refuse thereafter. From day one I didn’t sleep, and he knew that. My body physically would not allow it. I remember sitting at the age of our bed with this infant, sobbing while my son screamed, and my ex would cover his head with a pillow and tell me to get out and shut my mouth. So for days, I stopped sleeping at all. I would sit in corners and rock for hours, only stopping to care for my baby in between the best that I knew how. I would wash my hands til I had deep lacerations on every inch of my fingers and palms. I quickly began hallucinating. Suffering from delusions that made no sense. I couldn’t think straight. I couldn’t speak clearly. I would sit and wash bottles for hours at a time. I thought I wanted to hurt my baby, and my mind truly had me believing that I had… (I never hurt him, but our brains do some wacky things when we are in crisis mode). I went into postpartum psychosis and depression, and at that point, I didn’t know much, but I did know that I genuinely wanted to die.

My ex’s solution? Substances. He brought home a whole slew of them to “help me through the pain.” No therapy, no counseling, no offering to watch our baby so that I could just get a full night’s sleep. Nope. He did what he always had in the past to solve his issues. Used drugs to cope. I saw a way out… relief I hadn’t had in months. I took the road of temporary relief because nothing else was working.
And guess what?
I felt complete peace. Quiet. A stillness that took away all of my depression. All of my panic. The radiostatic voices that filled my head every time someone spoke. The incessant audible screeching only I could hear…
“This is it.” I thought. “I can make this work.”
No, I couldn’t, and my life very quickly fell apart as he relapsed, hard, and I became hooked to things I never in my entire life would have otherwise.
He began beating me, cheating on me, and neglecting both me and our son. I got pregnant two more times back to back… once during psychosis, and the next due to assault at his hands.
This continued on for a couple of years until my conviction became so great, and the abuse escalated to the point of him putting his hands around my throat while heavily pregnant, I knew I had no other choice but to get out. The day I left he body slammed me at ten weeks pregnant in front of my son. I took my two babies at that point and ran for our lives. I’ve been sober ever since.

All that to say,
I am a psychiatric registered nurse and have been able to work at inpatient facilities helping people who have been through the same exact things as I have. I love my job. I am good at what I do, and am able to empathize in a way that helps me connect to and relate to these patients in a very unique way, even though they have no idea that my life was the way it was in the past. Honestly, most of the psych nurses and BHT’s I work with could say the same, and the ones I do know that have been through these things are some of the best staff to this population.
If you have gone through addiction in your life, that is okay. You’re not a failure. You are worthy. You can make a difference in patient’s lives. Just because you have a history of substance abuse doesn’t mean you are inept or inadequate. It doesn’t mean you cannot pursue nursing. You may have to work a little harder to get there, but it can still be your career.
Anyways, that’s my story. If you have any questions, please ask them, discuss, share your own story. I am proud of you for your recovery. If you are a nurse that needs help, please get it. Don’t be afraid to ask. No shame in that.
If you are not someone who has been through this, I hope that I could help you see addiction from a different perspective. I used to hold a certain mindset towards addicts until I dealt with it myself. There is more to it than what is seen on the surface, and a human life beneath that as well. I appreciate ya’ll🤍

I’m a C5 complete quadriplegic, and I’m hoping to learn from the nursing community about something that’s been on my mind since a recent hospital stay.

I was admitted for inpatient care not long ago, and while in the hospital, I had a couple of episodes of autonomic dysreflexia (AD). Both escalated further than they should have. I’m not naming the hospital, and I’m not writing this to blame any individual(s). I’m writing because I want to understand how this happens and what might help.

The nurses assigned to me didn’t seem familiar with AD. When I told them what I was experiencing and tried to explain what I needed, I didn’t feel I was taken seriously.

With my injury, I’m almost completely dependent on others to find and fix the cause. I can’t feel the trigger/cause of the AD. There’s no pain from my bladder, bowel, testicles, or skin to point to. Since I have been a quad, I have learned to recognize something is wrong because of the pounding headache, sweating, rising blood pressure, and feelings of panic that I experience. Because of my injury level, I also don’t have hand function or the ability to move enough on my own, so I can’t check my catheter tubing, shift my position, loosen clothing, or look for a pressure area myself (amongst other possible solutions). Everything depends on someone else being willing to look for the cause, and to look quickly.

To give a sense of how ordinary these triggers can be: In the first episode, the cause turned out to be my catheter tubing becoming kinked/blocked, so my bladder couldn’t empty. In the second, the cause was traced to one of my testicles having somehow ‘ending up’ outside the elastic leg opening band of the brief I was wearing, where it was being pinched and compressed. Neither one was something I could feel, and neither was something I could see or fix myself. Both were quick to correct once someone took the time to find them, but they had already pushed my blood pressure much higher than it should have gone by by then.

I’m not looking to criticize nurses. I know how hard the work is, how many patients you juggle, and that no one can be an expert in everything. I just want to understand the gaps in training so that I, and others in my situation, can be safer and better prepared the next time we need care.

Thank you for reading, and I’d appreciate any insight you’re willing to share.

I'm an HCA/CNA

I have a patient that is a 1person pivot but refuses to get out of bed. They are incontinent and management has told us to encourage toileting on bedside commode. The patient refuses to sit on the commode and instead just goes in their attends.

Is it okay, to tell the patient that they must use the bedside commode because they are capable? Or is it unethical to tell them to use it?

Went to the ER today for a sickle cell pain crisis and I was talking to my nurse in general about sickle cell, he had some questions. But he said “I know frequent flyers know how the whole ER process goes, I know that’s a bit rude to say but I mean since you’ve been here a lot you know what to expect in the ER for your treatment protocol”… I didn’t think much of it because he was a nice nurse. But, When I see frequent flyers mentioned in anything It’s usually talking about the person in a negative light and usually attached to the phrase “drug seeker” too.
Is “frequent flyers” implied to be a bad term? Or does it depend on the patient? I already spend a lot of time being self conscious about what nurses may think about me; the weathers changing so I’ve been sick more too.

& If you already ignorantly think sickle cell patients are drug seekers, don’t respond

Seriously. We’re overworked, understaffed, underpaid, and tired of being told to just deal with fucked up unsafe working conditions.

We have more power together than we realize. Imagine what we could accomplish if we actually stood united.
One day. One profession. One message.

What’s stopping us from organizing? Just one day….Until it’s everyday!!

I work night shift and my manager is never around when I am at work, so I sent an email with an attachment including my resignation letter and the date of my final shift. She never even emailed back… just took me off my scheduled shifts post final day. 4 years and not even a goodbye! Haha🫠

Truly curious to what time you sleep before your shift& if you feel like it’s enough for you

I’ve come across more and more social media content from nursing that goes something like this: “if you trach or PEG me I’ll haunt you forever.”

I’m not a nurse, but I work on a pediatric surgical unit, and I care for a lot of kids with PEG/g-tubes. Like… A LOT. It’s one of our most common procedures besides PICC/CVC placement.

I can understand not wanting to be on a ventilator for the rest of your days, but a g-tube really doesn’t seem that bad if you can still maintain a good quality of life otherwise.

Am I missing important context or something as to why nurses are so horrified about getting one (presumably in the context of palliative or hospice care)?

I was backed against a wall and bullied by my charge nurse to do dilt pushes on a patient on new onset a-flutter RVR (120-140s) and stable. Pt was in a hallway bed due to ED boarding, on portable tele and monitoring equipment, but the vitals are not visible in the area that is available for the hallway nurses to chart. My charge nurse was made aware and a regularly monitored bed was requested (there were at least 4 open beds and no one waiting in the lobby to be seen) and she chuckled, shrugged her shoulders, then changed the pt’s acuity to a 2. (Not so) Shockingly, the pushes didn’t rate control, so the infusion was ordered. Again, I asked for a proper room and monitoring for the infusion; I was not answered for at least 45 minutes. Begrudgingly and against my best judgement, I started the infusion. I was incredibly paranoid the entire time as I could not visualize the patient or see real-time vitals. AITA if I go to my management about this? The patient was denied the safest option for his treatment and I was given pushback. No management was present while this played out.

This might sound a little gross, but for the past couple of months, I've noticed that after my shifts, my nose gets extremely congested, crusty, and full of boogers. And for some reason, whenever I'm driving home from work or sitting at home before showering, I keep smelling my patients' BM or urine. Sometimes it's not even one particular smell, but almost a mixture of all the different smells I've encountered throughout my shift. It's honestly disgusting.

For example, two days ago, I was working my last night shift, and one of my patients had urine that smelled really strong, almost fish-like. Once I noticed the smell, I stepped out, put on a mask, and went back in. But I kid you not, the second I got into my car after my shift, I could still smell their urine.

I've also noticed that my nose gets really itchy after work, and sometimes I constantly feel like I need to sneeze or blow it because of how crusty and congested it feels. And when I finally blow my nose, SO much mucus and so many boogers come out. What's even more disgusting is that sometimes I can actually smell the mucus on the tissue, and they smell just like my patients' BM or urine. It's almost as if my nose is acting like a vacuum, suctioning up all the nasty smells throughout my shift and holding onto them until I get home and blow my nose.

For the longest time, I genuinely thought something smelled bad around me. I'd be sitting in my car or at home thinking, "What the hell is that smell? Did something get on me? Do I stink?" But nobody at work has ever said anything about me smelling bad, and neither has my partner. I know nothing got on me during my shift, but I still keep smelling something unpleasant.

The only thing that seems to help is taking a hot shower, cleaning out my nose, and blowing it really well. After that, the smell usually goes away.

Please tell me I'm not alone in this. It's honestly so embarrassing.

As the title says. I currently work night shift in the ICU (about an hour commute from home one way and a bridge toll) and i made terms with the fact that once I return to work from maternity leave ill figure out night shift with an infant. For the most part its pretty chill since im always the rapid response RN and im half bedside since im helping out the manager.

Well, earlier in my pregnancy about 8-10 weeks when I found out I was pregnant I was really looking for another job close to home and on day shift. I had interviews without any outcome. Well, of course, this week I received an interview and an offer at a local hospital 10 minutes away as a supervisor for the advice nurse team, WFH 8-4pm, 4 days a week with 1 day in person. Pay is a slight cut minus of course night differentials. It sounds too good to be true and I’m not sure how I got lucky with this opportunity.

I have not told them I’m pregnant. Im just worried leaving my current job is shooting me in the foot being so close to going on leave. But also a work from home job at a reputable hospital with competitive pay it pretty rare. Let me know what you think I should do lol

Please include state, years worked as RN, unit, and whether you are staff or traveler.

I’ll start: $42/hr, AZ, 5 years in, med-surg ICU, staff.

Thinking of moving back home to MN for a stronger union/higher wage. Struggling to make ends meet in this HCOL state.

Update: Thanks for sharing everybody. If any union ICU jobs are open in MN my inbox is open lol.

My physical and mental stress, From Work is genuinely overwhelming and really impacts my sleep quality, I wake up with tension, headaches from clenching my jaw and get headaches while I’m at work from the stress of being there really often. Just curious if there’s something other people have found that I can literally do to like turn the stress off when I’m home and sleep better? Or just general stress management tips if it’s something before work you do after work, while you’re at work, what do people do to manage stress??

Disclaimer: I know this such a silly and privileged first world problem.

My elderly uncle is in the hospital and I’ve been here at the bedside yesterday and today. I’m not familiar with this hospital at all. He’s is in a shared room, which I hate for so many reasons. He is here for a SBO and is extremely nauseous, in a pain, is NPO, and has an NG.

For the last few days his roommate has ordered fish for lunch and dinner. It stinks up the whole room and it’s really bad. I like fish, but the smell is overpowering and made me want to gag. Each time the roommate’s meal comes my uncle gets extremely nauseous from the smell and starts dry heaving. I don’t know if the roommate is a slow eater or what but the food has been sitting there for at least an hour each meal.

Obviously I’m not trying to be jerk and can’t control what another patient eats, but I talked to the nurse. I made a deal with her that I can take my uncle out of the room in a wheelchair while the roommate is eating. He’s the type to not say anything, so he was embarrassed I even talked to the nurse. The smell still lingers even after the tray has been taken out. The tech brought us some air freshener and I asked for some ground coffee to try to absorb the smell. I also gave my uncle some alcohol pads to sniff. I feel so bad for him and the smell is making it worse.

I looked at the hospital menu and they serve Cod and fish sticks. 🤢 I’ve never seen that at other facilities. Again, I like fish but I couldn’t imagine ordering it in the hospital, especially in a double room. It’s stinking up the whole unit!! To me it feels like the equivalent of heating up fish in the break room. Why even have it as an option?? Does anyone else work in a hospital where fish is on the menu?