"But isn't it so sad?"

Paediatric nursing. The best/hardest/saddest/most rewarding/fun job you can imagine. Feel free to ask questions if you stumble across this!

[thehavenmh]

[adventuresinpaeds]

This is how I imagine some of the teens I work with when we ask them to make happy things to help depression. 😂

[heardatmedschool]

Med student: Yesterday, I had to learn how to touch boobs.

Engineering student: Why do I always arrive at the weird parts of conversations?

[adventuresinpaeds]

Today was the first day of strikes in an unprecedented action for the RCN. Making the decision to not go to work and instead stand on that picket line will have been a tough decision for everyone who did so today and will likely have to again next week or in coming days of strike action.

None of us want to leave our patients without the safe staffing they deserve, but the strain put on the NHS and the real terms pay decrease we've had over the last 10 years mean we can't recruit or train enough staff. Every day we have to face the fact we don't have enough people to allow us to give our patients what they really need from us, not to mention people are having to make a difficult decision on whether they can afford to stay in a job that doesn't allow them to afford their bills or food for their families.

NHS staff are going home in tears feeling like they failed their patients when really it's our government who have failed us all in not recognising and compensating our services for the work we do, which directly impacts on our ability to get those people we need.

Please support your NHS as we fight to give you the care you and your loved ones deserve.

[dxmedstudent]

After 28 years, I’m leaving the NHS. And it wasn’t the patients who pushed me over the edge

After 28 years, I’m leaving the NHS. And it wasn’t the patients who pushed me over the edge | Tara Porter

I just can’t take the health service’s top-down, cost-cutting bureaucracy any longer, says chartered clinical psychologist Dr Tara Porter

[adventuresinpaeds]

Our service and our staff are being pushed to their limits and beyond, while the politicians try to paint us as selfish and callous.

This is why we have to strike, to better our national health service and retain and recruit so we can safely care for our patients.

[adventuresinpaeds]

This tumblr stands with women and their right to choose.

Banning abortions doesn’t stop abortion, it stops safe abortion.

[adventuresinpaeds]

[pervocracy]

How to hack any hospital computer

-Use the password taped to the monitor

How to hack any hospital computer (L337 version for advanced security systems)

-Use the password taped to the back of the monitor

[dysgraphicprogrammer]

As a computer guy: This is what happens when you have too much security. It reaches a tipping point and then suddenly you have none. Security at the cost of convenience comes at the cost of security.  

[pervocracy]

This is true of so many things in healthcare.  Example: our software is designed to automatically alert the doctor if a patient’s vital signs are critically out of range.  If someone has a blood pressure of 200/130, the doc gets a pop-up box that they have to acknowledge before doing anything else.  It makes sense, in our setting.

But then some mega-genius upstairs realized something: the system was only alerting for critical vital signs, but not for all vital signs that could possibly be bad.  Like, yeah, 200/130 is potentially life-threatening, but 130/90 is above ideal and can have negative effects on health.  Should the doctors be allowed to just ignore something that could negatively affect a patient’s health?  Heavens no!

So now the system generates a pop-up for any vital signs that are even slightly abnormal.  A pressure of 120/80 (once considered textbook normal, now considered slightly high) will create the pop-up.  We have increased our vigilance!

Well, no, what we’ve actually done is train doctors to click through a constant bombardment of pop-ups without looking.  We’ve destroyed their vigilance and made it much easier for them to accidentally skim past life-threatening vital signs.

But you can’t tell that to management, because you’d have to confess that you are a flawed human with limited attention resources.  They’d tell you “well, all the other doctors take every abnormal vital sign seriously, it sounds like you’re being negligent.”  And if you’re smart, you back down before you start telling the big boss all about your habit of ignoring critical safety alerts.

The end result is exactly the same as if we had no alerts at all, except with more annoying clicking.

[softlyfiercely]

this here is an absolutely fascinating overview of how and why this happens

[hachama]

If everything is a priority, nothing is a priority.

This is not a bug in human behavior, it is a feature.

[sometimeswegetlonely]

Pop up 1 - note, patient is on diabetic register

Pop up 2 - note, patient is on kidney disease register

Pop up 3 - note, patient is on hypercapnia scale 2 observations

Pop up 4 - WARNING VTE assessment 72 hours overdue

Yes, computer system, the VTE assessment is overdue because I have to click through three other pop ups to know it is due and by that point I’m just clicking on autopilot

[the-potential-drgreen]

Beautiful floral medical art

Find them here :)

[defibforvfib]

Do you ever think about how crazy nursing really is?

And I don’t mean in the we deal with crazy people aspect, but more so how huge and ever increasing our scope is and how it has literally evolved so much even in the past 40 years. It’s literally insane when you think about it. The same license that allows you to take care of kids in a pediatrics office is the same one that allows a different nurse to independently insert PICC lines, and even still allow the critical care nurse to manage ECMO. Some of these nurses are doing it with a diploma or associates degree. Some nurses are anesthesia providers or primary care providers even still. Now obviously each specialty and advanced practice requires specific training or additional education, but the basis for all of these different avenues is the same RN license, and when you think about it, it honestly sounds literally so crazy. I would honestly love to sit down with older nurses or former nurses to see their views on how the profession has evolved, where it is currently, and where they think it’ll go. Like this is a crazy profession y’all. Never feel like you are “just a nurse” because it’s honestly one of the most badass professions out there.

[poking-kids-with-needles]

The hardest conversation of my intern year

Most people think that working in pediatrics is like this:

And it’s pretty true. But when it gets nasty, it gets really nasty.

 I started my rotation in the ED last week, and my second patient was a 4 week old with a finger fracture.

 Read that again.

 FOUR weeks old. Meaning that he can’t roll over, can’t crawl,  can only see about a foot in front of his face and can’t lift his head. So that fact that he reportedly just “woke up like that” sketched us all out.

So we got a skeletal survey, which is a series of x-rays of every bone in the body that we get on babies when we’re concerned that they’re being abused. And the results made me literally gasp out loud and feel like I was going to vomit.

12 fractures. 9 posterior rib fractures, which happen when adult hands squeeze a baby so hard that it breaks them. Two leg fractures, which happen when an adult picks a baby up and swings them by their leg. And then the finger, which I don’t even want to imagine. 

 It was then my job to go tell the parents what we had found and what was going to happen now. I took care of all of my other patients first and fiddled around on my computer for a few minutes. When I finally couldn’t put it off anymore, I walked towards their room, shaking so badly I wasn’t sure my voice would work. I was so afraid of what their reactions would be. Would they scream at me? Be physically violent? Take the baby and run (it happened to another resident earlier this month!)?

 "The x-rays came back and we found multiple rib fractures and two leg fractures. They are already healed and are older than the finger injury. At this point, we are required to contact CPS and admit him to the hospital to make sure that he will be safe at home before he can leave.”

 The mom was shocked beyond words and wanted to know how this could have happened. I thought “You tell me and we’ll both know,” but said “I can’t tell you how the fractures happened, I can just tell you that they’re there.” The dad had his face in his hands and… didn’t seem too surprised. I’ll never know the whole story.

 When we were in med school and all deciding which field to go into, people would often say, “I can’t go into Peds because seeing kids get sick with cancer is too sad.” I disagree. Our cancer patients are some of the strongest and pure-souled people on the planet. I am so honored to get to walk along side them on their journeys, and getting to know them is one of the best parts of my job.

But child abuse sucks. It keeps us up at night and makes us lock ourselves in the bathroom at the hospital to cry. It puts fire in the eyes of even the sweetest and gentlest pediatric nurses and doctors. It’s what I hate the most about my job.

Child abuse is one of, if not THE, worst thing that could ever happen to a child, and is 100% preventable. There are no excuses for hurting a child and there are no excuses for turning a blind eye when you see it. Everyone who works with children has to be on high alert and always trust their instincts.

If you want to learn more, check out:

https://www.cdc.gov/features/healthychildren/ and https://www.childwelfare.gov/topics/preventing/preventionmonth/

[badjokesbyjeff]

What do you get for winning a muscle loss competition?

Atrophy.

[spider-hands-mannos-deactivated]

Heres the thing you gotta understand about statistics. 

“Increases your chances by 80%” does not mean “there is now an 80% chance”. 

If your chances were previously 10%, your chances are now 18%, not 90%. 

if your chances were roughly 1%, they’re now just slightly less than 2%. 

thats how that works. 

[hopeful-weirdo]

Wow I don’t understand math at all

[freinhardt56]

‘if you have a baby after 35, the chance of deformities goes up by 100%’ is a line I hear alot.

It goes up from .5% to 1%

[fandomlockedfan]

I think my brain just stopped working

[authorgirl1111]

100% is just another way of saying twice more likely. So 100% more basically means multiply the number you do have by 2.

[that-catholic-shinobi]

Imagine how many woman are scared to have kids because of that statistic

[what-even-is-thiss]

This is why I took stats instead of calc. Because I don’t build engineer bridges in my everyday life but I sure do read studies that affect how I might live my life if I misinterpret them.

[bogleech]

I’m terrible at numbers and math but I knew this and I really take it for granted. The average person definitely assumes, quite understandably, that “600% INCREASE!!!” must always mean a whole lot even if it literally only means that one of something is now six of something. Politicians probably take a shitload of advantage of this confusion.

[hexmaniacmareen]

just remember that increased BY and increased TO are very different things.

[bogleech]

Oh god I didn’t even think about that whole other layer of confusion. Yeah if you’ve got 100 people and one of them is sick, that’s 1% of them who are sick, so if it “increased BY 100%” then that means now two people are sick. If it’s “increased TO 100%” then all 100 people are sick.

[gamma-dealer]

Politicians do it a lot. I mean I recall in recent history people taking about a tax increase by X%. Hell, I’d even consider the marginal tax increases part of this confusion.

[wheresonichedgehogwnt]

You know what bugs me about discussions of physician burnout and resiliency?

They seem to be based on the idea that people who completed four years of medical school and however many years of residency and worked hard and sacrificed and were constantly pushed out of their comfort zone and didn’t see their family or friends as often as they wanted and made new friends and communities wherever they found themselves, and did this their entire young adulthood, aren’t actually resilient and that the issues they’re facing can be fixed by meditating for five minutes a day and taking a walk at lunchtime.

First of all, since when did physicians get lunchtime?

Second of all, since when did becoming a doctor in the first place not take a lot of resiliency, so why do people assume physicians, who have already demonstrated themselves to be resilient, are the ones who need fixing?

[md-admissions]

Couldn’t agree more. Say it louder. Physicians are being blamed for being human in an inhuman system. It’s up to EVERYONE to realize this is a serious issue driving physicians to suicide and abandonment of a passion they once loved. And it’s on all of us to say this is not how we want healthcare delivered.

[telep0rt]

Yes. Yes. Yes.

I get really mad when I sit through those burnout discussions because I feel very blamed.

It is not the fault of someone who works 80-100 hours a week, never sees their family, and puts 100% of their emotional energy into a job that takes and takes from them that they feel burned out. So DON’T tell me to “practice mindfulness” or “do more yoga” or “make time for my family” – like I could somehow fix myself.

I am strong. As physicians and trainees we are incredible to fight through what we do every day. So let’s change the conversation – we’re not burned out. We’re taken advantage of. Our humanity and our love of our jobs is taken advantage of.

Don’t tell me to take a walk. Tell the system to allow me time for one.

[mariekavanagh]

Veterinary staff are a beautiful mixture of factual-thinking and intense superstition. 

Don’t ever remark on how smoothly the anaesthetic’s going, don’t ever assume the “just a booster” appointment will take 10 minutes, and for the love of God don’t even think about saying the Q-word. 

[adventuresinpaeds]

Oh I have developed so many random superstitions in this job. Didn’t manage to get coffee before handover? It’s going to be an awful shift.

[whitepeopletwitter]

[cranquis]

PREACH IT!!!

Co-signed,

A frustrated urgent care doctor

[wayfaringmd]

Also from a family doctor who has real work to attend to.

[adventuresinpaeds]

When your whole team have learned to predict that cranky nurse’s replies to handover so well it’s almost a running joke.

[dot-nursingstudent]

Our hospital shared some tips for dealing with stress during the pandemic. One of the suggestions was "maintain regular sleep and work hours".

Talk about not knowing your audience.

[adventuresinpaeds]

😂😂😂