talk nursey to me

Hi. I'm Nurse Anonymous, a twenty-something nurse with her heart in her scrub pocket and her hands deep in ... uh, hand sanitizer. I love nursing and the connections with people it allows me to have, but frustrations can run deep, and I've found that humor makes things more bearable. So, welcome -- and enjoy your stay.

[nursingdiary]

A Nurse's Thanksgiving

As a Nurse, I’m thankful for life. Thankful for each breath I’m able to take unassisted. Thankful for friends and family because I’ve seen those who don’t have those people in their lives. Thankful for a job that puts a roof over my head and food on my table. Thankful for education that gave me the ability to save lives and qualified to do what I love. Thankful for patients who appreciate what I do even if they aren’t able to express it. Thankful for the challenges and mistakes I’ve made that have made me a better person. Thankful for a God who has blessed me beyond measure. Thankful for everyone who has supported me on my journey.

Please share what you are thankful for and share the spirit of gratitude with a world that needs reminders of the GOOD things in our lives.

Happy Thanksgiving!

[nurseanonymous-blog]

Happy ridiculous super moon to all my fellow nurses. May your patients be slightly less crazy than could reasonably be expected 🙏🏼🙏🏼🙏🏼

[cardiacattack-deactivated202106]

Pediatric version of the tree of life! (Don’t worry about those vitals, they’re actually perfect 👌🏻).

[nurseanonymous-blog]

I'm a high school senior and I really want to be a nurse but I'm really confused because I wanna get a BSN but I guess you have to a apply as a pre nurse ¿ I'm so confused I need help

Yup! You'll apply as pre-nursing so you can do your school's nursing prerequisites. Then, usually during your sophomore year, you'll apply for the nursing program. Once you're in, you can officially declare your major as nursing. It's a little different than for other majors, but it works 😊

[whycantisayfork4]

Fellow night shifters!

What do you take to work for meals and snacks? I’m trying to meal prep and plan for my weekend. 3 nights in a row and our cafeteria sucks and I can’t afford take out. So, ideas? Please and thank you!

[emmysmusings]

Smoothies! I find its easier to actually have vegetables during night shift of I’m drinking them instead of eating them…

[boluscoffeestat-deactivated2020]

Depends on how hungry you get at night. Some of my coworkers literally eat the entire shift (variety of fruits, veggies, nuts, etc). I usually am pretty good and just need a decent snack midway through otherwise I get really hangry by 5am. My usual go-to snack is some yogurt, fruit, and more coffee. Mixing up the type of yogurt and fruit is helpful too. I like something quick because sometimes I don’t get a chance or really want to take a full hour long lunchbreak on nights or I want to take a nap instead. I also like doing some meats and cheese with some cut up veggies. I know there are some good pre-made snack pack ones but I usually just cut up my own. 

[nurseanonymous-blog]

I’m a very hungry person, so I basically take what I would normally eat during the day. I eat yogurt with peanut butter or fruit near the beginning of my shift, a salad, rice and veggies, or soup near the middle, and a granola bar or oatmeal near the end. And sometimes more than that. We don’t actually get lunch breaks on night shift (which is definitely not legal, but whatever), so we just eat at the desk.

[nursehumorprn]

When your patient asks for pain meds, but all you can give them is tylenol

[caringintensely]

The crazy thing is that IV acetaminophen (Omnivir) is incredibly effective pain relief, especially for post op pain. I didn’t take it seriously at first because I thought it was just another way to give dumb Tylenol but apparently it’s a whole different ball game when it’s given IV.

Tylenol is so hard on the liver and so much is removed in first pass that a safe PO dose doesn’t deliver much of the med, but you can get there with IV. Unfortunately it’s also very expensive. Our pharmacy will only dispense it if the patient is strict NPO, even with a doctor’s order.

[boluscoffeestat-deactivated2020]

We can only get it with an attending order but it can be really effective. Definitely a good one to get our hands on when we can.

[thedisagreeabledoctor]

Death and Dignity

“No, leave me alone!” she screamed as we attempted to examine her.  Her body was frail, her bones forming sharp edges where contours once were.  Her eyes rolled back in her head as she struggled for breath.  I quickly assessed the scene, 2 bags of saline were running wide open just to keep her systolic blood pressure in the 80s.  She was incoherent and relatively unresponsive as I tried to gather history.  Her husband stood at the bed side trying to maintain calm in the chaos of ER nurses, techs, and now physicians, rapidly assessing his wife.

Though she was obviously sick, one thing was clear: she did not want our help.  Every attempt at an exam was rebuked by screams and fighting.  But was this her?  Was this an altered state?  Questions abounded.  As we received records from an outside hospital the picture became more complex.  Metastatic cancer with a poor prognosis.  What were we to do?

As we looked to her husband, he struggled to answer.  Would she want us to be aggressive in our care?  Had they spoke about end of life matters?  Was she really refusing care or was she confused about what was happening?  He didn’t know how to respond to our tough questions.

Ultimately she was admitted and we managed as best we could, but her prognosis was looking grim and she was in very obvious distress.  I found her husband sitting by her bed, struggling to come to grips with this sudden deterioration.  “Perhaps we can talk outside,” I offered.

He and I sat together, in a private waiting area.  “Tell me about your wife,” I said.  He broke down, telling about her struggle with cancer.  He spoke of her strong personality that he loved; the same personality that sometimes drove him crazy.  He explained about her fear of hospitals, which resulted from her father’s experience dying in one.  As silence filtered into the conversation I summed up what he had told me.

“If she could speak for herself, what would she want?” I asked.

“She wouldn’t want this.”

We outlined a plan moving forward, about how to manage the pain and symptoms.  We called a chaplain to visit.  And we stopped all invasive treatment.  As I sat down, charting the discussion and decision, I came across a picture of her that had been placed in her medical record.  It was a picture that had been taken the first time she came to our institution, years prior to her cancer diagnosis and treatment.  I was shocked to see a vibrant, beautiful face staring at me.  She was almost unrecognizable.  The balding head I knew was full of dark curly hair.  Her face was plump, the eyes not sunken in.  She smiled at the camera.  

I stopped by her room as I left that day.  Despite her agonal breathing, she seemed much less disturbed.  Her face was calm.  Her eyes were closed.  There were no signs of pain.  Though I was looking at the aftermath of a body ravaged by cancer, I focused on that picture I saw earlier in the day, of a warm, vibrant, smiling woman.  And that’s who I said goodbye to.

[cranquis]

Bringing quality of life to end of life.

[nursefuratu]

Pokemon in the hospital

I’m seeing pediatric trauma patients who didn’t want to get out of bed to ambulate because of pain now walking the halls in search of Pokemon with smiles on their faces. This is such an amazing thing.

[a-very-purple-paper-prenurse]

Pharmacology study tip 132434:

Right, so if any of you guys are studying Pharmacology and are as bemused as I am (I literally just pterodactyl screamed at my tutor when she asked how I was going), then listen up.

I’mma going to tell you about an awesome MVP by the name of handwrittentutorials.com which explains a lot of things in a really easy way.

So yeah, check that out and good luck fellow student nurblrs and medblrs

[md-admissions]

Pre-rounding with my fellow and interns and a PokemonGo alert went off in my white coat.

I CAN BE A DOCTOR AND A POKEMON TRAINER OKAY.

[md-admissions]

Delighted to discover that my fourth year Med student and one of the third year residents also has PokemonGo.

Also my hospital is a gym on PokemonGo so I am now closer to achieving two lifetime goals:

1) complete residency and be a good internist 2) become a Pokemon gym leader

You will address me and my future Charizard as Queen Doctor Daenarys and Char-Char once I own this gym.

[md-admissions]

DZ never played Pokemon as a child and I’m definitely flipping out more than necessary at him right now. 

The part where I started sending him screenshots of all of my Pokemon and told him about my plans with Char-Char were probably weird.

[md-admissions]

APPARENTLY NOT WEIRD ENOUGH BECAUSE DZ LOVES THE IDEA AND HE SAYS HE’LL CALL ME KHALEESI

[scrubbed-out]

When work calls on your day off:

[freshrn]

trying to keep a straight face when the patient says something ridiculous

[copingnurse-deactivated20240217]

The Truth About Nurses, from an Ungrateful, Selfish, Arrogant Surgeon -

written by William R Blythe, MD (preface by Marta Farb)- Sep 18, 2015

Preface     I have entered the Golden Age of my career.  I call it gold because it is a precious commodity to work with people who have dedicated their lives to caring for others.  I train and support the leading electronic health record application of this country as a trainer and analyst.  But that’s not what I really do.  I encourage.  I dissect, decipher, and translate.  I listen, empathize, sympathize.  I stay in my classroom after training has ended to hold the hand of a nurse who breaks down crying, worried that she will lose her job of 40 years because she is not good with computers.  I’ve listened to the story of a pediatrician who is giving up the one profession he knows and loves because he sees the writing on the wall – he is long past retirement age and he is not interested in learning something new – not at 72.  And I observe the bright faces of the young residents and nursing school graduates staring back at me in the classroom, eager to learn but even more eager to care for patients.

The personalities found on a hospital floor fit the parallel world around us.  Yes, I’ve met and worked with the loving and the kind and the selfless.  I’ve also been elbow-to-elbow with some of the not so loving, not so kind, and not so selfless.  I’ve been the messenger that dozens have people have shot because they just don’t want an electronic health system changing their work life so dramatically.  Yes, I have scars but I wear them next to my badges of success.  One badge was given to me by the very same nurse who cried in my classroom.  I returned to the hospital and visited her on the med-surg unit about seven months later.  I found her busily typing away at her keyboard right outside her patient’s room.  She logged off, quickly retrieved her patient’s meds from the Pyxis.  Walking back I asked her how it was going.  She non-chalantly replied “Oh, it’s easy!  So much better than I ever thought it would be.”  And then she smiled and explained that she had advanced so quickly on the system that she had been chosen to be the unit’s Super User, training floor nurses herself.  I hugged her and saw, for a brief instant, a shimmer of gold.

In honor of those nurses and doctors, I am grateful to share Dr. William R. Blythe’s essay below:

“When a patient comes to our hospital for surgery, these are the people who take care of them:  The Pre-Op Nurses meet the patient, make sure they are ready for surgery, complete mountains of paperwork, reconcile their medications, sign permits, check labs, answer questions, allay fears, and make certain the patient is properly prepared for surgery.  And they put up with me.

The Circulator Nurse is in charge of the OR.  She makes certain the room, equipment, personnel, implants, disposables, medications and every other detail are ready.  She oversees that everything is checked twice, that everything is documented properly and that the proper surgery is performed on the right part and the right patient every time.  Her job is to ensure that we do everything right, every time, with no exceptions.  She makes certain that every sponge, needle, gauze, blade and specimen are properly accounted for.  And she puts up with me.

My CRNA puts the patient to sleep and attends to them through every moment.  She listens to their every breath and heartbeat.  She makes sure they are asleep, safe and comfortable.  She holds children her lap and talks to them like a mother while they go to sleep.  She makes certain every patient goes to sleep and wakes back up as safely as possible every time, no exception.  And she puts up with me.

The people who operate directly with me are Nurses or Techs, not doctors.  They make sure we have the proper instruments and equipment.   My Scrub hands me what I need before I ask for it.  She can anticipate what I am going to need next better than I can many times.  She makes my job easy and she makes me look like I know what I am doing when sometimes I am less certain.  The person across the table from me is often an RNFA or SFA.  They operate directly with me - tie the knots, cut the suture, retract, hold, pull, control the bleeders, close the wounds and a million other things.  I simply could not do what I do without them.  And they put up with me.

The PACU Nurses take the patients from the CRNA and recover them from anesthesia and surgery.  They assess and dress wounds.  They treat pain and anxiety and fear.  They hold screaming babies in their arms until they are awake.  They hold hands of grown men who are disoriented and fearful.  They re-assure and calm the parents, children and spouses of the patients.  They give wound, medication and discharge instructions, and they transfer patients to their room.  They land the plane, and it’s as important a job as any in the world.  And they put up with me.

The Nurses in the ICU and Floor take care of the patients, not me.   The ICU nurses are infinitely more capable of monitoring and assessing sick patients than am I.  I try to stay out of their way and let them do their job, and they let me know when they need me.  The Floor Nurses take care of every detail of every patient:  What and when they eat; medications; wound care; ambulation; checking vitals, labs, weights, sugars, pulse oximetry, I’s & O’s; draw and check labs; start and re-start IV’s; and countless other things that only nurses understand.   They spend time with the patient and family all day.  They educate and answer questions.  They pray with the patient and family.  They cry when their patients die.  And they put up with me.

The truth is that if a patient is in the hospital for 48 hours, they may see me for the smallest fraction of that time.  I say a brief hello before surgery, I operate, I speak to the family, and I make rounds each morning.  I may spend 15 minutes each day at any one patient’s bedside.  The rest of it - every second, every bit, every detail, everything - is performed by the Nurses.  Honestly, the one who probably needs the stethoscope least is me.

And in the end, through it all, they put up with me!”

Found on:

https://www.linkedin.com/pulse/truth-nurses-from-ungrateful-selfish-arrogant-surgeon-marta-farb

[copingnurse-deactivated20240217]

My first day off after a bunch of shifts in a row...

[nurseanonymous-blog]

I just tried to scan my badge to exit the bathroom.

What are your #nightshiftproblems ?

[madamepomfreyrn]

I sometimes quietly knock on doors while alone in my apartment.

[nurseanonymous-blog]

Can’t say I’ve never done it.

[turquoiseaqua-deactivated202301]

I tried to open the elevator by scanning my badge. Also, gently knocking on the door to the lab and then hoping no one heard you.

[flyingeagleclaw]

I tried to scan my badge to open my locker. It took me three times of smacking my badge on the turn dial before I realized my mistake.

[sarcasticbabywhispererjess]

I’ve tried to unlock my front door with my car’s keyless entry fob… it was a couple tries before I realized my problem.

[thisisblizzard]

I tap my sauce bottle the same way I tap a syringe to get the air bubbles out

[pedsnurse-sarah-deactivated2016]

Sitting at a stop sign waiting for it to turn. Green. 😕

[nurse-kp]

I’ve scared my fiancé by walking through the house in the dark, without realizing he was up. To him, there was someone moving around in pitch black so clearly an intruder. For me, the habit of not turning on lights and disturbing my patient is ingrained and my night vision is above average now, I suppose. Oh and PS, I’ve been on days for 3 years now and I still do it… whoops.

[caringintensely]

After four nights on I’m bouncing around awake last night at 0100 while everyone in the house was asleep. I decided to clean out the refrigerator. I managed to clog the garbage disposal, which exploded old nasty leftovers all over the kitchen.

It took two hours to clean up.

[freshrn]

Frantically searching my 50 scrub pockets and huge nurse bag for my phone… while I’m on my phone.

[caringintensely]

Just WAIT until you talk to the husband....

Patients with dementia can be tough.  You’ve got all their ordered treatments and all the standard nursing care aside from the constant battle to keep them calm and in their bed.  But this patient was intubated and sedated.  Easy patient, I was told….”as long as the husband doesn’t call.”  

He had dementia too.

The husband called about twenty minutes into my shift.  I had just left my other very unstable patient’s room.  I gave the standard nurse “Why Can’t Patient’s Families Wait Until I’ve Actually Seen The Patient To Ask For An Update” eye roll and answered the phone.  

I can’t remember most of the conversation.  I couldn’t even make sense of most of it, it was…demented.  Here’s a little snippet:

“When you talk to her, does she understand what you’re saying?”

“I can’t say, sir.  We need to keep her very heavily sedated right now becasue of the condition her lungs are in.  It’s very difficult to keep her breathing in sync with the ventilator when we turn down her sedation, so the doctor’s have ordered us not to do that right now.”

“Yeah, but you’re a nurse, right.  You went to school for this.  YOU CAN JUST TELL.”

“So when she wakes up, she’ll be able to understand and talk to me just like she used to?”

“Honestly sir, we can’t tell right now.  She wasn’t breathing for quite a while before help got to her.  She could have brain damage as a result, but we won’t know until we can wake her up.”

“Then do that. She can’t breathe with all the stuff in her mouth.”

“We can’t safely do that right now because her lungs are too filled with fluid.”

“Does she feel like she can’t breath?”

“She is heavily sedated right now, she doesn’t feel much of anything, I’m sure.”

“She said that?”

“Well I can’t talk to her, but…”

“That’s RIDICULOUS.  Aren’t you a real nurse?? YOU should be able to tell!”

“I’m sorry sir, we can’t answer that either way right now.  I really wish I could tell you more..”

“BUT YOU”RE A NURSE. You must not be one of the smarter ones if you can’t even tell.”

This conversation went on for a long time.  Many nurses passed by me with sympathetic looks, knowing who i was talking to.  I vaguely remembered a term from nursing school….”perseverance”, was it?  When a person with neuro issues gets stuck on a particular subject and can’t get past it.

He’s railing now…about how we don’t tell him anything, and we’re liars, and why can’t we just do our jobs.  

My other patient needs attention.  Hypotensive, tachycardic, looking very pale and shocky.  I need to get off the phone with this…..(insert synonym for crazy here) man and take care of it, but I can’t seem to get a word in.  

Until he stops, abruptly.  

THANK GOD, maybe he tired himself out.  Or forgot what we were talking about. Whatever, I need to get off this call.  I have no time for this nonsense. 

“We’ve been married 49 years.”

I know this is true because the offgoing nurse told me that the patient’s son told her his parents were going to celebrate their fiftieth anniversary this year. The son is unable to bring his Dad, who lives an hour away, to the hospital to visit his Mom, for various reasons.

“I really don’t know what to do here without her.  I don’t think we’ve been apart for a day since we got married.”

Dammit.

The shame hits.  At what point did I forget that I was talking to a human being who is living though a nightmare?  Who may not even have the capacity to process what he’s being told?  

“This has to be so hard. With her so ill, and not being able to visit.”

“Yeah.”

“I want you to know we are doing everything we can to get her better and back home to you.  Okay?”

“Okay.”

I make sure he has everything he needs, since the son is unable to help much right now.  He has Meals on Wheels, a neighbor who checks in. The call’s over. 

I run around doing all the things I need to do for my sicker patient. Call the NP, pressors, STAT labs, blood transfusion.  

When I finally make it into her room, I know I look at her differently than I would have if I hadn’t spoken to her husband.  She not an elderly septic lady on the vent who may be brain dead, not anymore.  She’s somebody’s sweetheart.  

The guy has dementia, sure.  But he cleared my thoughts up.

[freshrn]

Oh my heart. This is the nurse life, people. Everyone is someone’s sweetheart.

[modernathenamd]

Down, Boy

Attending: *walks into room in strappy stilettos*

Forty-something male patient: “I like your shoes. That reminds me, I need a refill on Viagra.”

Me: *shudders internally and eternally*

[md-admissions]

[homotology]

💃🏻👠🙅🏻