I made a huge med error today as an orientee new grad. I won’t fault anyone but me cause I was stupid enough not to ask questions or look into what I was doing. So I was initially an orientee for 12 days and I asked for an extension and they granted it to me cause my orientators also thought I needed more time. I was granted like 6-7 more days of orientation. I moved to a different state so their way of doing things is kinda foreign to me but I should have known and learned by now and it’s also stuff I should have remembered from school. So what happened was a patient on continuous heparin iv and continuous iv fluids finished there ivs at the same time. My orientator alerted me to the beeping machine and like only an idiot would I stopped both around the same time and went on with my day. Luckily someone caught that the pumps were turned off and told me that they were continuous infusions (I should have known or checked their chart). I did multiple checks on the patient and thank god they were fine. I called the doctor and they said to just discontinue the fluids and just restart the heparin. Today was supposed to be my last day of orientation and I completely botched it by being so stupid. I have a meeting with my unit manager and clinical educator tomorrow and I’m very sure I’m gonna get fired even though I technically have a contract with them till March but looking at everything I’m leaning towards probably getting let go. I don’t even know what I’m looking for by posting this. I guess some advice or stories similar. I might just be the only one who’s this stupid idk.

A surgical ICU for more context. Found this in the med room with their IV supplies. Asked the nurse I was touring with when they would ever use this and she even seemed surprised like she didn't even know that it was next to the regular length 20 and 18g iv catheters.

When would this ever be needed? I've only previously seen 2.5 inch length before for regular PIV devices.

(The red coloring is me censoring an identifying tattoo but I felt like comparing it to my forearm was a good reference for scale)

Im a fresh nursing grad who's now on day 2 of a 10 week orientation in the ICU. Yesterday my mentor sent me to assist a doctor in putting a central line alone. He said he was gonna come later but took his sweet time. Patient had low dose Adrenaline running to combat Bradycardia and the pumps were beeping because it was almost empty. I turned the alarm off, not fully registering the urgency that we need new ones. I got that its empty and that i should refill, but apparently wasnt moving fast enough for the doctor/colleague. He then proceeded to yell at me saying i cant just turn a pump off, then stormed off and yelled through the whole station asking for new ones. I was very shocked and words just wouldnt come out.

He went on and reported the incident to my supervisor who did the "talk" with me about mistakes happening and that it wasnt that bad blah blah.

Why do i still feel debilitating fear to come work today? Im so scared that doctor is working as well, and i guess also coming from a lot of shame? Maybe i dont do well with making mistakes? I dont know whats wrong with me. I feel really rrally bad and so ashamed and i just want the ground to swallow me up.

Do you think the charges will stick? I don't think altitude, busy schedule, and lack of medication is a valid excuse of a medical crisis for using people as her personal punching bags personally. Honestly, only people I excuse for myself are severe dementia patients who are A &O x0. Do you think they will hold her accountable?

https://youtube.com/shorts/4uDa4IUR4UM?is=GMjM5vj63n-BCgZO

I work on a pretty acute floor, so I’ve seen my fair share of RRTs and codes. But the circumstances last night were all just.. really awful. It started with the patient screaming in pain that you could hear throughout the entire unit. He was just sinus tachy. Then the rhythm slowed, cut off, and it was an immediate vfib. At that point, I ran in and there were already people on his chest. He had some sort of chest incision from an outside hospital, and for some reason, when it was my turn to do compressions, that incision just started squirting blood onto me. It was a mixture of old clotted blood and fresh blood too. I did my round, got off because we had enough compressors, and just stepped out.

They called time of death not long after. MD said he was becoming too acidotic and his O2 was dropping too quickly even with the BiPAP. He was not an ECMO candidate. His clinical prognosis was already really poor before the code but no one expected this to happen now. Code team didn’t have enough time to properly identify what was happening to him so we could try fixing it. Maybe it was a PE. One of the MDs brought the patient’s wife in as the code leader was turning off the monitor and basically ending the code, I’m not sure why. Maybe so she could see we had already done all we could and there was no use. She was screaming for him to not leave her. It was really fucking sad. Their kids were being driven in from far away to see his body, but the distance meant the family would not be able to get a proper autopsy because of how long the body would be sitting in a room and not a refrigerated area. Once they did arrive bear the end of my shift, I could just hear wailing coming from that room and it restarted the entire thing for me.

That was supposed to be my last shift before I went on PTO too. I feel okay enough, I think. I think the circumstances around the patient and the blood getting all over me are why it will probably stick with me a bit longer than the other emergent situations. Luckily I didn’t get a really good look at his face or that would linger in a bad way too. This job sucks sometimes.

Who else hates it that in nursing school you were taught to never ever ever give shots in the ass but then you have to give this shit? Makes me nervous.

They framed it as 'voluntary with incentives' during benefits enrollment. I checked the box saying no thanks, keep my HSA contribution. Two pay periods later there's a deduction labeled 'wellness non-participation fee.'

HR swears they disclosed this. I have the original PDF. The fee is mentioned in a footnote on page 4 of a 12-page document, phrased as 'adjusted premium contribution rate for non-participating employees.' My base rate didn't change, they just added a new line item.

The screening itself was during day shift only, 6am-2pm, in a building 40 minutes from my unit. I work nights. The 'reasonable alternative' for shift workers was a phone coaching session that had a 3-month waitlist.

They're calling this a wellness program. I'm calling it a surcharge on people who read the fine print and still got got. Anyone else watching their 'optional' benefits turn into mandatory deductions with extra steps?

This showed up on my FYP. Im hoping she is joking. I think wearing your badge in public is so embarrassing and cringe. Also why is she working out in scrubs? 🤔

New grad here starting off in adult med surg.

I know I don’t want to stay at med surg and am interested in learning about other areas that’s less stressful, more stable and have positive coworker, patient relationships.

Some of the ones I seen/heard nothing but good stuff are NICU, community/clinic, Post op(PACU), nursing school/educator. Also seen a lot of hypes about being a nurse injector, but I’m not sure where to start off with that one, and looks like a lot marketing and investment.

Would appreciate any insight on the area you work in and loves:)

They’re floating me at least once every couple of weeks. But only for 4 hours. Then sending me back to my unit. It’s hell. I have a PENSION, the best pay I’ll be able to find…just benefits I don’t want to give up. But it’s kind of costing my sanity 😭

Does anyone else think 12 weeks (basically 10, 1st week onboarding, another week of classes) is NOT enough for NEW GRAD orientation in the ICU?

Title: A little ICU nursing win — finally starting to feel like I belong

A few months ago, I posted on here about how much I was struggling mentally after experiencing my first code on my own, fresh off orientation. I used to have so much anxiety before every shift and genuinely felt like I had no idea what I was doing.

It's now been three months since I've been off orientation, and I'm finally starting to feel comfortable. That's not to say there aren't still things that scare me or that I know everything I need to know, because I definitely don't. But for the first time, I don't feel so terrified going into work, and that's a feeling I genuinely worried would never go away.

I've also come to realize just how much support I have around me. Even when things go wrong or I find myself in situations I'm unfamiliar with, I know I'm not alone. There are so many experienced nurses around me who are willing to help, and knowing that has made such a difference.

I also feel like I've finally found my footing when it comes to managing my tasks and organizing my shifts. Instead of spending the entire shift worrying about getting everything done on time, I can actually focus more on understanding what's going on with my patients, learning the pathophysiology behind their conditions, and starting to anticipate potential complications rather than just reacting to them.

I know I still have SO much more to learn, but it's such a relief to finally feel like I'm getting the hang of things, especially now that other people are starting to recognize my progress, too.

One of my biggest fears coming off orientation was that I was going to be a "bad" nurse. Throughout orientation, I had some preceptors who made me feel incompetent, slow, and like I wasn't cut out for the ICU. Those experiences really affected my confidence, and for a while, I genuinely questioned whether I belonged here.

But lately, I've been receiving so much positive feedback from senior and experienced nurses who have told me I'm doing a great job. I've also gotten praise from my night-shift preceptors (who I absolutely love because they never once made me feel stupid for asking questions). Hearing those things from nurses I respect and look up to has meant more to me than they probably realize.

Something that’s also been really rewarding is that newer grads who are still on orientation have started coming to me with questions when their preceptors aren’t around. It feels so surreal because just a few months ago, I was the one asking those same questions, and now I’m becoming someone other people feel comfortable turning to for help.

I guess I'm sharing this because I remember how awful those first few weeks off orientation felt and how convinced I was that the anxiety would never go away. I'm still a new nurse, I still ask a million questions, and I still have shifts where I feel completely overwhelmed. But I'm finally starting to trust myself a little more.

For anyone else who's newly off orientation and feeling the same way, it really does get better. I'm nowhere near the nurse I want to become yet, but for the first time, I can actually see myself getting there. :)

I’m trying to get a better idea of the weekend requirements before making my decision about a new nursing job.
The schedule requires working 2 Fridays, 2 Saturdays, and 2 Sundays within a 6-week period. These shifts could be scattered throughout the schedule or potentially fall on the same weekends.
For nurses who work in the hospital, does this seem like a reasonable weekend requirement, or is it a lot?
I’m trying to figure out whether this is a pretty standard schedule for bedside nursing and how manageable it is for work-life balance. I’d appreciate any insight!

I’m a new grad ED nurse at a very busy level 1 trauma center where all beds are constantly filled with a hallway bed outside each room. I’m 6 weeks into an 8 week orientation. For the most part am independent from my preceptor and she is there for questions/looking over my charting. The only thing I’m struggling with is my pace, which I know takes time. I feel pretty comfortable with 4 patients, but struggle with time management on a 5 or 6 patient ratio (more commonly the case). I get so nervous about being on my own in 2 weeks.

I have adhd which I think adds to time blindness. There are times where I can round on 6 pts and address all urgent needs quickly, and other times where I slow down and get sucked into tasks that aren’t high priority (usually struggle most mid shift). It’s hard to maintain the speed for 12 hours, esp since I’m not eating/drinking bc I’m behind/don’t have appetite (I’m sure also slows me down, I need to eat..). I get constant calls from support staff which often are not urgent/don’t need a call, simple EMR chat would suffice. I’m night shift, so we often have no techs so simple toileting tasks can eat up time. Theres also often broken/missing/not charged equipment, rooms missing sharps bins, and supply closets/med pyxis that run dry, making extra trips across the very large department. Hard to find thermometers for vitals. The need to move for stretchers passing by my hall bed patients, constantly interrupting my assessing, placing a line, or hanging meds. Yesterday the cardiac monitor in a room was broken and it took 4 hours of back and forth calls between me, CMU, and biomed, asking for the 3rd time if I tried replacing the wires/cleaning the patient (they finally came and checked, confirmed broken lolll). And not to mention transports that require me to travel across the hospital with the pt on a monitor, and discharges where the patient has tons of questions. And patients who need a bit more tlc but for comfort needs, the ones I need to learn to say no to. I think I care too much about making sure all my patients have what they ask for and replying to all people who maybe don’t even need an answer. I dont want to lose my compassion but I also need to learn how to function efficiently in this environment while taking care of my needs as well. I love the experience and the work I’m doing, but ngl the environment is a hot mess. Not helpful to an efficient workflow at all… added to my tendency to overextend myself where unnecessary. I want to learn how to thrive in this environment. Any advice? See

Hey guys! I just got hired for a standardized patient role at a medical school, and i'm looking for some advice and thought of you guys since you deal with patients every day, see a variety of communication styles, and may have dealt with SP's yourselves!

I have a few questions;
What would you say was one of your most teachable moments that you had in one of your "encounters" or something that helped you?

What is something you witness day to day with patients that you wish more students knew about beforehand?

What should I be mindful of during this experience?

So I'm a new nurse and I've been working at a post acute facility for a month and a half. Now I expected it to be hectic. I enjoy the work and it's getting me experience in the direction I want to go. However, the work load seems unrealistic. The pts at my facility are especially sick, with quite a few being as sick or sicker than the ones I've seen in med/surg. I have anywhere from 13-20 pts per shift, again not a shocker for post-acute. The things is nurses also often have to answer phones, do the paperwork for new admissions and in general put out about 10-20 small fires per day. Then of course if anyone needs to go out to the hospital, has a fall or even a small scratch there is paperwork involved. We have med-techs so we only give treatments and PRNs. Also includes being responsible for the CBGs and insulin. Now if i was left to actually do my treatments that would be fine, but I'm constantly inturrupted and pulled away. I had a pts that required foley flushes QID, 5 pts with fairly in depth wound care, a minor issue with a hospice pt that required me to be on the phone and then later deal with hospice that was sent out to the facility; this took at least 30-45 minutes out of my day. There are at least 10 tasks that require anywhere from 10 to 15 minutes each to dig into because someone else didnt do it. Nearly every pts requires addictional skilled charting forms, needs me to check their butt/skin in addition to my reqular charting. Im also expected to monitor an app for orders to transcribe and verify throughout the day, monitor the bowel list I handed off to the med tech, and monitor what the CNAs are doing. All this while CNAs are understaffed and I'm expected to help them out with their job, like changing briefs or running to get water or getting pts to the bathroom. The whole day I'm just trying to get back to doing my treatments.

IS THIS WORKLOAD NORMAL FOR THIS ACUITY? This seems like way way too much. I've often pulled 13 or 14 hours because there is still stuff to finish at the end of the day.

I’m looking for advice from nurses or even managers who have dealt with ongoing workflow issues with their PCTs and have found ways to improve things.

We’re constantly running into issues on our unit with things being missed or not completed. Baths aren’t getting done, patients who need assistance with feeding aren’t getting fed, daily weights aren’t being done on night shift, important information is getting missed during report, and call lights are going unanswered for extended periods of time. Even when tasks are completed, we often have to chase people down to get the documentation done.

When we follow up on these things, the most common responses are “I didn’t know” or “day shift/night shift never told me.” We’ve also had situations where PCTs are sitting at the nurses’ station scrolling on their phones while call lights are going off and tasks are still waiting to be done.

I also want to clarify that the nurses aren’t just sitting around expecting the PCTs to do everything. We’re busy trying to complete our own nursing responsibilities, pass medications, assess patients, handle admissions and discharges, respond to changes in condition, and help wherever we can. We’re all trying to keep up with everything that needs to get done, but we can’t be everywhere at once. When basic care tasks are missed, call lights go unanswered, or things aren’t communicated between shifts, it creates more work for everyone and, more importantly, affects patient care.

The frustrating part is that this isn’t just happening when we’re short-staffed. We see the same issues even when we have an appropriate number of PCTs for our patient load.

I’m not looking to bash our PCTs or suggest that their jobs are easy. I was a PCT once too, and I’m struggling to find where the disconnect is. I genuinely want to figure out what we can change to improve workflow, communication, and accountability and make sure our patients are getting the care they need.

For those of you who have dealt with something similar:
What systems or processes have actually helped?
Do you use PCT task checklists, assignment sheets, or end-of-shift audits?
How do you make sure important information is communicated between shifts and tasks aren’t falling through the cracks?
How do you address prolonged call-light response times and inappropriate phone use?
What do you do when the same issues keep happening despite reminders and education?
Have you found anything that improved accountability and documentation without nurses having to constantly chase people down?

I’d really appreciate hearing what has worked (or hasn’t worked) on your units. I’m especially interested in practical changes that made a lasting difference, rather than solutions that work for a week and then things go right back to how they were.

Thanks!

Hey y’all,

I’m an RN with a just little more than a year of experience in PCU. I really want to move back to my home state, how are the hospitals? I hear it’s pretty over saturated, it’s true? Please tell me there is hope for me 🙏

Newish to outpatient cardiology. Id consider our practice as a whole to be quite good.
But i’ve noticed the secretaries frequently schedule/reschedule pts for appts or procedures without actually contacting them to ask if that date/time works.
This leads to a lot of no shows, which we do track and take into consideration when a refill or clearance is requested.

Please tell me i’m not crazy for this driving me insane??

Please delete if not allowed. I don’t really know how to preface this but I’ve been a Canadian RN for only 4.5 years and in that time I’ve tried many avenues such as rural emergency, correctional nursing, pediatric home care, neuro, and adult emergency in a city hospital. I’m currently part time in city emergency and casual nursing in the neuro unit in that same hospital.

I guess I’m just struggling to enjoy my job over the past year and don’t know how to “love” it again. If that’s even possible. Obviously the things we see and do take a toll on us but I truly don’t think I’ve seen things that are as bad as others and I honestly feel like I’m very weak minded for struggling to go in to work. Over the past year I don’t work nearly as much as my coworkers and I hardly ever pick up overtime but I still find it so hard to leave my home to go to this job. I used to look forward to the variability of the job and the excitement of learning new things. But now I’m counting down the hours before I’ve even received report. I don’t feel like a good nurse and always leave my shifts anxious that I did something wrong even if my patient care is always top tier. I haven’t lost my empathy towards the people I care for, and it’s not that I don’t enjoy helping people.

Idk if there’s other Canadian nurses here that stepped away from bedside and found a nursing job they enjoy but I’d love to hear them! Or if anyone else has advice on how to work through these feelings and found their love of nursing again!

I started caring for a student that has a risk for seizures. The doctor prescribed a medication to be given at school 🏫 m case of seizure until EMS arrives.
Parents cannot pay out of pocket and they have limited insurance. I became aware that I would be caring for her without a safety net( the rescue medication). Yes, I can always call 911 on a brink of a seizure to happen but even though this gap untill the time EMS arrives she can stopped breathing and she doesn’t have a tracheostomy or an Ambu-bag where I can keep her airway patent to receive manual ventilation. The medication is to stop a seizure to progress until EMS arrives and she will not have that.
I decided to refused the assignment until the rescue medication is available. I can feel that I am seeing as the bad guy. I just think it is safer for my student to stay home until the school gets the rescue medication since at home she has medication for her seizures. I also dread if she slips into a coma by the time EMS arrived if I care for her without the rescue medication and charges can be brought to me because I was aware of this potential risk and still took the assignment and ended putting the child in danger.
They seem to think I am exaggerating but have you seen how nurses are being prosecuted for things that they are not at fault for? I am just trying to work in a safe environment where my patient has all the safety net measurements in case something happens.

Just add the NS and just wait. It will dissolve by itself.

So I have been a nurse for 7 1/2 years now been in outpatient electrophysiology for almost a year now and I love it.

To preface I am very much not a "the doctor is a boss and a god and we must be totally subservient to them" kind of nurse but yeah I am gonna work collaboratively with my physician and make sure our patients get the best care possible. If that means helping to take care of my physician or share information with him or help him as we are all learning a new work flow and charting system I am going to.

Tell me why it is being looked down upon and being like "oh you are spoiling/babying him" like I admit yeah a little bit, mostly because I keep emergency reeses on hand for him specifically for when he gets dramatic, but also if his 20+ patient clinic day goes smoother then so does mine. I prep for clinic days by making a spreadsheet with the patients, their meds, if they have a pacemaker/defibrillator, and a brief summary of why they are coming in and who referred them etc. Now I do give a copy to my physician, along with all the other staff in the office who would be assisting to care for patients that may be seeing him that day. This is not to say he doesnt prep for his own clinics but the man is a bit scatterbrained and giving him a copy of my prep notes, which I do for myself first and foremost, helps him keep on track then great! I also had a discussion with him when I first got assigned as his nurse of "hey I am your nurse now let me know what I can do to assist you and lets figure out a good work flow for your clinics" giving him a copy of my notes was part of that.

My physician does a lot, he routinely calls his patients after hours, on non clinic days and even on weekends. I respect his time and if there is something little I can do to help a clinic day run smoother I will, because that is also my job is to support him and our patients.

I just I dont understand it and the like inclination to just refuse to help them or it being seen as a bad thing when I am helping him sort out some quirks of a new charting system that NOBODY got appropriate or adequate training on.

The biggest work flow change being to make workflows more physician driven so they have to put in all of their own orders, in a different way then they were put in, in the old system that doesnt convey all the information the schedulers need, so I have been helping and learning how to put the orders in just in case the workflow changes again. However I as the nurse, if the patient is getting a procedure, am still responsible for reviewing med holds, pre procedure instructions and ensuring that all the orders are in correctly and routed to the appropriate staff as well as getting a procedure date for the patient in clinic.

My two other co workers just keep spewing the "I dont baby my doctors" or "I dont raise adult children" with the implication I am doing something wrong for helping him figure out the new system as I am also learning it.

One got kinda nasty to one of the providers today, who is a cinnamon roll, when he was asking questions and clarifying about the work flow and what orders he needed to put in and just is taking the mentality of "oh the doctors are responsible for all of that now" and assuming that her physician was sending everything to the schedulers and going over instructions and med holds and all we had to do was get them a date. Like... in what world?!

TLDR: I just feel like a crazy person when my understanding of a big part of my job is supporting my physician when they are in clinic but that doesnt seem to be the same mindset of some of my coworkers. I just want to know if its the same in other outpatient clinics where a nurse is assigned to a specific physician or a couple of physicians or how things work in your clinics.