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Viva, you have made a difference in my life. I've been with allnurses since 2013 (admittedly mostly a lurker) and always enjoyed what you had to say. I had wondered where you went. I am so sorry that this is happening to you. Wishing you only the best. Go with peace, love, no pain, and no regrets.

Sooo many of you guys that I would like to meet! Nurse Beth, Davey Do, JBMom, BTDT, Hoosier, Smiling Blue Eyes, Emergent, JKL, Night Nerd, Wuzzie, SilverBells, Lady Foxtrot, and a bunch of other names that I know I'm forgetting off the top of my head. I might not post alot, but I have gained much from lurking on the site here and there. Plus it's a great way to pass the time! Definitely hope to meet at least some of you!

What am I supposed to make of a unit that expects me to act as triage nurse, charge nurse, PCA, transport, and hold 10 patients simultaneously in an emergency department? Not only are we short on staffing, we also lack alot of basic supplies crucial to caring for patients. There was not enough staffing for anyone on my unit to take a break last week. Management is very aware of the issue since those of us who remain have bee very vocal about the issues. Please tell me where you work so that I can join this lone anomaly of a hospital in this vast wasteland of hospitals that care neither for their staff or the patients we serve. This is why I am still working at my current position. That, and I really love the patient population I work with. But with the current stress and limited resources at my job, I'm not sure it's worth it anymore.

It sounds like you don't actually hate your job; it's the hospital protocols that are stressing you out. It's not hard to see why. Just about everything you described is completely ridiculous! I've honestly never heard of so many rules in a hospital...

They always just say OK without asking questions. I've had a couple of managers insist nurses take sick time if a nurse looked ill, stressed, or needed a day off for whatever reason.

Agree with happyg8ful. I would never volunteer the reason for calling out, it's none of their business and it can only cause trouble. That being said, my unit is pretty great about calling out. Never had any issues with it.

Going to be introspective with this here... The three Dave's are various components of your psyche. One is more serious and the moral compass for your actions. The second is chilled out and chooses to worry as little as possible. I bet he was the one who cracked a joke about the names. The third is your subconscious, hence the silence. The dirty patient is a culmination of your frustrations in nursing. These are the figurative and literal messes that incompetent colleagues and administrators have left you to clean up. You are left with little to no resources and are forced to drag your patient and improvise to meet patient needs. The patient falls but turns out to be a robot. These are the incidents or near misses where no harm was caused but you still feel guilty about them, hence the fall report. You feel that you take your job more seriously than others and question their lack of involvement in the care of patients. Perhaps you feel guilty about your new found freedom. This dream occurs now as a reminder to why you are happily retired and to assure you that you did your job well as a nurse in impossible situations.

Limited perspective indeed. You think our jobs are easier?! You've obviously never seen what nursing care entails. Wound care is no picnic. On skin that is severely broken down, that can take a good hour alone to treat. Meds can be time consuming depending on the route of administration. I have had patients that take forever and are super difficult to give meds to. Giving meds via peg tube are the bane of my existence. Sometimes, we have to use clinical judgment to determine if certain meds could even be given based on various parameters, like those vital signs you complain about. We also do full body assessments, speak with patients and family about care (in their native language), foley care, deep suctioning, central line dressings, blood work, communicate with various healthcare personnel... The list goes on and on. Much of nursing is based on hard work, judgment, and critical reasoning. Oh, and when you are not looking, we clean the patients too. DO NOT blame nurses for the immense workload you have been given. Nurses are just as bogged down (if not more). We do alot of work that you are unable to understand at this time due to your current scope of practice. We (as in all Healthcare workers regardless of their roles) are all working hard here to accomplish the same goals and keep patients alive despite our limited resources.

Anonymity is so important to me that I have often written responses here, only to decide not to post it in the end out of fear that I might be identified. Paranoid, I know, but I have quite a few decades to go before I'm eligible to retire. I may not be happy at my current job, but it doesn't mean that I want to get fired just yet! This is supposed to be a safe place to air our frustrations, express insecurities, laugh over anecdotes, cry over our losses, or receive genuine advice. It wouldn't feel safe if everyone here knew who I was.

I was administering an enema to a two year old patient that immediately backfired, spraying explosive feces all over me. I gave a shriek and one of the doctor said "Oh sh**!"

Seriously, did we work at the same hospital?! This is exactly what my working environment is like right now. Perhaps I should clarify my statement. Yes, providing the staffing and supplies we need can be a sign of respect, and vise versa, but it's also cost effective. Administration doesn't need to respect the staff to realize that the current system is not viable. It's impossible to do a proper job when there is no on else left to do it. Hospitals are loosing money due to decreased patient satisfaction, law suits, fines, and the need to train massive amounts of staff from scratch. Even when we were well staffed, I often felt disrespected by various colleagues or administrators. Staffing made me feel safe, not valued.

At this point in time, I can't afford to care about respect; I'm the primary breadwinner and I've got mouths to feed. What I do care about more than money is whether administration is supplying me with the resources I need to properly perform my duties. This includes staffing and working equipment. When provided with neither, my license can be at risk due to inadequate care. Provision of resources isn't a sign of respect, it's basic management skills and common sense. It's about time the higher ups realize that.

Emergent, For years I have enjoyed your anecdotes and commentaries. I completely understand your need to get away from all this craziness. Even within the past year, nursing has become a dangerous environment for patient and nurses alike. As nurses, we are unsupported, understaffed, and missing basic necessities to function within our jobs. I wish you all the best and hope you get some well deserved TLC.

Asking every single patient at triage if they want to be tested for HIV regardless of the chief complaint. Half of my patients don't even know what HIV is and I don't have the time in triage to throughly explain what it is and why the the hospital is offering the test. The other half of my patients laugh at me for asking it when they are just there to get stiches.

I nearly did a spit take after seeing this...Sad thing is that I can actually see some of my patients doing this.

A few responses I have based on your concerns: 1. I can give plenty of horror stories where an MD made mistakes or missed a diagnosis and the heroic nurses save the day. It goes both ways. 2. Truth be told, being an NP is a major Responsibility. I would be terrified of YOU if you weren't scared of the implications. 3. Are you doing school full time? If so, maybe do college part time?

Sounds like Kaiser has hit rock bottom...

Oh come on, this needle is MUCH smaller than the last one!

Any skin changes that he has noticed? Pigmentation or thinning of the skin? Hair loss on his legs? EKG for heart abnormalities? Is he getting sick more often? What are his sugar levels and A1C? What about testing for TSH, T3, T4, thyroid antibodies, estrogen, or cortisol?

My father has always said that the truest cause of death is lack of life. That's what should be on everyone's death certificate. On a different note, happy birthday Davey! Hope you have many more happy and healthy years!

When the actively COVID positive patient says "Why are you placing me on the covid unit? I don't want them to make me sick!" The patient presents to the ER at two in the morning with mild chest pain...for a year. No other symptoms, nothing has changed. Decided now was the time to discover the pain source. Patient states "I have no medical conditions. I'm completely healthy!" Then dumps a truckload of medications that he takes on a daily basis. "I had diabetes but the Januvia and Metformin keep my sugar in normal range so I don't have it anymore." Patient comes in with severe abdominal pain, registers, and moments later asks the nurse (before even being fully triaged) "So when am I going home?" I've got many, many more...

So tell me, why do we learn pathophysiology and pharmacology? Why are we expected to know the rationale to certain treatments that are being provided? Why do we gain extensive hospital training on understanding EKGs? The physicians I work with are busy and rely on our assessment skills to keep patients safe and comfortable. I'm not just going to tell the doctor that the patient is at risk for ineffective airway clearance related to possible infectious etiology as evidenced by elevated temperature and cough. I'll say the patient has symptoms consistent with croup and has strider at rest. I will ask the doctor if she wants racemic epinephrine or if she has an alternative plan. The doctor will give the patient a quick look and determine what is wrong and what the plan of care should be. We are not automatons. We don't just deal with treatment of pain and fevers. This is why nurses will often be disciplined for giving the wrong medication to patients even if it was ordered by a doctor. A nurse should know better than to give metoprolol to someone with a slow heart rate or low blood pressure - even if there were no parametersfor holding the medication. We are expected to have some knowledge of medical conditions, indicated labs, and treatment. We are THE LAST LINE OF DEFENSE. Case scenarios like this are important for expanding knowledge. We are not diagnosing and ordering medications and I always make it clear that I am not providing an actual diagnosis. What we are doing is making suggestions to the doctors based on our assessments so that timely, streamlined care is administered. And yes, my charting DOES contain the NANDA required diagnoses rather than medical diagnosis. I leave it to the doctors to make the final decisions and chart the medical stuff.

Definitely want to do an ANA. PT/PTT, INR. I see a skin biopsy was done, maybe consider a kidney biopsy as well? Has she had nose or mouth sores? Any chest pain with deep inspiration?

Welcome back, Davey Do!

"H-hallucinations? N-n-no Dr. Grimm, Nurse Sharpe, I an NOT experiencing hallucinations. What on earth would make you ask me that?!"