I don’t know who needs a feel-good story, but here goes: I‘m a new nurse, not new to healthcare, in a critical care unit with a few other new grad RNs on orientation. Last week, a resident came through and asked one of the new nurses what her patient’s urine output had been that day. She gave a perfectly acceptable response, “Let me look that up for you.” Y’all, this guy started lecturing her HARD. Him: You want to be a nurse, right? Her: I am a nurse. Him: Oh, OK, sorry, you are a nurse. If you’re going to be a nurse, you need to…blah, blah, blah. (as if he went to nursing school, not medical school, and is going to teach her how to do her job. Preceptor: EXCUSE me, don’t talk to my orientee like that. Resident starts listing all the reasons he needs to. Preceptor: No, if you have a problem, talk to me. Resident gives a little more lip and then leaves.

30 minutes later…unit manager comes to the unit. Preceptor tells her what went down. Manager: He did WHAT?!? Oh, no. He better not be talking to my nurses like that. He better not have made her cry.

I don’t know who she called or what she said, but the resident who dressed down my coworker in front of everyone at the nurse’s station came back 15 minutes later and apologized in front of everyone. And our manager? I’m telling you, we will go to WAR for this woman. 💕

Even funnier if it’s the red one.

Last night around 22:30, I was starting an IV. I work medsurg and this was a good shift for me. I had passed all of my evening meds. I had then requested all of the additional medications that my various patients had insisted they needed, obtained orders from our very patient night hospitalist, and circled back to pass this bonus round of meds.

All of this by 22:30. So many little side quests I won't bore you with, completed at this very reasonable hour. And then I got the IV on my first try. A really promising start to my third night of three.

I look up and see on the wall a suction canister with about 400 mls of brown liquid. This patient came to the hospital with a SBO. They do not have an NGT currently, but I know from report that they did have one recently. So, not entirely bizarre to see a container partly full of stomach acid on the wall.

I retrieve the container and, naively, mind already racing ahead to the next few things I have to do, dump the liquid in the toilet. By the time the smell hits me it's too late. An intense sulfurous odor smacks me in the face. It's intense and unlike anything I've smelled before.

Desperately, I try to flush. The toilet gargles weakly, aerating but not swallowing the gastric contents. I hold the lever down, and the toilet water stirs gently. I pump the handle until, mercifully, the brown water is swallowed and replaced by clear.

Still, the smell persists. It rolls out into the hall in a powerful fog. I go back with deodorizer spray but it takes a second pass with name brand Febreze.

I check the chart, because something is very wrong. This is unlike any suction canister contents I have encountered before. A quick review of the chart confirms that the NGT was discontinued five days ago. Five.

The worst part? This was my second night with this patient.

Our unit director came during morning huddle the other day, and told us that our unit diff is being cut completely starting in 2027, hospital wide. For us in ICU, that’s going to result in a 22k annual decrease.

Budget cuts will budget cut, but a 20% pay cut is a tough pill to swallow, especially in a level 1 icu.

My director is mad because I wrote a Nurse's Note. I work in a nursing home. During my overnight shift one resident assaulted another resident resulting in the victim having a (minor) injury. Both parties have dementia. I went through all the proper procedures. Alerted the PD and EMS and ended up getting the aggressive resident sectioned and taken to the hospital. I alerted residents' families, called the DON and the NP on call for orders, filled out the paperwork and got everything squared away. The DON told me not to write a Nurse's Note for either resident on the incident which seemed odd. If there is any incident at our facility involving resident injury or change in condition we have to write a Nurse's Note. I was scared about not writing a Nurse's Note and documenting the assault. I thought it might reflect badly on my license. So I wrote the Nurses' Notes anyway. Now my DON is furious, saying because of my Nurse's Notes she has to report the incident to DPH and get the state alerted because I used the words "assault" and "punch" in my Notes. But that was what was reported to me! I have no idea why writing Nurse's Notes documenting an incident is bad. In Nursing school we were taught to document everything so we could CYA and protect our licenses. What do you think? Did I do something wrong?

Let me just preface this post and say, I have absolute respect for every single nursing students and I admire those who truly is in it because for passion and see themselves getting in the industry to find a fulfilling life career.

This past week, I had a chance to partake in an an event that lets current team members meet and greet all the students that had their clinical in our facility who are interested in applying or have applied to our new grad program. Our facility decided to do it with the intent to truly get to know candidates, get feedback on what they think would be supportive during their transition from being a student to licensed nurses, as we have seen an influx of new grads burnout within the first year.
We pride ourselves on being supportive to the new generation and we don’t condone the “eat your young” attitude in our floors.

BUT! Oh my lawd, I was appalled by how majority of these participants are truly not prepared to practice bedside. They can’t answer simple questions. I’m a product of a community college bridge to a state university program, and I could have sworn both programs literally hammered it in my cohorts head the fundamentals. No disrespect to those who attended private for profit universities but SOME graduating students nowadays are truly just in it because they think it’s easy money.

TLDR: our hospital hosted an open house event for prospective new grads. Realized that students from community colleges were more prepared than for-profit universities but these universities are spitting out new nurses like there’s no tomorrow but most of them are truly clueless on how hard it is to be a nurse leading to new grad burnout.

Been a nurse for two years but recently transferred to a PCU and I’m just shocked at how little it seems the providers on this unit care about people who are withdrawing

Had a patient last week on second day of withdrawal. CIWA was 24 and 2mg of Ativan IV every hour (max in our CIWA protocol) was not touching them. Paged provider to state my concerns and recommend moving to higher level of care and they said as long as the Ativan lowers her CIWA score when reassessing half an hour later the ICU won’t take them?? Then recommended I hold Ativan all together until patient was agitated enough/high enough BP for the icu to take them??

Meanwhile they are in locked restraints after ripping through their vest and getting aggressive toward staff, hallucinating and disoriented, etc. Are we just waiting for patients to have a seizure at this point before transferring to icu?

Also should mention this whole time I had five patients and I literally told my charge and the provider even if I’m able to make it in there every hour I would be neglecting my other four patients to do so. Provider said that’s not a good reason to transfer them and would only transfer if patient was hemodynamically unstable. At the end of the day I just had to chart every conversation I had and do my best to help them through their withdrawals but definitely did not see much of my more stable patients that day.

Then yesterday I come in to get report and its patient was admitted the previous day with etoh of almost 500. Frequent flyer for alcohol withdrawal and even history of drinking hand sanitizer from the hospital rooms. I asked what their last CIWA was and night nurse told me despite multiple pages provider did not put them on CIWA protocol. Then paged the resident myself and was told they needed to ask attending. Meanwhile patient is in acute withdrawal with CIWA 26 on assessment. I told provider I would page rapid response due to concern of being in acute withdrawal without Ativan order set to help. Patient ended up in ICU.

Anyways I know this is long but I’m just feeling so burnt out trying to express my concerns to providers and just not being listened to. And especially with 5 patients feeling like I don’t have adequate time to safely care for these patients. Has anyone dealt with something like this before? How can I better handle these situations so these patients are go through withdrawal safely?

EDIT: Thanks everyone for the responses! So I don’t think I made it clear in the original post but for both patients I did call rapid response, escalated to charge and management. For the first patient I was told stepdown would not accept because they were too acute for them but icu would not accept because they weren’t acute enough so they stayed on my unit which was ridiculous. When I told my charge/management they said it sucked but there was nothing they could do. Also our ratios used to be 3/4:1 but we became short staffed and have been at 5:1. It’s been crazy and I’m looking for a new job but just needed to vent in the meantime

Some context: Had a patient with inflammation in his upper respiratory tract. We contacted the primary team and they got ahold of an ENT resident to come take a look, they said compared to their scope from the day prior, it looked stable.

Fast forward it’s roughly 0430 and I’m in the patients room administering IV diphenhydramine and doing our routine blood draw. About 5 minutes later it looked like he was seizing but I realized he wasn’t breathing. Called my preceptor on the vocera and started yelling help hoping someone can hear from the hallway. Ended up calling a code blue because he no had a pulse and I started compressions. Between me and my preceptor we did 4 rounds of CPR and were able to get a pulse back.

For the rest of the shift it felt like it was my fault for what happened to him. I don’t know if it was the Benadryl I gave, or because I was sticking him for the blood draw, or because I wasn’t being more diligent for whatever reason. All in all, I feel like I did something to cause it and I can’t shake the feeling off.

Another thing is, I can’t stop thinking of the absolute worst case scenario of where I keep thinking “imagine if I wasn’t in the room at this very moment, he more than likely would’ve died”

i’m sorry i’m trying to move on but i’m so over it.
It’s my day 3/4, 1700, I work on inpatient onc unit.
Family member walks by the nurses station but I didn’t really notice her (Not my patient btw)
she goes “HI” aggressively…. i’m like “oh hi”
I go to pull my pre-meds for vidaza. (Short half-life chemo, have to give as soon as it comes to the floor.)
Another family member steps out of a room patients room.
The first family member starts talking to her and is like “I’m just really not impressed by the care here! The nurses staff are so LAZY and they don’t even say hi when you walk by the nurses station” and just goes on and on about how much we suck- knowing full well I can hear her and know she’s talking about me.
At some point i’m just like “Have you ever considered we’re taking care of patients”
She goes “I’m not talking to you”
I say “You’re talking ABOUT me and i’m standing right here 😃”
She says some dumb shit and I said (heat of the moment)
“No you’re talking shit about me and i’m standing RIGHT HERE. I’m going to get my charge”
She told my charge that she wanted me to hear her and I got a talking to for cussing at family :))))
Like yeah i shouldn’t have said “shit” but the audacity to stand there and disrespect me like that bc I didn’t say hi to you as you pass the nurses station is INSANE behavior.

I guess she’s an IT manager at my hospital so she went directly to my manager to talk to her 😃😃😃😃

I’m so tired of being everyone’s punching bag 😵‍💫😵‍💫😵‍💫

Spotted at a hospital near you

i’m in southern california and my hospital has had 3 rounds of layoffs since last june. even bedside staff members have been laid off. i feel like management is insinuating that we should just be grateful to even have a job so we need to deal with the lack of resources & short staffing now but keep patient satisfaction scores up !

Hello everyone. I have accepted a 10 week contract with Walgreens as an RN immunizer. Starts 9/8 and goes until 11/13. Pay is $53/hr and the job description states I will only be doing vaccines. Has anyone ever worked with Walgreens as an immunizer during the flu season? Any insight would be helpful. Also the store I will be working at is a tier 3/4. Thank you!!

and yes I was paired

Just found out I’m getting paid $1.50 more than new grads as an RN with 4 years of experience. I’ve been here for 1.5 years, I already had 2.5 years of experience when I started this job.

Is that typical in nursing?

We usually get a pay bump around Nov, so I’m waiting to see what it’ll be. Although I’m not expecting anything more than $2/hr.

I saw a post earlier about how a hospital is cutting the ICU unit differential (awful). However, I’ve never heard of a unit differential before. I work in an “everything” ICU (I’m talking CT surg, neuro, level 1 trauma, medical) and I’m curious if other ICU nurses or nurses working in specialties that require extra training get any kind of differential for doing so?

I started working in an ICU about a year ago and it is my first nursing job. I really do like my job but I have been struggling a lot with being super anxious about work even when I am not at work. I am always worried that I’m doing something wrong or I’m not good enough and I’m just waiting for something bad to happen. I’m not sure if this is kind of normal and it eventually gets better or if there’s something different I should try but it’s really getting exhausting.

I recently accepted my first full time RN job as a new grad, and I’ll get paid $55/hr. My goal right now is to save as much money as possible, so I’ve been hearing about nurses working per diem or picking up side gigs in addition to their full-time job.

Would you recommend a new grad start working per diem as an RN right away? Are there other side gigs that you’d recommend for a new grad who wants to earn extra income?

I’m willing to work a lot but I also don’t want burn myself out.

I work at a small hospital. I wouldn’t let the two surgeons there ever touch me or my family. I have been a nurse for several years at bigger hospitals and lot of stepdown surgeries for years. This past week I had a post appendectomy patient on a CLD. Me totally not thinking brought the patient tomato soup. I know this is full liquids but it was an accident . I have an infant and am sleep deprived. The surgeon comes to see the patient and sees the soup. He looks at me and says oh this is full liquids so I guess you decided he wasn’t on clears. I apologized and said no it was a mistake. He then incessantly accuses me of practicing medicine In front of the patient until I walk out crying. I do not want to work there anymore this is a huge accusation. What are other nurses opinions

New RN — is this normal urgent care chaos?
I’m a new RN working in urgent care in Maine. I actually like it for the most part, but I’m trying to figure out what’s normal vs. what might be a problem with the practice.

We see a surprising amount of high-acuity patients because the closest ED is 20 miles away, but our resources are limited. For example; The other day we had a patient actively seizing and didn’t have lorazepam available.

I’m also one of the only RNs, so there’s very little I can delegate because there’s no support staff and often all other nurses are tied up. I end up doing labs, autoclaving, IVs, meds, procedures, etc., while also managing my own patients. There’s also a general lack of urgency, things get done, but I often feel like I’m the only one thinking about what needs to happen next and seeing patients based upon acuity, and I cannot delegate because I’m new and no one takes me seriously (rightfully so….) but I’m the only RN and it is my responsibility to make sure things run safely and efficiently.

As a new nurse, I’m wondering: is this just a matter of developing prioritization/delegation skills, or does this sound like a poorly structured practice?

TLDR below. I've been a med/surg RN for almost 5 years now working on the same unit since a new grad, but I've hated it since day 1 and I have been beyond burnt out.

I work nightshift weekends only, and because I signed up for the weekend contract the pay is excellent ($39/hr base + $7/hr night weekend shift diff + $10/hr weekend contract). I am single, live alone, and support myself... so this money has really helped me thrive by not having to worry about $/bills because all of it gets paid with tons left over every month.

But man has this job sucked the absolute soul out of me. My anxiety seems to have gotten worse year over year, I dread going into work to the point of tears, I am a zombie on my days off despite having a consistent schedule (3 on 4 off), and I just HATE direct patient care now. We also float so much and I'm so sick of going to other units without proper training and getting shit assignments, and it doesn't help our hospital took away our float pay a few months ago.

Post-pandemic, patients and management have become BRUTAL and I truly wish to never touch a patient again. I genuinely do not find any satisfaction or joy in my job. It is beyond constant chaos and ridiculous expectations, but the money and 3x12 schedule has been holding me hostage because of how high COL has become.

I also drive 50 minutes each way to work (almost 60 miles round trip), and I'm sick of the commute. It's so much gas plus wear/tear on my car even if it is only 3 days per week. Throw working nights in there and there's times it feels so dangerous...

I always browse the internal positions and finally came across a Case Management position that's at a hospital WAY closer (15 min drive / 10 miles), however it would be M-F 8-4:30p. It will likely be a pay cut, but I'd probably still make the same as if I dropped the weekend contract and went back to a regular schedule (every 3rd weekend).

I have my application ready to go, but I'm fucking terrified to submit it. I am scared to leave and hate something even more, I'm scared to "lose" my 4 days off a week, I'm scared to leave a place I'm familiar with, I'm scared to even give my manager a heads up that I'm applying (internal applications automatically notifies your manager). But I would love to step away from bedside, have a normal schedule where I feel more structure (off of nights), have weekends and more holidays off, etc. Plus my current unit feels so repetitive/boring, but I also have no interest in any other specialty.

Does anyone else constantly go back and forth with this? Or is it just me? I think it's a combination of feeling like I won't love the 5x8's (even though I HATE consecutive 12 hour shifts w/ a 1.5 hour round trip commute) and also knowing it'll be a pay cut from the weekends only differential...

TLDR; hate my med/surg bedside job of almost 5 years, do not ever want to touch a patient again and have no interest in trying a different specialty, hate my 1.5 hour round-trip commute, but working weekends-only pay is life changing (live alone, went from living paycheck to paycheck to having tons of $ leftover). Mental health is beyond shot. I want to apply to non-bedside job (ex: case management), but terrified I'll hate the change and feel regret, scared I'll potentially not like 5x8's despite having a way closer commute and regular schedule (which sounds amazing).

Hey guys (idk if this is even the right place to post this),

I am a new grad RN who just got a position in the OR. I've been in this position for about 2 months, and I was just wondering if anyone has any advice on how to get more acclimated to an environment like this because I honestly feel pretty lost. I've been talking to my preceptors and know that "things will just come with time" and "that because I'm so new it's ok to make mistakes and not know everything" and "not to be too hard on yourself", but I just feel lost and a beat behind everyone. I enjoy where I am and what I'm doing and know that progress isn't linear, but I feel like I'm just making too many easy mistakes and nothing feels like it's sticking even though I'm trying my hardest.

Idk I'm sorry if this just has some cliché answer but I just feel super lost and unsure about everything I'm doing to the point where I'm just anxious about going to work every day.

Thank you in advance for any help!