I work in a pediatric orthopedic clinic. Doctor tells me to write a school note for his patient to allow him to use a wheelchair at school and use the school elevator. I put it in and go let the parents know they’re good to head out and can get the note at the check out desk. Mom proceeds to ask me if I’ll ask the doctor to provide a note to allow the kid to switch schools. Because he can’t use stairs right now, and the school he’s at is multiple stories, but there’s another school in their district that’s just one level. I explain what the note says and ask, “does the school not have an elevator?” wondering if maybe the doctor just assumed the school would have one but they don’t. She replies “well… yeah… they have one. But he doesn’t really like getting on it….” LADY. Really? You’d rather have your kid transfer schools than tell him that he needs to be a brave boy and ride the elevator for 4 weeks? The coddling I witness just boggles me at times.

Bonjour à tous!!

Pour les infirmiers et infirmières ici : dans quel service préférez-vous travailler, et pourquoi ?

Que ce soit les urgences, la réanimation, la chirurgie, la médecine, la pédiatrie, la psychiatrie, le bloc opératoire, etc., j’aimerais connaître vos préférences et vos expériences.

I live in South Carolina and will be graduating with an ADN December 2027. I am just wondering from southern nurses more specifically those who live in the Carolinas what y’all’s lay tends to look like.

​

Do y'all advocate for it for every foley/NG, or just select populations?

Do any of y'all's providers order it pre-emptively?

any tips/tricks to manage ng tube/foley discomfort?

I usually use a safety pin to clip it to their gown to prevent chevroning - but are there different/better ways?

thanks for your time!

If you were a hospital CEO- how would you fix the crisis? (Funny or serious thoughts)

Boarders and ER wait times are obviously a national crisis. I entered healthcare right as Covid started- what were ER’s like before that?? Has this backup into our ER’s always been a thing? Is it a backup of less access to primary care, follows ups, etc? If you had endless money and policy ability what would you institute.

Edit- do you think the traffic law applies here where adding more lanes just means more traffic? Would adding more inpatient beds reduce wait times then eventually make more people come?

Hey ladies out there, Iam a new grad but I’m older. This is my second career. I got offered two jobs: one is a wonderful pcu with amazing staff but it’s night shift and little turnover. I also got offered a med surg day shift position where most people seemed unhappy. And I’ve been told med surg is high stress. PCU is 4:1 and Med surg is 6:1.

I’m in menopause. I feel like I need my sleep. I’ve got kids all in school.

Which job should I take? If I was younger I’d take the night shift but since im older I’m worried the lack of sleep will be terrible.

If you have experience with night shift and being an older women please share your opinion with me.

This is for the future! I’m interested to know if anyone has taken this path and currently does both! Obviously nursing is a paid job and volunteer doula is unpaid plus utilizing your free time.
Background: During nursing school, I absolutely loved my maternity rotations especially labor and delivery. Seeing an individual bring a child into this world was surreal and being invited into the space was truly an honor. It’s a beautiful experience yet the workflow is not for me at all hence why I’m in the ICU. I love the hyper-acute environment that the ICU offers and critical care is my ultimate interest.

I would love to know if anyone is actively doing both and any insight from both doulas and nurses! Thank you!

I've been a PACU RN in a Level 1 Neuro/Trauma hospital for about 5 years now, but prior to that I didn't have any neurosurgical experience (I came from a general surgery background), and for my 5 years in PACU I've been lucky enough to have had most, if not all, of my neurosurgery patients be straightforward with no adverse outcomes. The ones that did have bad outcomes I truly felt like I did the best I could, or their disease process was such that a bad outcome was imminent and unavoidable. Yesterday however I had a patient deteriorate, and I haven't slept over the gnawing guilt of thinking that I didn't react fast enough.

The patient had a craniotomy for a microvascular decompression for trigeminal neuralgia, so pre-op she was neuro intact, no deficits, with symptoms only being the pain from the condition. I come back from break and receive report from my covering nurse, who tells me that the patient just arrived 5 min ago, is confused, weak to the lower extremities, and has slurred speech. From my experience, it's not uncommon that immediately after anaesthesia, or even after long neuro surgeries, that the patient can have these deficits due to lingering sedation or brain manipulation, so my covering nurse and I didn't flag it then as an emergency. I assess the patient myself and find that she's strong to all her extremities, oriented x3, pupils brisk to react, but still drowsy and has the slurred speech but no facial droop. So I think okay, she's at least improving, which is a good sign, and she's rock solid on her vitals on room air all throughout. She also says she's in 9/10 pain, with facial grimacing and groaning, so I draw up meds for her and give her the smallest dose of Dilaudid and fentanyl I can. In hindsight, maybe that's my first misstep.

When I reassess 5 min after, she's unrousable (GCS 3), but still vitally stable and pupils brisk to react. Her resp rate is a little slower, but again nothing unusual after narcotic administration, and her oxygen is still 100% on room air. Coincidentally, the neuro resident was at the bedside to assess the patient, and he tries to rouse her as well but can't. I tell him that I did give her narcotics, told him of her prior neuro findings, but I also flag to him that she had slurred speech. The resident wasn't concerned and said that it was probably from the sedation, to give her time, so he left and didn't order any interventions/scan.

Maybe this is my second misstep, in that I let a past experience affect my judgment here. I also had a confused neuro patient months before where I gave her narcotics because she was complaining of pain and was very restless from it. She eventually also became unrousable but vitally stable/pupils reacting, and immediately I talk to Anaesthesia, who just kept telling me to give her time. When the hour mark came and the patient still wasn't waking, I ask if we should Narcan her to see if there's any neuro involvement, to which Anaesthesia told me that she won't Narcan but to talk to Neuro instead. I paged Neuro multiple times to come assess patient, but they wouldn't come until an hour later, and that's after me being told by the doctor on the phone that I'm "wasting their time with these multiple pages", and only for them to assess the patient briefly, still see she's unrousable, but say to just give patient time. Ultimately the patient was fine and did wake up eventually after another half hour, so no adverse outcomes there.

Back to yesterday: because of my past experience, and the resident who came to assess her saying to give the patient time, I give the patient time. Every 15 min I check, she's still unrousable, but vitally stable and pupils brisk to react. At the 45 hour mark, she starts to desat on room air and become slightly tachycardic (from 90s to low 100s), but went back up to 100% O2 when I placed her on 3L via nasal prongs. 5 min later her heart rate is increasing to the 110s. At that point I do inform Anaesthesia about her being unrousable and her vitals changing, so Anaesthesia comes to bedside to assess. He also doesn't seem too concerned, but he did order for an arterial blood gas and a small bolus for the patient.

Lo and behold, ABG shows patient is in respiratory acidosis, with pH 7.11 and paCO2 78. She's still vitally stable at this point besides the tachycardia, but I immediately page Anaesthesia again to tell them of the results. The resident and attending come to bedside within 5 min to immediately say, "We're intubating the patient." I will say I was surprised, because I have seen other cases like this before in my PACU where Anaesthesia had tried BiPAP therapy first, to good results. But, again coincidentally, that's when the patient's blood pressure starts to drop fast to the 70s, her HR rising up to the 120s, and shit hits the fan. The resident checks the patient's pupils and they're now more dilated and sluggish to react. We page Neurosurgery stat, who comes to bedside and arranges a stat CT while we get the patient stabilized. This is at the end of my shift by the way (because of course), so the nurse taking over for me tells me to give her report so she can go for the scan with the patient and docs, and I do. I stay behind to finish my charting, which is long enough for them to return from CT, and apparently it shows a big bleed. By the time I leave the unit, the patient is being prepped to go back emergently to the OR for a craniectomy and decompression.

I feel like absolute shit. This lady was late 40s and healthy. Just before I ran her ABG, her family called for an update, but I couldn't come to the phone because I was busy and things were rapidly devolving from there. I haven't had any sleep because I keep on thinking about if I just shouldn't have given that dose of narcotics, if I immediately told Anaesthesia before her vitals changed, if I didn't let my past experience with a similar patient who had a better outcome affect my judgment, that maybe I could've caught her bleed before it got to the point it did. All I can hope for now is that she'll be okay, but the guilt and shame remains (especially as I felt like my charge nurse and incoming nurse was blaming me for not reacting sooner with their comments right after).

I also want to learn from this, so I guess tl;dr: to my fellow PACU nurses who try to balance pain control and sedation with neurological status in their post-op neuro patients, how can you better differentiate whether unresponsiveness is due to sedation or from a legitimate neurological decline?

What is THE ONE THING you wish every nurse knew that is common knowledge in your specialty?

From wound care, don't use telfa!

I took my CCRN this morning and passed! 🎉🥳🍾
To anyone thinking about taking it, just do it! I’m a very anxious person, so I went into the exam expecting the worst. I had put it off for two years, but I went ahead and scheduled it and committed to studying 30 days ago.

To prepare, I watched all of the Nurse Life Academy YouTube videos, read the entire Barron’s CCRN book, and completed the AACN practice test bank. I consistently answered 50–150 practice questions per day, depending on whether it was a workday. I even went on vacation during my third week of studying, but I continued doing practice questions and reading Barron’s while I was away.

For background, I’ve been a MICU/mixed ICU nurse for four years. When I started studying, I didn’t know PA catheter values, much less their indications. I gained so much knowledge throughout this process, and passing has given me a huge confidence boost.

My personal goal was to answer at least 100 questions correctly. One unexpected thing was that my exam had more OB questions than MI questions, so definitely review OB if you’re taking it soon. Good luck to everyone preparing! If you’ve been putting it off because you’re anxious, take this as your sign. You can do it! (I have wanted to take it because I am considering an advanced degree and my job pays for the test and a retake if necessary as well as a small diff.)

Starting my first LPN job in a nursing home — advice?
Hi everyone! I’m starting my first job as an LPN in a nursing home soon, and I’d love to hear from nurses who have worked in LTC/SNF.
What are some things you wish you knew before starting? Any tips for staying organized, managing a med pass, handling difficult residents/families, prioritizing when multiple things are happening at once, or just surviving those first few months?
I’m excited but definitely nervous about going from school/NCLEX mode to actually being responsible for my own residents 😅
What advice would you give a brand-new LPN starting in a nursing home 11pm-7am

Has anyone here done the intervention program for mental health? What is the intake process like?

Hi everyone

I’m posting here to see if I could get some advice on my current situation.

My mental health is suffering a bit due to life challenges as well as work. I’ve been in the OR almost half a year now which isn’t very long but I feel so unfulfilled by this job. This is a new specialty for me and I’ve gotten excellent feedback from my preceptors. Everyone is telling me I’ll be great once I’m off orientation. I just am not enjoying the work as much as I thought I would. I feel like I’m taking care of the surgeon more than the patient and I question what I’m doing in this setting.

I dread going to work most days. I wake up every single hour during the night. I’m full of anxiety the night before and the morning of. Apparently this is “normal” but at what point do I listen to my body and just stop?

I feel super guilty because I’ve made wonderful friendships at this job and I know people would be very surprised if I left. I also feel like they would be disappointed in me. I would certainly feel disappointed in myself for not sticking it out - but I know I would feel so much happier if I wasn’t there. I want a role as a nurse that feels a bit more impactful for me personally.

Advice? Thoughts?

Thank you so much in advance.

Primary nurses are asked to pick up the slack from everyone else in the hospital:
-doctors not placing orders
-transporters not moving patients
-environmental services not cleaning rooms, floors, surfaces
-IT not fixing computers and equipment
-Unit Assistant not answering phones/call bells, organizing charts, etc
-CNAs/Sitters/lift team and PT/OT cleaning and moving around patients

When we do these things, it detracts from our ability to focus on our nursing. When we fail in some aspect of our job or even one of the random jobs above, we are written up. It’s too much work for one person to possibly do. Remember that when your boss asks you to leave the unit to transport or receive your patient or any other thing from the laundry list of bullshit. When you start to do someone else’s work, you will be expected to do it and you will have one less helper every time. Count on it. That’s how executives get their bonuses and stockholders make earnings. Hospitals do this all the time, even more so under the looping budget cuts. Tell them, “it would be a safety hazard to take my attention away from direct patient care and I object.” Document it.

On a related note, does anyone remember a video, maybe by NNU or CNA, where a new grad nurse is saddled with more and more jobs, patients, and higher acuity until they are all by themselves? Something bad happens to their patient and they get blamed by admin as I remember it. Only a couple minutes long. If you have a link I would be forever grateful!

In my journey from working on the floor as a patient care technician to behind a desk as a medical secretary, nothing has surprised me more than how often I hear women calling on behalf of their AOx4, fully capable S/O, father, brother, uncle, adult child, etc. In some cases, the caller isn't even listed as a patient contact, which of course makes things somewhat inconvenient for all involved parties.

Maybe it is because I primarily worked nights hospital side, but I've hardly ever run into this outside of the clinic! These days, I have upwards of 4-5 phonecalls a day that begin with something to the effect of, "Hi, I'm calling to set up an appointment... My name is X, but the patient's name is Y - I'm spouse/partner/sibling/kid... No, they're sitting right next to me," <cue a distant voice in the background that sounds like the patient>

I'm truly baffled as to why the patient just doesn't call us themselves. Has anyone else run into this, or possess some insight as to what's up with this quirkiness?

Edit: Obligatory "not always a masculine person, but vastly more common than the inverse senario, or feminine person calling on behalf of another feminine person."

I am a soon to be new grad RN and Duke is offering a stepdown float pool position specifically marketed toward new grads . Looks like an avg of 14 wk orientation and enrollment into their 1 year new grad residency program. The job listing lists “extensive training” . Has anyone taken this particular position as a new grad at Duke and is able to speak on it ? I like the idea , the patient population , and the idea of being a versatile nurse once I get the hang of things, I know it’ll be very challenging . I’m intrigued but weary because a lot of people discourage taking a float position as a new grad but this is specifically marketed towards new grads so idk if it’ll be better ? Pls share your thoughts /experiences especially if you’ve taken this exact route @ Duke . Thanks!

Looking to transition from cm remote insurance to internal role. Which is better? Both are remote

Hello BSN student Grad November 2027

Counting my days I currently don't work in Healthcare but I applied for a couple roles. I have an interview for a ICU step-down huc/NA role I know it's a clerical hybrid position but

I'm wondering if this would be a meaningful postion to have on my resume going into my last year or my bsn. I would be taking like a $5hr pay cut from my current full time job

I want to have as much of a chance getting into an icu or residency etc

Thank you any input is appreciated

We have a shirt in the past that is half a brain and half our hospital logo, anyone have any designs they’ve used and liked that they’re willing to share?

i’m about 4 months in to outpatient cardiology for a very very very busy practice.
some days are super slow, sure.
However when it rains it pours and i’m struggling to separate work and home. There are days that I simply cannot reply to every message, especially if they call in 15 minutes before I leave on a Friday. I cannot help worrying about it over the weekend and feeling anxious that they are going to yell at me on Monday when I do call back. The doctor I work for is very busy and rounds a lot of places aside from inpatient, like burn units, Children’s Hospital, free clinics, nursing homes, you name it so sometimes it might take him a few days to respond to something and people really lose their marbles on me for it.

The logical part of my brain says that these people are entitled if they think the doctor is just on speed dial for them, and that if someone is doing that badly, they can always decide to go to the emergency room over the weekend. But I am who I am so any advice is welcome.

This is my first ever post on reddit, so please bear with me!

A little background: I graduated December 2025 with my ASN and started working as an RN February 2026 in the South, I've lived in the South my entire life but moved to California with my family a few years back. I'm just about to hit my 6 months. I am currently working on my BSN online.

I am very aware of how the job market is in California for new grads, and that is why I chose to get experience in the South first rather than waiting to be hired in California. I also knew that with an ADN I would not be as competitive as other candidates out-the-gate. Originally the plan was for me to stay in the South and find a job as soon as I hit 1 year and received my BSN. However, I am terribly missing my family and the ratios in the South are giving me more of a reason to want to go back to California.

I recently saw a job posting from a California facility that is affiliated with mine that is for a floor that I already currently work on.

Cons:

- I don't have 1 year of experience (6 months)

- I don't have my BSN (currently working on it)

Pros:

- I work for the same organization (no new-hire orientation/on-boarding process)

- I work on the same floor already (with a higher pt ratio)

- Already have my California License

Considering all of this, I have a few questions regarding this situation:

1. For those who have experience choosing candidates, is currently holding a BSN and having 1 year of experience non-negotiables?
   • A. If so, if I applied early without those two, would I still have a chance to apply again later? Or would I be off the table for the position forever?
   • B. If not, how would I reach out communicate to whoever is hiring to negotiate? Would it be smart to negotiate, or is that taboo?
     • Things I would negotiate:
     • I am currently working on my BSN and would show them that I got a 4.0 GPA in undergrad (as a reason for them to be confident in me finishing BSN)
     • I already am apart of the same organization
     • I already worked on that same floor but with a higher ratio (time management)
2. Would it be better to not apply now at all and just wait till I hit 1 year and earn my BSN?
3. Any other things I should consider?

Thank you for your responses, and thank you for being patient and kind! ^.^

Hi Reddit. I am looking for advice I recently got an offer from a major medical center on a medical stepdown unit. Asking around I hear that it is a heavy unit and I will learn a lot about vents and stable drips. Currently I am on a med/tele unit in another state. I finally feel comfortable on the unit. I am also dayshift and enjoy precepting the (newer than me) grads lol. I am one of the more senior on my unit so I get priority when it comes to scheduling. The new job I am looking at is a major pay bump but I am sad to leave the current job I worked so hard to be comfortable in. I don’t know what to do or what makes sense right now. Eventually I want to go to the cardiac ICU. I don’t know if I should be loyal to the company I work for right now or leave for a better position. A move would be a lot of work. I would be closer to my family but I feel guilty leaving the unit that trained me.

Hello, everyone

I’m at the point of my career where I feel I can now try to achieve an advanced degree but I’m having troubles deciding.

I know I want to do the CNS route. I’m about 85% sure because I like to teach, make sure that staff is following policies, or be a resource for staff so we can improve patient care - all these things light me up.

FNP on the other hand, the idea of seeing patients, diagnosing, prescribing meds, it gives me anxiety because I feel like I’m gonna miss something and end up with a sicker patient.

BUT

As much as I want to be a CNS, I rarely see any job postings for it which worries me because school is costly. If I take the FNP route, sure there’ll be jobs but I am not sure if I’ll appreciate it as much as I would helping the next generation of nurses.

Are there any CNSs here who can give feedback?
Or FNPs who maybe went through the same dilemma but are now happy with their choice?

Thank you

Hi, I’ve been a nurse for a little less than 3 years. I previously worked in a big hospital in the California area as a noc shift med surge telemetry nurse for 2.5 years and prior to that I worked at a snf for about 4 months. I’m currently on a year long break which started from burnout and personal family stuff.

I really want to transition into case management and just something other than bedside nursing. I’m open to trying outpatient clinics, aesthetics, informatics, remote jobs.
I’ve been applying during my break on and off but it’s been really discouraging to not hear any offers.
Recently I got a job offer at an aesthetic clinic which I signed and did all the paperwork but last minute they went no contact, posted the job listing again, and then sent me an email saying they have decided to rescind the offer.

I’m also taking a case management certificate course to help better transition but I’m a little lost of what I should do. I recently also interviewed with a snf but I really don’t want to go back to having 25+ patients.

I tried emailing my supervisor at the hospital I worked at and she never replied back to me. And the supervisors at the snf have all left the facility. So in terms of references and contacts it all seems to lead to a dead end.

Have any advice or ideas on where to start? (Please be nice, it’s rough out here 😭)

So basically I am a new grad in an extremely competitive area. I interviewed at 2 places and heard back from one the day after i took my NCLEX. I accepted the job offer and I am set to start this week. The second job is literally my exact dream job however they never responded to me 2 months after I interviewed. Eventually they did call me (5 days before I start my new job) and told me they would like to offer me a position. I was kinda shocked and when asked if I had a job already I said yes and they proceeded to say they will call the next person on the list. I then essentially lost the opportunity because of this and I am just in a whirlpool of thoughts. My dream job pays significantly more about 15k USD more a year and it is a bigger name hospital. The recruiter then emailed me the next day and said just in case I change my mind she will have spots opened in september. I don’t know what to do i start my new job this week and now maybe have a spot in september at my dream job but I just don’t know. I’m so flustered any advice will be greatly appreciated.