Without getting into details, I am currently being investigated at my workplace for an incident which absolutely did not happen in the manner alleged. I know that there is documentation in the chart that reflects my version of events because I charted it. Other coworkers that night also documented what they saw. This is going to ultimately save my ass, because the allegations are career-ending as presented.

Always CYA and document, y’all.

Why It Matters:

The rule would have let the Education Secretary disqualify employers found to engage in activities with a "substantial illegal purpose". One of the big focuses of the lawsuits was that the language was based on the administration's policy priorities about immigration, gender-affirming care, and DEl programs rather than settled criminal law. Teachers, nurses, and nonprofit workers faced losing credit toward forgiveness if their employer was cut from the program. This would include major non-profit University Medical Centers, and end contracts many Nurses entered into to reach PSLF after 10 years of payments while working for a qualifying facility. How day they target Nurses who have worked for years to achieve this changed employers to achieve this. Earned this benefit. Yet wealthy people qualified for PPP loans they didn’t have to pay back? No I’m sorry, this is political and they’re weaponizing the DOE against us. This is unacceptable.

So I’m not sure how the culture got started that every piece of communication needs to go through the bedside nurse, but it needs to stop.

The other day I get a patient up from the ED. The first thing she does is hand me her insurance card and tells me the registration lady couldn’t figure out how to upload it into the computer so she told the patient to give it to the nurse when she got upstairs and have us handle it.

Like, are you fucking kidding me? My job is to care for people from a medical standpoint, not spend my very limited time troubleshooting computer issues that are in no way affiliated with my role. Just because I CAN figure things out, does not mean I’m Mr. Fix It every time an issue arises in the hospital.

And this type of offloading of work exists has wormed its way into every discipline in healthcare. Doctors messaging me things to message other doctors instead of just doing it themselves. Kitchen staff calling because a diabetic patient wants an extra piece of cake. PT calling me to tell me the critical information that the patient refused therapy for the 5th day in a row. I could go on and on.

We as nurses HAVE to start telling people no and speaking frankly about what is a good use of time and what is not. I cannot control every situation on the hospital and constantly bombarding me with problems that are literally irrelevant to my role is asinine.

Anyone else with me here?

Just got off a 12 hour shift and my mom (retired doctor) told me she’s starting to get annoyed with the nursing strikes and that it’s “too much.” A little context, she used to work for Kaiser and she’s specifically referring to the Kaiser strikes.
I snapped a bit, told her “what do you want me to do about it? Maybe you guys should unionize too!” (But I know that it’s more complicated for doctors to strike and unionize).
I understand that doctors are also overworked, have their struggles, and deserve better work conditions but dang Mom sounds like you’re resentful (is that the correct word I’m looking for…?). Anyways, direct your anger towards admin! I wish we can all team up and fight for better workplace conditions for everyone in healthcare. It sucks that healthcare is pretty much all about business :/

If a breastfeeding woman is in the icu intubated, does the nurse have ger pump so she doesn’t get engorged/lose supply/get mastitis? I’m assuming the milk would be unusable because of the meds but I’m curious how it’s handled.

Guess the patient?

Inhaled...not eaten.

I hate it here. I'm about to go get my CDL and call it a day.

There’s a lot of talk in here lately about correct charting and what that means. We’re taught this is nursing school but when you work in a hospital sometimes you’re taught incorrect charting habits.

For example, in my ICU they encourage that you chart your assessments at 0800, 1200, and 1600 even when if you have two patients. I tend to chart in real time (0800 assessment for pt 1, 0845 assessment for pt 2) because I want my charting to tell a story if I were to be disposed (I saw pt 1 first and pt 2 second, clearly due my charting instead of charting both at 0800).

I’m looking for good rules that help us discern bad habits being taught at hospitals vs what actually serves us in court. I’m not looking for “chart as much as possible” here because sometimes my shifts can be insane. Insights from nurses who have been deposed or from legal nurse consultants are ideal. Thank you!

Edit: I appreciate the answers so far, thank you. I particularly appreciate all of the conflicting advice. I think that’s part of the problem too. Many of us may think we’re charting correctly but in court it may be a different story. Having extreme clarity of what is and isn’t okay in real situations (we’re busy AF, hospital pressures, etc) is my goal here.

I work 6:30p-7a on acuity adaptable and just got bumped up to 4 patients (our ratio is 1:4). Im in my 5th week of orientation. My preceptor comes in at 6 every shift to look through everyone’s H&P/orders and write down everything she needs before report. She’s been telling me I should come in early too so I can have all of that done and be in my patients rooms by 7.
The problem is we don’t get paid for that 30 minutes and I genuinely do not want to start coming into work at 6 every single shift just so I can stay ahead. I want to be able to get into a routine where I’m able to get report, see my patients and review H&P/orders without coming in early. I just don’t know how to get that time management down since my preceptor does it differently.
Am I being stubborn about this? Do you guys actually come in 30 mins early to look through charts or do you just get report and figure everything out from there?

three years of nights and i still have not figured this out. like i meal prep on my day off with the best intentions. little containers. protein. whatever. and then 3am hits and i am standing in the break room eating a string cheese and half a granola bar that was in my pocket since tuesday.

the cafeteria is closed obviously. vending machine options are depressing. i brought a real meal tonight and somehow left it in my car.

everyone talks about sleep hygiene and circadian rhythm stuff but nobody talks about how genuinely hard it is to eat like a normal human being when your body has no idea what time zone it lives in. hunger cues are completely broken. i am never hungry at the right time and then suddenly starving at 5am when i am also trying to finish charting and give report.

i have tried the big meal before shift thing. i have tried smaller snacks throughout. i have tried just not thinking about it and that was the worst one.

night shift nurses specifically. what actually works for you. not the theoretical stuff. what you are actually doing at 3am in that break room when you have eleven minutes.

I was told this was the perfect work/life balance.

It. Is. NOT!!

There are 3 nurses for this specific company. One of those nurses is out for a month so it’s 2 of us left. We have to take their caseload. On top of that we’ve had at LEAST 5 admissions within 7 days. I have a patient who’s on ACT so there’s a daily visit on top of my caseload and NEW admissions. I had to work on an admission last night until 7pm!! That’s 4hrs of work. Admissions are NOT short. On top of that I have IDG notes to complete on 11 patients, 6 of which are recerts. Those are ALSO not short narratives. Not to mention I’m on call tonight. Then it’s constant admissions with no help. My manager told me “it’s all about time management” EXCUSE ME?! How about we stop admitting all of these people with 2 nurses on board. That’s almost 35 patients divided between 2 and more to come. Then manager says “our sales team is doing a great job”. By burning everyone else out. We have no help!! I hate it here so much.

There is NO such thing as work life balance with this job and i cannot WAIT to quit. I’ve tried my best but this is the worst. I hate it for the current nurse but I’m placing my notice in as soon as I have a line up. I’m miserably here. This is awful.

Edit. I see 6ppl per day. So 35 is a guesstimate

Hi. I’m a new grad and I recently got trained on inserting IVs. I find myself kind of panicking when starting on people with barely visible and barely palpable veins. Like genuinely no matter how much I readjust the tourniquet there’s no fkn way I’m feeling anything still. I get really discouraged because I eventually want to move to a unit that regularly starts IVs, I work with generally stable pts, so it’s not often we get to start IVs. I know the arm anatomy and I somehow still miss often when it’s the forearm, have missed in the hand a few times.

Soooooooo I have had three separate instances with the MAs at the clinic, and it's not for "small snd silly" reasons, like clinically these MAs need more training. The first time I don't exactly remember what she did, but it was somrthing with vitals and her not having any clinical understanding of what those vitals mean. So I immediately told my PCP who said she would take care of it when she came in. That same MA in a separate visit was asking me what I do, I said I was doing some travel nursing. The MA said, "Oh, I did travel nursing as well!" I kept my mouth shut, and have been sitting on telling the clinic until the newest problem.

I had to get a skin TB test and she first of all freaked out about my tattoos and she didn't know where to place it. I disclosed to her I am a RN and she can place it on a spot on my arm. She decided to ask the clinic RN (I'm not judging this part, like I actually want someone to verify placement if she isn't sure!) Who came in, checked my arm, touched the two spots and said those were good and left. The MA started getting the test set up, I'm sitting there with my arm out chatting and she touches my arm again and next thing I know the needle is in my arm. She's not wearing gloves, I now have my skin germs, her skin germs, and the nurse's skin germs on me. No alcohol swab, and I am immunosuppressed.

I ended up calling the clinic like 30 minutes after I left, but wtf? This isn't a down and dirty crash resuscitation in the ER, there's no rush, no go go go for her to have missed this. Like I was afraid of reporting her because I don't want to get them in trouble, but this is two times potential medical harm was directed towards me, and someone lying that they are a RN.

Am i the only one here where this doesn’t make sense? I have CNAs and other RNs place one pad underneath a patient, and one in between the legs (if they have a foley or purewick/primofit)

I also see doubling or even tripling up on certain patients along with a pull-up or diaper. I feel like i am going insane?

I don’t know why the call bell system is allowed to be in the nurse break room. I hate sitting in here trying to scarf something down real quick or RELAX for a hot minute with the background cacophony of that damn thing going off every 20 seconds. I bet European nurse break rooms don’t have this!!!

Why do pay and working conditions change so dramatically when nurses cross a state line? Its kinda crazy how crossing and invisible line makes a difference considered how hard we all work.

Latest BLS median RN wages:

California: $67.44/hr | $140,270/yr
Oregon: $62.00/hr | $129,010/yr
Washington: $59.71/hr | $124,200/yr

U.S. median: $46.90/hr | $97,550/yr (if these wages are wrong please post your correct figure)

Alaska: $44.00/hr | $91,520/yr
Mississippi: ~$40/hr | ~$83K/yr
Alabama: ~$40/hr | ~$83K/yr
South Dakota: ~$39/hr | ~$81K/yr -- actually 73k reported by RN.

it’s not just pay. California mandates ratios including 1:5 med-surg, 1:4 telemetry and 1:2 ICU. Oregon now has 1:4 med-surg/tele and 1:2 ICU. Meanwhile, nurses elsewhere are still carrying 6, 7 or 8 patients.

Why the difference? Part of it is leverage...which we all have at our fingertips!

Some nurses have organized, struck and won major improvements. Others have accepted multi-year contracts where the annual raises barely keep pace with inflation and rising living costs. A cumulative raise over five years can sound impressive until you realize what your paycheck actually buys.

Then every time striking comes up, we hear: “We can’t strike. Patients could die.”

At some point, we have to grow a fucking backbone. Hospitals know nurses feel personally responsible for their patients, and that compassion becomes leverage against us. But if understaffing during a strike is dangerous, why is chronic understaffing the other 365 days of the year acceptable? Not to mention how harmful it is for our health. What the fuck about that.

California and Oregon didn’t get better wages and ratios because their hospitals are nicer. Nurses organized, laws changed, and hospitals adapted.

Being indispensable should give nurses bargaining power, not make us afraid to use it. We need to continue to talk about this, until we do something about it. Stay in this fight, for your patients, coworkers and families.

Via an email today. She told me that she was removing my "cancel lunch deduction" from Saturday as she saw me picking up a Jersey Mike's order at that time. That time? 7:30pm. My shift? 8am-7pm. I was off the clock and grabbing dinner on my way home for my fiancée and myself.

1) That's embarrassing as fuck for her.

2) To so boldly accuse me of time theft and issue me a warning about clocking out when you're so blatantly wrong? She better be apologizing to me and giving me my lunch deduction back. I've been working under her for 5 years. I've never falsified a time card.

ETA: She replied and actually doubled down. Then back tracked to "double check her timeline". Said that she thought I was there at 6, not 7pm. Then said "disregard". No apology.

I'm about done with this place.

Different floor from last time. Same situation. 🤣

I work as a LPN in an assisted living facility. I’m new here, but a nurse for 10 years and in healthcare for 17. As a nurse I’ve worked in peds home health, hospice, medical call center, LTC and now here. I have been involved in audits and state visits. I firmly believe in CYA and CMA and protecting my license. I also firmly believe that employers will through you under the bus, and following orders and good clear documentation protects nurses.

My new facility is really loosy goosy with some of this stuff. It’s rural and the staff and residents all know each other and are usually distantly or closely related. It makes the vibe that staff and management are family caregivers to be honest rather than being super clinical. It makes for a really pleasant, quiet day. But repeatedly issues are arising for me where something is too relaxed and I have to be a stickler for professionalism.

Today I was told by a visiting hospice nurse to irrigate a cath. No orders in our MAR/TAR for that. Old orders are in documents with the wrong foley info in it. I made sure I got an order for it because the assumption was I’d just do it because I was told. It was clogged and I was then told to change it, again I requested orders. You would have thought I requested a VIP reservation somewhere. The visiting nurse thought I was nuts for asking for this. I checked with a fellow nurse about what they’ve done in the past, she told me and it’s literally a med error but I don’t want to snitch. Even if I did, I know management doesn’t care, they’d agree. I have never had to work this hard to get an order or had to justify it like I did, honestly it felt so dumb. It was awful and I ended up crying in my car.

This weekend a new admit highly agitated, delirious resident started getting physically aggressive with multiple members staff over more than one day. He even put his hands on me and pushed me back when I was trying to calm him down. No way to get good PRNs for him. I eventually called for the ambulance to get him to a hospital. My management basically told me I made the wrong call, that I wasn’t thinking of the well being of the resident, that they’ve had worse. I can’t believe it. I’ve never had a management team not back us up when it comes to physical threats. If he had hurt someone after I left it would have been on me for not being proactive. Thank goodness I documented the crap out of everything, because they DID see that on paper my actions were correct. It just caused them a headache. If my management doesn’t care about that, they don’t give a damn about orders.

I’ve never had this experience with management. They are otherwise very lovely people who clearly care about the residents. But if state come? I was told state never visits so I don’t need to worry about it.

I’m even wondering if I should quit. This stuff is so basic to me, I feel like I’m taking crazy pills. And I feel very very alone.

Early career RN here (3 years in at a major trauma hospital) and wondering if anyone has experienced this and may have some advice:

I've done a few courses now regarding deterioration/arrest management (ALS etc) and have found I completely freeze in the simulation environment. I go TOTALLY blank. It is particularly frustrating and humiliating as in real-life emergencies I feel calm, focused and able to summon my training and knowledge. In the simulation environment I feel really distracted by the stilted nature of the simulation, and overwhelmingly self-conscious. I panic internally and I go blank; in the moment it feels like a bad dream where you're naked in front of the school or something!

Does anyone else struggle in the simulation environment? And how to you combat these struggles? I feel so humiliated and ashamed so very much appreciate the advice!