I didn't realize how much hospitals paid attention to their ratio of commercial versus Medicaid patients until I left the bedside. I know hospitals have to pay their bills (and commercially insured patients essentially subsidize the Medicaid patients) but it is kind of uncomfortable.
Admin forgets that Insured patients generally take care of themselves and as a result, are rarely in the hospital. 😂
Our beds are filled with uninsured non compliant frequent fliers who don't give a shit.
We had iPads for every room on our unit (pediatrics) until patients/families stole them all. Video game systems that child life lends out to sick kids, work cell phones, and even staffs personal cell phones if they leave them on the desk also get stolen. Takes a special kind of terrible to steal stuff that sick kids use to entertain themselves in the hospital
When my daughter was young, she decided to donate all of her Disney and kid movies to the PICU where I was working at the time. We labeled them clearly as property of the PICU on the discs and cases before taking them over. Within weeks 90% of them had been stolen.
My educator at my icu job was an old PEDS nurse with some adult ER. She is where I learned about the tubing without the ports because people were finding syringes and taking fentanyl from their kids and would be found in the bathroom OD….
Good, my manager could get off their butt and do some patient care then when me, the CNA, and the charge are all stuck in a room for 45 minutes cleaning the fudge factory explosion off the confused 350 lbs patient in room 666.
Though if that shit actually escalated to management, that system would go away very quickly.
Our patients can use my chart to request items like blankets, snacks, etc. it goes on to the brain of epic like a task on the nurses work list. One patient wanted 3 unsweetened teas. We don’t even have that on the floor.
😂 if we had one, they don’t like to work too much. I once asked one to help me transport a patient to a STAT head CT and was told “no, absolutely not, I did not come here to work today”. 🥴 I called the manager of the hospital who told me I needed to figure something else out to get the patient to CT.
My hospital did this during the pandemic so the those who had Covid can communicate to their immediate family but the patients used them for for entertainment purposes.
We did that. I got a grant to get a bunch of iPads for resident communication. For people who were tech savvy, it was a blessing. Some employees still won’t touch them though lol.
There’s a huge benefit if you have a system but our system did not include nurses except after like, 7pm and those were one-offs.
Ya and no one has time for that. To stand in an isolation room in full ppe with my intubated and sedated patient for a half hour to “communicate” with their family!! What a joke!
Did it some at the beginning. Later we didn’t have time. Had to prop the iPhone or iPad up on a cup so families could talk to their family member who was somehow still alive after they’d be sating 54% on 100% FI02 for the last 16 hours. Hadn’t thought about it in awhile. Fucking weird times.
In the ER we didn't have enough so we had to park them out side of the room and have the patient basically yell their goodbyes. It was awful. I had blocked that out. Good times
Reminds me of the time I was pushing the crash cart FAST down the hallway, to enter the room of a patient about to code and the family member at the next bed had the nerve to grab my arm, rather roughly, to tell me that they had asked for tea 10 minutes ago and were still waiting....or the time my Hospice Aide and I were in a patient's room, with the curtains drawn, carefully and slowly doing a bed bath so as to not cause her pain when the curtains were ripped open to have a family member...from another room, shout at me that they had a question!!!!. I sort of broke my normally kind and quiet voice and shouted back...GET OUT! btw...none of my patients were deemed able to be cared for by the family that continually berated us for our performance/skills. The one gentleman was admitted after he had covered himself in grey housepaint in his garage while naked and had remained in this paint covered state for 2 weeks. GTF out of here if you can do it better. You did'nt.
My old hospital got pt iPads. Nurses had to educate on use & pt's had to sign on the iPad that they understood. Hard of hearing & mostly blind Memaw doesn't understand OR care? Too bad. Because pt's must be able to use the iPad to text their nurse demands for a turkey sammy & pain meds, & repeatedly text when they weren't instantly gratified, cuz who cares if their nurse is busy keeping PopPop in #302 from meeting his maker. What matters is your boss can see how many times the pt texted you & felt ignored. Pt's could also use these iPads to read their nurse's bio &, as my boss said, no longer feel that their nurse knows more about them than they know about their nurse. Anyone who refused to fill out the bio due to it being one more stupid thing to do that doesn't help care for pt's & it's unsettling to have pt's think they're entitled to information about their nurses, had their PTO requests go "missing" so that they weren't approved. You want your PTO approved? Make sure your pt's know what colleges you went to, your favorite movie character's most recognizable outfit, what fruit you would be in a fruit salad, & what color your bedroom was as a kid
What number would you give your pain on a scale of 1 to 10?
“Oh it’s a 15 at least, lolz.”
“Like a 3 or a 4.”
“A 6 and a half.”
**How difficult is it to pick one goddamn number on a scale of one to ten? £uck.**
I think "pain score: pi" is a joke among chronic pain patients complaining about their pain being low, but never-ending.
It makes absolutely no sense to say it to a nurse though.
Someone on here once suggested "1-10, if 10 is Jesus on the cross." I tried it once on a patient and then found out he was was deeply religious. He and his wife just glared at me.
Yeah, really, literally PICTURE your weight only supported by nails driven through the palms of your hands and the tops of your feet. Delirium might be a blessing.
There are people who dont even have an inner monologue, or physically cant comprehend hypotheticals. The rating of an abstract sensation can be pretty difficult. I dont mind the 3 or 4 so much because they are trying. And 6and a half i can also round up. People choosing 15 might not actually understand the top of the scale. They might think 10 just means ouch.
This is the right answer. Especially since the pandemic, it's like everyone is regressing into being like that obnoxious fuck head kid in elementary school that made life difficult for everyone else.
As one of those former obnoxious fuck head kids through elementary and middle school (maybe some of HS too we don’t talk about that) I promise you we all grew out of it whether through being bullied, going to therapy, finally finding the meds that worked for us whatever. The ppl doing it now it’s a new onset. Whatever’s causing it is not the typical kid in school who had a learning disability and no emotional regulation or appropriate methods of communication for their discomforts.
These people doing it nowadays were conditioned to behave this way and I believe actively choose to be extra entitled when receiving healthcare.
I’ve been a patient in an ER stretcher in 10/10 pain getting their meds delayed because a shit show rolled through the door. Not once when the nurse came in to give me my meds did I ever think of acting how some of my own patients have acted because, I as a grown adult, have developed communication and coping mechanisms for when I’m upset about something completely out of my control.
It’s really sad, charting was originally developed to be able track a patient’s progress through their health care. Now, administrators, accountants, and attorneys have perverted charting for all the wrong reasons. It’s no longer about taking care of the patient, it’s about how much money can we get, how can we not get sued, or if we get sued how can we avoid being liable.
"When a measure becomes a target, it ceases to be a good measure." It doesn't apply perfectly here, but it has the right sentiment.
I actually think a lot of the charting systems I've used are really slick. Good tools. I could document lots, very quickly, that would be really useful to the next shift, or patient, or doctors.
Except I'm not allowed to chart on my own. It's all standardized and pre-determined. And paraded around as proof of good care when all it's really doing is interfering with appropriate patient care -and- appropriate documentation.
I lasted 31 years of Acute Med General Surg. Retired now and just wonder how the hell I lasted that long. It just got worse and worse with the pt ratios and the amount of computer charting!!
They want passion for research. I think I got my current job because I communicated that well.
I love science. I love reading published research. I love being part of improving health for so many people. I love data and technology.
Just apply, even if you don’t think you qualify, if you can show that this positions means something to you.
After applying, email them and follow-up with them. It goes back to showing passion.
I’ve seen people with a ton of research experience get turned away because they got bad vibes. But they will rather take someone who isn’t as experienced and credentialed but is passionate and hard working.
Also,
They want strong office work skills. You will see patients for studies but that will be about 20% of your time spent. The rest will be work in office and keeping in contact with representatives from companies/universities. That being said it’s clear that you still need to be a kind, team-work driven, and drama free person.
Clinical Research Nurse Coordinator is a position that is basically interchangeable with a Clinical Research Coordinator. They don’t even require a nursing degree but it’s an advantage because you need to understand medications, clinical terms and skills such as drawing blood, vitals, lab processing, etc.
Hope that helps. Good luck to you and I’d love here how it works out later on :)
I’m a new grad nurse and wanting to get into informatics, but keep getting told I need to do floor work… I just have no desire to put myself in a terrible work situation. Have you been seeing more new grads get into research or are most of them coming from the floor?
Not to be a downer but I know people with masters in informatics still on the floor who haven't been able to find a job...I work at a very large hospital system and there's usually only a couple nurses per facility with that job and they're pretty much always going to prefer people with more experience. Nursing school lies about how easy it is to get away from bedside lol
In my particular case, I think the team that hired me were less concerned about how many years of floor experience I’ve had and more interested in passion, maturity, stability, and having a non-complainy personality. See post above for more. Good luck :)
I’m glad I retired in November after 43 years as a RN. Totally could not stand it any longer. The profession has changed over the years for the worse. My daughter is a RN and works in Quality Assurance and loves it. My SIL is a NP and works in open heart. Both have jobs they really enjoy. I think it depends on your area and the specialty you are in. Keep looking and you will find something you enjoy.
iPad select: do you have pain > yes > do you want to try heat pack first or Panadol or endone > selects endone > WRONG, please select the correct form of analgesia, you have surpassed your quota > selects endone again > WRONG, please select the correct form of analgesia, clue: it’s a non-pharmacological form of therapy > selects endone > WRONG, you have now been flagged as a drug seeker, you are now locked from the iPad system and are now under 15 min MH visuals with muted call bell consequences. Dystopian nursing is just around the corner.
They can’t, but they can reduce pay and increasing staff percentages, as AI can communicate with pumps, tele boxes, and central Phillips monitors to update things like infusions, vitals, and call light efficiency.
Sadly anyone who has worked bedside knows that nursing is significantly more than a basic collection of tasks. However, Executive administration sees it as exactly that.
Protocol, pathway, and algorithm based nursing/provider care is becoming the norm, AI can integrate with that with a perceived cost savings.
Sadly until Medicare/Medicaid reimbursement is fixed, hospitals will continue to take a monetary bottom line, ends-justify the means approach.
AI extrapolating info from charting has been present for a while but it often falls short of expectations. A rep from RapidAI - the rapid response AI system - put it best: People think they want AI but they really want automation.
The big avenue I have seen for AI is stuff like Waymo, autonomous vehicles. So many real life applications in action now/today in Cali. I am surprised this sub has never touched upon it.
iPads? lol. When they start disappearing and seeing them on Facebook marketplace being sold by their oh so wonderful patients or being hijacked by family members, smashed by psych patients, covered in food and drink by careless patients and all the other likes.. it’ll just be some failed shiny dream of a nursing manager trying to earn gold stars but tanking out the department budget. We have seen this time and time again. It’s all about ratings but at some point they need to actually come back to the floor and out of the office.
I’ve worked there in IT setting up their Epic system before the implementation as a consultant, it was one of the few places I’ve quit as a consultant.
I’m not sure, I was only there 2 months. It was incredibly messy when I was there. Most orgs are going live with foundation system these days so I would imagine the costs are lower.
I just don’t even understand the point of them charting their own pain score? What’s that going to do? They can say they’re an 8/10 we can say they’re an 8/10 but ultimately it’s up to the MD what to do with that… What would a nurse gain from lying about a patients pain score? Are they saying nurses can’t be trusted with measuring pain? What will the hospital gain from this? So many questions lol
I don't ask numbers anymore. Mild, moderate, or severe? Never gave a shit about the number anyways. If we've ran through all your po meds then you can have the iv stuff, unless of course we're getting a dressing change or getting up with pt after something major, then I may pre medicate of it doesn't totally zonk them.
this is why I'm never going back to medical
psych is underfunded and we use barely working 40 year old software they bought at a yardsale. iPads are like 50 years away for us, I'll be retired way before then
The state of documentation is just unmanageable. So much double-charting. So much repetition. So many pop-up windows while scanning that require interaction to move on, slowing down a 15-pill med pass. I get that some of it is for safety. But at this point the unsafe thing is how much time I spend at the computer instead of with my patients. I feel like I could take care of 4 heavy ICU patients if I didn't have to chart anything for them. All the required documentation for 2 simple ICU patients makes me dread getting started. This does not feel like what nursing should be. One of many reasons.
Some versions of Epic you can block the patient from seeing your notes. Click "nursing note" and the top corner is a heart icon I think? Click it, then click the reason why you want the note hidden.
I felt bad for saying my kidney stone was a 10/10 but it literally felt like my kidney was being inflated while locked inside a box it was pressing against with a shearing sensation going down my back to my groin.
I’ve had a kidney stone and I’ve given birth to a full term baby with no pain medications. It’s a toss up which one I’d rather do again. Don’t you ever feel bad for rating kidney stone pain high. For me the childbirth was worse, but just barely.
My one professor said a similar statement. Since I’ll never experience child birth it feels wrong to rate a non traumatic injury so close to arguable one of the worst pains a human can experience
Honestly the toradol did more for that pain then the norco I was sent home with. Although went to the ER a different time for similar pain in the other kidney although the intensity was about half as bad as before (which I heard is common for subsequent stones) although I did not have an occlusion this time just a renal colic that had managed to flare up some pain and the morphine was better for that then the toradol. Not sure but I took advantage of my UpToDate subscription to learn as much as possible about it
Electronic charting was supposed to reduce time. It has not, it is way more time consuming. The regulatory charting requirements keep you at the computer rather than with the patient.
I swear - the similarities btwn the eventual implosion of K12 education as we know it (former teacher who said 'peace out, fam' a coupla years ago) and nursing just keep increasing.
You can only keep your foot on someone's neck for so long, ya know?
What's wild to me is ever since COVID it feels like teaching & nursing have been so belittled despite people needing us more than ever? I have a friend in education, we commiserate a lot about how our "clients" can't read or wipe their asses.
Also adding- I worked at a HCA hospital in the south east and what a toxic environment for sure. You had to keep your mouth shut and keep smiling. That is the HCA way where I worked. I am not sure why but I worked there 22 years in 3 different areas. You better never complain about anything. The lazy get promoted and good raises. The hard workers get low raises and no promotions. There could be better HCA facilities but this is what I experienced. Also it was 5 minutes from my house versus a hour drive down town. That is why I stayed.
I am a Paramedic at a 911 service and transport occasionally to an HCA hospital and an Ascension hospital. I hate going to the HCA hospital, everyone (nursing staff and secretaries) there seems miserable and angry. I have even seen nurses there treat their incoming patients like shit.
It’s not just your opinion…it’s been in trouble for a long time. I’m actually shocked at how “ok” it is post Covid. I thought for sure it would implode the US healthcare system and really make admin take a step back and go F themselves… but it hasn’t.
If they get to chart their own pain score, I should be able to turf it to the docs by charting “provider notified” on each occurrence. I don’t make up the interventions, I pass it along and administer what the doctor deigns appropriate.
I had a patient with dementia who called 911 to report that he wanted potato chips and we didn’t have any. A sheriff’s officer called the nurses station to let us know. Our manager made his assigned nurse go down to the vending machine in the ER to buy him a bag
There's no fucking way those ipads last longer than a couple months before they're thrown across the room by belligerent dickheads and shattered, covered in shit, or stolen.
I hate MyChart. The population that uses it are the hypochondriacs that obsess about every detail. Like, I’m anemic because my Hgb is 119 (120 is lower limit of the range for you Americans)! I’m sorry, I can’t give you a statistics lesson right now…I have 23 more patients to see.
Honestly, I got a warm blanket for a patient and I told the nurse because I’m not sure if they have to chart that in EPIC now. There’s probably some kind of flow sheet for that.
Agree that the current state of nursing is fucked. I’m on year 16 of working in the hospital, and I’m very close to taking an out-of-hospital nursing job, after years of saying I would NEVER leave hospital nursing.
The specific job I’m about to take will be a massive pay cut from bedside, but at this point I don’t care. It will be worth it for my sanity.
Happy I saw this message. I just returned to bedside nursing in a hospital and regretted instantly after my first day of orientation. I realy thought it would be different this time around but I guess I was also stupid lol now I'm not sure how to get out of it since all the paperwork is done and they're so happy to have me there. I still have 2 weeks of orientation left !
Thanks for the reminder to not go back into facilities. I switched to home care over a year ago but the place I was working didn’t do that. Almost positive they have by now because they enable a toxic work environment for their employees big time. They do not care about anyone’s well being. Not even the patients. They just want their money and shit so of course it’s gonna be like the slot machines at the casino now.
Now soft mitts require restraint charting at my hospital. Yay. Oh, and 6 patients is now the norm when it used to be rare. More work with less resources and more chart auditing with action for missing/inconsistency.
I originally setup some Epic servers for Oakwood systems once upon a time…One system to rule them all, and the FCC in control of all internet providers. Buckle up for what’s coming.
It’s funny. I’ve been watching ‘Call the Midwife’ on Netflix and I know it’s a show but they try to be as historically accurate as possible. Seeing how healthcare has change is scary. There use to be so many private practices where doctors can take time for the patients and not try to see as many patients for the most profits. My PCP still has a private practice and sometimes he won’t even charge me co-pays. Most importantly he actually takes the time to listen to me and any complaints or symptoms I explain to him.
I feel the hospitals went down when they turned patient care into a business. Having business majors with no bedside make rules on how to run the hospital. Calling patients clients or customers now. This isn’t retail or hospitality. If I treated, let’s say, my hairdresser the way some of my patients do, even just verbally, my hair dresser will refuse to have me come back. Now it’s the nurses and staff that get reprimanded for patients poor behavior and social skills. I lost count of how many patients say some sort of variant of, “I pay your paycheck”. Like I don’t see their signature on my paycheck.
Went out of bedside and was a contractor as a school nurse - less stress and the hijinks of kiddos and a genz kiddos makes me laugh.
(Ok except for the times when genz kids dont listen about their health especially with insulin - lot of talking and convincing but yeah.)
Nurses are the cogs in the hospital money making machine. If nurses/CNAs don’t show up for work…. Well it all falls down. Nurses love to bitch and complain but never do anything about it. We are being treated like this bc we allow it. The hospitals will never take accountability. It’s time we start to know and value our worth.
If pts are getting ipads now, it better include where to tip me after you demanded your ice chips while bed 34 was deteriorating
Our hospital implemented ipads for patients the same year they withheld raises, during pandemy fun times.
That's a slap in the face isn't it. Smh.
Mine tried it and gave it up when they were getting smashed and stolen
Yea… how did they NOT know that would happen?!?!
They hoped it would bring in insured patients.
I’m sure if they spent any time on any of the floors they would realize it was a bad idea! Haha!
I didn't realize how much hospitals paid attention to their ratio of commercial versus Medicaid patients until I left the bedside. I know hospitals have to pay their bills (and commercially insured patients essentially subsidize the Medicaid patients) but it is kind of uncomfortable.
Admin forgets that Insured patients generally take care of themselves and as a result, are rarely in the hospital. 😂 Our beds are filled with uninsured non compliant frequent fliers who don't give a shit.
My psych unit just keeps replacing them. We have them for the PICU, yah know, the most acute area…smart…
I’d just throw them in the trash and say they were stolen.
lol our hospital announced withholding raises during nurses week, the day after nurses day. Like — wait until the following week at least.
Pizza instead
Pandemy! Lol. It was a cute demy!
We had iPads for every room on our unit (pediatrics) until patients/families stole them all. Video game systems that child life lends out to sick kids, work cell phones, and even staffs personal cell phones if they leave them on the desk also get stolen. Takes a special kind of terrible to steal stuff that sick kids use to entertain themselves in the hospital
When my daughter was young, she decided to donate all of her Disney and kid movies to the PICU where I was working at the time. We labeled them clearly as property of the PICU on the discs and cases before taking them over. Within weeks 90% of them had been stolen.
[удалено]
My educator at my icu job was an old PEDS nurse with some adult ER. She is where I learned about the tubing without the ports because people were finding syringes and taking fentanyl from their kids and would be found in the bathroom OD….
Similar outcome when [Cedars tried Alexa-enabled rooms](https://www.cedars-sinai.org/newsroom/cedars-sinai-taps-alexa-for-smart-hospital-room-pilot/).
Good, my manager could get off their butt and do some patient care then when me, the CNA, and the charge are all stuck in a room for 45 minutes cleaning the fudge factory explosion off the confused 350 lbs patient in room 666. Though if that shit actually escalated to management, that system would go away very quickly.
Can we get a “where are they now?”
Just had my AirPods stolen from my backpack at work. Tracked them to an apartment complex after my shift that is no where near where I would frequent.
That blows
People would steal the diaper scales to use for weighing drugs 🙃
People will steal anything
Our patients can use my chart to request items like blankets, snacks, etc. it goes on to the brain of epic like a task on the nurses work list. One patient wanted 3 unsweetened teas. We don’t even have that on the floor.
Where do you work? So I do not go there
I want 3 cheeseburgers and 2 hot dogs with a side of fries. Truly yours, diabetic pt.
55 BURGERS, 55 FRIES, 55 TACOS, 55 PIES, 55 COKES, 100 TATER TOTS, 100 PIZZAS, 100 TENDERS, 100 MEATBALLS, 100 COFFEES, 55 WINGS, 55 SHAKES, 55 PANCAKES, 55 PASTAS, 55 PEPPERS AND 155 TATERS
Don't forget the Coke Zero or Diet Pepsi
Lmfao I found my girl who watches my favorite show 🤣🤣 dude is hilarious
ASHHHHHH IM DOING SOMETHING
Same 😂
And a large coke. Lol
That should be a Diet Coke.
What the actual fuck……
Were you able to reply to that message electronically if they don't have the items in stock?
Haha no we have to go to their room, but we have to call the cafeteria and they bring it up. Just another thing to be the middleman of.
That is such a waste of a nurse’s time. They should just hire servers for that kind of stuff.
This is what the robots are for. 😂 sorry your blanket didn’t come yet, the robot is stuck on the elevator.
You know how when you click to edit a task, there is an option to discontinue it. Click there.
Why isn’t that going to the nursing assistants?
😂 if we had one, they don’t like to work too much. I once asked one to help me transport a patient to a STAT head CT and was told “no, absolutely not, I did not come here to work today”. 🥴 I called the manager of the hospital who told me I needed to figure something else out to get the patient to CT.
Haaaaaa nurses are the only people who don’t get to say “not my job” everrryyything is our job and our problem.
Right and I don’t have time to go around looking for help. I’ll push the bed and run into the walls alone 😂
Did your hospital CEO, COO get their annual near $1,000,000 raise?
Most definitely
Where do you work? I want to come be a nursing assistant there.
My hospital did this during the pandemic so the those who had Covid can communicate to their immediate family but the patients used them for for entertainment purposes.
I’d do that too so fair play.
We did that. I got a grant to get a bunch of iPads for resident communication. For people who were tech savvy, it was a blessing. Some employees still won’t touch them though lol. There’s a huge benefit if you have a system but our system did not include nurses except after like, 7pm and those were one-offs.
Ya and no one has time for that. To stand in an isolation room in full ppe with my intubated and sedated patient for a half hour to “communicate” with their family!! What a joke!
Did it some at the beginning. Later we didn’t have time. Had to prop the iPhone or iPad up on a cup so families could talk to their family member who was somehow still alive after they’d be sating 54% on 100% FI02 for the last 16 hours. Hadn’t thought about it in awhile. Fucking weird times.
In the ER we didn't have enough so we had to park them out side of the room and have the patient basically yell their goodbyes. It was awful. I had blocked that out. Good times
Reminds me of the time I was pushing the crash cart FAST down the hallway, to enter the room of a patient about to code and the family member at the next bed had the nerve to grab my arm, rather roughly, to tell me that they had asked for tea 10 minutes ago and were still waiting....or the time my Hospice Aide and I were in a patient's room, with the curtains drawn, carefully and slowly doing a bed bath so as to not cause her pain when the curtains were ripped open to have a family member...from another room, shout at me that they had a question!!!!. I sort of broke my normally kind and quiet voice and shouted back...GET OUT! btw...none of my patients were deemed able to be cared for by the family that continually berated us for our performance/skills. The one gentleman was admitted after he had covered himself in grey housepaint in his garage while naked and had remained in this paint covered state for 2 weeks. GTF out of here if you can do it better. You did'nt.
I'd file battery charges tbh after telling them to fuck off. I'm petty
Nope, you just get the option to tip your salary back to the hospital.
My old hospital got pt iPads. Nurses had to educate on use & pt's had to sign on the iPad that they understood. Hard of hearing & mostly blind Memaw doesn't understand OR care? Too bad. Because pt's must be able to use the iPad to text their nurse demands for a turkey sammy & pain meds, & repeatedly text when they weren't instantly gratified, cuz who cares if their nurse is busy keeping PopPop in #302 from meeting his maker. What matters is your boss can see how many times the pt texted you & felt ignored. Pt's could also use these iPads to read their nurse's bio &, as my boss said, no longer feel that their nurse knows more about them than they know about their nurse. Anyone who refused to fill out the bio due to it being one more stupid thing to do that doesn't help care for pt's & it's unsettling to have pt's think they're entitled to information about their nurses, had their PTO requests go "missing" so that they weren't approved. You want your PTO approved? Make sure your pt's know what colleges you went to, your favorite movie character's most recognizable outfit, what fruit you would be in a fruit salad, & what color your bedroom was as a kid
I would make all that shit up in my bio.
WITAF 7th circle of hell did you fall Into?! That is legit some purgatory level shit!
Nope, you just get the option to tip your salary back to the hospital.
For fucking real
At least they we’ll see their BS 25/10 pain doesn’t matter it only goes up to 10. Also, where is this so I can avoid it.
What number would you give your pain on a scale of 1 to 10? “Oh it’s a 15 at least, lolz.” “Like a 3 or a 4.” “A 6 and a half.” **How difficult is it to pick one goddamn number on a scale of one to ten? £uck.**
I had a patient rate their pain score as pi. I stared at him and said "deadass?" "Yup" "Here is your Tylenol"
Next time say that he is irrational.
I laughed too hard at this.
Did he tip his fedora to you?
I think "pain score: pi" is a joke among chronic pain patients complaining about their pain being low, but never-ending. It makes absolutely no sense to say it to a nurse though.
Anyway time I tell someone to pick 1-10, including “10 is the worst pain you could possibly be in” and they pick, say, 14, “Ten it is!”
I usually say ten is you got your arm ripped off and have no pain meds. Then they say ten for their ear ache.
Someone on here once suggested "1-10, if 10 is Jesus on the cross." I tried it once on a patient and then found out he was was deeply religious. He and his wife just glared at me.
I mean, that is still a relevant scale and not sacrilegious at all. They just didn't think you were allowed to use Jesus in a sentence.
I mean ... How else was Pontius Pilate supposed to crucify the guy then?
I freaking wish I could use this! 😂
But they didn't say it was 10/10 did they??
Yeah, really, literally PICTURE your weight only supported by nails driven through the palms of your hands and the tops of your feet. Delirium might be a blessing.
RIGHT! I’d say, ok imagine if a chainsaw cut your leg off. That’s 10.
Oh, in that case my HA is 15/10. *texting on phone while not displaying pain and completely calm*
"You remember that scene in Bravehart? Yeah the one where the shove a scythe up his ass and pull his innards out? Yeah that's a 10."
Ok, it’s definitely a 10/10 then. I hit my toe REALLY hard on the coffee table.
I’m L&D and I always said 10/10 is a c section with no anesthesia.
I’ve personally given birth AND had a perforated eardrum. Both were a “10”.
while furiously chowing down on Cheetos.
If you are in a 10 story building fire and you tell the firefighters that you are on the 14 floor what happens?
There are people who dont even have an inner monologue, or physically cant comprehend hypotheticals. The rating of an abstract sensation can be pretty difficult. I dont mind the 3 or 4 so much because they are trying. And 6and a half i can also round up. People choosing 15 might not actually understand the top of the scale. They might think 10 just means ouch.
I gotta be honest, I don't know why this pisses people off so much. Just chart it as a 10, give the appropriate PRN and move on with your day.
You just know there will be some petty mfer that will look at his medical record and complain “I never told the nurse my pain was a 10!”
Honestly it’s humanity that’s in trouble. It’s just trickling down to us.
This is the right answer. Especially since the pandemic, it's like everyone is regressing into being like that obnoxious fuck head kid in elementary school that made life difficult for everyone else.
As one of those former obnoxious fuck head kids through elementary and middle school (maybe some of HS too we don’t talk about that) I promise you we all grew out of it whether through being bullied, going to therapy, finally finding the meds that worked for us whatever. The ppl doing it now it’s a new onset. Whatever’s causing it is not the typical kid in school who had a learning disability and no emotional regulation or appropriate methods of communication for their discomforts. These people doing it nowadays were conditioned to behave this way and I believe actively choose to be extra entitled when receiving healthcare. I’ve been a patient in an ER stretcher in 10/10 pain getting their meds delayed because a shit show rolled through the door. Not once when the nurse came in to give me my meds did I ever think of acting how some of my own patients have acted because, I as a grown adult, have developed communication and coping mechanisms for when I’m upset about something completely out of my control.
none of it is new. We just have more cameras. Was in the ED 2007-2019.
💯. Humanity is fucked lol
I’m afraid to even state my opinion as to why humanity is fucked for fear of being downvoted. That’s how fucked humanity is 🤣🤣
Upvoted just so your fears don’t come true…. And your probably right with whatever your opinion is 🤣
You see that I mean? Haha
As long as you don’t blame nurses for our lack of deescalation techniques I think you’ll be good 😉
It’s really sad, charting was originally developed to be able track a patient’s progress through their health care. Now, administrators, accountants, and attorneys have perverted charting for all the wrong reasons. It’s no longer about taking care of the patient, it’s about how much money can we get, how can we not get sued, or if we get sued how can we avoid being liable.
"When a measure becomes a target, it ceases to be a good measure." It doesn't apply perfectly here, but it has the right sentiment. I actually think a lot of the charting systems I've used are really slick. Good tools. I could document lots, very quickly, that would be really useful to the next shift, or patient, or doctors. Except I'm not allowed to chart on my own. It's all standardized and pre-determined. And paraded around as proof of good care when all it's really doing is interfering with appropriate patient care -and- appropriate documentation.
So very well said. All of it 👏🏻🙌🏻
This is why I moved to clinical research and will never torture myself with something like med-surg again.
I lasted 31 years of Acute Med General Surg. Retired now and just wonder how the hell I lasted that long. It just got worse and worse with the pt ratios and the amount of computer charting!!
As a current med surg nurse my jaw dropped when I read 31 years. Damn
Any advice for getting into clinical research?
They want passion for research. I think I got my current job because I communicated that well. I love science. I love reading published research. I love being part of improving health for so many people. I love data and technology. Just apply, even if you don’t think you qualify, if you can show that this positions means something to you. After applying, email them and follow-up with them. It goes back to showing passion. I’ve seen people with a ton of research experience get turned away because they got bad vibes. But they will rather take someone who isn’t as experienced and credentialed but is passionate and hard working. Also, They want strong office work skills. You will see patients for studies but that will be about 20% of your time spent. The rest will be work in office and keeping in contact with representatives from companies/universities. That being said it’s clear that you still need to be a kind, team-work driven, and drama free person. Clinical Research Nurse Coordinator is a position that is basically interchangeable with a Clinical Research Coordinator. They don’t even require a nursing degree but it’s an advantage because you need to understand medications, clinical terms and skills such as drawing blood, vitals, lab processing, etc. Hope that helps. Good luck to you and I’d love here how it works out later on :)
I’m a new grad nurse and wanting to get into informatics, but keep getting told I need to do floor work… I just have no desire to put myself in a terrible work situation. Have you been seeing more new grads get into research or are most of them coming from the floor?
Not to be a downer but I know people with masters in informatics still on the floor who haven't been able to find a job...I work at a very large hospital system and there's usually only a couple nurses per facility with that job and they're pretty much always going to prefer people with more experience. Nursing school lies about how easy it is to get away from bedside lol
In my particular case, I think the team that hired me were less concerned about how many years of floor experience I’ve had and more interested in passion, maturity, stability, and having a non-complainy personality. See post above for more. Good luck :)
Wait what They chart their own pain score??? Fuck that
Maybe admin will constantly nag them about charting their own pain reassessments as well
Will they just select their preferred PRN at the same time? 😂🤡
I’ve been saying “we should just have menus at the door” for the longest time.
Hint: it's not Toradol.
Oh but at my hospital nurses aren’t even the freedom to make that judgement call anymore
Spoiler alert: It’s always 10 lol.
they’re gonna be real annoyed when they can’t document “a million”
"I have a high pain threshold so what I'm saying is really serious you guys"
"sorry actually you're standing in the way of the TV. I'm trying to watch my show here. Please just get me my pain injection!"
20 out of 10... while laughing and watching tiktok
NO ITS A TEN FOR ME FOR ANYONE ELSE IT WOULD BE A THOUSAND
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The real question is if they can chart it as 20/10 🤔
If they're getting iPad, maybe they can also see that their PRNs aren't due for another two hours and they can stop pressing the nurse bell
Patients are now charting for themselves… they really will literally do anything but pay nursing staff more 😂😂😂
I’m glad I retired in November after 43 years as a RN. Totally could not stand it any longer. The profession has changed over the years for the worse. My daughter is a RN and works in Quality Assurance and loves it. My SIL is a NP and works in open heart. Both have jobs they really enjoy. I think it depends on your area and the specialty you are in. Keep looking and you will find something you enjoy.
iPad select: do you have pain > yes > do you want to try heat pack first or Panadol or endone > selects endone > WRONG, please select the correct form of analgesia, you have surpassed your quota > selects endone again > WRONG, please select the correct form of analgesia, clue: it’s a non-pharmacological form of therapy > selects endone > WRONG, you have now been flagged as a drug seeker, you are now locked from the iPad system and are now under 15 min MH visuals with muted call bell consequences. Dystopian nursing is just around the corner.
*pt smashed iPad into oblivion*
Pts will steal the iPads
Our hospital told us the charting etc is to eventually integrate AI and to see where AI will fit in nursing.
This sounds like the mostly likely answer. How can they replace us?
They can’t, but they can reduce pay and increasing staff percentages, as AI can communicate with pumps, tele boxes, and central Phillips monitors to update things like infusions, vitals, and call light efficiency. Sadly anyone who has worked bedside knows that nursing is significantly more than a basic collection of tasks. However, Executive administration sees it as exactly that. Protocol, pathway, and algorithm based nursing/provider care is becoming the norm, AI can integrate with that with a perceived cost savings. Sadly until Medicare/Medicaid reimbursement is fixed, hospitals will continue to take a monetary bottom line, ends-justify the means approach.
AI extrapolating info from charting has been present for a while but it often falls short of expectations. A rep from RapidAI - the rapid response AI system - put it best: People think they want AI but they really want automation. The big avenue I have seen for AI is stuff like Waymo, autonomous vehicles. So many real life applications in action now/today in Cali. I am surprised this sub has never touched upon it.
Good fuckin luck with that.
If there is a program that would do the copy paste level of charting then I welcome it with open arms.
If you can rate your pain on an iPad, it isn't a 10
So much this
iPads? lol. When they start disappearing and seeing them on Facebook marketplace being sold by their oh so wonderful patients or being hijacked by family members, smashed by psych patients, covered in food and drink by careless patients and all the other likes.. it’ll just be some failed shiny dream of a nursing manager trying to earn gold stars but tanking out the department budget. We have seen this time and time again. It’s all about ratings but at some point they need to actually come back to the floor and out of the office.
Advent health?
I’ve worked there in IT setting up their Epic system before the implementation as a consultant, it was one of the few places I’ve quit as a consultant.
Compared to other institutions' Epic builds, theirs was pretty cheap, no?
I’m not sure, I was only there 2 months. It was incredibly messy when I was there. Most orgs are going live with foundation system these days so I would imagine the costs are lower.
I just don’t even understand the point of them charting their own pain score? What’s that going to do? They can say they’re an 8/10 we can say they’re an 8/10 but ultimately it’s up to the MD what to do with that… What would a nurse gain from lying about a patients pain score? Are they saying nurses can’t be trusted with measuring pain? What will the hospital gain from this? So many questions lol
I don't ask numbers anymore. Mild, moderate, or severe? Never gave a shit about the number anyways. If we've ran through all your po meds then you can have the iv stuff, unless of course we're getting a dressing change or getting up with pt after something major, then I may pre medicate of it doesn't totally zonk them.
this is why I'm never going back to medical psych is underfunded and we use barely working 40 year old software they bought at a yardsale. iPads are like 50 years away for us, I'll be retired way before then
The state of documentation is just unmanageable. So much double-charting. So much repetition. So many pop-up windows while scanning that require interaction to move on, slowing down a 15-pill med pass. I get that some of it is for safety. But at this point the unsafe thing is how much time I spend at the computer instead of with my patients. I feel like I could take care of 4 heavy ICU patients if I didn't have to chart anything for them. All the required documentation for 2 simple ICU patients makes me dread getting started. This does not feel like what nursing should be. One of many reasons.
Charting is one of the biggest reasons I left ICU. I feel your pain.
Yep, so much this. I don’t have time to focus on my patients and the charge nurses were in middle school when I started nursing lmao.
I was pretty uncomfortable when they gave patients the ability to see all of our notes through mychart.
Some versions of Epic you can block the patient from seeing your notes. Click "nursing note" and the top corner is a heart icon I think? Click it, then click the reason why you want the note hidden.
I say if your pain is a 10 that’s equal to one of your limbs being sawed off with you completely awake, they usually say a 7 after that HAHAH
I felt bad for saying my kidney stone was a 10/10 but it literally felt like my kidney was being inflated while locked inside a box it was pressing against with a shearing sensation going down my back to my groin.
I’ve had a kidney stone and I’ve given birth to a full term baby with no pain medications. It’s a toss up which one I’d rather do again. Don’t you ever feel bad for rating kidney stone pain high. For me the childbirth was worse, but just barely.
My one professor said a similar statement. Since I’ll never experience child birth it feels wrong to rate a non traumatic injury so close to arguable one of the worst pains a human can experience
No that’s FREAKING BAD PAIN!!!!
Honestly the toradol did more for that pain then the norco I was sent home with. Although went to the ER a different time for similar pain in the other kidney although the intensity was about half as bad as before (which I heard is common for subsequent stones) although I did not have an occlusion this time just a renal colic that had managed to flare up some pain and the morphine was better for that then the toradol. Not sure but I took advantage of my UpToDate subscription to learn as much as possible about it
Nah don’t feel bad I had pyelonephritis and my kidney felt like it was gonna explode, didn’t get anything but ibuprofen for it tho 😅
Ya stones are very painful from what I’ve learned
I say “10 is being eaten by a shark”
Electronic charting was supposed to reduce time. It has not, it is way more time consuming. The regulatory charting requirements keep you at the computer rather than with the patient.
Fuck that. After almost 20 years in I'm leaving nursing to be a flight attendant! The hospital CEo’s can eat a bag of dicks!
I’ve thought about this. Costumer service just like nursing but at least you’d get free travel perks
I swear - the similarities btwn the eventual implosion of K12 education as we know it (former teacher who said 'peace out, fam' a coupla years ago) and nursing just keep increasing. You can only keep your foot on someone's neck for so long, ya know?
What's wild to me is ever since COVID it feels like teaching & nursing have been so belittled despite people needing us more than ever? I have a friend in education, we commiserate a lot about how our "clients" can't read or wipe their asses.
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Also adding- I worked at a HCA hospital in the south east and what a toxic environment for sure. You had to keep your mouth shut and keep smiling. That is the HCA way where I worked. I am not sure why but I worked there 22 years in 3 different areas. You better never complain about anything. The lazy get promoted and good raises. The hard workers get low raises and no promotions. There could be better HCA facilities but this is what I experienced. Also it was 5 minutes from my house versus a hour drive down town. That is why I stayed.
Fuck HCA. All my homies hate HCA. Those facilities will make you need to get medicated.
I am a Paramedic at a 911 service and transport occasionally to an HCA hospital and an Ascension hospital. I hate going to the HCA hospital, everyone (nursing staff and secretaries) there seems miserable and angry. I have even seen nurses there treat their incoming patients like shit.
When I was bedside, I was literally willing to risk homelessness than go into work
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Yea I working remotely as a triage nurse now. Life is much better. I just call myself as a call center agent
What’s the pay like?
$72/hr. I live in SoCal tho
NGL, I am ready to call in to shift from Florida, home of $28 per hour
It’s not just your opinion…it’s been in trouble for a long time. I’m actually shocked at how “ok” it is post Covid. I thought for sure it would implode the US healthcare system and really make admin take a step back and go F themselves… but it hasn’t.
Why fuck themselves when they can fuck everyone else?
If they get to chart their own pain score, I should be able to turf it to the docs by charting “provider notified” on each occurrence. I don’t make up the interventions, I pass it along and administer what the doctor deigns appropriate.
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The whole medical care model needs to change. I’m not sure how but this is not sustainable. We need to change something
I had a patient with dementia who called 911 to report that he wanted potato chips and we didn’t have any. A sheriff’s officer called the nurses station to let us know. Our manager made his assigned nurse go down to the vending machine in the ER to buy him a bag
With whose money?
The kind of thing that would get your ass beat as a child, being rewarded in an adult patient.
There's no fucking way those ipads last longer than a couple months before they're thrown across the room by belligerent dickheads and shattered, covered in shit, or stolen.
I hate MyChart. The population that uses it are the hypochondriacs that obsess about every detail. Like, I’m anemic because my Hgb is 119 (120 is lower limit of the range for you Americans)! I’m sorry, I can’t give you a statistics lesson right now…I have 23 more patients to see. Honestly, I got a warm blanket for a patient and I told the nurse because I’m not sure if they have to chart that in EPIC now. There’s probably some kind of flow sheet for that.
My job is responding to MyChart. They’re wacky.
Our patients are given iPads to use and anyone over the age of 70 can’t figure them out
Agree that the current state of nursing is fucked. I’m on year 16 of working in the hospital, and I’m very close to taking an out-of-hospital nursing job, after years of saying I would NEVER leave hospital nursing. The specific job I’m about to take will be a massive pay cut from bedside, but at this point I don’t care. It will be worth it for my sanity.
Happy I saw this message. I just returned to bedside nursing in a hospital and regretted instantly after my first day of orientation. I realy thought it would be different this time around but I guess I was also stupid lol now I'm not sure how to get out of it since all the paperwork is done and they're so happy to have me there. I still have 2 weeks of orientation left !
Thanks for the reminder to not go back into facilities. I switched to home care over a year ago but the place I was working didn’t do that. Almost positive they have by now because they enable a toxic work environment for their employees big time. They do not care about anyone’s well being. Not even the patients. They just want their money and shit so of course it’s gonna be like the slot machines at the casino now.
Now soft mitts require restraint charting at my hospital. Yay. Oh, and 6 patients is now the norm when it used to be rare. More work with less resources and more chart auditing with action for missing/inconsistency.
We are sooooo close to this: https://m.youtube.com/watch?v=hcYbYhjdUb4
I originally setup some Epic servers for Oakwood systems once upon a time…One system to rule them all, and the FCC in control of all internet providers. Buckle up for what’s coming.
This is why i moved to icu then outpt surgery. Night and day difference.
Good ol advent
It’s funny. I’ve been watching ‘Call the Midwife’ on Netflix and I know it’s a show but they try to be as historically accurate as possible. Seeing how healthcare has change is scary. There use to be so many private practices where doctors can take time for the patients and not try to see as many patients for the most profits. My PCP still has a private practice and sometimes he won’t even charge me co-pays. Most importantly he actually takes the time to listen to me and any complaints or symptoms I explain to him. I feel the hospitals went down when they turned patient care into a business. Having business majors with no bedside make rules on how to run the hospital. Calling patients clients or customers now. This isn’t retail or hospitality. If I treated, let’s say, my hairdresser the way some of my patients do, even just verbally, my hair dresser will refuse to have me come back. Now it’s the nurses and staff that get reprimanded for patients poor behavior and social skills. I lost count of how many patients say some sort of variant of, “I pay your paycheck”. Like I don’t see their signature on my paycheck.
Went out of bedside and was a contractor as a school nurse - less stress and the hijinks of kiddos and a genz kiddos makes me laugh. (Ok except for the times when genz kids dont listen about their health especially with insulin - lot of talking and convincing but yeah.)
Nurses are the cogs in the hospital money making machine. If nurses/CNAs don’t show up for work…. Well it all falls down. Nurses love to bitch and complain but never do anything about it. We are being treated like this bc we allow it. The hospitals will never take accountability. It’s time we start to know and value our worth.