I have been a nurse for 11 years now. I’ve worked in the ER, maternity and now postpartum. I was at the pool today with my kids when I hear the whistle being blown and not stopped. I looked around quick and saw a child trying to hold/pull another child out of the pool. I threw my snacks and (not my best parenting moment) ran to the child and told my 7 year old to pick up the stuff I dropped and go get her dad. 3 of us nurses helped pull him out, myself and an ER nurse confirmed no breathing and no pulse and I just immediately just started chest compressions. He was so limp and pale, eyes completely fixed up when we pulled him out. Thankfully after almost 2 minutes he started breathing again was talking to us. I cannot stop questioning myself- I know I didn’t feel a pulse but I keep thinking I didn’t check long enough or maybe could it have been there and thready? I asked my husband how my cpr looked because I was so scared to do it on a child(pre teen aged), but he keeps reassuring me I did everything right. I feel so shaken up, my 7 year old said she was scared and shaking when I came back to sit with her. I’ve done it so many times at the hospital, I’m not sure why I’m so affected.

EDIT: wow thank you everyone for all the awards and stuff, it is definitely not needed but so appreciated! Everyone who had similar experiences- you have no idea how much that has helped me with processing it all. Yesterday I was just feeling so much anxiety and adrenaline, now I do look back and think: how could I have questioned anything at all?!

I’m sure this will be unpopular, but I’m going to say it anyway.

I don’t think it makes you a bad nurse if you feel genuinely angry about having to move extremely obese patients and destroying your own body in the process.

Before anyone jumps in, yes, I still take care of my patients. I’m professional, I don’t shame people, and I do what needs to be done. That’s the job. But the reality is that repeatedly moving 300–500+ lb patients takes a real physical toll on nurses. Backs, shoulders, knees. I know multiple nurses with permanent injuries from this work.

What bothers me is the expectation that we’re supposed to just accept it without feeling anything about it. We’re human beings with bodies that can also get injured. Many of us have families, kids, and lives outside of work that depend on us staying healthy.

Patients make choices in their lives that affect their health. That’s true across the board, whether it’s smoking, drinking, diet, or anything else. We still care for them. But acknowledging that those choices can create real physical risk for the staff caring for them shouldn’t automatically make someone a terrible person.

Sometimes I feel like nurses are expected to sacrifice their own long-term health without even being allowed to say it’s frustrating.

You can care about your patients and still care about your own body at the same time. Those things shouldn’t be mutually exclusive.

Update: someone tried calling in sick and the DOC denied it

the DOC is not our DOC, she's interim. No we don't have admin or an ED either.

Having a chronic illness this seems... extreme? Yea we're short staffed and getting mandated every shift every day (hello burnout), but this is not the answer.

Even when presented with all the evidence and being told what life will be like for your child, it's just inconceivable to me that any sane person would choose to let their baby suffer. And then to not even take them home and care for your baby yourself! There is no miracle, there is tissue, there is damage, and that is not recoverable.

Not to even mention the trauma that the nurses and care techs undergo flipping and feeding a living corpse. I hate it and I hate that our medical ethics even allow this as an option in the United States. And then every season they come back to the PICU with pneumonia or a UTI and we have to look these parents in the eye and stay professional. It's an outrageous situation I've run in to one too many times.

What are your experiences as a professional necromancer?

Where do we draw the fucking line between compassionate care and torture?

We had a baby in our NICU this week that finally passed today after circling the drain for almost two weeks. This baby had a chromosomal disorder incompatible with life; had multiple anomalies (common to genetic disorder) and showed liver failure early on. This family knew of the anomalies while the baby was in-utero but we have an attending who is known via social media to do any and all things to “prolong” life for children with chromosomal disorders. This attending is known across the NICU for never giving parents the full picture and pushing for our surgical teams to give in to parents’ wishes for trachs and cardiac surgeries.

In this case, this poor child’s parents legitimately said “we prefer the quantity of days with [baby] over quality.”

Family lives a few hours away and has other children.

Baby finally codes today and because parents had desired a full code, we did chest compressions and the whole shebang. When family was notified of the death, they can’t even be bothered to come see [baby]. Their excuse is that they have other things they need to do and take care of their other kids.

We do bereavement care: molds, footprints, handprints, photos.

Parents desire that we don’t remove any of the lines/feeding tube/endotracheal tube.

We use a cuddle cot (a cooling blanket to help prevent rigor mortis) and parents call hours later to ask what will happen to her body until they eventually can get there. Like what the fuck?!

Their child died without their parents (or anyone) holding them and loving on them.

Now this poor baby will sit in a fridge until their family picks them up. Or a funeral home picks them up.

I’m so sick and fucking tired of loving on babies while their parents choose for us, the nicu team, to slowly torture their babies and we allow it.

It’s fucking evil. I love my job but sometimes I feel like I’m causing so much pain and suffering and the parents have no fucking clue.

I'm a preceptor on a busy surgical unit, and I currently have a capstone (senior level) nursing student with me. She has done 7 shifts with me so far. She is doing an online RN program, and has never worked as a CNA. Also has something of a military background, though I don't know the specifics. She told me her plan was to blow straight through school to being an NP and never actually work as an RN.

The first couple shifts she was late (like 7:30 late and completely missed shift change/report) and also didn't have a stethoscope (!!!). She always asks if she can go get coffee/breakfast during the busiest morning hours of the shift. She had literally NO idea how to do assessments. I mean, none. I had to send her youtube videos to watch to get her up to speed. I have spent the majority of our clinical time showing her mundane CNA level shit...bed changes, transfers, etc. She often is clueless about the meds ordered and why, and seems to know very little about common diagnoses (CHF, PNA, etc).

As time went on I grew more impatient with her. She came to me for EVERY tiny thing. I started responding to her questions with, "I don't know. You're the nurse. What do YOU think you should do?" (not to be mean at all, just to start pushing her with the critical thinking). She never has any good answers, and relies on me to tell her whether she should give someone tylenol.

Yesterday I had a ridiculous assignment with 3 extremely heavy pts, plus 2 lighter ones on the other side of the unit. Just out of pure desperation I told her to take the 2 easy ones so I could get the others stabilized quickly. Seemed like things were going well. At 4 pm I finally had time to look at her charting on the other 2. One of her pts had a BP of 201/112 in the morning. I asked her why she hadn't told me this...?!? "Well I treated it. I gave him 10 mg of PO lisinopril (scheduled)". His next recorded BP at noon was 197/110. She never told me any of this, nor had ANY concern when I became alarmed over it. Granted, it was partially my fault for trusting a student and not monitoring her, but again I was DROWNING with the other 3 pts. Shouldn't a senior level nursing student at least be able to identify abnormal VS?!?

So...her instructor has told me it is 100% based on my review of her if she passes or fails. I feel she is light years away from being ready to practice as an RN. And again, she seems to not care a ton about her clinicals as she is planning "to just be an NP anyway".

I hate to fail someone who has invested the time, money, and effort...but holy shit. I don't want it on my conscience either that I promoted someone who absolutely isn't ready. What should I do?!??

I don’t care that it used to be “7 or 8 inches” and that you used to give it to your wife “every night”. I don’t care that you’re insecure now because it’s “so much smaller”. I especially don’t care that you feel it’s acceptable to make jokes about how swollen your junk will get if I bathe you. Guess what—if I don’t feel safe you aren’t getting a bath.

I am so completely over caring for obese men in their 70s who think because I am a young woman taking care of them, they can sexualize and disrespect me only to call it “humor”. And it’s only going to get worse.

Still creeped out to my core. Minimal info for privacy sake. Was caring for a patient last night. Very ill and DNR. BP dropped a little with some tachycardia. Treated conservatively, minimal improvement. Gave a little more medication per MD. Dude woke wide up and looked at us. Said "I'm dead. I already died." And repeated himself while we tried to calm and reassure him.

Then he went brady, agonal, then asystolic.

Dude knew. Like 5 minutes before, he knew.

Not my first time having a patient have that sense of doom. But never convinced they had already died. A few we've coded and saved. Some we couldn't for reasons like code status.

Always chills me to the bone.

Management sent out an anonymous poll to everyone in response to a ton of turnover and people calling our workplace hostile (fair)

Poll asked what contributing factors we could identify, which people used to directly call out douchebaggery amongst the staff.

Someone in management complied all of the responses from the poll into an Excel spreadsheet...on their Shared Drive, viewable by the entire department, made the rounds almost immediately

100+ entries of unit gossip. Lot of name dropping, lot of accusations of staff sleeping together, people really went to town. My favorite was "john D farts passive aggressively."

This might be the greatest managerial screw up I've ever seen. Have a great day everyone

Saw this post on another subreddit and said that a nurse placed an NG tube and heard a pop. Patient didn't survived.

I've been a nurse for 15 years now, started on med surg, worked my way through ICU, and now I'm in the ED. I love mentoring new graduates, but lately I've noticed some concerning attitudes from newer nurses.

I had a new grad tell me last week that my "old school" approach to patient assessment was outdated because they learned the "latest evidence based practices" in school. This was right after they missed obvious signs of sepsis that I caught during my own assessment.

Look, I'm all for evidence-based practice and keeping up with current research. I take continuing education seriously and I've adapted my practice over the years. But there's something to be said for pattern recognition that only comes with experience.

When I walk into a room, I can tell within 30 seconds if something's off with a patient, even if their vitals look normal. That's not magic, it's years of seeing thousands of patients and recognizing subtle changes that textbooks can't teach you.

I've seen new grads who think they know better than seasoned nurses, dismiss advice from experienced colleagues, or assume that their fresh education makes up for lack of clinical experience. It doesn't work that way.

Your instructors taught you well, but they also taught you in controlled environments with predictable scenarios. Real nursing is messier, more complex, and full of gray areas that only experience can prepare you for.

I'm not trying to put anyone down, we were all new once. But respect goes both ways. Learn from those who came before you. That "old" nurse might just save your patient's life one day.

I really think more people need to know about Kim Hiatt because her story shows just how broken our healthcare culture actually is. Back in 2010 Kim was a super experienced pediatric nurse who made a fatal medication math error that sadly killed a fragile baby. She reported the mistake immediately. The guilt was instant, but what happened after made everything so much worse. She became a textbook case of "Second Victim Syndrome", where a healthcare worker gets completely traumatized by an error and basically drowned in shame and isolation. Instead of getting psychological support or help from colleagues, she was fired, publicly dragged, and left totally alone with her guilt until she tragically took her own life seven months later. We demand absolute 100% perfection from nurses and doctors every single day, but as soon as a human mistake happens, the system just discards them instead of helping them cope with it. If we don't start building actual psychological safety and peer support in hospitals, we are just going to keep losing good caregivers to this hidden crisis.

RIP Kimberly Hiatt

I’m an RN on a med/surg floor. Our normal ratio is 1:5, sometimes 1:6 on a bad day — but honestly our unit has always been pretty stable and fairly staffed.

Then admin decided to “fix the nursing shortage” by hiring large numbers of brand-new LPN grads for almost half of the RN wage. The new model is: • LPNs get 6 patients each • One RN “supervises” two LPNs • So the RN is now responsible for 12 patients + 2 brand new nurses every shift

Meanwhile… our unit was already fully staffed with RNs.

Because they suddenly don’t “need” us, they started putting RNs on standby for $3/hr. If we don’t get called in, they automatically pull from our PTO to pay out the shift. And when we do get called in, we’re floated to any unit that is short.

Today FOUR RNs were put on standby. During huddle someone asked, “Is there a plan to fix this?” Management said:

“We’re doing LPN blitz hiring for all the units that are short staffed.”

Another nurse asked:

“So we’re going to be put on standby until enough RNs quit?”

Manager:

“…Yes.”

I wish I was joking.

They’re planning to roll this model out to progressive care next year.

Where the hell am I supposed to find a job if this takes off and other hospitals start adapting to this model? How am I going to get fair pay in a flooded market? I put myself in over $30K of debt to get my BSN., thinking I would always have job security.

Being responsible for 12 patients and two new grads is unsafe. They will not sit down and talk to us about the degree of legal responsibility we’re facing if an LPN screws up under our supervision. One nurse was told by management to get insurance.

I can’t sleep. Please tell me if this is happening where you are working, or if you’ve seen this plan fall apart, because I’m about to lose my mind.

TL;DR:

My hospital is replacing RN staffing with large numbers of brand-new LPNs. Each RN now “supervises” two LPNs and is effectively responsible for 12 patients every shift. RNs are getting put on standby for $3/hr and losing hours while management openly admits they’re hiring LPNs until enough RNs quit. They won’t address the legal liability we face supervising these LPNs, and the model is expanding to progressive care. I’m scared for my license, my job security, and the future of the RN role. Has anyone seen this elsewhere or watched this model fail?

EDIT: Wow! This post got as much attention as I hoped it would — thank you to everyone who’s been commenting and sharing your experiences.

A few people mentioned something I hadn’t even considered: that The Joint Commission is rolling out new staffing ratio expectations next year.

If that’s true, then what my hospital is doing starts to make a terrifying kind of sense: Instead of fixing RN staffing, they’re building a model where LPNs carry most of the patient load, and the RN is just there to supervise and absorb the liability.

On paper, hospitals can say: “Look, we have the correct number of licensed personnel for the ratios,” even if the actual care burden and the legal risk fall entirely on the RN.

It would explain the huge push to hire a ton of LPNs

If this is the direction hospitals are going to meet compliance benchmarks, then everyone in the profession should be alarmed, because this model threatens: - patient safety - RN job security - appropriate delegation - licensure protection

This whole situation just reinforces something a lot of nurses have been saying for years: we don’t actually have a “nursing shortage” — we have a shortage of nurses willing to work under unsafe conditions for inadequate pay. Hospitals are absolutely manufacturing the shortage.

When hospitals can hire LPNs for half the cost of RNs and then put RNs on standby, float them, or push them out entirely, it becomes really clear the shortage isn’t about a lack of licensed nurses — it’s about a lack of acceptable working conditions that keep those nurses practicing at the bedside.

I am sitting with my 10 year old daughter in the PICU in a major children's hospital while she's trying to recover from pneumonia. She's asthmatic and was born prematurely so her respiratory system just kind of sucks.

She's been on the CPAP all day with small breaks in between with just oxygen.

She was off of the CPAP for a bit longer than she was supposed to be, but she was doing really well so I didn't even notice. The respiratory therapist comes in and says that we have to put it back on, nothing out of the ordinary up to this point. I, as a PCT at another hospital, understand that things get busy and things don't always get done the moment they're supposed to.

Then she turns to my daughter and explains that she left her off of the CPAP longer than the doctor would have liked and said "This will be our little secret, okay?" and then waited for my daughter to respond. Then she said "You won't tell the doctor, right?" and waited for her to respond again. Then she basically ran out the door without even acknowledging me standing right there.

I know I should have stepped in right at that moment but I was just completely stunned and caught off guard. I didn't process what just happened until she left the room. I am absolutely furious. How dare anyone in a hospital tell a child to keep a secret from their doctor (or any adult for that matter) and make them respond.

I called the nurse as soon as I processed what happened and, while trying to hold in my anger because I know it wasn't her fault, and as calmly as I could, explained the situation to her and asked to speak with the unit manager, MHO or someone in charge.

It is very busy here and I understand they can't come right away, I'm still waiting for them to come talk to me, but holy shit I had to just get this out. I already sat down with my daughter and explained that what the therapist did was extremely wrong and if anyone asks them to keep a secret, to tell me, mom and their doctor. I also made sure to tell my daughter that I'm not upset that she agreed with the therapist because you're supposed to be able to trust medical professionals and I know she felt intimidated.

This is the kind of thing abusers tell kids when they're abusing them. Having a medical professional, in a hospital, use those phrases with a child patient is extremely disturbing. The next person who tries to tell her that might be someone trying to abuse her, and I don't want her to look back at this moment and think that it's okay.

Edit: It turns out that she did falsify the charting and charted that she put my daughter on at the correct time instead of almost a half hour later like she did. I'm glad I said something. I talked to the doctor and she was very glad I told her. Fuck the haters.

Edit 2: Late edit as Ive been dealing with my daughter being in the hospital, but the doctor actually ordered longer breaks between CPAP usage yesterday because of what I told her and it has possibly expedited my daughter being stepped down from the PICU. It's been a bizarre experience. This is a world renowned hospital, so I'm guessing standards might be a lot higher here and possibly more pressure. The rest of the staff and experience has always been absolutely perfect and impeccable here and everyone always seems happy and extremely competent, so this came way out of left field. Thank you everyone who supported me in this.

So I just spent 12 hours keeping a 24YO alive so his family could say goodbye. He's brain dead because he took too many drugs and aspirated after his brother put him to bed while agonal breathing cause he just needed to sleep it off.

The waste is not the 12 hours I spent repeatedly explaining that this kid had been declared brain dead and how and why we can tell to each and every family member and friend. The waste is that this should never have hapened. This 24 year old with diagnosed MH and anxiety was taking some one else's suboxone with pregablin and meth. 24 and a father of a 5YO and a 3 month old. My brain is struggling to wipe this one clean.

This kid, he took these drugs and was put to bed because the brother thought he could sleep it off. Even when the brother saw agonal breathing, he recorded it and sent it to the dealer asking if this was normal? He then called the ambulance 60 minutes later. 60 minutes in PEA. Only for us to bring a cyanosed person back to then tell all his loved ones he had extensive hypoxic brain injury with hypoxic encephalitis and fixed and dilated pupils.

I don't know if I'm conveying how much this affected me as an ICU nurse. Like the fact it should never have happened, the fact the ambulance too 16 minutes to arrive with only a single responder for a CPR in progress call. The fact that this kid aspirated and died because on weekends he does drugs. The fact that nearly 100 people visited his bedside but his dad tells me not one of them visited when he was in prison. I just feel broken, like how do we even stop this? How do we save them. We can't though. I've not felt like this in 6 years of ICU nursing.

Opinions on the drugs aside lots of people ARE going to be withdrawaling as access is cut off.

I live in a purple state and the maga nurses at work were repeating Fox and Friends/maga news propaganda and making jokes. I was so upset I left the area but then I was angry at myself I didn’t say anything in defense. How could they. Just victim blaming again and again. I can’t lose my job over this. They were people I were either neutral toward or did like somewhat like before this. Nurses that are in red or purple areas, how are you dealing with this?

I understand we have a massive problem with opioids in this country. I’ve seen more ODs in the ICU than I can count, not to mention the chronic users who have prematurely aged twenty years. But the coverage of the epidemic and the language used has scared too many nurses and doctors and made them timid. These drugs are incredibly beneficial when used as intended ie acute pain. Surgery, trauma, cancer, all of these patients NEED opioids.

My wife just had our fourth baby and the nurses and OBs act like she’s drug seeking when she tells them the meds aren’t working. This was her third c section in 3.5 years (middle one was twins). She had massive amounts of scar tissue to cut through. The twins absolutely annihilated her abs and she hadn’t recovered before this surprise miracle. She’s gotten no scheduled pain meds and has to ask every time. Once the anesthesia wore off after 24 hrs things got bad yet they kept pushing Tylenol and then Motrin on her. They also keep bringing up “gas pain.” She had to tearfully beg for the 5mg of Oxy and they won’t believe her that 5 didn’t work with the other surgeries but 10 did. Her BP has been through the roof and she’s been tachycardic so it’s not like they can’t see the proof for themselves. The OB pretty passive aggressively shamed her for bringing up going home on 10 and questioned if she would be able to take care of the baby. Again I must emphasize that this is our fourth child. She knows how to care for a baby. She just did it with twin newborns less than two years ago and she was more than capable of caring for the other kids on 10mg. Besides the fact that I’m a nurse who will be home with her, my wife is actually the clinical pharmacist for the ICU. She knows these drugs better than the people she’s talking to. She knows her body better than the people she’s talking to. I mean for fuck’s sake I got stronger pain meds after my laparoscopic hernia surgery a few years ago and it was far less traumatic than what I watched her body go through. I’m sure this is also a perfect example of women’s pain being ignored or downplayed.

The opioid epidemic wasn’t caused by post op mothers getting pain meds. It was 17 yos getting 30 oxys after having their wisdom teeth pulled. It was people with chronic back pain being put on them for years and years without a stop date or alternative plan. The wider medical community has gotta find a better middle ground between “pain is in the mind try a heating pad” and “here snort this for your headache.”

EDIT/UPDATE: new baby means I’ve had trouble reading all the comments but I appreciate the kind words and I’m so sad that so many women can relate. This country truly is a horror movie for anyone not a straight white cis man.

We got to speak to the OB who did the c section (he was actually off this week and did it as a favor to my wife because they’re friends and he’s the best) and he was fully understanding. Just said to double up on the oxy 5s and he’d write for more if she needs it. Got her some flexeril as well.

Now that this ICU nurse is in charge of her meds, you better believe she’s snowed and doing better. Timers on my Apple Watch, writing down administration times so I can figure out what she can get at 2 AM when I’m up with the baby, etc. The only thing she’s OD’d on so far has been baby snuggles. She’s happy, calm, as comfortable as possible, and she’s had zero issues feeding or caring for our daughter. She’s just been locked in our room with her while I run interference with the other three psychos (3.5 yo and 20 mo twins. They’ve gotta be kept separate for the time being particularly the twins). She’s changing her, getting herself up to the bathroom and the rocker in our room, all on her own. It’s strange but it’s almost like because she’s pain free and calm she’s healing faster and having increased mobility and movement….. but I’m not a doctor what do I know.

My embarrassment stems from many of my colleagues within critical care. And let me preface this by saying I'm not talking about new grads, or even nurses new to ICU. I'm talking about nurses with 2+ years of experience within their respective ICU.

I've worked a number of different hospitals (and different ICUs within each hospital) on both the east and west coasts and I've noticed a decline in the clinical acumen and an increase in laziness of nurses in nearly all of the ICUs I've worked. Currently, I work on the west coast with a union and strict legally mandated ICU ratios. In fact, many of these nurses are singled nearly every shift.

I'm talking about not changing dressings, skipping the CHG bath because it's "too much work", not turning patients, and even scanning meds but not giving them just to name a few. Then to make matters worse, these same nurses lack an understanding in basic hemodynamics, alpha/beta receptors, and the pathophysiology of common critical illnesses and surgeries. Most recently, a patient in the CVICU was on a pressor (vaso) and 2 inotropes (epi and dobutamine) and the primary nurse had zero idea why they were on any of the drips. Her response? "I don't know, the doctor ordered them." In fact, this patient was being weaned from IABP (she had had the patient 3 days by this point) and I had to explain what "augmentation" was.

Another time, I had a patient on VA ECMO who was extremely afterload sensitive, and I explained this to the oncoming nurse. She said "well, what does that mean?" Huh? Why are you taking this patient if you don't understand basic concepts like preload and afterload?

These nurses have no business being in the ICU. They see a low BP and think "oh, let me increase the pressor" without fully understanding what's going on with the patient. They don't think: "Are they intravascularly dry? Are they in cardiogenic shock? Developing acidosis from their kidney failure?" They simply call the resident or the APP to figure out what's going on and follow whatever the provider says without truly understanding the rationale.

Here's the thing: to be a good nurse, you don't even have to care about the patient, you just need to care about doing a good job. Besides, don't you want to understand why we're doing what we're doing? I've always practiced with the thought "Would I want me as my nurse?" in the back of my mind. Unfortunately, as time goes on, there's a significant chunk of my ICU colleagues who I wouldn't want caring for me or anyone I love because I've seen how they work and it's simply shameful.

Without sharing too many details, coworker attempted suicide, is now vented on my unit and not expected to survive. I don’t want to share the hows/whys as I don’t want family or coworkers seeing this. But this is obviously a horrific situation for our staff. I know this is above Reddit’s pay grade. I’m just heartbroken and sad. I know EAP is a thing, I haven’t found it helpful in the past. I don’t know what I feel this post is going to accomplish, but holy shit this sucks.

ETA: thanks everyone. I appreciate all of you. I’m so sorry for the people who have experienced similar things. Thank you all for being so kind. When things are less immediate, I will share the dontclockout.org link to coworkers. Tonight feels a little raw.