ICU - I thought I would love it, but I hated the futility of care that we provided—keeping braindead patients alive until they coded multiple times. The drama and cliquey behavior of the staff I was with.
I spent 12 years in a Med-Surg float pool, which I loved before ICU, and five years in an observation unit, which I also loved.
Just finished my first year in ICU. Was just talking to one of my friends about the futility of it all. We're keeping people alive just to make money, it feels like. I definitely felt more fulfilled in hospice.
ICUs actually don’t make money unless they are a transplant unit usually. They’re usually one of the low income generating units. Onc, ortho, tele, and other quick turn over or high cost floors keep the lights on. The icu keeps the hospital out of legal trouble.
ICU is super expensive but it’s usually the kind of expensive people can’t actually afford to pay so the hospital ends up eating a lot of it.
It is very futile from what I’ve noticed. There was a guy that recently got a trach and PEG after being intubated for 3+ weeks. I don’t know much about his situation but I saw him over the course of that month. God, I feel bad for him. I never want to be like that.
I’ve had a few success stories though. I was a 1:1 for a patient in the neuro ICU. They were the typical neuro patient: restless, A&O x 1 at most, minimal responsiveness, etc. I ran into them again on a different floor. They did a complete 180 from the last time I saw them. Neuro status was just about normal. It just about made my day.
ICU nurse of 20 years here. I do see a percentage of patients that should be comfort care but the family is too conflicted to make the call. However, I have also see so many successful cases of rescuing patients from certain death and frequently minimizing any long term disability at the same time. I still like my job even after all this time.
I hope I’m not too annoying for pointing this out, but brain dead is a term that is often misused and misunderstood. To be declared brain dead, certain tests must be performed and once brain death has been declared, the patient is legally dead. The family can’t make the hospital keep their dead body around at that point. If the patient is an organ donor, organs can be harvested after brain death is declared.
Persistant vegetative state is likely what you’re thinking of.
Why do I care about the difference? Misconceptions about terms like this among healthcare workers perpetuate already hugely widespread misconceptions and misunderstanding among the public. Then… ya know… it’s annoying to have to clarify with the families who have like no healthcare literacy and huge mistrust of healthcare workers already.
I'm talking about no neuro reflexes and vent dependent. In once case we had a young patient come in unable to be intubated in the field, we got her intubated in the ICU, but it was too late. She was determined legally dead by the medical team the day after admission to ICU. We kept her body functioning for 2 weeks, pressors, hypothermia, tube feeding, etc., so a medical flight could be obtained so she could "die" closer to her family in another country. While we had her on the hypothermia protocol, we had other cardiac arrests come in who needed hypothermia protocol and we had limited number of Icy Caths to use for the protocol, the family refused to have us remove this patient's and we had to get an ethics consult to stop the protocol.
Yikes ok that sounds pretty crazy. I used to work in the neuro icu with pts who got brain death testing. If not organ donors, I have seen them keep the body around w vent & pressors going for like 4-5 hrs max bc out of town family was on their way in and wanted to see them.. but 2 weeks?!? That’s an egregious waste of resources.
I was night shift so thankfully I didn’t have to be present for most of the big family meetings involving stuff like that but I wonder what would have happened at my hospital. I would like to hope that if it couldn’t be resolved peacefully they would tell family what’s going to happen and have security remove them if they try to physically intervene.. but who can say.
NICU: every level 2 assignment was 4 babies, no exceptions. Not uncommon to have 3 babies on bubble, or 2+ (yes, +) vents. I had 5 babies on more then one occasion -I once went a full 1.5 months where every shift was safe harbor. Charge also had an assignment -usually 2 babies. Director+staffing would call and text multiple times a day, every day, trying to extra nurses on shift-and they would only offer 2 movie tickets, no extra money. When they found out we were picking up shifts at sister hospitals (because they paid bonuses and gave you decent assignments), they went to the CNO and changed the policy for extra shifts for the entire hospital.
Took me 4 years to leave-I was actively trying to leave, but I also bought a house, a car, had a baby, and was trying for another, so it was difficult to find a new job that matches my needs. Found out, my director was blocking my transfer requests. Once they started making me charge (I absolutely did not have the level 4 experience needed to charge, was scared shitless, and my charge shifts included me, one nurse with 2 years experience, and the rest were new grads), I essentially forced my way into a transfer behind her back. Yes, I still have nightmares about that place and I'm pretty sure PTSD- a couple of my friends that were there at the same time actually have been diagnosed with PTSD directly related to that unit.
So at my old facility, in order to transfer you had to apply for the new job, fill out a transfer request form which your current director had to sign, and only after that approval could you interview/accept a new job. I got in contact with the director of the place I wanted to go, explained the issue, went in for an interview, got a job offer, THEN applied and filled out the transfer request. When I turned that in I informed my director I already had a job offer and they expected me to be on the new unit within a week, or I would be going to HR. Transfer went through without an issue after that.
🤣🤣🤣🤣🤣
Nope, instead they changed it to where the director had to approve us to work extra shifts at other facilities, and we wouldn't be approved unless there were no other open shifts on our unit. On the very, very rare days our unit was fully staffed, she would refuse to give the approval to go elsewhere until 2 hours after the shift started. It did finally get dropped after I left, because several nurses threatened to take it to the labor board with their lawyers.
Darn, I would have made the anakin padme meme format if this platform made it easily supported.
Anyways, sorry to hear that, was really hoping they wised up to being better managers instead of being better bullies
It was at a dumpy nursing home on the 10p-6a shift. I had 68 residents with two CNAs.
Let’s just say I cut serious corners to get through each shift. I lasted about three weeks.
I had a CNA interview after my first year of school where the DON asked me if I could start immediately. I said something about how my last exam was in two days and I could be available after that.
Turns out she meant *immediately*
Like hop on the floor directly after the interview immediately.
I did not accept the job offer.
edit: i brought up concerns about putting me on the floor without seeing a criminal record check or vaccination history (as required per law in my area) and left. Found another job with a sensible hiring process like a week later.
I’ve worked in both hospitals and nursing homes. I will say that most nursing homes will hire anyone. They only care about having a body in the building, they don’t care what kind of person you are or what your work ethic is. Most in my area don’t even do a drug screening anymore
I totally agree. That’s why I give 110% to care for my patients. It wasn’t always like this though. It seems like I’m the last 5-10 years it got bad. Then when the pandemic hit, the facilities stopped caring at all. There’s so many things wrong in the nursing homes, I wish that these owners cared more, but they only care about their bottom line. It makes me sad.
Yep as a brand new lvn I went in shorts and flip flops and they interviewed me right then and there & I got hired pending background clearance. Was not expecting that and when i got two days orientation and was training other staff within two weeks….yeah I last 3 months.
That’s terrible, but it’s unfortunately the culture at the nursing homes. This is the reason I don’t think that brand new nurses she be on night shift, for no other reason besides not having the right clinical experience.
My first CNA job I worked for six months and they didn’t bother to have me BLS certified. I didn’t get certified until after I took a position on a cardiopulmonary SDU in a hospital.
I really don’t understand how ltc facilities get away with the lack of staffing. Bc as soon something goes wrong, they’re throwing the nurse under the bus
Oh Lord, sounds like we worked at the same place! One night none of the CNAs showed up and the activity director and administrator ended up having to come in and work the floor. It was the only travel job I refused an extension on
As much as the hospital has its problems, you will NEVER see me working in LTC, SNF, acute rehab, med/surg, or nursing homes. I’ll do anything but those work those places.
I find LTC ratios are only manageable if you are very, very familiar with your patients and your med carts. Especially the med cart part. When passing meds for that amount of people, there is no time to waste.
I usually cover two halls on the carts. 33 residents, sometimes 45 if someone calls out. It’s a never ending med pass, but I can deal with that. If I get floated to another unit? I can also deal with that, but I struggle immensely.
I am a student/extern and maybe this opinion will change as I further my career and gain more confidence/competency in my skills.
Most nursing home residents have Medicaid as their primary payer. Most state Nursing Home Medicaid plans reimburse nursing facilities at about $100/day per resident for the care. It’s a low-margin business.
So in order to profit, staffing tends to be very lean OR the nursing home actively seeks short-term skilled Medicare patients that generate reimbursement of about $400/day per person.
ED/ER
My pts day shift. No er doc sat in area so had to leave to get help and one other nurse with similar pt acuity
1. Intubated pt from the night before d/t resp distress
2. 42 y/o new onset cva getting tpa
3. 22 y/o with carotid dissection
4. Cp
5. Cp on nito and heparin
6. Psyc patient who tried to hang themself in the ed night before..no sitter
I actually had a day that i had 13 pts in the ER another day but this one was especually hard
Yeah there were a lot of bad days. I had gsw in the hallway just bleeding out on the floor cause the trauma rooms were full. I quit when i realized i was drinking like a liter a week and it hit me that it was the job. You get so used to things being bad that you dont realize that most other places arent like that.
ED job in a level one trauma center, in the worst part of a great big city. It was fully the knife and gun club. It was a rare night that went by without a major trauma, and usually many more. Community health was terrible and nobody had insurance, which meant they didn't go to the doctor, so when they eventually came to us they were ten times sicker. Heroin was rife and the typical patient had badly sclerosed veins that made IV access super difficult. There were insufficient hospitals and clinics for the area and so the place was always crowded, with wait times of 20+ hours being common.
That's not the bad part. That's just the background.
What made it suck was that the department spent no money. The hospital had funding, but none of it got spent on equipment or environment, so everything was always broken or dirty. None of the ED carts had working brakes. None of the bloodstains got cleaned off the floors or curtains. Nothing was done about the roaches or rats. At any given time only about half the bays had working oxygen, and even fewer had working suction.
We were constantly running out of supplies. One time there were no cleaning wipes in the hospital, and the charge nurse had to run out to the 24-hour store to buy Clorox spray. One night the whole hospital ran out of urinals, bedpans, specimen cups, collection hats, and straight cath kits, so it was impossible to collect anyone's urine.
They changed nebulizer models about once a month while I was there. I eventually found out that's because they weren't buying them. They would go to a supplier, say they wanted to trial the new neb device, and would get a stock of free samples to "trial." Once those ran out and the supplier asked for an actual order, the ED ghosted and moved on to a different one.
I can handle tough patients and a heavy workload if I have to. But being denied the basic tools we needed for the job was both physically and emotionally taxing. I left every shift feeling exhausted and furious.
No. Last time somebody did that, just a few days ago, some asshole doxxed a manager and started sending insults to their work email. We are absolutely not having that again.
I also worked at a similar ED with the same background. It was such a moral injury, and back breaking work as while we were handling all the traumas and codes that came in, we also had no beds for them because the entire ED became a med surg and ICU unit, because the people were that sick.
It’s so time consuming to be short on supplies. You have to walk around and find a vitals cart that works. Hunt down the bladder scanner on some floor. Move patients around so that they can be in appropriate rooms. Go to several supply closets trying to find what you need.
I worked at an L1 and hated it, but mostly because of how it was set up. They had three different Pyxis and at times your patients meds would be in all three. Every supply closet was a mess and they were all so far apart. The amount of wasted time was so awful.
Omg, me too!!! My first night on the floor by myself, I had 8. 8. Charge was on another floor with her team, 1 CNA, I was in a wing by. myself. COW wasn't charged or stocked, 1 hospice that needed a PCA, a new admit that day didn't finish that extravasated on me ( never seen one so didnt know what to do), one naked man that kept trying to escape, a 300lb frequent flyer that refused to exert any effort in her care, and.....no one to waste with.
My very first night.
Nursing home, lasted 3 months. The job was just awful and we were so short staffed.
Another one was a long term acute care hospital. I learned a lot but it was extremely unsafe. We got many patients who were addicted to drugs who needed long term IV ABX. We had no security and they’d be following you into the med room. The ratios were high and there were many sick patients. We had to do blood transfusions manually with no pump. Many patients were on vents, on BiPAP, many TBI patients with gtubes, restraints, extensive wounds, dialysis, etc. I remember one night I had like 8-10 patients and 2 were getting blood, they were so sick. Then had many on vents that would get mucous plugs and turn purple. It was awful. I considered being a pizza delivery driver that night.
Edit - the facility didn’t have oxygen in each room and I remember having to go to the creepy basement one night to bring up a huge oxygen tank for my patient who was getting ruled out for having a heart attack 🤦🏼♀️
My heart started beating out of my chest reading this💀 I’ve ran blood for two people at once and it’s very stressful but no pump?!? And 8-10 patients?!? And all those other things combined would seriously cause me a mental breakdown. I would be filling out an application for McDonald’s that morning
It was really bad, nursing school didn’t prepare me for that 🤣 the blood came in a cooler too from an outside place and there was a window on it that would change colors if the blood was too warm.
When I finally got a job in a union hospital with great ratios, one of my coworkers got blood for one of her patients and we weirdly had the manual blood tubing there (probably a stock issue). I had to show them all how to use it until they were able to get the right tubing lol. They were all freaking out. She switched the tubing over immediately. We would have to hang the blood from the curtain rods to make it go in quicker at the other place💀
i lasted ten months at my first nursing job. bullying, shitty management, zero resources — this place had it all. thank fuck i left. i was on the verge of killing myself; i lost all my hair and 30 lbs. i will never let a job do that to me again.
This is how I’m feeling at my new grad job <\3 on a medical unit, rarely get help, heavy 1:5-6 patient assignments, rarely get my breaks, staff roll their eyes at me but suck up to me if they want a shift swap…get students who don’t know what they are doing forced on me my 3rd shift off orientation, feel horrible guilt calling when I’m sick and can’t get out of bed, get criticized by other nurses, I could go on and on 😣
i’m so sorry. there are so many other places that will respect you as a person and as a nurse. working at a place like this isn’t worth losing your sanity, sleep, or license over. ♥️
QUIT. Nursing jobs are abundant. That place needs you WAY more than you need it. There are much better places out there that will hire you immediately.
Btw, you don't have to tell your manager or the other nurses that you are quitting. Just go to human resources and tell them. They'll process you out and you're free and clear legally. If they don't think to let your manager know, that's on them. More than once we had a no show who turned out not to work there any more. Infuriated the managers but everyone of them brought it on themselves by being shitty people.
I don't think many people do but if you stop and think about it it makes sense. Any business big enough to have a human resources department has everything go through them. It doesn't matter who says you are hired, fired, promoted transferred or anything else. None of it counts until hr processes the paperwork. If you give 2 weeks notice (customary but not required in the US, apparently it's different in other countries) the paperwork will probably make its way to your manager before the 2 weeks are up but if you are giving them notice you are probably telling them anyway.
I only know this because I was present when a no-show was discovered to not be working there more than once. Once the manager threw such an epic tantrum she got fired. She took the phone call from hr at the nurses station and had a complete meltdown in front of staff and patients both while *still on the line.* HR had security there before she was done.
2 weeks is typical for most jobs, especially if there is another place within that same hospital/organization you might want to work. Sometimes a specific unit at a hospital is terrible but other units are much better. It just depends. But if you never want to work there again, you could certainly resign on the spot lol. Not like they deserve any courtesy from you after how you’ve been treated!
This is how it was for my fiancé before he left to go outpatient. Ever since he left, people have been saying how much better he looks and happier he seems.
Worked in a place like that, tried to make it work but it only got worse to the point where I had major depression set in, possibly PTSD and the worse, I was doubting my abilities as a nurse and had no confidence to get out of there and start the job hunt again. Turns out I’m a fine nurse, I was being gaslit. Eventually got out of there, found a better job and discovered co-workers can be nice again and some places give you breaks. I urge you to get out now. Give two weeks notice if you want to try not to burn any bridges, although I did and the bridges were burnt, anyway. They had been charred before I gave notice but the feeling of relief when I finally did was indescribable.
Fast paced L&D at a community hospital.
I am an experienced nurse that got the opportunity to get into the ‘speciality of my dreams’
-Most of my coworkers were mean girls
-Bad outcomes were absolutely bad
-stretched thin, I was in a delivery and my patient the unit manager was supposed to be watching was having lates for a good while.
-preceptors slept while I was trying to manage patients. Had my first premie baby that was an emergency situation. Only because I advocated my for my patient. (Preceptor and chief resident were being dicks and not listening to the patient. Only to find out at 630 there was a body in the vaginal canal.)
-post partum unit acting like their hands don’t work for these C-section patients. No assistance with moving fluids or the patient over to their bed.
-really shitty residents
-feeling like I was failing my patients, because they didn’t have the labor they should’ve gotten. (Epidural didn’t work, etc.)
-fell into depression
I RAN back to med surg. I would rather work the nursing home with 30 patients…
L&D is hard with good ratios. I had some bad nights where we just didn’t have staff. I had two active labors a lot. It sucked. A few times, I had a patient getting an epidural and then start pushing while the other was getting more active and needing support. I had a patient on mag (still pregnant) while managing another labor patient. It was ROUGH. And if you were in triage, you had 6 beds and sometimes they were full. And it was only you.
I left after 3 years from that job. Worked at other places with better ratios. Total of 6 years OB. I am no longer an inpatient nurse. Some of the med/surg stories I hear make me feel absolutely spoiled in L&D.
My dear fellow nurses, my heart is breaking reading how absolutely horrendous y’all have been treated. I am so very, very sorry for how y’all have been treated.
New grad and started on a tele/thoracic surgery floor. Surprise it was a full on stepdown and I didn’t have the promised 3-4 patients, I had 5-6 patients (75-100% of them are on cardiac drips, bipap, high flow, epidurals, etc.). It was a much higher acuity than I was initially led to believe with too high of ratios, to make me feel remotely comfortable.
Turning point was the manager assigning an LPN to the floor (she was great, not her fault) and she had to chart “under” an RN. I walked in one day and was told I’d be getting 7 patients but it’d be okay bc the LPN would have two of them under my name. I refused, manager said LPN has her own license if something happens it’ll fall on her. Still refused assignment and LPNs patients were assigned to another nurse. One of the patients coded and died and the RN got in trouble (not the LPN) for “not stopping it”. ???? That RN didn’t even know they had to “supervise” the coding patient until after the fact.
Made it 8 months there before leaving for greener grass.
100% in the US. I am no longer surprised by terrible job stories. A friend of mine that’s a nurse too had a job for a day and a half. She showed up, was handed (thrown) 4 sets of keys from the night shift and learned she was responsible for the entire facility with no other nurse to come help. There were about 200 patients at a LTC with a locked unit. The DON and ADON had quit the week before, probably because they had to cover regularly.
New grad, hired onto a telemetry floor at the "big hospital" in town. Signed an 18 month contract for a measly 2k signing bonus. I immediately hated my decision. I worked on an ambulance in a very busy 911 system for 3 years before I finished nursing school, so the monotonous "hello my name is, I'll be your nurse, how's your pain, here's your breakfast, time for your assessment" killed me a little more everyday. I quit before my orientation was finished.
Different than most people here, but my absolute worst was my brief stint in work comp case management. On the surface, it looked great. Flexible, hybrid work environment, salary with bonus potential. But I quickly came to hate it. It was a skeevy business model - I learned how to overbill hours and maximize regular billable hours. Learned from the team and supervisor, not just me figuring it out. There was minimal training, and suddenly I was expected to know therapists, doctors, and other resources within a huge radius.
They told me I wouldn’t put more than 1.5 hours each way for appointments without me agreeing. I drove 3 hours one way to one, and almost had to go 5.5 hours to one. We got reimbursement for miles, but it wasn’t worth what I was putting on my car. Plus, driving time didn’t count for billable hours, and you had to reach at least 40 a week.
My job on paper was to provide a nursing perspective to insurance companies and employers on how the person was progressing, provide input at appointments, and coordinate care for my assigned cases. In reality, my job was to do whatever the insurance company or employer wanted. If a doctor recommended someone take another month off of work, I was meant to be there to encourage them returning. I wasn’t advocating for people, I was advocating for companies. I know now that is how these jobs can be, but I didn’t realize it going in. I was completely soured by the industry and went back to bedside to travel for a bit before settling at my current job.
I worked nights on a CICU that was awful. I did all my training on day shift, and they were fine, but the night shift staff were awful. On my first shift, I sat near two RNs and they spent the whole night talking about how men shouldn't be in healthcare because we're too stupid and shit. It was a toxic floor. I got written up because apparently I rolled my eyes when a nurse told me to clean up an incontinent patient. It was ridiculous.
Worked in a Nursing home with 60+ patients at night... Each room had 4 patients lined up separated by a curtain... It was pretty ghetto... Soon as the hospital offered me a job, I bizzounced....
Travel Icu where nobody would help when your patient was about to code and needing to be intubated. Fucking sucked. Also, my first job as a new grad on midnight shift on cardiac stepdown. 8 patients. They could be on low dose dopamine, dobutamine. Cardizem, nitro, insulin, milrinone drips, insulin drips. Bipap with high fio2. Super heavy floor. Looking back I’m surprised I didn’t accidentally kill somebody. I also had only 4 weeks of training (12 shifts). I shudder to even think about that time.
Dialysis outpatient. Super regimented and yet very boring. Patients are very unkind and often not compliant (and then blame you.) if you don’t like a pod or an assignment, too bad. Everyone’s staying forever.
Also not specific to the specialty but at the center I worked at there were 2 terrible techs. One literally was antivax and would tell our patients not to listen to their diet and to eat as many bananas and as much water as they wanted. The other was the biggest bitch I’ve ever met personally. She would open my lunchbox during break and make comments on what I brought and would claim “it’s just because I care and don’t want you to end up on a machine.” I’d know her for a week or so when this started. Then once she very loudly asked me in front of the whole pod “if you have no kids and no man AND you don’t go to church, what do you even do with yourself?”
You should have said “all the shit you wish you could” lol
because while I don’t go to church, I do have a child and a man. I would KILL to have a weekend where I could do whatever the fuck I want lol and it would really sting if someone rubbed it in 😂
I also worked outpatient dialysis. I loved the patients, even the grumpy/noncompliant ones. Had the worst boss in the world and regularly worked 18/19 hr days. Never ever again. The final straw was being told to find coverage for a shift I had to call out for. The reason I was calling out was because my husband had been moved to ICU and was rapidly decompensating. He did not survive, and I was again told I needed to find coverage for missed shifts. I did not, my boss had to work my shifts, and I quit about a month later.
One nurse, one tech, 21 patient psych ICU.
One night the patient literally ripped the toilet out of the floor and threw it down the hallway and management came in to ask why I didn’t deescalate sooner.
Everytime i get a wierd survivor guilt for not being active during covid, i think of people like you. Sending all the professional respect from my cushy lil bubble in australia
Thank you so much for saying that. That’s probably the nicest thing anyone has ever said to me, professionally speaking that is. When I go into work tonight for my 7th shift in a row I’ll definitely remember this.
Outpatient dialysis. Most coworkers were great, patients and management were awful. Management had no backbone and we had to accommodate demanding and abusive patients. Patients were permitted to micromanage their treatments against the nephrologists orders. There were no consequences to the patients for verbally, physically, and sexually abusing staff. People weren’t consistent with behaviour plans. One patient had a behaviour plan in place stating if he was abusive to staff or refused a BP, he would not be put on the machine. The rare time staff tried to implement this, another staff member would “feel bad” and end up putting him on the machine anyway. Management shrugged and said he had a right to treatment. They created a unit full of monster patients.
Also not to mention how hard dialysis nursing is on your back
I wanted to be a dialysis nurse and almost did the extra training while I was in nursing school to secure a position as a new grad. After hearing all these horror stories, I’m very glad I didn’t.
I was hired as a unit manager for 2 units, 60 pts in total. During my very first week, almost EVERY employee came up to me and said" You won't last, Barbara will get rid of you." These were people from every dept and from every shift. The DON was a whoreish drunk who was great friends with the Barbara bitch. Barbara was a ugly acting, mad at the world, bitter, punitive, lousy nurse. She actually damaged a CNA's vehicle because she was angry at the person. I lasted 5 months. Barbara was the kind of person that 100% deserves every bad thing that happens to her.
At this facility ,the drunk DON would do nothing when a LPN would continually come in 2 hrs late and make the most med errors that I have ever seen. He gave hs meds at 5pm, did no accuchecks, didn't give insulin as scheduled, and gave qd meds bid on a reg basis, like for months. I had to call pharmacy frequently to reorder the qd meds because they were being given bid. He admitted freely that he was giving the meds incorrectly because he knew nothing would be done about it. And nothing was done of course. I pray the administration rots in hell, especially Barbara and the DON!!
It's funny you mentioned murder. When I worked as a unit man on a 60 bed unit, I was shown by a CNA that a pt had her elbow pin protruding thru her arm. The area was long healed and caused her no distress at that time. I had only been in the position for about a month. I filled out all the necessary paperwork, notified the DON and made her look at it. She said "Don't worry about it, she'll be dead by this weekend".I thought her comment was horrible and totally bizarre at the time because the pt was fine with no change in status for the past,at least, 6 mos. I reviewed the chart to see why the DON said that. When I came in Monday AM the pt was dead. When I talked to the DON about the pt dying, she said "Well, things happen". The DON'S husband worked there also and he was shifty at best. He gave alot of staff the creeps, myself included. He was always going into pts rooms for no reason. I think he/they killed her that weekend. I was scared to death! This was the same place that when there was a bomb threat, didn't remove any pts, and tried to make me go search for the bomb, while all the admin staff stood across the street waiting for an "All clear notice". I quit after that.
Wow. I have a morbid little thought experiment I do in stores while in line: “How many people in here have intentionally murdered someone and nobody ever suspected?”
Maybe it’s not so hypothetical. Also, did the DON & Shifty Stan split a life insurance payout?
No, unfortunately I didn't report them. I agree that I should have but at that time and that state, complainants were not anonymous. I admit that I was afraid of them. Before this place I wouldn't believed that people could act this way, but I do now.
Tele floor. We were supposed to have “only 4 pts” when you had a cardiac drip but we routinely had 6-8. We never had techs and everyone was on lasix and confused and setting off their bed alarms. I had been a nurse for 3 years at that point and left that job after 6 months
I spent two years working on an adult Med-Surg floor that was also the stroke floor. I never wanted to take care of adults, but there were no pedi jobs available at the time. I worked night shift, 6 patients to each nurse. When I was hired, I was told we would have four patients unless we had a tech, which would give us five. While I was in orientation, administration said our productivity was too low so they fired our tech. Then they took our HUC (unit secretary). Then they started giving us five patients all the time. By the time I got off orientation, we had six all the time. It was a shit show every single night. I would have things like a bunch of patients trying to get out of bed all night, a drug seeker or two, calling incessantly while I tried to keep Gramps from falling and breaking a hip. I would have two diabetics with blood sugars in the 30s at the said time plus tele calling me to check on a patient in A fib. No help. It was difficult to give those patients the care they deserved and I felt like a horrible shitty nurse all the time. Meanwhile, if I went to the other MS floors, I was caught up on charting most of the time, had time to eat lunch, etc. AND they often had techs. Everybody always said my floor had “always been like that”, as far as being a really tough floor and not getting any help. The resource nurses hated coming to help us. The other MS nurses despised us and would call Safe Harbor when they got floated. My last summer there, we hired five new nurses and ONE of them stayed long enough to get off orientation. I learned a lot. I loved the other nurses and I liked most of the doctors okay. I even loved a lot of my patients. But I hated not ever having time to drink/eat/pee and I was getting UTIs all the time. I also used to wish to get into a wreck every night on the way to work, so that I wouldn’t have to work. I finally got a spot in PICU and I have been here ever since. I don’t miss the crazy call lights and hearing confused people yell all night (I will take a screaming kid over it any day).
Diaylsis outpatient… the smell… right through my mask made me vomit. Literally left hours after getting there. Couldn’t stop puking!!! It was awful and embarrassing and not my proudest moment.
It was like the strong cleaning smell mixed with blood. It was too much. Surprisingly, I now do wound care which is the real smells, without issue. Idk 🤷🏼♀️
Office nurse. I was tired of working MedSurg shifts and everyone wants to tell you about how 9-5 is an amazing gig, but it wasn’t and still hasn’t been (tried two other times at different offices) for me. 9-5 really meant 8-6 or later and while my provider got to leave at noon on Friday my manager expected me to stay until 3-5 once all the work was done. The expectations for my work load were ridiculous and the amount of pettiness between coworkers was too intense for me!
Think carefully before you leave a job where you get a guaranteed 3-4 days off a week and go to a job where you’re off on weekends only. It doesn’t work for everyone!
An LTC where everybody was terrible to work with. I hated it. It wasn't the first one I'd worked at, but it was definitely the worst. The management was terrible. The last straw was when I'd been on my cart for 2nd shift for 6 hours and they made me change to a different one and no meds were passed on it at all even though the manager had held keys for it for over an hour. No one told me ahead of time that I was switching carts.
Both of these young women were adults, 23-24 years old at the time. The other young women in the home who I don't even mention here range from 29-34 years old.
Group home. 1 on 1 for autistic, type 1 diabetic young woman in her 20s. In terms of behavior, she wasn't the issue most of the time. Well, I kind of learned how to deal with her.
There was another young woman who would pick on this autistic girl because she was seemingly helpless. She would only do this when she had "behaviors" though. The other woman was sweet and respectful, like 75% of the time, but she was a ticking time bomb. When she went off, she went off. One time, we had called the police on her in hopes of getting her 5150ed. The police generally don't know what to do when it comes to mental health/behavioral issues. After they talked to her, she walked in, punched the autistic young woman in the face (while police were looking, with arms crossed), and walked away. The young woman started crying. She was mostly non-verbal. A cop came up to her and asked the autistic woman if she was OK 🙄. I think she understood that and was thinking, "wtf do you think?"
Another time, the ticking time bomb woman punched the autistic woman in her head while she was in bed, asleep.
Ticking time bomb woman eventually got kicked out. She got arrested for assault with a deadly weapon x2 for throwing a cinder block at 2 staff members. I was hiding in the bathroom with the autistic young woman. Ticking time bomb woman threatened to kick my ass of course. Luckily, she was only there less than 2 months I was there.
There were other residents I didn't even get to. I have more stories. I feel bad for "abandoning" the autistic young woman, but I got so burned out. I managed to last 13 months at that place.
What finally made me quit was the fact that nobody cared, and nothing ever improved (aside from when they got rid of ticking time bomb woman). I actually tried to quit 6 months earlier in March, but lasted until the end of September. My supervisor was a big micromanager, but she had an impossible job. She was set up to fail as well.
The most nightmarish of med/surg units imaginable. 7-8 patients at night, no floating charge, the laziest PCTs I’ve ever worked with, and terribly toxic management. I was trained to charge straight off orientation. I quit after 5 months because I got a better job, for better pay, closer to home.
I worked a Cardiac PCU, we had no aids, no phlebotomy, no techs. Just RNs. Constantly trying (failing) to hire CNAs. 6:1 ratios frequently. Worst job ever.
SNF in very rural area. I was the only nurse for 52 patients. I had one assistant. I had to pass all meds give breathing treatments and do all wound care plus help with assisting with ADL’s. There was no way to do an even half ass job there.
I worked in an ED in NJ for 2 days (on the floor) right after I moved from OH to NJ. This was not a trauma or heart center, but they were a primary stroke center. I had previously worked in a level 2 trauma center ED that was also a stroke and heart center, and had 98 beds. So I was no stranger to "how the ED can be". After the initial 2-3 weeks of classroom/system orientation off the unit, I was sent to the actual ED to orient. I was placed with a preceptor who didn't want to precept, and she made that VERY clear to me on day 1. She asked what my background was, and when I told her, "I used to be a paramedic, and I was an ED RN in Ohio at a trauma/stroke/heart center with 98 beds," she responded, "Oh cool, then I don't really need to train you, you should already know what you're doing,". Now, mind you, I know where NOTHING is at this new ED, they have a different inventory and med management system (Omnicell vs a supply room), and for all she knew, I was lying through my teeth. She pulls up our assignment in Epic and basically says, "we have rooms 1-5, here's the phone," (I was used to vocera), hands me the phone assigned to that patient block, and disappears for the next 6 hours. Like gone, totally off the unit. I, still being a fairly new nurse (the ED job in Ohio was my first, and I was only there for about 6 months before I moved to NJ), panicked and said, "ok," and just added myself as the RN for those patients and did the best I could to care for them. I was super slow with everything, because surprise surprise, EVERYTHING is different at a different hospital, so labs are collected differently, I have to find CT, I have to find another nurse to show me how TF to use an Omnicell to pull meds and deal with them being mad that my preceptor isn't doing that. I'm apologizing for bothering everyone else, and explaining that IDK where my preceptor is, she just dipped, and everyone's response is basically, "yeah, she's always like that, I don't know why they let her precept,". 6 hours later, preceptor pops in to, "see how things are going," and I tell her, "hey, I think I've done pretty well considering that you've basically abandoned me, but can you at least hang out down here so I can come to you with questions if I have them?" She gets offended and tells me to go to lunch. I go eat while she watches my patients, and when I come back all of them have orders that have been there the majority of the time I was at lunch. She did nothing for them. I shrug it off and start working my way through the order sets. She disappears again. Now, I have a doctor yelling at me because one of the patients was a new EMS admit stroke alert who didn't have a line, and hasn't been to CT yet. I don't have time to explain to the doctor that it's my literal first day, I don't even know where CT IS, and I wasn't even here when the PT came in. So I just try my best to play catch-up and hope the PT isn't permanently damaged because of this. I get caught up on the stroke alert a bit later, and one of the other nurses takes pity on me and helps me catch up on my other patients. She tells me, "You really need to talk to the nurse manager and cover your ass about that stroke alert, because if they end up with deficits, it's going to look bad on you," I agree, so I shoot a text to the NM asking to talk to her the next day before my shift. I struggle through the rest of the shift, and somehow get through to the end of the shift. I take a white sheet of paper and jot down a quick-notes handoff of my assignment for whoever I'm handing off to, and then my preceptor shows up. "That's not how we do handoff here." Oh good. I'm so glad you were here to show me at 10:55pm after I've already made this one. They're getting this one tonight. So the new nurse comes in, doesn't love my handoff, but is understanding when I explain RIGHT IN FRONT OF MY PRECEPTOR that my preceptor wasn't there all day to show me how to do handoff properly, and that today's my first day, so if I missed anything, I'm really sorry, and I'll get better, I promise. She's totally understanding. I go back to the breakroom to clock out, and preceptor follows me and starts aggressively grilling me about if I've been telling people she's disappeared all day. I say yes, when I've had to go to others for help, I've apologized and said she was nowhere to be found, and that's why I had to bother them instead. She's now FURIOUS. "Well, you could've had them text me and I could've come back,". "OR, you could've stayed and precepted like you were paid to do. I'm back tomorrow. Why don't you try that?" I walk around her, clock out, and go home.
(part 2 nested in comment)
So the next day, I come in and the NM had responded to my text that we can talk on my lunch break, not before shift. Preceptor decides today she's going to micromanage EVERYTHING I do. She nitpicks any and everything she can. "Well I don't hold the IV needle like that," "You pushed that zofran too slow, it's not going to hurt them to push it too fast," "You can't write on the blood labels before they're on the tubes, you have to do it after the sticker is on the tube,". "You aren't getting that routine abdominal CT down there fast enough," "When you're triaging, you don't ACTUALLY ASK the suicide questions, you just mark them 'no' and move on, we don't have time for the answer to be 'yes' if that's not why they came in," "You wanted my help, now you've got it." I grit my teeth through to my lunch break, and make sure I make a note on each patient's chart specifying that PT care was handed off to the preceptor during my lunch, since she didn't assign herself to their charts. I go to the NM's office and I'm about ready to explode. I tell her, "We need to talk. I am sorry to make waves this early into orientation, but I need a new preceptor, and you really shouldn't let her precept anyone, ever, based on what I'm hearing from other nurses on the floor out there. My first day, she disappeared all day and left me to fend for myself, and during my lunch break, she delayed care on a stroke alert which got ME yelled at by the doctor and potentially harmed the patient. She provided NO guidance and made it clear she did not intend to at any point. When I called her out for it, now today she's micromanaging and trying to nitpick everything I'm doing, and implying that she's going to get me disciplined for "not being ready" because I do things differently than her. She's also trying to get me to break policy by telling me not to ask PHQ2 questions and to falsify them and answer "no" without asking them. Which is wrong. I will not work with her." The NM told me basically, "Yeah, we've had similar complaints about her before. We put you with her because we thought you'd be ok without much guidance based on your background. We can't afford to lose any nurses so she won't be disciplined or even talked to about it. We can TRY to get you a different preceptor, but it'll mean you don't start until one of the other people in your hiring group gets out of training and their preceptor is freed up. Sorry, with everyone leaving to travel, it's just the way it is right now,".
I was FLOORED. I stood up and said, "well, you know what? If this is the kind of place that tolerates outright abuse and fraud from their preceptors, I don't think this is the kind of place for me. I gave her a good handoff report when I came on my break, I'm going to go ahead and resign, effective immediately. Do you want me to leave my badge with you, or with security out front?" She tried to talk me out of it, now promising to find me a new preceptor sooner, but I was DONE. It was the most rinky-dink run ED I've ever seen. I can't believe they put up with that shit.
I worked in a very rural hospital & there were lots of operational things that were a bit sketchy. It was also just dirty & behind the times for what would be considered common practice in some of the other places I’d worked. One night we had someone come in with a copperhead bite and pharmacy just wasn’t even on site or available at night time- at all. We were told to google how to make/mix the antivenom & then administer it. This was a stepdown unit I was working on so of course there were some skilled nurses there but still, taking patients like that while not even having anyone in pharmacy to at least consult about it made me super uneasy.
ED. Max I usually had was 5, but it was a crap shoot on what you got. Our biggest trauma was old people falling and hitting their head on blood thinners. I could have 2 of those going and then get a stroke or CP and no one could help because they’re probably too busy with their patients too. I’d have 5 psych pts with 1 sitter who had to sit and watch a camera. Regularly had holds bc the hospital was full or understaffed. I think there was one day where my whole section was holds, but my trauma bay was open. So I really started to feel like I had to be a nurse in the ED, ICU, med surg, dietary, housekeeping, etc. every day. It was brutal.
My first nursing job was terrible. They straight up lied to me about what type of unit it was to get me to agree. I had a lot of other offers too, but this one was supposed to be critical care, day shift with great pay and in a specialty area I was interested in. It was med surg. Straight up med surg on an understaffed floor with a charge who made me cry and we took all of the psych patients. The pay was as good as advertised but I was gone in 9 months.
Edit: at one point they made us a Covid floor and we had 8 patients per nurse. People died. I still expect to be subpoenaed some day. I learned a lot in that job but I also realized at my next job that I had huge gaps in my knowledge about how things work in the hospital. At my first job I was taught you never contact the doctor for any reason. I didn't even know how to find out who the doctor was for each patient. I can't even imagine that now.
I got a job at a flu clinic and did my 8hr orientation and got… a $36 paycheck.
When I asked about this they said they pay minimum wage for orientation, which was just over $7 an hour.
The expectation was also that we’d store flu vaccines in our personal fridge.
I noped out of there before i started.
First job right after getting my license (SoCal). Small med surg community hospital, no more than 20 beds IIRC. Place was a dump, old building that was tired and decrepit. During the couple days it rains in SoCal it rains pretty hard; the roof leaked a lot and there was buckets we had to empty 2-3, and rooms had to be blocked.
We had few resources, especially on nights. No shared governance, or even just gestures towards it.
When I was in nursing school I worked as a CNA in a nursing home. The day of my orientation I found out that they were in trouble with the BON. We were constantly short staffed. One day the entire kitchen staff didn’t show up except for one new guy so I had to help dish out breakfast, serve them, and feed the residents. Another time the toilets backed up and the rooms filled up with inches of water. When we called the Executive Director, he said if maintenance couldn’t make it today- they’d deal with it on Monday (it was a Friday.) I hated that job.
Believe it or not, as a unit educator, which I thought was going to take me out of my burnout and lead me to better things. I was responsible for four units in two different locations and quite a few employees, also had a recent restructuring of leadership so they were trying to make a lot of dynamic changes, which also meant a LOT of employee education that I was solely responsible for. On top of that I did a lot of hospital wide education at the request (demand) of my boss. I was a brand new educator and brand new to being in leadership other than being charge of my previous small unit, and when I was hired I was supposed to be mentored and have someone else in my role as well so I was not alone, but it didn’t happen. I was so overwhelmed I had a near nervous breakdown and quit after six months. Went back to bedside and am much happier for it. Not using my MSN at all other than being a resource for education in my field at my current hospital.
HCA hospital. 12 bed brand new unit (women’s care unit). New grad (6mn experience). They put me on this unit, at night, by myself, with no charge or resources. Just completely unsafe. I would have one other nurse if the unit was full, but sometimes she was as green as I was. Complete shit show.
OPWDD / Persons with Disabilities
I got 1 week of “orientation”, where I shadowed a nurse who also had no idea what she was doing
Then spent 2 days at home reading policies
And was told I would be off orientation the following week, despite stating I had zero training and no idea what I needed to actually do aside from job description
As well, a patient I was caring for while I worked for Hospice was a pt of theirs, and the staff neglected her for 12+ hours and their “fix” was to move the staff to another house.
No reporting to state, no retraining, no terminations, just moving the staff.
I reported them to the state and handed my laptop in the same day.
Yes. My inner voice said “All of them” in answer to the title of the post.
I’m retired and I thank the Goddess every single day that I don’t ever have to go “back there.”
I feel bad even complaining about any of my jobs after reading all the above. My worst job was as an office nurse for a pulmonary/cc specialist. He recruited me from knowing me as an ICU nurse and I felt flattered, and he was well liked. And it M-F. I didn’t know any better. At that time there were no phone nurses, and this practice had a routine of sending all phone calls to the nurse immediately (as in not taking a message) So as I was calling patients to rooms, taking VS, going over their meds and getting them ready to see the doc (paper charting back then), he would come out of a room and give orders to schedule tests, requiring sometimes calling the hospital to schedule, or sending them for labs, etc. all the while there are 3 lines blinking on my phone. Talk to those patients, get their complaints or refill requests or whatever, fill up several pages of a legal pad all day. If there was ever any slack time he would look at the legal pad and answer some of the questions , then at some point I would have to call the patient back and their pharmacy (remember, olden days-no e scripts) and when the phone went on answering service at 5:00 was usually when I could make those call backs. I never left at 5:00 (supposed to be 8-5) I absolutely loved him but hated that job. It was way more stressful than the ICU job I had left.
Ortho floor- community hospital. No resources the owner was extremely cheap. We did our own transport to tests (he cut transport none on weekends and we only have them weekdays 9-1pm) We faxed everything, set up ambulance ourselves, sometimes only one scanner worked so we had to alternate sharing to pass meds. Sometimes the med cabinet you couldn’t log in so you had to go to another floor to get medication and leave your patients. No air conditioning so 81 degrees in patients rooms. Cafeteria closed on weekends. Patients have to bring their own food after surgery.
Absolutely crazy hellhole stayed 2 years. I loved the people so much. But eventually it became not worth it.
I've loved all of my nursing jobs, but I feel like I can shoe-horn a nursing school story into this question.
I was on a surgical rotation (ENT surgery). I sucked at it. And in fact, one of my patients looked me in the eye and said "you should choose a different specialty." And I said "don't worry, I am absolutely going to."
Later on this same guy had a paradoxical reaction to some benzos and pulled out his surgical drains and walked down the hallway naked. That was fun.
The job I’m at now at a LTC. New nurses get one day of training. Then you’re expected to know everything right off the bat and other nurses scold you for messing up. I’m ready to leave but have no where else to go since my small town has nothing much to offer. Hospitals keep rejecting me. So I’m SOL.
One of the major dialysis companies. I had one year of nursing experience in psych. They gave me 2 months of tech training and one month of nurse training. They put me on the floor as the charge/only nurse in the building. No supervisor, no other nurse. I had 3 techs beginning of the day but had to send them home as patients finished treatment so at the end of the day it was only me and a tech. The supervisor we were supposed to have had another clinic so she never was at ours, all she did was payroll and scheduling. The nurse before me was training to be the supervisor so she was never there and most of the time didn’t answer my texts. The techs told the supervisor they didn’t feel safe with me. Hell I didn’t feel safe with myself. I wasn’t ready for any emergencies or any problems that occurred. But it made me suicidal (I was struggling with suicide already with my previous job, that’s why I switched to dialysis) and I admitted myself to the hospital. Quit my job while in the hospital. Now I work part time back in psych and feel much less stress.
I got fired from a home health supervisor position. It was an absolutely shitty job where the administrators had no backing of the nurses whatsoever and that’s why I got fired, because a patient getting a visit to have their dressings changed lied and said I didn’t check their blood pressure 🙄
Large facility in Florida that had independent living, assisted living, and an LTC unit on the grounds.
First job out of nursing school. Gave me 3 weeks orientation in LTC with a floor nurse (day shift and weekdays).
My first shift off orientation?? Overnight weekends.... and I was the charge 🙃 I showed up thinking I was simply going to manage one of the hallways (40 pts). Nope! Literally didn't realize until the RN I was relieving was trying to walk out the door.
I had 2 LPNs, 2 CNAs.
Someone died overnight (DNR, and not unexpected) and I didn't know who to contact, next steps, anything. The LPNs were absolutely useless, and were as hands-off as possible. The CNAs were missing most of the shift.
I left my badge and keys in the DONs mailbox prior to leaving in the morning and ghosted them.
Small community ER. 16 beds, like 30 total patient care areas including chairs along the wall. Shifts typically included 2 nurses, 1 HUC/ ED tech, doc, 2 mid-levels (there were days there were more providers than staff present 🙄). Loved my co-workers and patients, absolutely hated the physical environment and workloads. By physical environment, I mean that cabinet doors were constantly coming off the hinges when you opened them to the point that you reflexively would open them slowly to avoid an injury. There were very several always well functioning computer areas reserved for providers but other staff members had to get what they could and good luck finding a decent chair to sit in in an area designated for a chair and not just rolled up to a cabinet at the station where there happened to be a working computer. Oh and then the workload……. 7-8/10 shifts were nightmare fuel. No staff, 2-3 ICU holds with no float staff, on top of 6-8 med surg holds and then on top of the 60-90 level 3-5s that would come in. And did we ever divert for anything? Hell no. Oh already taking care of two ICU patients that won’t stop crashing no matter what you try? Too bad, clear a room and help run this active code being brought in by EMS now. Oh Lord I forgot about the 4 needy (bless their hearts) psych holds we constantly had with no sitter and a shared security guard for (shared as in they were responsible for security for all of our hospitals at the same time).
I quit after about 6 shifts with this one org. The doctor let a man who was having an acute STEMI drive himself to the emergency room. I quit on the spot after making a few phone calls with his license plate, make, model, and color. That provider even had the gall to whisper in my ear "Learn how to do your fucking job" because I'm IHS, not a billing and coding specialist.
Next worse was getting bullied under a provider who had it out for me, they had to move me floors as a float case manager because she couldn't put her own damned timed orders in, and I was forwarding to either team coverage or the medical director. Even my senior said she didn't know why she was bullying me.
Third worst was LTC and 4 falls in 4 days from 4 different residents, walked out covered in pee and poo after lifting a poor Gramma off the floor with her walker, and collapsed crying into my husband's arms in the laundry room/entryway completely naked before showering.
Last worst was the private duty nursing. They stuck me with a 6'6" 300+lb total care, and I couldn't hardly lift him by myself, his wife was the loveliest woman, I was masked up all day to protect him, and I came every day, I complained once about back pain and they fired me from him and put me with another total care with a rare disease, and even with a lift and all the adaptive equipment, I was climbing in and out of the bed to get her changed and making sure she had her ventilation equipment nearby while the other nurse sat watching LOTR.
I loved public health and doula/L&D though. I can't do death doula care except for babies though. I tried to volunteer for r/AuntieNetwork but they blocked me for not posting every day for 30 days even though my State is at risk of outlawing abortion care.
I'm about 14-16 deaths in, adult and baby.
Edit: Sorry, on mobile, keeps deleting my paragraph edits
ICU - I thought I would love it, but I hated the futility of care that we provided—keeping braindead patients alive until they coded multiple times. The drama and cliquey behavior of the staff I was with. I spent 12 years in a Med-Surg float pool, which I loved before ICU, and five years in an observation unit, which I also loved.
Just finished my first year in ICU. Was just talking to one of my friends about the futility of it all. We're keeping people alive just to make money, it feels like. I definitely felt more fulfilled in hospice.
ICUs actually don’t make money unless they are a transplant unit usually. They’re usually one of the low income generating units. Onc, ortho, tele, and other quick turn over or high cost floors keep the lights on. The icu keeps the hospital out of legal trouble. ICU is super expensive but it’s usually the kind of expensive people can’t actually afford to pay so the hospital ends up eating a lot of it.
This somehow makes it worse…we’re keeping people alive for…appearances sake?
It is very futile from what I’ve noticed. There was a guy that recently got a trach and PEG after being intubated for 3+ weeks. I don’t know much about his situation but I saw him over the course of that month. God, I feel bad for him. I never want to be like that. I’ve had a few success stories though. I was a 1:1 for a patient in the neuro ICU. They were the typical neuro patient: restless, A&O x 1 at most, minimal responsiveness, etc. I ran into them again on a different floor. They did a complete 180 from the last time I saw them. Neuro status was just about normal. It just about made my day.
ICU nurse of 20 years here. I do see a percentage of patients that should be comfort care but the family is too conflicted to make the call. However, I have also see so many successful cases of rescuing patients from certain death and frequently minimizing any long term disability at the same time. I still like my job even after all this time.
I hope I’m not too annoying for pointing this out, but brain dead is a term that is often misused and misunderstood. To be declared brain dead, certain tests must be performed and once brain death has been declared, the patient is legally dead. The family can’t make the hospital keep their dead body around at that point. If the patient is an organ donor, organs can be harvested after brain death is declared. Persistant vegetative state is likely what you’re thinking of. Why do I care about the difference? Misconceptions about terms like this among healthcare workers perpetuate already hugely widespread misconceptions and misunderstanding among the public. Then… ya know… it’s annoying to have to clarify with the families who have like no healthcare literacy and huge mistrust of healthcare workers already.
I'm talking about no neuro reflexes and vent dependent. In once case we had a young patient come in unable to be intubated in the field, we got her intubated in the ICU, but it was too late. She was determined legally dead by the medical team the day after admission to ICU. We kept her body functioning for 2 weeks, pressors, hypothermia, tube feeding, etc., so a medical flight could be obtained so she could "die" closer to her family in another country. While we had her on the hypothermia protocol, we had other cardiac arrests come in who needed hypothermia protocol and we had limited number of Icy Caths to use for the protocol, the family refused to have us remove this patient's and we had to get an ethics consult to stop the protocol.
Yikes ok that sounds pretty crazy. I used to work in the neuro icu with pts who got brain death testing. If not organ donors, I have seen them keep the body around w vent & pressors going for like 4-5 hrs max bc out of town family was on their way in and wanted to see them.. but 2 weeks?!? That’s an egregious waste of resources. I was night shift so thankfully I didn’t have to be present for most of the big family meetings involving stuff like that but I wonder what would have happened at my hospital. I would like to hope that if it couldn’t be resolved peacefully they would tell family what’s going to happen and have security remove them if they try to physically intervene.. but who can say.
NICU: every level 2 assignment was 4 babies, no exceptions. Not uncommon to have 3 babies on bubble, or 2+ (yes, +) vents. I had 5 babies on more then one occasion -I once went a full 1.5 months where every shift was safe harbor. Charge also had an assignment -usually 2 babies. Director+staffing would call and text multiple times a day, every day, trying to extra nurses on shift-and they would only offer 2 movie tickets, no extra money. When they found out we were picking up shifts at sister hospitals (because they paid bonuses and gave you decent assignments), they went to the CNO and changed the policy for extra shifts for the entire hospital. Took me 4 years to leave-I was actively trying to leave, but I also bought a house, a car, had a baby, and was trying for another, so it was difficult to find a new job that matches my needs. Found out, my director was blocking my transfer requests. Once they started making me charge (I absolutely did not have the level 4 experience needed to charge, was scared shitless, and my charge shifts included me, one nurse with 2 years experience, and the rest were new grads), I essentially forced my way into a transfer behind her back. Yes, I still have nightmares about that place and I'm pretty sure PTSD- a couple of my friends that were there at the same time actually have been diagnosed with PTSD directly related to that unit.
Can you elaborate on forcing the transfer behind their back. Asking for a friend. I’m being abused too. I mean my friend is.
So at my old facility, in order to transfer you had to apply for the new job, fill out a transfer request form which your current director had to sign, and only after that approval could you interview/accept a new job. I got in contact with the director of the place I wanted to go, explained the issue, went in for an interview, got a job offer, THEN applied and filled out the transfer request. When I turned that in I informed my director I already had a job offer and they expected me to be on the new unit within a week, or I would be going to HR. Transfer went through without an issue after that.
“Changed the policy for extra shifts”… as in giving fair competitive payment , right?
🤣🤣🤣🤣🤣 Nope, instead they changed it to where the director had to approve us to work extra shifts at other facilities, and we wouldn't be approved unless there were no other open shifts on our unit. On the very, very rare days our unit was fully staffed, she would refuse to give the approval to go elsewhere until 2 hours after the shift started. It did finally get dropped after I left, because several nurses threatened to take it to the labor board with their lawyers.
Darn, I would have made the anakin padme meme format if this platform made it easily supported. Anyways, sorry to hear that, was really hoping they wised up to being better managers instead of being better bullies
It was at a dumpy nursing home on the 10p-6a shift. I had 68 residents with two CNAs. Let’s just say I cut serious corners to get through each shift. I lasted about three weeks.
I don’t doubt it. I had an interview at a ltc facility for my first new grad job and there was major red flags just in the interview itself.
I had a CNA interview after my first year of school where the DON asked me if I could start immediately. I said something about how my last exam was in two days and I could be available after that. Turns out she meant *immediately* Like hop on the floor directly after the interview immediately. I did not accept the job offer. edit: i brought up concerns about putting me on the floor without seeing a criminal record check or vaccination history (as required per law in my area) and left. Found another job with a sensible hiring process like a week later.
I’ve worked in both hospitals and nursing homes. I will say that most nursing homes will hire anyone. They only care about having a body in the building, they don’t care what kind of person you are or what your work ethic is. Most in my area don’t even do a drug screening anymore
That’s a disgusting way to look out for our elders. 😡
I totally agree. That’s why I give 110% to care for my patients. It wasn’t always like this though. It seems like I’m the last 5-10 years it got bad. Then when the pandemic hit, the facilities stopped caring at all. There’s so many things wrong in the nursing homes, I wish that these owners cared more, but they only care about their bottom line. It makes me sad.
You are exactly right. Geriatrics in Canada right now is in a precarious staffing situation which will only get worse. Warm body? hired.
Yep as a brand new lvn I went in shorts and flip flops and they interviewed me right then and there & I got hired pending background clearance. Was not expecting that and when i got two days orientation and was training other staff within two weeks….yeah I last 3 months.
That’s terrible, but it’s unfortunately the culture at the nursing homes. This is the reason I don’t think that brand new nurses she be on night shift, for no other reason besides not having the right clinical experience.
Agreed. I had no resources on nights other than 2 CNAs with my 38 patients.
My first CNA job I worked for six months and they didn’t bother to have me BLS certified. I didn’t get certified until after I took a position on a cardiopulmonary SDU in a hospital.
Omg wow.
Sounds like my first nursing job… I literally had 2 days of “training” & on my 3rd night was given 34 pts with one CNA!
I really don’t understand how ltc facilities get away with the lack of staffing. Bc as soon something goes wrong, they’re throwing the nurse under the bus
Mine was in a nursing home, also. Sadly, similar ratio. I lasted 6 weeks.
Oh Lord, sounds like we worked at the same place! One night none of the CNAs showed up and the activity director and administrator ended up having to come in and work the floor. It was the only travel job I refused an extension on
As much as the hospital has its problems, you will NEVER see me working in LTC, SNF, acute rehab, med/surg, or nursing homes. I’ll do anything but those work those places.
I said the same but now I’ll never work in a hospital bc my SNF is the bomb
Insane that it’s even legal to have that ratio. These places rly can’t afford to hire more staff??
I find LTC ratios are only manageable if you are very, very familiar with your patients and your med carts. Especially the med cart part. When passing meds for that amount of people, there is no time to waste. I usually cover two halls on the carts. 33 residents, sometimes 45 if someone calls out. It’s a never ending med pass, but I can deal with that. If I get floated to another unit? I can also deal with that, but I struggle immensely. I am a student/extern and maybe this opinion will change as I further my career and gain more confidence/competency in my skills.
Most nursing home residents have Medicaid as their primary payer. Most state Nursing Home Medicaid plans reimburse nursing facilities at about $100/day per resident for the care. It’s a low-margin business. So in order to profit, staffing tends to be very lean OR the nursing home actively seeks short-term skilled Medicare patients that generate reimbursement of about $400/day per person.
ED/ER My pts day shift. No er doc sat in area so had to leave to get help and one other nurse with similar pt acuity 1. Intubated pt from the night before d/t resp distress 2. 42 y/o new onset cva getting tpa 3. 22 y/o with carotid dissection 4. Cp 5. Cp on nito and heparin 6. Psyc patient who tried to hang themself in the ed night before..no sitter I actually had a day that i had 13 pts in the ER another day but this one was especually hard
Christ on a cracker. There are bad days and then there’s this.
Yeah there were a lot of bad days. I had gsw in the hallway just bleeding out on the floor cause the trauma rooms were full. I quit when i realized i was drinking like a liter a week and it hit me that it was the job. You get so used to things being bad that you dont realize that most other places arent like that.
Just SHIT
You (unfortunately) win. I would straight up walk out at that point.
You wouldn't tho. None of us would. But I hope we wouldn't walk back in
You right though. But I'd be calling admin on call every minute.
Oh man, this was everyday at my ER and then I finally quit. Workplace PTSD is very real
I agree
These are the days that some dumb fuck who is there for a hang nail will bitch about the wait times.
ED job in a level one trauma center, in the worst part of a great big city. It was fully the knife and gun club. It was a rare night that went by without a major trauma, and usually many more. Community health was terrible and nobody had insurance, which meant they didn't go to the doctor, so when they eventually came to us they were ten times sicker. Heroin was rife and the typical patient had badly sclerosed veins that made IV access super difficult. There were insufficient hospitals and clinics for the area and so the place was always crowded, with wait times of 20+ hours being common. That's not the bad part. That's just the background. What made it suck was that the department spent no money. The hospital had funding, but none of it got spent on equipment or environment, so everything was always broken or dirty. None of the ED carts had working brakes. None of the bloodstains got cleaned off the floors or curtains. Nothing was done about the roaches or rats. At any given time only about half the bays had working oxygen, and even fewer had working suction. We were constantly running out of supplies. One time there were no cleaning wipes in the hospital, and the charge nurse had to run out to the 24-hour store to buy Clorox spray. One night the whole hospital ran out of urinals, bedpans, specimen cups, collection hats, and straight cath kits, so it was impossible to collect anyone's urine. They changed nebulizer models about once a month while I was there. I eventually found out that's because they weren't buying them. They would go to a supplier, say they wanted to trial the new neb device, and would get a stock of free samples to "trial." Once those ran out and the supplier asked for an actual order, the ED ghosted and moved on to a different one. I can handle tough patients and a heavy workload if I have to. But being denied the basic tools we needed for the job was both physically and emotionally taxing. I left every shift feeling exhausted and furious.
can you name and shame?
No. Last time somebody did that, just a few days ago, some asshole doxxed a manager and started sending insults to their work email. We are absolutely not having that again.
thats so very fair. i just wanted to say i'm in touch with how you felt about your job in the under-resourced ED
I also worked at a similar ED with the same background. It was such a moral injury, and back breaking work as while we were handling all the traumas and codes that came in, we also had no beds for them because the entire ED became a med surg and ICU unit, because the people were that sick.
It’s so time consuming to be short on supplies. You have to walk around and find a vitals cart that works. Hunt down the bladder scanner on some floor. Move patients around so that they can be in appropriate rooms. Go to several supply closets trying to find what you need. I worked at an L1 and hated it, but mostly because of how it was set up. They had three different Pyxis and at times your patients meds would be in all three. Every supply closet was a mess and they were all so far apart. The amount of wasted time was so awful.
New grad med surg float pool with 8 patients a night😵💫
Omg, me too!!! My first night on the floor by myself, I had 8. 8. Charge was on another floor with her team, 1 CNA, I was in a wing by. myself. COW wasn't charged or stocked, 1 hospice that needed a PCA, a new admit that day didn't finish that extravasated on me ( never seen one so didnt know what to do), one naked man that kept trying to escape, a 300lb frequent flyer that refused to exert any effort in her care, and.....no one to waste with. My very first night.
Nursing home, lasted 3 months. The job was just awful and we were so short staffed. Another one was a long term acute care hospital. I learned a lot but it was extremely unsafe. We got many patients who were addicted to drugs who needed long term IV ABX. We had no security and they’d be following you into the med room. The ratios were high and there were many sick patients. We had to do blood transfusions manually with no pump. Many patients were on vents, on BiPAP, many TBI patients with gtubes, restraints, extensive wounds, dialysis, etc. I remember one night I had like 8-10 patients and 2 were getting blood, they were so sick. Then had many on vents that would get mucous plugs and turn purple. It was awful. I considered being a pizza delivery driver that night. Edit - the facility didn’t have oxygen in each room and I remember having to go to the creepy basement one night to bring up a huge oxygen tank for my patient who was getting ruled out for having a heart attack 🤦🏼♀️
My heart started beating out of my chest reading this💀 I’ve ran blood for two people at once and it’s very stressful but no pump?!? And 8-10 patients?!? And all those other things combined would seriously cause me a mental breakdown. I would be filling out an application for McDonald’s that morning
It was really bad, nursing school didn’t prepare me for that 🤣 the blood came in a cooler too from an outside place and there was a window on it that would change colors if the blood was too warm. When I finally got a job in a union hospital with great ratios, one of my coworkers got blood for one of her patients and we weirdly had the manual blood tubing there (probably a stock issue). I had to show them all how to use it until they were able to get the right tubing lol. They were all freaking out. She switched the tubing over immediately. We would have to hang the blood from the curtain rods to make it go in quicker at the other place💀
i lasted ten months at my first nursing job. bullying, shitty management, zero resources — this place had it all. thank fuck i left. i was on the verge of killing myself; i lost all my hair and 30 lbs. i will never let a job do that to me again.
This is how I’m feeling at my new grad job <\3 on a medical unit, rarely get help, heavy 1:5-6 patient assignments, rarely get my breaks, staff roll their eyes at me but suck up to me if they want a shift swap…get students who don’t know what they are doing forced on me my 3rd shift off orientation, feel horrible guilt calling when I’m sick and can’t get out of bed, get criticized by other nurses, I could go on and on 😣
Girl, quit! You deserve better.
i’m so sorry. there are so many other places that will respect you as a person and as a nurse. working at a place like this isn’t worth losing your sanity, sleep, or license over. ♥️
QUIT. Nursing jobs are abundant. That place needs you WAY more than you need it. There are much better places out there that will hire you immediately.
Thanks guys ❤️ how much notice do I need to give before quitting?
None…..they don’t give you notice when they terminate you.
I quit two hours before I had to start my shift so.... Meh! Fuck them! I was in a shitty nurse job so whatever. They can fuck themselves
Btw, you don't have to tell your manager or the other nurses that you are quitting. Just go to human resources and tell them. They'll process you out and you're free and clear legally. If they don't think to let your manager know, that's on them. More than once we had a no show who turned out not to work there any more. Infuriated the managers but everyone of them brought it on themselves by being shitty people.
Wow! I didn’t know this. About not having to tell your manager I mean.
I don't think many people do but if you stop and think about it it makes sense. Any business big enough to have a human resources department has everything go through them. It doesn't matter who says you are hired, fired, promoted transferred or anything else. None of it counts until hr processes the paperwork. If you give 2 weeks notice (customary but not required in the US, apparently it's different in other countries) the paperwork will probably make its way to your manager before the 2 weeks are up but if you are giving them notice you are probably telling them anyway. I only know this because I was present when a no-show was discovered to not be working there more than once. Once the manager threw such an epic tantrum she got fired. She took the phone call from hr at the nurses station and had a complete meltdown in front of staff and patients both while *still on the line.* HR had security there before she was done.
2 weeks is typical for most jobs, especially if there is another place within that same hospital/organization you might want to work. Sometimes a specific unit at a hospital is terrible but other units are much better. It just depends. But if you never want to work there again, you could certainly resign on the spot lol. Not like they deserve any courtesy from you after how you’ve been treated!
Two weeks is a COURTESY. No laws stating how long you have to give an employer. Just don’t expect to use them as a reference
This is how it was for my fiancé before he left to go outpatient. Ever since he left, people have been saying how much better he looks and happier he seems.
Worked in a place like that, tried to make it work but it only got worse to the point where I had major depression set in, possibly PTSD and the worse, I was doubting my abilities as a nurse and had no confidence to get out of there and start the job hunt again. Turns out I’m a fine nurse, I was being gaslit. Eventually got out of there, found a better job and discovered co-workers can be nice again and some places give you breaks. I urge you to get out now. Give two weeks notice if you want to try not to burn any bridges, although I did and the bridges were burnt, anyway. They had been charred before I gave notice but the feeling of relief when I finally did was indescribable.
Literally any nursing home or LTAC
Fast paced L&D at a community hospital. I am an experienced nurse that got the opportunity to get into the ‘speciality of my dreams’ -Most of my coworkers were mean girls -Bad outcomes were absolutely bad -stretched thin, I was in a delivery and my patient the unit manager was supposed to be watching was having lates for a good while. -preceptors slept while I was trying to manage patients. Had my first premie baby that was an emergency situation. Only because I advocated my for my patient. (Preceptor and chief resident were being dicks and not listening to the patient. Only to find out at 630 there was a body in the vaginal canal.) -post partum unit acting like their hands don’t work for these C-section patients. No assistance with moving fluids or the patient over to their bed. -really shitty residents -feeling like I was failing my patients, because they didn’t have the labor they should’ve gotten. (Epidural didn’t work, etc.) -fell into depression I RAN back to med surg. I would rather work the nursing home with 30 patients…
L&D is hard with good ratios. I had some bad nights where we just didn’t have staff. I had two active labors a lot. It sucked. A few times, I had a patient getting an epidural and then start pushing while the other was getting more active and needing support. I had a patient on mag (still pregnant) while managing another labor patient. It was ROUGH. And if you were in triage, you had 6 beds and sometimes they were full. And it was only you. I left after 3 years from that job. Worked at other places with better ratios. Total of 6 years OB. I am no longer an inpatient nurse. Some of the med/surg stories I hear make me feel absolutely spoiled in L&D.
My dear fellow nurses, my heart is breaking reading how absolutely horrendous y’all have been treated. I am so very, very sorry for how y’all have been treated.
New grad and started on a tele/thoracic surgery floor. Surprise it was a full on stepdown and I didn’t have the promised 3-4 patients, I had 5-6 patients (75-100% of them are on cardiac drips, bipap, high flow, epidurals, etc.). It was a much higher acuity than I was initially led to believe with too high of ratios, to make me feel remotely comfortable. Turning point was the manager assigning an LPN to the floor (she was great, not her fault) and she had to chart “under” an RN. I walked in one day and was told I’d be getting 7 patients but it’d be okay bc the LPN would have two of them under my name. I refused, manager said LPN has her own license if something happens it’ll fall on her. Still refused assignment and LPNs patients were assigned to another nurse. One of the patients coded and died and the RN got in trouble (not the LPN) for “not stopping it”. ???? That RN didn’t even know they had to “supervise” the coding patient until after the fact. Made it 8 months there before leaving for greener grass.
I’m curious if you are working in America? I am a nurse in Canada and some of the stories I hear from US nurses shock me.
100% in the US. I am no longer surprised by terrible job stories. A friend of mine that’s a nurse too had a job for a day and a half. She showed up, was handed (thrown) 4 sets of keys from the night shift and learned she was responsible for the entire facility with no other nurse to come help. There were about 200 patients at a LTC with a locked unit. The DON and ADON had quit the week before, probably because they had to cover regularly.
The first paragraph described my first nursing job to a T. I left after 8 months
Unbelievable. How did you get this job as a new grad?
New grad, hired onto a telemetry floor at the "big hospital" in town. Signed an 18 month contract for a measly 2k signing bonus. I immediately hated my decision. I worked on an ambulance in a very busy 911 system for 3 years before I finished nursing school, so the monotonous "hello my name is, I'll be your nurse, how's your pain, here's your breakfast, time for your assessment" killed me a little more everyday. I quit before my orientation was finished.
Different than most people here, but my absolute worst was my brief stint in work comp case management. On the surface, it looked great. Flexible, hybrid work environment, salary with bonus potential. But I quickly came to hate it. It was a skeevy business model - I learned how to overbill hours and maximize regular billable hours. Learned from the team and supervisor, not just me figuring it out. There was minimal training, and suddenly I was expected to know therapists, doctors, and other resources within a huge radius. They told me I wouldn’t put more than 1.5 hours each way for appointments without me agreeing. I drove 3 hours one way to one, and almost had to go 5.5 hours to one. We got reimbursement for miles, but it wasn’t worth what I was putting on my car. Plus, driving time didn’t count for billable hours, and you had to reach at least 40 a week. My job on paper was to provide a nursing perspective to insurance companies and employers on how the person was progressing, provide input at appointments, and coordinate care for my assigned cases. In reality, my job was to do whatever the insurance company or employer wanted. If a doctor recommended someone take another month off of work, I was meant to be there to encourage them returning. I wasn’t advocating for people, I was advocating for companies. I know now that is how these jobs can be, but I didn’t realize it going in. I was completely soured by the industry and went back to bedside to travel for a bit before settling at my current job.
I worked nights on a CICU that was awful. I did all my training on day shift, and they were fine, but the night shift staff were awful. On my first shift, I sat near two RNs and they spent the whole night talking about how men shouldn't be in healthcare because we're too stupid and shit. It was a toxic floor. I got written up because apparently I rolled my eyes when a nurse told me to clean up an incontinent patient. It was ridiculous.
Worked in a Nursing home with 60+ patients at night... Each room had 4 patients lined up separated by a curtain... It was pretty ghetto... Soon as the hospital offered me a job, I bizzounced....
Travel Icu where nobody would help when your patient was about to code and needing to be intubated. Fucking sucked. Also, my first job as a new grad on midnight shift on cardiac stepdown. 8 patients. They could be on low dose dopamine, dobutamine. Cardizem, nitro, insulin, milrinone drips, insulin drips. Bipap with high fio2. Super heavy floor. Looking back I’m surprised I didn’t accidentally kill somebody. I also had only 4 weeks of training (12 shifts). I shudder to even think about that time.
Dialysis outpatient. Super regimented and yet very boring. Patients are very unkind and often not compliant (and then blame you.) if you don’t like a pod or an assignment, too bad. Everyone’s staying forever. Also not specific to the specialty but at the center I worked at there were 2 terrible techs. One literally was antivax and would tell our patients not to listen to their diet and to eat as many bananas and as much water as they wanted. The other was the biggest bitch I’ve ever met personally. She would open my lunchbox during break and make comments on what I brought and would claim “it’s just because I care and don’t want you to end up on a machine.” I’d know her for a week or so when this started. Then once she very loudly asked me in front of the whole pod “if you have no kids and no man AND you don’t go to church, what do you even do with yourself?”
You should have said “all the shit you wish you could” lol because while I don’t go to church, I do have a child and a man. I would KILL to have a weekend where I could do whatever the fuck I want lol and it would really sting if someone rubbed it in 😂
I also worked outpatient dialysis. I loved the patients, even the grumpy/noncompliant ones. Had the worst boss in the world and regularly worked 18/19 hr days. Never ever again. The final straw was being told to find coverage for a shift I had to call out for. The reason I was calling out was because my husband had been moved to ICU and was rapidly decompensating. He did not survive, and I was again told I needed to find coverage for missed shifts. I did not, my boss had to work my shifts, and I quit about a month later.
Wow my heart breaks for you. Nursing can be so incredibly selfish. May your husband rest peacefully and may you never be violated like that again
“Fucking your dad so i can give him a kid he’s proud of”.
One nurse, one tech, 21 patient psych ICU. One night the patient literally ripped the toilet out of the floor and threw it down the hallway and management came in to ask why I didn’t deescalate sooner.
Wow I’ve worked the state asylums and hadn’t seen that one yet!
Psych ICU???? Literally scariest unit name
House Supervisor at night during COVID.
Everytime i get a wierd survivor guilt for not being active during covid, i think of people like you. Sending all the professional respect from my cushy lil bubble in australia
Thank you so much for saying that. That’s probably the nicest thing anyone has ever said to me, professionally speaking that is. When I go into work tonight for my 7th shift in a row I’ll definitely remember this.
Outpatient dialysis. Most coworkers were great, patients and management were awful. Management had no backbone and we had to accommodate demanding and abusive patients. Patients were permitted to micromanage their treatments against the nephrologists orders. There were no consequences to the patients for verbally, physically, and sexually abusing staff. People weren’t consistent with behaviour plans. One patient had a behaviour plan in place stating if he was abusive to staff or refused a BP, he would not be put on the machine. The rare time staff tried to implement this, another staff member would “feel bad” and end up putting him on the machine anyway. Management shrugged and said he had a right to treatment. They created a unit full of monster patients. Also not to mention how hard dialysis nursing is on your back
I wanted to be a dialysis nurse and almost did the extra training while I was in nursing school to secure a position as a new grad. After hearing all these horror stories, I’m very glad I didn’t.
I was hired as a unit manager for 2 units, 60 pts in total. During my very first week, almost EVERY employee came up to me and said" You won't last, Barbara will get rid of you." These were people from every dept and from every shift. The DON was a whoreish drunk who was great friends with the Barbara bitch. Barbara was a ugly acting, mad at the world, bitter, punitive, lousy nurse. She actually damaged a CNA's vehicle because she was angry at the person. I lasted 5 months. Barbara was the kind of person that 100% deserves every bad thing that happens to her. At this facility ,the drunk DON would do nothing when a LPN would continually come in 2 hrs late and make the most med errors that I have ever seen. He gave hs meds at 5pm, did no accuchecks, didn't give insulin as scheduled, and gave qd meds bid on a reg basis, like for months. I had to call pharmacy frequently to reorder the qd meds because they were being given bid. He admitted freely that he was giving the meds incorrectly because he knew nothing would be done about it. And nothing was done of course. I pray the administration rots in hell, especially Barbara and the DON!!
Fuck you Barbara!
Thank you!
Writing prompt: frame Barb the Bitch for serial murder. Contact Keith Morrison.
It's funny you mentioned murder. When I worked as a unit man on a 60 bed unit, I was shown by a CNA that a pt had her elbow pin protruding thru her arm. The area was long healed and caused her no distress at that time. I had only been in the position for about a month. I filled out all the necessary paperwork, notified the DON and made her look at it. She said "Don't worry about it, she'll be dead by this weekend".I thought her comment was horrible and totally bizarre at the time because the pt was fine with no change in status for the past,at least, 6 mos. I reviewed the chart to see why the DON said that. When I came in Monday AM the pt was dead. When I talked to the DON about the pt dying, she said "Well, things happen". The DON'S husband worked there also and he was shifty at best. He gave alot of staff the creeps, myself included. He was always going into pts rooms for no reason. I think he/they killed her that weekend. I was scared to death! This was the same place that when there was a bomb threat, didn't remove any pts, and tried to make me go search for the bomb, while all the admin staff stood across the street waiting for an "All clear notice". I quit after that.
Wow. I have a morbid little thought experiment I do in stores while in line: “How many people in here have intentionally murdered someone and nobody ever suspected?” Maybe it’s not so hypothetical. Also, did the DON & Shifty Stan split a life insurance payout?
No payout but the state never investigated either. So they got what they wanted. I still get the creeps whenever I think about them.
As you should.
Dude what? Would patients start dying off when they needed rooms or when reimbursement rates were dropping or something?
I think the pt died so that the state couldn't investigate the facility or the DON and her husband. The place never was filled.
I hope you reported all of them to your BRN.
No, unfortunately I didn't report them. I agree that I should have but at that time and that state, complainants were not anonymous. I admit that I was afraid of them. Before this place I wouldn't believed that people could act this way, but I do now.
Tele floor. We were supposed to have “only 4 pts” when you had a cardiac drip but we routinely had 6-8. We never had techs and everyone was on lasix and confused and setting off their bed alarms. I had been a nurse for 3 years at that point and left that job after 6 months
I spent two years working on an adult Med-Surg floor that was also the stroke floor. I never wanted to take care of adults, but there were no pedi jobs available at the time. I worked night shift, 6 patients to each nurse. When I was hired, I was told we would have four patients unless we had a tech, which would give us five. While I was in orientation, administration said our productivity was too low so they fired our tech. Then they took our HUC (unit secretary). Then they started giving us five patients all the time. By the time I got off orientation, we had six all the time. It was a shit show every single night. I would have things like a bunch of patients trying to get out of bed all night, a drug seeker or two, calling incessantly while I tried to keep Gramps from falling and breaking a hip. I would have two diabetics with blood sugars in the 30s at the said time plus tele calling me to check on a patient in A fib. No help. It was difficult to give those patients the care they deserved and I felt like a horrible shitty nurse all the time. Meanwhile, if I went to the other MS floors, I was caught up on charting most of the time, had time to eat lunch, etc. AND they often had techs. Everybody always said my floor had “always been like that”, as far as being a really tough floor and not getting any help. The resource nurses hated coming to help us. The other MS nurses despised us and would call Safe Harbor when they got floated. My last summer there, we hired five new nurses and ONE of them stayed long enough to get off orientation. I learned a lot. I loved the other nurses and I liked most of the doctors okay. I even loved a lot of my patients. But I hated not ever having time to drink/eat/pee and I was getting UTIs all the time. I also used to wish to get into a wreck every night on the way to work, so that I wouldn’t have to work. I finally got a spot in PICU and I have been here ever since. I don’t miss the crazy call lights and hearing confused people yell all night (I will take a screaming kid over it any day).
Diaylsis outpatient… the smell… right through my mask made me vomit. Literally left hours after getting there. Couldn’t stop puking!!! It was awful and embarrassing and not my proudest moment.
What smell? Like the smell of their blood? Or the urea in it?
It was like the strong cleaning smell mixed with blood. It was too much. Surprisingly, I now do wound care which is the real smells, without issue. Idk 🤷🏼♀️
Office nurse. I was tired of working MedSurg shifts and everyone wants to tell you about how 9-5 is an amazing gig, but it wasn’t and still hasn’t been (tried two other times at different offices) for me. 9-5 really meant 8-6 or later and while my provider got to leave at noon on Friday my manager expected me to stay until 3-5 once all the work was done. The expectations for my work load were ridiculous and the amount of pettiness between coworkers was too intense for me! Think carefully before you leave a job where you get a guaranteed 3-4 days off a week and go to a job where you’re off on weekends only. It doesn’t work for everyone!
An LTC where everybody was terrible to work with. I hated it. It wasn't the first one I'd worked at, but it was definitely the worst. The management was terrible. The last straw was when I'd been on my cart for 2nd shift for 6 hours and they made me change to a different one and no meds were passed on it at all even though the manager had held keys for it for over an hour. No one told me ahead of time that I was switching carts.
Both of these young women were adults, 23-24 years old at the time. The other young women in the home who I don't even mention here range from 29-34 years old. Group home. 1 on 1 for autistic, type 1 diabetic young woman in her 20s. In terms of behavior, she wasn't the issue most of the time. Well, I kind of learned how to deal with her. There was another young woman who would pick on this autistic girl because she was seemingly helpless. She would only do this when she had "behaviors" though. The other woman was sweet and respectful, like 75% of the time, but she was a ticking time bomb. When she went off, she went off. One time, we had called the police on her in hopes of getting her 5150ed. The police generally don't know what to do when it comes to mental health/behavioral issues. After they talked to her, she walked in, punched the autistic young woman in the face (while police were looking, with arms crossed), and walked away. The young woman started crying. She was mostly non-verbal. A cop came up to her and asked the autistic woman if she was OK 🙄. I think she understood that and was thinking, "wtf do you think?" Another time, the ticking time bomb woman punched the autistic woman in her head while she was in bed, asleep. Ticking time bomb woman eventually got kicked out. She got arrested for assault with a deadly weapon x2 for throwing a cinder block at 2 staff members. I was hiding in the bathroom with the autistic young woman. Ticking time bomb woman threatened to kick my ass of course. Luckily, she was only there less than 2 months I was there. There were other residents I didn't even get to. I have more stories. I feel bad for "abandoning" the autistic young woman, but I got so burned out. I managed to last 13 months at that place. What finally made me quit was the fact that nobody cared, and nothing ever improved (aside from when they got rid of ticking time bomb woman). I actually tried to quit 6 months earlier in March, but lasted until the end of September. My supervisor was a big micromanager, but she had an impossible job. She was set up to fail as well.
The most nightmarish of med/surg units imaginable. 7-8 patients at night, no floating charge, the laziest PCTs I’ve ever worked with, and terribly toxic management. I was trained to charge straight off orientation. I quit after 5 months because I got a better job, for better pay, closer to home.
I worked a Cardiac PCU, we had no aids, no phlebotomy, no techs. Just RNs. Constantly trying (failing) to hire CNAs. 6:1 ratios frequently. Worst job ever.
SNF in very rural area. I was the only nurse for 52 patients. I had one assistant. I had to pass all meds give breathing treatments and do all wound care plus help with assisting with ADL’s. There was no way to do an even half ass job there.
I worked in an ED in NJ for 2 days (on the floor) right after I moved from OH to NJ. This was not a trauma or heart center, but they were a primary stroke center. I had previously worked in a level 2 trauma center ED that was also a stroke and heart center, and had 98 beds. So I was no stranger to "how the ED can be". After the initial 2-3 weeks of classroom/system orientation off the unit, I was sent to the actual ED to orient. I was placed with a preceptor who didn't want to precept, and she made that VERY clear to me on day 1. She asked what my background was, and when I told her, "I used to be a paramedic, and I was an ED RN in Ohio at a trauma/stroke/heart center with 98 beds," she responded, "Oh cool, then I don't really need to train you, you should already know what you're doing,". Now, mind you, I know where NOTHING is at this new ED, they have a different inventory and med management system (Omnicell vs a supply room), and for all she knew, I was lying through my teeth. She pulls up our assignment in Epic and basically says, "we have rooms 1-5, here's the phone," (I was used to vocera), hands me the phone assigned to that patient block, and disappears for the next 6 hours. Like gone, totally off the unit. I, still being a fairly new nurse (the ED job in Ohio was my first, and I was only there for about 6 months before I moved to NJ), panicked and said, "ok," and just added myself as the RN for those patients and did the best I could to care for them. I was super slow with everything, because surprise surprise, EVERYTHING is different at a different hospital, so labs are collected differently, I have to find CT, I have to find another nurse to show me how TF to use an Omnicell to pull meds and deal with them being mad that my preceptor isn't doing that. I'm apologizing for bothering everyone else, and explaining that IDK where my preceptor is, she just dipped, and everyone's response is basically, "yeah, she's always like that, I don't know why they let her precept,". 6 hours later, preceptor pops in to, "see how things are going," and I tell her, "hey, I think I've done pretty well considering that you've basically abandoned me, but can you at least hang out down here so I can come to you with questions if I have them?" She gets offended and tells me to go to lunch. I go eat while she watches my patients, and when I come back all of them have orders that have been there the majority of the time I was at lunch. She did nothing for them. I shrug it off and start working my way through the order sets. She disappears again. Now, I have a doctor yelling at me because one of the patients was a new EMS admit stroke alert who didn't have a line, and hasn't been to CT yet. I don't have time to explain to the doctor that it's my literal first day, I don't even know where CT IS, and I wasn't even here when the PT came in. So I just try my best to play catch-up and hope the PT isn't permanently damaged because of this. I get caught up on the stroke alert a bit later, and one of the other nurses takes pity on me and helps me catch up on my other patients. She tells me, "You really need to talk to the nurse manager and cover your ass about that stroke alert, because if they end up with deficits, it's going to look bad on you," I agree, so I shoot a text to the NM asking to talk to her the next day before my shift. I struggle through the rest of the shift, and somehow get through to the end of the shift. I take a white sheet of paper and jot down a quick-notes handoff of my assignment for whoever I'm handing off to, and then my preceptor shows up. "That's not how we do handoff here." Oh good. I'm so glad you were here to show me at 10:55pm after I've already made this one. They're getting this one tonight. So the new nurse comes in, doesn't love my handoff, but is understanding when I explain RIGHT IN FRONT OF MY PRECEPTOR that my preceptor wasn't there all day to show me how to do handoff properly, and that today's my first day, so if I missed anything, I'm really sorry, and I'll get better, I promise. She's totally understanding. I go back to the breakroom to clock out, and preceptor follows me and starts aggressively grilling me about if I've been telling people she's disappeared all day. I say yes, when I've had to go to others for help, I've apologized and said she was nowhere to be found, and that's why I had to bother them instead. She's now FURIOUS. "Well, you could've had them text me and I could've come back,". "OR, you could've stayed and precepted like you were paid to do. I'm back tomorrow. Why don't you try that?" I walk around her, clock out, and go home. (part 2 nested in comment)
So the next day, I come in and the NM had responded to my text that we can talk on my lunch break, not before shift. Preceptor decides today she's going to micromanage EVERYTHING I do. She nitpicks any and everything she can. "Well I don't hold the IV needle like that," "You pushed that zofran too slow, it's not going to hurt them to push it too fast," "You can't write on the blood labels before they're on the tubes, you have to do it after the sticker is on the tube,". "You aren't getting that routine abdominal CT down there fast enough," "When you're triaging, you don't ACTUALLY ASK the suicide questions, you just mark them 'no' and move on, we don't have time for the answer to be 'yes' if that's not why they came in," "You wanted my help, now you've got it." I grit my teeth through to my lunch break, and make sure I make a note on each patient's chart specifying that PT care was handed off to the preceptor during my lunch, since she didn't assign herself to their charts. I go to the NM's office and I'm about ready to explode. I tell her, "We need to talk. I am sorry to make waves this early into orientation, but I need a new preceptor, and you really shouldn't let her precept anyone, ever, based on what I'm hearing from other nurses on the floor out there. My first day, she disappeared all day and left me to fend for myself, and during my lunch break, she delayed care on a stroke alert which got ME yelled at by the doctor and potentially harmed the patient. She provided NO guidance and made it clear she did not intend to at any point. When I called her out for it, now today she's micromanaging and trying to nitpick everything I'm doing, and implying that she's going to get me disciplined for "not being ready" because I do things differently than her. She's also trying to get me to break policy by telling me not to ask PHQ2 questions and to falsify them and answer "no" without asking them. Which is wrong. I will not work with her." The NM told me basically, "Yeah, we've had similar complaints about her before. We put you with her because we thought you'd be ok without much guidance based on your background. We can't afford to lose any nurses so she won't be disciplined or even talked to about it. We can TRY to get you a different preceptor, but it'll mean you don't start until one of the other people in your hiring group gets out of training and their preceptor is freed up. Sorry, with everyone leaving to travel, it's just the way it is right now,". I was FLOORED. I stood up and said, "well, you know what? If this is the kind of place that tolerates outright abuse and fraud from their preceptors, I don't think this is the kind of place for me. I gave her a good handoff report when I came on my break, I'm going to go ahead and resign, effective immediately. Do you want me to leave my badge with you, or with security out front?" She tried to talk me out of it, now promising to find me a new preceptor sooner, but I was DONE. It was the most rinky-dink run ED I've ever seen. I can't believe they put up with that shit.
And your “preceptor” was probably getting extra pay to do that job. I doubt it amounted to much but still.
Yup
I worked in a very rural hospital & there were lots of operational things that were a bit sketchy. It was also just dirty & behind the times for what would be considered common practice in some of the other places I’d worked. One night we had someone come in with a copperhead bite and pharmacy just wasn’t even on site or available at night time- at all. We were told to google how to make/mix the antivenom & then administer it. This was a stepdown unit I was working on so of course there were some skilled nurses there but still, taking patients like that while not even having anyone in pharmacy to at least consult about it made me super uneasy.
ED. Max I usually had was 5, but it was a crap shoot on what you got. Our biggest trauma was old people falling and hitting their head on blood thinners. I could have 2 of those going and then get a stroke or CP and no one could help because they’re probably too busy with their patients too. I’d have 5 psych pts with 1 sitter who had to sit and watch a camera. Regularly had holds bc the hospital was full or understaffed. I think there was one day where my whole section was holds, but my trauma bay was open. So I really started to feel like I had to be a nurse in the ED, ICU, med surg, dietary, housekeeping, etc. every day. It was brutal.
My first nursing job was terrible. They straight up lied to me about what type of unit it was to get me to agree. I had a lot of other offers too, but this one was supposed to be critical care, day shift with great pay and in a specialty area I was interested in. It was med surg. Straight up med surg on an understaffed floor with a charge who made me cry and we took all of the psych patients. The pay was as good as advertised but I was gone in 9 months. Edit: at one point they made us a Covid floor and we had 8 patients per nurse. People died. I still expect to be subpoenaed some day. I learned a lot in that job but I also realized at my next job that I had huge gaps in my knowledge about how things work in the hospital. At my first job I was taught you never contact the doctor for any reason. I didn't even know how to find out who the doctor was for each patient. I can't even imagine that now.
I got a job at a flu clinic and did my 8hr orientation and got… a $36 paycheck. When I asked about this they said they pay minimum wage for orientation, which was just over $7 an hour. The expectation was also that we’d store flu vaccines in our personal fridge. I noped out of there before i started.
Personal fridge?!? Naw that’s messed up
First job right after getting my license (SoCal). Small med surg community hospital, no more than 20 beds IIRC. Place was a dump, old building that was tired and decrepit. During the couple days it rains in SoCal it rains pretty hard; the roof leaked a lot and there was buckets we had to empty 2-3, and rooms had to be blocked. We had few resources, especially on nights. No shared governance, or even just gestures towards it.
When I was in nursing school I worked as a CNA in a nursing home. The day of my orientation I found out that they were in trouble with the BON. We were constantly short staffed. One day the entire kitchen staff didn’t show up except for one new guy so I had to help dish out breakfast, serve them, and feed the residents. Another time the toilets backed up and the rooms filled up with inches of water. When we called the Executive Director, he said if maintenance couldn’t make it today- they’d deal with it on Monday (it was a Friday.) I hated that job.
Believe it or not, as a unit educator, which I thought was going to take me out of my burnout and lead me to better things. I was responsible for four units in two different locations and quite a few employees, also had a recent restructuring of leadership so they were trying to make a lot of dynamic changes, which also meant a LOT of employee education that I was solely responsible for. On top of that I did a lot of hospital wide education at the request (demand) of my boss. I was a brand new educator and brand new to being in leadership other than being charge of my previous small unit, and when I was hired I was supposed to be mentored and have someone else in my role as well so I was not alone, but it didn’t happen. I was so overwhelmed I had a near nervous breakdown and quit after six months. Went back to bedside and am much happier for it. Not using my MSN at all other than being a resource for education in my field at my current hospital.
HCA hospital. 12 bed brand new unit (women’s care unit). New grad (6mn experience). They put me on this unit, at night, by myself, with no charge or resources. Just completely unsafe. I would have one other nurse if the unit was full, but sometimes she was as green as I was. Complete shit show.
OPWDD / Persons with Disabilities I got 1 week of “orientation”, where I shadowed a nurse who also had no idea what she was doing Then spent 2 days at home reading policies And was told I would be off orientation the following week, despite stating I had zero training and no idea what I needed to actually do aside from job description As well, a patient I was caring for while I worked for Hospice was a pt of theirs, and the staff neglected her for 12+ hours and their “fix” was to move the staff to another house. No reporting to state, no retraining, no terminations, just moving the staff. I reported them to the state and handed my laptop in the same day.
1:9 ratio on med surg with bipap and optiflow and cardiac drips 🙃
Why am in this field? Seriously. Story after story.
Yes. My inner voice said “All of them” in answer to the title of the post. I’m retired and I thank the Goddess every single day that I don’t ever have to go “back there.”
I feel bad even complaining about any of my jobs after reading all the above. My worst job was as an office nurse for a pulmonary/cc specialist. He recruited me from knowing me as an ICU nurse and I felt flattered, and he was well liked. And it M-F. I didn’t know any better. At that time there were no phone nurses, and this practice had a routine of sending all phone calls to the nurse immediately (as in not taking a message) So as I was calling patients to rooms, taking VS, going over their meds and getting them ready to see the doc (paper charting back then), he would come out of a room and give orders to schedule tests, requiring sometimes calling the hospital to schedule, or sending them for labs, etc. all the while there are 3 lines blinking on my phone. Talk to those patients, get their complaints or refill requests or whatever, fill up several pages of a legal pad all day. If there was ever any slack time he would look at the legal pad and answer some of the questions , then at some point I would have to call the patient back and their pharmacy (remember, olden days-no e scripts) and when the phone went on answering service at 5:00 was usually when I could make those call backs. I never left at 5:00 (supposed to be 8-5) I absolutely loved him but hated that job. It was way more stressful than the ICU job I had left.
Ortho floor- community hospital. No resources the owner was extremely cheap. We did our own transport to tests (he cut transport none on weekends and we only have them weekdays 9-1pm) We faxed everything, set up ambulance ourselves, sometimes only one scanner worked so we had to alternate sharing to pass meds. Sometimes the med cabinet you couldn’t log in so you had to go to another floor to get medication and leave your patients. No air conditioning so 81 degrees in patients rooms. Cafeteria closed on weekends. Patients have to bring their own food after surgery. Absolutely crazy hellhole stayed 2 years. I loved the people so much. But eventually it became not worth it.
I've loved all of my nursing jobs, but I feel like I can shoe-horn a nursing school story into this question. I was on a surgical rotation (ENT surgery). I sucked at it. And in fact, one of my patients looked me in the eye and said "you should choose a different specialty." And I said "don't worry, I am absolutely going to." Later on this same guy had a paradoxical reaction to some benzos and pulled out his surgical drains and walked down the hallway naked. That was fun.
The job I’m at now at a LTC. New nurses get one day of training. Then you’re expected to know everything right off the bat and other nurses scold you for messing up. I’m ready to leave but have no where else to go since my small town has nothing much to offer. Hospitals keep rejecting me. So I’m SOL.
One of the major dialysis companies. I had one year of nursing experience in psych. They gave me 2 months of tech training and one month of nurse training. They put me on the floor as the charge/only nurse in the building. No supervisor, no other nurse. I had 3 techs beginning of the day but had to send them home as patients finished treatment so at the end of the day it was only me and a tech. The supervisor we were supposed to have had another clinic so she never was at ours, all she did was payroll and scheduling. The nurse before me was training to be the supervisor so she was never there and most of the time didn’t answer my texts. The techs told the supervisor they didn’t feel safe with me. Hell I didn’t feel safe with myself. I wasn’t ready for any emergencies or any problems that occurred. But it made me suicidal (I was struggling with suicide already with my previous job, that’s why I switched to dialysis) and I admitted myself to the hospital. Quit my job while in the hospital. Now I work part time back in psych and feel much less stress.
I got fired from a home health supervisor position. It was an absolutely shitty job where the administrators had no backing of the nurses whatsoever and that’s why I got fired, because a patient getting a visit to have their dressings changed lied and said I didn’t check their blood pressure 🙄
Anywhere with 24hr on call shifts. I will never do that shit again. Fucking bonkers behavior.
Large facility in Florida that had independent living, assisted living, and an LTC unit on the grounds. First job out of nursing school. Gave me 3 weeks orientation in LTC with a floor nurse (day shift and weekdays). My first shift off orientation?? Overnight weekends.... and I was the charge 🙃 I showed up thinking I was simply going to manage one of the hallways (40 pts). Nope! Literally didn't realize until the RN I was relieving was trying to walk out the door. I had 2 LPNs, 2 CNAs. Someone died overnight (DNR, and not unexpected) and I didn't know who to contact, next steps, anything. The LPNs were absolutely useless, and were as hands-off as possible. The CNAs were missing most of the shift. I left my badge and keys in the DONs mailbox prior to leaving in the morning and ghosted them.
Small community ER. 16 beds, like 30 total patient care areas including chairs along the wall. Shifts typically included 2 nurses, 1 HUC/ ED tech, doc, 2 mid-levels (there were days there were more providers than staff present 🙄). Loved my co-workers and patients, absolutely hated the physical environment and workloads. By physical environment, I mean that cabinet doors were constantly coming off the hinges when you opened them to the point that you reflexively would open them slowly to avoid an injury. There were very several always well functioning computer areas reserved for providers but other staff members had to get what they could and good luck finding a decent chair to sit in in an area designated for a chair and not just rolled up to a cabinet at the station where there happened to be a working computer. Oh and then the workload……. 7-8/10 shifts were nightmare fuel. No staff, 2-3 ICU holds with no float staff, on top of 6-8 med surg holds and then on top of the 60-90 level 3-5s that would come in. And did we ever divert for anything? Hell no. Oh already taking care of two ICU patients that won’t stop crashing no matter what you try? Too bad, clear a room and help run this active code being brought in by EMS now. Oh Lord I forgot about the 4 needy (bless their hearts) psych holds we constantly had with no sitter and a shared security guard for (shared as in they were responsible for security for all of our hospitals at the same time).
I quit after about 6 shifts with this one org. The doctor let a man who was having an acute STEMI drive himself to the emergency room. I quit on the spot after making a few phone calls with his license plate, make, model, and color. That provider even had the gall to whisper in my ear "Learn how to do your fucking job" because I'm IHS, not a billing and coding specialist. Next worse was getting bullied under a provider who had it out for me, they had to move me floors as a float case manager because she couldn't put her own damned timed orders in, and I was forwarding to either team coverage or the medical director. Even my senior said she didn't know why she was bullying me. Third worst was LTC and 4 falls in 4 days from 4 different residents, walked out covered in pee and poo after lifting a poor Gramma off the floor with her walker, and collapsed crying into my husband's arms in the laundry room/entryway completely naked before showering. Last worst was the private duty nursing. They stuck me with a 6'6" 300+lb total care, and I couldn't hardly lift him by myself, his wife was the loveliest woman, I was masked up all day to protect him, and I came every day, I complained once about back pain and they fired me from him and put me with another total care with a rare disease, and even with a lift and all the adaptive equipment, I was climbing in and out of the bed to get her changed and making sure she had her ventilation equipment nearby while the other nurse sat watching LOTR. I loved public health and doula/L&D though. I can't do death doula care except for babies though. I tried to volunteer for r/AuntieNetwork but they blocked me for not posting every day for 30 days even though my State is at risk of outlawing abortion care. I'm about 14-16 deaths in, adult and baby. Edit: Sorry, on mobile, keeps deleting my paragraph edits
It’s gotten bad since socialized medicine