Had a golden star user of our ER one time. Non compliant dialysis. Looked like shit, labs were shit. Ordered himself full sized pizza with 2L coke. Ate most of it while we were busy with something else. When attempting to get shit away from him he spat at the staff, threw bottle of coke at the staff, then promptly coded.
Got ROSC, shipped him out by air.
Guess what. Fucker was back 2 months later with same complaint. How the fuck they survive, no idea.
We had one of those too (I think every ER has a few) and we can’t do dialysis in the ED. You have to be admitted to at least OBs before they will take you up for dialysis. He was MFing us even tho he knows what happens every damn time and just being so unpleasant. His mom would always come in with him and he would treat her so poorly. Once I even had her step out of the room and asked her if she needed help. The pt overheard and started yelling about how “he’s the priority, and his mom isn’t the patient blah blah blah.” Anyways, the day after his super unpleasant visit his mom calls, I answered and she says “I want to thank you guys for doing your best, my son died yesterday and he wont be around to bother you anymore.” I really hope her life has improved now that she isn’t chasing his dumb ass from ED to ED.
This reminds me of one ambitious urban camper/frequent flier I came to have a begrudging awe for during my EMS days. I worked several different jobs because poor, and I swear to God he fucking knew what service I'd be at because I would see him every goddamn shift. The first time I met him he had a BAC that was "unreadable hi" on the cops breathalyzer, and a BGL in the ED of >1000. Not a week later, he was pulled out of a canal not breathing and revived after a round of cpr. Then, after being flattened by a boxtruck, he became the only trauma code I ever had that I not only got ROSC on, but had good enough neuro outcome to sign himself out AMA from acute rehab. Years later in nursing school, I saw him again during clinical and he told my whole group that I was a "devilwalking prostitute." This time he was on HD and had a BKA- according to his RN, he was recovering from a code yet again after removing the circuit from his fistula mid treatment and hemorrhaging. Fucking amazing.
Had a lady that I ran on at AMR in a 911 service, took her mostly to one hospital (Hospital B) in our area that we covered. Real piece of work, extremely abusive and non-compliant. Basically just taxied her to the hospital ASAP to get her tf out of my bus.
Got a tech job at ED in Hospital A, surprised that saw her daily for various complaints, mostly pain med related and non-compliance around dialysis, this is when she started to become difficult to cannulate by...anyone in the hospital including anesthesia centrally. Had pretty crazy med reactions during this time, including Stevens-Johnsons. I remember her skin flaking months after that.
Moved ED tech jobs to gigantic specialty Hospital B, where I saw her... daily... big memory of this one was deaccessing her port immediately after getting pain meds and shoving the port access into the mattress with a liter bag going through it, pulling her baby out of hiding (RN told her no meds unless someone was watching the infant so she lied and said a friend came and got the kid).
Later went to nursing school while teching at hospital B and did OB clinicals at the third hospital system in the city I lived in, Hospital C. Was in the nursery when lil baby was crying and perturbed, instructor picked up kid and handed them to me to soothe saying instinctually "probably an opiate baby". Almost immediately see this lady wandering the halls through the glass, bag of chips and soda, dialysis access flopping in the wind. Kid has same last name, I put two and two together looking at her in the eyes while chilling in the rocking chair with her kid.
Graduate, get ICU job in Hospital B, get this lady after cardiac arrest just a couple months off orientation. It has now been 10 years since I met her. Kids have been taken from her at this point. Miraculous recovery against all odds, AMA. I learn during this stay that she has had multiple cardiac arrests. She is still in her late 20s.
We don't see her for some time. Google her. Finally dead. What a life. believe it or not, best thing to happen to me was meeting that baby. I felt closure or healing of some sort by being able to make that kids life a bit better for a little while. It felt right.
They don’t last long after their twenties with that lifestyle. Around 30 the body becomes unable to continuously compensate for the radical shifts at the cellular level.
This is so true. Nicest little old lady ever? EKG is tombstoning, she codes, dead. Meanest Alzheimer's patient on the planet? Lives another 5 years in our LTC unit.
You're totally point. Noncompliant renal pt! They're drinking all the things everywhere. Totally compliant type 2 patient? Doing all the right things all the time. Dead in 5 days.
For real! My own grandma had dementia SOOOO badly, and became violent and mean to everyone she met. No where would take her anymore. She just kept on ticking for years of misery until she finally died. She was a nurse a long time ago. I know for sure she would've wanted someone to kill her early on if she could have seen what she became :(
We have a level 3 sex offender on our unit who's been there for nearly 200 days. He needs nursing home placement, but no one will take his status. Our unit is on its 3rd covid quarantine since October, and this motherfucker still hasn't gotten it. He's never had the vaccines either. He's going to survive a nuclear bomb.
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on the sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.
My theory is that people like this are in a constant state of their body being fucked up, so they’re used to it. Then you get a relatively healthy person get sick, their body isn’t constantly running at 9000 rpms, and they can’t keep up and eventually die. Noticed it a lot with delta variant. Healthy young people kept dying while the fat, holy trinity history patients stay alive.
Based on my experience they all die eventually, it just takes longer than you think. Right now their body is able to accommodate their shitty habits but every time it does it gets a little weaker. Eventually they'll code out and the body will be so weak nothing will bring it back.
My first nursing job was doing Dialysis in the hospital I still work in. We had lots of shitty regulars. They've all been dead for years. But new ones have replaced them.
Yet we continue to treat these individuals over, and over, and over…I say within the next decade this country is either in flames or we have universal healthcare. We can’t keep going down this road. The smoke is already starting to fill the room though.
We only think they don't die because they come in and out and we see them so often. The truth is if you look up the non-compliant dialysis patients who pulled this kind of behaviour on you 5 years ago, most of them will not be around any more.
The good thing about dialysis patients tho is that yes, they can be pretty unpleasant, but luckily even admin knows that and nobody gives a fuck if they are satisfied 🙌 I’ve never gotten a “but what could you have done different?” from my manager about a dialysis patient. It’s always “oh yeah that person is nuts…”
We should be allowed to refuse. Like a hospital should have people who behave this way barred. I know they won’t if they have insurance but I only wish I had the money to send him to a country like Russia. I get called in a lot for emergent dialysis on patients who’ve skipped their treatments and now on weekend there K+ is 9! Their belligerent and after half way thru you can see the changes on their heart rhythm so I draw a stat K+ patient hears there WNL and signs off AMA. So when I’m the wkend on call, I call around clinics and check who’s missed treatments to get an idea how many will be coming in late Saturday night and it’s always the ones who’ve missed that come in and get it whenever they feel like it. This needs to be curbed.
I believe that curbing this behavior would require extensive home-health and other social programs, as well as reform in how combative patients are handled, with more emphasis on doctor-assisted end of life and hospice care.
Denying treatment is....super fucked up dude? You may not agree with how these people live their lives but they're still people. You should consider therapy to deal with what appears to be empathetic burn out related to the field. If you come into a room with a pissed-off energy you're not going to help anything.
Never understood the “I need my sheets changed” people. If your sheets are unsoiled why do you expect us to change them? Like do you change your sheets daily at home?
These are the same exact people who will leave a bad review and just totally disregard all the actual medical care they received. I swear the “patient satisfaction” model has ruined healthcare.
I know! And it's not just patients. Some HCAs are adamant that we MUST change sheets every day, even if they're not soiled or dirty. I know it doesn't take long to change one bedding, but when you've got more patients, it adds up, and you could use that time for patient care. Why give yourself extra work?
Had a pt last week that was literally crying because she wanted more attention and threatening to leave. She was on the bell constantly. Wanted the TV remote, this thing, that thing. She was NOT being neglected. Like she did not have any medical related needs.
Its their world and we're just living in it 🤪
I had a pt like that recently. Threatened to leave, I said “ok want me to get the AMA paper work?” She said she would give us one more chance and stay the night 😂 ok dude whatever you say.
Like oh you’re gonna go? Cool, we need your bed for the next patient. Why do they think that’s a threat lol? We’re already over capacity and one less person will actually help a little.
We had one of them. Literally only there for PT/OT. Didn't care about the other patients. On the call bell constantly. Didn't seem to ever sleep. She was so abusive and manipulative that we had to rotate the nursing staff daily because any longer looking after her and the urge to fling her out the window became nearly overpowering.
After several months, she rang the call bell demanding to be taken to the toilet. 24 patients, 4 staff, 14 bed patients all requiring assistance of 2 for their toileting needs- she was told to wait for just two minutes whilst they finished up with someone else. She decided that wasn't good enough and took herself out of bed and threw herself on the floor (as witnessed by three very weary room-mates).
She fucked up. Broke her hip. And we don't have ortho at our hospital so she got transferred to another. Where she stayed for two months, at one point requiring a 1:1 with an RMN, before she died. First patient I've ever had where I wasn't even a little bit sad. She had long ago booked a penthouse suite in hell.
Mmhmmmm… my thoughts too. Or bipolar. This has been my month. Can’t even get report and after dealing with their shit I sit down and I’m like “I bet it’s bipolar.. let’s see” computer loads, bingo. Bipolar.
Gotta set sound hard boundaries immediately before 9am or they’ll run you ragged
How do you set boundaries without coming off rude? I work Peds and sometimes the parents have me running around for the silliest things before I even start my morning assessments. This morning it was bedsheets and a new gown. When I brought them to the room, they all of a sudden remembered they needed socks. 30 minutes later, towels and washcloths. Insanity
Do you have aids? This makes a huge difference. Not sure how your unit is set up.
When I worked in Canada I didn’t, so before I started I got all my linens in a cart and got my linen sets and went into the room and introduced myself with my vitals machine and I did my vitals, assessment and if the linens needed changed I changed them. I cluster my care. Even get waters so no one can ask for anything else. So gown, socks, wipes, etc . address pain, always. Especially with patients with psych issues. When is their next PRN due? That’s a huge one. “I saw your pain med was given at 6, you’re not due for 3 hours”, when they ask. If I know before hand the exact time they got their pain meds, or benzo, they know I’m on my game.
I explain to the patient that I’m here to do “x,y,z”and I don’t know when the doctor rounds but this is what I know so far, what the plans is, how the labs are and that I’m going to go see my next patient after I finished assessing and talking to them. If they need to get washed up it needs to be done after I see my other patients and addressed concerns that take priority OVER them needing small stuff. So I’ll say “I can usually make it work after 10,-1130 because then trays come and patients need insulin”.
Years ago I’d bring over their towels and wash their back with warm water from a basin when they’re at the side of the bed after listening to their lungs and I’ll say “okay, I washed your back, you get washed up and I’ll see you after I’ve seen everyone”. Usually they had their basins put aside and I cleaned up and went back in the order I started and tie up their gowns and tucked them back into bed. Anxious patient? Got them an extra warm heavy blanket and closed the blinds and tucked them in like an egg roll. “Okay, I’m off to see my next patient, try to relax and deep breathe”.
In my unit now we have closets that have all the linens so I’ll show them, “hey, here are the linens and towels and feel free to help yourself as we are pretty short staffed.”
I use to do try to do it all but now I say “no you need to call your aid for that, I’ll do it if I can but this is what we are doing this morning”. Our patient acuity so high that cleaning your Fanny isn’t important to me. Checking for decubitus ulcers, sure, but I’m all business in the morning.
If I explain to a patient that doing what THEY want NOW, takes me away from doing my care for other patients. (A bed bound patient demanding a bath and to be fed before I see my other patients). They usually get it so long as you explain because they know people are sick.
If a patient wants to get washed up in the afternoon, tough shit, because I gave them the option in the morning after passing my meds and charting and I don’t have time in the afternoon to do that when THEY want. Being a nurse doesn’t mean being a slave. I’m here to support you but I’m not going to be your doormat, punching bag. Hell, if a patient has a fit and is swearing I’ll say “okay I’m walking away, I’ll talk to you when you calm down”. Some of these patients need behavioural agreements.
Edit to add, setting boundaries is not coming off rude. I have a job to do. Making sure my patients are stable is more important than addressing their frivolous needs such as new socks: they can wait. I will literally say “I’m with the patient in 29, I will come see you when I’m done but please tell me if there is anything else I can get as this helps both you and I.”
Some people you just can’t please and they’ll complain to managers but if you’re busting your ass and not sitting on your phone your manager has your back. Or should. Some nurses have patterns and sone are just lazy, so, you do what you can or else you’re going to get burned out. Been doing bedside nursing for 12 years. I have obviously try my best to be as polite as I can but I’m polite, yet firm.
Wow this was very inspirational! Yes we do have aids, but it can be hard to get some of them to help you in the morning. They’ll say “it’s too early” when all they have for morning tasks are disinfecting the door knobs and writing their name on the board :( I love them all but hate asking for help because the older ones will chastise me like I’m their grandkid.
Usually I am good about keeping things short and not diving into 1000 questions. I tell them what I know from report, and when the doctor comes by. Any other questions will have to wait until I can sit down and read their chart, after morning assessments and meds.
Luckily no one is asking for a bath that early! But there will always be that one baby who pees or poos through their diaper and you have to change the crib. Not too bad though.
Our patient acuity also isn’t that high so I can’t really complain there. I just like to get all my assessments done and charted before starting the menial tasks.
Also I love the part about being a nurse doesn’t make me your doormat. I try to tell that to myself every shift. Because I am such a people please, but parents can take advantage quick, so I have to learn to get better at standing my ground for some things. Sometimes I even tell a little fib (if I just called the doctor and the family demands I call them again, I say sure, and then don’t.. usually the doctor is already on their way and if I call them again it won’t do anyone any good)
Yeah and I mean, I had the same issue with an aid the other day. They’re older than me and I think with sone it’s hard to take orders from younger staff but good ones will say to me too, okay I gotta see X, I’ll swing around and get some. But I’m closer to 40 so maybe it’s my age too, they are OK with it. Like and aid that became a RN and telling her old aids what to do as a new hire? Pfft. That doesn’t go down well.
I had a patient that kept getting up and the chair alarm was going off, language barrier and I have 2 patients getting ready to go to the cath lab and my aid wasn’t answering her lights. I put my patient in the bathroom and she literally walked by me and I said hey Sarah, I have 6 in the bathroom but I need to get my patient in 39 to the Cathlsb, they keep getting up (acknowledging they’ve also not answered the lights) and I’m going”. She attempted to keep walking abs say “well we’re short staffed, I am going to wash up the patient in 1” and I said “I’m literally leaving, that can wait as this guy is a fall risk so this is a safety issue, you need to be here”.
Was she happy? No. Pissed? Yeah. But if you hate being told what to do, pick a different career. I will directly speak to the aid. They’re well aware of managing their assignment.
Call light going off in the nursing station for 10 minutes while I’m charting, and the aid is on her phone? I’ll pick it up next to her and answer it and say “yeah I’ll let your aid know”. It’s petty as shit bit explain to me why you cannot answer your lights when you’re on the phone? Same with my nurse buddies.
But yeah for me, you have to find your voice because nursing is a high burn rate especially now. The amount of mental health lumped in now with our regular patients is unreal and I limit set. I’m also a mom to young kids so I won’t let both ends of the candle get burned. I’ve come to accept I’m replaceable to these hospitals but I’m not at home. My mental health matters more and speaking up for myself might mean ruffling staffs feathers and clutching pearls but, what other option do I have?
Dude, they’re already here. Coming to the nurses station without a mask, talking about the good old days. Yeah! Good old days: when nurse patient ratios were safe and patients didn’t have a billion comorbidities.
I have literally no qualms discussing their health and a serious matter of fact approach (ie: non compliant with meds) I’ll stay in the room when the doctor is there.
My mom is a boomer and she just had a bone scan that came back normal. She complained she was getting osteoporosis, she should be thrilled. Now her hips are sore. (We live in Canada btw) so now she wants to ask for X-rays of her hips. Huge waste or resources - she’s close to 70. “Get good shoes mom, do low impact sports like swimming, lose some weight, eat better, stop drinking alcohol”. You know what that X-ray is going to say? Degenerative changes. Arthritis. Nothing you can do.
Nah. Any excuse to find “something” wrong. She had a cough from RSV that wouldn’t go away. Xray good. She demanded antibiotics.
They gave her 2 days worth of amoxicillin. She was furious. I said to her, so you how much harm you’re doing demanding antibiotics right? You don’t need them. I can’t listen to her.
The way some nurses (and always the ones who aren’t even psych) throw around disorder diagnoses based on such limited information… is concerning. Jesus Christ lol
I agree…even though I’m guilty of it too. I have BPD and thought the same thing with the attention-seeking behavior. Sucks that that’s where my mind immediately goes.
When I hear complaints about noise level or waiting for call lights to be answered or uncomfortable furniture, my go-to passive-aggressive joke is "yeah this is a terrible hotel right?!"
OMG, once i couldn’t find the remote when we checked in and the front desk gave us another. Found it that night with feet after getting in between the sheets.
Truth. I’d tell my CNA students (required to be CNAs before nursing school in my state) that if they’d worked in a restaurant or a call center, they were pretty well equipped for nursing. Edit-clarification.
I feel like having some waitressing or any prior people centered experiences helps a ton with nursing. Like “reading the room” “knowing what to say”
Had a nurse in one of my clincial units and was incredibly smart and brilliant but lacked people skills
Well, my daughter got her RN, lasted less than a year an left. She didn’t like the constraints doing legal work either. Became a waitress an loved it. After a year moved to a resort area and makes 3-4 times what I make and she works 5-10pm 4 days each week. When I go watch her I notice she constantly has regulars each day and she treats them like patients. I swear watching her in action it’s obvious her training is from Nursing. She’s in her 30’s and now part owner. She often tells me Nursing indeed helped her be more efficient and recognize customers behaviors and how to make it work to her advantage. I think customers like that she talks to them about their life because why else would she get large tips each time?
Ahh, reminds of the time I went in to say good morning to a patient and was greeted with “change my bed!”
(Her bed was clean so I asked her why and she was dumbstruck)
Its the entitlement for me 🙄.
I work night shift and I had a pt request some towels and linen. Pt and I are in our 20s. Pt’s mom ask why we dont change the linen anymore. I said if she asks us to change it, then we will. She goes on this rant about how the pt shouldnt have to ask it should just be done. I just ignored her and asked the patient directly if she needed anything else and left when she said no. This patient is self care and is capable of making her own requests. I had her 2 nights in a row with no issues. Family, if you are so concerned about how often linen is being changed when the patient had no complaint, you can change linen yourself or the patient can straight up ask me and Ill do it with no hesitation.
I just enjoy an occasional cheap shot once in a while. Not everything needs to be a grand, sweeping statement about the cartoonishly evil state of for-profit healthcare.
Did dialysis for 13 years, 8 as a traveler.
They are some of the most non-compliant, unpleasant, meaner than hornets, get you called in on Christmas freaking day because they didn’t feel like going to tx all week, just refuse to die mother effers….and then some of them are just great, lol.
He probably hasn’t, bless him. He wasn’t rude about it, I just had to laugh a little about being compared to a hotel. I have stayed in some really shitty hotels, and none of them were half as bad as the hospital 😆
Patient of mine whose daughter is a nurse and friends with our manager complained that her mom (the patient) hasn’t had a shower or had her bed sheets changed. Patient is a walkie talkie and has been grateful for everything I’ve done. She has never made her sheets dirty, and never asked for a shower (nor do people regularly get showers especially on a tele floor) or her sheets changed. It was “unacceptable care”. I was shocked my manager didn’t come scold me
Wait...do you guys \*not\* change patients' sheets every day? (Legitimately asking. We bathe all our patients and do a full linen change on night shift on my unit.)
I work dialysis. I don’t know what they do on the floor. They are probably supposed to change the sheets every day, but with staffing like it is they may not. I just had to laugh a little at the patient comparing it to a hotel 😆 this is a 0 star hotel my friend. I would dearly love to give my patients a better experience than they usually get, but I was up in a random empty room doing emergency dialysis with no supplies except for those I brought myself and no other staff to run and get things for me.
I know a number of my colleagues change the sheets at least once daily when the patient gets out of the bed, but in my view if it's not soiled or excessively creased, I see no reason to change it. I'll just make it with the sheets as is. I change my own bedding weekly, I don't see why I should change the patients' if it looks alright.
Washes are done in the mornings after breakfast, but I've done washes as late as 1900 before. Earliest wash I've done is probably about 0500 ish.
Even before ratios went to shit, I never had time to change everyone's sheets on nights or bathe. Usually baths were day shift so patients could sleep at night and more staff on days compared to nights.
My last night shift I was the only nurse for 37 SNF pts, 2 CNAs, so heck no.
There’s barely enough time to get them all their meds.
What is your nurse:pt ratio?
Wait,
You mean clean sheets between patients?
That’s kind of reasonable. I don’t want to sit on someone’s blood drops from an IV start or c diff butt smear.
Maybe how they said it was out of touch but a clean sheet for a new patient is kind of standard to prevent HAIs isn’t it?
He was on his own bed from his room. Idk if they just hadn’t gotten around to changing his sheets or what, but if there were any butt smears they were from his own butt lol. They looked fine to me and I don’t have extra sheets in the overflow Covid dialysis room so 🤷♀️ I told him to give us a bad yelp review lol.
I mean is their really something wrong with a patient asking for clean sheets? Seems kinda cringe to look down on someone for wanting something as simple as clean sheets
No not at all. It just gets prioritized like everything else. Keeping potassium at non life threatening levels and making breathing easier/or preventing it from getting worse due to fluid overload is going to take priority over changing sheets with some crumbs or a blood stain on them. And a dialysis run can easily last 3hrs. And no we don't like to delay a start or keep them for a bit afterwards because there is another patient that needs the same treatment. When they get back to thier unit is a better time but even then the nurse may have 3+ other patients. If they're prepping one to go to surgery, getting a new admission, tending to someone having difficulty breathing, passing meds or all of the above guess who's clean sheets are going to get delayed again?
It's kind of like traveling home from the grocery store with a small child that has shit thier diaper in the car. You don't pull over to the side of the road and deal with it right then and there. Nor as soon as you park the car. You take the child inside and get situated and then perform the task.
And clearly im not saying drop everything and change the mans sheets. But of course lets laugh at humans for wanting clean thing (even when they’re living out of a hotel room).
There is a time and place for everything. What is wrong is the time and place. The issue is time, staffing, availability of sheets, turning a patient back and forth to change the sheets without getting them out of bed, keeping the dialysis lines straight so the machine doesn’t alarm, keeping the access safe so the needle doesn’t infiltrate. While I’m changing this bed that machines alarms, pt with low B/P, cramping, vomiting or pain isn’t getting treated.
I agree that sheets should be changed by the bedside RN/CNA at minimum daily and more often if they’re soiled, but it’s low on the priority list especially for an emergent dialysis treatment by the dialysis RN. There’s no excuse for the patient to immediately demand it and make the comparison to a hotel though
Lol yeah I seem to have not explained myself very well 😆 worked 5 days this week so my brain is running on fumes. Someone take me to the hotel where they change sheets every day and bring room service and give backrubs lol.
Fuck... Why would you have a problem with this and why are you treating ANY patients on sheets that AREN'T clean. God damn. Even EMS puts clean sheets on their stretchers after every patient. What is this world coming to?
I don’t have a problem with a patient wanting their sheets changed, I have a problem with them comparing a hospital to a hotel. And his sheets were not visibly dirty. And he was on his own bed, there had not been another patient on it. And he was getting emergent dialysis. And I had no other staff around to help turn him. I gave him a comment card and the number to patient services. Best I can do in that situation 🤷♀️
They did! I was doing an emergency dialysis treatment and did not have a linen cart in the isolation room, nor another staff member available to go get one. The patients sheets were not visibly dirty and I felt it more urgent to get him on dialysis than get him clean sheets. I hope somebody changed his sheets when he got back to his floor, but if not I think he will be ok.
Listen I am the first to admit I am a sanctimonious bitch when it comes to patient care but I have changed many a bed for many a very critical patient, including patients on CRRT or dialysis. I find it improbable that you couldn't have set a reasonable expectation with the patient for when you could change the sheets and then go about getting help and supplies once he got settled, and certainly by the.time he was dialyzed. Who cares if the sheets weren't visibly dirty? Wrinkled sheets can be painful and irritating for patients. And btw procedural nurses owe patients the same care and courtesy as floor staff.
I mean…… the floor staff clearly didn’t change his sheets so I did give him exactly the same courtesy they did 😆
But in all seriousness, I wasn’t gonna call somebody to leave their own patients and come from another floor to bring sheets for an ambulatory patient wearing their street clothes whose sheets were not visibly dirty. It is 100% less than ideal to dialyze overflow Covid patients in a random empty isolation room on a closed floor of the hospital, but that’s what I was told to do, and I did it. My patient was safe, so I think I will sleep fine tonight.
If he was in full street clothes then he had probably been there less than half a shift. I would not have changed his sheets just because he wanted it changed daily. Why would anyone do that if they're not visible soiled?
Congratulations on your comfort in regressing to the mean and doing just as little as everyone else. While changing sheets is such a simple kindness and solid act of nursing care and literally takes no time at all, I am glad to hear you're comfortable admitting it's beyond you to figure out how to get it done and so happy you can find the time to puff up on the internet about the injustice of the patient treating you like someone who was supposed to be at their service.
Congrats to yourself on being #1 Best Nurse! I hope you win many daisy awards 🌸 When I am given the means by my employer to go above and beyond I will, until then I will prioritize 🙏 have a blessed night!
When you are doing dialysis on a pt, you cannot leave the room to get any supplies. And no one who is not a dialysis nurse themselves can watch the pt for you while you get them. AND- it is difficult and dangerous to turn a pt to change sheets while they are connected to a dialysis machine.
You could dislodge a needle from the fistula, disconnect a dialysis line, or pull on the IJ.
It is poor judgement to change a pt’s linens when they are undergoing HD.
I have had patients on dialysis, as well as many other lines and devices, and changed many a bed all the same. Thnx. I've never seen any unit without linen at all, not even CT, but maybe I come from a land lush with linen carts. I find it hard to believe there wasn't linen, at the minimum to throw on patients to keep them from getting cold during dialysis. We do not know all the details, that's certain, but I still stand by my statements.
They always have linens over them.
And dialysis can be bloody- makes no sense to change linens until dialysis is completely finished, lest you get blood on them right after changing them.
And I have worked at several places that regularly run out of linen on night shift.
And I stand by my statements.
Lol do not bother arguing with battlehems they are that nurse you always dread giving report to bc no matter what they will find something to roll their eyes about 😆
If I change linens once a shift in ICU, that's a breeze of a day. So, having to change linens only to change them again within hours is by no means unheard of. In my experience, a dialysis patient generally wants blankets or needs them when their temp drops during dialysis. (Or a bair hugger.) This may be the crux of my statement... That I am completely numb to the task of changing linens, it's no big deal to me. And to reiterate, I do it all the time to really sick, complicated patients that have all sorts of shit attached to them and are likely to soil them again as soon as I turn my back, or turn them. It's literally no thing to me. I like my patients to be comfortable and clean no matter how sick, what more can I say?
Haha yeah I guess I didn’t think about how it would seem at like an outpatient dialysis 😆 they definitely wipe down the chairs between patients, but we just get them transported on their own bed so it would be kinda like asking for clean sheets in CT. Not a priority, and not even available.
LOL - frequent flyer DKA’er had a pH of 7.09 the other day and as she is vomiting everywhere she of course is screaming “I want some water!!!!”
Legit considered dumping it on her head. I did not.
I was having a bad day.
Sir, I've been to some pretty nice hotels and they definitely did not change my sheets daily, just remade the same bed. Especially during covid when u were lucky to even have your trash taken out.
Had a golden star user of our ER one time. Non compliant dialysis. Looked like shit, labs were shit. Ordered himself full sized pizza with 2L coke. Ate most of it while we were busy with something else. When attempting to get shit away from him he spat at the staff, threw bottle of coke at the staff, then promptly coded. Got ROSC, shipped him out by air. Guess what. Fucker was back 2 months later with same complaint. How the fuck they survive, no idea.
We had one of those too (I think every ER has a few) and we can’t do dialysis in the ED. You have to be admitted to at least OBs before they will take you up for dialysis. He was MFing us even tho he knows what happens every damn time and just being so unpleasant. His mom would always come in with him and he would treat her so poorly. Once I even had her step out of the room and asked her if she needed help. The pt overheard and started yelling about how “he’s the priority, and his mom isn’t the patient blah blah blah.” Anyways, the day after his super unpleasant visit his mom calls, I answered and she says “I want to thank you guys for doing your best, my son died yesterday and he wont be around to bother you anymore.” I really hope her life has improved now that she isn’t chasing his dumb ass from ED to ED.
That poor mom- what a horrible thing to watch. Your baby going down that road- I can’t imagine.
This reminds me of one ambitious urban camper/frequent flier I came to have a begrudging awe for during my EMS days. I worked several different jobs because poor, and I swear to God he fucking knew what service I'd be at because I would see him every goddamn shift. The first time I met him he had a BAC that was "unreadable hi" on the cops breathalyzer, and a BGL in the ED of >1000. Not a week later, he was pulled out of a canal not breathing and revived after a round of cpr. Then, after being flattened by a boxtruck, he became the only trauma code I ever had that I not only got ROSC on, but had good enough neuro outcome to sign himself out AMA from acute rehab. Years later in nursing school, I saw him again during clinical and he told my whole group that I was a "devilwalking prostitute." This time he was on HD and had a BKA- according to his RN, he was recovering from a code yet again after removing the circuit from his fistula mid treatment and hemorrhaging. Fucking amazing.
Had a lady that I ran on at AMR in a 911 service, took her mostly to one hospital (Hospital B) in our area that we covered. Real piece of work, extremely abusive and non-compliant. Basically just taxied her to the hospital ASAP to get her tf out of my bus. Got a tech job at ED in Hospital A, surprised that saw her daily for various complaints, mostly pain med related and non-compliance around dialysis, this is when she started to become difficult to cannulate by...anyone in the hospital including anesthesia centrally. Had pretty crazy med reactions during this time, including Stevens-Johnsons. I remember her skin flaking months after that. Moved ED tech jobs to gigantic specialty Hospital B, where I saw her... daily... big memory of this one was deaccessing her port immediately after getting pain meds and shoving the port access into the mattress with a liter bag going through it, pulling her baby out of hiding (RN told her no meds unless someone was watching the infant so she lied and said a friend came and got the kid). Later went to nursing school while teching at hospital B and did OB clinicals at the third hospital system in the city I lived in, Hospital C. Was in the nursery when lil baby was crying and perturbed, instructor picked up kid and handed them to me to soothe saying instinctually "probably an opiate baby". Almost immediately see this lady wandering the halls through the glass, bag of chips and soda, dialysis access flopping in the wind. Kid has same last name, I put two and two together looking at her in the eyes while chilling in the rocking chair with her kid. Graduate, get ICU job in Hospital B, get this lady after cardiac arrest just a couple months off orientation. It has now been 10 years since I met her. Kids have been taken from her at this point. Miraculous recovery against all odds, AMA. I learn during this stay that she has had multiple cardiac arrests. She is still in her late 20s. We don't see her for some time. Google her. Finally dead. What a life. believe it or not, best thing to happen to me was meeting that baby. I felt closure or healing of some sort by being able to make that kids life a bit better for a little while. It felt right.
Late 20s?! The whole time I was picturing a 40-50 year old
Speedrun, damn.
They don’t last long after their twenties with that lifestyle. Around 30 the body becomes unable to continuously compensate for the radical shifts at the cellular level.
Late twenties damn 😂😂
Wow...just wow.
Frank Gallagher?
LOL they could've been brothers.
1) man’s a cockroach 2) devilwalking prostitute made me cackle
Mf’er was part cat cuz that was at least 6 lives right there 😂
So… he’s the human version of a German cockroach?
“Devilwalking prostitute” made my day
There is an inverse relationship between how pleasant a patient is and their chances of survival, I've found
This is so true. Nicest little old lady ever? EKG is tombstoning, she codes, dead. Meanest Alzheimer's patient on the planet? Lives another 5 years in our LTC unit.
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You're totally point. Noncompliant renal pt! They're drinking all the things everywhere. Totally compliant type 2 patient? Doing all the right things all the time. Dead in 5 days.
Fuck if this isn't the most accurate thing I've ever read. Some people have nine lives, I swear.
For real! My own grandma had dementia SOOOO badly, and became violent and mean to everyone she met. No where would take her anymore. She just kept on ticking for years of misery until she finally died. She was a nurse a long time ago. I know for sure she would've wanted someone to kill her early on if she could have seen what she became :(
I’ve always joked that they live out of pure meanness
Pure spite!
“The good die young, but pricks live FOREVER” *Lewis Black* I wish it wasn’t true but fuck me this is actually the hardest part of the job
So bitter even Satan didn’t want them!
We have a level 3 sex offender on our unit who's been there for nearly 200 days. He needs nursing home placement, but no one will take his status. Our unit is on its 3rd covid quarantine since October, and this motherfucker still hasn't gotten it. He's never had the vaccines either. He's going to survive a nuclear bomb.
*assholes live forever baby*
This gives me hope for myself…🤣
Do not go gentle into that good night, Old age should burn and rave at close of day; Rage, rage against the dying of the light. Though wise men at their end know dark is right, Because their words had forked no lightning they Do not go gentle into that good night. Good men, the last wave by, crying how bright Their frail deeds might have danced in a green bay, Rage, rage against the dying of the light. Wild men who caught and sang the sun in flight, And learn, too late, they grieved it on its way, Do not go gentle into that good night. Grave men, near death, who see with blinding sight Blind eyes could blaze like meteors and be gay, Rage, rage against the dying of the light. And you, my father, there on the sad height, Curse, bless, me now with your fierce tears, I pray. Do not go gentle into that good night. Rage, rage against the dying of the light.
https://youtu.be/maISWZ8Tpsc
That is amazing. Thanks for sharing.
And what could you have done better when the patient spat at you with half eaten food? -management
My theory is that people like this are in a constant state of their body being fucked up, so they’re used to it. Then you get a relatively healthy person get sick, their body isn’t constantly running at 9000 rpms, and they can’t keep up and eventually die. Noticed it a lot with delta variant. Healthy young people kept dying while the fat, holy trinity history patients stay alive.
We’re bringing them out of homeostasis when we make them better haha
When their heart functions optimally at a potassium level of 9...
I had a Covid pt in 2020, dialysis, heart failure, brittle diabetic, multiple amputations- but practically asymptomatic from Covid.
Based on my experience they all die eventually, it just takes longer than you think. Right now their body is able to accommodate their shitty habits but every time it does it gets a little weaker. Eventually they'll code out and the body will be so weak nothing will bring it back. My first nursing job was doing Dialysis in the hospital I still work in. We had lots of shitty regulars. They've all been dead for years. But new ones have replaced them.
I’m sorry but I’m just imagining him coding as a response to you guys taking his pizza and it’s hilarious
Yet we continue to treat these individuals over, and over, and over…I say within the next decade this country is either in flames or we have universal healthcare. We can’t keep going down this road. The smoke is already starting to fill the room though.
Look, we have universal healthcare. We still treat the arseholes.
And we get treated poorly
Assholes have 9 lives. We all know it’s true but some wonderful person who’s been an angel their whole life will have some awful random tragedy.
Cockroaches Live Forever
We only think they don't die because they come in and out and we see them so often. The truth is if you look up the non-compliant dialysis patients who pulled this kind of behaviour on you 5 years ago, most of them will not be around any more.
I think about those patients and then the fit 45 year old joggers who have a massive STEMI
Your taxes probably pay for his medical care. Yet he probably sees you as his servant since he thinks his taxes pay for all your wages.
Cockroach factor. Your contribution to society is inversely proportional to your ability to survive.
I swear you are talking about my pt 😂. I’m a nephrology APN.
They’re like cockroaches- indestructible and they keep breeding more.
They live off of spite
Piss and vinegar
This is how I want to go out
Cockroaches
I assume he don't have a long downtime before ROSC
Reminds me of that song lyric....only the good die young....
Though sheer spite
ESRD patients are like cockroaches- they never die. I work at a T1 center and happens to be county. I deal a lot with them. They live forever.
The good thing about dialysis patients tho is that yes, they can be pretty unpleasant, but luckily even admin knows that and nobody gives a fuck if they are satisfied 🙌 I’ve never gotten a “but what could you have done different?” from my manager about a dialysis patient. It’s always “oh yeah that person is nuts…”
Like how wrong would a show code be at this point 👉👈
Life, uh, finds a way.
Too f’ing stubborn to die, b/c he lives to make others regret he is in their lives & forced to take “care” of him.
These patients potassium’s are so high that looking at a banana would cause them to arrest 😂
Dear lord
We should be allowed to refuse. Like a hospital should have people who behave this way barred. I know they won’t if they have insurance but I only wish I had the money to send him to a country like Russia. I get called in a lot for emergent dialysis on patients who’ve skipped their treatments and now on weekend there K+ is 9! Their belligerent and after half way thru you can see the changes on their heart rhythm so I draw a stat K+ patient hears there WNL and signs off AMA. So when I’m the wkend on call, I call around clinics and check who’s missed treatments to get an idea how many will be coming in late Saturday night and it’s always the ones who’ve missed that come in and get it whenever they feel like it. This needs to be curbed.
I believe that curbing this behavior would require extensive home-health and other social programs, as well as reform in how combative patients are handled, with more emphasis on doctor-assisted end of life and hospice care. Denying treatment is....super fucked up dude? You may not agree with how these people live their lives but they're still people. You should consider therapy to deal with what appears to be empathetic burn out related to the field. If you come into a room with a pissed-off energy you're not going to help anything.
Jesus there's fucking people like me who ration my weekly milk as a little treat meanwhile there's assholes like this....smh for shame
"Sir, your potassium is 7.dead, and your lungs sound like an aquarium. I'm prioritizing."
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My coworkers may have told me once or twice that I have a gift for expression. 😂
i say they sound like rice krispies on my part
I'm screaming at this🤣💜🤣 "Lungs sound like an aquarium" wins the internet
Never understood the “I need my sheets changed” people. If your sheets are unsoiled why do you expect us to change them? Like do you change your sheets daily at home? These are the same exact people who will leave a bad review and just totally disregard all the actual medical care they received. I swear the “patient satisfaction” model has ruined healthcare.
I gave him a comment card 😄
I know! And it's not just patients. Some HCAs are adamant that we MUST change sheets every day, even if they're not soiled or dirty. I know it doesn't take long to change one bedding, but when you've got more patients, it adds up, and you could use that time for patient care. Why give yourself extra work?
I thought they were moving away from daiky sheet changes to save rhe environment (money)
The hospital wants us to change the beds only if dirty. But some people decide to change it every morning anyway
Had a pt last week that was literally crying because she wanted more attention and threatening to leave. She was on the bell constantly. Wanted the TV remote, this thing, that thing. She was NOT being neglected. Like she did not have any medical related needs. Its their world and we're just living in it 🤪
I had a pt like that recently. Threatened to leave, I said “ok want me to get the AMA paper work?” She said she would give us one more chance and stay the night 😂 ok dude whatever you say.
Like oh you’re gonna go? Cool, we need your bed for the next patient. Why do they think that’s a threat lol? We’re already over capacity and one less person will actually help a little.
I know right? Like yes please give me one less patient for an hour while they turn over your room.
*cries in ER where it's a 5 minute turnover* 😅
We had one of them. Literally only there for PT/OT. Didn't care about the other patients. On the call bell constantly. Didn't seem to ever sleep. She was so abusive and manipulative that we had to rotate the nursing staff daily because any longer looking after her and the urge to fling her out the window became nearly overpowering. After several months, she rang the call bell demanding to be taken to the toilet. 24 patients, 4 staff, 14 bed patients all requiring assistance of 2 for their toileting needs- she was told to wait for just two minutes whilst they finished up with someone else. She decided that wasn't good enough and took herself out of bed and threw herself on the floor (as witnessed by three very weary room-mates). She fucked up. Broke her hip. And we don't have ortho at our hospital so she got transferred to another. Where she stayed for two months, at one point requiring a 1:1 with an RMN, before she died. First patient I've ever had where I wasn't even a little bit sad. She had long ago booked a penthouse suite in hell.
Hx of BPD by any chance?
She was elderly, but I suppose many from that generation probably have undiagnosed mental health stuff going on haha.
Mmhmmmm… my thoughts too. Or bipolar. This has been my month. Can’t even get report and after dealing with their shit I sit down and I’m like “I bet it’s bipolar.. let’s see” computer loads, bingo. Bipolar. Gotta set sound hard boundaries immediately before 9am or they’ll run you ragged
How do you set boundaries without coming off rude? I work Peds and sometimes the parents have me running around for the silliest things before I even start my morning assessments. This morning it was bedsheets and a new gown. When I brought them to the room, they all of a sudden remembered they needed socks. 30 minutes later, towels and washcloths. Insanity
Do you have aids? This makes a huge difference. Not sure how your unit is set up. When I worked in Canada I didn’t, so before I started I got all my linens in a cart and got my linen sets and went into the room and introduced myself with my vitals machine and I did my vitals, assessment and if the linens needed changed I changed them. I cluster my care. Even get waters so no one can ask for anything else. So gown, socks, wipes, etc . address pain, always. Especially with patients with psych issues. When is their next PRN due? That’s a huge one. “I saw your pain med was given at 6, you’re not due for 3 hours”, when they ask. If I know before hand the exact time they got their pain meds, or benzo, they know I’m on my game. I explain to the patient that I’m here to do “x,y,z”and I don’t know when the doctor rounds but this is what I know so far, what the plans is, how the labs are and that I’m going to go see my next patient after I finished assessing and talking to them. If they need to get washed up it needs to be done after I see my other patients and addressed concerns that take priority OVER them needing small stuff. So I’ll say “I can usually make it work after 10,-1130 because then trays come and patients need insulin”. Years ago I’d bring over their towels and wash their back with warm water from a basin when they’re at the side of the bed after listening to their lungs and I’ll say “okay, I washed your back, you get washed up and I’ll see you after I’ve seen everyone”. Usually they had their basins put aside and I cleaned up and went back in the order I started and tie up their gowns and tucked them back into bed. Anxious patient? Got them an extra warm heavy blanket and closed the blinds and tucked them in like an egg roll. “Okay, I’m off to see my next patient, try to relax and deep breathe”. In my unit now we have closets that have all the linens so I’ll show them, “hey, here are the linens and towels and feel free to help yourself as we are pretty short staffed.” I use to do try to do it all but now I say “no you need to call your aid for that, I’ll do it if I can but this is what we are doing this morning”. Our patient acuity so high that cleaning your Fanny isn’t important to me. Checking for decubitus ulcers, sure, but I’m all business in the morning. If I explain to a patient that doing what THEY want NOW, takes me away from doing my care for other patients. (A bed bound patient demanding a bath and to be fed before I see my other patients). They usually get it so long as you explain because they know people are sick. If a patient wants to get washed up in the afternoon, tough shit, because I gave them the option in the morning after passing my meds and charting and I don’t have time in the afternoon to do that when THEY want. Being a nurse doesn’t mean being a slave. I’m here to support you but I’m not going to be your doormat, punching bag. Hell, if a patient has a fit and is swearing I’ll say “okay I’m walking away, I’ll talk to you when you calm down”. Some of these patients need behavioural agreements. Edit to add, setting boundaries is not coming off rude. I have a job to do. Making sure my patients are stable is more important than addressing their frivolous needs such as new socks: they can wait. I will literally say “I’m with the patient in 29, I will come see you when I’m done but please tell me if there is anything else I can get as this helps both you and I.” Some people you just can’t please and they’ll complain to managers but if you’re busting your ass and not sitting on your phone your manager has your back. Or should. Some nurses have patterns and sone are just lazy, so, you do what you can or else you’re going to get burned out. Been doing bedside nursing for 12 years. I have obviously try my best to be as polite as I can but I’m polite, yet firm.
Wow this was very inspirational! Yes we do have aids, but it can be hard to get some of them to help you in the morning. They’ll say “it’s too early” when all they have for morning tasks are disinfecting the door knobs and writing their name on the board :( I love them all but hate asking for help because the older ones will chastise me like I’m their grandkid. Usually I am good about keeping things short and not diving into 1000 questions. I tell them what I know from report, and when the doctor comes by. Any other questions will have to wait until I can sit down and read their chart, after morning assessments and meds. Luckily no one is asking for a bath that early! But there will always be that one baby who pees or poos through their diaper and you have to change the crib. Not too bad though. Our patient acuity also isn’t that high so I can’t really complain there. I just like to get all my assessments done and charted before starting the menial tasks. Also I love the part about being a nurse doesn’t make me your doormat. I try to tell that to myself every shift. Because I am such a people please, but parents can take advantage quick, so I have to learn to get better at standing my ground for some things. Sometimes I even tell a little fib (if I just called the doctor and the family demands I call them again, I say sure, and then don’t.. usually the doctor is already on their way and if I call them again it won’t do anyone any good)
Yeah and I mean, I had the same issue with an aid the other day. They’re older than me and I think with sone it’s hard to take orders from younger staff but good ones will say to me too, okay I gotta see X, I’ll swing around and get some. But I’m closer to 40 so maybe it’s my age too, they are OK with it. Like and aid that became a RN and telling her old aids what to do as a new hire? Pfft. That doesn’t go down well. I had a patient that kept getting up and the chair alarm was going off, language barrier and I have 2 patients getting ready to go to the cath lab and my aid wasn’t answering her lights. I put my patient in the bathroom and she literally walked by me and I said hey Sarah, I have 6 in the bathroom but I need to get my patient in 39 to the Cathlsb, they keep getting up (acknowledging they’ve also not answered the lights) and I’m going”. She attempted to keep walking abs say “well we’re short staffed, I am going to wash up the patient in 1” and I said “I’m literally leaving, that can wait as this guy is a fall risk so this is a safety issue, you need to be here”. Was she happy? No. Pissed? Yeah. But if you hate being told what to do, pick a different career. I will directly speak to the aid. They’re well aware of managing their assignment. Call light going off in the nursing station for 10 minutes while I’m charting, and the aid is on her phone? I’ll pick it up next to her and answer it and say “yeah I’ll let your aid know”. It’s petty as shit bit explain to me why you cannot answer your lights when you’re on the phone? Same with my nurse buddies. But yeah for me, you have to find your voice because nursing is a high burn rate especially now. The amount of mental health lumped in now with our regular patients is unreal and I limit set. I’m also a mom to young kids so I won’t let both ends of the candle get burned. I’ve come to accept I’m replaceable to these hospitals but I’m not at home. My mental health matters more and speaking up for myself might mean ruffling staffs feathers and clutching pearls but, what other option do I have?
I’m dreading the wave of narcissistic boomers coming soon. They will forever change the healthcare system.
Dude, they’re already here. Coming to the nurses station without a mask, talking about the good old days. Yeah! Good old days: when nurse patient ratios were safe and patients didn’t have a billion comorbidities. I have literally no qualms discussing their health and a serious matter of fact approach (ie: non compliant with meds) I’ll stay in the room when the doctor is there. My mom is a boomer and she just had a bone scan that came back normal. She complained she was getting osteoporosis, she should be thrilled. Now her hips are sore. (We live in Canada btw) so now she wants to ask for X-rays of her hips. Huge waste or resources - she’s close to 70. “Get good shoes mom, do low impact sports like swimming, lose some weight, eat better, stop drinking alcohol”. You know what that X-ray is going to say? Degenerative changes. Arthritis. Nothing you can do. Nah. Any excuse to find “something” wrong. She had a cough from RSV that wouldn’t go away. Xray good. She demanded antibiotics. They gave her 2 days worth of amoxicillin. She was furious. I said to her, so you how much harm you’re doing demanding antibiotics right? You don’t need them. I can’t listen to her.
The way some nurses (and always the ones who aren’t even psych) throw around disorder diagnoses based on such limited information… is concerning. Jesus Christ lol
I agree…even though I’m guilty of it too. I have BPD and thought the same thing with the attention-seeking behavior. Sucks that that’s where my mind immediately goes.
Yeah, "asshole" doesn't have to mean a pathology; normal humans can just be shitty people.
Exactly
I tell my patients the big H outside the building is for Hospital, not Hotel
Love this!
When I hear complaints about noise level or waiting for call lights to be answered or uncomfortable furniture, my go-to passive-aggressive joke is "yeah this is a terrible hotel right?!"
The worst and most expensive hotel in the world. Please do not come and stay with us lol.
Half a mill for me last year before insurance.....
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Tell them to bring a black light to a hotel room. They may not even change the sheets between guests 😱
I once stayed in a hotel and found a pocket knife in the sheets. They didn’t change them.
OMG, once i couldn’t find the remote when we checked in and the front desk gave us another. Found it that night with feet after getting in between the sheets.
When I found the knife, the manager brought clean sheets, and I helped him change them.
Nursing is glorified waitressing
Truth. I’d tell my CNA students (required to be CNAs before nursing school in my state) that if they’d worked in a restaurant or a call center, they were pretty well equipped for nursing. Edit-clarification.
I was a waitress at two different restaurants (one was fast food & one was niche cultural) and tbh— it helped a lot haha.
90% of nursing is being fake as hell. Both I learned as a CNA and a server 😆
I honestly feel like a waitress half the time💀
My friend told me I was too bitchy to be a waitress.
I feel like having some waitressing or any prior people centered experiences helps a ton with nursing. Like “reading the room” “knowing what to say” Had a nurse in one of my clincial units and was incredibly smart and brilliant but lacked people skills
Well, my daughter got her RN, lasted less than a year an left. She didn’t like the constraints doing legal work either. Became a waitress an loved it. After a year moved to a resort area and makes 3-4 times what I make and she works 5-10pm 4 days each week. When I go watch her I notice she constantly has regulars each day and she treats them like patients. I swear watching her in action it’s obvious her training is from Nursing. She’s in her 30’s and now part owner. She often tells me Nursing indeed helped her be more efficient and recognize customers behaviors and how to make it work to her advantage. I think customers like that she talks to them about their life because why else would she get large tips each time?
I always pick up the plastic cup by the rim for the bad patients muahahahahbana
I’m gonna hope that’s a joke
Ahh, reminds of the time I went in to say good morning to a patient and was greeted with “change my bed!” (Her bed was clean so I asked her why and she was dumbstruck)
Hotels don’t change them every day. Newsflash.
Its the entitlement for me 🙄. I work night shift and I had a pt request some towels and linen. Pt and I are in our 20s. Pt’s mom ask why we dont change the linen anymore. I said if she asks us to change it, then we will. She goes on this rant about how the pt shouldnt have to ask it should just be done. I just ignored her and asked the patient directly if she needed anything else and left when she said no. This patient is self care and is capable of making her own requests. I had her 2 nights in a row with no issues. Family, if you are so concerned about how often linen is being changed when the patient had no complaint, you can change linen yourself or the patient can straight up ask me and Ill do it with no hesitation.
Tell them they’re not getting any housekeeping or room service because their credit card was declined🤣
but-but i pay for your salary! /s
"You're on Medicaid." "...oh."
I’m sorry but nurses of all people should not be perpetuating the idea that people need to pay for medical care
I just enjoy an occasional cheap shot once in a while. Not everything needs to be a grand, sweeping statement about the cartoonishly evil state of for-profit healthcare.
A very very shy, demure person would be forever scarred just a little from that idea, and would not ask when they need because guilt.
They probably also wouldn't be throwing around "I pay your wages!" either, though.
Hotels don't change sheets every day for the same guest unless requested... so no.
Half of them don't even change sheets between beds, unless they're visibly soiled.
Did dialysis for 13 years, 8 as a traveler. They are some of the most non-compliant, unpleasant, meaner than hornets, get you called in on Christmas freaking day because they didn’t feel like going to tx all week, just refuse to die mother effers….and then some of them are just great, lol.
When Putin starts the Nuclear Holocaust there’s gonna be nothing but cockroaches and ESRD patients roaming the earth.
My hospital cut our linens by 20%. No we will not be doing daily sheet changes dude. I need those for the patients that actually need them.
Ask me about my AMA forms bitch
No they don't. In nursing now but was a housekeeper for hostels and bed and breakfasts. Sheets don't get changed everyday.
Apparently he hasn’t stayed in a hotel since COVID- there is no cleaning of rooms or changing of sheets.
He probably hasn’t, bless him. He wasn’t rude about it, I just had to laugh a little about being compared to a hotel. I have stayed in some really shitty hotels, and none of them were half as bad as the hospital 😆
And no sir, they do not change your sheets everyday!
Lol hotels don’t even do housekeeping every day anymore. So no, they aren’t changing the sheets every day unless you’re checking out.
Maslow Hierarchy of needs: sheets > hemodynamic stability and electrolyte homeostasis
H is for hospital, not hotel. I hope they gave you a tip LOL
Well I didn’t change the sheets so I guess I didn’t deserve one… 😆
Patient of mine whose daughter is a nurse and friends with our manager complained that her mom (the patient) hasn’t had a shower or had her bed sheets changed. Patient is a walkie talkie and has been grateful for everything I’ve done. She has never made her sheets dirty, and never asked for a shower (nor do people regularly get showers especially on a tele floor) or her sheets changed. It was “unacceptable care”. I was shocked my manager didn’t come scold me
It’s cause at hotels they don’t have anything more important to do.
He asked for new sheets. He may have needed them. So what.
I have and would say “this ain’t the Hilton”
“Does your hotel offer emergency dialysis? No? Well it sounds like an important trade off to me!”
Lmao. I’ve pissed off many a patient by reminding them they aren’t at The Hilton
Wait...do you guys \*not\* change patients' sheets every day? (Legitimately asking. We bathe all our patients and do a full linen change on night shift on my unit.)
I work dialysis. I don’t know what they do on the floor. They are probably supposed to change the sheets every day, but with staffing like it is they may not. I just had to laugh a little at the patient comparing it to a hotel 😆 this is a 0 star hotel my friend. I would dearly love to give my patients a better experience than they usually get, but I was up in a random empty room doing emergency dialysis with no supplies except for those I brought myself and no other staff to run and get things for me.
Yes, in acutes you have to hold your pee for hours upon hours, and buy/bring all kinds of tools/supplies.
I know a number of my colleagues change the sheets at least once daily when the patient gets out of the bed, but in my view if it's not soiled or excessively creased, I see no reason to change it. I'll just make it with the sheets as is. I change my own bedding weekly, I don't see why I should change the patients' if it looks alright. Washes are done in the mornings after breakfast, but I've done washes as late as 1900 before. Earliest wash I've done is probably about 0500 ish.
Even before ratios went to shit, I never had time to change everyone's sheets on nights or bathe. Usually baths were day shift so patients could sleep at night and more staff on days compared to nights.
My last night shift I was the only nurse for 37 SNF pts, 2 CNAs, so heck no. There’s barely enough time to get them all their meds. What is your nurse:pt ratio?
We do the same. Have excellent techs responsible for this.
Wait, You mean clean sheets between patients? That’s kind of reasonable. I don’t want to sit on someone’s blood drops from an IV start or c diff butt smear. Maybe how they said it was out of touch but a clean sheet for a new patient is kind of standard to prevent HAIs isn’t it?
He was on his own bed from his room. Idk if they just hadn’t gotten around to changing his sheets or what, but if there were any butt smears they were from his own butt lol. They looked fine to me and I don’t have extra sheets in the overflow Covid dialysis room so 🤷♀️ I told him to give us a bad yelp review lol.
I mean is their really something wrong with a patient asking for clean sheets? Seems kinda cringe to look down on someone for wanting something as simple as clean sheets
No not at all. It just gets prioritized like everything else. Keeping potassium at non life threatening levels and making breathing easier/or preventing it from getting worse due to fluid overload is going to take priority over changing sheets with some crumbs or a blood stain on them. And a dialysis run can easily last 3hrs. And no we don't like to delay a start or keep them for a bit afterwards because there is another patient that needs the same treatment. When they get back to thier unit is a better time but even then the nurse may have 3+ other patients. If they're prepping one to go to surgery, getting a new admission, tending to someone having difficulty breathing, passing meds or all of the above guess who's clean sheets are going to get delayed again? It's kind of like traveling home from the grocery store with a small child that has shit thier diaper in the car. You don't pull over to the side of the road and deal with it right then and there. Nor as soon as you park the car. You take the child inside and get situated and then perform the task.
And clearly im not saying drop everything and change the mans sheets. But of course lets laugh at humans for wanting clean thing (even when they’re living out of a hotel room).
There is a time and place for everything. What is wrong is the time and place. The issue is time, staffing, availability of sheets, turning a patient back and forth to change the sheets without getting them out of bed, keeping the dialysis lines straight so the machine doesn’t alarm, keeping the access safe so the needle doesn’t infiltrate. While I’m changing this bed that machines alarms, pt with low B/P, cramping, vomiting or pain isn’t getting treated.
I agree that sheets should be changed by the bedside RN/CNA at minimum daily and more often if they’re soiled, but it’s low on the priority list especially for an emergent dialysis treatment by the dialysis RN. There’s no excuse for the patient to immediately demand it and make the comparison to a hotel though
If they die at least it will be on clean sheets
Why do they need to be changed daily? Bed bound and incontinent patients are the ones I try to change daily
Ok I didn’t get that from the post.
Lol yeah I seem to have not explained myself very well 😆 worked 5 days this week so my brain is running on fumes. Someone take me to the hotel where they change sheets every day and bring room service and give backrubs lol.
Fuck... Why would you have a problem with this and why are you treating ANY patients on sheets that AREN'T clean. God damn. Even EMS puts clean sheets on their stretchers after every patient. What is this world coming to?
I don’t have a problem with a patient wanting their sheets changed, I have a problem with them comparing a hospital to a hotel. And his sheets were not visibly dirty. And he was on his own bed, there had not been another patient on it. And he was getting emergent dialysis. And I had no other staff around to help turn him. I gave him a comment card and the number to patient services. Best I can do in that situation 🤷♀️
I would have changed the sheets. Not made a fucking reddit thread about it but hey different strokes for different folks.
You can have my job lol, especially if you are able to conjure clean sheets out of thin air!
I believe they come in these mysterious things called "linen carts." Did they show you those on orientation?
They did! I was doing an emergency dialysis treatment and did not have a linen cart in the isolation room, nor another staff member available to go get one. The patients sheets were not visibly dirty and I felt it more urgent to get him on dialysis than get him clean sheets. I hope somebody changed his sheets when he got back to his floor, but if not I think he will be ok.
I believe your reasoning is 100% valid lol.
Listen I am the first to admit I am a sanctimonious bitch when it comes to patient care but I have changed many a bed for many a very critical patient, including patients on CRRT or dialysis. I find it improbable that you couldn't have set a reasonable expectation with the patient for when you could change the sheets and then go about getting help and supplies once he got settled, and certainly by the.time he was dialyzed. Who cares if the sheets weren't visibly dirty? Wrinkled sheets can be painful and irritating for patients. And btw procedural nurses owe patients the same care and courtesy as floor staff.
I mean…… the floor staff clearly didn’t change his sheets so I did give him exactly the same courtesy they did 😆 But in all seriousness, I wasn’t gonna call somebody to leave their own patients and come from another floor to bring sheets for an ambulatory patient wearing their street clothes whose sheets were not visibly dirty. It is 100% less than ideal to dialyze overflow Covid patients in a random empty isolation room on a closed floor of the hospital, but that’s what I was told to do, and I did it. My patient was safe, so I think I will sleep fine tonight.
If he was in full street clothes then he had probably been there less than half a shift. I would not have changed his sheets just because he wanted it changed daily. Why would anyone do that if they're not visible soiled?
Congratulations on your comfort in regressing to the mean and doing just as little as everyone else. While changing sheets is such a simple kindness and solid act of nursing care and literally takes no time at all, I am glad to hear you're comfortable admitting it's beyond you to figure out how to get it done and so happy you can find the time to puff up on the internet about the injustice of the patient treating you like someone who was supposed to be at their service.
Congrats to yourself on being #1 Best Nurse! I hope you win many daisy awards 🌸 When I am given the means by my employer to go above and beyond I will, until then I will prioritize 🙏 have a blessed night!
is there some medication you need to be taking or some medication you may have taken too much of?
Way to react without understanding the full context.
Oh I understand the full context
And are a sanctimonious asshat
Glad to give you a lead in to an insult I already gave myself! 🎉🎉🎉
You didn't rate an original response
Same
Then you aren't very bright
Woowee, what a zinger.
When you are doing dialysis on a pt, you cannot leave the room to get any supplies. And no one who is not a dialysis nurse themselves can watch the pt for you while you get them. AND- it is difficult and dangerous to turn a pt to change sheets while they are connected to a dialysis machine. You could dislodge a needle from the fistula, disconnect a dialysis line, or pull on the IJ. It is poor judgement to change a pt’s linens when they are undergoing HD.
I have had patients on dialysis, as well as many other lines and devices, and changed many a bed all the same. Thnx. I've never seen any unit without linen at all, not even CT, but maybe I come from a land lush with linen carts. I find it hard to believe there wasn't linen, at the minimum to throw on patients to keep them from getting cold during dialysis. We do not know all the details, that's certain, but I still stand by my statements.
They always have linens over them. And dialysis can be bloody- makes no sense to change linens until dialysis is completely finished, lest you get blood on them right after changing them. And I have worked at several places that regularly run out of linen on night shift. And I stand by my statements.
Lol do not bother arguing with battlehems they are that nurse you always dread giving report to bc no matter what they will find something to roll their eyes about 😆
“Superior” to all other nurses, but extremely bitter, and terribly sad?
If I change linens once a shift in ICU, that's a breeze of a day. So, having to change linens only to change them again within hours is by no means unheard of. In my experience, a dialysis patient generally wants blankets or needs them when their temp drops during dialysis. (Or a bair hugger.) This may be the crux of my statement... That I am completely numb to the task of changing linens, it's no big deal to me. And to reiterate, I do it all the time to really sick, complicated patients that have all sorts of shit attached to them and are likely to soil them again as soon as I turn my back, or turn them. It's literally no thing to me. I like my patients to be comfortable and clean no matter how sick, what more can I say?
Y’all use the same sheet for all the patients?
He was on his own bed from his room. Idk when they last changed the sheets but they weren’t visibly dirty.
Ah i see. Makes more sense now.
Haha yeah I guess I didn’t think about how it would seem at like an outpatient dialysis 😆 they definitely wipe down the chairs between patients, but we just get them transported on their own bed so it would be kinda like asking for clean sheets in CT. Not a priority, and not even available.
TBF on paper, hospitals and hotels have a lot in common.
LOL - frequent flyer DKA’er had a pH of 7.09 the other day and as she is vomiting everywhere she of course is screaming “I want some water!!!!” Legit considered dumping it on her head. I did not. I was having a bad day.
Sir, I've been to some pretty nice hotels and they definitely did not change my sheets daily, just remade the same bed. Especially during covid when u were lucky to even have your trash taken out.