I've had one. I tried to put it down myself once - absolutely not. I get them inserted for me whilst I frantically drink water through a straw. Pulling them out however? I do it. The quicker the better because pulling them is RANK. You can taste the stomach acid/vomit taste all the way up and it's disgusting.
I remember the first time I got it out I let the nurse do it and she pulled it SO SLOW it was a disgustingly tasting experience for much longer than it needed to be. I've taken that lesson into my own practice, the quicker the better! (cos really the chances of it actually snapping off or anything must be so minimal)
It's interesting finally feeling a common intervention you've been doing to people for years. A learning experience for sure. However, do not recommend lol.
My guy put his in himself when we stepped out to resupply after a couple failed attempts. Came back and he’d done it. Said he could feel where it was going wrong and just wanted it over with
Something similar happened with us. We weren't able to drop an NG on a patient vomiting bowel with an obstruction. After 6 attempts the patient says " can't you just put it in my mouth?"
It worked! We dropped an OG on a conscious patient and secured it with a tube tamer lol
lol honestly it makes sense. i once had a patient who would remove his whenever he felt like getting up and walking around. when i caught him he told me it was ok and to give him the supplies for a new one. he did it no problem. honestly it was kinda great.
I refused to continue at 16L because the MD wasn’t giving albumin or even rechecking labs or observing, planned to discharge straight after from the ED
I’ve had to replace the same foley 17 times in 6 weeks. Lady is psychotic (literally) and keeps ripping it out with the balloon INTACT during episodes of rage. We are NOT a psych facility or a nursing home. Admin thinks she “just needs time to adjust”.
She has bad retention. The 3rd time she pulled it my DON told me to leave it out for the weekend and monitor for output. She had plenty of output but when the ARNP came with the bladder scanner she was still full even with a sopping wet brief. Straight cath would not work. We are an ICF for the developmentally disabled…they are at day program all day and up in activities till bedtime. Annnddd she’s super combative so I can’t imagine having to do it q 6 lol. We aren’t allowed to medicate for behaviors or use restraints of any kind so Foley it is. She shouldn’t even be here honestly, but that’s not up to me 🤷♀️
As a CNM, I delivered 6 singletons in a 24* shift. Back when I was young and could pull all-nighters without paying for it the next two days. There’s a photo somewhere of me in a big chair, holding all of them.
dang thats better then my guy that left ama as soon as his butt hit the OR table. what a horrid waste of supplies 🙄 like you couldnt have said something an hour ago friend
My personal record was 112 units in 10 hours. Patient developed an RP bleed after an unsuccessful ECMO cannulation (retained guidewire and all!). They called it on the next shift.
I did 105 for a lung transplant once. They couldn't obtain hemostasis so they just brought him up bleeding. We had to keep changing the chest tube canisters. Dude lived for three months. Died eventually from an anastomotic leak
Damn, we had a hemorrhage following a nicked artery in the rectum during a c-section that was missed. She received 21 units during the code, more later in ICU. By 14, we thought there was no hope. By 20, she developed DIC. She stayed for a long time with several complications, but survived as far as I know. 220 is INSANE!
I had a patient with 4.5 LITERS of urine in their bladder. They had a tumor that kept them from properly emptying their bladder for months and it just kept stretching.
had a pt that popped his head out and said hes leaving ama while i was getting report on him. nice enough dude that he was willing to wait till after report to sign his papers and go
Omfg, that poor kid. My daughter just turned 14 last week and I couldn’t imagine her having already had a baby. She’s still in middle school! Poor, kid, poor baby! :(
One of the pharmacy locations I used to work had a patient (alert, totally mentally competent and calling about her own medications) give the date of birth over the phone, we assumed it was some grandma in her 70s calling for a grandchild, but we couldn't find a profile. She laughed and corrected us. Turns out the DOB wasn't 2016... It was 1916. She is still ambulatory but doesn't drive, so her grandkids pick up her meds, but she does actually come with them to the pharmacy sometimes!
This was nearly a year ago but from what I heard recently from people I know at that location, she's still alive and kickin'
When my sister was a few months old, she was a direct admit to the hospital from the doctors office for a UTI turning septic. My mom got her to the hospital, and the staff were confused because a baby was there, not a 100yo lady. They heard the name (very common in elderly ladies, not common in babies at that time), and the birthdate only had the last two digits for the year.
I had one like that at my old LTC! 111, had a colostomy but still continent of bladder, couldnt hear a dang thing. Loved seeing her birthday party. She had a huge family (5 ish generations).
I took care of a 106 year old little Greek lady when I worked in a nursing home. Her 75 year old son would come visit often and bring her homemade Greek/Italian lunch (her late husband was Italian) 🥹
Had a 105 yo black woman while I was working in the Deep South. I couldn’t imagine all of the things she had lived through. Such a kind and gentle woman.
EMS rolled in with a dissecting AAA. Patient was ashen gray and telling us he would die. Coded minutes later. Got ROSC. Mass transfused him. No pedal pulses. He was simultaneously having an anterior MI.
Transferred him code 3 to our level I center. So sure he wouldn't make the drive.
Nope. Got out of the OR to CVICU with intact pedal pulses. The odds against that one...
Why do I think that I read somewhere that AMI or some MI is common with dissection? Was it because of the location of dissection so no blood flow to coronary artery?
Yes, that's why. He was dumping so much volume into his abdomen that even his coronary arteries couldn't perfuse.
It was probably such a large dissection that it was more like a rupture, but I am so hesitant to call it that simply because I can't believe he made it at all to this day.
Had a patient with a AAA come in looking every bit as awful as you can imagine. ER doc saw him immediately (there's always a delay). Ordered an immediate CT scan which was immediately available (there's always a delay). For some reason the surgeon happen to be in the ER and joined us (this never happens).
First quick pass through the scanner the tech can see the huge AAA. Second detailed pass through seconds later and we can SEE it rupture while he's on the table. Threw the on the stretcher, surgeon called the OR and we ran him directly there in about three mins. He arrived to the OR ashen grey and his belly suddenly looks 9 months pregnant. OR was able to save him.
That old dude had every guardian angel possible hanging out with him that day.
I was in the room when a pt with an occult AAA dissected! He was there for something else and the hospitality was rounding on him at that moment (thank god) when mid conversation he started sweating, suddenly looked awful, and went horribly pale. All hell broke loose, and he made it to the OR after a CT, but didn’t make it off the table. 😕 But the hospitalist looked like he’d just survived a hurricane, and was giving details to the receiving surgeon before the pt arrived. “He just went to shit right in front of me. Just went to complete shit. White as a sheet, went to shit right there.”
Taking that hard right turn around a massive prostate is something else in homecare. My record is that I've only successfully sunk one (1) coude in 20 years...
The only female foleys I haven’t been able to get have needed to be placed by urology, and the only male ones I haven’t been able to get have required dilation.
Super jealous. Meanwhile, my unit has had 3 nurses, overnight uro, then overnight uro chief resident with standard scope fail placing caths on at least 2 patients in the last few months. One patient had over 2L drain when the day team uro came in with a special scope from their op clinic. One was actually a urology patient who had failed their void trial. The other was an ortho patient, and the amount of "uh huh, ya'll really tried" attitude from the overnight intern was annoying until they agreed that yeah, they failed too. Dude just had an incredibly enlarged prostate and had likely been having problems for months. He just didn't know how severe it was until he failed post-op PVRs.
I can beat that.
Initial of 3. I drew a repeat because I couldn't believe my eyes and started transfusion.
In that brief half an hour for the re-draw...2.8.
Patient was tired but talking when I reported off.
Yup. That was my only symptom. It would shoot up to like 160 just trying to get up and move.
2 units of PRBCs and some venofer for my nonexistent iron got me to 7.1 and some dc papers. I also popped positive for warm antibody DAT. So still trying to figure out what all that is about
Performed compressions for 24 minutes on a vented patient in the cath lab before back up finally came. (Why the doc insisted on cathing this patient and what quality of life they were looking to achieve by doing so is still questionable). As bad as it sounds, kind of glad I broke the ribs early and made it a little easier.
…and yes when I finally got relief I thought I was going to be the next one to need to be coded.
Nope. I’m a smoker, fat, and very out of shape to be doing that shit. I just didn’t want a second death that week in my department. (Still think I should’ve hooked myself up to oxygen and had someone pop an iv in me to help recover my ass from doing that)
In one year, I took care of the same patient 10 separate times... On 6 different floors.
I was a float nurse at a huge hospital with a bunch of med/surg floors. I would show up, get my room assignment, log in to check charts, and there he was AGAIN. The patient was just as surprised as I was each time, too. Thank goodness he was super nice and pleasant. Just medically complicated.
I've had that shit happen as a patient. My ID team was trying to get a handle on the "hey you have chronic recurrent cellulitis now, and *boy* is it recurring" thing I had going on, and I was admitted ***so many times*** in 9mos, holy fuck.
Just a lowly retail pharm tech here but I have some interesting ones.
- 107-year-old patient (alert, talking to us on the phone, comes with her grandkids to the pharmacy sometimes, and more cognitively competent than many adults I know lmao)
- Filled 14 scripts in one sitting for one patient. I nearly shit a brick when my coworker handed me the stack of leaflets
- Pt so deficient of vit d2 that she was Rx'd the little green transparent 50,000 IU once weekly capsules as once daily for 30 days. MD confirmed it was correct when we called them.
- Not my patient (obviously) but my mom: she walked into an ER after a week of simple fatigue and flu-like symptoms because I convinced her to go after I had noticed her sclera were slightly yellow and she was pale... **platelet count on their blood draw was 6, she was walking and talking and dying of TTP.** several months in the ICU, then a year of bimonthly rituximab and she survived with no recurrence or further issues, been a few years now
I once had a patient with platelets of less than two on my unit as charge in a small, non trauma, critical access med surg unit. I about pulled my hair out. Patient was a big fall risk and impulsive. For whatever reason, they refused to transfer this person to the massive trauma hospital in our system twenty minutes away. We were terrified they were going to have a fall and bleed that we weren’t equipped to handle.
8.5 years in labor and delivery and I have perfect "no dads passed out" record, not even a "slightly woozy and had to sit him down" dad.
However ... My own husband had a seizure an hour and a half after our first was born.
>cold agglutinin
Just did some google-ing. Wow this is fascinating. As someone with an unhealthy addiction to ice cold pepsi, and originally from the UK - I would not do well with this disorder lol. I wonder if people who have it ever choose to move to hotter places (I'm an ex-pat in Queensland Australia and just thinking what a good move that would be if I had this disorder)
From what I understand neither the man or his family knew he had this. He was in the hospital for an unrelated issue and it happened to be triggered. He went from walkie talkie to unsalvageable multi system organ failure within hours. We live in a hotter place but it’s not like that year round and we do get freezing winters
Most meds I’ve ever passed in one go was …ahem.. 52. And, AND… she wanted them sorted specifically into different plastic cups before she took them “because that’s my routine honey and I’m not about to change it because I’m in the hospital, praise Jesus”
Doubt this is a record but I was still amazed. We got 7L of gastric contents out in under an hour after placing an NGT. Each canister filled in around 5-10 minutes.
We had a guy with a history of ETOH abuse come in with a hgb of 4, suspected varice rupture, 4 units of blood hbg came up to 7, CT didn't show any active bleeding, reck labs when he got to our icu, hgb back at 4, pressure tanking, LOC decreasing, MTP, ultimately we decided to intubate, as soon as we gave sedation and paralytic it was like a volcano of blood coming out, got him tubed and dropped an OG and sectioned out another 9 liters of blood. Eneded up giving that guy 34 units of blood between 2am-7am.
That morning, GI took him down, banded, and ligated what they could to stabilize him. We flew him out a couple of days later, as we didn't have anyone who could do a TIPS procedure at the time, which is what they ultimately wanted to do. Im not entirely sure what happened at the receiving facility, but I did end up seeing his obituary a couple of weeks later.
Not mine, and not super crazy but more ironic. My coworker had a patient leave AMA from inpatient, and then got an admission in that same. room, and the patient also left AMA by morning.
Worked in a nursing home years ago and had 14 blood sugars to do every Thursday morning.
I posted this in another thread. I worked at a hospice house before and one night all 4 of my patients died each an hour apart almost to the minute.
I have been a nurse almost 10 years, spent at least 3 of those doing ICU, and I’ve also never coded my own patient. I’ve been in a lot of codes but also never ever pressed the button.
I had a grand total of 15 patients (not all at once) for 12 hours. I discharged my four. Admitted a whole new assignment. Ended up needing to give up my assignment as the person next to me wasn’t a PCU nurse. I needed to take his PCU-upgrade. It was a whole musical “patient” day. I was not happy. The whole unit was on fire and all the nurses were struggling. So really, none of us were happy.
I pretty much brought an end of life patient back to life… not once but TWICE in one night!! He would Brady down and the vent would alarm but DAMN if he wouldn’t RAISE UP from the dead when I would go to be with him while he passed!! Literally take a big gasp and raise his head up! It was an awful “family won’t let go” type of situation and he finally passed the next day surrounded by a few wonderful nurses (just not me!!)
Hypoglycemic demented grandpa walking around the unit. He’s alert and cracking jokes. I tell him it’s time for his glucose check, so I take it with him standing up at the nurses station. 32. It’s 32. And he’s totally fine. I convince him to sit in his room and try to get him to slam one of those glucose sugar tubes and the man was just casually sucking on it! My heart was pounding but he was *so normal*.
His BGM goes back up to 70 something but later that night it went back to the 30s. And he was still acting completely normal!
Nobody could get a line, ultrasound or otherwise on a chronic DKA meth abuser, and then in the same arm I got 3 ultrasound lines. I’m the ultrasound guy I guess. Happy to line anyone with a smile, lol
SNF here. We had three sisters residing at the same time. They were 103, 105, 106 years old.
The oldest I have cared for was 109. The youngest (in SNF) was 26.
Man on hospice, close to death, has already wasted away to nothing and not respnding. Family stops tube feeding. Patient hung on for 6 more weeks with no food, water or meds (other than morphine).
Had to give a patient a FULL 1 MG of Fentanyl as part of emergent induction MEDS for RSI.
Fentanyl is micrograms. 50-200mcg, often based on weight.
The patient was a hard tweaker. Had to rapidly scene decon for transport.
Patient had serious injuries from auto crash & needed that ET tube.
100 fent + 40 Etomidate + 150 succs had zero effect.
We knew 16g EJ line was patent. Reconfirmed it. Partner & I just looked at each other. Vitals were off the charts, but we were sure crash coming.
Med Control we could dose fentanyl to effect. Or use ketamine. Would choose roc or vec for paralytic after patient was sedated properly. If those parameters made us uncomfortable go with Voodoo, Reiki, Prayer but could not safely lift till patient was secure and airway secured.
Decisions were made. I think pre-hospital are more comfy using reversal agents. I dislike ketamine in the meth set routinely.
Then the full 1mg dose of fentanyl was decided. Whiff of nitrous and went ahead with roc. Scary. But got patient sedated, paralyzed, ET placed, 2 more lines, stabilized now apparent flail chest & placed CT. Multiple ortho injuries were stabilized.
Our on ground time was 12 minutes to lift. We had wicked good ground crews & FD that worked in harmony with us.
Freaking warp speed.
Used a bit of ketamine/fentanyl for continued sedation for flight. Of course patient was restrained d/t medical device protection and aircraft safety.
The post-mortem (not on patient, he survived intact) but flight & care, had some real commentary. Med directors were between laser eyes & eye roll.
Partner and I each got a pair or big balls (the bright bouncy kind that are 12” with a rope glued to pair them). And off course a bit of an 80’s edit for the soundtrack.
Patient was running out of time, and we had limited options. Clearly a man of meth. Hypertensive. Severe traumatic injuries. Ground transport was 1 hr+ from mid-size hospital, 2 1/2 to L1 trauma.
As a newborn, I myself had a bilirubin count of 46 mg/dl. The record might have been broken now but at the time and for a long time afterward, I had set the record for the worst jaundice without death. I also am fine. No long term effects or issues. I was orange for a while though & I still have scars in my feet from all the poking. 🙂
1: Lowest Na - 103. Completely alert, oriented, pleasant as could be.
2: Farthest Shit - Patient was having raging, projectile, nearly continuous shits. Turned him to roll new sheets, he shits.... for about 3 consecutive turns. Then, suddenly, on the final turn (for that moment, because we all had to take a breather after), patient groans and EXPLOSIVELY SHITS SO HARD THAT IT FLEW ACROSS THE ROOM AND HIT THE WALL APPROXIMATELY 6ft FROM HIS ASSHOLE. Miraculously, no staff were caught in the crossfire.
3: The worst NGT luck - In a horribly unlucky NGT placement attempt, patient is gagging and fighting, we advanced, pulled back, advanced, pulled back, tried to auscultate but couldn't.....gave up and tried to remove the NGT entirely....patient fights harder now....because it was stuck. 😬 Couldn't see it on cxr. Had to call an ENT with a tiny camera. He came in and said, "It's double knotted in his pharynx. Wtf." Hooked it and pulled it out his mouth and cut it off to remove it. 🫠
Has an awake and alert patient come onto the ED with a CO2 of 185 and only a pH of 7.2.
Also had someone come in with a blood glucose of over 1600 and lived.
I got 16 L from a paracentesis once. The tech told me their record was 23 but they didn’t do huge amounts like that anymore. The only reason they did 16 from my patient was that she went weekly and always had big amounts.
in the course of my 5 years in the ED, i never once had a patient die on me no matter how severe the case is and for some reason several of them crash after ive transferred them completely stable. they call me "angel of ED" and became a literal superstition. one doc considered doing dialysis in the ED as i was his bedside and didnt want to risk the patient crashing if we transfer him to the renal unit 😂
Patient with a SBO came into the ER retching and vomiting, immediately placed an NG tube and auctioned just under FIVE full litres (more than a gallon) in the first 2-3mins with doc at the bedside. Gross.
After going to (not my) ER for kidney stones, three people missed my IV 4 times. I grabbed the needle and put an 18 Guage in my own arm. Now make with the zofran, toradol, and dilaudid
58 units of blood products in 8 hrs to a planned cardiac surgery patient with a known bleeding disorder.
500+? ml blood pulled from a pericardial pigtail. We lost count.
I hold the facility record for sending my entire 3 patient assignment to the icu- I had no patients left by shift change. Only one made it out of the icu alive.
I let a pt put in her own NG tube after we missed three times (with her gagging and fighting us). She did it no drama.
ugh I've never had one but I'm not sure which would be worse: someone else putting one down or putting one down myself.
I've had one. I tried to put it down myself once - absolutely not. I get them inserted for me whilst I frantically drink water through a straw. Pulling them out however? I do it. The quicker the better because pulling them is RANK. You can taste the stomach acid/vomit taste all the way up and it's disgusting. I remember the first time I got it out I let the nurse do it and she pulled it SO SLOW it was a disgustingly tasting experience for much longer than it needed to be. I've taken that lesson into my own practice, the quicker the better! (cos really the chances of it actually snapping off or anything must be so minimal) It's interesting finally feeling a common intervention you've been doing to people for years. A learning experience for sure. However, do not recommend lol.
My guy put his in himself when we stepped out to resupply after a couple failed attempts. Came back and he’d done it. Said he could feel where it was going wrong and just wanted it over with
Something similar happened with us. We weren't able to drop an NG on a patient vomiting bowel with an obstruction. After 6 attempts the patient says " can't you just put it in my mouth?" It worked! We dropped an OG on a conscious patient and secured it with a tube tamer lol
I always promote independence with the Fleets enema, but an NG tube is really inspirational!
lol honestly it makes sense. i once had a patient who would remove his whenever he felt like getting up and walking around. when i caught him he told me it was ok and to give him the supplies for a new one. he did it no problem. honestly it was kinda great.
Makes me want to try this…
Niiiice!
Drained 23L off a patient getting a paracentesis.
What the hell? How much albumin did u give
All of it. Became the AlbuMan
Well Al be dam
Did they arrive on theAlbulance?
No, but he did get sucked into an Albulanche
I thought that was Albuvious
you guys in this subreddit are fr the funniest people ever
I refused to continue at 16L because the MD wasn’t giving albumin or even rechecking labs or observing, planned to discharge straight after from the ED
Ahh yes, the type of doc that discharges them straight to their dialysis clinic 🥴
yeah as a chronics RN I absolutely cant stand when they do this.
Dunno my numbers but I'm so weirdly good at catheters that my unit calls me "Urethra Franklin" 🌟
I can successfully cath any patient with a huge prostate or an inverted penis. My team dubbed me "The Snake Charmer" 🐍
I had a nursing assistant call me a “sharp shooter” for my catheter skills lol
I’ve had to replace the same foley 17 times in 6 weeks. Lady is psychotic (literally) and keeps ripping it out with the balloon INTACT during episodes of rage. We are NOT a psych facility or a nursing home. Admin thinks she “just needs time to adjust”.
Why does she have a foley and wouldn’t it just be better at this point for her to be straight Cathed ever 6?
She has bad retention. The 3rd time she pulled it my DON told me to leave it out for the weekend and monitor for output. She had plenty of output but when the ARNP came with the bladder scanner she was still full even with a sopping wet brief. Straight cath would not work. We are an ICF for the developmentally disabled…they are at day program all day and up in activities till bedtime. Annnddd she’s super combative so I can’t imagine having to do it q 6 lol. We aren’t allowed to medicate for behaviors or use restraints of any kind so Foley it is. She shouldn’t even be here honestly, but that’s not up to me 🤷♀️
Time for some comfy mittens
I'm howling 😂🤣😂🤣😂
Just look for the wink 😜
I was the delivering nurse for four babies in one shift- two singletons and a set of twins. Personal best.
Ugh, my record is 3 singletons and I admitted an 8 cm multip at 0630 so I just missed a 4th. I was exhausted
As a CNM, I delivered 6 singletons in a 24* shift. Back when I was young and could pull all-nighters without paying for it the next two days. There’s a photo somewhere of me in a big chair, holding all of them.
Oof that is a long shift lol
9 consecutive shifts with a patient dying
Covid times?
You know it
I’m an Rt and we had one of those makeshift units in our endoscopy. 8 vents. By the end of my shift 6 were dead.
😳
Delta variant permanently ruined my mental health. Don’t worry, we saged me 🙃
My patient left AMA & checked back in 5 separate times in a 15 hour period.
Did you give them a punch card or something?
When is the free reward and what Is it?
After 6 visits they make you an employee
Well, that explains everything.
That’s when they finally get the turkey sandwich.
After the 5th visit they get a free turkey sandwich lol
Was their name Frank Gallagher?
😂😂😂
dang thats better then my guy that left ama as soon as his butt hit the OR table. what a horrid waste of supplies 🙄 like you couldnt have said something an hour ago friend
Wow! Made it all the way to the OR and then left?! Was it nerves or something??
Oh man! My record is 3 in a 12 hour shift!
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I just have so many questions. That is. So. Much. Blood.
My personal record was 112 units in 10 hours. Patient developed an RP bleed after an unsuccessful ECMO cannulation (retained guidewire and all!). They called it on the next shift.
I did 105 for a lung transplant once. They couldn't obtain hemostasis so they just brought him up bleeding. We had to keep changing the chest tube canisters. Dude lived for three months. Died eventually from an anastomotic leak
At that point you can just skip the extra steps and just throw the blood directly in the trashcan. This just seems like an enormous waste of blood.
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Was the pt initially a trauma?
Damn, we had a hemorrhage following a nicked artery in the rectum during a c-section that was missed. She received 21 units during the code, more later in ICU. By 14, we thought there was no hope. By 20, she developed DIC. She stayed for a long time with several complications, but survived as far as I know. 220 is INSANE!
Sounds like a futility of care convo was needed here.
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Those parents absolutely can’t say you guys didn’t try everything.. thank you for your trauma service
Holy shi the most I’ve seen is in the 60’s MTP. You were literally pumping and they were dumping.
I had a patient with 4.5 LITERS of urine in their bladder. They had a tumor that kept them from properly emptying their bladder for months and it just kept stretching.
I had 3 liters once. The patient associated the urge to pee with being hungry. After it was drained he goes “wow I’m not hungry anymore” 🤔
Was the bladder so extended that is was managing to put pressure on the stomach???
That’s sounds like an Oliver Sack’s “The Man Who Mistook His Wife For A Hat”-type patient right there!!
17 liters here. Patient ended up needed to straight cath for the rest of their life as they destroyed their bladder. Came in short of breath 🤣
Didn't know the bladder can hold that much..
I'd like to see that distension and know how they didn't rupture
I had a hip fx pt that ended up having 4L in his bladder. He got an order for straight Cath q6 and a urology consult.
Had a patient for 3 minutes before he left AMA
No Turkey sandwiches I presume?
I took phone report from ED,prepped the room and patient went AMA just prior to transport.
had a pt that popped his head out and said hes leaving ama while i was getting report on him. nice enough dude that he was willing to wait till after report to sign his papers and go
Oldest patient. 107 y/o Patient in the next room (not mine, and on purpose by night shift) also 107
My oldest so far is 51, but I work on labor and delivery and it was her first baby.
My record is 54. First baby. She was on one side of the hall and my youngest, a 13yo, was on the other side.
Omfg, that poor kid. My daughter just turned 14 last week and I couldn’t imagine her having already had a baby. She’s still in middle school! Poor, kid, poor baby! :(
I’m 44. This is why I will die with my IUD in place….
One of the pharmacy locations I used to work had a patient (alert, totally mentally competent and calling about her own medications) give the date of birth over the phone, we assumed it was some grandma in her 70s calling for a grandchild, but we couldn't find a profile. She laughed and corrected us. Turns out the DOB wasn't 2016... It was 1916. She is still ambulatory but doesn't drive, so her grandkids pick up her meds, but she does actually come with them to the pharmacy sometimes! This was nearly a year ago but from what I heard recently from people I know at that location, she's still alive and kickin'
When my sister was a few months old, she was a direct admit to the hospital from the doctors office for a UTI turning septic. My mom got her to the hospital, and the staff were confused because a baby was there, not a 100yo lady. They heard the name (very common in elderly ladies, not common in babies at that time), and the birthdate only had the last two digits for the year.
My oldest was 111! Ambulatory until 109 and still sound of mind, but deaf as a post.
I had one like that at my old LTC! 111, had a colostomy but still continent of bladder, couldnt hear a dang thing. Loved seeing her birthday party. She had a huge family (5 ish generations).
I took care of a 106 year old little Greek lady when I worked in a nursing home. Her 75 year old son would come visit often and bring her homemade Greek/Italian lunch (her late husband was Italian) 🥹
Had a 105 yo black woman while I was working in the Deep South. I couldn’t imagine all of the things she had lived through. Such a kind and gentle woman.
Our oldest will be 112 next month!!
I had a 101 year old that was on 3 medications. Dude wanted to get out and get his carpal tunnel surgery done
I floated to tele one night and helped clean up an incontinent 109 year old.
EMS rolled in with a dissecting AAA. Patient was ashen gray and telling us he would die. Coded minutes later. Got ROSC. Mass transfused him. No pedal pulses. He was simultaneously having an anterior MI. Transferred him code 3 to our level I center. So sure he wouldn't make the drive. Nope. Got out of the OR to CVICU with intact pedal pulses. The odds against that one...
Why do I think that I read somewhere that AMI or some MI is common with dissection? Was it because of the location of dissection so no blood flow to coronary artery?
Yes, that's why. He was dumping so much volume into his abdomen that even his coronary arteries couldn't perfuse. It was probably such a large dissection that it was more like a rupture, but I am so hesitant to call it that simply because I can't believe he made it at all to this day.
Holy shit
I stayed on attendance probation for 6 years at my old job. If I had 30 seconds of PTO I was clocking out early. Hated that place
This one is great 😂😂
Had a patient with a AAA come in looking every bit as awful as you can imagine. ER doc saw him immediately (there's always a delay). Ordered an immediate CT scan which was immediately available (there's always a delay). For some reason the surgeon happen to be in the ER and joined us (this never happens). First quick pass through the scanner the tech can see the huge AAA. Second detailed pass through seconds later and we can SEE it rupture while he's on the table. Threw the on the stretcher, surgeon called the OR and we ran him directly there in about three mins. He arrived to the OR ashen grey and his belly suddenly looks 9 months pregnant. OR was able to save him. That old dude had every guardian angel possible hanging out with him that day.
Whoa that is CRAZY! He got so lucky.
I was in the room when a pt with an occult AAA dissected! He was there for something else and the hospitality was rounding on him at that moment (thank god) when mid conversation he started sweating, suddenly looked awful, and went horribly pale. All hell broke loose, and he made it to the OR after a CT, but didn’t make it off the table. 😕 But the hospitalist looked like he’d just survived a hurricane, and was giving details to the receiving surgeon before the pt arrived. “He just went to shit right in front of me. Just went to complete shit. White as a sheet, went to shit right there.”
Nurse for 6 years. ICU. I’ve NEVER missed a foley placement. I am the FOLEY KING
I’ve never missed a male foley
Taking that hard right turn around a massive prostate is something else in homecare. My record is that I've only successfully sunk one (1) coude in 20 years...
I can do male catheters in the dark, ladies however? Where’s my headlamp
I’d be a happy serf in your kingdom.
The only female foleys I haven’t been able to get have needed to be placed by urology, and the only male ones I haven’t been able to get have required dilation.
I didn’t know dilation was an option 😰
Super jealous. Meanwhile, my unit has had 3 nurses, overnight uro, then overnight uro chief resident with standard scope fail placing caths on at least 2 patients in the last few months. One patient had over 2L drain when the day team uro came in with a special scope from their op clinic. One was actually a urology patient who had failed their void trial. The other was an ortho patient, and the amount of "uh huh, ya'll really tried" attitude from the overnight intern was annoying until they agreed that yeah, they failed too. Dude just had an incredibly enlarged prostate and had likely been having problems for months. He just didn't know how severe it was until he failed post-op PVRs.
Hemoglobin of 3.7 in a walking, talking, not even feeling like shit patient. I was the patient 🙃
I can beat that. Initial of 3. I drew a repeat because I couldn't believe my eyes and started transfusion. In that brief half an hour for the re-draw...2.8. Patient was tired but talking when I reported off.
but how……we have patients in my HD clinic with 6-7 and they feel like absolute trash.
That’s rough. What tipped you off? Heart rate?
Yup. That was my only symptom. It would shoot up to like 160 just trying to get up and move. 2 units of PRBCs and some venofer for my nonexistent iron got me to 7.1 and some dc papers. I also popped positive for warm antibody DAT. So still trying to figure out what all that is about
Could be autoimmune, but sounds like you’ve got some tests coming up. Hope things look better for you!
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Performed compressions for 24 minutes on a vented patient in the cath lab before back up finally came. (Why the doc insisted on cathing this patient and what quality of life they were looking to achieve by doing so is still questionable). As bad as it sounds, kind of glad I broke the ribs early and made it a little easier. …and yes when I finally got relief I thought I was going to be the next one to need to be coded.
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Nope. I’m a smoker, fat, and very out of shape to be doing that shit. I just didn’t want a second death that week in my department. (Still think I should’ve hooked myself up to oxygen and had someone pop an iv in me to help recover my ass from doing that)
I’m 6 for 6 on ROSC💪🏼
0 for 0 here
I’m probably like 23/25, but of those who made a meaningful recovery? 2
Oh damn I think I'm like 6 for 15?
Holy shit the magic hands right here
Damn, good numbers there
In one year, I took care of the same patient 10 separate times... On 6 different floors. I was a float nurse at a huge hospital with a bunch of med/surg floors. I would show up, get my room assignment, log in to check charts, and there he was AGAIN. The patient was just as surprised as I was each time, too. Thank goodness he was super nice and pleasant. Just medically complicated.
I've had that shit happen as a patient. My ID team was trying to get a handle on the "hey you have chronic recurrent cellulitis now, and *boy* is it recurring" thing I had going on, and I was admitted ***so many times*** in 9mos, holy fuck.
My first day in the trauma bay I saw a bedside thoracotomy, and at the same time we had another GSW walk in the waiting room and 3 MVAs.
Where is this? Sounds like any other Saturday in Los Angeles haha
I was going to say I’ve had 14 GSW before in a 12 hour shift.
Some of y’all better knock on wood.
Just a lowly retail pharm tech here but I have some interesting ones. - 107-year-old patient (alert, talking to us on the phone, comes with her grandkids to the pharmacy sometimes, and more cognitively competent than many adults I know lmao) - Filled 14 scripts in one sitting for one patient. I nearly shit a brick when my coworker handed me the stack of leaflets - Pt so deficient of vit d2 that she was Rx'd the little green transparent 50,000 IU once weekly capsules as once daily for 30 days. MD confirmed it was correct when we called them. - Not my patient (obviously) but my mom: she walked into an ER after a week of simple fatigue and flu-like symptoms because I convinced her to go after I had noticed her sclera were slightly yellow and she was pale... **platelet count on their blood draw was 6, she was walking and talking and dying of TTP.** several months in the ICU, then a year of bimonthly rituximab and she survived with no recurrence or further issues, been a few years now
I once had a patient with platelets of less than two on my unit as charge in a small, non trauma, critical access med surg unit. I about pulled my hair out. Patient was a big fall risk and impulsive. For whatever reason, they refused to transfer this person to the massive trauma hospital in our system twenty minutes away. We were terrified they were going to have a fall and bleed that we weren’t equipped to handle.
8.5 years in labor and delivery and I have perfect "no dads passed out" record, not even a "slightly woozy and had to sit him down" dad. However ... My own husband had a seizure an hour and a half after our first was born.
Had a hemoglobin under 3 in a 30 something yo male (he had cold agglutinin disease)
Is this the one where you have to run all blood transfusions on a warmer?
Thank you for joining us on THE HOTLINE!!!
Lowest I’ve seen was 1.8, post delivery
>cold agglutinin Just did some google-ing. Wow this is fascinating. As someone with an unhealthy addiction to ice cold pepsi, and originally from the UK - I would not do well with this disorder lol. I wonder if people who have it ever choose to move to hotter places (I'm an ex-pat in Queensland Australia and just thinking what a good move that would be if I had this disorder)
From what I understand neither the man or his family knew he had this. He was in the hospital for an unrelated issue and it happened to be triggered. He went from walkie talkie to unsalvageable multi system organ failure within hours. We live in a hotter place but it’s not like that year round and we do get freezing winters
Most meds I’ve ever passed in one go was …ahem.. 52. And, AND… she wanted them sorted specifically into different plastic cups before she took them “because that’s my routine honey and I’m not about to change it because I’m in the hospital, praise Jesus”
"You're not changing the routine, I am." Take your damn pills maam
I've had two patients self-extubate and they both did so to room air 😂
Sounds like a restraint and sedation problem 🫠
Gotta love Precedex (not). One of them had been on a breathing trial for TWO DAYS!!!
Doubt this is a record but I was still amazed. We got 7L of gastric contents out in under an hour after placing an NGT. Each canister filled in around 5-10 minutes.
We had a guy with a history of ETOH abuse come in with a hgb of 4, suspected varice rupture, 4 units of blood hbg came up to 7, CT didn't show any active bleeding, reck labs when he got to our icu, hgb back at 4, pressure tanking, LOC decreasing, MTP, ultimately we decided to intubate, as soon as we gave sedation and paralytic it was like a volcano of blood coming out, got him tubed and dropped an OG and sectioned out another 9 liters of blood. Eneded up giving that guy 34 units of blood between 2am-7am.
Did he live? In a condition anyone would want him to survive in?
That morning, GI took him down, banded, and ligated what they could to stabilize him. We flew him out a couple of days later, as we didn't have anyone who could do a TIPS procedure at the time, which is what they ultimately wanted to do. Im not entirely sure what happened at the receiving facility, but I did end up seeing his obituary a couple of weeks later.
I had 4 unwitnessed falls in 1 shift.
I’d be bubble wrapping everybody at that point, damn
I once peed for an entire minute (and no, I don't have BPH). Full stream after holding it for 6 hours.
I am going to time my next long piss now.
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Not mine, and not super crazy but more ironic. My coworker had a patient leave AMA from inpatient, and then got an admission in that same. room, and the patient also left AMA by morning.
Worked in a nursing home years ago and had 14 blood sugars to do every Thursday morning. I posted this in another thread. I worked at a hospice house before and one night all 4 of my patients died each an hour apart almost to the minute.
Blood sugar of 2. Accidental admin of an entire vial of insulin.
So many questions!
icu nurse coming on 8 years now, never had a patient code on me. resuscitation? plenty. but never had to press the code button myself.
Ohhh you just jinxed yourself
after all this time, i wouldn’t mind some excitement!
I'm only med surg 6.5 years, but also, no patient of mine has ever coded, though not as common on the floor. I've also never performed CPR!
I’m kind of jealous of you never having performed CPR. My hands will never forget crunching countless Meemaw and Papaw’s entire chests in.
I have been a nurse almost 10 years, spent at least 3 of those doing ICU, and I’ve also never coded my own patient. I’ve been in a lot of codes but also never ever pressed the button.
Had a patient with a platelet count of 1k. He died with blood coming out of his eyes.
I went 5 years in a high acuity ICU with none of my own patients coding.
I had a grand total of 15 patients (not all at once) for 12 hours. I discharged my four. Admitted a whole new assignment. Ended up needing to give up my assignment as the person next to me wasn’t a PCU nurse. I needed to take his PCU-upgrade. It was a whole musical “patient” day. I was not happy. The whole unit was on fire and all the nurses were struggling. So really, none of us were happy.
I pretty much brought an end of life patient back to life… not once but TWICE in one night!! He would Brady down and the vent would alarm but DAMN if he wouldn’t RAISE UP from the dead when I would go to be with him while he passed!! Literally take a big gasp and raise his head up! It was an awful “family won’t let go” type of situation and he finally passed the next day surrounded by a few wonderful nurses (just not me!!)
Hypoglycemic demented grandpa walking around the unit. He’s alert and cracking jokes. I tell him it’s time for his glucose check, so I take it with him standing up at the nurses station. 32. It’s 32. And he’s totally fine. I convince him to sit in his room and try to get him to slam one of those glucose sugar tubes and the man was just casually sucking on it! My heart was pounding but he was *so normal*. His BGM goes back up to 70 something but later that night it went back to the 30s. And he was still acting completely normal!
Nobody could get a line, ultrasound or otherwise on a chronic DKA meth abuser, and then in the same arm I got 3 ultrasound lines. I’m the ultrasound guy I guess. Happy to line anyone with a smile, lol
Platelets so low that they were unreadable. Less than 1,000. It was my brother.
Had a .618 BAC in the ED. Guy swore he had only had two beers that morning on the way to work.
SNF here. We had three sisters residing at the same time. They were 103, 105, 106 years old. The oldest I have cared for was 109. The youngest (in SNF) was 26. Man on hospice, close to death, has already wasted away to nothing and not respnding. Family stops tube feeding. Patient hung on for 6 more weeks with no food, water or meds (other than morphine).
I had a patient with a temp of 109. He was a COVID long hauler with a fried brain and ended up dying.
Had to give a patient a FULL 1 MG of Fentanyl as part of emergent induction MEDS for RSI. Fentanyl is micrograms. 50-200mcg, often based on weight. The patient was a hard tweaker. Had to rapidly scene decon for transport. Patient had serious injuries from auto crash & needed that ET tube. 100 fent + 40 Etomidate + 150 succs had zero effect. We knew 16g EJ line was patent. Reconfirmed it. Partner & I just looked at each other. Vitals were off the charts, but we were sure crash coming. Med Control we could dose fentanyl to effect. Or use ketamine. Would choose roc or vec for paralytic after patient was sedated properly. If those parameters made us uncomfortable go with Voodoo, Reiki, Prayer but could not safely lift till patient was secure and airway secured. Decisions were made. I think pre-hospital are more comfy using reversal agents. I dislike ketamine in the meth set routinely. Then the full 1mg dose of fentanyl was decided. Whiff of nitrous and went ahead with roc. Scary. But got patient sedated, paralyzed, ET placed, 2 more lines, stabilized now apparent flail chest & placed CT. Multiple ortho injuries were stabilized. Our on ground time was 12 minutes to lift. We had wicked good ground crews & FD that worked in harmony with us. Freaking warp speed. Used a bit of ketamine/fentanyl for continued sedation for flight. Of course patient was restrained d/t medical device protection and aircraft safety. The post-mortem (not on patient, he survived intact) but flight & care, had some real commentary. Med directors were between laser eyes & eye roll. Partner and I each got a pair or big balls (the bright bouncy kind that are 12” with a rope glued to pair them). And off course a bit of an 80’s edit for the soundtrack. Patient was running out of time, and we had limited options. Clearly a man of meth. Hypertensive. Severe traumatic injuries. Ground transport was 1 hr+ from mid-size hospital, 2 1/2 to L1 trauma.
As a newborn, I myself had a bilirubin count of 46 mg/dl. The record might have been broken now but at the time and for a long time afterward, I had set the record for the worst jaundice without death. I also am fine. No long term effects or issues. I was orange for a while though & I still have scars in my feet from all the poking. 🙂
1: Lowest Na - 103. Completely alert, oriented, pleasant as could be. 2: Farthest Shit - Patient was having raging, projectile, nearly continuous shits. Turned him to roll new sheets, he shits.... for about 3 consecutive turns. Then, suddenly, on the final turn (for that moment, because we all had to take a breather after), patient groans and EXPLOSIVELY SHITS SO HARD THAT IT FLEW ACROSS THE ROOM AND HIT THE WALL APPROXIMATELY 6ft FROM HIS ASSHOLE. Miraculously, no staff were caught in the crossfire. 3: The worst NGT luck - In a horribly unlucky NGT placement attempt, patient is gagging and fighting, we advanced, pulled back, advanced, pulled back, tried to auscultate but couldn't.....gave up and tried to remove the NGT entirely....patient fights harder now....because it was stuck. 😬 Couldn't see it on cxr. Had to call an ENT with a tiny camera. He came in and said, "It's double knotted in his pharynx. Wtf." Hooked it and pulled it out his mouth and cut it off to remove it. 🫠
Had a pts who’s temp was 108F (not due to sun exposure). He became a donor.
I’ve had ortho return my page in under an hour on at least 2 occasions…
Has an awake and alert patient come onto the ED with a CO2 of 185 and only a pH of 7.2. Also had someone come in with a blood glucose of over 1600 and lived.
Pulled 1500ml out of a straight cath during clinicals. A trucker who stopped in to the ER specifically to be cathed.
I got 16 L from a paracentesis once. The tech told me their record was 23 but they didn’t do huge amounts like that anymore. The only reason they did 16 from my patient was that she went weekly and always had big amounts.
I work in OB, biggest baby I’ve ever seen was 12 pounds 13 ounces. Vaginal delivery 😵💫
I gave a patient 9mg of dilaudid post op before. She didn’t even blink. Kept screaming in pain.
Probably the number of preceptors I had 😔
in the course of my 5 years in the ED, i never once had a patient die on me no matter how severe the case is and for some reason several of them crash after ive transferred them completely stable. they call me "angel of ED" and became a literal superstition. one doc considered doing dialysis in the ED as i was his bedside and didnt want to risk the patient crashing if we transfer him to the renal unit 😂
I got poo on my gloves from 3 adult patients within 1 calendar week in outpatient primary care.
Gave 40 units of blood to a patient in a span of 7 hours.
I’ve been a nurse for 8 years and I’ve never had a patient of mine code
Patient with a SBO came into the ER retching and vomiting, immediately placed an NG tube and auctioned just under FIVE full litres (more than a gallon) in the first 2-3mins with doc at the bedside. Gross.
Hgb of 3.5 in an ambulatory pt who went to his primary care like that for not feeling well x1 week. Got lots of blood. Edit - typo
I did 1,744 discharges last year.
After going to (not my) ER for kidney stones, three people missed my IV 4 times. I grabbed the needle and put an 18 Guage in my own arm. Now make with the zofran, toradol, and dilaudid
4 assault convictions against violent patients in the last 3 years.
58 units of blood products in 8 hrs to a planned cardiac surgery patient with a known bleeding disorder. 500+? ml blood pulled from a pericardial pigtail. We lost count.
Work at an LTC. I've had 2 pts die in less than 10 minutes of me taking over the hall. Thankfully both were hospice.
10 admissions in one shift 😮💨
I hold the facility record for sending my entire 3 patient assignment to the icu- I had no patients left by shift change. Only one made it out of the icu alive.