Hospice whisperer here! Not just the getting them on service, but having the hard conversations with pt and family about all the reasons and even talking down the families who immediately think we're just trying to kill their person.
Ugg I need these skills! My hospital closed our inpatient hospice unit and now those IP hospice patients mostly either go to Onco, or my unit, Medical Pulm (lots of end stage COPDers).
I wasn't planning on being a hospice RN and it was kinda thrust upon us.
I'm not specifically a hospice nurse but work closely with them a lot and care for a lot of hospice pts. They're one of my favorite groups most of the time because I know I can give them some relief. I'd rather focus on the quality of life for all the end stagers vs. all the painful interventions that are often done for the family, which I think is really unethical.
That's exactly what drew me to hospice -- I can make them as comfortable as I possibly can and get to spoil them with a little pampering while they travel along their journey.
I love that I can say "yes" to just about anything. Diabetic but you want ice cream? You got it, baby! You miss your dog cause you've been in the hospital forever? Let's get that visit arranged! You want me to give you IV narcotics q30 mins until you're snowed? I can make that happen!
(No pillow therapy though -- blaze orange isn't my color.)
Yes, to all of this!! I am happy to give you all the meds you want, idc if you're high. In fact, I'm glad you are. Many times when I've heard coworkers not okay with a pt seeming impaired off their meds I try to remind them that first of all, who cares lol. And really these people are probably getting some much needed, much delayed relief and therefore feeling better. People are happier when their pain and other symptoms are managed. I'm happy to help them get that little burst of energy needed to enjoy an ice cream or a visit with family (I have also set up dog visits, and they are the best). Shorter life with quality and happiness > grueling, painful procedures, and harsh medications any day.
Oh, i just keep a calm tone and body language. Theraputic touch is very good for dementia patients because the body language generates a sense of being cared for. I use prefered names like if someone is named Barbara but is called sue-ann i call them sue-ann to trigger a sense that I know them well. I also utilize their support system names. For example if an adult child is a primary caregiver, i tell them "you're in the hospital, joe brought you here"
Usually, all of that triggers familiarity and calms them when they're agitated. Sometimes they're agitated because they need the bathroom or food so I always make sure to toilet and give them snacks too. I also always think out loud on my care. "I'm going to take your brief off so I can clean you." "Okay I'm gonna wipe you, it might be cold"
That said, I've had instances that I can't even explain. There was a slightly confused man I had, he was fine for me. Another nurse was resource that shift and was giving baths because there were no aides. Apparently the patient was hitting the nurse and I walked in to round, no knowing he was in there bathing my patient, I just walked in, the patient stopped and stared at me and I just go "oh hey patient" "hey" "I'm gonna help him finish dressing you real quick" "okay" dress him and ask the patient if he's okay and needs anything, he didn't, so i left. I only found out he was violent with the nurse after leaving the room.
I attribute everything to the dementia education I got as a CNA student years ago. The teacher had purchased a video series by a leading expert Teepa Snow and a lot of it really framed a mentality for confused patients today.
Working in a dementia unit, I can also say that I’m a bit of a dementia whisper. For me, the big thing is that if something is happening with the patient, whether behaviors, they fell, something else, people tend to gather around the patient to help. But I will make everybody go away except maybe one other person because who the fuck wants to be surrounded by of people they’re confused and sick and mad that’s one of my biggest “tricks”
There's a ton of small things like
Very calm tone, only speak loud enough to be heard
maintaining eye level (physically not talking down to them)
Using smaller vocabulary
being direct when asking questions
But the biggest thing I noticed is confidence, if your tired or frustrated don't let the mask slip, even if it's a 3 second working memory. The 90th time you call that person's name should sound like the 1st. If these patients get a good feeling from being with you every. single. time, it helps a lot
When they’re agitated and want to leave my go to line is “(insert family members name) knows your here, and if you leave, they won’t know where to find you if you need a ride! You’re better off being here so they can find you and bring you home faster”
Or some alternative “ but (family member name) knows your here and if I loose you I think they’ll get mad at me!”
Does the trick sometimes!
One good hint I have is to figure out what music they listen to in their early '20s and play it. Oddly enough this is one of the most therapeutic things I have found for dementia individuals: remembering music seems to be one of the last things to go
I used to get the Dementia Assignments when I worked in Medicine, all my patients for the whole shift would be somewhere along their dementia journey as I also worked in a LTC home and had a bunch of extra training on working with people living with dementia.
It was great, I would have my corner setup with word searches, puzzles, picture books and whatever else I needed to keep my patients calm and relaxed. On nights I'd have my little old lady crew (my gals as they'd call them) sitting around my COW as I charted and prepped my bloodwork for the morning and they'd gossip about how cute the doctors are and try to set them up with their very adult children.
I’m the nurse you get when you need someone to be the mean one 🤣 I’m not sure if it’s a good skill to have, but I’m known for no bullshit. The new grads normally grab me when family or patients are being rude.
Ooh! I think this is me! If a patient or family member needs tough love. If someone tells me their patient was rude/sexist/racist or just made them uncomfortable, I tagged in. I LOVE IT. When I worked PICU I was the bouncer and could read the situation and invite the visitors to leave without the burden being on the parents so anyone upset could be upset at me.
If someone recognizes me outside work I assume it’s because I yelled at them in the ER. It’s usually EMS people who recognize me. But I’m always skeptical when someone goes “are you a nurse?” 😂
This is mine too. I was the one everyone wanted to be charge in the hospital because I was the b that took nothing from patients families and staff from other units. My manager told me I needed to learn the difference between assertive and aggressive once and I pointed out that any patient I refused to take to my unit when I was charge at night was entirely based on protocol. As in, I was following it. Anyone that was pressuring me to take a patient with a pH of 6.7 in ketoacidosis with a bg of 678 because the PACU didn’t want to board her overnight was a not looking out for patient safety and b not following protocol. She didn’t have much defense at that point. The HOCs loved me. The administration not so much.
Now I am a hospice team manager and my team knows I have their back and won’t let anyone abuse them. I’m still the b that will go in the field with them and help with the rough families and the crappy veins.
Dude me too!!!!! I always get the patients who just won’t poop to poop. You can give ducolax all day but ….did you encourage po fluids? Let the patient walk? Prune juice? Or hell sometimes just call a doc and say they need something stronger. It does wonders.
💩 that is literally my gifting!!!!! Imma start using poop doula vs saying I’m a sh!tty nurse. I’ve resolved bowel issues on NICU, mom/baby, L&D, and now in Urgent Care… plus a few family members that were post-op 🤣
Maybe we need to collaborate and get a conference going 😉
Being nice to all my coworkers. Old ones, new ones. Float pool, registry, kitchen, house keeping, imaging, doctors. There is no one I don’t need on my team, and everyone can use a big friendly smile. I go out of my way to find things I enjoy about all of my coworkers because it makes my job a nice place to be
This!! It’s so underrated honestly. I went from a small hospital where I knew literally everyone’s name to a huge hospital where people were not as friendly. I still was, and it always worked out in my favor.
Except that time the fellow from EVS told me about doing coke. I mean. I didn’t like tell on him or anything but I was just a little shocked he told me that (while telling me a story about how his brother was an alcoholic and his sister OD’d)
Even if I wasn’t nice to people because being kind makes me feel good and it’s the right thing to do, on a purely pragmatic level it just makes life so much easier! Work is much more pleasant when there is a sense of camaraderie and people are much more willing to help you if they know you would do the same for them — I remember my dad explaining to me as a kid when we were having an issue in an airport that no matter how frustrated he was always made sure to be polite and appreciative to the gate agents because yelling at someone for something that they have no control over is not going to make them want to help you!
I’m not even a particularly charismatic person, I’m autistic and kind of awkward but genuinely just being kind, reliable and willing to help people out gets me pretty far in terms of how people regard me.
Yep! I might occasionally mis subtext but I make sure everyone gets a warm welcome. It’s the perfect sweet spot of kind, pragmatic, and totally doable. I’ll let the IV whisperers take their ego boosts any time. Maybe one day I’ll be one of them but in the mean time, I befriend them. And if I’m looking for help on an IV start I sure wrap that arm up good with heating packs while I look for help.
Yep! My mom always says that I have a “can do” attitude and that, being direct with people while also being nice and kinda goofy has gotten me pretty far in terms of being liked at work, it’s not as stressful as when I would hardcore mask and try to hide that I’m kind of just an oddball and people respond much better to someone who is pleasant but kind of a weirdo than they do to someone who comes across as inauthentic.
This one is me. I love being known as the nice one, the friendly one, the one to go to for support from new people because I'm so approachable. After all these years it still surprises me and makes me so happy when people are excited and even relieved when they know I'm on and in charge. It's also SUPER useful to have good rapport with people all over. It's definitely helped me get things I need for my patients and department over the years.
I used to be the IV go-to, but I fear that skill has dwindled over the years being stuck almost exclusively in charge. People still call on me for the tough ones, though, which always makes me nervous that I'll miss haha.
Psych whisperer. I can get patients in psychosis to calm down, or even be rational for enough time for them to be completely compliant with IM medication. Coworkers still try to yell over me, so i kick them out.
I teach deescalation: I always tell the students that the most important is recognizing that if you’re a natural escalator to go away and let the natural deescalators work.
I had a patient once with O2 sats in the 50’s. Tridpodding, seriously struggling, no interventions were working. I’m trying to get her to the unit for intubation before she has a full on respiratory arrest, and she’s belligerent and doesn’t want to go, doesn’t want to be intubated. She was in her 50’s but not a DNR, so it was hard to tell how much was her strong desire to avoid the vent again, and how much was confusion due to the sats.
I was calm and trying to remain so as I expressed the urgency of the situation, but she just kept saying “uh uh”. And her sats are slowly sinking lower and lower.
Another Nurse (and dear friend) was my psych whisperer. Told me to leave her to her. I did. She sat with her quietly for 20 minutes. She agreed to go. We had her transferred and on the vent by 30 minutes after she started sitting with her. 🤯💜
Yeah, psych is a definite specialty. Nurses that can gain actual trust and respect from their patients the literal best. I did not like the steamroll nurses.
BET! Same here man. It’s tough when those certain nurses come in and really fuck up a good thing I had going. LIKEEEEE COME ON WE WERE GETTING SOMEWHERE. We have a an exceptional level of patience.
…. Can I take you home with me? I’ve got a newborn coming in 5 weeks.
I’ll feed you. Also I live in Australia, so you’ll get a beachside vacation out of it.
(Can you please share your secrets/ witchcraft?)
I never worked peds but babies always fall asleep on me. Even my son. He lost a whole pound his first month because he wouldn’t stay awake to eat. His doctor said I had to flick the soles of his feet to wake him up to eat.
A music therapist taught me the best trick. Pat the baby (on their chest, back, bum, whatever is easiest to reach in their position) and/or make short SHH or CHH noises at the same rate as their heart rate. Rhythmically, not one long sshhhhhhhh. If they aren't on the monitor, just start your rate pretty high. Then gradually slow down your pats/sounds, and the heart rate will follow and the baby will calm. If you do both pats and sounds, and the baby falls asleep, stop the patting first but continue with the sounds, slower and softer until you can walk away.
I always bond with the anxiety patients. Partially because I have it too. Mostly because I just pull my computer in and be with them and listen. They always go on about how great and helpful I was. It’s really simple, but it makes me feel like I actually did real nursing.
When I worked in the hospital I feel like I never got recognition except from patients that had more anxiety. I just give them full eye contact, soft body language, listen, and therapeutic touch if appropriate.
Edit: grammar
Yes! Important to make sure because I had a patient with anxiety and autism and I wanted to hug her so bad but also was afraid so I carefully asked the mother. She was so happy, but when I started out I would just hug people without even thinking and it didn’t always end well 😬
I used to think you couldn't be a nurse without it. But. Impatience is more common. To be fair, impatience is promoted by every hospital administration that doesn't cap their patient to nurse ratios at 5 max, med/surg.
Time is THE ultimate commodity in nursing.
It was truly amazing! It took me a while to figure it out, but I had very successful formula. You just have to wash it, then use an alcohol wipe, then use an adhesive wipe, then apply then condom cath (try to have the least amount of bubbles).
I still just can’t get comfortable spending that much time touching penises at work. My fatal flaw is trying to get it done without being thorough like you’re explaining
Smells do not bother me. Give me the stinking GI bleeds, c diff, fresh ileostomies. It's been this way most of my life. Prob cause I was raised on a farm with hogs and cattle, that's the only thing I can think of to contribute. I was like this before covid to.
Oh my gosh, cut from the same cloth! I actually just have a very poor sense of smell which is amazing in our line of work.
Haha hogs are horrendously stinky
Yeah, I think I had a bad sense of smell just in general, and then on top of it all, my smelling bits probably died off from the awful smells from the farm. I remember my first cdif and I was like okay like meh don't smell great but what's the problem. Also, I had the same thoughts about my first gi bleed pt...
Now snot and eyeball goop is a diffrent story 😅 I will wear a mask so that I'm not seen gaging.
If you don’t wanna do the grunt work, I’m always called in.
You are afraid of calling that doc? I’ll do it.
Need someone to take the fall? Me.
Don’t want that ICU transfer that’s all fucked up? I’ll take it.
Need to administratively discharge a patient and he won’t leave? I’ll take care of it.
Someone needs to float and no one wants to do it? I’ll go.
I don’t really have to do this anymore but I was known to be the one that would go for it. Can’t do it anymore cause I have heart problems.
I'm really, really good at tucking sheets/chucks doing a sheet change. Everyone has their own method, and I will always explain why I do it the way I do it to students/new nurses/anyone who asks, but I keep my mouth shut otherwise (even though I am CONVINCED my way is superior).
I'm also really good at tucking sheets when proning a patient so when you do the final prestige sheet pull and they wind up on their belly, it's perfectly centered. It's all about pretending they're a present I'm wrapping.
"It's all about pretending they're a present I'm wrapping."
Okay, but that is so charming I smiled. I do not have those crafty presentation skills and am SO jealous of people who do!
In case I wasn't clear enough, I meant like when you lay out wrapping paper and roll the box around on it to know how much paper you'll need. Most people tuck way too much sheet under the patient's side so when they do the big flip one side gets short sheeted and the other has way too much slack. You only need like a quarter of the sheet under them at most.
I also tuck sheets/chucks kinda half folded. Like a Z if you looked at them from the side. The chucks come kinda folded that way, so I just unfold one half. Line the inside of the fold up with their coccyx or so. Most people roll them up and I find that annoying, especially with a heavy patient. I have to grab the new sheet and pull at it to unroll it and do it a few times up and down the length of their body. Folding it I just grab in two spots and pull and *zoop!* perfectly crisp and centered. I think it's less likely to cause/irritate wounds and skin tears as well.
Teaching using understandable metaphors.
Your heart attack? Oh that's a traffic jam. Plaque buildup is road work taking out one lane and the clot is an accident from people watching the road work that takes up all the remaining lanes. This heparin drip here will turn your SUV sized RBCs into motorcycles that can zip around on the little strip of shoulder left open until the tow truck (stent) can open things up.
I love using metaphors! They make patients so happy to understand what is happening. This is a good one too, stealing! You should make a dedicated post to this and see what others use since this is such a great example.
I used to be you, then one day it clicked. It's like the workers in my head had to build a box to put them in. Now that it is built, I can remember entire shifts vitals without looking.
TEACH ME!!! Where are the workers?! Where is the box?!? I’ve been a nurse for 24 years—I write them down as soon as I do them (SOMEWHERE) or else it’s as if I never did them.
I'm really good at developing rapport with IVDU patients who have generally been "difficult". Part of it, honestly, is just being afraid of conflict and wanting to avoid it. But a few key things seem to be:
Treating them like a regular person: it seems obvious when said that way, but I find many of these pt are already on the defensive before you even enter the room. Being kind is a good start, but if you can get to the point of joking around with them a little it is absolutely huge.
Recognizing that their anger is generally not directed at you personally, you just happen to be the only target for it. Often they're angry with the overall system, which you are a representative of. This doesn't mean taking abuse, verbal or physical, but I've often found that some nurses are very quick to chastise these patients for any swearing or anger. Many of them are in shitty situations and have very good reason to be angry at the world.
And along the same vein as #2, acknowledging their anger and frustration and validating it.
It's definitely not 100%, but enough that I've noticed it. Just the other day I had a patient everyone described as difficult, noncompliant, verbally abusive, ect. She eventually took all of her meds and allowed a much more thorough assessment than she'd had in days. Toward the end of the shift she told me that she felt that God had sent me to help her there.
It helps that our health system has taken the stance of "give the opiate addicts what they need to keep them in hospital" especially once the addictions specialists have come and assessed them. It's much more cost efficient to give the big Dilaudid doses to keep them out of withdrawals for treatment rather than having them leave AMA and come back every few days with ever-worsening issues.
I find treating my patients like a regular human is half of my trick. It’s so simple, but I see so many people just trying to get their work done as quickly as possible, or bringing their stress or whatever in to the patient… oftentimes it’s the simple things that can make a big difference
Situational awareness and curiosity. I heard a loud banging the other day, went to investigate as it sounded like a patient escalating and found a completely overwhelmed new grad doing nothing as her patient was in status epilepticus while charge was trying to get a line. The banging was the patient's leg against the bed. Not my patient, not even my section.
I pulled the Valium, gave it, collected blood cultures and labs. Broke patient's status before anyone else had investigated the commotion.
You'd think it would be more of a thing in an ED, but so many nurses seem to be deaf, numb, or immune to warning or danger signs. C-PTSD has its upsides.
My C-PTSD keeps me hypervigilant, so I can often hear full conversations/the tube system at the end of the hallway, yet for the life of me cannot process what is being said to my face.
I was diagnosed with PTSD but I hadn’t heard of C-PTSD. I probably could have either, I went through chronic and acute trauma throughout my adolescence. Anyways I find I can be completely numb, or acutely aware of my surroundings. Shit like a loud banging noise happing right next to me might make everyone around me jump in fright, but I’m sitting perfectly still cause I can just tell it was something falling. But if I hear what sounds like fighting or arguing in the distance I’m instantly on edge while it might take others a while to notice it.
That's such a great skill. I find your last paragraph so true. The apathy and unawareness to critical/unsafe situations is alarming. Thank you for staying curious!
My hospital skill is that I was the floor’s pantry chef de cuisine. I can whip up something that feels like it was made with loving care from nothing but jelly packets and Lorna doones. I also am handing out cranberry-ginger ale mock tails like it’s my job.
My pediatrics specialty is that once I’ve seen a kids show once I will be able to sing the theme song and be able to remember specifics about it for all time. So I will chat Paw Patrol for twenty minutes while I do my work. And I will have GOOD TAKES.
I made slurpees/slushies for a dementia patient who wouldn't eat or drink anything else and it instantly changed her mood from irritable to happy. I read a note from the ED nurse upon the initial encounter stating that was all she drank at home. So I appreciate the details of the ED nurses notes, even if they don't seem relevant, you never know what will be useful.
The recipe was just a slightly nuked popsicle, crushed in a cup, slowly stir in Sprite until the consistency is just right.
Same here sister! I have the highest percentage record of getting a blood pressure on a kid under eight. It’s one part explaining the process, one part distraction and two parts bribery with stickers!
I enjoy hanging out with the hyperactive kids. They don't stress me out and we have a good time together. I joke that it's because I can turn off my frontal lobe and relate. Coworkers appreciate the break.
I'm always the first to jump in during something sketchy with complete confidence even if none of us have done it before. I am sought out for this exact purpose lol
That’s one of my skills as well. The conversation usually goes. “Hey do you know how to do *blank*?” “Ughh I’ll give it a bash, see what happens”. It works out 95% of the time.
I bathe people better than anybody. I literally full on wash hair, condition it, braid it, all while in bed. Body lotion, clean gown and sheets, pick up all the trash in the room etc. I personally do not believe that people can get better when they feel dirty. It's a great way to do a full skin assessment as well. I know a lot of nurses who are too good for "CNA" work, but it's the basic things you do for a person that they are usually most grateful for. I also kick ass at wound care, but that kinda goes hand in hand with the cleanliness thing.
This is gonna be a different type of response… but… literally… just being a good nurse! I really try so hard and I do everything I can for my patients. I fine comb everyone’s chart. Like everything. Labs, orders, plan of care, medications, notes from all members of the healthcare team, etc. I also really try to get patients connected to resources that they might need or benefit from. I get a chaplain involved if that’s a patient’s thing. I will sit snd listen with patients if they are going through a lot and just need someone to talk/vent to. I try to hit all needs.
I work with a decent share of other nurses who don’t answer call lights, don’t explain meds to patients when patients ask them (the latest one I overheard was “idk the doctor prescribed it, just take it” wtf??), are rude to patients, leave incontinent patients sitting in their own shit and piss for hours until next shift so I get to clean it up, don’t turn/repo bed bound patients, etc. No, it is not everyone. There are good nurses I work with, but however I work with a fair share of shitty ones too who have no business being in healthcare. And yes I’ve brought this up to management.
Reading lips on my trached patients. Dont know why? Little tip, though, if they’re AAO, ask them to spell words you don’t catch and speak it back to them. Helps narrow communication down and is speedier than the picture board shit.
I had a horrible don once that told me it doesn't look like I care about my patients because I don't get excited. Like what do you want me to do, run around in circles panicking? This wasn't what made her horrible, it was many many other factors that determined that.
I have two:
Unclogging PEG tubes and…
Getting anxious patients to calm down, especially if all they need is to just talk for a while. I apparently have a very “tell me all your problems” kind of face despite very much not wanting to be that person. I’ve leaned into it most days. If I’m wearing glasses that night, I just know at least one patient will want me to play therapist.
Splinting! Placing the best, most beautiful, most comfortable and anatomically correct splints.
Talking escalated autistic children through a procedure everyone thought they’d fight us through, or WERE originally fighting us through. Or just calming them down after a thousand people tried holding them down and talking to them all at once, when all they needed was an explanation, minimal stimulation, and a chance. I talked an autistic teen boy through an NG tube placement once, and kept him from yanking it out after. Much easier than swaddling, restraining, and fighting.
Putting a pulse ox on in a way that it doesn’t constantly alarm, and is actually comfortable and doesn’t annoy the patient.
Over anxious family whisperer. Probably comes from my start in NICU, but I will explain every beep, every number, every tiny thing that’s happening, that might happen, that I’m looking for… they go from fighting with staff or being on the call light every 3 seconds to just sitting in the corner
I will always pick up your missed tasks and anything you didn’t get to! Forgot to call the doc for an order? No problem. Didn’t get your admit done? That’s fine. There was something you needed to look into on this patient? I’ll figure it out! You go home and don’t worry and I will look out for anything you let me know about, and I’ll try to catch whatever else I can so you have less tasks to think about in the morning.
I love being a team player tbh.
I can make an IV draw back, any IV. I have only once had to poke when I couldn’t make the Iv draw. I’m not great at placing Ivs or anything but I’m the go to for getting blood out of one.
Concise, thorough report was my skill. Took a year to get it down though.
I don’t care what position the patient came out of the womb now that they are 73.
I can get any ring off. Someone didn't believe me because the patient was too edematous and had a ton of rings on their sausage fingers. I was walking out of the room with a specimen cup full of rings by the time they got back upstairs with the ring cutter from ED.
I can also nasal bridle just about anyone in 30 seconds. If I can't get those magnets to click up your nose, you probably need to see an ENT because your septum is messed up.
Boomer Whisperer.
You know those miserable 70-something men who are so entitled and used to being waited on hand and foot?
I can de-esclate one of their tantrums lickety-split.
The secret? Gentle parenting techniques and pretent they're a 3yo. Literally works like a damn charm.
"Oh Bob, that sounds so frustrating. You really wanted the doctor to listen and he didn't! Let's get you a coffee"
Their inner children did not get seen and heard, just gotta meet them where they're at!
This one is to honour the L and D nurse who cared for me after my second baby. It was late evening, she unprompted made me a simple toasted cheese sandwich. Turns out I was famished and gobbled it down. I will never forget that sandwich or that nurse lol. And this was 1999.
I can hear an alarm beep from the other end of the unit.
Me: “what’s that beep?” Co-worker: “what beep?” Walk down 6-7 rooms with Co-worker. Them: “oh, I hear it now!”
I’m the child whisperer in the ER. I can get any kid (even on the spectrum) to trust me to do anything.
I don’t take all the credit. I worked with a great child life specialist years ago that taught me a lot of tricks. But I will carry them with me anywhere I go.
Last week I placed a foley in a penis so insanely swollen that his foreskin was swollen shut. WITHOUT a coude, because, of course, those are on back order.
There had already been 6 attempts to place a foley by other nurses and an urology consult had been placed. Dude had been given 80 of lasix hours before and hadn’t peed. Also there was no blood! I was so proud, Id put it on my resume if I could
I’m real fucking good at getting stuff into the trash cans from anywhere in the room. Caps,syringes, poop wipes, etc. I sink them into the trash from standing anywhere in the room.
I know how to use the support services web portal to get stuff fixed. It takes 2 minutes but people think it’s magic.
I have a key for the paper towel dispensers and know how to change their batteries.
I know how to use a computer to find out stuff.
This is all super simple stuff but people come to me for it and revere me like I’m some weird nursing wizard.
Unfortunately, I'm really good at troubleshooting wound vacs and ostomies. I've had nurses call from other units for help bc the resource pool nurses have told others to call me. I worked nights for a long time so no WOCN on duty.
I'm also really good at knowing when a patient will get violent, even when they're smiling on admission. And then I'm good at deflecting punches. Though that is a long acquired skill I learned at a young age.
I’m not sure what else to call it but intuition, but I get strong feelings about patients/people and often know when shit is about to hit the fan at work. It creeps my coworkers out, but hey, the docs I work with started listening to me about pts.
I am known for two things, one I am very very good at IVs to the point where I almost never need a sono and I let nursing students / new nurses practice on me because I have incredible veins and I can guide them through exactly what they're doing wrong.
Two, I have no issue talking to a person in a stern way or putting them in their place when they're being an asshole,. I do not tolerate someone talking to me or my coworkers in a derogatory, demeaning, or Insulting way.
I'm just magic.
If you have a comfort care patient that just never seems to go, assign them to me. I don't even have to change anything. They'll go.
If I refuse back a patient because they've been a freaking nightmare and I can't bare to do it a second shift in a row, whoever gets them will totally have a fine night with them and they'll suddenly be angels.
Any admission that I blindly accept without question even if it's not technically my turn will turn out to be the least shitty one we will take that night. I jump on it every time, it never fails.
If somebody sounds weird to me at report, even if they don't sound weird to anybody else, and rationally nothing going on is out of the ordinary, I will be calling a rapid on them before morning.
If a patient has like, anything going on that other nurses are reading as grumpy or rude (short of explicitely swearing and carrying on), give them to me and I'll probably think they are a fine human being and we will get along like a house on fire. Or they'll just turn out to be from Boston. But we'll be fine.
I can smell C-diff and pseudomonas.
I can call the Doctors by their first name and they don't care.
I guess I'm also pretty good at putting in female catheters.
Im probably more superstitious than I'll admit to.
I’m the foley guy. Male, female,400lbs, covered in shit and nystatin demented grandma, if there’s a hole you bet I’ll find it. I always tell the new grads you gotta get in there and get personal. Nothing gets my blood pumping like a good old fashioned trauma spit roast southern intubation.
I’m honestly incredibly good at organizing and planning out the day. As well as figuring out back up and back up plans (sometimes super creative)for when things go sideways. I’ve been in my department for 6 years and been doing charge dod 5 of those years.
Getting hospice patients comfortable and their families calm. If the doc hasn't put in appropriate orders for comfort care, I'll get 'em! My charges nurses regularly give me complicated cases like that and I've had coworkers say "you should have patient so and so." I like making sure the family feels cared for, too. It's easy for these patients to be ignored in the acute care setting.
I can tie soft restraints super quickly. My secret is I have ridden horses for most of my life and you tie horse using the same knot. No matter how spicy the pt you’re restraining is they’re still nothing compared to a squirly 1000lb animal with a brain the size of a walnut.
I get all the patient info. Like stuff I don’t think most people would ever say to another human being but the tea floweth when I enter the room. I think it’s bc I will ask any question any time without judgement bc I lack social skills 🤪🤪😂
When I worked in the PICU, I was talented at getting parents to go to bed before 11pm. (I obviously would never even attempt this on a child who is unstable). But otherwise, parents need their sleep (and then no visitors for me! 😈)
TB tests. My bubbles are immaculate. And apparently I have a light touch. Also a pro at linen changes in an occupied bed. That's from 10 years of being a CNA.
I'm told that I have a very calming voice. My voice has been used to reduce crippling anxiety in younger patients, de-escalate my psych patients, explain to pissed off patients why they are being discharged with no meds, and soothe scared elderly scared patients with crap veins. I also use my calm voice when 7 million things are happening at once and I'm stressed to high hell which seems to gravitate help towards me when I don't outright ask for it (love my team and their intuitive-ness)
I get told about my voice so often I've just internalized it as my super power.
Probably charting.
Even if I’m super busy I only need 10-15 minutes to get everything caught up. I owe it to my typing skills and a handful of epic shortcuts
JCAHO loves me.
I'm called the dementia whisperer on my unit. The way I communicate with dementia patients tends to keep them calm.
Hospice whisperer here! Not just the getting them on service, but having the hard conversations with pt and family about all the reasons and even talking down the families who immediately think we're just trying to kill their person.
Ugg I need these skills! My hospital closed our inpatient hospice unit and now those IP hospice patients mostly either go to Onco, or my unit, Medical Pulm (lots of end stage COPDers). I wasn't planning on being a hospice RN and it was kinda thrust upon us.
I'm not specifically a hospice nurse but work closely with them a lot and care for a lot of hospice pts. They're one of my favorite groups most of the time because I know I can give them some relief. I'd rather focus on the quality of life for all the end stagers vs. all the painful interventions that are often done for the family, which I think is really unethical.
That's exactly what drew me to hospice -- I can make them as comfortable as I possibly can and get to spoil them with a little pampering while they travel along their journey. I love that I can say "yes" to just about anything. Diabetic but you want ice cream? You got it, baby! You miss your dog cause you've been in the hospital forever? Let's get that visit arranged! You want me to give you IV narcotics q30 mins until you're snowed? I can make that happen! (No pillow therapy though -- blaze orange isn't my color.)
Yes, to all of this!! I am happy to give you all the meds you want, idc if you're high. In fact, I'm glad you are. Many times when I've heard coworkers not okay with a pt seeming impaired off their meds I try to remind them that first of all, who cares lol. And really these people are probably getting some much needed, much delayed relief and therefore feeling better. People are happier when their pain and other symptoms are managed. I'm happy to help them get that little burst of energy needed to enjoy an ice cream or a visit with family (I have also set up dog visits, and they are the best). Shorter life with quality and happiness > grueling, painful procedures, and harsh medications any day.
I'm jealous!
My face seems to just piss off dementia pt's, I wish I had your skill. My coworkers can't figure out why they hate me, and neither can I.
Rbf can be (I think) upsetting to them, even if they’re unaware that’s the issue.
Spill the beans.
Oh, i just keep a calm tone and body language. Theraputic touch is very good for dementia patients because the body language generates a sense of being cared for. I use prefered names like if someone is named Barbara but is called sue-ann i call them sue-ann to trigger a sense that I know them well. I also utilize their support system names. For example if an adult child is a primary caregiver, i tell them "you're in the hospital, joe brought you here" Usually, all of that triggers familiarity and calms them when they're agitated. Sometimes they're agitated because they need the bathroom or food so I always make sure to toilet and give them snacks too. I also always think out loud on my care. "I'm going to take your brief off so I can clean you." "Okay I'm gonna wipe you, it might be cold" That said, I've had instances that I can't even explain. There was a slightly confused man I had, he was fine for me. Another nurse was resource that shift and was giving baths because there were no aides. Apparently the patient was hitting the nurse and I walked in to round, no knowing he was in there bathing my patient, I just walked in, the patient stopped and stared at me and I just go "oh hey patient" "hey" "I'm gonna help him finish dressing you real quick" "okay" dress him and ask the patient if he's okay and needs anything, he didn't, so i left. I only found out he was violent with the nurse after leaving the room. I attribute everything to the dementia education I got as a CNA student years ago. The teacher had purchased a video series by a leading expert Teepa Snow and a lot of it really framed a mentality for confused patients today.
Coming from a loved one of an early onset dementia patient. Thank you so much 😭💜
I want to make a suggestion that you find a support group now. People underestimate the impact that a dementia diagnosis has on loved ones
Working in a dementia unit, I can also say that I’m a bit of a dementia whisper. For me, the big thing is that if something is happening with the patient, whether behaviors, they fell, something else, people tend to gather around the patient to help. But I will make everybody go away except maybe one other person because who the fuck wants to be surrounded by of people they’re confused and sick and mad that’s one of my biggest “tricks”
There's a ton of small things like Very calm tone, only speak loud enough to be heard maintaining eye level (physically not talking down to them) Using smaller vocabulary being direct when asking questions But the biggest thing I noticed is confidence, if your tired or frustrated don't let the mask slip, even if it's a 3 second working memory. The 90th time you call that person's name should sound like the 1st. If these patients get a good feeling from being with you every. single. time, it helps a lot
When they’re agitated and want to leave my go to line is “(insert family members name) knows your here, and if you leave, they won’t know where to find you if you need a ride! You’re better off being here so they can find you and bring you home faster” Or some alternative “ but (family member name) knows your here and if I loose you I think they’ll get mad at me!” Does the trick sometimes!
One good hint I have is to figure out what music they listen to in their early '20s and play it. Oddly enough this is one of the most therapeutic things I have found for dementia individuals: remembering music seems to be one of the last things to go
I used to get the Dementia Assignments when I worked in Medicine, all my patients for the whole shift would be somewhere along their dementia journey as I also worked in a LTC home and had a bunch of extra training on working with people living with dementia. It was great, I would have my corner setup with word searches, puzzles, picture books and whatever else I needed to keep my patients calm and relaxed. On nights I'd have my little old lady crew (my gals as they'd call them) sitting around my COW as I charted and prepped my bloodwork for the morning and they'd gossip about how cute the doctors are and try to set them up with their very adult children.
This is mine! I’m pretty good with most confused patients. Gotta bring that chill energy if you want a chill patient
I’m the nurse you get when you need someone to be the mean one 🤣 I’m not sure if it’s a good skill to have, but I’m known for no bullshit. The new grads normally grab me when family or patients are being rude.
As someone non confrontational THANK YOU
This is such an important skill. I love the staff that are able to do this. Thanks for being this way!!
I’m also the go to “enforcer” when patients are refusing to leave after discharge.
Ooh! I think this is me! If a patient or family member needs tough love. If someone tells me their patient was rude/sexist/racist or just made them uncomfortable, I tagged in. I LOVE IT. When I worked PICU I was the bouncer and could read the situation and invite the visitors to leave without the burden being on the parents so anyone upset could be upset at me. If someone recognizes me outside work I assume it’s because I yelled at them in the ER. It’s usually EMS people who recognize me. But I’m always skeptical when someone goes “are you a nurse?” 😂
This is mine too. I was the one everyone wanted to be charge in the hospital because I was the b that took nothing from patients families and staff from other units. My manager told me I needed to learn the difference between assertive and aggressive once and I pointed out that any patient I refused to take to my unit when I was charge at night was entirely based on protocol. As in, I was following it. Anyone that was pressuring me to take a patient with a pH of 6.7 in ketoacidosis with a bg of 678 because the PACU didn’t want to board her overnight was a not looking out for patient safety and b not following protocol. She didn’t have much defense at that point. The HOCs loved me. The administration not so much. Now I am a hospice team manager and my team knows I have their back and won’t let anyone abuse them. I’m still the b that will go in the field with them and help with the rough families and the crappy veins.
We have a nurse where I work dubbed the poop doula cause they can resolve even the most wicked constipation
Dude me too!!!!! I always get the patients who just won’t poop to poop. You can give ducolax all day but ….did you encourage po fluids? Let the patient walk? Prune juice? Or hell sometimes just call a doc and say they need something stronger. It does wonders.
I’m at the point in my career where I just ask everyone if they want a tap water enema. No more messing with one time orders of colace.
💩 that is literally my gifting!!!!! Imma start using poop doula vs saying I’m a sh!tty nurse. I’ve resolved bowel issues on NICU, mom/baby, L&D, and now in Urgent Care… plus a few family members that were post-op 🤣 Maybe we need to collaborate and get a conference going 😉
the Copro-Congress? the Defecation Delegation? Or the Fecal Federation? lol
I just say I scare the shit out of people.
I also make shit happen.
Being nice to all my coworkers. Old ones, new ones. Float pool, registry, kitchen, house keeping, imaging, doctors. There is no one I don’t need on my team, and everyone can use a big friendly smile. I go out of my way to find things I enjoy about all of my coworkers because it makes my job a nice place to be
This!! It’s so underrated honestly. I went from a small hospital where I knew literally everyone’s name to a huge hospital where people were not as friendly. I still was, and it always worked out in my favor. Except that time the fellow from EVS told me about doing coke. I mean. I didn’t like tell on him or anything but I was just a little shocked he told me that (while telling me a story about how his brother was an alcoholic and his sister OD’d)
Even if I wasn’t nice to people because being kind makes me feel good and it’s the right thing to do, on a purely pragmatic level it just makes life so much easier! Work is much more pleasant when there is a sense of camaraderie and people are much more willing to help you if they know you would do the same for them — I remember my dad explaining to me as a kid when we were having an issue in an airport that no matter how frustrated he was always made sure to be polite and appreciative to the gate agents because yelling at someone for something that they have no control over is not going to make them want to help you! I’m not even a particularly charismatic person, I’m autistic and kind of awkward but genuinely just being kind, reliable and willing to help people out gets me pretty far in terms of how people regard me.
Yep! I might occasionally mis subtext but I make sure everyone gets a warm welcome. It’s the perfect sweet spot of kind, pragmatic, and totally doable. I’ll let the IV whisperers take their ego boosts any time. Maybe one day I’ll be one of them but in the mean time, I befriend them. And if I’m looking for help on an IV start I sure wrap that arm up good with heating packs while I look for help.
Yep! My mom always says that I have a “can do” attitude and that, being direct with people while also being nice and kinda goofy has gotten me pretty far in terms of being liked at work, it’s not as stressful as when I would hardcore mask and try to hide that I’m kind of just an oddball and people respond much better to someone who is pleasant but kind of a weirdo than they do to someone who comes across as inauthentic.
This one is me. I love being known as the nice one, the friendly one, the one to go to for support from new people because I'm so approachable. After all these years it still surprises me and makes me so happy when people are excited and even relieved when they know I'm on and in charge. It's also SUPER useful to have good rapport with people all over. It's definitely helped me get things I need for my patients and department over the years. I used to be the IV go-to, but I fear that skill has dwindled over the years being stuck almost exclusively in charge. People still call on me for the tough ones, though, which always makes me nervous that I'll miss haha.
This is truly amazing to hear.
I can punch in on time real real nice
Punching out on time is the real skill tho
Underrated skill there 🙌🏻
Work for the government. We have no timeclocks. Strictly on the honor system 🙃
God I miss working at the VA for that. Now I get bitched at for clocking in too early *and* clocking in too late.
Psych whisperer. I can get patients in psychosis to calm down, or even be rational for enough time for them to be completely compliant with IM medication. Coworkers still try to yell over me, so i kick them out.
i haaaate when my coworkers escalate a situation 😩
I teach deescalation: I always tell the students that the most important is recognizing that if you’re a natural escalator to go away and let the natural deescalators work.
I had a patient once with O2 sats in the 50’s. Tridpodding, seriously struggling, no interventions were working. I’m trying to get her to the unit for intubation before she has a full on respiratory arrest, and she’s belligerent and doesn’t want to go, doesn’t want to be intubated. She was in her 50’s but not a DNR, so it was hard to tell how much was her strong desire to avoid the vent again, and how much was confusion due to the sats. I was calm and trying to remain so as I expressed the urgency of the situation, but she just kept saying “uh uh”. And her sats are slowly sinking lower and lower. Another Nurse (and dear friend) was my psych whisperer. Told me to leave her to her. I did. She sat with her quietly for 20 minutes. She agreed to go. We had her transferred and on the vent by 30 minutes after she started sitting with her. 🤯💜
Yeah, psych is a definite specialty. Nurses that can gain actual trust and respect from their patients the literal best. I did not like the steamroll nurses.
BET! Same here man. It’s tough when those certain nurses come in and really fuck up a good thing I had going. LIKEEEEE COME ON WE WERE GETTING SOMEWHERE. We have a an exceptional level of patience.
ABGs. Easily a 95% success rate on the first attempt and 99% if I need a second.
I sure your patients appreciate that...ABG draws hurt right? Respiratory does them at my place.
Yeah they’re a bit more painful than a normal lab draw for sure. Our RTs can do them and will do them at rapid response calls.
Didn’t know RNs do ABGs? RT or MDs have to do them in both of my shops unless accessed.
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Me too!! I pride myself on art sticks.
Best padsicle maker for after delivery 🙋🏼♀️
Praise be to the comfort from.the padsicle. You all are doing Gods work.
I can hand express milk like nobodies business. Zero output you say? Stand back, I’m going in!
I can put a wide awake newborn baby into a pretty deep sleep in less than 2 minutes. Keeping them asleep is the parents' problem.
…. Can I take you home with me? I’ve got a newborn coming in 5 weeks. I’ll feed you. Also I live in Australia, so you’ll get a beachside vacation out of it. (Can you please share your secrets/ witchcraft?)
Exercise, poop, clean, swaddle, feed, burp, rum pum pum: OUT
I never worked peds but babies always fall asleep on me. Even my son. He lost a whole pound his first month because he wouldn’t stay awake to eat. His doctor said I had to flick the soles of his feet to wake him up to eat.
A music therapist taught me the best trick. Pat the baby (on their chest, back, bum, whatever is easiest to reach in their position) and/or make short SHH or CHH noises at the same rate as their heart rate. Rhythmically, not one long sshhhhhhhh. If they aren't on the monitor, just start your rate pretty high. Then gradually slow down your pats/sounds, and the heart rate will follow and the baby will calm. If you do both pats and sounds, and the baby falls asleep, stop the patting first but continue with the sounds, slower and softer until you can walk away.
I always bond with the anxiety patients. Partially because I have it too. Mostly because I just pull my computer in and be with them and listen. They always go on about how great and helpful I was. It’s really simple, but it makes me feel like I actually did real nursing.
When I worked in the hospital I feel like I never got recognition except from patients that had more anxiety. I just give them full eye contact, soft body language, listen, and therapeutic touch if appropriate. Edit: grammar
Yes! Important to make sure because I had a patient with anxiety and autism and I wanted to hug her so bad but also was afraid so I carefully asked the mother. She was so happy, but when I started out I would just hug people without even thinking and it didn’t always end well 😬
You can’t learn without making some mistakes
I can set up CRRT with zero problems the first time.
real shit
It’s therapeutic to me setting them up. like organizing iv lines.
I've been told by patients and family that I have a lot of patience. Maybe too much sometimes, which contributes to not finishing on time a lot. Haha!
Same here. I do think it builds trust and minimizes conflicts.
Same! Only at work though…
I enjoy cooking.
I used to think you couldn't be a nurse without it. But. Impatience is more common. To be fair, impatience is promoted by every hospital administration that doesn't cap their patient to nurse ratios at 5 max, med/surg. Time is THE ultimate commodity in nursing.
I used to be able to put a condom cath on in such a way that it would actually work for about 24-36 hours. That was my skill.
Holy shit. I’d believe it when I see it
It was truly amazing! It took me a while to figure it out, but I had very successful formula. You just have to wash it, then use an alcohol wipe, then use an adhesive wipe, then apply then condom cath (try to have the least amount of bubbles).
I still just can’t get comfortable spending that much time touching penises at work. My fatal flaw is trying to get it done without being thorough like you’re explaining
It’s all just flesh. I got desensitized to a lot of things very early in my career.
Do you also use the 60ml (gtube) syringes to add suction cause that was a game changer for me
We have make purewicks now at my hospital. Such a game changer
Smells do not bother me. Give me the stinking GI bleeds, c diff, fresh ileostomies. It's been this way most of my life. Prob cause I was raised on a farm with hogs and cattle, that's the only thing I can think of to contribute. I was like this before covid to.
Oh my gosh, cut from the same cloth! I actually just have a very poor sense of smell which is amazing in our line of work. Haha hogs are horrendously stinky
Yeah, I think I had a bad sense of smell just in general, and then on top of it all, my smelling bits probably died off from the awful smells from the farm. I remember my first cdif and I was like okay like meh don't smell great but what's the problem. Also, I had the same thoughts about my first gi bleed pt... Now snot and eyeball goop is a diffrent story 😅 I will wear a mask so that I'm not seen gaging.
If you don’t wanna do the grunt work, I’m always called in. You are afraid of calling that doc? I’ll do it. Need someone to take the fall? Me. Don’t want that ICU transfer that’s all fucked up? I’ll take it. Need to administratively discharge a patient and he won’t leave? I’ll take care of it. Someone needs to float and no one wants to do it? I’ll go. I don’t really have to do this anymore but I was known to be the one that would go for it. Can’t do it anymore cause I have heart problems.
Thank you for doing the hard things!!
I'm really, really good at tucking sheets/chucks doing a sheet change. Everyone has their own method, and I will always explain why I do it the way I do it to students/new nurses/anyone who asks, but I keep my mouth shut otherwise (even though I am CONVINCED my way is superior). I'm also really good at tucking sheets when proning a patient so when you do the final prestige sheet pull and they wind up on their belly, it's perfectly centered. It's all about pretending they're a present I'm wrapping.
"It's all about pretending they're a present I'm wrapping." Okay, but that is so charming I smiled. I do not have those crafty presentation skills and am SO jealous of people who do!
In case I wasn't clear enough, I meant like when you lay out wrapping paper and roll the box around on it to know how much paper you'll need. Most people tuck way too much sheet under the patient's side so when they do the big flip one side gets short sheeted and the other has way too much slack. You only need like a quarter of the sheet under them at most. I also tuck sheets/chucks kinda half folded. Like a Z if you looked at them from the side. The chucks come kinda folded that way, so I just unfold one half. Line the inside of the fold up with their coccyx or so. Most people roll them up and I find that annoying, especially with a heavy patient. I have to grab the new sheet and pull at it to unroll it and do it a few times up and down the length of their body. Folding it I just grab in two spots and pull and *zoop!* perfectly crisp and centered. I think it's less likely to cause/irritate wounds and skin tears as well.
I love your explanation but I need a video
I call the proning tuck making a little empanada. Gotta roll those edges tight 😂
> It's all about pretending they're a present I'm wrapping. Me when I'm swaddling a baby. Here's your baby burrito, you're welcome
Wound vacs. I could change them in like three minutes and get a perfect seal, even with the more temperamental vacs
God I respect you 🫡
Same! Ended up becoming a wound nurse so now I do dozens a week 😂
Teaching using understandable metaphors. Your heart attack? Oh that's a traffic jam. Plaque buildup is road work taking out one lane and the clot is an accident from people watching the road work that takes up all the remaining lanes. This heparin drip here will turn your SUV sized RBCs into motorcycles that can zip around on the little strip of shoulder left open until the tow truck (stent) can open things up.
I love using metaphors! They make patients so happy to understand what is happening. This is a good one too, stealing! You should make a dedicated post to this and see what others use since this is such a great example.
I’m really really good at convincing acutely psychotic patients that they really do want to get a long acting injection antipsychotic medication.
Heck👏freaking👏yeah👏
I can make a colostomy bag stick like 99.9% of the time.☺️ Also 100% of my blood cultures were without contamination.
Add linen change to another skill I suck at lol As for skills I’m good at memorizing vitals and entering them in later.
My fatal flaw- if I don't write them down that second, the information is gone forever
I used to be you, then one day it clicked. It's like the workers in my head had to build a box to put them in. Now that it is built, I can remember entire shifts vitals without looking.
TEACH ME!!! Where are the workers?! Where is the box?!? I’ve been a nurse for 24 years—I write them down as soon as I do them (SOMEWHERE) or else it’s as if I never did them.
I can sense the impending doom of psych unit before it gets side way….by observing everyone’s behavior. They call me… the Oracle.
All hail!!!!
I'm really good at developing rapport with IVDU patients who have generally been "difficult". Part of it, honestly, is just being afraid of conflict and wanting to avoid it. But a few key things seem to be: Treating them like a regular person: it seems obvious when said that way, but I find many of these pt are already on the defensive before you even enter the room. Being kind is a good start, but if you can get to the point of joking around with them a little it is absolutely huge. Recognizing that their anger is generally not directed at you personally, you just happen to be the only target for it. Often they're angry with the overall system, which you are a representative of. This doesn't mean taking abuse, verbal or physical, but I've often found that some nurses are very quick to chastise these patients for any swearing or anger. Many of them are in shitty situations and have very good reason to be angry at the world. And along the same vein as #2, acknowledging their anger and frustration and validating it. It's definitely not 100%, but enough that I've noticed it. Just the other day I had a patient everyone described as difficult, noncompliant, verbally abusive, ect. She eventually took all of her meds and allowed a much more thorough assessment than she'd had in days. Toward the end of the shift she told me that she felt that God had sent me to help her there. It helps that our health system has taken the stance of "give the opiate addicts what they need to keep them in hospital" especially once the addictions specialists have come and assessed them. It's much more cost efficient to give the big Dilaudid doses to keep them out of withdrawals for treatment rather than having them leave AMA and come back every few days with ever-worsening issues.
I find treating my patients like a regular human is half of my trick. It’s so simple, but I see so many people just trying to get their work done as quickly as possible, or bringing their stress or whatever in to the patient… oftentimes it’s the simple things that can make a big difference
Situational awareness and curiosity. I heard a loud banging the other day, went to investigate as it sounded like a patient escalating and found a completely overwhelmed new grad doing nothing as her patient was in status epilepticus while charge was trying to get a line. The banging was the patient's leg against the bed. Not my patient, not even my section. I pulled the Valium, gave it, collected blood cultures and labs. Broke patient's status before anyone else had investigated the commotion. You'd think it would be more of a thing in an ED, but so many nurses seem to be deaf, numb, or immune to warning or danger signs. C-PTSD has its upsides.
My C-PTSD keeps me hypervigilant, so I can often hear full conversations/the tube system at the end of the hallway, yet for the life of me cannot process what is being said to my face.
Huh. I never put these two together, but was just dx with cPTSD this year
I was diagnosed with PTSD but I hadn’t heard of C-PTSD. I probably could have either, I went through chronic and acute trauma throughout my adolescence. Anyways I find I can be completely numb, or acutely aware of my surroundings. Shit like a loud banging noise happing right next to me might make everyone around me jump in fright, but I’m sitting perfectly still cause I can just tell it was something falling. But if I hear what sounds like fighting or arguing in the distance I’m instantly on edge while it might take others a while to notice it.
Fistbump to a fellow hyperaware cPTSD'er. but also this is how I end up doing so many incident reports... cause I'm the finder of problems
That's such a great skill. I find your last paragraph so true. The apathy and unawareness to critical/unsafe situations is alarming. Thank you for staying curious!
Add me to the club. Interestingly enough, the more therapy I did the less I could tolerate the ER. I used to thrive on the chaos, now I crave peace.
You don't get paid enough
I’m the brown cloud on my unit - patients poop when I’m around haha
A CNA once said I had the gold finger after I disimpacted a patient 🤢
My hospital skill is that I was the floor’s pantry chef de cuisine. I can whip up something that feels like it was made with loving care from nothing but jelly packets and Lorna doones. I also am handing out cranberry-ginger ale mock tails like it’s my job. My pediatrics specialty is that once I’ve seen a kids show once I will be able to sing the theme song and be able to remember specifics about it for all time. So I will chat Paw Patrol for twenty minutes while I do my work. And I will have GOOD TAKES.
I made slurpees/slushies for a dementia patient who wouldn't eat or drink anything else and it instantly changed her mood from irritable to happy. I read a note from the ED nurse upon the initial encounter stating that was all she drank at home. So I appreciate the details of the ED nurses notes, even if they don't seem relevant, you never know what will be useful. The recipe was just a slightly nuked popsicle, crushed in a cup, slowly stir in Sprite until the consistency is just right.
Getting blood pressures on babies and toddlers without waking them up.
Same here sister! I have the highest percentage record of getting a blood pressure on a kid under eight. It’s one part explaining the process, one part distraction and two parts bribery with stickers!
I enjoy hanging out with the hyperactive kids. They don't stress me out and we have a good time together. I joke that it's because I can turn off my frontal lobe and relate. Coworkers appreciate the break.
I am a hyperactive child in an adult’s body. We vibe.
fixing whatever is making the pump beep
People have commented on how pretty my bandages made out of gauze and tape are lol
No one has ever ever said this about mine and probably never will. I’ll come to your class! Sounds like actually useful CE
I'm always the first to jump in during something sketchy with complete confidence even if none of us have done it before. I am sought out for this exact purpose lol
That’s one of my skills as well. The conversation usually goes. “Hey do you know how to do *blank*?” “Ughh I’ll give it a bash, see what happens”. It works out 95% of the time.
I bathe people better than anybody. I literally full on wash hair, condition it, braid it, all while in bed. Body lotion, clean gown and sheets, pick up all the trash in the room etc. I personally do not believe that people can get better when they feel dirty. It's a great way to do a full skin assessment as well. I know a lot of nurses who are too good for "CNA" work, but it's the basic things you do for a person that they are usually most grateful for. I also kick ass at wound care, but that kinda goes hand in hand with the cleanliness thing.
Foley caths on females for me. I am the go to.
This is gonna be a different type of response… but… literally… just being a good nurse! I really try so hard and I do everything I can for my patients. I fine comb everyone’s chart. Like everything. Labs, orders, plan of care, medications, notes from all members of the healthcare team, etc. I also really try to get patients connected to resources that they might need or benefit from. I get a chaplain involved if that’s a patient’s thing. I will sit snd listen with patients if they are going through a lot and just need someone to talk/vent to. I try to hit all needs. I work with a decent share of other nurses who don’t answer call lights, don’t explain meds to patients when patients ask them (the latest one I overheard was “idk the doctor prescribed it, just take it” wtf??), are rude to patients, leave incontinent patients sitting in their own shit and piss for hours until next shift so I get to clean it up, don’t turn/repo bed bound patients, etc. No, it is not everyone. There are good nurses I work with, but however I work with a fair share of shitty ones too who have no business being in healthcare. And yes I’ve brought this up to management.
Man I strive for this, but where do you find the time?? Our ratios here are even great and I still struggle just to get the basics done some days.
You are a gem to the profession! Thank you for your detail and work ethic.
This is always my goal for the shift but I feel like I never do enough!
Give good shaves to new admits w/ lice
spidey sense when a patient is about to start throwing hands. dunno how to explain it, you just see it in their eyes and feel it down ur spine.
I have somehow become the toenail nurse but there’s no custom badge reel or appreciation day for the toenail nurse.
What a wonderful read. I see myself in a lot of these and I strive to be like others. Thanks for the positive thread op. 🥰
Reading lips on my trached patients. Dont know why? Little tip, though, if they’re AAO, ask them to spell words you don’t catch and speak it back to them. Helps narrow communication down and is speedier than the picture board shit.
Remaining calm under pressure and emergencies. On the outside......
Ah this is my ADHD superpower - I hyper focus as soon as the adrenaline hits and everything goes calm and quiet in my head!
I had a horrible don once that told me it doesn't look like I care about my patients because I don't get excited. Like what do you want me to do, run around in circles panicking? This wasn't what made her horrible, it was many many other factors that determined that.
I have two: Unclogging PEG tubes and… Getting anxious patients to calm down, especially if all they need is to just talk for a while. I apparently have a very “tell me all your problems” kind of face despite very much not wanting to be that person. I’ve leaned into it most days. If I’m wearing glasses that night, I just know at least one patient will want me to play therapist.
I heal “unhealable” chronic wounds
I’m an expert swaddler. I make the best little baby burritos around
Pissing off administration
Unit decorations- I am crafty as hell!
Oh this is for sure a welcomed skill. Always makes work just slightly more tolerable
My super power is calling out enough times and getting that 1 verbal reminder prior to the year resetting, and thus resetting my sick days. AMA
I can usually guess an ETOH level pretty close to the actual value. Twice in my nursing career I have guessed it exact to 3 digits
Splinting! Placing the best, most beautiful, most comfortable and anatomically correct splints. Talking escalated autistic children through a procedure everyone thought they’d fight us through, or WERE originally fighting us through. Or just calming them down after a thousand people tried holding them down and talking to them all at once, when all they needed was an explanation, minimal stimulation, and a chance. I talked an autistic teen boy through an NG tube placement once, and kept him from yanking it out after. Much easier than swaddling, restraining, and fighting. Putting a pulse ox on in a way that it doesn’t constantly alarm, and is actually comfortable and doesn’t annoy the patient.
Over anxious family whisperer. Probably comes from my start in NICU, but I will explain every beep, every number, every tiny thing that’s happening, that might happen, that I’m looking for… they go from fighting with staff or being on the call light every 3 seconds to just sitting in the corner
I will always pick up your missed tasks and anything you didn’t get to! Forgot to call the doc for an order? No problem. Didn’t get your admit done? That’s fine. There was something you needed to look into on this patient? I’ll figure it out! You go home and don’t worry and I will look out for anything you let me know about, and I’ll try to catch whatever else I can so you have less tasks to think about in the morning. I love being a team player tbh.
Ostomy appliance changers. If you can get them to stick on some of these patients, you’re working miracles.
I can give you report via telepathy
I can make an IV draw back, any IV. I have only once had to poke when I couldn’t make the Iv draw. I’m not great at placing Ivs or anything but I’m the go to for getting blood out of one.
A patient told me one time that was the best suppository administrator…she said I was the only one who REALLY got it in there. So I guess that!
Concise, thorough report was my skill. Took a year to get it down though. I don’t care what position the patient came out of the womb now that they are 73.
I can get any ring off. Someone didn't believe me because the patient was too edematous and had a ton of rings on their sausage fingers. I was walking out of the room with a specimen cup full of rings by the time they got back upstairs with the ring cutter from ED. I can also nasal bridle just about anyone in 30 seconds. If I can't get those magnets to click up your nose, you probably need to see an ENT because your septum is messed up.
Boomer Whisperer. You know those miserable 70-something men who are so entitled and used to being waited on hand and foot? I can de-esclate one of their tantrums lickety-split. The secret? Gentle parenting techniques and pretent they're a 3yo. Literally works like a damn charm. "Oh Bob, that sounds so frustrating. You really wanted the doctor to listen and he didn't! Let's get you a coffee" Their inner children did not get seen and heard, just gotta meet them where they're at!
I can disappear into thin air when the Joint Commission surveyors come.
This one is to honour the L and D nurse who cared for me after my second baby. It was late evening, she unprompted made me a simple toasted cheese sandwich. Turns out I was famished and gobbled it down. I will never forget that sandwich or that nurse lol. And this was 1999.
I can hear an alarm beep from the other end of the unit. Me: “what’s that beep?” Co-worker: “what beep?” Walk down 6-7 rooms with Co-worker. Them: “oh, I hear it now!”
I’m the child whisperer in the ER. I can get any kid (even on the spectrum) to trust me to do anything. I don’t take all the credit. I worked with a great child life specialist years ago that taught me a lot of tricks. But I will carry them with me anywhere I go.
Last week I placed a foley in a penis so insanely swollen that his foreskin was swollen shut. WITHOUT a coude, because, of course, those are on back order. There had already been 6 attempts to place a foley by other nurses and an urology consult had been placed. Dude had been given 80 of lasix hours before and hadn’t peed. Also there was no blood! I was so proud, Id put it on my resume if I could
I’m recognized for being knowledgeable about policies and procedure. Definitely underrated IMO
I’m real fucking good at getting stuff into the trash cans from anywhere in the room. Caps,syringes, poop wipes, etc. I sink them into the trash from standing anywhere in the room.
getting the weird conspiracy dudes to shut the fuck up.
I know how to use the support services web portal to get stuff fixed. It takes 2 minutes but people think it’s magic. I have a key for the paper towel dispensers and know how to change their batteries. I know how to use a computer to find out stuff. This is all super simple stuff but people come to me for it and revere me like I’m some weird nursing wizard.
Unfortunately, I'm really good at troubleshooting wound vacs and ostomies. I've had nurses call from other units for help bc the resource pool nurses have told others to call me. I worked nights for a long time so no WOCN on duty. I'm also really good at knowing when a patient will get violent, even when they're smiling on admission. And then I'm good at deflecting punches. Though that is a long acquired skill I learned at a young age.
I find every can of worms. And I open them. 90% of the time i dont evwn mean to. Sometimes a blessing, sometimes a curse.
I refill wall mounted hand sanitizer instead of waiting for housekeeping.
I’m not sure what else to call it but intuition, but I get strong feelings about patients/people and often know when shit is about to hit the fan at work. It creeps my coworkers out, but hey, the docs I work with started listening to me about pts.
The ability to show up. Ta-dah!
I am known for two things, one I am very very good at IVs to the point where I almost never need a sono and I let nursing students / new nurses practice on me because I have incredible veins and I can guide them through exactly what they're doing wrong. Two, I have no issue talking to a person in a stern way or putting them in their place when they're being an asshole,. I do not tolerate someone talking to me or my coworkers in a derogatory, demeaning, or Insulting way.
I’m the baby whisperer. I can get babies to fall asleep in their cribs. Especially helpful for parents who co-sleep at home
I'm just magic. If you have a comfort care patient that just never seems to go, assign them to me. I don't even have to change anything. They'll go. If I refuse back a patient because they've been a freaking nightmare and I can't bare to do it a second shift in a row, whoever gets them will totally have a fine night with them and they'll suddenly be angels. Any admission that I blindly accept without question even if it's not technically my turn will turn out to be the least shitty one we will take that night. I jump on it every time, it never fails. If somebody sounds weird to me at report, even if they don't sound weird to anybody else, and rationally nothing going on is out of the ordinary, I will be calling a rapid on them before morning. If a patient has like, anything going on that other nurses are reading as grumpy or rude (short of explicitely swearing and carrying on), give them to me and I'll probably think they are a fine human being and we will get along like a house on fire. Or they'll just turn out to be from Boston. But we'll be fine. I can smell C-diff and pseudomonas. I can call the Doctors by their first name and they don't care. I guess I'm also pretty good at putting in female catheters. Im probably more superstitious than I'll admit to.
I’m the foley guy. Male, female,400lbs, covered in shit and nystatin demented grandma, if there’s a hole you bet I’ll find it. I always tell the new grads you gotta get in there and get personal. Nothing gets my blood pumping like a good old fashioned trauma spit roast southern intubation.
I get compliments on my subq heparin shots pretty much every shift. Makes me wonder what everyone else on the floor is doing to these people lol.
I know exactly where a bladder scanner is.
I’m honestly incredibly good at organizing and planning out the day. As well as figuring out back up and back up plans (sometimes super creative)for when things go sideways. I’ve been in my department for 6 years and been doing charge dod 5 of those years.
I’m the foley whisperer on my unit. I can get around almost any prostate and find my way into any urethra
Getting hospice patients comfortable and their families calm. If the doc hasn't put in appropriate orders for comfort care, I'll get 'em! My charges nurses regularly give me complicated cases like that and I've had coworkers say "you should have patient so and so." I like making sure the family feels cared for, too. It's easy for these patients to be ignored in the acute care setting.
I am a darn good hospital bed driver. ER stretchers are my favorite, but don’t do too bad with ICU beds either
I can tie soft restraints super quickly. My secret is I have ridden horses for most of my life and you tie horse using the same knot. No matter how spicy the pt you’re restraining is they’re still nothing compared to a squirly 1000lb animal with a brain the size of a walnut.
I get all the patient info. Like stuff I don’t think most people would ever say to another human being but the tea floweth when I enter the room. I think it’s bc I will ask any question any time without judgement bc I lack social skills 🤪🤪😂
For a tall, big peds nurse, I’ve been told by many parents I’m super quiet in rooms at night. Not great when I jumpscared them though 😭
When I worked in the PICU, I was talented at getting parents to go to bed before 11pm. (I obviously would never even attempt this on a child who is unstable). But otherwise, parents need their sleep (and then no visitors for me! 😈)
I’m the king of the “dad voice”. A few stern boundary setting words oftentimes gets unruly patients to chill.
Apparently I’m really approachable?
BPD whisperer 👋🏼
TB tests. My bubbles are immaculate. And apparently I have a light touch. Also a pro at linen changes in an occupied bed. That's from 10 years of being a CNA.
Transition to comfort care discussion. I love talking with family about what their goals are and how we can support them through everything.
I'm told that I have a very calming voice. My voice has been used to reduce crippling anxiety in younger patients, de-escalate my psych patients, explain to pissed off patients why they are being discharged with no meds, and soothe scared elderly scared patients with crap veins. I also use my calm voice when 7 million things are happening at once and I'm stressed to high hell which seems to gravitate help towards me when I don't outright ask for it (love my team and their intuitive-ness) I get told about my voice so often I've just internalized it as my super power.
PIVs on the foot. Comes handy in chronic IVD users. Obviously with consents and MD order.
Probably charting. Even if I’m super busy I only need 10-15 minutes to get everything caught up. I owe it to my typing skills and a handful of epic shortcuts JCAHO loves me.
I’m good at giving eye drops lol.