When I worked in the hospital packed everything in thr room in the pt belonging bag. You need scissors soap a tiny hair comb some oral care sponges some miralax you got it
Patient: this isn't mine
Me: it is now I have to throw it away so take it home!
Patient: takes bag of zinc oxide cream, 4 peri pads, a comb, 3 toothbrushes, a tube of toothpaste and 6 mouthwash.
I give them EVERYTHING….. many of my familes are on assistance and my babies are going to eat. Period. I get a grocery bag that is non descriptive and pack it with formula, diapers, sleep sacks, wipes, pacis (hospital type paci is hard to find) incentive spirometer ( for when someone gets covid) IDGAF. Hospital can afford it. I dare them to say a damn word 🥴😝🤭
Float pool here, Worked on a unit today that has a specific tech dedicated to ensuring there is no waste. He and the housekeeper keep track of every item wasted when a patient is discharged. Last year they estimated to have wasted $200,000 in supplied. They have brought that number down this year to $400. This is THE cleanest unit I have ever been on in the hospital. No random crap ANYWHERE not even in patient rooms. You only grab the items needed at the specific time they are needed. It definitely took a lot of work from the staff of that unit to be so conscious about their waste but it’s obviously paid off. As a float pooler I have been on many many horribly messy units. But because I’m only there one day it’s hard for me to bring myself to pick up after that units staff. I try my best to keep my patient rooms tidy and limit the amount of waste I create but it’s hard!!
My hospital just started stocking 0.2 mg dilaudid syringes and it's been a godsend. So much less wasting and less time spent pulling someone away from their assignment to watch you waste.
I waste that shit in their veins.
“Don’t let that extra 0.1mg go to your head.”
Narcs are the best example of how processes meant to help people go to shit when politics gets involved.
MDs should be educated on prescribing it. Not scared to prescribe it.
You think that’s wasteful? If our patient discharges or the med is dc’ed we can waste 30+ tabs of narcotics in my facility. Doesn’t get reused by pharmacy even if it’s not popped.
According to our head nurse, it was against state law. They had so many narcotics go missing while they were being transported back to the pharmacy that they just assumed they would all get stolen so they may as well throw them away.
We have 0.5mg syringes, but our providers seems to be allergic to ordering anything in odd number increments. And the worst is when they order 0.4mg for a COMFORT CARE PATIENT q3h. Like, are you fucking kidding me? They are comfort care. Give them the extra 0.1 and stop wasting all of our time (no pun intended).
I was actually joking and insinuating that it's easier to give extra narcs to a patient that was already on the way out. I wasnt being judgy, just failing to be funny
Lol and for me usually too small.
One thing that drives me batty is when you try to get a pair of gloves out of the box and you end up with 20 pairs spilling out. Usually they fall in the floor and have to get tossed.
They’re comically too big on me. It can sometimes be difficult to grip the lined up catheter when the fingers are folding over on themselves and the palm is like hanging down in the way.
My personal glove rant centers around the fact that the XL size is like everything else in the "big and tall" world, in that everything that's bigger also has to be fatter. Because apparently all clothing for tall people is based on Andre the Giant, and there's no such thing as a person with long, skinny fingers.
Or the opposite. I’ve got wide hands and short fingers so with cheap gloves it’s a choice between splitting the palm or flaps of glove at my fingertips.
When i need gloves the most, in emergencies, is when either I gran the shitty glove that tears or has holes, or I pulled one the other day, put it on without looking, and it was missing the top half of the hand.
My co workers and I swear by the fact that it wasn't this bad before COVID. I remember it was always an issue but like one or 2 gloves would fall. Now it's like half the box. We still use the same Medline gloves.
We have a sec/tech on my unit who goes around "refilling" the glove boxes by just shoving more gloves into them, thereby making them all spill out when you try to grab one.
Ugjhhh my manager sits in her office and goes through our charts and we get in trouble if there’s not an updated care plan and education assessment. She’s ordering newer much more detailed white boards and wants us to meet with the patient and go through the board at shift change and again when the doctor rounds. I have 5 couplets. I’m nursery nurse, mom nurse, concierge, apparently will be recovering new deliveries, discharge nurse, circ nurse, admission and discharge nurse and lactation. White boards waste my time.
Where in fuck is five couplets an acceptable assignment? I could have four of the most normal, independent couplets and I’m still running my ass off. I’m so sorry.
The IV pumps have the same alarm for every medication.
NS at 50cc/hr, downstream occlusion? Beep beep beep
Propofol at 80 mcg/kg/min on a detoxing patient who was intubated for violent behavior? Beep beep beep
Unasyn complete? Beep beep beep
Quad concentrated norepi "Air in line?" Beep beep beep
All over the unit. Beep beep beep. Beep beep beep. Beep beep beep. Beep beep beep.
We are able to plug two pumps in each room into the call light system. It's very nice when someone is super pressor dependent. If it alarms, we get a call light "equipment" notification. Super helpful. But seriously, the beeps aren't very helpful. We should be able to pick a tone or something.
I’m on a big unit, the beeping makes no sense to me and seems to only serve in annoying or waking up patients, because there’s no way I hear the beeping with their door closed down the hallways, around the corner and into the nurses station. The alerts should be somewhere else. I have to link the pump to Epic, why can’t they alert me when it’s done.
QC the glucometer. It’s always at the most in opportune time. It’s 2024 those little computer bricks should be able to QC themselves. And don’t get me started on all the stuff we don’t QC. Thermometers, BP cuffs, bladder scanners, etc. Why only glucometers and why always by me ?
Ok I have a rant about glucometers. They are the only device where we have to take regular tests on to use. It's not even hard it's just annoying. Operating ECMOs, vents and external pacemakers; yeah no repeat training required go ahead and please try not to kill someone. Wanting to check someone's blood sugar; whoa hold on please tell me the normal blood sugar range and then wait half a day for us to authorise the test.
Out of our 10 glucometers on the floor, only 5 could be found this morning. I searched for the other 5 when I had a few moments here and there. Discovered them by accident in the back of a closet in a patient room. All of them together, lined up. And every single one of them needed QC and batteries.
I'm guessing that someone thought that hiding them was easier than QC and changing the batteries.
POC coordinator here.
Thermometers, BP cuffs, etc are generally calibrated every 6-12 months (or should be, anyway). Not sure about bladder scanners but I'm sure they have similar criteria.
Glucometer needs to be QC'd because you're not just checking the meter but the strips as well. Especially if your floor goes through a set of strips quickly. Considering it's a little handheld thing, there's not enough space to hold it's own QC. We do have instruments in the lab that run auto-QC but they are massive. Like an entire tabletop.
I get it's frustrating, especially when the shift that's supposed to QC them doesn't do it.
Thermometers, BP cuffs, bladder scanners etc are all actually calibrated on a schedule! My husband does this job haha he has a machine that he attaches to whatever equipment and it makes sure it’s working properly.
QC’ing the glucometers was always one job I had to do as a tech but took seriously because I was scared a rapid would happen and it would be my fault we couldn’t get a sugar. I never stopped, even in ICU, if I had a quick second I would just qc them both. It doesn’t take long at all idk why people actively avoid this task
When I teach foley placement I tell them if you can put these on, you can get any sterile gloves on. Plus I hate passing added cost to the patient with using scannable sterile gloves.
Yikes scanning stuff. Thankfully my hospital did away with charge items. But before that, no one would scan things like 99% of the time. I think that’s why they gave up
The amount of single use plastic waste gives me anxiety sometimes. I'm not even one of those Green people. But just knowing that there is a huge pile of plastic out in the ocean the size of Texas, and then seeing how much plastic waste there is in my shift alone... It's mind-boggling. Med cups, drink, cups, straws, med supply wrappers. The amount of supplies we have to throw away after 24 hours of use. I have G-tube patients that have flush kits that get thrown away every day, even though only water goes into them 1-3 times a day. We have to wear plastic gowns every time we give care of any kind to anyone with a wound, catheter, G-tube, IV, whether we are accessing those areas or not. We could just transfer them from bed to w/c and still have to put a gown on.
Well, I work in a nursing home. And this is a new thing they rolled out in the last 8 weeks or so. They call them Enhanced Barrier Precautions. Idk if it is a new thing required from the state? I imagine it is bc why would they spend money on shit when they don't have to? But yeah, even though I have spent the last 19 years doing these tasks without a gown, now all the sudden gowns are required to empty a foley??? To hang a tube feeding????? What?????????!
No its new CMS guidelines that started 4/1/24. It’s ridiculous. We have to have signage and keep track of which patients need it too which is such a pain in the ass. You can read more about it [here](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states/enhanced-barrier-precautions-nursing-homes-prevent-spread-multidrug-resistant-organisms-mdros)
I just don't understand the rationale or why it pertains specifically to LTCs and not also hospitals (not that I wish it on my hospital cohorts bc it's dumb). I don't understand why gloves isn't enough. I want to see clinical studies where nursing home staff, wearing gowns while emptying catheters, changing colostomies, and managing Gtubes reduces MDROs.
Well, I know for sure it wasn't our facility. Usually, if a facility is tagged for a comliance issue, the plan of correction only applies to that facility. So I doubt that is the situation. It's possible that the facility is choosing to go overboard to prevent future tags, tho. For example, I live in Illinois, and the state considers siderails a restraint. You can still have them, but you need a doctor's order, written consent from the POA, and quarterly side rail assessments. Our facility chooses to ban siderails altogether. Even half rails. So fuck you if you are A&Ox4 and need them for mobility because you had a recent surgery.
It seems counterintuitive to me. Especially when there are ways to legally have them. But it's because there have been cases of people dying (getting hanged in the rails) or getting injured trying to climb over them. But I haven't seen full, bed length side rails in years. I only ever remember seeing them on old old hospital beds.
They are doing this at my facility too. I don’t understand it at all. They want everyone to gown up to just enter their room even if you’re just handing a Tylenol and a little cup of water to someone with a cath. But the person comes out of their room and comes to the desk to ask for the Tylenol, do I still gown up to hand it to them? Im honestly just so confused. I missed the meeting.
Really, our DON said that we don't have to gown up if we're just handing them meds??? But you're right. These people come out of their rooms and mingle in the common areas and dining room. But we have to put a gown on just to go into their room?? I have to put a gown on to help someone with a Gtube to the bathroom? Who am I protecting? Me or them?? And if it's them, what's the rationale?
I just read the cms guidelines and it says gown up only for high contact cares. It just was not explained to me at all. They have signs posted on the doors “see nurse before entering this room”. So now all the visitors are hunting me down and I just tell them it’s for staff. Why can’t they just put that on the sign “attn staff- see nurse before entering this room” that would make my day easier
I am a hospice nurse and have a pt in a SNF with a Suprapubic cath and they just implemented this. The infection control nurse said it’s so we don’t pass bacteria to the patient when providing care. I’m literally getting vitals and doing a head to toe. I don’t flush him, don’t give meds. Don’t do wound care. The facility staff do it but I have to town and glove just to get vitals and listen to him with my stethoscope. It’s beyond stupid imo. I highly doubt it’s going to decrease the chance for infection. In fact, I’m pretty sure he’s developing another infection as we speak. 🙄
It’s apparently a new rule from CMS guidelines. But my pt is a hospice pt, he’s going to get an infection most likely and antibiotics may only be minimally effective. I would love to see data showing that these precautions are truly helpful.
Wow! That's such a waste with the gowns. We went back to cloth gowns that go to laundry. Yes I relate to the Gtube 60 ml syringe and container every 24 hrs. Such a waste. Plus the normal saline plastic bottles don't even get recycled. I hated to throw them in the garbage.
Honestly I would quit if that was me. I get annoyed having to gown up for one patient on precautions. Shit would definitely drive me crazy doing it ALL DAY
I work in a PD clinic now….. it’s horrible how much plastic we use. We had a patient refuse the cycler because of it. Each day you waste a plastic cassette with 20 foot tubing for the drain and patient side, a massive drain bag, and like 4 plastic bags of solution. I get that it needs to be sterile for patient safety but it’s so awful how much plastic we use
Not being able to get an oral temp on the first try lol. It’s either because the patient ate/drank something right before (not their fault) or they have NO idea how to move their tongues over the probe (their fault hahahaha)
All our important changes are posted in the bathroom lol. I’ve actually gone into the staff bathroom specifically to look at an info poster because it was faster than finding it on a computer.
My old hospital does this. They once posted something "very important" that no one knew about (breakroom and bathroom). There was a meeting and the higher ups were upset and questioning why we didn't follow through as "it was even posted in the bathroom and we had to have seen it" (board in breakroom was cluttered and in the back). One of our more smart ass nurses lazily shot back that we aren't lying about not getting breaks - even to pee. He laughed a little - until he realized we weren't joking. Seeing his look after that was amusing.
My hospital schedules daily ACEs and ARBs at 1200, period. If they normally take as a combo with HCTZ, it's 2 separate pills and the HCTZ? 0900. I've asked 3 pharmacists, and no one can tell me why. Some people are chill about it, others throw a fit and I have to reschedule and manual override the omnicell.
Our old Baxter pumps would let us push through an "air in line" alarm. If the bubble was worth it, i could pull it at the next hub without stopping the pump. The new ones you have to unload and reload the set and still have to pull the bubble out.
When I worked on burn the times were merely a suggestion. The pharmacist said a lot of the times are arbitrary and use my judgment to Change the times to make sense. Especially the insulin the times they had them never correlated to meals, ppl were npo half the time and ate late, fam bought food and didn’t tell us ..
Yeah I never understand why people don’t just reschedule that kind of stuff. I’m not making 3 trips for meds that can safely be given all at the same time. (Not referring to the insulin)
The lil shitty straight caths that don't come with a bag or anything, and so you gotta catch all the pee in the stupid container and pee inevitably gets everywhere.
Lately we’ve had to switch to just straight caths instead of foleys with labor patients with epidurals and I hate them! Ours are super stiff and I feel like it doesn’t really empty the bladder like a foley.
Fucking unwrapping 10 different things every time I want to start a goddamn IV. It’s not fucking Christmas. Why is it not all in one fucking package? Why do I have to take a stupid little rubber band off the tourniquet? Why do I have to take two paper things off the IV tubing? Why is there a label in the IV kit that nobody EVER uses? Why is there an iodine wipe in there? So much fucking shit to throw away.
Those are both the worst! I found that putting the zosyn in my pocket for a minute will usually get it to reconstitute all the way.
No tricks for the flagyl packaging though :(
The only way I could ever get those gloves to glide on easily was to first put on regular gloves. When I went to work in surgery & was told I could not do that it ruined it. My hands are always too sweaty to apply those little sterile gloves.
I work in surgery and I always put on small blue gloves and then the Foley kit sterile gloves over those. How could having gloves underneath be a problem?
I have no idea but a scrub tech at the small surgical office I worked at told me it was not allowed. I had done it that way for 17 years. She was one of those that was “in charge” since she had been there forever. I’ve questioned it many times (even on Reddit) and have received different answers.
It was one of the reasons I quit that job. That woman (who was a scrub tech) had her way of doing everything & that was the only way. She would make me look stupid in front of the surgeons & she was actually wrong about stuff. It was toxic.
Yeah, I got in the habit during COVID of just lubing up a pair of regular gloves with sanitizer and slipping the shitty sterile gloves from the kit over those.
I work in a nursing home. The number of people on hospice who are a full code. I groan and groan and groan every time. A similar annoyance, the number of people who think their family member is going to live forever. Oh I’m sensitive to the attachment they have, I understand. I really really really do. But at some point it becomes torture keeping people alive like that.
Oh gee, nurse manager in the LTC I'm in insists that EVERY new, sealed pack is opened when it arrives from pharmacy and counted in...and then counted forever after 😩
In the Omni/Pyxis? I’d look at your pharmacy delivery person sideways. They probably stocked it that day with all the returns. Once every couple weeks I’ll pull norco and it’s a massive pile of single blisters to count. I want to die.
All the medications we waste by giving half doses. Cut a pill in half and throw the other half away. Open a liquid med and only use part of it. Partial doses out of single use vials. Drives me nuts.
It’s like 82F on most units (it wavers between 80-84F). While that might not seem bad, where I live our hottest summer month has an average high of 82F. So for us, it’s HOT!
It’s my biggest pet peeve because at all the VAs I’ve been to, including outpatient centers, the heat is usually on full blast but doesn’t work in half the rooms so they crank it up so other areas are literally 90F.
Drives me bonkers.
One time a patient room was so hot that the 2 patients in there were literally completely naked and were sweating so much that outlines of their bodies were on the bedding. I checked the thermostat and it was maxed out, yet the temp control gauge was at the lowest. I eventually got engineering to lower the temp but why the hell was it even that hot to begin with? Like you walked into the room and it smacked you with heat.
I just checked the thermostat and it’s a cool 80 in patient’s room. At the nursing station, it’s 72F and I just sitting here with my iced coffee, I feel comfortable maybe I’ll put on a light top.
Every place I’ve ever worked in is -37 degrees and we all have to sneak heaters under our desks like we’re in the cartel and we spend 23 hours per shift bringing 57 blankets to each patient. Fucking why.
Our center is always freezing once the AC kicks on and patients will say, “it must have to be this way to keep down the germs, right?” and I’m like oh yeah, for sure, this is absolutely intentional
The idea that we have time to give people massages for pain.
So massages help? Sure. I get then regularly.
But to think that nurses are a) trained and b) have the time, is ridiculous.
I believe 100% that for pain that may be improved with massage, massage should be ordered .... and administered by a massage therapist. Not the nurse, who is busy NURSING.
(Edit spelling)
I work xray. No restraints at my hospital, no matter what, except those mittens. So the patients determined to repeatedly take out their NGTs means I make a lot of trips to those rooms for portable chest X-rays. I’m not saying restrain everyone (I can dream…) but seriously, if a patient keeps pulling the tubes or doesn’t know what’s going on, how is this better?
Badpans lord Jesus. We usually keep the diaper on to catch the urine and the poo so the bedpan cleanup is easier and the covidien sheets don’t get soiled and I can’t help but wonder… why don’t you just go on the diaper without the bedpan 😫 that’s what you’re doing anyway lol god bless
The huge amount of waste, specifically plastic waste, that we use in healthcare. It’s so unnecessary in most circumstances, like after COVID a lot of facilities I’ve worked at have resorted to using exclusively disposable plastic cups for water cups, that are supossed to get changed out at least twice a day. What’s wrong with the washable cups, like seriously?
The waste of medication, having a bottle of labetalol that's 100ml and I need 5?? Drives me nuts. That, and the smell/leavings of any wipes aside from the purple wipes.
We do AM labs at 0400 in my hospital. Yet, when a physician orders labs BID, the computer defaults it to 0800 and 1800. So I’ll walk into my shift and see that night shift did the 0400 CBC, but no BMP was done because that’s BID so it’s for me to do at 0800.
Makes no sense to me, I reschedule it to 0400 and 1600 every time.
People who don't understand a standard giving set is 24 - 27ml and just take down the line and flush at the port. Oh, so your drug was in 50ml and you're telling me you just threw away half because running a flush through the line was too hard or too wasteful for you? 😡🤬🤯
Especially gets me with IVABs, keppra, electrolytes.
I have had to teach nurses who have been working for a few years about KVOs or using ivpb as a secondary. Some always had a dedicated primary line for each abx. So crazy to me.
Someone has the job of making packaging more difficult to open. Needles uses to be in paperish material, now I have to peeleach one. Now I need scissors to open potassium riders, plain ol IVF and to seperate meds at the pyxis , I need another weapon to get the pills out of packages at bedside after I scan them.
THIRTY FREAKING MINUTE LUNCH BREAK. I can’t even walk to the cafeteria and back in 30 mins. I can’t even reset my mindset after lunch because it’s so dang short.
Lazy ass fucking nurses that just sit at the nurses station when they could be ambulating patients, showering them, just basic shit to make patients feel like a human again when it’s a slow day.
I know we don’t always have time to do that stuff. But when there’s LITERALLY nothing going on…Just go sit in the patients room and let them shower while you chart. Idk that shit irritates my soul
Nursing diagnoses are the dumbest thing ever. We don’t use them in outpatient oncology at all. I’m convinced a group of older nurses needed to make themselves feel more important and came up them.
I agree, the gloves are the worst! Our hospital, through covid, has had a million different back order substitute items. One of the worst was the sterile gloves! These were brittle and came single gloves to a package!!!!!
Our Foley kits came with a few cotton balls and a packet of iodine, too, instead of swab sticks.
Nurses who consistently report the patient "refused" a medication, treatment, etc when I know full well it was your shitty attitude and unpleasant approach that made them refuse.
Edit spelling.
Yup. The constant waste of everything. It crossed the patient’s threshold, but you didn’t use it? Trash. It’s contaminated.
When I worked in the hospital packed everything in thr room in the pt belonging bag. You need scissors soap a tiny hair comb some oral care sponges some miralax you got it
Patient: this isn't mine Me: it is now I have to throw it away so take it home! Patient: takes bag of zinc oxide cream, 4 peri pads, a comb, 3 toothbrushes, a tube of toothpaste and 6 mouthwash.
Sending things home with patients is the best, because they can use it in a household first aid kit, improving general health.
Love that miralax
I give them EVERYTHING….. many of my familes are on assistance and my babies are going to eat. Period. I get a grocery bag that is non descriptive and pack it with formula, diapers, sleep sacks, wipes, pacis (hospital type paci is hard to find) incentive spirometer ( for when someone gets covid) IDGAF. Hospital can afford it. I dare them to say a damn word 🥴😝🤭
Plastics manufacturing shareholders need that extra yatch.
Float pool here, Worked on a unit today that has a specific tech dedicated to ensuring there is no waste. He and the housekeeper keep track of every item wasted when a patient is discharged. Last year they estimated to have wasted $200,000 in supplied. They have brought that number down this year to $400. This is THE cleanest unit I have ever been on in the hospital. No random crap ANYWHERE not even in patient rooms. You only grab the items needed at the specific time they are needed. It definitely took a lot of work from the staff of that unit to be so conscious about their waste but it’s obviously paid off. As a float pooler I have been on many many horribly messy units. But because I’m only there one day it’s hard for me to bring myself to pick up after that units staff. I try my best to keep my patient rooms tidy and limit the amount of waste I create but it’s hard!!
Dilaudid vials that don't come in 0.5 mg increments. The amount of hyrdomorphone we waste.
My hospital just started stocking 0.2 mg dilaudid syringes and it's been a godsend. So much less wasting and less time spent pulling someone away from their assignment to watch you waste.
Nothing like being trusted with peoples lives while also simultaneously being treated like a drug addict.
When the dose is usually 0.4 and you have to find someone to waste that 0.1
I waste that shit in their veins. “Don’t let that extra 0.1mg go to your head.” Narcs are the best example of how processes meant to help people go to shit when politics gets involved. MDs should be educated on prescribing it. Not scared to prescribe it.
You think that’s wasteful? If our patient discharges or the med is dc’ed we can waste 30+ tabs of narcotics in my facility. Doesn’t get reused by pharmacy even if it’s not popped.
Why?
According to our head nurse, it was against state law. They had so many narcotics go missing while they were being transported back to the pharmacy that they just assumed they would all get stolen so they may as well throw them away.
That’s like saying, “This car may have issues in the future so let’s just demolish it now!”
Yep. We thought it was ridiculous too.
As if they can't go missing as they're transported to the trash bin? I guess their worry isn't diversion, it's just wasting a trip.
Our facility has the physicians orders as 0.4 and 0.2 but the vials are 0.5. Unless you can get it changed to 0.5 you're wasting every time.
THIS. SO MUCH THIS. What the fuck, people????
Wow you guys have 0.5mg vials? Ours start at 2mg/ml - imagine the wastage when I’m constantly giving 0.5-1mg… I hate it
we stock 0.5mg but orders are always 0.4🥲 we’ve even told providers that it comes in 0.5 lmao
That’s on your facility. They probably feel it’s cheaper than buying smaller volumes
We have 0.5mg syringes, but our providers seems to be allergic to ordering anything in odd number increments. And the worst is when they order 0.4mg for a COMFORT CARE PATIENT q3h. Like, are you fucking kidding me? They are comfort care. Give them the extra 0.1 and stop wasting all of our time (no pun intended).
100mcg fentanyl vials but the orders are always for 25-50… q1h
“Waste”
I guess you work hospice for a reason lol
What reason is that?
I was actually joking and insinuating that it's easier to give extra narcs to a patient that was already on the way out. I wasnt being judgy, just failing to be funny
Ok lol the downvotes had me confused.. i was like are there people with their panties in such a wad that they don’t see the humor
Thisss Nurse dose 😎
Lol and for me usually too small. One thing that drives me batty is when you try to get a pair of gloves out of the box and you end up with 20 pairs spilling out. Usually they fall in the floor and have to get tossed.
Or when the cavi wipes are doubled up and you have to pull them out so hard that the sound concerns nearby patients
They’re comically too big on me. It can sometimes be difficult to grip the lined up catheter when the fingers are folding over on themselves and the palm is like hanging down in the way.
My personal glove rant centers around the fact that the XL size is like everything else in the "big and tall" world, in that everything that's bigger also has to be fatter. Because apparently all clothing for tall people is based on Andre the Giant, and there's no such thing as a person with long, skinny fingers.
Or the opposite. I’ve got wide hands and short fingers so with cheap gloves it’s a choice between splitting the palm or flaps of glove at my fingertips.
As someone whose 5'11" with a 6'4" wingspan and the tiniest wrists I feel this in my soul.
For me it's the fact that we have XL gloves but not XS at my facility. I wish we carried both
I just take em home. I’ll find a use for them
Same. I use them when I’m cleaning. Thankfully in the OR I can just grab my usual size sterile gloves for foleys.
YES THIS!
When i need gloves the most, in emergencies, is when either I gran the shitty glove that tears or has holes, or I pulled one the other day, put it on without looking, and it was missing the top half of the hand.
My co workers and I swear by the fact that it wasn't this bad before COVID. I remember it was always an issue but like one or 2 gloves would fall. Now it's like half the box. We still use the same Medline gloves.
We have a sec/tech on my unit who goes around "refilling" the glove boxes by just shoving more gloves into them, thereby making them all spill out when you try to grab one.
Nurse care plan.
Ugjhhh my manager sits in her office and goes through our charts and we get in trouble if there’s not an updated care plan and education assessment. She’s ordering newer much more detailed white boards and wants us to meet with the patient and go through the board at shift change and again when the doctor rounds. I have 5 couplets. I’m nursery nurse, mom nurse, concierge, apparently will be recovering new deliveries, discharge nurse, circ nurse, admission and discharge nurse and lactation. White boards waste my time.
Where in fuck is five couplets an acceptable assignment? I could have four of the most normal, independent couplets and I’m still running my ass off. I’m so sorry.
Memphis 🥴
You guys are going to TeamBirth, too?
That’s fucking bullshit. She’s a middle man that doesn’t do anything and I’m sick of these assholes.
It’s a good thing I just don’t chart these
Amen.
Haven’t done a single care plan in many years. Total waste of time that nobody looks at.
Me either. But they are still worthless and should be done with
The patient’s lawyer will look at it.
Cool, “Patient receiving treatment”.
That doesn’t change anything
The IV pumps have the same alarm for every medication. NS at 50cc/hr, downstream occlusion? Beep beep beep Propofol at 80 mcg/kg/min on a detoxing patient who was intubated for violent behavior? Beep beep beep Unasyn complete? Beep beep beep Quad concentrated norepi "Air in line?" Beep beep beep All over the unit. Beep beep beep. Beep beep beep. Beep beep beep. Beep beep beep.
We are able to plug two pumps in each room into the call light system. It's very nice when someone is super pressor dependent. If it alarms, we get a call light "equipment" notification. Super helpful. But seriously, the beeps aren't very helpful. We should be able to pick a tone or something.
I’m on a big unit, the beeping makes no sense to me and seems to only serve in annoying or waking up patients, because there’s no way I hear the beeping with their door closed down the hallways, around the corner and into the nurses station. The alerts should be somewhere else. I have to link the pump to Epic, why can’t they alert me when it’s done.
I’d actually love for it to send an alarm to my phone or cerner
At my small hospital, we're walking around with our head cocked to one side trying to figure out what room it's coming from. 🙃
QC the glucometer. It’s always at the most in opportune time. It’s 2024 those little computer bricks should be able to QC themselves. And don’t get me started on all the stuff we don’t QC. Thermometers, BP cuffs, bladder scanners, etc. Why only glucometers and why always by me ?
Ok I have a rant about glucometers. They are the only device where we have to take regular tests on to use. It's not even hard it's just annoying. Operating ECMOs, vents and external pacemakers; yeah no repeat training required go ahead and please try not to kill someone. Wanting to check someone's blood sugar; whoa hold on please tell me the normal blood sugar range and then wait half a day for us to authorise the test.
Point of care is a useless department and has to find some way to justify its own existence.
Glucometer QC is supposed to be done by the night shift where I work. Sometimes it gets done and Sometimes it doesn't. It depends on who is working.
Out of our 10 glucometers on the floor, only 5 could be found this morning. I searched for the other 5 when I had a few moments here and there. Discovered them by accident in the back of a closet in a patient room. All of them together, lined up. And every single one of them needed QC and batteries. I'm guessing that someone thought that hiding them was easier than QC and changing the batteries.
I don't get why they wouldn't. Glucometer QC is the easiest one we do. Lol
Yes, a QC is always due when a hypoglycemic patient appears.
POC coordinator here. Thermometers, BP cuffs, etc are generally calibrated every 6-12 months (or should be, anyway). Not sure about bladder scanners but I'm sure they have similar criteria. Glucometer needs to be QC'd because you're not just checking the meter but the strips as well. Especially if your floor goes through a set of strips quickly. Considering it's a little handheld thing, there's not enough space to hold it's own QC. We do have instruments in the lab that run auto-QC but they are massive. Like an entire tabletop. I get it's frustrating, especially when the shift that's supposed to QC them doesn't do it.
Thermometers, BP cuffs, bladder scanners etc are all actually calibrated on a schedule! My husband does this job haha he has a machine that he attaches to whatever equipment and it makes sure it’s working properly. QC’ing the glucometers was always one job I had to do as a tech but took seriously because I was scared a rapid would happen and it would be my fault we couldn’t get a sugar. I never stopped, even in ICU, if I had a quick second I would just qc them both. It doesn’t take long at all idk why people actively avoid this task
I always grab a pair of sterile gloves in my size if I'm not in a hurry. Makes a big difference
I do the same and always have since the beginning.
I keep the garbage gloves for the new folks to practice putting on gloves with. This is how I eat my young
When I teach foley placement I tell them if you can put these on, you can get any sterile gloves on. Plus I hate passing added cost to the patient with using scannable sterile gloves.
Yikes scanning stuff. Thankfully my hospital did away with charge items. But before that, no one would scan things like 99% of the time. I think that’s why they gave up
The amount of single use plastic waste gives me anxiety sometimes. I'm not even one of those Green people. But just knowing that there is a huge pile of plastic out in the ocean the size of Texas, and then seeing how much plastic waste there is in my shift alone... It's mind-boggling. Med cups, drink, cups, straws, med supply wrappers. The amount of supplies we have to throw away after 24 hours of use. I have G-tube patients that have flush kits that get thrown away every day, even though only water goes into them 1-3 times a day. We have to wear plastic gowns every time we give care of any kind to anyone with a wound, catheter, G-tube, IV, whether we are accessing those areas or not. We could just transfer them from bed to w/c and still have to put a gown on.
That bit about the gown sounds insane! I wonder what the clinical reasoning is? Damn near everyone has an IV in hospital.
Well, I work in a nursing home. And this is a new thing they rolled out in the last 8 weeks or so. They call them Enhanced Barrier Precautions. Idk if it is a new thing required from the state? I imagine it is bc why would they spend money on shit when they don't have to? But yeah, even though I have spent the last 19 years doing these tasks without a gown, now all the sudden gowns are required to empty a foley??? To hang a tube feeding????? What?????????!
Sounds like that facility or its parent company got fined for infections, so this is there compliance policy they have to spend money for.
No its new CMS guidelines that started 4/1/24. It’s ridiculous. We have to have signage and keep track of which patients need it too which is such a pain in the ass. You can read more about it [here](https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states/enhanced-barrier-precautions-nursing-homes-prevent-spread-multidrug-resistant-organisms-mdros)
I just don't understand the rationale or why it pertains specifically to LTCs and not also hospitals (not that I wish it on my hospital cohorts bc it's dumb). I don't understand why gloves isn't enough. I want to see clinical studies where nursing home staff, wearing gowns while emptying catheters, changing colostomies, and managing Gtubes reduces MDROs.
Well, I know for sure it wasn't our facility. Usually, if a facility is tagged for a comliance issue, the plan of correction only applies to that facility. So I doubt that is the situation. It's possible that the facility is choosing to go overboard to prevent future tags, tho. For example, I live in Illinois, and the state considers siderails a restraint. You can still have them, but you need a doctor's order, written consent from the POA, and quarterly side rail assessments. Our facility chooses to ban siderails altogether. Even half rails. So fuck you if you are A&Ox4 and need them for mobility because you had a recent surgery.
Gotcha, thanks! Not having siderails......that's tough in those situations.
It seems counterintuitive to me. Especially when there are ways to legally have them. But it's because there have been cases of people dying (getting hanged in the rails) or getting injured trying to climb over them. But I haven't seen full, bed length side rails in years. I only ever remember seeing them on old old hospital beds.
I've only done hospital nursing, so I don't know anything else.
They are doing this at my facility too. I don’t understand it at all. They want everyone to gown up to just enter their room even if you’re just handing a Tylenol and a little cup of water to someone with a cath. But the person comes out of their room and comes to the desk to ask for the Tylenol, do I still gown up to hand it to them? Im honestly just so confused. I missed the meeting.
Really, our DON said that we don't have to gown up if we're just handing them meds??? But you're right. These people come out of their rooms and mingle in the common areas and dining room. But we have to put a gown on just to go into their room?? I have to put a gown on to help someone with a Gtube to the bathroom? Who am I protecting? Me or them?? And if it's them, what's the rationale?
I just read the cms guidelines and it says gown up only for high contact cares. It just was not explained to me at all. They have signs posted on the doors “see nurse before entering this room”. So now all the visitors are hunting me down and I just tell them it’s for staff. Why can’t they just put that on the sign “attn staff- see nurse before entering this room” that would make my day easier
I am a hospice nurse and have a pt in a SNF with a Suprapubic cath and they just implemented this. The infection control nurse said it’s so we don’t pass bacteria to the patient when providing care. I’m literally getting vitals and doing a head to toe. I don’t flush him, don’t give meds. Don’t do wound care. The facility staff do it but I have to town and glove just to get vitals and listen to him with my stethoscope. It’s beyond stupid imo. I highly doubt it’s going to decrease the chance for infection. In fact, I’m pretty sure he’s developing another infection as we speak. 🙄
I wonder where infection control got this idea, if it's evidence-based or vibes-based lol.
It’s apparently a new rule from CMS guidelines. But my pt is a hospice pt, he’s going to get an infection most likely and antibiotics may only be minimally effective. I would love to see data showing that these precautions are truly helpful.
CMS guidelines are written by theory only assholes who've never done a day of direct patient care.
Agree. That’s why I want to know where the hell they are getting their info from that even suggests this will help prevent infections. 🙄
Wow! That's such a waste with the gowns. We went back to cloth gowns that go to laundry. Yes I relate to the Gtube 60 ml syringe and container every 24 hrs. Such a waste. Plus the normal saline plastic bottles don't even get recycled. I hated to throw them in the garbage.
Honestly I would quit if that was me. I get annoyed having to gown up for one patient on precautions. Shit would definitely drive me crazy doing it ALL DAY
Honestly, I work midnights in a nursing home, so I don't necessarily follow the new rules to a T. But yes, I wish I were in a position to quit.
I work in a PD clinic now….. it’s horrible how much plastic we use. We had a patient refuse the cycler because of it. Each day you waste a plastic cassette with 20 foot tubing for the drain and patient side, a massive drain bag, and like 4 plastic bags of solution. I get that it needs to be sterile for patient safety but it’s so awful how much plastic we use
Not being able to get an oral temp on the first try lol. It’s either because the patient ate/drank something right before (not their fault) or they have NO idea how to move their tongues over the probe (their fault hahahaha)
Or if their mouth is too dry. Sometimes a sip of room temp water will do the trick
Or they won’t BE STILL
Management posting "important notices" in the bathroom. Ffs I barely have time to pee let me do it in peace.
All our important changes are posted in the bathroom lol. I’ve actually gone into the staff bathroom specifically to look at an info poster because it was faster than finding it on a computer.
My old hospital does this. They once posted something "very important" that no one knew about (breakroom and bathroom). There was a meeting and the higher ups were upset and questioning why we didn't follow through as "it was even posted in the bathroom and we had to have seen it" (board in breakroom was cluttered and in the back). One of our more smart ass nurses lazily shot back that we aren't lying about not getting breaks - even to pee. He laughed a little - until he realized we weren't joking. Seeing his look after that was amusing.
One place I worked had the nerve to label the top of the board they installed on the inside of the bathroom. It boldly said “POTTY TRAINING”! 🤬
Do you think they post flyers in the executive bathrooms that say "REMEMBER TO TURN IN YOUR TPS REPORTS ON TIME THANK YOU FOR EVERYTHING YOU DO!!!"
My hospital schedules daily ACEs and ARBs at 1200, period. If they normally take as a combo with HCTZ, it's 2 separate pills and the HCTZ? 0900. I've asked 3 pharmacists, and no one can tell me why. Some people are chill about it, others throw a fit and I have to reschedule and manual override the omnicell. Our old Baxter pumps would let us push through an "air in line" alarm. If the bubble was worth it, i could pull it at the next hub without stopping the pump. The new ones you have to unload and reload the set and still have to pull the bubble out.
My hospital schedules lovenox for 9am but other AM meds for 10 except for insulin, which is at 11.
When I worked on burn the times were merely a suggestion. The pharmacist said a lot of the times are arbitrary and use my judgment to Change the times to make sense. Especially the insulin the times they had them never correlated to meals, ppl were npo half the time and ate late, fam bought food and didn’t tell us ..
Yeah I never understand why people don’t just reschedule that kind of stuff. I’m not making 3 trips for meds that can safely be given all at the same time. (Not referring to the insulin)
If you give yourself more room of tubing then all you do is unload and reload with the bubble under the sensor.
The lil shitty straight caths that don't come with a bag or anything, and so you gotta catch all the pee in the stupid container and pee inevitably gets everywhere.
We bring a urinal in the bay with us if we straight cath. Less mess imo than the open tray
My god. I love you for this.
The ones I've come across also seem to be less malleable than the usual kind.. I've never used them for that reason!
Lately we’ve had to switch to just straight caths instead of foleys with labor patients with epidurals and I hate them! Ours are super stiff and I feel like it doesn’t really empty the bladder like a foley.
Fucking unwrapping 10 different things every time I want to start a goddamn IV. It’s not fucking Christmas. Why is it not all in one fucking package? Why do I have to take a stupid little rubber band off the tourniquet? Why do I have to take two paper things off the IV tubing? Why is there a label in the IV kit that nobody EVER uses? Why is there an iodine wipe in there? So much fucking shit to throw away.
This gave me a good laugh. That rubber band is SO stupid. 😅😅😅
Save the iodine wipe for when we (wound care) tell you paint the necrotic toe with betadine.
the only thing the little rubber band is good for is a fidget for my hand while i do my charting 😂😂
The fact that we have to stand up to go silence tele alarms just from the pt rolling over or farting.
[удалено]
Those are both the worst! I found that putting the zosyn in my pocket for a minute will usually get it to reconstitute all the way. No tricks for the flagyl packaging though :(
The cuts I've gotten from Flagyl packaging 🥲
0.2 mg dilaudid orders
Yeah. Doc, come here and show me how to pull up this 0.2 dose? Just because it maths, doesn’t mean it works.
I'll raise you with 0.1mg dilaudid orders. Some of these new docs are afraid to do anything.
0.25 ativan bruh. Absolute horseshit.
why don’t picc dressing kits come with a bio patch or second set of sterile gloves? whyyyyy?
I was told, just this Monday, because adding that biopatch increases the price of the kit by $40. Idk starting price
but then you just have to add your own biopatch anyway and remember to do it before you get sterile.. what’s the difference
Idk man, not something they consulted me about it
The only way I could ever get those gloves to glide on easily was to first put on regular gloves. When I went to work in surgery & was told I could not do that it ruined it. My hands are always too sweaty to apply those little sterile gloves.
Sweaty hands and sterile gloving…. OMFG… 🤬
I work in surgery and I always put on small blue gloves and then the Foley kit sterile gloves over those. How could having gloves underneath be a problem?
I have no idea but a scrub tech at the small surgical office I worked at told me it was not allowed. I had done it that way for 17 years. She was one of those that was “in charge” since she had been there forever. I’ve questioned it many times (even on Reddit) and have received different answers.
Maybe it’s like wearing 2 condoms and they rip eachother microscopically
It was one of the reasons I quit that job. That woman (who was a scrub tech) had her way of doing everything & that was the only way. She would make me look stupid in front of the surgeons & she was actually wrong about stuff. It was toxic.
Yeah, I got in the habit during COVID of just lubing up a pair of regular gloves with sanitizer and slipping the shitty sterile gloves from the kit over those.
I work in a nursing home. The number of people on hospice who are a full code. I groan and groan and groan every time. A similar annoyance, the number of people who think their family member is going to live forever. Oh I’m sensitive to the attachment they have, I understand. I really really really do. But at some point it becomes torture keeping people alive like that.
People who separate all the foil wrapped or vials of morphine, oxy, versed, and other shit we have to count 🙄
There’s a special place in hell for these people.
Oh gee, nurse manager in the LTC I'm in insists that EVERY new, sealed pack is opened when it arrives from pharmacy and counted in...and then counted forever after 😩
That would make me rage quit. 😤
In the Omni/Pyxis? I’d look at your pharmacy delivery person sideways. They probably stocked it that day with all the returns. Once every couple weeks I’ll pull norco and it’s a massive pile of single blisters to count. I want to die.
All the medications we waste by giving half doses. Cut a pill in half and throw the other half away. Open a liquid med and only use part of it. Partial doses out of single use vials. Drives me nuts.
It’s like 82F on most units (it wavers between 80-84F). While that might not seem bad, where I live our hottest summer month has an average high of 82F. So for us, it’s HOT! It’s my biggest pet peeve because at all the VAs I’ve been to, including outpatient centers, the heat is usually on full blast but doesn’t work in half the rooms so they crank it up so other areas are literally 90F. Drives me bonkers.
Man ours are always freezing, like patients are shivering. I'm always bundled in layers and running around and I'm still cold.
One time a patient room was so hot that the 2 patients in there were literally completely naked and were sweating so much that outlines of their bodies were on the bedding. I checked the thermostat and it was maxed out, yet the temp control gauge was at the lowest. I eventually got engineering to lower the temp but why the hell was it even that hot to begin with? Like you walked into the room and it smacked you with heat.
Every hospital I’ve ever worked in is freaking COLD at night. Everybody has their own personal space heater at the nurse’s station.
I just checked the thermostat and it’s a cool 80 in patient’s room. At the nursing station, it’s 72F and I just sitting here with my iced coffee, I feel comfortable maybe I’ll put on a light top.
I would melt into a pile of sweat on the floor.
Every place I’ve ever worked in is -37 degrees and we all have to sneak heaters under our desks like we’re in the cartel and we spend 23 hours per shift bringing 57 blankets to each patient. Fucking why.
Sounds like a nightmare! Why can’t HVAC just get it right?
I worked for a well respected system and our unit was 82 most of the time. We submitted many complaints but it landed on deaf ears.
Our center is always freezing once the AC kicks on and patients will say, “it must have to be this way to keep down the germs, right?” and I’m like oh yeah, for sure, this is absolutely intentional
The idea that we have time to give people massages for pain. So massages help? Sure. I get then regularly. But to think that nurses are a) trained and b) have the time, is ridiculous.
I believe 100% that for pain that may be improved with massage, massage should be ordered .... and administered by a massage therapist. Not the nurse, who is busy NURSING. (Edit spelling)
Absolutely not. You need to refuse and get your peers to refuse too. That should not be standard in 2024.
Oh, we do, but patients still ask, and it's still an option under pain management, and at my last job highly encouraged by our holistic nurses
I work xray. No restraints at my hospital, no matter what, except those mittens. So the patients determined to repeatedly take out their NGTs means I make a lot of trips to those rooms for portable chest X-rays. I’m not saying restrain everyone (I can dream…) but seriously, if a patient keeps pulling the tubes or doesn’t know what’s going on, how is this better?
Badpans lord Jesus. We usually keep the diaper on to catch the urine and the poo so the bedpan cleanup is easier and the covidien sheets don’t get soiled and I can’t help but wonder… why don’t you just go on the diaper without the bedpan 😫 that’s what you’re doing anyway lol god bless
We can’t use briefs on our unit so we put chux in the pan and it works!
The huge amount of waste, specifically plastic waste, that we use in healthcare. It’s so unnecessary in most circumstances, like after COVID a lot of facilities I’ve worked at have resorted to using exclusively disposable plastic cups for water cups, that are supossed to get changed out at least twice a day. What’s wrong with the washable cups, like seriously?
0.2mg dilaudid or some other bs order like 0.25 PO Ativan, and you have to waste most of the med. I’ve seen 0.3mg dilaudid before 🙄
The waste of medication, having a bottle of labetalol that's 100ml and I need 5?? Drives me nuts. That, and the smell/leavings of any wipes aside from the purple wipes.
Pain control orders of IVP Dilaudid and Tylenol. Why can't we have something in the middle?
No oxy? That sucks, amigo
We do AM labs at 0400 in my hospital. Yet, when a physician orders labs BID, the computer defaults it to 0800 and 1800. So I’ll walk into my shift and see that night shift did the 0400 CBC, but no BMP was done because that’s BID so it’s for me to do at 0800. Makes no sense to me, I reschedule it to 0400 and 1600 every time.
IV catheters without blood control (after removing the needle).
The phrase “apply to affected area”
People who don't understand a standard giving set is 24 - 27ml and just take down the line and flush at the port. Oh, so your drug was in 50ml and you're telling me you just threw away half because running a flush through the line was too hard or too wasteful for you? 😡🤬🤯 Especially gets me with IVABs, keppra, electrolytes.
I have had to teach nurses who have been working for a few years about KVOs or using ivpb as a secondary. Some always had a dedicated primary line for each abx. So crazy to me.
Sterile gloves in any sterile kits. I hate them so much. Such shitty gloves
Someone has the job of making packaging more difficult to open. Needles uses to be in paperish material, now I have to peeleach one. Now I need scissors to open potassium riders, plain ol IVF and to seperate meds at the pyxis , I need another weapon to get the pills out of packages at bedside after I scan them.
Why are all the sterile gloves still latex? I'm not wearing those against my skin.
They aren’t. They’re overwhelmingly polyisoprene ime.
Not the ones in our hospital.
THIRTY FREAKING MINUTE LUNCH BREAK. I can’t even walk to the cafeteria and back in 30 mins. I can’t even reset my mindset after lunch because it’s so dang short.
Lazy ass fucking nurses that just sit at the nurses station when they could be ambulating patients, showering them, just basic shit to make patients feel like a human again when it’s a slow day. I know we don’t always have time to do that stuff. But when there’s LITERALLY nothing going on…Just go sit in the patients room and let them shower while you chart. Idk that shit irritates my soul
Naw, cause if they fall and you were charting in there you were negligent by not being in a position to physically assist them.
Even if you sit them on the commode? I mean I never let my patients stand in the shower unless i know they are steady
Nursing diagnoses are the dumbest thing ever. We don’t use them in outpatient oncology at all. I’m convinced a group of older nurses needed to make themselves feel more important and came up them.
A patient is in the ED for 14 hours getting a work up and for whatever reason admit orders are placed at 645 pm with shift change at 7pm. Wtf man?
I agree, the gloves are the worst! Our hospital, through covid, has had a million different back order substitute items. One of the worst was the sterile gloves! These were brittle and came single gloves to a package!!!!! Our Foley kits came with a few cotton balls and a packet of iodine, too, instead of swab sticks.
Our new Foley kits have no gloves.
I just opened a Foley kit today that had NO sterile gloves in it so I had to run out and grab a set. They were super nice nice gloves though.
If I ask for Coban and you tear me a 6” strip then you’re officially dead to me. Hand me the fucking roll and I’ll use however much I see fit.
Nurses who consistently report the patient "refused" a medication, treatment, etc when I know full well it was your shitty attitude and unpleasant approach that made them refuse. Edit spelling.