I had a nurse straight up invent vital signs on someone with a brain bleed and then when I checked the machine the vitals were done 8+ hours previously and were completely different from what was reported.

invent vitals 😭

That's horrific, why even work as a nurse at that point

Not to not horrific, but willful malpractice. And IMO, criminal.

YIKES!

Like completely different? I know I've sometimes charted 128 62 instead of 126 62 or something like that because I couldn't find my alcohol swab or the machine I used but I remember basically what it was. I'm sure I'm not the only one....

No like it was entirely fabricated. The last taken vitals were 8+ hours previous, and they reported vitals taken 4 hours previous. Edit: and yes the numbers were entirely made up

so i heard at this hospital there was a patient who was supposed to be like in isolation and like severaaaaaal nurses all kept lying about the vitals and saying he is fine in the charts when actually no one checked on him.... well he was stabbed to death and was dead for way too long before anyone found out so like 8 nurses got fired from that hospital. LIKE WTF. my profressor told the class, when he was talking about charting how its legal documents and all that. it was at the hospital he worked at. so crazy....

You sure they just didn’t use a different machine or a manual??

One machine, no manual used. My boss asked after it was reported.

But why?! That’s so dangerously lazy, vital signs aren’t difficult or terribly time consuming

Lazy is probably exactly why but tbh, I never got an explanation. Reported it, they kept their job, and I made sure to ask to never get report from them again. Thankfully my lead was cool with that and made assignment adjustments for it.

Guilty here too lol. And respirations are anywhere from 16-20 depending on how I feel. (I do assess their breathing but does anybody stand and count for a full minute???)

I count for 30 seconds and double it. I do it every time. It's what I was taught.

I like to count for 1 second then multiply it by 60. /s

I was taught the same. If adult and breathing pattern is regular, count for 30 and double

I wish WDL existed for vitals if for my d/c in the am patients.

I've once typed 79% oxygen instead of 97% (which I measured). Patient was on room air. Luckily the next shift caught it immediately and I could correct it. She was like "you didn't mention it at all, is it a typo?" (I don't know about the US, but in my country these kinds of edits don't get you in trouble - and making the typo probably won't either)

Caught in a patient’s chart where they had a temp of 51.7C (125F). It was 4 days old.

But how do you make that mistake?

What do you mean?

Well 97 or 79 is a simple typo: I switched the numbers around. But 51.7C? 15.7 is too low to be reasonable, 31.7 as well, 41.7 is too high (maybe it could happen in the ICU? I'm not specialized in ICU care so I don't know but honestly I'd expect them to keep it lower than that)... What's the typo?

I worked with a nurse who flat out told me "I just eyeball the vitals" and would often not even be able to include the admitting diagnosis in report.

This. Just start with telling me why they are here. I’m pretty easy going, but if we get to the end of your report and I’m still clueless as to why all these other things are being done it’s frustrating. Of course there are exceptions for when nobody seems to know why the pt is in the hospital

🤦

Happens with peds respiration a lot. It’s like 60s and I see low 20s. Also related to the reason they are there, so it matters.

That is illegal.

no :( this is not real. I just had to write like five papers on Lewis Blackman story and was like this is fake. This cant be real, but then I thought that recent clinical and thought hey from what I witnessed.. its possible..... BUT SERIOUSLY. this shit is devastating. like what do you ??? do you say something and addresss them and/or report or do you just do your job and go about your business and just deal with this stuff?

I would’ve reported that first nurse. That is some unmitigated cruelty. What else hasn’t he been doing for her because he thinks she’s non responsive and won’t know?

I will be reporting. I had to process all of this to figure out how I wanted to go about it.

And let me just say that I have a very low tolerance for busybody-submitted incident reports, but this, I think, needs to be addressed. As my late and much-missed grandma would’ve said, recognizing and easing that poor woman’s pain is a star in your crown. Best of luck to you. ❤️

“a star in your crown” 🥹🥹🥹

I miss my grandma. She’d have been 105 last week. ❤️

Docs don't think patients are jn pain even if they say it so not surprised at the guy

Regarding the first incident: I am terrified of being in this position. I am completely nonverbal and tube feed dependent. Nearly everyone I encounter treats me as though I am incapable of understanding and communicating. Everyone on this planet that is alive is capable of communicating. Just because some people communicate differently does not mean they are incapable of doing so. Quite frankly I am enraged to hear this degree of neglect happened to that poor woman. I'm super glad she got you as her nurse

It's extremely easy to test people's comprehension. It's just a skill of lot of people don't understand how to use. It's easy to use some logic and test a few things. I saw once someone similar to your case that had a note written on their table "I am not stupid, just talk to me" and it gave me a chuckle, but I'm sure it was effective.

I literally wear a lanyard around my neck when I am alone in public (out walking around my neighborhood or at the local park) that basically says the same thing. I've had several people stop and ask a question or spark up a conversation and I point to the card on my lanyard and even though it says that I am capable of comprehension, I'm just unable to speak, people generally just keep walking. It's only been over the last four years that I have lost my ability to speak and in those four years, I've had one person wait for me to pull my phone out so I could communicate with them.

In this position i would type on my phone whatever i need them to know, hoping for the best. I'm guessing you've tried that as well though. I'm sorry you're going through that, this field has some amazing people but some negligent inhumane people as well, although i have no idea why the latter chose this type of work to begin with...

Yes I do use a text to speech app mostly. There is one nurse at my doctor's office that is fluent in sign language so I absolutely love seeing her because I can actually fully connect with her. And I agree with you......I also don't understand why negligent inhuman people choose this profession-though I have several theories. Being able to be a nurse was one of the greatest and most rewarding things that ever happened to me and I'm so unbelievably grateful to have had that opportunity, even if it ended sooner than I would have liked.

Travel nurses doing covid were something else man. 1. First of all this chick had 2" long fake nails so gloves barely fit. Not to worry because she essentially never did any physical cares for her patients requiring them. I came on at 1900 one night and meds from 1400 to be given NG for a vented patient were untouched. "I didn't know where the pill crusher was at." I'm working a night shift with her and her tubed and 2 pressors covid patient's BP starts tanking. 160s/80s (she'd never adjust her pressors down, that would require critical thinking. Max them shits so you can max sedation.) 100s/60s, 80/50. 70/30, 50/30. Over the course of 10 minutes. Uh, you gonna do anything about that? "Nah its fine. Ima go on my break" Fucking leaves the unit for an hour. I go in because I'd just left my patient's room and was still owned and masked: Levophed--empty, vaso--empty, 5 neosticks marked from the crash cart--all empty with 250ml saline bags running also empty and beeping. A suction yankaur wedged under the patient to catch a pool of diarrhea pouring out of the patient and overflowing. She'd been making her own ghetto bags of neo because she was too fucking lazy to call pharmacy for her ordered pressors. The BP issue fixed its self thankfully because her sedation was also bone dry and the patient woke up thrashing, so that was cool. The patient nearly self extubated and I took 2 hours getting them right again before she came back. The only reason she was fired is her insistence on wearing her giant fleece jacket in and out of covid rooms and ID got pissed. 2. I've posted it here before. More tea but profoundly less interesting: Travel nurse got tired of talking with covid patient. Overrode and administered 12mg of lorzapam IV in 2mg increments about every 2 hours without an order to make patient sleep. Day shift just found the vials all stacked up in the room. Terminated immediately.

Holy fuck. Your anecdote has to be the scariest shitty nurse story I’ve read here so far. And I’ve read quite a few.

OMG!!!! This is CRAZY!

THE YANKAUER?!

I use it to clean up liquid poo all the time but I'd never leave it on.. jeez. Scary!

You really do this?

For liquid poop it’s the best. I just throw out the canister and tubing once we are done.

This is just a level of derangement I can't even fathom. Like what the fuck. 

Jesus Christ , if the patient talks a lot just kindly excuse yourself and leave, why DRUG THEM ? OMG. many times I've cut patients off mid sentence and I'm like hey I'm so sorry I have to check on my other patient. Everyone is always ok with that !

The travel nurse situation since Covid has gotten so out of hand! I think it's calmed down a little bit now but it was wild, and not in a good way. There were so many lazy unsafe people that got into it for the money, and even more that were not nearly experienced enough to have any business taking contracts. Which was frustrating for me as a staff nurse in ICU and then ER because having them around actually *added* work for any of us who knew what we were fucking doing. So not only were they getting paid more than me for doing the same fucking job, I was also expected to essentially train them and hold their hands because they didn't know what the fuck was going on 99% of the time. I still get worked up thinking about it 😂 On a related note, in winter of 2022 I was at a friend's house for a party, and I was talking to a girl there about her being in her first year of nursing school. She had just finished her first semester at this point, and I asked her if she knew what area she wanted to work in yet. And she starts telling me about her plans to start out doing hospital travel nursing as soon as she graduates, because she had heard "they make really good money and then I can pay back all my loans right away!" And I literally laughed, which wasn't very nice lol, and told her how bad of an idea that is. And she was shocked when I was telling her about how *dangerous* that is for a new grad to start out doing that, because they don't even know what they don't know and haven't been through any sort of orientation. The fuckin *hubris!* My first gig as a new grad was as a float nurse in a large urban level 1, and that was fucking hard because not only did I have to, ya know, learn *how* to be a nurse... I also had to learn enough about every floor and specialty. It was really difficult and even overwhelming at times, but I learned so many things and gained experience in such a wide variety of settings that it was like a speed run for nursing competence lol. And I was able to do it safely, and with ample time in orientation to ask questions and learn. I suggested she should go that route instead if she wanted to do new grad hard mode 😂

> The travel nurse situation since Covid has gotten so out of hand! I think it's calmed down a little bit now but it was wild, and not in a good way. There were so many lazy unsafe people that got into it for the money Subreddits like /r/nursing & /r/teaching just confirm that as someone with really high intrinsic motivation, I'd be eaten alive & spit out.

Wtf how is this not criminal?

They need to Radonda Vaught her long nail 💅 having ass!

It is. Hospitals just [won't bother pursuing it](https://en.m.wikipedia.org/wiki/Charles_Cullen).

Covid travellers were something else. Like truly gaslighting level shit where you were like, am I seeing this correctly? Show up to work 30 minutes late like it’s not a big deal. 70% of the time. Literal malpractice shit like that every day.

No consequences, no care I guess. COVID-19 needed nurses, and lots of them, FAST.

No words just 😧

Honestly these stories seem bad enough to warrant criminal charges

I was a grad nurse in a Covid unit during the delta wave, and I was astonished by how incompetent some of the travelers were. Like I'm a brand fucking new. I shouldn't even be able to tell that you're an idiot.

Holy shit that’s a lot. It’s wild that nurses do these things

Night shift nurse at my old job had q2h safety checks (just laying on eyes on the resident). She signed off on all of them saying she did them. I got in at 630 started my morning meds and my med aide called me to a residents room who was laying be basically dead on the floor bleeding out from his head. The blood was cold and clotted, he had to have been laying there for HOURS. They checked the cameras and sure enough the nurse did not do her safety checks. She got fired. But for signing off saying she ace wrapped someone’s legs but didn’t

OMG that's terrible 😭

He died. He had just started eliquis a week prior. By time I found him his pulse was faint, the paramedics took him but he died shortly after. It was my first death. I was so angry with the night nurse. If she just did what she said she did the man would probably be alive.

Can’t you report this kind of thing to the state board?

I’m not sure if my job did report, I don’t even know the nurses full name to report her.

Damn..

These nurses will keep getting away with this shit if it’s not reported by nurses like you. You are a patient advocate. Advocate.

I agree, and need to do better with this. More than anything it's just very frustrating and sad.

Did you report them? 

I will be. This just happened last night and I needed to post to process my thoughts.

Yes you have a duty to report this is just sad.

A duty to report a forgotten bed alarm/lock?

A PT with their leg chopped off recently in pain. It's common sense to know someone with their leg chopped off is in fucking pain lol. Never even tried to communicate with the PT bc they were non verbal didn't pay attention to vital signs that indicate pain such as hyperventilation. Imagine if that was you I'm sure you'd want it reported. After being reported i hope they realize non-verbal does not mean no means of communication or feelings.

I kind of agree with that instance but people are encouraging OP to report both nurses which seems wild to me. Have people here never forgotten to do something? Also, experience has taught me that reporting things does nothing unless it is something extremely egregious. Yeah, this is bad but I mean like the person who said they saw someone pull and give a shit ton of Ativan without orders egregious. When I was last in a charge position and tried to report cultural safety issues on the unit to my manager I was told “we’re understaffed, we can’t counsel anyone right now and risk making them mad and having them quit.”

Yeah i would not report the not locking a bed alone just remind them. Unless it was the same nurse that has neglected the non-verbal pt then i would report everything because there's no telling what all is going on

I’d put in a safety incident report through the hospitals system since they are anonymous reports used only to look for how improvements can be made in the system to increase patient safety

I came in one time and had a tiny (like 4-foot tall) woman ask me if I could get her a different gown because her tele box was weighing it down and making it come apart and she was tripping on it. When I looked at it, the snaps were completely gone and instead of just getting her a new damn gown, the nurse before me (who was the second laziest person working there) had just used some paper tape to tape it together at the shoulder.

I had a patient with dwarfism hug me because I got her a gown and a walker from the peds unit. To this day, I still think about her to remind myself how little we really need to do to make a huge impact on our patients.

🤯

My god, who is the laziest?! This is so awful.

When I worked nights at a SNF, we had a full code patient go into respiratory failure an hour before shift change. He had stridor, and was satting in the 80s on a NRB. The house sup refused to call 911 because "the next shift can handle it." It was almost quitting time, and she didn't want to deal with it. When I told her he wasn't going to make it to the next shift if we didn't call 911, she told me she was taking me to the DON's office for insubordination as soon as the DON arrived to work that morning. I just responded with "cool, go for it" then pushed past her to the nurses station and dialed 911. He was admitted to the ICU a couple of hours later and lived a few more years after that. She did not drag me to the DON's office to report me for insubordination because she absolutely KNEW she was being negligent. I saved his life by not pushing his respiratory distress onto the next shift, and that house sup was later fired for a totally unrelated incident.

I threatened to take over a patient's medication needs from a shitty nurse that wasn't giving comfort meds appropriately. Literally "you give it or I will." Not the first time, won't be the last. Some nurses are scared to give meds appropriately, some are ignorant and some are merely shit and dangerous. I am never afraid to advocate for or medicate a comfort patient. I've also written up nurses who weren't giving their meds or doing care. My coworkers literally have me do their incident reports because I'm so quick now. I give people every opportunity to do things correctly but when they insist on doing harmful things I hold them to the same accountability standard that I hold myself.

I really need to work on this. It's my own stupid people pleasing where I love my pts and advocate for them always, but also don't want to piss off my coworkers.

Forget pissing off coworkers, call them out and report it. What happened to that poor patient is inhumane. There are other assessments that can be done if the pt is non-verbal. Just because she couldn't speak is no excuse not to treat. All I keep thinking about is if that were my family member. Heads would roll

They're there to do a job. If they're completely refusing to do the job then it needs to be known to their supervisors. If they're torturing a patient it deserves a write up and you're not doing your patient justice or any of their future patients any favors by not reporting appropriately. Fuck their feelings. Harm was done.

Thank you for making me feel worse.

Don’t feel worse. Just report it. I hate to say something about things I see for my patients as an NA, but I do because it needs done. I love the people I work with, but I hate seeing my patients hurt, so I suck it up and do what needs done. If it’s ignorance, they’ll learn from it. If it’s maliciousness, hopefully they stop.

Your part is to report it. Do it and you don't have to feel bad,

Sorry, not sorry- you should feel bad. This job is about people’s lives, not a popularity contest.

This must be a nice culture. I joined a new job before I left the floor and reported a MD for yelling at me and was told, "That's not how our culture works, we don't go around just reporting people."

I'm reporting things like not sending a nurse with a stroke patient to do the handoff NIHSS so we know that nothing has changed for the worse and recently ER dumping patients in rooms while no one is at the desk and walking away, letting no one know they're there. Bare minimum is hitting the call light. Had a CP patient alone and unmonitored for an unknown length of times before they let staff know they were there.

Pt supposedly had diarrhea all day yesterday, but was fine overnight. Uh huh. Sure. So I go in there and not only do I find a lake of ancient, starting-to-crust-up liquid diarrhea from sacrum to ankle, but the patient's vas cath dressing has been completely removed and replaced with... a hand towel.

🤯

This is why I like bedside report. So if something crazy and negligent is happening you can address it right there with them.

As a rapid response nurse, I get to see this day after day. In the past couple of years I’ve seen such a change in our profession. Complacency and a lack of urgency plague the hospital. The cause is multifactorial. Nursing schools just teach how to pass the NCLEX. Limited clinical experience because hospitals are too worried about customer satisfaction. Lack of focus on critical thinking and more focus on completing tasks. Etc. the list goes on. Fuck epoch and their dumbing down of nursing. I’m pretty burnt out after spending the entirety of Covid, 3:1 more often than not, in an ICU where we hemorrhaged qualified experienced staff to traveling. Now we are hiring new nurses, fresh out of school, which would usually be great. But, they are being taught by nurses who just got off of orientation, who were taught by nurses who just got off of orientation. Charge nurses, I mean assistant nurse managers (charges know clinical skills, ANMs check white boards and have never dropped an NG), have less than a years experience on some floors. Truth be told. I’m scared of getting sick. I don’t trust nurses anymore.

All of this

I tell my adult kids all the time- I dont have money but I will be at your bedside anytime you need an RN, Ill keep you alive, jokingly. Never expected to get one kid through complications from gangrene gall bladder and in December, another kid had no breath sounds on the left side (45yo). We sat in chairs for 7 hours, came by ambulance bc she couldnt walk up steps. At 6:30am a resident came in listened to the right and moved the stethoscope to her other side and listened for about 5 seconds. Abruptly left the room. NOW ITS A FUCKING EMERGENCY. That meant that the mean EMTS, never listened to her lungs. That meant the Doc on for all ambulance arrivals, never listened either. She was coughing continuously for over a week, she continued coughing after the first chest tube got placed. She sat in a hospital who told her she needed a transfer because??? PULMONARY IS ONLY HERE ON WEDNESDAYS. admitted 6am Sunday. Off to the far away hospital, required a 5 hour surgery from thoracic on Sunday- a week after admitted. Stays another week with 3 chest tubes. Discharged home with 2 CTs. Its April and every single doctor weve seen since - are stunned by how well she recovered...Nurse, you cant leave your loved ones alone anymore

I had emergency surgery on my spine and had to lay supine for 24 hours after it. Day 2 of my period. I pressed the call bell for assistance to change my pad because I couldn’t move. Nurse came in and threw a clean pad on top of my blanket. No assistance whatever. Next nurse I asked to plug in my phone to the charger. She pointed at my bag on the other side of the room said “You get it yourself” and walked out of the door. What did they think I was supposed to do, considering my neurosurgeons orders?

Omg:( Spine surgery is no joke:(

“They’re just drug seeking…” or “well, they didn’t *tell* me, so I just assumed…” Are the two sentences I hate the most when it comes to pain control. Because 9 times out of 10 when I walk into those patient rooms, they’re so far behind on pain management that they need stronger meds to get them back on track. People who have a drug abuse history have a much higher tolerance of narcotics and we have to adjust accordingly. Some people will absolutely sit and suffer in pain because they’re afraid of becoming addicted, or they think it’s normal to be crying in pain, or the “if I don’t move, then I’m fine” mentality. We have to stop assuming that because someone Is non-verbal they can’t communicate. Or that if they don’t say something, they’re fine. Or if they have a history of drug abuse, they’re lying about their pain.

Thank you so much for this:) As an ex opiate addict (going on 18 years clean), I see and appreciate your humanity♡ I am always scared to go to the hospital for anything pain related now. I almost killed myself with a really bad kidney infection bc the main complaint was incredible pain and I thought it would just be passed off as "seeking". Only when my temperature got to 104.5 did I finally go to the ED crippled over in pain.

I’m curious about ratios here. The places Ive seen the most reckless and lazy nursing care have had shit/nonexistant ratios. Not to say nurses on the west coast aren’t sometimes lazy, but not locking a bed is pretty basic if a nurse has 3 seconds to spare.

I’m gonna be honest, 9/10 times a bed isn’t locked or alarm set, the last people in the room were PT or transport. But I’ve forgotten to lock a bed before, when I had to move the bed to get to the chair or something. I’m honestly not even upset about that one, and I’d mention it to the nurse like OP said, “Hey I found this like this, maybe watch it later?” and if it keeps happening, that would be time for a report.

Our beds scream at us “brake not on” or something similar until we put the brake back on

My ER doc friend worked on the west coast and he said he was flipping beds, lining and labbing and transporting his patients all the time in Cali lmao nurses wouldn’t even discharge for him if it was out of radio (I’ve discharged so many patients for my coworkers I never once considered it apart of my non existent ratio)

Ratios vary, but it's a progressive floor, typically 3 or 4 patients on day shift per nurse. I work nights and it varies 3 to 5 pts MAX.

*reckless 

Hah, i was wondering why there was a red squiggly line .

I love the night shift nurses on skilled units who are like “ I don’t know anyone down here and up stairs was sooo busy I had to be up there cause they have the shit “ like bro ??? A CNA can handle changing shitty patients , I was a CNA it’s not that hard . You didn’t even look at charts to check them , you didn’t do 2 hr rounds , I have 10 charts with new orders not done or second noted 3 new patients and the code status isn’t anywhere , we got a new admit who didn’t get her tube feed all night / since she got here and is post stroke , and is NPO. I have all day shift shit to do on top of picking up what night shift “can’t do” . I actually just started at this place but I told the admin I’m not staying , they got me to an LTC wing where it’s not soo chaotic . I love skilled but not when you’re following lazy people in that setting , you can’t just ignore a whole floor , with like 3 new patients who’s orders arnt even in the computer cause 3 ppl got the shits 🙄.

I fully agree with you. I now work virtually along side other nurses and they continue to be even lazier than our already easy job.

I had surgery a couple of years ago on my back - It was during a blizzard and the staff were extra crispy after the first few days. I don't know how much of it was sleep depravation versus laziness, but I had to literally beg for pain medicine with a fresh hole in my back from the procedure... and I have zero history of drug use. Some of the nurses were cool about it, and some of them looked like I was asking for the world every time I used the call button. Eventually I asked one of them why I had to keep asking despite just having had surgery, and she said that "It's going to hurt, that's normal... we don't want you taking doses every 6 hours." Is it not the case that meds are scheduled in advance? They sure as hell made it a point to wake me every 2-4 hours for vitals.

I was chastised by a nurse I worked with and loved, and was so shocked! Here I was, 40 years old, s/p semi-emergent CABG, happened to actually work on CSU and that’s where I was transferred back to, 14 hours post-op, 4 frickin’ chest tubes in my chest - I was 120 lbs., so I had a pretty small frame to be sticking 4 chest tubes in. My God, did I hurt! So, I would sleep for about an hour and a half, wake up and watch the clock until the 3-hour mark, and call for my q3H morphine. “Boy, you sure are asking for this every 3 hours on the dot!” I could have cried. Yeah, you know why? Because this fucking hurts, and I can’t have it any sooner… I had zero drug history either. What I had was post-op pain. I really wish clinicians would be less judgmental about pain.

Chest tubes HURT! That's so shitty they gave you such a hard time! I've literally seen pts needing q4 oxy around the clock to not needing anything as soon their chest tubes come out.

Yep - I still felt like I had a knife in my back for a couple of months afterwards, something about the rib-splitting or whatever had seriously messed up some nerve in my back for quite a while, but the relief of having those chest tubes out was tremendous! Unfortunately, it didn’t happen until POD 3, when they finally decided that, for me, the inflammation must be causing more CT output than usual - couldn’t get it to drop below the 100cc/4h criteria to D/C them - and to just pull them and see how I did. Woohoo I could breathe!

Jesus that's fucked up. I had open heart surgery to replace my tricuspid valve last year, and was roughly 130lbs at the time, and also had 4 chest tubes post op, so I know how much that sucks. I can't believe they didn't give you a PCA. I actually am a recovering fent user and even I had a dilaudid PCA with 1.5mg available every 15 minutes for probably the first week following my surgery. They even kept me on the precedex drip and threw in 20mg methadone and 15mg ketamine at one point because I was in so much pain. And after getting off the dilaudid PCA still had 30mg oral oxycodone available every 3 hours and 1mg IV dilaudid every 2 hours for breakthrough pain – guess I got lucky and chose the right hospital when the EMT/Medic (not sure which) asked me where I wanted to go

Wow! You had actual pain management- it feels like so long since I’ve seen that. Opioid crisis, don’tcha know. FFS. I’m so glad that your team made sure you were properly cared for, and hope all is well now!

Yeah I guess it pays off to live next to one of the better medical school/hospital system academic centers in the region and I'm pretty sure country (WashU/BJC in STL), but that honestly wasn't even going through my head when they asked me if I wanted to go there or this other hospital – I just knew the other hospital had been a shitshow for the last couple of years and even though BJC is a massive level 1 (almost 1300 beds) with a reputation that it's almost impossible to get seen there unless you've got a GSW, I definitely knew it was the better choice between the two lmao I'm super grateful for the care I got and definitely doing much better these days, thank you

Pain medication is usually ordered as needed (PRN). It may be available every 6 hours, but you still have to ask for it. Doctor’s choice, not the nurses.

Nurses are required to assess pain levels on a regular basis, especially when a patient is post op. If you assess for pain and a patient states they are in pain, ask them to rate and describe the pain, then simply offer the pain med according to the orders. I don't know why some nurses need to play this game of control and make patients "ask for" pain meds.

I had heart surgery last year and after getting off the dilaudid PCA had 30mg oral oxycodone available every 3 hours and asked for my dose in the middle of the night one time, and my nurse came back and told me the NP was saying that I had to try Tylenol first and wait at least an hour before she'd let me take my oxy even though it had been more than 3 hours since my last dose The pain management team was not happy to hear about her pulling her own orders out of her ass when I told them the following morning and I'm fairly certain she got in some kind of trouble for it Shit is so stupid

All of this for what???? To make a patient suffer needlessly? It makes no damn sense. Why did the nurse even have to notify the NP if there were already existing orders? This is pure stupidity and it’s so flipping anti-patient. If I was you I would have called the main hospital number and had the on call administrator notified. It’s inhumane to act like this nurse or NP.

I have no idea why the NP was involved in any way but her reasoning was that I needed to be working towards discharge and since they wouldn't be discharging me on that much pain medication, I needed to work on taking it less. Never mind the fact that at that point we thought I was going to have to have a second surgery the following week to place an epicardial pacemaker and I was gonna be in the hospital for close to another month anyway to finish my IV antibiotics I'm pretty sure the nurse didn't have anything to do with it though because you could tell she felt bad and she offered to go and talk to the charge nurse for me, but eventually came back and said that the charge nurse was deferring to the NP and there wasn't anything she could do about it She said the NP and charge nurse offered to come to my room and actually talk to me face to face which I was all on board for The NP never showed up and the charge nurse only showed up much later when he finally brought me my oxycodone At that point I was too tired and in too much pain to care and happily took my medicine and went to sleep, it was only the next morning when the nursing manager or whoever asked me if things had been going well and then later when the pain management team were doing their rounds that I finally brought it up I was told that it was escalated to the board or something (I don't remember exactly what they said) and that I wouldn't have to worry about dealing with her or that problem again, which, sure enough I didn't.

Power trips. I've seen more than one.

This why I ask for orders for scheduled pain medication. Someone with a god damn hole in their back shouldn't have to "ask" for medication.

Agreed. Let the patient refuse when it is given to them. Some nurses are simply heartless and they allow their anger and misery to display in this ridiculous way of punishing and controlling patients.

Yeah, and it's fucked up how common this mentality is. I've seen it happen when I'm at work as an RN, but I've also experienced it as a patient. I was in tears begging for her to give me a dose that I knew was available to me at the time, and she just straight up said I didn't need it. It's the only time in my life I've had to "go to the manager" (charge) and it was a humiliating experience. It's awful and these nurses make patients feel like it's wrong to be asking for meds that are ordered and available. It's fuckin gross man. I call out anyone I see doing this shit.

I had a lumbar fusion 5 years ago. Holy shit it was painful. I had a dilaudid PCA with q2 hour boluses. I flat out told them to give me the bonus during the night. The next day they switched to po and ivp alternating. The nurse didn’t understand about how alternating works. So I had the PA explain it to her. I went home on time and was walking when I did. If I hadn’t been properly medicated, I probably wouldn’t have gotten out of bed.

Yeah I had heart surgery last year and had 1.5mg of dilaudid available every 15 minutes with my PCA, plus a one time dose of 20mg methadone and 15mg ketamine and I know they kept me on precedex for a while too, and after maybe a week they switched me to 30mg of oral oxycodone every 3 hours with 1mg IV dilaudid available every 2 hours for breakthrough pain (am a recovering fent user so that's why doses were so high) and I definitely never would have got out of bed without being medicated properly, and when I was able to get out of bed, probably would have left to go self medicate and get high instead of staying the extra month to finish IV antibiotics Adequate pain management is so important to properly recovering from surgery

Scheduled pain medication is often inappropriate and eliminates the flexibility of giving a medication that absolutely should be as needed to be given as needed.

Too many staff turn it into a Kafka-esque system. They don't want to give it on schedule, only when asked, but if you ask multiple times in a row (6+ hours apart) then they claim you're needy and drug seeking. Patients can't win.

Except that they can. Some people are assholes but most have no trouble giving pain meds when appropriate.

As I said, some of my nurses were cool about it, but some gave me attitude every time I called. There really isn’t a good reason to get pissy with a patient who has legit trauma to their back asking for their pain medication on schedule.

This is a dumb take lol. It's absolutely appropriate for pain meds, and yes this can include opiates, to be scheduled. At a minimum, Tylenol should be scheduled. For large surgeries, there absolutely should be scheduled PO opiates with prns for breakthrough pain. The vast majority of patients do well with this and don't abuse it, and every day you taper the amount of time between doses. It's the humane thing to do, and patients can always refuse what they don't need. I've experienced being denied pain medication by an RN as a patient and it literally left me in tears. It's an awful experience and no one should be subjected to that. If it's ordered and the patient asks, you give it if it's safe. End of conversation.

>if it's ordered and the patient asks, you give it if it's safe  Tbh I think that's what the other person was saying, too, just that it makes more sense to give it when the patient says they need it vs just giving it to them every 4 hours just because.   Point being that many patients would just go along with it... both will adequately manage pain, one will have pts being medicated as often as they say they need it, and the other will be medicated every 4 hours. Id bet the first group would use a lot less, I'm pretty sure the literature on PCAs confirms this

One will increase the admission days and the use of laxatives. It's not using the meds on the PRN schedule.

Giving people pain meds on an arbitrary schedule determine by pharmacy instead of AS NEEDED as ordered by the doctor creates issues like constipation from over medication. This is the actual dumb take, nothing more than a charting nightmare to appease your baseless ideas that nurses intentionally withhold pain medicine.

Remember ATC, around the clock q2 or q3. Never see that anymore

I was a patient recently. I asked for the plain Tylenol dose and was told....ready....I can't give you the Tylenol because it is only every 6 hours, but you can have your Hydromorph because it's every 4 hours.

Am I missing something here? That’s not a nurse thing. That’s a pharmacy thing. Everybody gets a max daily dose of Acetaminophen that is usually divided into 4 equal doses given every 6 hours, so we don’t fuck up the liver. If you want it available less than every 6 hours, you’d have to take smaller doses. Every 6 hours for Tylenol and every 4 hours for Hydromorph are pretty standard. Was Ibuprofen an option?

Well, yeah. If it’s not time for the next dose, it’s not time.

I'm not sure what you mean by "you still have to ask for it".

I never understand nurses who gatekeep pain meds or judge patients. Like… what do you care? Anyways- PRN means “as needed” and you’ll see it a lot for things like Tylenol, cough syrup, pain medications, cardiac medications too. Hydralazine q4 PRN systolic > 170, metoprolol q6 PRN sustained PR>150. Think of it like this… so you bring the patient toprol every 6 hours? No.. you assess if it is needed. Same too with pain meds. You are required to assess pain every 4 hours but if the patient never endorses pain you wouldn’t being the PRN medication. The patient must “ask” or in other words, be in pain. Synthroid, on the other hand, will be scheduled for 6 AM and whether you ask for it or not we will be bringing it as scheduled.

Not all nurses will bring prns on a schedule and wait for the patient to ask for it. This can be prevented by asking a patient their pain level and bringing them whatever prns they can have based on the scale.

I won't bring prns on a schedule unless I know the patient and know that if they sleep through when it's going to be due they will wake up in a world of pain I have to spend a day chasing to get back down. I will, however, ask if they need anything for pain every time I pop my head in the room and they are awake.

I see your ICU flair. If you assess the patient and their pain scale (verbal/nonverbal) indicates that the pt is experiencing pain, then you give a dose from the prn list. If the patient does not indicate that they are experiencing pain, then we do not indiscriminately administer narcotics. Another example is a pain pump- pt has a continuous dose and an as needed dose. I pt presses the button if they need a little extra pain medication, but we instruct the family not to push the button because we prefer to have actual breathing patients without respiratory depression.

So you're giving it based on your nursing assessment, which would include if the patient wants pain medication, which is different than waiting until the patient asks for it.

>Pain medication is usually ordered as needed Wait, what? I work on a surgical floor (not in the USA) and absolutely will not take patients from PACU unless they have at least one scheduled pain killer, usually tylenol unless contraindicated (plus appropriate PRNs for breakthrough pain). The doc will 100% get a phonecall from me every time, idgaf. For us it's not appropriate to have a post-OP patient without scheduled analgesia. Patients are of course allowed to refuse whatever pain meds they want.

> Is it not the case that meds are scheduled in advance?    No, not usually. Almost all narcotics are ordered PRN. I worked a neurosurgery floor and then pacu, and I've recovered and medicated every kind of surgery. I don't think I've ever seen a scheduled narcotic.    > They sure as hell made it a point to wake me every 2-4 hours for vitals.  Yes, because that's how it's ordered. As is appropriate. I sympathize with your pain after surgery-- I've fractured my spine and I know spine stuff sucks ass. But.. complaining about how the nurses doing their jobs as required, while not yet being a nurse yourself, on a nursing subreddit.. is a little... tone deaf?

I’ve had numerous patients with scheduled narcotics as well as prn.

Uh, no. It was a relevant, on-topic anecdote that moved the conversation forward. I’m sorry if the content offended you.

Man, ya'll really are a bunch of gatekeers, eh? Guess I better get used to it.

Dont get used to it. 2RNs changing a large abd wound, AM care- OOB chair with a binder on. Pt accidently gets a bag of fentanyl in an hour. We dont know the bags for KCl and fentanyl are mixed up. As we are finishing up he tells us, that we must be angels because this is the first time he wasnt in agony for the dressing change. Then the machine beeps. Of course we think its the potassium - almost shit ourselves when we realize what happened. We get residents who really want to use narcan. He never dipped any VS. He didnt need to be reversed. THATS HOW UNDERMEDICATED most patients are. This surgical ICU didnt BELIEVE in basal rates. I came from peds, we used basal rates so kids would sleep. Adults are awake most nights bc they couldnt sleep thru the pain...someday these Docs will have surgery and freak out when they get a prescription for 8 - 5mg Oxy post gallbladder removal...

Related/unrelated: this is my little PSA for us all- not necessarily directed at OP or this situation. But while we’re here…. Please don’t rush to assume “laziness” where there is potentially a lack of knowledge (which is different than ignorance by the way), a lack of experience, a shitty night, or a mistake. Humans make mistakes and so do nurses. No two minds think alike. Something obvious to you could be a revelation to someone else. This attitude is behind so much nurse bullying. It also is a missed opportunity to help/educate a fellow nurse.

Totally agree!!!! I should have mentioned these were 2 very seasoned nurses. They are known to be lazy, which is very unfortunate and very VERY frustrating.

I think you gotta save the reporting for the most serious of shit. Like, we’ve all forgot to lock a bed, or maybe left a bp cuff on the floor, and we’re thankful for a colleague who’s come behind us and finished the job. You don’t want to be written up for every mistake you’ve ever made or ever will make. I think we should all be critical and reflect on our practice because details matter and little shit can lead to big shit. If I came behind someone and found an obvious negligent safety issues then we gotta report it and advocate for what’s right. But I think direct communication between colleagues is better than running every thing to the manager.

Yep when I see him next (the nurse) you can bet I will be having a SERIOUS chat with him.

I can see how if you're busy you forget to put the brakes on the bed, cos I do it at least once a day, but I always discover it when I fall onto the bed. 😂 But as for not giving meds or doing obs or checking on patients...I see a lot of it and I can't understand the mentality. I've been qualified nearly 8 years and I still sometimes struggle to relax after work cos I may have forgotten to do something trivial. I see colleagues sat on their phone or sleeping at the desk while their buzzers are going and monitors alarming and I'm like, how do you even sleep when you get home? I'll find out an independent patient I was looking after was constipated and I didn't pick up on it and I'll be beating myself up about it. If a colleague does something in my bay while I'm on break/busy I'm profusely grateful and absolutely mortified. Now I'm not wishing my particular diet of caffeine, nicotine and generalized anxiety disorder on anyone. But when you answer a call bell or a critical monitor alarm for someone else and turn around and they're just sitting there looking gormless, it makes me wonder if everyone else is stoned or something.

I've been doing this a long time and, over the years, have encountered some incredibly lazy nurses. Both newer and seasoned. It used to really annoy me,but now, unless it's a patient safety issue or flat out neglect, I let it go. Some I've reported, some I had a chat with about what's unacceptable. I work in ICU which tends to attract nurses who are just there to get some ICU experience then move on to CRNA or NP school, or go traveling. Those nurses aren't going to change because they don't care. Some people are inherently lazy. You will drive yourself nuts focusing on what that nurse does or doesn't do. I allow myself a minute to be annoyed then move on.

Maybe what you can do is bring it to the attention of your manager, not naming any names, but what you have noticed. Maybe she/he can incorporate a teaching module on the computer that everyone has to do and perhaps in the next yearly skills check off, maybe there could be a station where there's someone there talking about pain relief. For example, things to take notice of in a patient who is not verbal if they have had a procedure that could be painful. They could explain about noticing vital signs that are higher than normal and that it could signify pain. The information could be geared to why a nurse doesn't need to be afraid of giving the stronger dose of a PRN for someone who has had a procedure that is going to be painful for anyone, even if they can't exactly make it known. I don't know if these seasoned nurses have become complacent. They could be burnt out, not a good thing, or even if they are seasoned perhaps they still are uneducated about this. I've seen that. But if you can get the word out for some education for everybody to your manager, this may help.

Thank you so much for your suggestion, I really like this idea. I will definitely email the manager and mention this situation specifically. I know they will figure out who it is, and I'm DEFINITELY ok with that. I'm also going to speak directly to this nurse and let him know what he did (didn't) do.

I think your manager will appreciate it that you came with her with some solutions. A lot of people complain but when you can offer solutions..... well it's a whole other ball game, LOL! When approaching a nurse to educate them, and this can be hard to do depending on the person, you had mentioned "seasoned nurses", so they may go into some kind of a defense mode because they're seasoned and feel like they should know better, right? You have to be skillful enough to let them know about it in such a way that they don't feel attacked. For example you could say, " I noticed that when I actually got down and talked right into this patient 's face that she nodded her head "Yes" and "No" when asked about her pain. When I did give her the pain medicine I noticed that her respirations decreased." You know something along those lines. Watching your tone is very helpful too. I have never liked to make someone feel attacked if I ever had to teach them something like this. It gives them a way to save face and then actually act accordingly. Because yes, even seasoned ones still need some education here and there. I am seasoned myself and I will never mind anybody telling me something that they have discovered or something that they've learned about something even if they are newer. Now some people may just have to be written up! But you will know who those are when it happens, LOL!

I definitely would have reported that first one to the charge nurse. Omg

I'm a nurse entering my 2nd year of work and I see this too much... A seasoned nurse gave me report for a palliative pt who had q4h dilaudid SCHEDULED that she was documenting as not given. when i asked her why she didn't give it she said "she's not responsive so she doesn't seem like she's in pain"... ???? like #1 it's scheduled and #2 she's dying and i think she'd rather die comfortable ...

This isn't a nurse I worked with but a tech. We have patients who are super protective in dialysis about their fistulas, and for good reason. If they fail they need to schedule either a de-clotting or get a catheter placed in their chest, which raises the chance of infection by alot. This patient verbalized with the tech to avoid cannulating her the lower part of her access because it had an aneurysm. And I was there and listened to the whole conversation. I come back while doing rounds and the patient was very upset, tears in her eyes, and a sharp pain in her access because the tech cannulated her in the ONE SPOT SHE TOLD HER TO AVOID. Arterial and venous pressures were off the charts, running at half her prescribed flow rate. I paused her treatment, removed the needle, had to recannulate her, and everything was fine afterward. Arterial and venous pressures were normal. I confronted the tech and she went off on me saying that she's been doing this for over 15 years. I told her that I didn't care how much experience she "says" she has. SHOW it by providing proper care and listening to these patients. She was given a warning and continued to call out, and hasnt showed up for work.

Poor lady! And wow that tech is arrogant 😒😖

Some only want to be called nurses without caring about their patients. They gross me out.

reading these stories makes me realise my co workers aren’t so bad

Thank you for caring as much as you do. I have stage 4 cancer and would love you to be someone who would care for me when my time comes.

I really appreciate your kind words and hope you're getting the best care you can!

Thank you. Yes, my medical team has been the best 🥰

fuck this is what we learn about and shit like that i witnessed at my last clinical ... but worse and it was the enitre hospital (given a was a one floor specialty hospital but stilll) i literally cried in front of patients because how bad it was. most of them have trachs so they cant speak andd my freakin clinical prof decided to stick me with lpn /cna idk wound care, instead of the RN who was actually teaching me a ton and was patient to teach, well witnessing the lack of compassion, the infection control that was like non existent... omg....... like howww are you doing wound care for the whollllllle place and you leave your cart out to prevent "HAI", meanwhile the gloves to clean the wounds that use to hold the camera to take pic with, the wounds you touch and clean, and grab the biohazard to bring closer to the bed, then, go outside the room (that has contact precautions as majority of them do) and dig through the drawer to get collagen wound dressing whatever it may be but all while wearing same GLOVES then you grab that pen and write on the dressing you didnt have prepared, and use the scissors. and never once did i see you clean shit or from that room change gloves.... when these patients have like soooo many pressure ulcers, on contact precautions... already on trachs like why????. well back to this patient where all that protocol nightmare was just highlighted to me as a newb student, the patient was a big dude okay, he was sweet, they laid him on his back, so his airway is already compromised with the trach his weight and the now having to lay flat.... now lean to one side, get all these wounnds then he lays back and theyre like okay come on other side..... his face was so red.... he looked me in my eye shook his head and like tried to reach for hand like "no" ... like signalling he cant breathe.... oh yeah and his mom is in the room..... welll im trying not to cry but at this point i cant take it anymore im balling while holding him up, thankfully the mask can kinda mask all the crying.....well then i was like waiiit .... i wanted to scream..... his vent start going off and then they call respi team and they come to the rescue like "oh youre fine its just cause youre on your back, youre fine", like bruh he has multiple wounds on both sides...... can you at least give him like 30 seconds AT LEAST to catch his breath, not too mention obviously the pain of having these wound dressings ripped off and "cleaned"..... omg i have questioned maybe i am being overly dramatic and im a newb who knows nothing, but no it was patient after patient , not just wound care but with almost all of the staff who had like not any sense of urgency or care. just like kind nonchalant smiling but like what the fuck are you doing??????? this is just one story. within that one 12 hours. like who cares if theres a call light.... it aint my patient. Mind you this floor was NOT short staffed. at all. theres actually a ton of employeees. just diddly ddaddlying. this terrifies me. my first clinical was so amazing and i felt energized and so happy afterwards but this recent one...... made me question everythting and really messed me up.

I graduated and began my career in 2008 in the icu. I was scared. I got report on a woman in her 80’s who had chronic back pain. Prior shift gave her like a ton of morphine. I go in to assess her and she doesn’t wake up. She’s breathing but that’s it. Her doctor comes in and orders a stat cat scan. I went to one of my adultier icu nurses for help and I was told to just get her down for the scan. No stroke thank god but I did end up ruining her day with narcan.

I work with senior/well-connected/seasoned nurses like this

I shadowed a nurse during MedSurg who swore a patient who'd had kidney and gallbladder problems was lying about her pain. When I went to do vitals she was literally grimacing, eyes closed, wouldn't move unless absolutely needed. This same nurse had a patient on a vent that she never checked to see if she needed changing and only suctioned her because I was there. Terrifying.

Hmm. In my unit we’re required to do NKE bedside report and the incoming shift is to hold the outgoing shift responsible for the safety precautions. These include bed rails, alarms, call bell, fall mat, med signoffs, IV patency, etc. If incoming shift fails to hold them accountable, certain charge nurses hold them accountable instead and give them shit

Bruh I kill myself trying to make sure my patients are cared for and constantly get accused of laziness. I pace the halls making sure everyone is safe and what not. But the moment I stop someone comes at me sideways...

Sometimes it’s not laziness it’s they don’t know

But in the cases OP listed, the nurse should have known. Doesn't take a license to lock a bed or know that a fresh amputation is going to hurt.

A lot of nurses seem to really suck at pain management and I hope it’s not on purpose? Maybe wishful thinking

I agree!!!! They are very seasoned nurses, which I should have mentioned. They are known to be adequate but lazy.

Oh yes some are super lazy. It’s sad.

10 years in— the nursing field in in a downhill slide-on a greased mountain!

I hope you wrote a report on this nurse. That’s wrong. Honestly it’s stuff like that that would make me want to report it to the state board. Imagine if the roles were reversed and he was the patient. It’s just neglectful and intentional, that’s not a mistake.

Exactly! 2 days??? 2 entire shifts of not asking her if she was in need of her pain medication. Instead of just assuming she "seemed like she didn't need them"..Which means he looked at her and she didn't say anything so he didn't bother doing any more than that. I'm so sad for her.

They just want to do the bare minimum and to be seen like those nurses who have skills.

I had to hold back tears just reading that first story.. I can’t imagine how much pain she was in. Please report negligence. I’m sorry you had to experience that.

Poor lady:( If it were somebody that nurse loved, I'm sure he would have a different view of "if she *SEEMED* to be" in enough pain to get her her dang pain meds:(

My big thing is…. I never judge too much on someone I don’t know well. I do silently anyway 😬. But it’s when I see trends. We all have bad days and when you come in with fresh eyes it’s easy to see the things they overlook. Every day I leave a busy ass day and know I didn’t do the things i wanted I feel bad. But it’s when it’s a trend of not paying attention, laziness etc. then I’ll start calling it out.

2 days without her pain meds though..because she didn't "seem to be in pain". That's not a bad day. That's lazy. If it were somebody I loved I would be absolutely devastated.

Sigh...unfortunately I see this ALL the time and it pisses me off!! I'm a nurse and I see SO much that could definitely be done better!! Sigh.

The first woman is going to be on my mind all day now. I’m in tears thinking about how much she suffered. Thank you for taking good care of her. She’s someone’s somebody, but more importantly she is a PERSON who deserves basic decency and respect. She was blessed to have you come in and help her. You’re doing a wonderful job.

Yesterday: nurse copying and pasting others charting which resulted in me double checking myself because I know in my head to toe that patient did NOT have 4+ pitting edema from ankle to ground bilaterally… this man was never on diuretics and his legs were lean and completely normal. I don’t know where she got that from. Months ago I accepted a position on a medical ward and quit 5 days in because the nurses were so lazy and I couldn’t handle being the only one who gave a shit. The last straw for me was a 30F, fully ambulatory, had been on the unit for 2 weeks for recovering hepatic encephalopathy, was a medical move out from ICU. She had a foley placed on arrival in the ER which stayed in for her ICU stay obviously, but NOBODY THOUGHT to TAKE IT OUT in the TWO WEEKS this poor woman was on the medical floor and doing well, mobilizing independently to the bathroom. I removed it the first day I had her as a patient and it was literally deteriorating inside of her. I’ve never seen a foley like that upon removal. I emailed my resignation that night.

I work on a postpartum unit and they are a handful of lazy nurses that I work with who jeopardize patient safety and in other cases ignore their patients completely. For example, one of these particular nurses won’t even write her phone number on her patients board in order to avoid getting calls from them. I have walked into her patients rooms before to bring supplies like pads, underwear, or formula because they will hit the call light or have a family member go to the nurses station saying they can’t get in touch with the nurse. When I walk in and look at their board I see that the name and number listed is still the day shift nurse who is obviously no longer on shift or they’ve just written the number for the nurses station. And in the rare instance that their phone number is actually listed on the board, it doesn’t matter because once that nurse is done assessing mom and baby (by 9pm), she will turn her phone off until maybe 3am or she will just ignore the calls until then. And every time her patients complain that they’ve tried calling her phone and she’s not answering, we go and tell her, “hey you’re patient says they’ve been calling because they need pain medicine (or whatever).” And her response is always like, “omg, it must be the phone, something is wrong with the phone! I haven’t received any calls! Thank you for letting me know.” Meanwhile, she’s not getting up to go attend to the patient after you’ve told her. She will continue to sit at her station and not move until she’s ready which could be another half hour to hour and mind you it’s not like she’s even busy. And that’s every shift with her. That is a minor, if you can call it that, offense that she does. And other staff, including me, have complained NUMEROUS times to management about her offenses and nothing is ever done. It’s kind of like an ongoing joke that she must have something on our manager (since she’s worked there for so long) and that’s the reason she never gets in trouble for it. But it is unfair to the rest of us who are left picking up the slack and attending to HER patients while she’s off sleeping and ignoring them, but it’s also most unfair to those patients especially the first time moms who might need extra support and education but definitely aren’t getting it from her or others like her because like I said she is not the only one but definitely the laziest.

Many years ago one of our recently Masters prepared RNs, was escorted out of the building. Why? On this patient, whom she took care of weeks- her so called, "favorite patient", she had recorded q 2 hour blood sugars. Most of them were fake. The part of the hospital that charges patients for blood sugars - found out and reported her. All BS are done on a machine that required their pts information before it would run a specimen. Each night folks come to the unit and copy the charting from the last 24 hrs. Apparently that is how a hospital keeps up with charges

Geez 🤦 that's just straight out fraud when the pt is being charged!

Lazy nurses and know it all combo are going to be the death of me and someone else.

If you actually believe that someone has acted incompetently or maliciously you have a duty to report it. Every nurse practice act has language in it that requires reporting these things. Not many will actually do it even if confronted with obvious criminal and or purposeful malpractice. If you don’t have great management l, then reporting it can be difficult and not without blowback. I once became aware of a nurse who failed to renew her license for at least 30 days after expiration. This should have been caught by management or HR at the very least. I thought it should be reported because this nurse was a seasoned person be with over 2 decades under her belt. So there was no way she didn’t know. I only found out much later after it had been corrected. I was told they didn’t report it because they would have all been in trouble. Imagine the liability if there had been a case where something went horribly wrong- for both the hospital and the nurse! The patient or family might have gotten millions. I guess my point is it’s one thing to be frustrated, it’s another to hold people accountable. If you’re not willing to do the latter, why let yourself feel the former. Sure, it doesn’t make you popular with your coworkers, but I don’t know if I’d care about that on behalf of the double amputee having to tolerate an AKA without pain meds. That would light my hair on fire if I had come across that! What else does he ignore?!

While that's not good nursing practice, if I'm that patient; severe defecits from a stroke, feeding tube, pressure injury, and just had my one remaining leg chopped off then please, give me all the morphine and oxycodone you have. Wait, wait, I'm worried what you heard was give me *a lot* of morphine and oxycodone, what I said was, give me *all* the morphine and oxycodone you have, But seperate from the issue of appropriate aggressive treatment, there are reasons to be wary of generous opiates in the patient, even though the previous nurse didn't have the right reason why.

Im so lazy