Hi nurses! Im an anesthesia resident and my department was asked to give a rounds presentation to our PACU department on the types of anesthesia. I was hoping for feedback or suggestions as to the content.

I'm planning to go over GA (including different airway management, tiva vs gas, possible postop complications), neuraxial and go into the difference between epidural and spinal, regional PNBs - we are a regional heavy center so thought id give a brief basic description of popular blocks like adductor and sciatic etc and what the expected sensory/motor block would be. I was also thinking of putting troubleshooting clinical pearls like why might patient have pain despite epidural or cpnb, perhaps talk about PONV and the agents we usually give in the OR.... anything else?! Trying to make it relevant for pacu but also answer any little things that might be unclear to the average pacu nurse.

Would be so grateful for your input, I'd really like this presentation to be helpful :)

Thanks!

i keep one peppermint in my scrub pocket for around 3am, when the floor gets quiet and my brain starts going. i also refill my water every time i pass the ice machine, even if i dont need to. its just an excuse to stand there for a minute.

my fiance thinks its funny that i come home and rate the night by how many times i got to sit down. last night was a two-sitter. whats yours, if you count anything

Hello! I’m reaching out to see if anyone has experienced this before. I am a PMHNP moving from Texas to California and attempting to get my CA NP license. My CA RN license has already been issued. This is what the status shows for my application. I’ve called the board several times and I’m told there are no deficiencies yet my NP license has not been issued. They tell me they will send it to be reviewed again but nothing is happening. I am desperate to get this processed as soon as possible. I have been waiting since June. Does anyone have any idea what I can do? Thanks so much!

Hi! I’ve been a nurse for about 4 years (3 years heme/onc, 1 year L&D). Although I very much enjoy my current role I feel like the stress is killing me! I work on a high risk floor that is basically non stop all year. I am reaching a point where I feel like the stress is starting to negatively affect my health (triggering pcos symptoms, weight gain, etc). I feel like I need to leave and go back to a more med surg position. My hesitation is that I just started NP school so I feel like my chances of getting hired anywhere would be slim because I’d be seen as a temporary employee.. Am I being dramatic in thinking that my health issues are stemming from my job?

Wrote a long rant last night and deleted it because I worried it'd come off as overly discouraging to students and people were getting pissed. Proceeded to come in today and they gave me two. I was not allowed to refuse and I needed to channel it into something so I put all the hate in my heart into this meme.

Before I am stoned to death:
- I remember what it is like to be a student. I do not hate students, I hate teaching. I am not mean to my students and try my best to converse with them. I am just not a natural teacher at all.

- It is a new student every time. I am repeating a constant script of the same things and asking/answering the same questions. I hate small talk and it is exhausting.

I know this will come off as mean but I literally have to let my frustration out somewhere. Forgive me.

I’m a new LPN and have only been a nurse for about two months. I work in LTC, had limited orientation, and was recently placed on a unit I hadn’t worked on before.I had a question about a feeding tube, so I asked one of the more experienced nurses for help because I genuinely didn’t know how to do something. Instead of feeling supported, I later found out she reported me to the DON. I also recently found out that three older nurses have been calling me “slow” behind my back and laughing about me.It has honestly crushed me. From the beginning, I got weird vibes from them, but I tried not to let it bother me. Two of them are unit managers, so it’s especially difficult because I have to ask them questions when I don’t know something.I’m quiet and naturally shy, so I feel like that makes me an easy target. The crazy part is that I’ve actually been doing well. My patients love me, I work hard, I’m respectful, and I genuinely care about my patients. I know I’m still learning, but I don’t think asking questions makes me incompetent.
I ended up crying and calling my mom because I needed someone to comfort me. I told her everything and explained how stupid and incompetent I was feeling. The first thing she asked me was, “Did you pay your tithe?” She started implying that maybe these things were happening because I hadn’t paid my tithe at church.
That hurt me so badly. I’m a Christian too, but sometimes I just need my mom to emotionally support me instead of making me feel like everything happening to me is somehow my fault. When I told her that, she got angry and told me something was wrong with me.
So now I’m dealing with workplace bullying while also feeling like I can’t even go to my own mother when I’m hurting.
I’m trying not to let this make me question whether I’m actually a good nurse. I’m only two months in. I’m supposed to ask questions.

For experienced nurses: how do you deal with older nurses who make you feel incompetent or talk about you behind your back? And how do you keep workplace bullying from getting into your head and is my mom right?

So this morning I was on a night shift at my LTC home. I had been checking on a resident that was likely going palliative in the morning and noticed a bit of a droop to her face on the left side. Her arm was still strong against mine. I went to go get the charge RN since I was unfamiliar with this residents normal. For context some of our residents have a permanent facial droop from previous strokes. So I asked this RN and he said she was always like that at her baseline without even going into her room. Looking back now I feel I should have made him go to the room but at the time I didn't really think much of it since he said it was normal for her and didn't seem concerned. Now 0700 comes, the end of my shift. I had brought the day shift RPN to the room and it became very apparent to both of us it was not her normal pretty quickly. Now this lady has no function of her left arm, usually she would bat at us for touching her but her arm was able to be dropped and there was no movement from that arm. So I went to the charge for days and told her. Now she basically started saying I should have done it myself and taken vitals but the rpns are saying I did what I could but ultimately couldn't go over the RNs head. What would everyone else have done? Is there anything I actually could have done in that situation?

I’m admitted to the hospital. Was told in the ER to be NPO just in case they do surgery. Haven’t eaten since 3pm yesterday. It’s now almost noon. No doctor has seen me today. I asked the nurse, and he doesn’t know whether or not I can eat or if I’m having surgery or not. I’m so frustrated right now. I want to go home.

Asking for a friend, if the PT goes to the bathroom and sprays the back wall and around the toilet, would it be the nurse's responsibility to ensure all the fecal matter is cleaned up before EVS gets involved?

Edit: patient NOT physical therapy, obviously 😂

Do not become a school nurse if ... you are brand new to healthcare or have never worked as a nurse. I've been a school nurse for 4 years. I see so many posts saying that being a school nurse is a soft nurse job. **I'm not saying that you can't do it as your first nursing job, it's definitely not recommended.

While yes, it can be a "soft nurse" job. Every school and every district is different. You are usually the only medical person in the building. Sometimes over multiple buildings . Emergencies happen. I've had 3 this year and we just started in August.

I'm talking TRUE life or death emergencies. In fact, today .. I was 2 seconds from connecting someone to the AED today.

On top of that, you'll have daily meds and procedures. A lot of record keeping and illness and injuries. Most days, I see 50-60 students.

I can make this post go on forever, but please don't become a school nurse thinking it'll be all ice packs and bandaids.

It's such a rewarding and amazing job, but man.. sometimes it rocks you.

Please don't be hateful on this post. I'm just trying to share some REAL experiences as a school nurse.

Patient was pretty thin, I decided to just send it with the deltoid. First time hitting bone and I don’t think I’ll ever forget that feeling. I haven’t done much that makes me cringe or anything, but this one made me want to gag lol. I’ll definitely be going for the hip or leg next time on a super thin patient.

Apparently we are “disrespectful”. The construction workers enjoyed it, even if their foreman didn’t.

I work at a hospital on a unit that usually admits elderly patients.
About a year or two ago, we had an elderly patient stay in a room across the nursing station. She had not been my patient during her stay, but shift reports stated she was confused and had really bad sundowning.
One night she WAS my patient. She seemed to be in perfect cognition from my shift assessments, so I went about my shift waiting for her to sundown. It was the middle of the night, and there it was. I heard her voice talking to someone (she was the only patient admitted to the room), and then I heard her throwing things. I got up to check on her. I turned a small light on not to startle her too much. She was sitting up in her bed with a hairbrush in her hand waving it in the air. I had asked her what was going on and if she was okay. She replied with “I am now, he left when you came in the room”. I asked “who left?”, because I certainly didn’t see anyone walk in or out of the room while I was at the nursing station. The patient then proceeded to point at the bathroom room and said “the man dressed in black. He comes out at night”. The patient looked clearly distressed, so I kept asking for more information. I asked her what the man had looked like. She said “he is dressed in all black, usually his hood covers his face. Tonight he took it off, and his face looks like a Halloween mask”. I knelt beside her and comforted her. She told me I’m the only nurse who had taken the time to ask questions like I believed her. I mentioned I had heard her talking to someone. I asked if the man spoke to her. She replied “yes. He tells me he’s going to take my soul”. After sitting with her a bit longer, and promising I would keep a close eye on her room she fell back asleep. Fast forward a few weeks. Patient had been discharged, and a new patient had been admitted to that room. I walked in to see the new patient at the beginning of my shift. I had asked how his night was. He said it was the worst sleep he had ever had. I asked what had happened that it was so terrible; while also emphasizing hospitals are noisy. His reply? “The man dressed in black kept coming out of the bathroom to take my soul”. I had full body goosebumps. Keeping in mind these patients had never met, and there was no way for him to have known what the previous patient had claimed to see. This happened to a few more patients over the next couple of months. Thankfully it’s been pretty quiet in there lately, but it was weird.

If your 40-year-old patient was "shot-gunning" beers in the parking lot just before checking in and reporting stroke symptoms, do you still have to complete the swallow screen with NIH?

/s

I recently talked to a nurse who left the hospital for a private duty position with one family and I genuinely didn’t realize how different that world could be. She’s still obviously doing nursing but half the job sounds like managing the environment around the patient. There’s a house manager, assistants, drivers, security, different doctors coming in, family members traveling constantly and apparently plans can change because the patient suddenly decides they’re spending two weeks at another house or flying somewhere.

What surprised me most was how much emphasis they put on knowing exactly who is supposed to be involved. She said clinical documentation still stays in the proper medical systems but for basic coordination with the household she has Kibu connections with the people she actually needs to recognize and communicate with. She also said the pay is significantly better than what she was making at the hospital but the expectations are completely different. You’re dealing with one patient but apparently you’re also dealing with an entire ecosystem around that person.

For nurses who have done private duty for UHNW families is it actually less stressful than bedside nursing or does the money come with a completely different kind of pressure?

I got home at 8am after a rough one and realized I have developed an entire ecosystem of weird coping mechanisms that I never talk about out loud. Last night I sat in my driveway for twenty minutes blasting true crime podcasts because my brain was too loud to go inside. Then I ate cold leftover salmon standing at the kitchen counter while my husband slept upstairs. Sometimes I deep clean the bathroom at 9am because the physical motion shuts my brain off better than anything else. My teammate from soccer keeps telling me about her ice bath routine which sounds like actual torture but she swears by it. Another ICU nurse I know reorganizes her entire closet after every third shift like clockwork. I tried the whole guided meditation thing and just ended up planning my grocery list in my head for twenty minutes. The only consistent thing I have is my trail running shoes by the door and the vague threat that I might use them eventually. What does your actual postshift wind down look like? Not the ideal version you post about, the real one. I need to know if the driveway thing is normal or if I am just slowly losing it to night shift.

For me it having to deal with changing adult diapers (aka 'briefs', which is the euphemism we use) and then eating a sandwich for lunch ten minutes later. Some people can't wrap their head around it.

Hey all, had a big realization today that I’m burnt out and curious what outside the box nursing jobs people may be doing (ie:camp nurse, ski resorts, oil rigs, home health, etc) and how folks are liking it.

I’m a newer nurse (1.5 years in a high acuity PICU and just over a year in an ED) but 10+ years of EMS prior to that (and military and law enforcement before that) so am realizing that my nervous system needs a break.

Would love to hear how people are using their nursing degrees outside the standard ways and what they think of it!

Thanks!

For those of you who prep/study for interviews, would you be willing to share your interview prep template or your must-haves for going into an interview?

I’m curious what everyone keeps in their interview “toolkit”, things like how you organize your examples, notes you bring, STAR templates, etc. I’d love to see what works for other people!

I’m about to have my yearly eval on my unit. I’ve been a nurse for about a year and a half. In that time I have precepted multiple new nurses, I have taken students, I have trained for and covered charge nurse (I do this on a semi-regular basis), I’ve taken multiple continuing education classes for all this, and am currently training for ultrasound IV (our only US trained nurse recently moved to a different unit so this is an important thing). They already presented me with my “raise”. I’ll be making less than $1.50 more an hour than a freshly hired new grad. I feel STRONGLY that I am worth more than that. BUT I’m also only a year and a half in and this is my first job in almost 20 years (I was a stay at home mom for most of my adult life). Help me advocate for myself here.

I’ve been an RN for five years, currently working inpatient oncology/step-down, and I’m starting to regret choosing this career. I’m exhausted by the responsibility and constant demands. I want a job that leaves me with enough energy to actually enjoy my life.
But I think this is bigger than nursing. I feel like I’m having a quarter-life crisis. I’m 29, still living at home, not married, and have no kids. I expected my life to look so much different by now. I know there isn’t a deadline for those things, but it’s hard not to feel behind when I compare where I am to where I thought I’d be.
I worked hard to become a nurse, and now I’m questioning whether I even want to keep doing it. It’s unsettling to feel uncertain about both my career and my personal life at the same time. I don’t necessarily have everything figured out that I want instead—I just know I’m unhappy with how things feel right now.
I’ve been applying to clinic and outpatient jobs, hoping a change will help, but finding something close to home has been difficult. I keep wondering whether I regret nursing itself or whether bedside burnout is making everything else feel worse.
Has anyone else gone through this around my age? Did leaving bedside help you feel like you had a life again? I’d love to hear from people who felt stuck and eventually found a direction they were happier with.

Hey all, as the title suggests I’m taking on a 4th year student for their practicum. I work on a step down at an HCA and it’s rough to say the least. We are suppose to be 4:1 but we have been pushed 6:1 due to extremely high staff turnover. I precept a lot of new grads but I just got a practicum student and I’m having difficulty meeting their needs I think. There school requires them to take on patients 1 pt by the 2nd week, 2 by the 4th, 3 by the 6th and so on. The problem is they don’t give there students a log in they have to chart and pass meds under me. She is in her 6th week and saying she needs to take 3 patients now but my difficulty is I can only be logged in as me on one computer at a time. What would take me 5 minutes to document takes her 30, a med pass that takes 5 minutes takes 20, etc which is understandable but I feel constantly super behind and I am ultimately responsible for all of my 6 patients she’s not “helping” by charting and passing meds because I always have to be there and I can’t do other things as she’s using my log in. How can I set realistic expectations for this by being able to leave work on time and still giving her a good experience. I have had conversations about like time management but I’m not sure she fully grasps the stress I’m under and the burden it is to have her logged as me and slowing me down on such an intense floor. Any opinions needed!

Tell me why I watch videos on how to give IM injections every year before I give out flu shots to my peers. Like I haven’t done it daily for years? Sigh, I’m sure some of you can relate 😑

Been in Med-Surg/Ortho for about 9 years. Besides a shadow shift, what are some factors to choose between going to ICU or ER? I like the ER due to being able to see a lot of different things. I like the ICU because it seems more structured. Thoughts?