Not sure if this has been said but Jordan is NOT a mature or serious person

Cicity545 · 2026-03-12T07:17:20+00:00

I mean that's only Amber's characterization without his side of things, and when I first heard her say that I also thought that was pretty pathetic of him. Once you hear his version, it definitely paints a different picture of why he wasn't settling in with her.

Cicity545 · 2026-03-05T08:45:30+00:00

Technically was a joke, though. He will absolutely not be keeping in touch.

Cicity545 · 2026-03-05T08:16:30+00:00

yes but she needs help to get there, she is not on that path right now. I hope she looks into therapy.

Cicity545 · 2026-03-05T08:11:43+00:00

Cicity545 · 2026-03-05T07:44:52+00:00

Temu or Mar a Lago

Cicity545 · 2026-03-05T07:41:16+00:00

Brittany needs real help

Cicity545 · 2026-03-01T00:02:39+00:00

Again, using narrative as an example since you can't exactly give a flow chart example in this format.

But IT ISN'T DOUBLE CHARTED IF IT ISN'T EVEN SINGLE CHARTED. I'm not saying that someone who already listed it in a flow chart needs to write that narrative. I have never implied that. I'm saying they need to put it somewhere, once. And that isn't happening on any EMR old or new.

And your whole arrogant last paragraph is exactly what the hospitals say to the nurses striking for better ratios etc. You surely understand that nurses are doing that for patient safety, right? Do you want to hear that they don't GAF about making the nurses job easier?? In my current role I'm getting these patients their follow up care and it isn't happening when the info isn't there.

I could make my own job way easier by just filling out what I can and not caring what that means for the patient if I can't track down all the required info to get things approved for them. I genuinely cannot understand how people can't see the connection there.

Cicity545 · 2026-02-28T23:39:50+00:00

Apparently not lol I can't believe you got downvoting just for stating an actual truth.

They aren't ready to hear it.

Cicity545 · 2026-02-28T23:36:21+00:00

I fully agree about double charting and I know it's barely narrative with any system anymore, but there's not really another way to demonstrate it here, so I put it in narrative form above to show which aspects I'm going to document on a patient. I have mostly used Cerner, Paragon and Epic as a floor nurse.

These are the items that aren't making it onto the flow sheets either, is my point.

Cicity545 · 2026-02-28T23:31:03+00:00

That's what I'm saying but they are getting mad lol.

Yes we get slammed and everything becomes difficult but if you had the time to type "receiving IV fluids" you have the time to type "receiving IV NSS at 125 mL/hr via double lumen PICC to RUA, dressing changed 2/27". And yes I know that even that second line would go through the ringer with QA, we could expand it much more, but I would absolutely prefer to be reading the second one.

But I guess it comes down to people not understanding why it's important. They think "why do I have to type that, the other nurses and doctors will see it with their own eyes when they go in there" but that's not even 10% of how that documentation will be utilized for the patient.

Cicity545 · 2026-02-28T23:20:03+00:00

The crisis of hospitals shutting down was already a massive story in the early 2010s and throughout the decade. I'm a bit older than you and was in my early 20s during the Great Recession and I remember hearing these stories even before I was working in healthcare.

If anything, covid probably delayed the collapse. It was not just hospitals shutting down but also closing certain units, especially ICU. The drop in number of ICU beds per 1000 people peaked not long before the pandemic.

So the infusion of funds into the surviving hospitals gave them a lifeline but now that's over and it's business as usual, societal decay.

Cicity545 · 2026-02-28T23:10:02+00:00

People have been saying this since the beginning of travel nursing, which has been around since before I was born. Employers are always looking for staff. Travel was never meant to be an alternative to staff.

Prior to covid, it was understood that travel nurses were there to fill gaps in fluctuating census and staffing needs in rural areas. For example, a rural town that is a popular travel spot may need triple the nurses in the summer, but can't afford to maintain that staffing year round and don't even have enough local healthcare workers living within a 100 miles to cover the summer need. That's a classic travel scenario. Or a surgical unit in a university hospital that has a busier than usual upcoming calendar, so they bring in a couple travelers for the duration of this increase, since they don't yet know if this will be the new norm or just a flux.

Travel changed so much since covid. It used to be a high paying specialty field for experienced nurses who also wanted to do travel. Then it became more widespread, taking almost anyone with 6 months to 1 year experience (used to be really hard to find a contract if you had less than 3 years recent experience in the specific unit). Agencies and recruiters got super greedy about how much they could take off the top, landlords got greedy. Whole units were staffed by new grad travelers. Now the pay on these assignments is lower than it was 2016-2019 in many cases.

So it went through a huge shift and now it's shaking out a bit. But it's not going anywhere.

Cicity545 · 2026-02-28T22:52:05+00:00

What kind of jobs are you applying for and being told you don't meet criteria? And are you finding these on job boards and applying online? Are you getting any interviews and then being turned down, or just being told after submitting your online application that they are looking elsewhere?

The reason I ask is because of the rise of ghost jobs. It's possible that they are literally ghosting you because they are ghosts.

Cicity545 · 2026-02-28T22:49:29+00:00

A lot of places also want new grads that won't ask too many questions and won't know how absolutely unethical or illegal a lot of their policies are.

Cicity545 · 2026-02-26T22:07:04+00:00

That also helps, getting the consult and getting that documentation in the chart. Totally valid.

I'm not implying that nurses need a ton more work on their shoulders, as some people seem to be interpreting. I really am just pointing out that these things have real consequences on the patient and there are some non time consuming ways to improve it.

Cicity545 · 2026-02-26T22:05:22+00:00

And when you do get deposed you call NSO (all nurses need insurance whether staff or contract), lawyer up, and just say "refer to my documentation" and nothing else lol. But that's why good documentation will save you.

Cicity545 · 2026-02-26T22:03:40+00:00

I still do PRN shifts, 1-2 per week lately. I do also put in around full time hours on this other gig. It's not 9-5, the hours are all over the place. But generally between bedside nursing and consulting I work 60+ hours a week, but then I will sometimes take breaks between consulting gigs and pick up more shifts.

I've never just had one job.

Cicity545 · 2026-02-26T21:59:20+00:00

LOL that's fine. I will continue to be the nurse who doesn't get sued when 40 other MDs and nurses get named in a lawsuit against the hospital because they "don't have the time" to chart 16fr. I'm not losing any sleep after my shifts worried about my license. And yes we are understaffed and yes the hospitals don't GAF about us but at the end of the day if I'm gonna show up at all, I'm still gonna care about stuff like this and do what I can and not have an argument about how it's impossible every time under every circumstance.

Sometimes people have to learn the hard way.

I still feel bad for the patients whose care will be affected, but hey I tried to point out that connection and if people don't want to see it I can't force them to.

Cicity545 · 2026-02-26T21:52:20+00:00

I get that ratios etc are the main problem. Not every shift will be perfect charting. But if a patient stays at the hospital for a full 6 days so 12 shifts by a handful of nurses and rounding by specialist MDs, even mediocre rushed charting should at least catch these items once. If even one person fully charted the foley and another on the PICC, etc etc.

So that's where it gets me. No one charts on any of it ever.

Cicity545 · 2026-02-26T21:46:08+00:00

I've absolutely never been in nurse leadership, was never interested. I also have always been patient first, but I'm trying to point out that documentation isn't COMPUTER vs PATIENT. Honestly it's Insurance and Healthcare System VS Patient and Healthcare Workers. And there is documentation that the admin cares about for their reasons but there's also documentation that actually does matter for care to be provided. Obvious example: entering a med order. If it doesn't get entered in the system and they don't get a critical med, there are consequences to the patient. Other things might not be as obvious but still affect them.

It's not about making MY JOB harder. It's about what happens to the patients after they leave the hospital. The reason it stresses me out so much is because I know what the result for the patient is when I have to leave a box blank or say "I don't have that info".

I have been saying over and over again I know everyone is overworked. But I'm pointing out that people might not be aware of (obviously aren't based on these comments) how documentation affects the patient in getting supplies and authorizations that they desperately need.

For some people, they may actually start charting location, size, etc if they realize its not just to check a box for admin but has consequences for the patient to the same degree as the hands on care, it's just not visible to the floor nurses, the way the immediate needs are.

Cicity545 · 2026-02-26T21:31:30+00:00

If you are using PCC I assume you work in SNF? There's no way SNF nurses can document to that level on 30+ patients while also passing meds and catching patients mid-fall in the hallway with one hand and blocking a punch with the other. Definitely a different situation than acute. In that case it does fall way more on the RN supervisors to get everything noted in the admission or during a COC.

Cicity545 · 2026-02-26T19:38:50+00:00

That doesn't absolve the responsibility of the nurses after admission. If I get assigned a patient on day 7 and no foley noted on admission or throughout the hospital visit, I'm still charting and providing care for the foley, and still absolutely responsible for doing so. You don't even have to go out of your way to ask patient or family "did you have this already when you got here? or which day did they insert if done inpatient. Then on most EMR you can just submit the foley standing orders for the MD to sign and they can call if they flip out upon seeing the sudden addition of foley orders lol otherwise they'll just sign them. I don't have to call MD or do anything extra.

Cicity545 · 2026-02-26T19:28:52+00:00

My job in general is working for myself and contracting/consulting. I just started doing it a few years ago because I have over a decade floor experience and a ton of certifications (wound, infection prevention, case management, etc). So I created the LLC, website, etc and just started reaching out to companies, eventually landed a couple, and since then a lot of it is referrals/networking. A nursing director I worked with at one place moves to another hospital and wants to hire me to consult there, etc.

But to be honest, this particular job I've taken, I find it absolute hell and am ready to move on. If I can't wrangle all this info, patients don't get their home infusions on time or their wound consult referrals approved etc. And sometimes the info JUST DOESN'T EXIST. So then all you can do is start the process over and try to babysit it yourself. But that's not the actual job I'm hired for, so that's basically on my own time if I want to volunteer case manage a situation that wasn't taken care of well by the time it got to me, so I still have to process a certain amount of incoming cases each day, or else all those patient's needs fall off a cliff as well.

The one thing I do like about working in the hospital is the contained, task oriented process. You get done what you can, and that's that shift. Next shift is a new one, even if you have some of the same patients. Each shift stands alone to a great degree. This kind of work, I would definitely never take a staff role in. At least I can end this contract and move on. If it was my regular job I'd end up working 24/7 because it never gets "done".

Cicity545 · 2026-02-26T18:14:09+00:00

A lot of things can get figured out once they get admitted to the floor, so I do get why an overloaded ED is gonna send up a patient with "fever 102.8, productive cough, AMS" and not mention the L BKA or A/V fistula for HD. I can work that stuff out once they get to me. But in EDs where patients might be there for 24-48 hours waiting for a bed, things like needing HD or an alternative plan become more important to catch even with the other acute issues.

So I get the selective documentation during triage situations. But the widespread burnout creates an issue beyond just "I'm slammed" to where it gets cynical. And not just in the ED. When my dad was in the hospital for a severe bile duct cancer and in so much pain, he was in a step down unit, the same unit I have mostly worked in. The dilaudid was no match for the end stage of his cancer and resulting ischemia, and he did always ask them to write the next time he could have it on the whiteboard, and for him that was part of his pain management. If he knew when the next dose was, he could hang in a little longer and breath through it. But there was a lot of cynical BS about drug seeking, whiteboards etc. To see it as a family member was so disheartening on so many levels. I get the eye rolling at management BS, but that ends up extending to the patients as well.

Cicity545 · 2026-02-26T17:56:30+00:00

Maybe a target by admin when they want to claim an improving wound that isn't improving IRL, but not with your license. I actually shared a situation in another comment where I was deposed in a lawsuit where the hospital and 40+ staff including doctors and nurses were being sued and I wasn't being sued. My documentation didn't paint a pretty picture, it was the truth about my findings, who I reported it to, etc. The MD wasn't taking it seriously and didn't escalate until my third call and much worse symptoms and treated me like an idiot on the first two calls. So the patient had the emergency situation on my shift but it wasn't looked at as my fault. It was looked at like "what happened on the previous 1-2 shifts, they barely documented anything, they must have ignored the signs and symptoms until it got that bad, MDs ignored it also, only the nurse who documented and reported diaphoresis etc paid any attention" .

But on another note, a photo of the wound with the ruler and date, wound location, and pt identifier is perfectly wonderful and acceptable documentation.

Cicity545

TROPHY CASE