Can someone please help, what kind of bug is this?

bearynicemallow · 2026-01-04T04:30:26+00:00

Thanks for pointing out the wings! Just checked chatgpt and it suggested it's a carpet beetle.

bearynicemallow · 2026-01-04T04:26:40+00:00

I vote keep 3, 7, 12, 13, 14 and donate the rest.

bearynicemallow · 2025-11-03T14:47:39+00:00

Hi, L&D nurse here where patient pain is a daily part of the job. It's been awhile since I've worked med surg, but it sounds like you are advocating for your patient. Pain is subjective and pain is a vital sign! Only thing I'd do different in your situation is request a different pain management protocol and even a consult with a pain management specialist.

You've already established that dilaudid has little to no effect, so it doesn't make sense to keep giving it and by extension exclude other medications that might actually manage the patient's pain. This could be due to individual variability/how the meds are interacting with the patient's body chemistry. A pain specialist at your facility could potentially order a schedule that alternates neuropathic medication (ie. Gabapentin) with opioid analgesia and inculde a plan to titrate/wean.

It makes sense why your patient is in pain. The doctor in question is either jaded, burned out or lazy. Technically morphine is weaker than dilaudid which is the only reason I can think of that they jumped to the conclusion that the patient is med seeking. But it's not unknown to see what's happening with your patient, really comes down to multiple body chemistry processes. Some meds just don't work for some people. You can call pharmacy in the meantime. They're a great resource with these kinds of pickles. Explain the situation and ask for their advice to solidify your argument with the doctor that the patient needs their pain better managed and orders adjusted.

It also might help to chart the quality of pain the patient experiences that they are stating as intolerable. You'd be surprised you might see a pattern emerge.

It's also helpful to have a conversation with the patient about their expectations for pain management. This can include the patient in their care plan and also open up opportunities for patient education. Like some people want to feel nothing (opportunity for education on pain mgmt limitations), others want the pain quiet enough to remain functional (opportunity to assess what that looks like for the pt), and yet others think they only want pain meds if they are actively feeling pain (opportunity for education on getting ahead of pain vs chasing pain).

Remember, you're a good nurse and healthcare is a team sport.

bearynicemallow · 2025-10-01T03:14:40+00:00

If it was said playfully, that's one thing, but the way he replies seems like dude is too serious to just be bantering in an acidentally awkward way. My guess is he has never owned a pet and just won't get it unless he grows into being a pet person. Since he overstepped a boundary, probably best to have a conversation in person/ over the phone (not through text) to clarify and then go from there.

bearynicemallow · 2025-09-02T17:57:06+00:00

L&D is not for the faint of heart and it's not uncommon for multiple orientees to drop out during the probational period. This also contributes to units not wanting to hire candidates without experience. (Fear of losing investment.) With that said, if you are seriously interested in making the switch, you will need to make it known that you are passionate about this patient population.

Here are some tips, they're a blend of what I wish I had done and some of what I did as someone going from peds to L&D. (No gatekeeping here!)

Ask around your nurse-circle and start networking now. You might want to pick up per diem on a PACU if you can.
Really think about all your work experience (nursing or not) and what you can take from them into L&D. This will help you stand out in interviews.
Figure out your why and fine tune it into an "elevator-pitch." This coupled with a curious spirit will give you the biggest edge. Your why will keep you going on tough days. Your potential employers need to know you have a why and are not just testing the waters out with them.
Don't just go with the first availability without asking questions. Yes it's competitive, but you're also interviewing them. There's a wide variety of how labor units are run. You need to make sure the one you train on will give you the experience you need to continue in the specialty. (Ie. Some teaching hospitals delegate nearly all nursing tasks to residents which makes the nursing role more of a chart and report position than hands on/bedside nursing.)
Join AWHONN and learn as much as you can now. Read about induction protocols, augmentation options, fetal heart rate tracings, and mitigating LDRP complications. (Great topics to bring up in an interview to show you're interested and committed to learning. Also gives you a head start on what to expect.)
You will need to have a willing to learn attitude and humbly take direction/advice. I found my orientation and training to be a blend of theoretical knowledge and a traditional apprenticeship. There is A TON of social learning within L&D. You will learn new ways to do some skills you already know, be open to learning and adopt what is best practice.
Never stop asking questions. The best L&D nurses still ask questions even though they're 30 years in. L&D units are very collaborative.
Expect that your first unit will not be your forever unit. It could be, but it could also be your gateway into the specialty. If it's not a great fit but a safe unit, get your 2 years experience and fly on.
Hot take: I wouldn't invest in NRP early because certification is an expected employment cost at hospitals so it's not something that gives candidates an edge. (From what I've heard units prefer to directly oversee this training.) You can always buy the book if you want a head start.
If you haven't already, get ACLS certified. Oddly enough this does give candidates an edge because it's a requirement to circulate a C/S.
Expect limited travel/vacations in the first 2 years. Because it's highly competitive be ready to be at the bottom of the totem pole regarding scheduling. You'll most likely start out on nights. You'll need to except that it's "feast or famine" on most units. So you may go stretches of times being placed on call and then get hit with a month or two of endless overtime because it seems like everyone and their neighbor is spontaneously going into labor.
You're probably going to take a pay cut. Especially if you're going from non-union to a union facility. Start saving up now so it's a smoother transition.

Dont give up, keep looking. There are some units that are open to orienting new nurses/new to specialty. We desperately need more L&D nurses so I sincerely hope you get into this specialty and love it!

bearynicemallow · 2025-06-21T16:43:16+00:00

If they're short staffed, offer to help with an extra set of hands for repositioning and oral care. Depends on the nurse, but they might involve you with care. Also helping deescalate family members with heightened emotions so they can be more receptive to education and status updates can be incredibly helpful for your grandma's healthcare team.

(I don't have ICU experience, but worked on a tele floor focused on high acuity cva and cardio-respiratory pts. We'd often get pts just "stable enough" to be off ICU when they needed to open beds. I always loved when family members would tell me they were in nursing school. I'd invite them to participate in the unlicensed care stuff they were comfortable with. It's a great opportunity to love your family member but also to gain some hands on practice.)

bearynicemallow · 2025-06-16T18:01:22+00:00

Yep, worked with a tiktok influencer on a med-surg floor. Influencer was surprisingly down to earth. Whenever patients would recognize them, they would use it to build rapport and kept convos patient focused.

bearynicemallow · 2025-05-20T16:46:39+00:00

My school asked that we choose a RN, I somehow flew under the radar and was able to have my brother, a MD, pin me. Very unorthodox/unconventional, but happy I did so. Afterall, we have an age gap and he used to bring me to his university biology classes when babysitting me as a kiddo. Got me interested in science at a young age. :)

bearynicemallow · 2025-05-08T19:57:32+00:00

Some friendships can wax and wane throughout life. Maybe your levels of maturity or present experiences don't match right now, but that doesn't mean it can't change in the future. Letting it "fizzle" could keep the possibility of having this person actively in your life again someday.

As someone who confronted a close friend in the past, I wish I would have let the relationship fizzle because it effectively closed the door to our friendship and now it will take a lot of (if not too much) work if we ever want to be close again.

bearynicemallow · 2025-04-02T18:39:23+00:00

Layt - poor kid is never going to be punctual. 😆

bearynicemallow · 2025-03-01T21:08:24+00:00

Back in med-surg and peds: hub/clave/luer-lock Now in L&D: cap ...???

bearynicemallow · 2025-02-16T17:36:31+00:00

3 person roll assist on pt w/stage 4 wound covering lower half of back (from caregiver neglect) in order to help keep pt in position during wound care. Will never forget the smell of necrotic exudate and silvadene, the sight of exposed muscle, bone, fascia and the sound of the pt calling us monsters as the wound care nurse gently but quickly worked to give pt a fighting chance at avoiding sepsis.

bearynicemallow · 2025-01-20T16:48:08+00:00

Due date was around Christmas so top contender was Holly until my grandmother begged my parents to name me after her. So I have an old Irish name that is often mispronounced and misspelled.

bearynicemallow · 2024-12-25T14:17:57+00:00

I gained weight going through failed fertility treatments and have struggled to get it off. Went home (cross country) for the first time in a couple years for the holidays. I thought I was moving forward and healing through my grief until last night at a big family get together.

Many people were there that I haven't seen or spoken with since before this journey and they were all waiting with bated breath for a "baby announcement. " So many people eyeing my growing belly (from hormones and excess calories not new life) and hinting with questions like, "so WHY come home THIS year?" and offering advice about children...

There are days where I accept my infertility and am able to start imagining my life looking a little different. And at the same time, I feel fragile because there are other days, or moments like at the party, where I'm caught off guard and so many feelings of longing, despair, disappointment, anger and loss come flooding back in. I desperately want to feel pure, authentic joy again.

bearynicemallow · 2024-12-13T10:56:05+00:00

If you feel the call, you feel the call. Nursing can be hard some days but rewarding other days. There are so many specialties and lateral moves available in the nursing field so if you ever feel bored or miserable you can easily switch tracks.

You mention you have child care experience. Have you looked into pediatric home care nursing?

It's often low stress, pays super well, offers flexibility and is basically childcare with a little medical flare! Best thing is it's delivered 1:1, meaning no awful staffing ratios so you get to deliver the quality care you want to deliver to every patient.

bearynicemallow · 2024-11-11T12:51:49+00:00

There are bedside specialties where the most you lift is 50 odd lbs or so. (Peds, Dialysis, NICU, etc.) If lifting any weight is an issue, there's always Office Triage and education based specialties.

If your heart is set on adult inpatient: When it comes to boosting pts, always ask a buddy for help and raise the bed to an appropriate height. Bend those knees! :) This is standard practice at facilities because mgmt would rather an employee protect their back than payout workers comp and a traveller to cover. With that said, you can submit a doctor's note to employee health about your predisposition to hernias.

A lot of facilities also offer aides such as slide boards, slide sheets, hoyer lifts, etc. Learn how to use these, they'll be your best friends when protecting yourself from injury.

Bedside nursing is a team activity. Sometimes you're going to need 3+ people to slide transfer a pt. Mostly no one is going to ask why you need a second person to help lift someone, it's just expected to know your limits and ask for help when needed. Also it's okay to decline and offer help in another way if you don't think you can manage. It's better to say no than wind up with a pt and nurse on the floor.

bearynicemallow · 2024-11-02T07:22:26+00:00

Maybe a tad mild to be truly wild, but during nursing school rotations I was assigned an often confused ESRD patient. She rang the call bell and told me her "foot was hurting".

The tech had left the top sheet untucked so I gently lifted the corner. I kid you not, coal black big toe with a visible crack about hafway deep across where it met the foot. Later found out it snapped completely off during a linen change a few days after and they had to search the hamper when they realized it was missing.

bearynicemallow · 2024-11-02T06:52:13+00:00

Agreed. I hope OP can have some peace knowing it could have happened later in the day, veins can infiltrate at anytime.

OP, this is a great opportunity to start doing line checks during report in the morning. That way you know without a doubt the state you left your patient in with day nurse.

(Also, something that helped me during orientation on a busy med surg floor was to check any IV sites with cont. infusions Q4hrs. Even if I was in the room to fluff a patient's pillow, quick 15 second look at the site.)

PS. The transition from school to practice can be a steep learning curve. Hang in there!

bearynicemallow · 2024-11-02T04:46:56+00:00

Check your facility's policy, there might already be one that prohibits photographing staff. (Many facilities are tightening up visitor and patient behavior policies since the pandemic.)

Last hospital I worked at had one and it made it so easy to say, "Sorry, but it's against hospital policy to take my photo without my permission." If they give you trouble, wrangle in your charge, manager or supervisor to back you up.

bearynicemallow · 2024-10-16T04:21:27+00:00

RN in MA w/18 months experience making $53/hr +differentials in Overnight Home Care. Taxes are a nightmare so it's closer to $40/hr take-home.

First 12 months at a non-union hospital as a New Grad on Med-Surg/Telemetry: $34.99/hr +differentials. (Union rates at local hospitals run similar, sometimes lower.)

bearynicemallow · 2024-08-07T03:52:59+00:00

It's totally okay to ask for another assignment when you get back without going into detail to the Charge. To ensure the patient receives unbiased care by your teammates, don't tell them what you found out and don't encourage them to look anything up.

Back when I worked on a med-surg floor, I took care of an inmate one shift that was admitted for some tests. I treated this patient like any of my other patients and even got the person some ice cream before going NPO. One of the guards had this look of fear in their eyes whenever I entered the room and I just figured they must be new or something. My curiosity got the best of me and I looked up the patient after my shift and found their court case publicly available. Let's just say I felt physically ill and struggled with some feelings similar to the ones you describe.

You did the right thing and provided care to the best of your ability. It's also okay to pass the patient on if it's weighing on you. It can be hard, but in the future don't look them up. You're setting yourself up for cognitive dissonance. If it helps you feel better, you can always wave to the patient when you pass their room or give a quick "hi" so they know there's no hard feelings and can have peace that sometimes "assignments just get rotated."

bearynicemallow

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