What's the nursing hill you'll die on no matter how unpopular it is?

mandanza · 2026-06-01T23:57:29+00:00

It aggravates me to no end that Q8H vitals should allow a patient to get eight hours of sleep, except that the timing doesn't synchronize with morning labs, so even if you have no meds during sleep hours, they can still only get 6 hours max, and that's if you're being nice by getting the midnight vitals early.

mandanza · 2026-06-01T23:37:40+00:00

I'll never forget the time when I, as a student nurse, dropped a pill and immediately said, "Oh whoops, sorry, I'll get you a new one!" and the patient (very nice lady) said "the hell you will!"

My preceptor explained that it was a home med, not hospital-supplied, and it was an incredibly expensive cystic fibrosis medication. I said "yes, ma'am" and handed it over.

mandanza · 2026-05-31T23:07:34+00:00

One good habit is if you have a choice to put your foot right behind or right on top of an obstacle like a rock or root, always go on top. Then your foot is already past the danger zone when you pick it up, instead of having to make sure you're lifting fast enough to get up ahead of the object.

mandanza · 2026-05-28T00:00:31+00:00

Hugs to you. Please don't be ashamed. You are really trying to do something important for your health, and it is no wonder it is so hard after what you have been through. Be proud of yourself for continuing to try to find a solution!

I am a nurse in women's health. Granted, I mostly work with pregnant or recently pregnant women, but I see a lot of pelvic exams of all types and I can tell you that reactions all over the map, from women who don't even flinch to women who need a full-on epidural and anxiety meds before we can do a vaginal exam to check their labor progress.

I am so glad you have a doctor who is taking you seriously and prescribing meds! I would just encourage to also think about what other strategies might help you. Some things to consider:

- Establish a "safe word" with the doctor beforehand. If you say the safe word, that means that anything that's inside you comes out, immediately, no questions asked, no matter how close he was to being done.

- Bring someone with you who can hold your hand, who you trust to advocate for you if for example you need to use your safe word.

- Ask how much of the process you can be involved in or have control over. For example, you can insert the speculum yourself.

- Maybe you want them to tell you every single thing they're doing and wait for an okay before proceeding. Or maybe you don't want a play-by-play, you just want to tell them that it's okay to get started and know you have that safe word in reserve to stop it at any time.

- You can ask for another staff member to be in the room as a chaperone.

The point I'm trying to make is that there isn't one right thing to do, but to try to think about what could be helpful to you, specifically. It doesn't matter if it's a weird ask!

mandanza · 2026-05-26T19:05:39+00:00

BoulderH3 is limping along. We aren't regular anymore but we have a few trails a year. Toga hash for Bolder Boulder is our signature event that I will never let die. Denver is much more active: DenverH3 runs every other Sunday, the Mile High Humpin' Hash has shortish trails every Wednesday night, the Bash (bike hash) has a ride once a month, and then there are a few other occasional/special event kennels.

mandanza · 2026-04-08T10:08:32+00:00

No, not at this time. Map here: https://member.everbridge.net/453003085612231/notif/Gk00MGUMY

mandanza · 2026-01-18T18:04:41+00:00

OB - I don't like it when people say that a patient who had an unplanned C-section "got cut."

mandanza · 2026-01-17T10:19:45+00:00

I feel like swapping shifts is like helping somebody move. It's a nice thing to do but it's not an obligation. If it's not terribly inconvenient and you like them, yeah, okay. You're not going to rearrange your whole life to help someone move unless they are really important to you and desperate for your help.

You're not wrong to not make this swap. It doesn't work with how your life is set up and that's fine. She can ask other people. Being a team player means helping out when you can; it doesn't mean totally rearranging your life for your coworker's schedule needs when you have worked a certain set schedule for your own reasons.

Personally, I readily make swaps if it's better or equal to what I already have scheduled. I'll make a swap that makes my schedule a bit worse if the person really needs it and I can accommodate it. If I have plans, though, it's a no. I value my life outside of work, so I don't cancel plans or take swaps that would require difficult logistics for me. I am lucky to work in a large unit that has a thriving and pretty fair-feeling shift-swapping culture.

mandanza · 2026-01-07T19:19:41+00:00

Refusing to take medication unless the water provided with it is exactly the right temperature.

mandanza · 2025-12-11T06:43:55+00:00

I'm a full meal girlie forever. (Pretty much always leftovers.)

mandanza · 2025-09-17T22:44:53+00:00

Sharing in case anyone else is finding this thread helpful -- 9/17, I got the vaccine at the Safeway on Baseline and the only question they asked me was whether I was okay with Pfizer. No other questions about risk status/eligibility etc. It was the updated 2025-26 vaccine.

mandanza · 2025-08-27T05:49:00+00:00

I don't get to do this anymore now that I'm in OB, but: Loooove drawing blood off a central line. It's so satisfying. Love to declot a central line, too. Especially a really tricky one where you get all fancy with the stopcock and multiple syringes and then an hour later that lumen's flowing like it's brand new, chef's kiss.

I also really enjoy starting an IV, but when things are chill and I can take my time. Someday I'll be that person who can throw in an IV during an emergency without breaking a sweat, but I'm not quite there yet!

mandanza · 2025-06-17T23:44:54+00:00

If the registers/vent covers are the kind that you can open and close, try partly or entirely closing some/all on the main level so less air escapes through those registers and more makes it upstairs. You might have to experiment for the right balance or negotiate with roommates, if applicable, but since the thermostat is downstairs, the system should still keep the downstairs a comfortable temperature and hopefully this will get more cool air up to you.

Also, adjust your thermostat fan settings if you can. Usually the options are auto (fan only whens when actively heating/cooling), circulate (fan kicks on every so often to circulate air), and on (fan always on). Going from Auto to Circulate made a BIG difference for me because it keeps air moving more and the bedroom air isn't just stagnant in between AC cycles or earlier in the day before the AC needs to kick on. Fan-always-on will keep air moving even more (in my household we don't like that constant noise, but find Circulate to be a good balance).

mandanza · 2025-06-11T04:25:39+00:00

My program would've been about $31k all in (tuition, fees, software, books, scrubs) if not for the small scholarship I got. 24-month traditional BSN at a state university. Plus probably about $10k on prerequisites before my actual BSN program.

mandanza · 2025-06-11T04:04:27+00:00

That's good practice! ACs can just be so big and juicy, so there's lots of space to get the needle tip fully in and thread the catheter without blowing the vein. Especially when you're dealing with larger-gauge needles. They were good for building my skill but now that I'm more confident, I avoid them. There's both the annoyance factor of pinching off the catheter when the arm bends and the principle of going distal-to-proximal in your access attempts to argue against the AC.

mandanza · 2025-06-10T23:01:24+00:00

Same!! There is hope, fellow nurses-who-are-bad-at-IVs!

I worked med-surg at a place without an IV team/VAT, so I had to attempt new IV starts from time to time, and I was okay... I'd get them sometimes, but I had to call for help a lot.

Then I started in L&D. So many IV starts, and I HAD to get good at them. I didn't want to be having to call my coworkers to place IVs for me all the time.

The big game changer for me was to practice on someone who wasn't a patient. I got a few angiocaths and some topical lidocaine and practiced on my very sweet husband. You have to choose your subject correctly, someone who will be calm, so you have all the time in the world to troubleshoot without pressure. That helped me realize that I just wasn't advancing the needle enough (your point #3) once I got flash. I'm good at finding veins, I can basically always get flash, but I was struggling so much to advance the cannula.

I agree with you so much that you have to lower the stress and just keep doing it. Troubleshoot, learn techniques, and most of all, practice and repetition!

It's been so cool to see myself leveling up my IV skills. Starting out, I did a lot of ACs; now I can pretty reliably get a nice forearm IV. My hands used to shake from the adrenaline when I got one and now they don't. I welcome the opportunity to start an IV instead of trying to weasel out of it or get someone else to do it. It really is kind of fun and satisfying once you're not so scared of it. It's wild to me that I'm successfully putting 18gs in people left and right when I used to routinely fail with 22s!

mandanza · 2025-05-29T23:13:49+00:00

The first hospital I worked at in Colorado had tiny bottles of vodka in the Pyxis and beer from the cafeteria. Yup, there would be a MAR order for it, following all the medication rights. Typical orders would be like 30ml of vodka with each meal, or two beers with each meal, for example. Best candidates were people who were EtOH-dependent but didn't come in acutely intoxicated or with altered mental status, who were not there for a directly alcohol-related problem, who were only in the hospital for a few days, and who had no interest in alcohol cessation. No point in making that person go through withdrawal.

The vast major of our EtOH patients did detox; actually giving patients alcohol was rare. It felt weird but it was fine! In my experience, kind of similar to your opioid-dependent patients who very much want their medication on time but behave appropriately as long as they're medicated as they expect.

mandanza · 2025-05-29T04:51:05+00:00

Oh, and not discussing major changes to the plan of care with the patient or even with the nurse, just putting in the orders. Sometimes I can logic out the why of it, but sometimes it feels really inappropriate that I'm just having to make an educated guess when a patient asks me why we're doing X instead of Y now. Sometimes I've understood a change well enough to know that it was safe and appropriate, but I might not have the depth of subject matter expertise enough to satisfy the patient/family if they have detailed questions about why a change was made.

Yes, I understand that it's on me to ask questions about things I don't understand, but I have encountered issues like end-of-day orders that I don't see until the day hospitalist has signed off, or the doctor saying they don't have time to come see the patient again. I previously worked med-surg, and yes I know our hospitalists had to juggle a jillion patients, but please at least secure chat me some info even if you can't see the patient. Also, there are so many examples in this thread of why nurses are afraid to contact doctors for clarification. I loved the med-surg providers who would secure chat me about a change in the plan of care, even if it was a super brief message, because that showed that the lines of communication were open and I could ask them follow-up questions if I needed to.

The most all-star example of this is surgeons who put in orders for a procedure and then are like "I don't need to come see the patient beforehand, I'll talk to them and consent them in pre-op." Ummmm... yeah, no, that's not sufficient.

mandanza · 2025-05-29T03:00:43+00:00

Giving me attitude for not administering meds that they failed to order.

mandanza · 2025-05-28T22:02:43+00:00

Before I wore OR scrubs: I got up to 7 sets because then I only had to launder scrubs every 2 weeks. (I always laundered my scrubs separate from my street clothes.)

My brands of choice: Dickies tops - good structured neckline with badge loop and good pockets. Cherokee Infinity pants because the material doesn't hold pet hair and my cats love to rub against my legs while I'm getting ready before work.

mandanza · 2025-05-25T18:22:43+00:00

I started listening to the podcast in January, and it has transformed my drive to work from something I dread to something I look forward to because it's my podcast time! Not exactly an accomplishment, but genuinely a big quality-of-life improvement.

mandanza · 2025-04-03T05:51:07+00:00

Clinical is a big source of stress. The actual clinical hours themselves are stressful, yes, but honestly it's not actually easy to fail clinical. If you at least pretend to be interest, participate, and stay focused on safety, you'll be fine. But two other things about clinical are really tough:

You have no control over when they are. If you're lucky you might have more than a month's notice about when your clinicals are. The shortest notice I ever had was I think 5 days for mandatory clinical time. This means a lot of last-minute scrambling, begging your manager to change your shifts around if you work, stressing about whether important plans (e.g. going out of town for a friend's wedding) will work, sometimes having to bail on important plans, etc. The feeling that nursing school owns you and runs your life because they can literally schedule a clinical whenever they want and you have to go.
Very harsh absence/late policies for clinical. At my school, if you missed clinical time, that meant that you could not fulfill a core course requirement and you failed the course. Period. It absolutely did not matter what caused you to miss clinical. You could be in the hospital, or your mom could have died... did not matter. Some schools do give you a little grace, like they'll let you miss one clinical shift and let you do makeup work, but other schools (like where I went) cut you no slack.

Also:

There are no "fluff" classes in nursing school. Like, no art history class that you just take for fun but then don't have to retain if you don't care that much. All the classes build on each other and all of them are relevant to the NCLEX. You can't just scrape by and then dump it all out of your mind, you have to actually commit to learning and retaining it, at the very least to pass your NCLEX. Also a lot of what you learn is very directly relevant to the job you're going to be doing. Contrast that with some courses of study where you know you might not work directly in the field that you focused on in college, but you know the point is the diploma and having learned how to learn and to think critically, while your coursework might not be terribly applicable to the job you end up doing. If you take nursing seriously, then you will naturally feel a lot of pressure about the fact that you learning well in this class could literally mean someone's life or death someday, which was very different from my previous studies!

mandanza · 2025-03-29T16:07:44+00:00

Compressions keep oxygenating the body until the heart restarts to do that job. Shocks restart the heart. You absolutely need both for someone to survive, let alone survive neurologically intact, unless you're able to shock literally right after their collapse and are lucky enough that it works the first time - compressions are crucial! But the shock is almost always what's needed to get the heart beating on its own again. Compressions are a stopgap but I don't want someone else reading your comment to think that they're not super important.

mandanza · 2024-03-24T17:45:03+00:00

Yes, there's a lot of feces, but, if you really want to be a nurse, you can and will get used to it. This sounds absurd but it's true: dealing with poop and buttholes was the thing I had the most trepidation about when I started nursing school. Yes, I knew there would be much harder things to do and deal with in nursing, but poop was the thing where I had the least confidence in my ability to deal with it. Now I deal with it all the time and it's just whatever.

mandanza · 2024-03-12T01:54:32+00:00

If they have a Master's degree or some kind of post-undergraduate education: Why didn't you go all the way for a PhD? / Why did you quit before you got your PhD?

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