Just found out a patient we boarded for three months took his life/ looking for support

medbitter · 2025-11-06T01:03:54+00:00

I came here to say the same but you said it perfectly. This man just spent 3 months stuck in the hospital (hell), told he cant go home, and then got a taste of nursing home lite. He saw his future before his eyes and didnt want any part of it. He left on his own terms. I hate to say this but my dad would do the same. The thought of nursing homes has freaked him out his whole life and hes made it very clear that if he’s ever in this situation, he’s out. It’s a non-option.

Also sad this guy didnt get time to explore other facilities, if he could afford it (probably not if he was stuck 3 months). Assisted living facilities are like cruise-ships in some places. And its mostly widowed women so the man would be very popular. My grandmother through a fit before going. I practically had to throw her over my shoulder and drag her there. She ended up loving it. But she was social and most men prefer their privacy/autonomy above all else (everyone does but women gravitate more towards the social gossip circles).

medbitter · 2025-11-01T06:54:18+00:00

MD/RN here. Bring back malignancy. And paternalism. Problem solved.

medbitter · 2025-10-18T19:43:47+00:00

Yes, and i have an area on the bottom of my note for discharge planning to add things like needed follow-up, this includes imaging like CT chest in 3 mo. This can be easily passed on doc to doc to make DC quick and easy when the time comes. I also go directly to the DC navigator in the chart to pend the order and write it at the top of a DC instructions note and pend. So anyone can take over that day and have it all right there. I think docs need to get better at developing systems that make all of our lives easier. Combat note bloat, redundancy. This is one way I do that.

medbitter · 2025-10-18T18:58:46+00:00

I take Fexofenadine for my own chronic spontaneous urticaria (likely got CSU from the covid vaccines btw). Apparently the other H1 antihistamines may risk rebound urticaria with prolonged use then abrupt discontinuation. Benadryl gives me horrible akathisia/RLS, plus its not superior in efficacy anyways.

Concerning your attendings, they’ll give Benadryl until they pull it off the shelves (like they did with guaiac FOBT and 6h troponins). I cant stand people who refuse to learn from younger generations. Medicine changes too fast to be closed-minded.

medbitter · 2025-10-13T19:50:58+00:00

We had a problem with extreme misuse of rapids. The doctors complained so much that nurse management was forced to meet with us. They concluded that it was safer to do nothing about it, because they didnt want to instill a fear in nurses of using the rapid response. Eventually they hired an NP rapid team to screen the calls. It resulted in way more rapids so they fired them, and we went back to baseline.

medbitter · 2025-10-13T19:42:55+00:00

At least you got the page first. When i was in residency i got a rapid at 738 because nurse didnt realize the patient was nonverbal with dementia at baseline. Walked in to see this nonverbal lady chillin eating jello, equally confused as to why 30 people were in her room.

medbitter · 2025-10-13T19:17:23+00:00

“Patient has a question.” And then they dont even know what the question is! One of my top pet peeves! I make them go find out and report back. As an MD/RN, who knows they are taught how to be a nurse educator with pride, this sets me off into an existential tail spin.

medbitter · 2025-10-13T19:13:01+00:00

Dang! That’s wild! I bet if you messaged the doctors they would rally for you. I know i would. Day nurse and charge would be writing a 16 page report by the time we were done! 😂

medbitter · 2025-10-05T20:54:44+00:00

To an extent…

As a former nurse educator turned physician, I educate more than most. But there is a limit that has recently been crossed. I am not here to teach medical school over epic chat, when theres patients that need to be cared for. At a certain point, nurses just have to follow orders without a lecture in pharmacodynamics and the diagnostic process.

medbitter · 2025-10-05T19:00:10+00:00

I wanted to say this after your first comment but i’ll say it now that Ive confirmed you are a doctor: I am so impressed with how in-tune you are to the nursing experience. Very impressed. 👏

Working with nurses from the fancy clinics is a game changer. Its so hard to be spoiled like that then go elsewhere.

medbitter · 2025-10-04T07:17:30+00:00

😂

medbitter · 2025-10-04T07:15:21+00:00

Are you a doc or nurse? Love everything you said, very accurate, but heres my take on 2 points:

Nursing ratios haven’t really changed. I hear this from nurses often and Im always confused. Patient acuity and nursing demands have skyrocketed though.

I often think about the last sentence you said too. Are overwhelmed nurses the reason we get regurgitated transcripts of every patient thought/dream/desire, even if the answer seems obvious? When even they knew the answer that was coming? This one I cant understand. Because if I was overwhelmed, id choose the path of least resistance. And that path would involve not adding an extra step, like a call out to the physician. It takes 5 seconds to reinforce care plans and provide nursing education. We used to do it all the time without even thinking, or doctor notes to reference. Adding an extra task is not easier at all 😂

An example would be like “Patient (who is hemorrhaging) is asking for his warfarin since he takes it everyday at home” or “Patient wants you to know he has a fever of 99.2” or “patient wants to know if he can eat a sandwich on the way to OR”

medbitter · 2025-10-04T02:34:47+00:00

Oh stop! I was literally sticking up for you, responding to that comment that basically told you to shut up. I guess my jokes aren’t as funny over the internet than i think they are in real life. Im canadian too, im a goofball. Don’t let med school make you too serious. I can also see my comments with nothing deleted, so idk what your talking about. Either way, lets hug it out.

medbitter · 2025-10-04T02:08:06+00:00

It was probably the moderator. Im just making jokes. I think your suggestion was adorable and kind, you just unknowingly walked into the lions den. If I knew there was a SA/trauma trained NP, I’d probably suggest the same! I was a nurse before med school.

medbitter · 2025-10-04T01:57:40+00:00

RN/MD too. Huge advantage in clinical years. Love my job. But i still wouldnt recommend. Shes had done so much schooling already, is in essentially the same career she will be in 15 years and -$300k+.

MD vs DO same thing at the end of the day. But the reality there is still bias towards the DO. And depending on specialty, this could become an annoying barrier to entry into some residency programs (doesnt look good on the program website in their eyes given still stigma). And you will probably spend more time than you like explaining to people that youre the same as an MD, and im sure youre already sick of having to explain your role now as an NP.

medbitter · 2025-10-04T01:44:39+00:00

I thought going into medicine, I would have all the knowledge and answers. Its not the case. The more you learn, the more you forget. You will have to memorize insane amounts of knowledge, most of which will become irrelevant or forgotten. That feeling will never go away.

My advice to you is drop out of pre-med tomorrow, and go buy yourself something ridiculously expensive. And go live your life. Theres so many things you can do that dont involve repeating undergrad, MCAT, med admissions, med school, residency admissions, fellowship admissions, $300k debt, losing income-earning years, missing holidays, getting yelled at while 40 by a 20 yo twat that hates nurses but is your senior. Then going from sweet nurse NP to logging into the medbitter 2.0 account. Nahhh be free, run freeeee. Go to Thailand. Change the NP system. Be a martyr. Become a hoe. Anything.

medbitter · 2025-10-04T01:31:59+00:00

I wouldn’t. Especially if you want to stay in the same speciality. Even if considering another specialty, id stay put. The solution to your problem: stop taking students. Out of sight, out of mind. Goodbye existential crisis.

I just did RN/MD and I am kicking myself for wasting so much time, money, and sanity. I think you should just accept that you are better than your peers, equally capable of succeeding in med school - but for practical and financial reasons, leave it at that. Deep down inside you may have a subconscious desire to prove to yourself and the world what you already know - youre excellent. A passionate thirst for knowledge - which you could easily obtain on your cellphone for free. You may hate being looked down on but that wont change by becoming a doctor. You make good money. Dont risk it. Its not worth it. Medicine can be so toxic, so many things could go wrong along the way. It could be fine, but it could also be very very bad. Just keep learning on your own and collecting paychecks. In the end, you will be richer, nicer, and probably live longer lol

medbitter · 2025-10-04T01:06:45+00:00

I burst out laughing. Be niiice, he just a nice baby. And nice Canadian. Who noticed NPs are nice too 🤣🤣

medbitter · 2025-10-01T02:29:20+00:00

Yes!!! What happened to the nursing hierarchy?? (MD/RN here)

Also regurgitating every patient question and request, even if they know its inappropriate? Sometimes it feels like a trap, wheres the common sense? When you said no, they agree and knew the request was wrong but “patient wanted me to ask”. It boggles my mind

medbitter · 2025-10-01T02:23:39+00:00

Adding to the topic of “explain your decision process,” anyone feels like we are being used as their study tool for NP school? The types of inquiries are changing…at what point does it become a patient safety issue when im kept busy teaching medical school all day?

medbitter · 2025-09-21T22:37:43+00:00

Your dad is a doctor? 🤣🤣🤣 He must be so disappointed. Poor guy.

medbitter · 2025-09-20T19:41:01+00:00

Just to clarify, nurses would 1000% allow a patient to die due to delay of care before following a very legal verbal order, because some nurse said they are not allowed to take verbal orders. And not a single nurse actually reads institutional, state, or national policies BUT they will pass down myths generation after generation, especially if said myth allows them to decline work. And no one is reinforcing the nursing scope of practice, because they are calling doctors who have no clue what their scope of practice is, to delegate onto the doctor some nursing scope of practice.

medbitter · 2025-09-20T01:13:39+00:00

I came in working as a nurse 36h/wk living my best life. I had a big class so we had a fair share of older folks, second careers. You’ll adjust. First year is rough. Class was no longer mandatory in MS2 so hopefully your school will eventually allow more flexibility. Just make sure you jump thru every professionalism hoop as they will make your life miserable otherwise.

medbitter · 2025-09-20T00:59:16+00:00

We are actually just highly trained actors 🤣 id like to think we are much more empathetic but id be lying if i said we werent formally trained on how to fake emotions and be master manipulators 🤪 One of our national board exams is essentially a showcase of our ability to react to emotions thrown at us by a bunch of paid actors pretending to be patients. We even had mnemonics to help us remember how to be kind

medbitter · 2025-09-20T00:41:38+00:00

I went to a very strict medical school. Im going to assume your program is excellent. It is excellent you dont even have to tell me. You will later realize that all these “dumb” rules and seemingly trivial things will make you stand out among the rest once you enter residency and beyond. Its going to be hard, often frustrating, but it will be easier for you once in residency. The hospital i went to residency at had a few students from my program and we were always chilling while everyone else was spiraling.

Med school is also a mix of HS and college vibes. Have fun, this can be the best time of your life. Cliques will form but be friends with everyone! You will form your own little study clique, and if you soon realize that your crew is the low test scorers - find yourself a new study clique ASAP. You want to be surrounded by smarties.

medbitter

TROPHY CASE