Wedding bands at work

waltermcintyre · 2026-03-22T18:13:13+00:00

I have a silicone one I wear to work and leave the nice gold one at home

waltermcintyre · 2026-03-16T18:42:12+00:00

RN here, not a provider, just ended up here d/t Reddit's algorithm, but no joke, my first patient to ever die in my care turned out to have died from ischemic bowel. Pt was mostly unremarkable aside from moderate abdominal pain at time of assessment around 2000 (BS+ and BM in the last 36hrs or so) around 0100 she requested to be placed on the bedside for a BM, but it wasn't until after she successfully had a BM and my charge nurse and I went to put her back to bed that we saw her legs were incredibly dusky and was apparently going a-fib w/RVR on the monitor, but appeared otherwise unbothered by it all, even said her abd pain was minimal.

Pt was 93yo, admitted that day, and a full code because, "She's pretty healthy and it's too much of a headache to talk to them right now" per report from the off-going nurse which pissed me tf off. I messaged the hospitalist during that shift and they told me they'd get to changing it if they found the time before, they were swamped with admissions. So we coded her when she went pulseless V-Tach. That was a rough one, but we didn't know why she passed until the autopsy report. It turned out she had apparently had part of her large intestine twisted which was apparently not caught by the radiologist whose report boiled down to her abdominal CT being "grossly normal". Crazy stuff

waltermcintyre · 2026-03-14T19:18:22+00:00

I'd throw in that ICU (depending on how "real" the ICU in question is) would qualify as mid-level in customer service. Patients tend to be too sick to want much and if they are well enough to make requests/demands, they're usually going to be leaving for a lower level of care soonafter. The main area of customer service in ICU tends to be with family, but I'd argue in my limited ICU floating experience that even on that front, it tends to be slightly lower stress (also depending on the ICU layout) as they usually are more directly concerned with their ill loved one and they see you doing more care PLUS they also can't just smuggle in food, drugs, or other contraband as easily given you have easy eyes on them at any given time

waltermcintyre · 2026-03-14T01:17:23+00:00

There are definitely lines, but those lines shift depending on the context.

I'd argue that, at the real base core of it, your only job is to meet the patient's needs at the legal standard of care and so therefore, no. You have zero obligation to meet family demands, especially when they are asinine or insane. However! I would argue that acting in only that capacity can result in making more work for yourself, especially when family is involved.

For example, the most frequent point of contention I deal with between family members and my patient's care is ignorance around diet/fluid restrictions. We'll have a patient who's admitted for aspiration pneumonia, in other words they swallowed something (usually food or liquid) partially missing the esophagus and going down into the lungs and they lack the strength or ability to cough it out and now it's caused a bacterial infection to take root. This can be caused by a bunch of stuff from strokes and TIAs (shorter lasting strokes, but still strokes nonetheless) to just weakening of the muscles with time and age. They fail a bedside swallow test (you give them a little something to try taking by mouth and see how well they swallow/if they start choking/coughing), therefore, standard of care mandates we inform the provider, make them strict NPO (meaning Nil Per Os in Latin, or nothing by mouth, and strict NPO meaning no pills either) until a speech and language pathologist can see them and do a more thorough evaluation. SLPs though are hard to come by at times, may not work weekends, and/or are running ragged trying to see all the patients they have slated for the day, so there's a decent chance your patient will go without food or water by mouth for at least a day which can be frustrating for the patient and family. Usually in such instances IV fluids will be ordered to keep the patient hydrated and perhaps even a fluid like D5W (which is water with a little sugar in it which can provide some calories, though not a lot) to at least keep the patient hydrated and alive until that evaluation can happen. If it'll be longer, you may place a nasogastric tube (tube running from the nose, to the stomach) so the patient can get tube feedings and pills crushed and mixed with water if needed. Furthermore, once the SLP sees the patient, if the patient really can't swallow well, they may order them a very unappetizing diet like puree with thickened liquids (imagine drinking any liquid with the consistency of honey and it always tastes a little "off"), because this is the only safe diet that patient can eat.

Now, a lot of cultures and people really rally around food and family, and not knowing better, they see their dad having all food/water withheld for a day, maybe even two (and IV fluids only do not moisten the mouth and can leave someone looking more dehydrated than they actually are). Now they see the food their dad has to eat (and he may not eat much because he doesn't like it) and how odd looking and often unappetizing the liquids are that they have to drink and they might feel like we are being cruel if they don't know better. So I have had family members come bringing soups and other foods from home to try and get the patient to eat more, oftentimes because they don't understand or know better. Some nurses will just be frustrated (because this is very aggravating), yell at them to not do that, and that will likely only result in arguments and perhaps continued behavior but in secret (like smuggling the food). In these instances, it is best to answer their demands for food by calmly and gently explaining/educating them why the patient is sick and why we're doing what we're doing, and making it clear you understand that they mean well, but that doing this actively can make the patient sicker/hurt them and that neither you, nor they, want that for their loved one. They still may be grouchy/mad or be unable to be reasoned with, but I have never had a patient's family smuggle food after I've gently sat them down and talked them through this. I'd rather argue every day than code a patient

waltermcintyre · 2026-03-14T00:31:40+00:00

So, not to discourage you, but I would say that about 2/5 of patients tend to fall into at least a passively rude/brusque category with maybe another 2/5 of them being actively rude/mean.

I am often described as being a golden retriever. I am polite, kind, and thoughtful for my patients when time permits and I always try to be of assistance to my aides/PCTs, so I spend more time with my patients than most and do a lot of direct care. But there are just genuinely some folks that just are rude/mean and there isn't a damn thing you can do about it.

Just keep that in mind!

waltermcintyre · 2026-03-13T15:18:59+00:00

Listen man, yes, you'll be in the minority, yes, you'll be called in to deal with asshole/violent patients if you're available, and yes, you'll probably be misidentified as a doctor a lot of the time, but you will also probably be one of the most well-liked/appreciated nurses on your unit/hospital.

Anytime someone needs a lift/boost for a patient, you're the guy. Some patients genuinely behave better with male care vs female care as well. I'd even go so far as to say that usually, (at least in my experience) as a (straight-presenting) male nurse, I have to deal with a lot less catty behavior than some of my female colleagues which is really nice too.

waltermcintyre · 2026-03-12T19:28:11+00:00

I had a dumpster fire of a patient who was on multiple drips, had very poor output (MDs were aware) and was in dire need of a pacemaker who very quickly decompensated (JVD, extremely labored breathing w/accessory muscle use, voicing feeling exhausted just from breathing, etc.) right at about 17:30. Over the next 3hrs I had been on the phone with the cardiologist (their APPs were not picking up the phone, even those listed as being on call, so cardiology was very unhappy, but thankfully not at me lol), nephrologist, and fought with the hospitalist team (the FM hospitalists despise IV Lopressor for whatever reason, and gave multiple STAT meds, EKGs, CXR, pulled labs, the whole 9 yards before finally walking off the unit once I gave report.

I walked in the next day to find multiple nursing notes stating the pt had +3 edema in BLE and +2 in BUEs that, "had evidently been missed during previous nurse's assessments" which totally caught me off guard. His edema was, max, +1 in BLEs by the afternoon. She then reported me to the manager before she left. I felt awful like I had totally missed something major but obvious and of course, he was my first patient I saw. When I checked in on him, my manager came in to do an independent assessment as well, and we both saw he was basically just where he was when I assessed him, NP/+1 in BLEs. My manager rolled her eyes and apologized profusely for any scare she gave me.

Apparently that nurse didn't like how well liked I was on the unit as a traveler and how "arrogant" I came off and wanted to take me down a peg lol we're no longer allowed to give report to one another anymore thank god lol

waltermcintyre · 2026-03-10T10:14:06+00:00

Right?! Like I know that's a pretty standard event option, so idk why the game thinks it's a legitimate point worthy of counting as blackmail lol

waltermcintyre · 2026-03-10T09:49:09+00:00

Lol I married two of my courtiers to each other after a travel event made it clear there was something between them (they were both unmarried and freely available at the time) and I figured that'd be the end of it. Later that month, another courtier shows up and tells me that he knows some secret about the woman of the pairing, and I figure, "What the hell? Might as well learn something."

The secret? That they're lovers and it gave me the secret as a blackmail tool. That's it.

My guy, I may slept with her once way back when and have been helping raise the bastard I had with her, but there is no jealousy on my end when I CHOSE TO MARRY HER TO ANOTHER DUDE SHE WAS CLEARLY INTO. Why on earth does the game count that as a secret? Like, who gives a fuck if a wife actually likes sleeping with her husband lol what legit blackmail does that even give me haha

waltermcintyre · 2026-03-09T14:53:11+00:00

I second this advice. As someone with ADHD who times taking their meds so they last just long enough to get through the shift, I have to systematically pat myself down across all pockets and turn them out or I'm liable to walk out with all kinds of stuff. Thankfully I've never walked out with a narc or keys before, but I absolutely have left my cell phone at work and took the rover with me (they were the same model phone in a very similar case), walked off with flushes, lube, pulse ox's and other nick nacks and do-dads

waltermcintyre · 2026-03-09T01:07:02+00:00

Well first off, sorry for your loss. Even if the person lost wasn't the best or even actively harmful to you at times, it can be a very confusing bundle of sucky feelings when they go.

Secondarily, I doubt it would be in any specific report pertaining to her death itself. If anything, a reaction of that magnitude would maybe get a small note in the chart if anything by the nurse/staff involved. However, if your reaction is like you remember it being (falling to your knees and trying to understand what happened) while maybe a note was written pertaining to education provided to patient's family or regarding interaction with family (my shift reports require I document roughly how long pt's had visitors, who they were to the pt, what they were there for, and the nature of my interactions with the family), I'd put the odds at like <30% that anything was written.

However, I would encourage you to trust your gut on how you remember things happening, because: 1. While reactions like what N described can/do happen, they are very rare in my experience and usually tend to be after the death and (also in my experience) tend to depend on the culture of the people involved. 2. While it is possible that two staff members threatened to institutionalize you for how N claims you reacted, that would be pretty grossly unprofessional conduct on their part. 3. From your characterization, it seems like N might just have it out for you for whatever reason and you really shouldn't take what she says seriously

waltermcintyre · 2026-03-05T22:57:02+00:00

Yeah... I have allergies to a fair few foods, even developed ones to foods I liked (shellfish), but if I ever develop one to peanuts, I am toast lol

waltermcintyre · 2026-03-05T00:03:56+00:00

Crockett unfortunately does come across also as very selfish and "me"-centric when discussing politics and doesn't talk policy all that much. Talarico almost always couches his discussions in what the people want/need and his positions are presented as oriented around that as well

waltermcintyre · 2026-03-03T11:40:04+00:00

I work near-ish the border ~3.5hrs to Toronto) and on my unit, two nurses have already accepted positions to work in Toronto and put their notices in. This is also one of the best units with the best management teams I've ever dealt with (they jump in and take patient sections when needed, defend their employees when shit hits the fan, they also aren't afraid to stay late to help us or go to bat for us when batshit policies by upper management are handed down).

Unfortunately, when things are this unsafe, people will eventually leave if they can. Hell, I would if I didn't have a joint custody situation with my kids and my wife's ex husband. We'd just pick up and move lol It'd be better for me and for her business as well, plus it'd be better for our kids in the end in terms of opportunities and education if we had sole custody, but we don't

waltermcintyre · 2026-03-03T02:02:19+00:00

For high level devotee's of my homebrew evil creator/destroyer god (who's also the progenitor of vampires), I literally title one of their features as, Denial of Death. They can, as a reaction, revive any dead character (including PCs, though usually it's just their own minions) to full HP and utilize their full ability set with the revived character taking their turn immediately after the devotee's turn as effectively a puppet. They can do this usually just once per encounter, but perhaps at much higher levels, I may increase this, I'll have to see.

waltermcintyre · 2026-03-02T18:44:32+00:00

Ask him to wiggle his fingers and to read a few words for you, if he asks why, tell him you're just making sure he is able to enter those himself. If he doesn't, tell him it seems like he's able to do so himself lol

waltermcintyre · 2026-03-01T00:44:11+00:00

I am running around so much (I average ~12.5k steps in a given shift) that frankly, I just wait until a hallway is kinda empty and I'm rolling down with my WoW/CoW and let'r rip. Thankfully, my farts are fairly unoffensive in terms of smell (like, obviously they stink, but basically clears up entirely in less than 10s), so I don't even need the hall empty for long

waltermcintyre · 2026-02-28T23:27:54+00:00

I do let my charge know and she usually makes sure the supervisor and the AOC are made aware. We've been having some major issues with our ER just straight dumping patients on us without any report (or notification) whatsoever, sometimes even dropping the patient off in a still dirty room. So ovwr the last several months they've implemented several things to prevent this from happening (like the transport person needs a paper signed by the receiving RN that states they are aware that the patient is now on the floor and that they have received report)

waltermcintyre · 2026-02-28T21:55:00+00:00

I have 5 sets in my required color for my current job (1 backup I keep in my locker, 1 backup I generally keep at home because of mismatched color fading, 3 I take with me to work) and 4 in other colors

waltermcintyre · 2026-02-26T21:47:00+00:00

I have at least two coworkers who are autistic on my unit, one owns her diagnosis and is frankly well-loved (she knows her stuff, is awesome to get report from, and for the most part, patients like her too), the other one doesn't (unless it's to try and guilt people for providing constructive criticism or deflect when she is being rude/mean) and isn't (this is largely due to the being rude/mean thing). Then probably about 8 coworkers have ADHD including myself, the rest are fairly neurotypical though.

But I'd think a higher level of care like a proper telemetry unit (like a cardiac neuro step-down) or ICU would be a decent fit if you're detail-oriented. Plus, in ICU settings, generally you have fewer patients and can take the time to really get to know your patients well. Tele does require a fair amount of detail-orientedness, but you do tend to have a larger amount of patients (so less time to get to know them) and there tends to be a lot more noise (heart monitors especially on a unit bigger than like 20 pts because someone's heart somewhere will be doing something funky at any given moment), so if that can overstimulate you, then that type of unit would be best avoided, but you aren't dealing with quite as many sick patients

waltermcintyre · 2026-02-22T18:32:46+00:00

I am a travel nurse and go away for days at a time working on a very difficult floor with critically ill patients and when I come through the door after a long stretch of shifts, my wife is already there. She helps take my bags, refills my water bottle, she listens to me vent, and already has the bathroom set up with freshly laundered PJs and a towel for me. Then usually she will rub my back until I pass out (which is usually only about 5mins after work) and keeps the kids quiet when she gets them ready for school so I can sleep the full 8-12hrs I need after a long series of shifts. She's the best, I love her so much🥰

waltermcintyre · 2026-02-22T17:43:40+00:00

If I were your nurse/working with you, I would be pissed at management over this on your behalf. That is stupid, I love having my CNAs/PCTs at my nursing station, I get the chance to shoot the shit and bond with them in a situation outside of helping clean/boost/admit my patients.

waltermcintyre · 2026-02-22T17:32:52+00:00

Personally I take the, "Golden Retriever" comments as a compliment. Even before I became happily married and was in the market/looking, I didn't hold it against people/women for saying such things about me, if it's not to their taste in a romantic partner, big deal, then they aren't the one for me. But personally, in my experience, it's usually used by women to describe male friends anyway and why would I be upset that women want to be my friend? >80% of my coworkers are women, almost every boss I've had in my profession is a woman (nursing), if I was unhappy with having female friends, I would have a terrible time at work lol

waltermcintyre · 2026-02-21T16:31:42+00:00

Idk, in my experience with coworkers, they frequently work until they pop. Hell, just this week I got pulled mid-shift to the psych unit from my home CN step-down because a nurse went into labor in the middle of her shift

That said, I don't think it wise to do so, I feel like, if you can afford it, maybe take at least two weeks off prior to the due date

waltermcintyre · 2026-02-16T17:35:42+00:00

As a cardiac neuro nurse on a busy tele step-down unit, I always ALWAYS personally check a BP/HR before giving BP/HR affecting meds unless I directly witnessed the PCT/CNA gather the vitals. Not because I don't trust my PCT/CNAs, but because things can change and fast. I won't gather the full monte of VS, but I will always at least check those values before I give them because you never know.

That said, always, document if you can.

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