I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

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Joined 1 year ago
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Cake day: June 12th, 2023

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  • Nah do it like they do in Europe. Pictures of what it looks like to be held to the bed screaming by a 19y/o who had no idea what they signed up for while an ICU nurse shoves a tube up your ass so that the diarrhea they induced to rebalance your ammonia doesn’t dissolve your anus as quickly except she can’t get the tube to stay in because your anus has already been slightly dissolved so she keeps shoving the tube back in and you’re still screaming because you’re in acute alcohol withdrawal and the terrified child they’re paying $12 an hour to help the ICU nurse restrain you seems to have snakes crawling out of their dinner-plate sized eyes.





  • I try to read all the articles I post but for this one I noped out after 1 sentence. Enjoy!

    I gotchu.

    Bro had prostate cancer at some point and the article says they removed his bladder. The “surgical wound” is likely a permanent ostomy, where the internal ureters (which no no longer have a bladder to drain into) are redirected right out of the abdominal wall (there’s usually a bag taped on to catch the urine). I forgot they usually just drain them into the intestines if you still have them, which is why they were involved in this. Anyway, my guy was doing well and they were pretty sure he was healed up, but age and possibly chemo both slow healing and doctors (like the rest of us) aren’t perfect. Because he was pretty sure he was healed up, he went to breakfast to celebrate, and happened to sneeze. Sneezing raises pressure in the abdomen, and busted his intestines right out of that almost healed wound. The article correctly refers to this as “wound dehiscence (opening) and evisceration (the bowels protruding).”

    In nursing school, they actually teach you specifically what to do about this specific occurrence. First you sit the patient all the way up and honestly leaning forward over their legs a little. This takes pressure off the abdominal skin so it doesn’t tear any further than it has. Then you cover the wound in sterile gauze soaked in sterile saline. If you have an abdominal surgery that has dehiscence and evisceration as possible complications, you likely will not have access to sterile gauze or sterile saline on you at all times, especially not if you’ve gotten far enough into recovery to be going to brekkie, but any reputable surgeon will be happy to provide their own specific instructions as to how to manage the situation until the EMTs arrive, which I encourage you to follow.







  • Yeah but in practice you catch the face by accident a lot anyway. You also have to realize that these people are uncomfortable and scared for both real and delusional reasons, so they’re not exactly heavy sleepers. I should also add that sleep is arguably the single biggest factor in recovery from most acute episodes of any psychiatric disorder. When I’ve had inpatient stays they even disrupted my sleep occasionally and I can usually sleep through anything. Even opening the door wakes a lot of people up and a lot of people can’t sleep with the door open, and also sometimes things get loud in the hall, even at night.

    It’s another example of people who have never actually spent any real time in that environment either working or receiving care trying to make rules that don’t make any sense and without regard for what the people those rules actually affect are telling them. As someone who’s done both several times over in several different places, that kind of thing hits me doubly so.

    People also have a tendency to make decisions based on what makes them personally feel better instead of allowing the disabled and institutionalized the dignity of privacy and making at least some of their own decisions. In this case they want me spying on them more but there are lots of ways this manifests. People especially get super uncomfortable thinking about disabled people having sex or even just a sexuality at all. People would also literally rather me tie their 98y/o grandma to the bed and let her scream until the drugs kick in than let her crack her head falling on the way to the bathroom and die and/or admit that they were blessed she made it that far to begin with.





  • Oh hey! I’m one of the Healthcare workers getting hit! Well they try a lot anyway, but that’s psych nurse reflexes for you (which we’ll talk a bit more about below). There’s a lot of things contributing to this, but the biggest is just that they don’t pay enough or for enough people to take care of people properly while we’re simultaneously trying to prop up the housing crisis with arguably the worst possible solutions.

    And the psych hospitals are probably going to fail first (they’re currently in the process) due to both staff burnout caused by the above but also because most of our population is homeless, meaning they can’t pay (medicaid is a joke) AND they actually often seek out psychiatric hospitalization to avoid injury or death from exposure (although mental illness is also common), so not only are we dealing with increased mental illness with little reimbursement due to the stresses of abject poverty and homelessness, but now we have to do the homeless shelter’s job too! Psych hospitals failing means less and less facilities which means these patients are backing up into the Emergency department and General medical-surgical units. This is one of the worst possible scenarios.

    There’s two problems with this situation:

    1. Emergency and medical nurses did not sign up to get swung on and have little to no training and experience doing so. Remember those psych nurse reflexes? I can almost physically feel someone walking behind me even like 50 feet back, I get a twinge of anxiety when I don’t hear a door latch behind me, and I can make shifting around so that I’m always facing the patient and always between them and the door look completely natural and smooth (realistically I probably have PTSD, by it keeps me alive). Medical-surgical nurses have 0% of any of that. Emergency nurses have slightly more experience than medical-surgical nurses, but they’re also simultaneously having to line stretchers up in the hall just to hold all the people using the ER as their primary care physician for their wildly uncontrolled diabetes and hypertension, so joe-bob sullivan from buttfuck county who’s tweaking on an entire disability check laundered as baby formula worth of meth and thinks all the ER nurses are the aliens from the titular movie but can otherwise walk and breathe just fine is going to be taking a Haldol nap while the nurse goes back to checking on way more patients than an ER nurse should EVER be assigned (because they’re using the ER for primary care) between jumping on people’s chests and plugging bullet holes.

    2. The ER and med-surg units are fundamentally not designed to manage ANY psych patient, god forbid a violent one. My unit is a trashpile full of leaks and mold in a building built in the 70s. I am not pleased with either the interior design or the feng shui. That said, every hook or similar ourcropping my patient could hang themselves on is removed (shelves only), all the plastic bags and strings they could choke or suffocate themselves or someone else with are replaced with stiff paper bags, and, pretty much all furniture is 80 pounds or more with no easy handholds. There are no IV poles to swing at me, no hard plastic meal tray to bludgeon me with, no metal silverware or glass to sharpen or break and stab me with. There are no long corded ball bells or remotes like in other units to use as a flail (happened all the time when I worked medsurg), and the hall phones have 10-inch cords (I measured them after a patient tried to hit me over the head with one but couldn’t reach). I can afford to take things slow and talk things out because I’m holding all the cards; those med surg and ER nurses are just going to get clubbed over the head and stabbed.

    A significant number of patients also have types of mental disorders that aren’t treatable with medication, and will actually likely worsen in a hospital environment, particularly personality disorders (like mine!). I needed 3 years of outpatient therapy twice a week in 1h individual and 1.5h group sessions. I can’t even find people who do that kind of therapy anymore, and I was just lucky my parents felt bad enough about fucking me up to pay for it. So even if you can find that kind of therapy, it’s a long-term commitment both financially and in terms of willpower. And we hardly do talk therapy inpatient because no one has the time to sit down and do it!

    Also people with certain presentations of personality and other behavioral disorders need consequences like jail time to face up to the fact that the way they are treating others is unacceptable (our current correctional system also needs a looooot of reform, but that’s a different subject). These patients aren’t vividly hallucinating or detached from reality like a manic or psychotic patient, they’ve just learned a bunch of shitty behaviors over the course of their life that they would have to commit a ton of time and effort to unlearning. Throwing a patient like that into a psych hospital is often dangerous to the staff members AND other patients, and sometimes a sentence can lead to personal growth (I will eternally envy the Norwegian prison system for doing this regularly).

    Even when people DO have mental illnesses that are treatable, the drug crisis means doctors are super stingy with… well everything actually, but narcs especially and when someone’s been using ativan as a bandaid solution for their anxiety and insomnia for a decade, they’re going to feel some type of way when you rip that bandaid off. The doctors are willing to control the withdrawal (they better; it can be fatal), but as nurses we still catch shit for making the decision to give the as-needed meds “too much” because they’ve got it in their head that the patient is drug seeking and I’m drug pushing when the patient is just trying to stop hallucinating my face warping and I’m trying not to get punched.

    I’m getting tired and need to go call my insurance company so there’s probably more to say or better ways to say some of this but I’m gonna tap out for now.

    TLDR; the issue is mentally ill people are poor so they get fucked.


  • Oh shoot I was worried a bunch spoiled and was going to weep for the loss but it sounds like it’s just a logistics problem. 😮‍💨

    Reminder that even if you have O-positive (O-negative is the universal donor), O+ is still very useful! Negative blood types in general are fairly rare, and O+ can give to all other positive blood types. This means that blood can be used for most patients who they have time to type and crossmatch, and the only time they really don’t have time for that is traumas like car crashes and gunshots (so obviously they need as much of the O-negative as possible too). Unless they’re a negative blood type, all the anemics, the scheduled surgeries, and childbirth where the person can be typed and crossmatched in advance, they can often use the O+. Using the O+ for scheduled infusions means they can save that rarer O- (that might otherwise get used if no other match was available) for the emergencies where they need it most!