AITA? A thread for when you just need to know

[Apollyon]

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I think it's because we get to be part of a Reddit-like discussion, without actually going to Reddit!

 

[Janders]

Rule 8-
Things on the break room table are open season; things inside the fridge are off limits unless you’ve been told to eat them.

Clearly the move would have been to walk out to the nursing station, declare you’ve found an abandoned pie, and ask who wants a slice. That would have given you maximum protection against retribution.

 

[HoosierdaddyO]

Rule 8-
Things on the break room table are open season; things inside the fridge are off limits unless you’ve been told to eat them.

Clearly the move would have been to walk out to the nursing station, declare you’ve found an abandoned pie, and ask who wants a slice. That would have given you maximum protection against retribution.

Well, I normally would absolutely agree with your Rule number eight, but I feel like food that has been in the fridge since the day of a potluck is also equal equally fair game three days later lol.

Oh well, it was rather delicious of a pie lol.

 

[RustedFox]

Rule 8-
Things on the break room table are open season; things inside the fridge are off limits unless you’ve been told to eat them.

Clearly the move would have been to walk out to the nursing station, declare you’ve found an abandoned pie, and ask who wants a slice. That would have given you maximum protection against retribution.

Are there other rules?
Like, what are rules 1 thru 7?

 

[BoardingDoc]

Rule 8-
Things on the break room table are open season; things inside the fridge are off limits unless you’ve been told to eat them.

Clearly the move would have been to walk out to the nursing station, declare you’ve found an abandoned pie, and ask who wants a slice. That would have given you maximum protection against retribution.

Ahh yes, the load the boat strategy.

 

[HoosierdaddyO]

I guess this could be fun for rules 1 to 7 in the social constructs of the ER… I start 🙂

Rule 1: as the Attending, when I’m in the room taking a history… unless it’s an emergency, you as the nurse are not to be asking questions or taking a history as well. Bc if so, I will be sure to stagger orders for the rest of my shift… no cares given 🙂.

 

[DocEspana]

Ok hijacking the thread briefly lol…
AITA:

Last week there was a full potluck, nurses doctors techs everyone. I worked the evening shift and at the end of my shift at night I saw a leftover untouched, untagged apple pie sitting in the back of the fridge.

I come in the next day for my shift and still the apple pie is sitting there untouched, untagged… sorta just staring at me but I let it go because I didn’t want to be that guy.

Come in the following day and the apple pie is still sitting there… at this point I’m like who the heck leaves an apple pie in the break room fridge for 3 days after a potluck so I help myself to a healthy serving lol.

Come to find out it was left over from the potluck for a specific nurse. Obviously I feel bad but AITA for eating a left over pie that’s been in the fridge for 3 days after a potluck? Please don’t hold back lol??

You did god's work. It would have been spoiled by day 4.

 

[DocEspana]

I guess this could be fun for rules 1 to 7 in the social constructs of the ER… I start 🙂

Rule 1: as the Attending, when I’m in the room taking a history… unless it’s an emergency, you as the nurse are not to be asking questions or taking a history as well. Bc if so, I will be sure to stagger orders for the rest of my shift… no cares given 🙂.

Rule 2: There are always 3 'good' chairs in any department. The physician gets one. The unit secretary gets one. The third one is an open competition (with trickery and thievery allowed) between the charge nurse and any MD 2 if there is double coverage. Anyone else found to be using a 'good' chair must give it up immediately once they are identified as being on it.

If one of these three people wishes to use that one random stool that no one else wants and we normally reserve for the med student who 'wants to do derm', they can CHOOSE who gets the good chair.

 

[Janders]

Historically I have many numbered rules.
But only rule 1 and rule 2 keep their numbers. All other numbers are maleable , etherial and ever changing. Like Calvinball.

Rule 1 is “do what is right for the patient” which grants you permission to break all other rules (nuance here… consider your options)

Rule 2 is “don’t poke your friends with sharps” which is literally about not leaving your dirty needles in the room, but also mostly about having each other’s backs. Team sport and such.

Most of the house of god rules fit my cosmology, but I usually don’t remember the numbers from the book. The often quoted ones are “The patient is the one with the disease.” And “They can always hurt you more” and “If you don't take a temperature, you can't find a fever.”

In a character defining paradox, I do remember rule 13, which is “The delivery of good medical care is to do as much nothing as possible”. This one is important.

As BoardingDoc notes, “load the boat” is also a key rule (really more strategic philosophy). When you realize you are going into treacherous waters do not go alone. Load the boat.

 

[NITRAS]

Rule 2: There are always 3 'good' chairs in any department. The physician gets one. The unit secretary gets one. The third one is an open competition (with trickery and thievery allowed) between the charge nurse and any MD 2 if there is double coverage. Anyone else found to be using a 'good' chair must give it up immediately once they are identified as being on it.

If one of these three people wishes to use that one random stool that no one else wants and we normally reserve for the med student who 'wants to do derm', they can CHOOSE who gets the good chair.

About spit my coffee. Thank you!

 

[xaelia]

Rule #3: No running in the ED unless I tell you to run.

 

[bky3c]

Historically I have many numbered rules.
But only rule 1 and rule 2 keep their numbers. All other numbers are maleable , etherial and ever changing. Like Calvinball.

Nice Calvin & Hobbes reference. Good way to start my day.

 

[RustedFox]

Rule #0:

The number one cause of burnout is the patient .

 

[valianteffort]

Posting an AITA on behalf of an active member of the thread whom regularly posts but wishes not to be named.

On the regular I see quite a few older people in my ER that will absolutely refuse to give urine and decline a catheter. I work in a shop where we do not hand off patients and we usually finish up our own stuff before leaving. Recently I have started giving patients that are here 2 hours, with iv fluids running, refusing a catheter and pending a UA a small sprinkle of lasix. Not much, I’m talking 5mg to at most 10mg. Has always works like a charm within 20 mins or less without a reaction. Admin is happy with my times. I’m getting out on time. Patients urinating for a few hours at home in the comfort of their bathroom and dropping a pound or two. AITA for giving lasix?

 

[Apollyon]

As long as they don't have a sulfa allergy, you're good!

 

[dpmd]

Posting an AITA on behalf of an active member of the thread whom regularly posts but wishes not to be named.

On the regular I see quite a few older people in my ER that will absolutely refuse to give urine and decline a catheter. I work in a shop where we do not hand off patients and we usually finish up our own stuff before leaving. Recently I have started giving patients that are here 2 hours, with iv fluids running, refusing a catheter and pending a UA a small sprinkle of lasix. Not much, I’m talking 5mg to at most 10mg. Has always works like a charm within 20 mins or less without a reaction. Admin is happy with my times. I’m getting out on time. Patients urinating for a few hours at home in the comfort of their bathroom and dropping a pound or two. AITA for giving lasix?

I like it better than slamming in way more IVF than they could possibly need to make them pee. Barring allergies or other contraindications to Lasix I don't see a problem. But I am gen surg so achieving desired results via intervention is what I am all about.

 

[thegenius]

Posting an AITA on behalf of an active member of the thread whom regularly posts but wishes not to be named.

On the regular I see quite a few older people in my ER that will absolutely refuse to give urine and decline a catheter. I work in a shop where we do not hand off patients and we usually finish up our own stuff before leaving. Recently I have started giving patients that are here 2 hours, with iv fluids running, refusing a catheter and pending a UA a small sprinkle of lasix. Not much, I’m talking 5mg to at most 10mg. Has always works like a charm within 20 mins or less without a reaction. Admin is happy with my times. I’m getting out on time. Patients urinating for a few hours at home in the comfort of their bathroom and dropping a pound or two. AITA for giving lasix?

I like it, and I have wanted to do this many times. Never have though.

Reminds me of an episode from "Untold Stories of the ER".
A prisoner came in, yet again, for putting a paperclip in his urethra.
The Pecker Docs knew him well and have pulled a variety of objects from his urethra in the past.
The current UroHero oncall did not want come in, yet again. So he said "As long as he can urinate, it's an outpatient procedure."

Prisoner refused to pee.

So the ER doc gave 1L NS and 40 lasix IV! Guy pissed like crazy and was discharged.

 

[emergentmd]

Foley out = path of least resistance after telling pt his chance of returning is high. No different than someone wanting to leave AMA.
Food in fridge, label or not, I do not touch. I didn't bring it, I don't take it.
If someone leaves $10 on the counter and it has been there 3 dys, it is not mine. I don't touch, I don't take.
I will never understand why someone would take food from the fridge unless it is explicitly labeled as fair game. Even then, I don't eat.

 

[DocEspana]

As long as they don't have a sulfa allergy, you're good!

I've always been told thats essentially an issue of our limited vocabulary and not a 'real thing.' We refer to the allergies to sulfonamide antibiotics as sulfa allergies and then notice that furosemide also has a 'sulfa' (sulfonamide moiety).... but its not the SNO2 itself that is causing the allergy, but rather a larger "portion" containing the sulfonamide that is common in the sulfonamide antibiotics but not in the sulfonamide loop/thiazide diuretics. But because we don't have a word for that larger sulfonamide-containing commonality, we think that its just the sulfonamide element and overgeneralize allergic crossreactivities.

 

[DocEspana]

Posting an AITA on behalf of an active member of the thread whom regularly posts but wishes not to be named.

On the regular I see quite a few older people in my ER that will absolutely refuse to give urine and decline a catheter. I work in a shop where we do not hand off patients and we usually finish up our own stuff before leaving. Recently I have started giving patients that are here 2 hours, with iv fluids running, refusing a catheter and pending a UA a small sprinkle of lasix. Not much, I’m talking 5mg to at most 10mg. Has always works like a charm within 20 mins or less without a reaction. Admin is happy with my times. I’m getting out on time. Patients urinating for a few hours at home in the comfort of their bathroom and dropping a pound or two. AITA for giving lasix?

Oh I like this. I like this a lot. I use a lot of (not so) subtle psychology to get the pee. I come off as a very sweet and charming kid. I can't help it, I look super young and get that "aww its doogie howser" response still even 10+ years into this. So I lean into it hard for customer satisfaction. Get them to fall in love with the sweet little guy who looks like their kid nephew and "please" and "pretty please" everything at first.

The second I actually *need* something though, there is no please. There is no polite. They get to watch, in front of their eyes, the switch flip and I tell them that I simply cannot compromise. We are doing this and we are doing this now. The sing song is gone from the voice, the smile is flat, the eyebrows are slightly down, the phrasing is terse. "lets go" "get up" "I'm going to do it with you. I'll hold this urinal and you're going to go right now. come. lets go." "no it can't wait. We need this now and its been plenty of time. I need to know whats wrong with you now." The stretcher goes to 90 degrees bolt upright sitting. My hand is in their axilla getting them to their feet within seconds of telling them its happening now.

I truly think, and the nurses have told me as much as well, that its not so much the firm and terse approach itself. Its that I go from sweet kid to demanding suddenly and it reads like they disappointed me and patients have told nurses they feel bad they disappointed me after I have to do stuff like that. Haven't heard complaints about it (at least not in this type of case. I may use it in other situations where occasionally it has caused friction)

I might have to switch to a sprinkle of lasix though. Because I cant play this game forever. I'm getting grays that the patients are going to be able to see soon.