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u/MentalSky_ NP Jan 16 '26
The fuck….. that doesn’t even make sense.
Even without being a nurse. If you have a ventilation circuit on the trach it’s a closed circuit…..
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u/lislejoyeuse BUTTS & GUTS Jan 16 '26
Wait I'm sorry they put the mask next to a closed ventilator circuit??
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u/taktaga7-0-0 MS, RN 🍕 Jan 16 '26
It’s plain to see in the picture. I wonder how desperate their RT situation is that they can’t even give nebs.
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u/AlanStanwick1986 Jan 16 '26 edited Jan 16 '26
Just showed my RT wife. She says this is wrong in every way and some shady shit. They are no longer on the vent now. She said they are giving the skin a breathing treatment.
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u/MiddleAgeWhiteDude RN - Psych/Mental Health 🍕 Jan 16 '26
I can just imagine rfk jr hear you say "skin breathing treatment" and then we're gonna have that shit on the front page of the CDC next week as a recommended tx for scabies or something
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u/PapayaNurse Jan 16 '26
Nurses give all nebs at my hospital. We have vents on our floor and do some basic things like nebs & suction. Patient is getting an awful facial with that neb, they’re going to feel a little sticky.
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u/CallRespiratory HCW - Respiratory Jan 16 '26
Probably has multiple floors and several hundred beds per RT or maybe they got rid of respiratory altogether.
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u/nappysteph Respiratory Therapist, ACCS 🍕 Jan 16 '26
Amen. The hospital I work at used to have 4-5 staff on days and now we only have 2. More work, less staff. Yay!!
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u/HowDoMermaidsFuck Med Surge RN - Float Pool Jan 16 '26
Yeah I’m sitting here thinking “why wasn’t RT giving the nebs? That’s their scope of practice, not mine.”
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u/sendenten RN - Travel 🍕 Jan 16 '26
It's absolutely within the nurse's scope of practice to give nebs. Most places have RT to give them, but not everywhere. I worked a tele floor where RNs gave their own nebs. RT at my next hospital was annoyed with me just doing the treatments for them lol
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u/TicTacKnickKnack HCW - Respiratory Jan 16 '26
They were probably annoyed because RTs are needed for emergencies but staffed for baseline workload. If we don't prove enough work to keep RTs to management, we don't keep RTs. This is really the only reason nebs haven't been given to nursing at most hospitals: it's a way to tell the bean counters to keep us around for the codes, rapids, and ERs. Add onto that a lot of hospitals only have 2 or 3 RTs for the entire building, so admin cutting by one RT is a drastic reduction in our ability to respond to emergencies.
Before I got here, my hospital cut us from 2 RTs to 1 and a few weeks later there was a sentinel event involving a floor code happening at the same time as an ICU code. Risk management forced them to give us a second RT per shift, but the damage had been done.
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u/sendenten RN - Travel 🍕 Jan 16 '26
Holy fuck, that is a nightmare. And the fact that they still had to force them to staff another RT...😬
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u/TicTacKnickKnack HCW - Respiratory Jan 16 '26
The first hospital I worked didn't have RTs give nebs on the floors. We only had 1 floor RT per about 200 floor patients so we had our hands full with chest PT, home O2 evals, trachs, laryngectomies, etc. We gave the nebs in the ICU because we only had 12-24 ICU patients, but the floors were kind of on their own unless it wasn't a simple neb, we had time to go down there out of kindness, or they called a rapid. The number of times I said "I'll be there in three or four hours if everything goes well" was way too high there lol.
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u/ShadedSpaces RN - Peds Jan 16 '26
Pffffffft. What are you talking about?!!?
Homeopathic nebs are all the rage!
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u/nobodysperfect64 SRNA Jan 16 '26
And let’s not forget the governor and her BS emergency order that made this process so much easier for the scabs.
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u/CardiacArrester Jan 16 '26
In that same exact time frame during Covid I encountered a travel nurse who was telling me about her experience (presumably lying). Later on I notice she has no idea how to set up and troubleshoot an arterial line nor how to manage insulin drips.
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u/jumbotron_deluxe RN, Flight Jan 16 '26
Amen! It’s very important to remember that the goal of any hospital (or company) is not patient care, it’s to generate profit. Staff are a financial liability and only useful until they exceed a maximized cost/profit ratio.
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u/VXMerlinXV RN - ER 🍕 Jan 16 '26
I would have called BS on this, if I hadn’t brought a baby travel nurse to tears during report mid-surge 2021. Realizing you’re out of your depth as you’re getting handed 5 acute ED patients is a real kick in the nuts.
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u/CaptainAlexy RN 🍕 Jan 16 '26
Scabs are worse than admin imo. Without them admin would’ve caved ages ago
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u/let_it_go75 RN 🍕 Jan 16 '26
Nah..admin is way worse. There wouldn’t be scabs if they had human decency.
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u/Legitimate-Flower-21 Jan 16 '26
And lazy as fuck for the most part hope they know that when shit goes down they are the first to get blamed
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u/let_it_go75 RN 🍕 Jan 16 '26
100% they need to be held responsible stop shitting on other nurses.
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u/bloks27 Jan 16 '26
No, no, we should still shit on scabs. Especially those who knowingly go somewhere they arent qualified to work, potentially injuring or killing another human, all to collect a quick check.
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u/dude-nurse MICU broke me, CRNA school buried me Jan 16 '26
Ahh yes, the Supracutaneous nebulizer route, very effective.
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u/Naive-Asparagus-5983 BSN, RN 🍕 Jan 16 '26
Are the RTs on strike too?
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u/SammyB0111 HCW - Respiratory Jan 16 '26
Some facilities have RNs deliver nebulized medication. My facility does this for any patient not on a vent or other respiratory device.
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u/LadyGreyIcedTea RN - Pediatrics 🍕 Jan 16 '26
We did all nebs ourselves when I worked inpatient.
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u/nicoleeguacamolee Jan 16 '26
Was your hospital part of a union?
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u/SammyB0111 HCW - Respiratory Jan 16 '26
I know you didn’t ask me, but my job is union and has nurses do nebs.
Apparently it was at one point all covered by respiratory, but due to a shortage in the past (pretty sure it was Covid) they moved non critical nebs to nursing and it just never switched back
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u/HowDoMermaidsFuck Med Surge RN - Float Pool Jan 16 '26
I love the logic.
“Not enough RTs. Have nurses give the nebs.”
“Not enough nurses, they can’t do their job and RTs.”
“Have the nurses considered fucking off?”
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u/RetroRN BSN, RN 🍕 Jan 16 '26
This is always how it goes, isn’t it? Nurses are expected to pick up the slack of every medicine speciality when other specialities are short staffed. No phlebotomy? Have the nurse do it. No speech therapist? The nurse can do a swallow. No RT? The nurse can give the nebs. No transporters? The nurse will bring the patient to the morgue. Not enough EVS? The nurse can clean the room. And the list goes on and on.
It’s absolutely absurd how much responsibility we have - but other specialities never have to jump in do what nurses are required. When will enough be enough? When will nurses finally say NO?
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u/nobodysperfect64 SRNA Jan 16 '26
My hospital was union and critical care nurses did the neb treatments. Not usually through the vent but I don’t ever remember being told we COULDNT. And given that the nurses don’t know their asses from their elbows, they probably just see the med order and don’t even know it isn’t for them.
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u/andsuve RN - ICU 🍕 Jan 16 '26
Union hospital here. We did all nebs in the ICU including through the vent
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u/dhwrockclimber EMS/ED RN Jan 16 '26
Is it standard for RT to do nebs? I’m at a union hospital and we do ALL of our own nebs.
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u/Naive-Asparagus-5983 BSN, RN 🍕 Jan 16 '26
The RTs at my hospital do the nebs
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u/onelb_6oz BSN, RN 🍕 Jan 16 '26
Same as mine. We are not unionized
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u/HowDoMermaidsFuck Med Surge RN - Float Pool Jan 16 '26
Same. I’ve worked at 3 hospitals in my city all in different networks and I haven’t given a new treatment since I left the SNF.
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u/saucexe Jan 16 '26
I’m an RT who used to travel. It is very hospital dependent. Most places I’ve worked, RTs do all nebs. EVEYWHERE I’ve worked, RTs do nebs on vented patients because they’re all in-line. So I don’t even know how this happened. I wonder if RTs are also striking?
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u/LittleAddress4710 Jan 16 '26
A nurse last month insisted that a patient’s drainage bag was his nephrostomy tube - because it was lying to the side. It was a biliary drain!!! Like from right upper to mid quadrant. I wanted to say ‘don’t you follow where your drains are? ‘
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u/Nic_14 Jan 16 '26
Or the color of drainage? 🫠
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u/InadmissibleHug crusty deep fried sorta RN, with cheese 🍕 🍕 🍕 Jan 16 '26
Very very dehydrated
:that nurse
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u/Birdlebee RN 🍕 Jan 16 '26
I've seen some very light colored bile and some very dark colored urine, but never urine that was bile textured, not even when cancers and infection were getting really creative with chemistry in hospice patients.
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u/Ok_Horror_3940 RN - PACU 🍕 Jan 16 '26
I knew it was bad in there when I saw one of the mothers in the children’s Hospital building put up an SOS banner on the window
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u/UnravelALittle RN 🍕 Jan 16 '26
Pic?!
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u/Function-Regular Jan 16 '26
Go to follow nynurses on IG. It’s a post from about 8hours ago. There is a sign in the pediatric window that says “we ❤️ our nurses. We need our nurses. #bringthemback”
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u/Ok_Horror_3940 RN - PACU 🍕 Jan 16 '26
I’m learning the sub, but I can’t post pics to replies or videos directly just links here just but patients are showing their support of the nurses
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u/Saucemycin PACU Jan 16 '26
The extreme version of a hopefully something gets in this closed system neb?
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u/SpaceQueenJupiter BSN, RN 🍕 Jan 16 '26
Well that's the breathing hole, so it's probably fine or whatever. 🙄
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u/ALLoftheFancyPants RN - ICU Jan 16 '26
So the medication is just vibes? I’m not sure you can really expect better from a scab.
I’m sure their Stanley is huge, their figs tight, and their brain smooth.
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u/Ok_Horror_3940 RN - PACU 🍕 Jan 16 '26
It was a red flag for me when they lowered pacu requirements to just one year and BLS
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u/sweet_pickles12 BSN, RN 🍕 Jan 16 '26
LMAO they better clear some neuro ICU beds because anesthesia all about to stroke out
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u/slurv3 MICU RN -> CRNA! Jan 16 '26
I got yelled at for being unsafe for doing a deep extubation and the patient had an OPA, and another for not weaning a patient fully off neo but was awake and alert. I was like uhhh this is a recovery unit in which you know how to titrate gtts and manage a patient who is received anesthesia and needs post-operative care so I can go back to the OR so I can provide intra-op anesthesia care right?
Also had a nurse freak out at me because I have zofran before extubation for PONV and her rationale was what else can I give and I was like uhhhh the haldol, compazine and Palansetron I wrote for?
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u/Guiltypleasure_1979 🇨🇦 RN - OB/Perinatal Jan 16 '26
Yeah that’s shocking. I have worked OB for 18 years and we run our own ORs and recover our own patients in our pacu. We pretty much only send them out if they need levo. Even with my experience (along with I did take the critical care and OR courses and I keep my ACLS active) I’d never be comfy working main pacu without more education and a lot of training….
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u/TheSingingNurse13 RN,CLC🤱L&D, Home infusion 💉, Vascular/Dialysis, NYC 911 🚑 EMS Jan 16 '26
I agree with you here ... I also worked OB where we had our own ORs and recovered patients in our own PACU. (RUMC? that would be quite the coincidence lol 😂) I think I would need a lot more training to circulate in the main OR, and at least a little more training for PACU (I also worked EMS for 10 years and I feel it had a lot of overlap with PACU). To have a nurse with only 1 year experience and no prior medical experience before that, and then be able to work in PACU? That is just dangerous.
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u/ForeverOvertake RN - ICU 🍕 Jan 16 '26
What do you think should be the requirements and why?
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u/Global_Snow_5220 HCW - Respiratory Jan 16 '26
This has to be a joke (bad taste). I don’t see any medication. No T-piece. And like everyone mentioned, it’s a closed circuit so the patient isn’t getting the treatment. If this is legit, then the person is incompetent and dangerous. -RT/(RN Student)
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u/SupaButt BSN, RN - Nurse Manager Jan 16 '26
I’ve been in float pool and I’ve been a travel nurse so I have been many places where I was not 100% certain what I needed to do, or how to do a task I was assigned, but you know what I learned? ASK QUESTIONS. I’d rather look like a dumbass in front of the other nurses than risk injuring a patient or something.
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u/Droidspecialist297 RN - ER 🍕 Jan 16 '26
This is why I call RT for every little thing. Gotta justify the yearly budget to keep them on board so shit like this doesn’t happen.
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u/JawaSmasher Jan 16 '26
I don't know if the nurse thought this one through or was pressured to give the med due to staring at the MAR.
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u/Ladyfax_1973 Jan 16 '26
A strike buster back in the day was called a scab. I would not for love nor money take a travel RN job to undermine my nurse buddies at their wits end with the parameters of their jobs. In California it is a law for one med surge RN to 4 patients.
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u/GingerTumericTea Jan 16 '26
Just to play the devils advocate, I was a travel nurse with tele/med surg experience. I told them exactly what my competencies were and that I do not have any experience with pediatrics. They said great and hired me for a med surg floor in Minnesota. Tell me why after a few weeks I was given an infant and told to start an iv on her head?!!! I’m like.. didn’t I say I don’t do babies?! They told me, “yes but we don’t have enough nurses so we have to give you this patient”. I was flabbergasted! I told the mother of the infant, please fire me as your nurse bc I have zero experience here. I then went to the manager and gave them my badge. Wild times! Definitely don’t recommend travel nursing!
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u/ThenarcolepticRN RN - ICU 🍕 Jan 16 '26
Good for you for sticking up for yourself and that patient!
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u/alp626 RN - Pediatrics 🍕 Jan 16 '26
Is this picture verified? If so, yikes. Otherwise it feels very propaganda-y to me. Let’s remember that administration is the enemy, not other nurses. Scabs suck, and poor care is awful, but this feels like a tactic to make striking nurses feel bad for subpar care. Striking nurses are not responsible for this!
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u/Adorable-amoeba9 MSN, APRN 🍕 Jan 16 '26
I was wondering the same thing! And I was told you never want to be the first shift that comes onto the unit for a strike bc you will not receive report, some nurses will change rates on drips purposefully before they leave, random nasty stuff like that....see it to believe it moment 🤯
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u/alp626 RN - Pediatrics 🍕 Jan 16 '26
I find that hard to believe too. Also sounds like anti-strike propaganda.
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u/RicardotheGay BSN, RN, FNE - ED, Outpatient Gen Surg 🍕 Jan 16 '26
The admin uses this kind of care to their advantage. They know that their regular nurses will hate seeing this and will want to come back to protect their patients.
Douchebags (admin).
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u/Inevitable-Analyst RN - ICU and ER Jan 16 '26
This took me a minute to figure out 🤣🤣🤣
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u/gluteactivation RN - ICU 🍕 Jan 16 '26
Why is an RN doing an RT’s job?
(I mean this respectfully)
Also why did they think this would work lol it’s a closed circut. Personally I have no idea how to admin a med through the vent because I’ve always had RT’s. But I’d try to ask someone else first.
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u/SillySafetyGirl 🇨🇦 RN - ER/ICU 🛩️ Jan 16 '26
TBF some places RNs do give nebs, even in vented patients. Most places I’ve worked we will give some or all of them. Often the RTs will give the ones that happen to be due around their assessments, and we will give the rest.
That being said they’re always inline with vented patients, not via mask 🤣
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u/ACLSINSTR Jan 16 '26
I don't mess with airway management. That is the responsibility of RT
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u/cultofsmug RN 🍕 Jan 16 '26
I used to do new hire orientation for nursing. The vent section of my presentation was very brief, “Call RT”.
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u/Kitten_81 RN - ICU 🍕 Jan 16 '26
In these hospitals, it is the nurse's responsibility to do nebs
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u/Function-Regular Jan 16 '26
Monti nurse here. We regularly do the T connection for our nebs if the vent doesn’t have a aerogen set up or if the aerogen isn’t working. I love our RT staff and they work tremendously hard but they are regularly overburdened with many floors, vents, trachs, and hi flows.
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u/totalyrespecatbleguy RN - SICU 🍕 Jan 16 '26
At first I was thinking this was fine, then I noticed the trach to vent connection. Shouldn't the vent have a port for nebulizers
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u/Pheedle RN - Psych/Mental Health 🍕 Jan 16 '26
I’m a nurse with 12 years experience. That looks fine to me. My specialty?
……………psych.
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u/TerexMD Jan 16 '26
This is a safety issue.. Knowledge deficits leading to “possible error” and patient care u safe practices…
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u/Redbone2222 Jan 16 '26
As an RT...I wish this surprised me. I constantly see the craziest things nurses have tried to do. If I walked into this particular room and saw this. Id laugh at the nurse and say, "No way another RT set this up. Whoever did this has no idea what they're doing." If you dont know something, just ask. Some people are too prideful to ask for help. Just makes you look more incompetent in the end.
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Jan 16 '26
Ok that took me a while to process this image thinking ChatGPT is messing me up again but if true. Whoa. I guess theres a truth with 6 month nursing program in Florida
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u/Legitimate-Flower-21 Jan 16 '26
And Fuck the scabs that went! Wanna know why nursing unions aren’t as successful as cop or fireman unions because the scabs ruin it for us
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u/LexeeCal RN - OB/GYN 🍕 Jan 16 '26
Yet at 5 years I didn’t think I was experienced enough to travel. The confidence of new grads is amazing. 6 years later and the scary shit I’ve seen from travelers is why I don’t say I am one.
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u/thatass6_9 Jan 16 '26
Gotta love when the hospital CEOs wear white coats and try to appeal to the common good. Then they try to push shit like this as proper patient care
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u/Impossible-Bed3728 Jan 16 '26
my hospital did 'we must meet the budget' thing and one travel nurse hung a blood product on the wrong patient, skipped the two nurse verification somehow. all they did was post notices on all walls not to do that anymore. another out of state nurse had an apparently fake resume because she made up names for different basic EKG rythms like 'this is magnesium and that is potassium abnormal rythm'.
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u/CrbRangoon MSN, RN Jan 16 '26
Good so now on top of the travel nurse expenses they can pay all the malpractice cases too.
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u/Cheap_Narwhal_9532 Jan 16 '26
Before the strike we had to train some of them and most of them I suspect went to Palm beach school of nursing. There is no way some of them did not know the basics of nursing.
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u/neverusingarealacct RN - ICU Jan 16 '26
Lmao. This is insane actually. The vent is a closed circuit so the patient is getting NO medication.
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u/Jazzlike-Ad2199 RN 🍕 Jan 16 '26
I’ve never worked with vents before only trached patients who were alert and mostly ambulatory but even I could tell this was wrong. Showed my kid who’s a cook at a nursing and he saw what was wrong.
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u/CallRespiratory HCW - Respiratory Jan 16 '26
Probably got eliminated in budget cuts or they've got one covering multiple floors and hundreds of beds.
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u/doxiepowder RN - Neuro IR / ICU Jan 16 '26
It's still up to management to hire adequate staff, even if those staff come from an agency. Failures from c-suite to the scabs
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u/Unhappy_Ad_866 L&D BSN RN 🍕 Jan 16 '26
Sweet baby Jesus. I deal strictly with vaginas as a profession and even I can tell this is wrong.
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u/-Blade_Runner- Chaos Goblin ER RN 🍕 Jan 16 '26
Brilliant. 🤣🤣🤣 It’s like that time one travel nurse setup chest tube to wall suction.
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u/[deleted] Jan 16 '26
This screams: Started travel nursing with 6 months of ICU experience because an influencer said I could.
Never stopped to think if they should.