swoon ganz
@swoonganz
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a person, doing a job, living in a place
Joined January 2023
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About a year ago I came across a TT video of a woman around my age who developed a tongue sore that kept growing. Her doctors attributed it to her Crohn's disease. In the span of 6 weeks, it continued to grow along the entire side of her tongue.
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I've been following her journey and today I saw an update from her family. She has been enrolled in inpatient hospice. She has a husband and 3 young children (the youngest is around 1 year old). My heart absolutely breaks for her and her family.
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By the time she got a diagnosis, her cancer (squamous cell carcinoma) was already stage IV. She filmed herself throughout her recovery from extensive surgery (removal of half her tongue, flap creation, lymph node excision, tracheostomy, feeding tube).
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In one of her videos she talks about how she didn't even know what kind of doctor to try to see. The appointment they offered her was months in the future so she pleaded with an ENT to do a biopsy of her tongue.
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The cancer kept coming back despite aggressive radiation, chemotherapy. It spread to her lungs and she required surgery to stent her airway and very briefly required ECMO. Still, it continued to spread. She had been in the process of enrolling in a clinical trial.
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If you regularly see a dentist, they should be inspecting your tongue and palpating it during your visit. It's also not a bad idea to do this at home from time to time. Her cancer grew at an extremely rapid pace.
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*slaps side of boat*
This baby can hold so much norovirus
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As a HCW it is your duty to inform your patient that they’re welcome to the supplies in their room as well as whatever else they want before discharge. Wound care supplies? Here’s a bag. You want another pair of mesh underwear? Here’s 5. If you can carry it, you can have it.
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Her TikTok account is here:
She also has a GFM:
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A woman on TT made a video asking people who tested positive for group b strep during pregnancy whether or not they declined antibiotics because she’s getting her swab and wants input so she can make an “informed decision” and now I will never know peace.
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The way doctors will just leave ultrasound gel on a patient’s chest and walk out of the room is disturbing.
PLEASE leave a patient how you found them or even better. If you unsnapped their gown, took off a dressing, muted their TV, turned their lights on brighter…undo, fix, redo, make right all of that before you leave the room.
Not only for patient safety but their dignity as well!
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A few people are asking about mouth sores and Crohn’s. It is a known occurrence. Doesn’t change the fact that her concerns were dismissed, but it’s not entirely out of left field. This is from UpToDate:
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And if you come here to spread misinformation about HPV vaccines specifically or ask if Rachel was vaccinated against COVID, you will be blocked and your comment will be hidden if I see it. Do not use Rachel's story to spread dangerous lies.
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Behind every “heart warming” story, is a systemic failure in this country.
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As
@kiswanson
has pointed out, a large majority of oropharyngeal cancers are linked to HPV infection. The HPV vaccine is now approved up to 45 years of age.
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@RNingScissors
I can't even imagine. I've taken care of a lot of head and neck cancer patients post-op and even just the drastic changes to your appearance (nevermind the life threatening cancer) would shake anyone.
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One dose of penicillin vs. septic baby. Tough choice for some people it seems.
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I will give you as much as I reasonably can without arousing suspicion. And if you see me pouring rolls of kerlix into a patient belongings bag, no you don’t.
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Routine heart surgery doesn’t exist. Source: former CVICU RN.
Fitness influencer Joey Swoll revealed that his routine heart surgery turned into a six-hour ordeal, a situation which his doctors had 'never' seen before
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@RNewstat
She knew. They were pretty upfront about her 5 year survival rate. She knew it wasn’t curable and that the treatments were palliative at that point.
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If you come to visit a patient in the ICU (or any unit) and they are very delirious and restless, a few things
Helpful: be a calming presence, hold their hand, tell them they are safe, tell them who you are
Unhelpful: repeatedly ask them if they know who you are/remember you
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Quaking in my clogs at the idea of trying to get a 6’8” NBA player out of bed for the first time after transplant as a 5’2” person.
Not even 12 hours post heart transplant and he is standing! We are all amazed at his progress! Keep it going! ❤️🩹🙏🏼💪🏼
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Nothing would make me happier than to save the patient some money and this is one of the few ways I can do it.
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Don’t tell cardiologists, but I think we do a huge disservice to patients by putting them on a fluid restriction (while admitted) that they won’t follow at home and optimizing their home medications to an unrealistic scenario.
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I just learned that in the UK it’s GORD not GERD because their spelling of esophageal is so dramatic (oesophageal).
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Today I learned that I am not allowed to send medical leeches via the hospital's pneumatic tube system.
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If it’s not attached to the floor, ceiling, or wall and you can lift it unassisted it’s yours. Plus whatever you can carry in a bag.
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Hell I’ll even get you an extra pair of hospital pants if you are low on clothes.
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1. That’s a person. A person whose gown you left undone with cold goo on their skin.
2. I’m not your maid.
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The Board of Nursing should be paying /me/ to renew my license, not the other way around.
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Every time nursing merch with scraggly EKG tracings are purchased, a patient dies of polymorphic VT. Do your part. Just say no.
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When my pal was sick with COVID, I had access to an incentive spirometer for them. Like I said, I gotchu.
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I cannot express just how fulfilled I feel helping to discharge a NICU baby home. Never once have I discharged anyone who had any quality of left. Switching specialties has renewed my excitement for this profession. Making the choice was terrifying, but I feel free.
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When a cardiac arrest patient gets cooled and wakes up neuro intact >>>>>>
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It’s funny because nursing school teaches nurses how to ask for tests/medications in a way where physicians think it’s their idea.
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Ah yes, my annual training refresher that reminds me that medical leeches cannot be sent through our tube system.
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To all the nurses considering quitting:
@caseydanielee
You need to work at least one more week so we can all see what unhinged gift your employer gets you for nurses week.
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A Mormon nurse on TikTok posted a video budgeting her paycheck and mentioned she gives 10% of all her income to the church. Then made a separate video repeating over and over again how this money definitely doesn’t go to the church leaders. Oh honey.
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For when you work night shift as a nurse and then go straight to your second job as a UPS delivery driver.
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I wonder how much ICU delirium we could prevent if we didn't abruptly precipitate psych med withdrawal in critically ill patients.
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Codes on every single unit (ICU and ED included) should have debriefs. People shouldn’t be put in a position where they have to ask for this.
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I became a nurse when you used the same N-95 for days/weeks and stored it in a paper bag with your name on it.
I am ‘I became a nurse when beds had to be cranked to raise them’ years old
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It’s really sad to see how early the anti-APP indoctrination begins (medical school). A PGY-0 is already opining on how the entire NP profession shouldn’t exist.
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If you work at a hospital that scans flushes as meds (outside the NICU), I’m sorry.
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At my hospital it is ENT that is notorious for leaving dirty instruments, sharps, and a disheveled patient after bedside procedures.
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Working in the NICU has unfortunately given me a front row seat to this particular circle of hell.
the best part about being in a ton of 2023 pregnancy/baby groups is getting to see all the absolutely wretched names parents are coming up with these days. here are some highlights i’ve collected
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Just spent 12 hours taking care of critically ill infants and came back to this having gone viral. Surprisingly few trolls (for which I’m thankful). Vaccines work. Take the antibiotic. Take the vitamin K.
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Out of all the ones I’ve worked with, I can tell you who it isn’t: neurology
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If you like the look of a tucked in shirt, you can just,,,tuck the shirt in?
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When I said I wanted to wear overalls to work, this is not at all what I had in mind. This is a crime.
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I would still give them out by the fistful without scanning lmaooo
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The scream I scrumpt.
Never ever use an NS flush for IV medication dilution of any kind. It is not approved for this use. It is not harmless and it needs to be taken seriously.
fellas is it a good idea to dilute IV pain meds with saline in a medicine cup & drawing it back up in the same flush & then administering to the patient.
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Just reflecting on the last 5 weeks at this job and how proud I am of my growth. 5 weeks ago I had never changed a diaper or bottle fed a baby. And now I'm caring for babies on ventilators and CPAP, doing solid assessments and supporting parents/families.
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Have you ever had a code brown so bad that you just throw the sheets straight into the biohazard bag instead of into the dirty linen bin?
"I just lived through a nightmare so horrific that I must protect EVS from it".
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Reminiscing about the time I took ACLS with an anesthesiologist who didn’t know the difference between defibrillation and cardioversion. Recall feeling deeply concerned.
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Had a shift where my cardiac surgery patient was about to be extubated. I called the provider to ask if he wanted to be bedside for it. He said yes. I went to go get set up. He arrived and held the patient’s hand the whole time. He could have said no, but he chose to be there.
I received feedback that holding the patient’s hand as they are put under is not in my job description as a medical student intending to apply to surgery and I gotta say, the idea of that being a negative thing about me really sums up a lot of what’s wrong here
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ICU nurses looking at their patient’s lines after they’re dropped off by OR staff post-op.
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When I was on orientation, I took care of a patient who ended up in the ICU after some serious complications from what was supposed to be an outpatient surgery. They wrote me this note at the end of my shift while intubated. I still have it.
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Anywayyyyy, so far the residents here know the rules*
*don’t you dare unswaddle the baby without permission from the nurse
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I’m not saying I want a giant earthquake to happen in my lifetime, but if it were to happen while I’m at work, I’d go out in style.
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When I worked in the CVICU, everyone was scared of the currently pregnant or freshly postpartum patients. That heart failure is no fucking joke.
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One time an anesthesiologist shoved a bunch of sharps in a medication disposal bin in the patient’s room and I politely told him that wasn’t where sharps go.
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Having an extremely normal day on Twitter dot com. I have the opposite of an ego when it comes to this. I’m very self conscious of my IV skills and basically stopped even attempting IVs on adults.
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I specifically requested that they wait until I could premeditate the patient. Was gone for all of 30 seconds getting dilaudid and when I came into the room they already started 😤
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Anyone who graduates nursing school during the pandemic should be legally permitted to do any drug they want for however long it takes to forget the entire traumatizing experience.
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How I wish I lived a life where I couldn’t immediately identify a suppository on sight for both personal and professional reasons.
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Biggest lie of nursing school:
Flush the feeding tube between every separately crushed med you’re giving.
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God really said: “what if a vegetable, but it tastes like potting soil?” and then made beets.
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@MediClit
So if by your reasoning, they look like FGM, do people who have survived that not deserve to be represented either? Can't have it both ways Jessica. Also, this is embarrassing and you should delete it.
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@atscommunity
You do not actually have to entertain both sides if one side is arguing against basic human rights.
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Fondly remembering nursing school clinicals when I dutifully pushed lasix over the full 5 minutes without letting go of the syringe because I thought you had to stand there and push the plunger continuously + sloooooowly (instead of little tiny pushes). The nurse laughed at me 🥰
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Clearly this product was designed for me because I went to the bathroom for the first time at 5:30 pm this shift.
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Levetiracetam
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God bless all the NICU volunteers (pretty much exclusively retirees) for helping hold and soothe some of these crabby patties. As nurses we can’t always hold and cuddle all our babies at the same time and this helps so much.
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I absolutely love hyping up birthing parents when they bring me the first bit of milk they were able to pump for their NICU baby. I don’t care if it’s barely a drop, you are getting all the hype from me.
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@shesinscrubs
I can’t take another “a whole unit donates all their PTO to a coworker battling cancer who would otherwise be fired and without income or insurance”.
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What if, and I know this is a very scary concept so stick with me, being a doctor or a nurse is just a job like any other and doesn’t require a “love language”?
@ATMwithJacy
Because they should be in a position where helping others doesn't drain them. If it drains you to help others than your love language does not match your job.
Doctors and nurses = acts of services, words of affirmation
Therapists = quality time, words of affirmation
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I remember when we had a really extensive Epic update and no one could find the lab results section anymore. Please god someone hire nurse informaticists who have worked bedside. We are all suffering down here.
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Little premature babies getting their caffeine so they can stop being in a silly goofy mood and BREATHE ALREADY
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Fucked around* and found out**
*accepted a new job
**panicking about starting said job
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When did you last have your MMR titer drawn? Might be time to get it again. Just in case.
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If you, a relative, or a friend ever have a choice between several small hospitals outside a large city and you want to know which to avoid: ask your friends who work critical care in a large trauma center.
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If there’s one thing patients love to do, it’s code on the commode. The code brown to code blue pipeline is very real.
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If you want to work in a specialty, apply to that specialty. Med-surg is not a stepping stone to other units and is its own specialty. Do not listen to the people who insist that you won't succeed in L&D, the ICU or the ED as a new grad RN.
Lots of nursing students have just graduated. It’s time to stop eating our young.
What’s one piece of advice you would share with a new grad?
What do you wish you’d known that you know now?
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6 mg of melatonin makes an ICU patient sleep.
What’s a medical myth that you’ve seen perpetuated over the years?
I’ll start: If your nose is bleeding, you should tilt your head backward.
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I already caught a TPN error and I’m not even off orientation. For patients who weight < 5 pounds, this could literally be life or death. I notified the ordering provider who told me he didn’t know how to fix it and left (as we are nearing the TPN order deadline).
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Ended up needing ortho surgery because I slept with my arms tucked under me every night for years.
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Checking residuals is no longer evidence based. If someone is vomiting or having abdominal pain with tube feeds, stop the feed. Your order will likely tell you this, as well as what rate to restart at.
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