We actually really care about you. You aren’t a number to us and when you have an unexpected outcome, we grieve and have to support each other and have care conferences to process our feelings. Sometimes we even need some time off of work to emotionally recover.

I never knew how much doctors and nurses really cared until I became one.

Nurse to patient ratios are now dangerously unsafe. If your nurse has 5+ patients the odds of you dying are like 60% or more. Hospitals can’t hire enough nurses and all of the good ones left due to low wages. Also your nurse may have an inappropriate nursing assignment. This means, the patients are really sick and that nurse shouldn’t have ALL of those patients. This also means some patients who are really sick (think, on life support in the ICU with multiple devices to keep them artificially alive) are not that nurses only patient, when they should be. This also increases the risk of patient harm. Also, a brand new nurse may be given a challenging patient assignment that is extremely inappropriate for them. Due to staffing shortages, this is the only option for the nurse in charge. Many experienced nurses are burnt out and left the bedside, so this has left a lot of inexperienced nurses to be in charge of a unit or taking care of extremely sick patients that they really shouldn’t be.

CEOs, CFOs, or anyone else in the C-suite typically don’t care about patient outcomes, only the hospitals bottom dollar.

The number of assaults on nurses is really high. And nurses are pressured by management to not press charges.

If you don’t have an advanced directive or living will, or don’t know what that is, you should look into one ASAP.

CPR is brutal and many times do not have good outcomes. Many people do not have a good quality of life after these events. I would not want my loved ones to go through CPR.

Don’t distract the nurse or talk about irrelevant things when they’re scanning, hanging, and administering medications. This is a very critical time that the nurse needs to be focused on administering medications. There are certain checks the nurses are required to do. This is the last stop for the nurse to be sure they have the right patient, right d**g, right dose, right route, right frequency, and verifying they’re not giving you a d**g that you’re allergic to.

Just because you see the nurse sitting at the desk doesn’t mean they’re not busy. They are likely documenting care they have provided, checking physician orders and documentation, looking at their schedule, etc.

Nurses very often don’t get 30 minute lunch breaks. Or 15 minute breaks. Or bathroom breaks. Or water breaks. There have been many 12-14 hour shifts I have worked in the ICU where I went to the bathroom 1 time and didn’t drink any water. Oh, and I inhaled my cold lunch in under 5 minutes. If I was afforded that opportunity.

If you see a nurse or hospital staff member running, now is NOT the time to ask them for water, snacks, a blanket, etc. They are likely handling an emergency.

If you are in the ER and someone is actively dying (think, needing CPR, needing immediate life support, actively having a heart attack or stroke, suffering from a life threatening emergency, etc), I don’t care how long you’ve been waiting, they WILL be seen before you even if they have been in that ER for one minute.

The ER is not the place to get an STD test.

Our entire healthcare system is falling apart and insurance companies and big pharma are the only ones winning.

Wheelchair jousting with towel wrapped crutches do happen on nights.

CEOs make as much as great surgeons but don’t help anyone but themselves.

In the US, insurance companies are buying up doctor practices, urgent care centers, minute clinics, surgery centers, and pharmacies. This is centralizing all the profit under an organization notorious for screwing over medical providers and patients alike, and there’s a real risk of insurance companies steering their customers toward centers owned by that insurance company without transparency. Hospitals are corrupt enough, but imagine receiving care at one owned by United Health.

A whole lot of unnecessary suffering that families bring upon their supposed loved ones. Imagine how horrified you’d be if your friend told you they are putting their elder dog Luna on a ventilator because, after her aging achy hips failed her and they did the hip replacement, luna got pneumonia. Of course she can’t eat anymore so they will put a feeding tube in her and feed her. Then they will have people clean her up when she s***s on herself but at least they don’t have to worry that she will pee on herself because after the pneumonia her kidneys failed and now she’s on dialysis. They visit her a couple times each week because they love her.

No. That’s considered inhumane to do to a dog. We do it to millions of elderly humans though.

Not really hidden and kinda minor but I’ll say it anyways. I deliver food to patients and it’s not hard to tell when someone is on their way out. Could be simply not being hungry, or could be the inability to eat. Had one patient who hadn’t eaten anything off their tray for 3 days straight. The last time I delivered to them, they smiled and gave me a wink. Next day, they were gone. It’s rough seeing these things happen in real time. I’m a grown a*s man who doesn’t cry often, but it always leaves me feeling extra empty picking up the untouched trays and replacing them with another tray that I know will stay untouched as well.

When nurses/MDs etc are laughing/joking with each other it is a coping mechanism. We aren't trying to be rude we are compartmentalizing the trauma that we see all day every day. If we don't lighten the load we would cry all day and never come back to work it's literally the only way to watch a baby die and then deal with screaming karen next door with out punching them in the face.

Just because the person seeing you is professional in the room about your weird issue doesn't mean they aren't walking out of there and telling other staff members all about that person that slipped on a bottle and it went in their a*s. No names are used to avoid HIPAA violations but chances are within an hour the entire floor will know about it.

More often than not, they’re beyond short staffed.

Someone died in the bed you’re sitting in.

The lab. The many labs inside a hospital are what you don't know about.

A hospital without a lab is just a bunch of people guessing. A hospital without a lab is a collection of doctors' offices.

Think about that for a moment.

The lab is not where they draw your blood. The lab is where that blood is sent to have various tests. Each color tube does something very specific. Those tubes need to be filled to a certain amount. They need to be drawn in a certain order to keep contamination from causing issues. Sometimes, they even need to be drawn from certain places.

The lab takes your blood, sweat, urine, fluid drainage (from cysts, wounds, around your heart/lungs/liver, brain, etc.), nose swabs, cheek swabs, feces, tumors, removed organs and appendages, growths, and many other unwanted parts and fluids. The lab knows that you eat too much sugar, you lie about that cigarette you enjoy every day, and that you need to stop taking so many over-the-counter pain relievers.

The lab knows when you have chemotherapy. The lab watches your platelet count go down. The lab knows about the deletion of that one gene or the doubling up of another. The lab ran your PCR COVID test and saw you become a statistic. They then asked a blood donor program to hit you up for COVID convalescent plasma, so that you might save a life.

The lab monitored your time on the heart-lung machine. The lab knew when you needed platelets and blood.

The lab saw your lupus diagnosis first. The lab was nearly as upset as you were about it.

The lab was overjoyed when they got the news to pass along to your doctor that the stem cells came in for your bone marrow replacement.

Nurses and doctors see you face to face, but the lab knows you from your insides. The lab is faceless to almost everyone in the hospital (even other staff), which is a shame because the lab is cheering you on in your recovery.

Not hidden, per se, but for the love of all that is holy, if you insist on bringing your kid into the hospital, do NOT let them crawl or play on the floor. The amount of literal blood, urine, p**p, and vomit that has been on it and hastily (not thoroughly) cleaned up is, well, a lot. The hospital, especially the floors, is NOT a clean environment.

Added to that, think of all the rooms nurses, doctors, housekeeping staff, etc. have walked into. Rooms that have COVID or Norovirus or group A Strep. We walked into those rooms and those same shoes walked into other rooms.

Tl;dr hospital floors are disgusting as f**k.

If you sit there on your phone the whole time the mother of your child is in labor such that a nurse has to step in and fulfill the supportive role instead, yeah everyone knows and you’re getting judged by the whole unit.

People abusing nurses and when the nurses report it nothing happens. Nurses deserve safety and the attackers deserve accountability.

I worked as a case manager at a for profit long term acute hospital many moons ago. I left because I thought it was very unethical even though I made bank for a social worker. Back then (2013ish), discharge date was determined by DRG payments and totally divorced from what was in the best interest of the patient. I got a printout every morning of when people needed to be discharged by for max profit and at which date we would start losing money. People were often hastily discharged to a lower level of care ready or not when their DRG date came up. Then we got into a length of stay crisis because we were discharging too quick (the rules at the time said an LTACH had to have an average length of stay of 25 days). When this crisis was identified people were kept longer than they needed to be. It was awful. I had a CEO breathing down my throat constantly. I sure hope they have reformed things since then.

A lot of mistakes are made and people have no idea.

The dark reality of medicine is the insipid political intrigue that goes on that sabotages care for the advancement, wealth and ego of powerful doctors. This means that, as a young physician, you have to take orders from seniors even when they have no idea what they’re doing and even when their actions threaten the welfare of patients. It also means that, to advance to a level of respect where you can actually practice medicine, as opposed to just doing what everyone wants you to do, you have to obsequiously defer to the establishment, to bide your time, even if that establishment consists of dullards who only got their position of authority through patronage of some other powerful authority. I am finally at a level of respect in my profession, critical care, where I can mostly afford to practice as I think best, but it’s taken me years to get there as I looked the other way and let people have their way that shouldn’t be allowed. This reality exists for many professions but in medicine, it threatens lives and isn’t just petty jealousy. There is no meritocracy. You just have to learn to play the game.

How many physicians practice counter to well-evidenced guidelines. I'm not obsessed with guidelines, mind you-- they can get out of date quickly. I'm talking about sturdy ones. It astonishes me how rampant it is for practices to do strep swabs on kids with obvious URI symptoms, even before the patients are seen. I'm not talking about kids who seem to possibly have more than one thing going on-- I know Hickam's Dictum. I'm talking about kids with colds and nothing suspicious for strep.

I taught students for years, and I know they know this is wrong and why when they leave. I know they learn pretest probability. I know they understand the harms of inappropriate antibiotics. It's not rocket science. But it seems like they mostly go out and ignore the existence of the common cold.

I have done private practice more years than I taught, and no, it's not hard or time consuming to explain this stuff to patients. I do it every working day. Once I've explained the first time, I don't have to repeat it. I've had rare parents get upset and leave but if we all followed the science, even that wouldn't happen. Parents appreciate honesty, and I have "grand-patients", children of former patients.

Peer pressure is not a good excuse. We have an ethical responsibility towards our patients.

I do not think I will ever understand how seemingly intelligent and well educated people can do this nonsense. It makes me lean towards absurdism sometimes, as a life philosophy.

How much of how I practice medicine is controlled by administration and insurances rather then what makes sense/is best for the patients and how much I hate that.