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.
In the ICU you spend a lot of time keeping corpses alive until their family comes around or their body gives out
“Oh Jesus ain’t ready for her yet!”
Yes, Jesus is ready for her; we’re just actively delaying it
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.
Sometimes when people die we just put an oxygen mask on them and wheel them through the corridors. Less distressing for other patients and visitors to think they are asleep rather than see a body with a sheet over it.
An ambulance ride is not a one way ticket to the front of the line. You still get triaged and could be rolled right to the waiting room if you’re non-emergent.
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.
Some families reject death so much, they beg the doctors and nursing staff to do lifesaving measures on their 95 year old grandma who has cancer everywhere and is begging for death. It’s just unacceptable.
You are doing your 90 year old grandmother a great disservice by making her a full code, she will not survive CPR and her death will be significantly more traumatic because of it.
Wheelchair jousting with towel wrapped crutches do happen on nights.
It’s not uncommon for families to abandon elderly members at the hospital. They will straight up ghost or at least will be polite enough to say they won’t give any assistance to us in placing them in a nursing home, so Adult Protective Services will get involved and make them a ward of the state. This process can take weeks to months, so these abandoned people just live in the hospital and take up the resources that could be used treating sick people.
There are also many families that keep elderly members in unsafe living conditions so they can continue to take their Social Security checks for personal use.
I got a fast bleep (ie. drop everything you’re doing and attend this emergency please) one night to a side room on the ward to find no patient in the bed. Was just about to leave the room and go back out to the nurses station, where there had been a bit of a hubbub when I’d dashed past the first time, when something caught my eye.
Looked up to see a face with wide, slightly wild “psych eyes” peering down at me from a gap in the ceiling tiles. She was a lady waiting for a bed in the psych hospital who’d clearly thought the ceiling was the best place to hide from the people trying to poison her.
Honestly can’t think of another occasion that I’ve been quite so terrified.
Worst thing was that I had to walk (well, dash) back out underneath her to get help from the nurses and security to get her down.
If you come into the ER drunk there is guaranteed a pool of bets on your blood alcohol level, possibly with odds if there’s a pharmacist available to do the math for us.
That patient families will do anything to keep the patient alive for their own comfort instead of abiding by the doctors orders. For example: feeding an intubated patient a hamburger because “he’s hungry” when they are already getting tube fed and ordered NOT to interfere with the vent or trach. This has resulted in many patient deaths than you think.
I worked in the kitchen, so I was the lowly peon delivering food trays. Delivered to one guy who had a horrendously infected foot. Most of the toes were necrotic and black and the rest of the foot wasn’t doing much better. I wouldn’t be surprised if he was waiting on amputation. His dietary requirements were Diabetic, so it was likely. The room smelled AWFUL.
Anyway, these rooms are small, with typically two beds in them. Because of the smell from his infection, the other bed is empty. I still have to squeeze by the foot of his bed, and as I’m paying attention to the tray so I don’t knock it into equipment, I accidentally brush my leg against his infected foot that he has sticking out of the covers and hanging off the bed. His big toenail comes off onto my leg. It’s just, stuck to my leg. We look at each other in horror. I clear my throat, ask my usual questions, clear and adjust his table, give him his tray and wish him a good day. I leave calmly, and then run to the nurse’s station and ask for help getting this dude’s entire necrotic toenail (with bonus flesh) off my f*****g leg.
The nurse who got it off soaked that portion of my pantleg in some disinfectant liquid that smelled like it could take the paint off a car.
There is an army of pharmacists in the basement that approve every medication entered by every doctor, frequently catching errors that need a change in therapy (patient on dialysis can’t have x med due to toxicity risk, why is this patient on two nitrate-containing meds?, this patient is 90 and her QTc is already 500 so maybe let’s reconsider the Levaquin, this guy just got that antibiotic in surgery two hours ago so I’ll reschedule it to tomorrow, why is this patient not on blood thinners when they are at high risk for a clotting event, another doctor already ordered potassium repletion for this patient so do you want me to delete your order as a duplicate, you forgot to order a thyroid test before starting amiodarone, this person’s kidney function has stabilized so we can increase their antibiotic dose again, can I change this pantoprazole order to lansoprazole because you can’t crush pantoprazole and the patient has a G-tube, please enter an updated weight for the tiny NICU baby so I can redose all of their weight-based medications, did you really mean to order 1030 units of insulin for this patient or did you want them to get it at 10:30, etc)
Imagine being stuck in a windowless white environment with bright florescent lights, beeping machines, pained moaning, and poop smells for 12 hours. Now do it with less staff than what’s required to manage the volume of people. Now throw in 3 years of burnout from the pandemic.
Now consider how grumpy and frustrated you would be, and consider what would make you stay in the job.
I am an ICU Nurse. I had a patient who was declared brain stem dead. The family did not want him to become an organ donor so we withdrew treatment. I switched off the ventilator, pumps etc and extubated the patient. A few moments later the patient displayed “Lazarus Sign” which is a reflex that causes the patient to raise their arms in the air. I was by no means new to the role but this really scared me as I had never even heard of it let alone witnesses it.
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, poop, 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.
That all the sweet treats and food you bring in for the units to eat usually only go to day shift and night shift gets left out of yummy goodness.
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.
I help patients to the bathroom nonstop all day. The amount of patients that just leave the bathroom without washing their hands is disgusting. If I didn’t hear the sink or soap dispenser your a*s is getting led right to an alcohol hand station
How often we have to hide how we are made to feel.
Patients blame staff for systemic issues. It’s not your nurses fault the wait time is long, it’s not the individual staff that created the big picture issue. Most of us are trying our best in an unappreciated field and are here trying to help.
Hospital lab worker here – Not particularly scandalous, but most people don’t realise their lab tests are just very accurate guesses, and have an error range. When we say your ‘X’ is 10g/L, we might actually mean it’s 10g/L ± 10-20%.
I see too many people get extremely worked up about small fluctuations in blood test values that aren’t actually in excess of the reference change value, and so technically aren’t genuinely different from a previous value.
EDIT: If you’re interested, have a little play with [this tool](https://www.bmj.com/content/368/bmj.m149/rr-8) to see how variability affects things!
DOUBLE EDIT: Also, inter-lab variability is a big problem! [Check out this inter-lab comparison data for oestradiol](https://i.imgur.com/zsSUZpu.jpg). Identical copies of 3 samples sent to 230 labs around the UK and tested using all our various different machines. As you can see, none of us could agree on an answer, only that the true value was ‘*Somewhere between 100 and 200, probably about 130*’.
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.
There is sex and drama, but not in a Grey’s Anatomy way…more of an overgrown high schoolers shoved together in really stressful situations way. And not as much sex as Grey’s…though maybe I’m just ugly and not in on the scene
I haven’t seen it on here yet, may have missed it but I’ll add.
You, as a patient, have every right to refuse any test or treatment or even leave. At any time. For any reason. (Unless a harm to self or others- that’s different, at least in the US) Added bonus you should know: leaving against medical advice DOES NOT mean insurance will not pay for the care you’ve received. Your insurance will still be billed the same as anyone else who stayed the whole time till discharge.
But if you leave with an IV in your arm we will call the police to find you and bring you back to remove it, because of [substance] abuse..
The hospital I work at has these big square covers. When I first started, I would see transport staff pushing these things around the halls. I thought they were food trays, or large boxes of hospital equipment. Turns out it’s a structured bed cover, so when they are transporting a deceased patient to the morgue, it doesn’t look like a person under a sheet.
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.
I know one. I used to manage hospital laundry services. Medical waste (body parts etc) gets accidentally thrown in the laundry more often than you’d expect. Also needles and all sorts of other medical devices and personal items. Once we even had a (deceased) fetus come through to the sorting facility.
As a hospital social worker, a lot of people think “home care” is going to include an insurance covered home health aid. There is no such thing. You have to private hire or get sent to a nursing home for “rehab.”
The staff gossip about all the patients’ families. It is easy to get labeled aa needy or difficult.
Bringing in food for the staff goes a long way.
The updates you get from the OR while your family member is on the table are BS. The case could be going really bad and the OR nurse will still tell you “everything is going great”
We have mice in the lab, and they’re not for experimentation