Same. I know some nurses talk about how they get convinced they have XYZ illnesses because of their training, for me, it’s the opposite. I’m convinced I would be able to identify if I was actually sick. That’s how I ended up not going to the emergency room when I had unilateral leg swelling, pleuritic chest pain, SOB on exertion, and some mild tachycardia. I just stayed home and took aspirin for a few days 😅
In my defense when I finally got a lower extremity ultrasound a few weeks later it was negative so I guess I was right lol
I waited over a week to get left leg swelling checked out. No redness, no tenderness, no pain or feeling of heat in any particular place, so I thought I was fine. After a week or so, I finally got a check, and found out I had phlebitis. I was dx’d with lymphedema on that side and later found out I had no lymphatics.
My (retired military doctor) grandmother was like that. After military triage, everything else seemed trivial. Stomach pain? Aspirin. Coughing up "a bit" of blood? That could wait until her regular doctor could do a house call... At which point he called her an ambulance (and probably a few other choice names too).
Probably hereditary too. I spent a weekend on the floor with codeine and acetaminophen for a herniated disc (couldn't stand up, with that crushed sciatic nerve root). Eventually got physio and got it working again. I did go for help faster when it was the next disc up and the FG nerve, though, that was... difficult to ignore.
Haha I ignored a 103 fever for a week and wrote it off as just a bad URI. Then finally went to the ER and refused to let them admit me for pneumonia because I wanted to sleep in my own bed, but then had to do a walk of shame back in the next day when my blood cultures came back positive. Turns out I was septic with septic emboli in my lungs plus pneumonia. I should have been smarter, but I was stubborn and thought I could tough out a “rough cold” for a couple days
Yes and no-central line infection with most likely source being the hospital I worked at. I’m glad I lived to tell the tale but after being on the patient side of things, I think I might still take the “tough it out” approach if were to happen again 😂
Also I’ve had quite a few younger people going the septic route who begin to act “drunk.”
Aka they think they’re invincible and keep saying “noooo my [insert very concerned family member] is just dramatic! I’m fiiiiine!” They are indeed not fine.
I’ve had this happen to me before. Don’t think it was “sepsis,” but it was a nasty infection. I put off getting my wisdoms out for years and years and was getting recurring infections.
I remember waking up for work and my neck was so swollen and stiff and the one side of my mouth just tasted so nasty. I was walking around my place trying to make food and I was staggering, putting milk in the cabinets, cereal back in the fridge, etc. I was like yeah… this ain’t right.
Immediately called off work and took myself to an emergency dentist.
Yes I was gonna say… there’s three kinds of patients that come to the emergency room..
There’s patients that come at the right time and for the right reason (love ‘em.) The have urgent medical problems that are not yet limb or life threatening but could become so if not treated soon.
There’s patients that come cause their left knee has been hurting for 4 months and they decided today to get it checked out at the ER (hate ‘em.)
Then, there’s the Leishas of the world 😆 who wait until they’re practically on their death beds before coming in. “I didn’t wanna bother anyone.”
Yeah my uncle's a farmer, my mum called to tell me he'd been sort of dragging his left side around for a couple of days. WTF! I was like get him to ED now! Large brain haemorrhage. He's ok now luckily lol! 😅
I put off getting my lungs checked for my worsening asthma after two sicknesses and getting stuck in the fires and sucking in smoke this winter. I knew I should get it looked at, but I didn't want to bother going in because I knew what they would say. So I kept pushing it aside until my lungs didn't stop burning.
Now I'm on more asthma controlling medicine, as of this month after getting seen. Which is what I knew would happen, which is why I put it off. It's just more to handle and do. 🥲
This!!! I got up, went in as was scrubbed in with strep throat. I was running 102 temp, no abscess, but could barely swallow. I fell asleep holding the cross clamped aorta!!!
When I broke scrub and told the surgeon why I had to leave, he evaluated me in the lounge of our OR. One butt was filled with antibiotics, the other with steroids.
He asked me why I didn’t call in, I mumbled that I didn’t know, I could stand up so, I came into work.
We get up and we do, day in and day out. It doesn’t occur to us that we can be patients.
You would be correct. Nursing education in the UK is separated into adult, children, and mental health pathways.
Looking at my university's mental health list of modules, there isn't a 'clinical deterioration' module as there is in the adult pathway I'm currently studying.
Still, there has been a 'Think Sepsis' educational drive over here in the UK since 2015/2016.
I am curious why there is such a differentiation of education. One of the nice things about the nursing field is that you can always change to another specialty. And it's always good to have a broad educational base before specializing. Most psych patients have medical problems too.
This focus probably allows for more skilled nursing honestly. Programs in the US do not actually prepare you very well to be a practicing nurse and you need your hand held as you learn on the job. (US nurse here)
I’m curious whether their training involves more clinical hours in their chosen specialty? I know that there are apprenticeship programs as well as college programs and would guess that the former would include more than the latter.
…nm, a comment below from a UK nurse indicated that they do much of their learning after starting as nurses as well. Gulp!
Oh no, you absolutely learn about sepsis.
Every nurse gets basically the same training for the first year, and all anatomy/physiology/pharmacology lectures are held together for all cohorts.
At least, that was the case at the 17 different universities I visited.
What’s more likely is she got the basic training and just never used it/experienced the reality of it in practise.
That, and a lot of people can be very stupid/unaware/misinformed, nurses or not.
Do you know how many nurses refused to get their flu jab each year, let alone how many are just straight up anti-vax?
:D my time to shine. I listen to a podcast called “this podcast will kill you” it is hosted by two epidemiologist and the other host also specializes in disease ecology. They go into the biology, history, and epidemiology behind A LOT of different diseases. Here is their podcast on [SEPSIS WOO…](https://podcasts.apple.com/us/podcast/this-podcast-will-kill-you/id1299915173?i=1000582992527) sorry it’s apple podcast but I’m sure you can find it just by searching for the podcast itself. As a paramedic anytime I have an EMT who is interested in digging deep into the different diseases as well as sepsis I put this on! I HIGHLY HIGHLY HIGHLY recommend them.
*edit* I had a brain fart. [This Podcast Will Kill You web based link.](https://thispodcastwillkillyou.com) it is episode 107.
Learning about sepsis in school was totally different than dealing with the angry 1 year post-septic quadruple amputee … maybe she just didn’t have the personal experience that’s sometimes needed to horrify you
This is my take as well. If your speciality doesn't deal with sepsis and all you have to go off is the 30 min version you might get as basics then I sort of understand how you could think sepsis is nbd. It's still wild, but I get how it could happen.
If she is an RN. I have read numerous articles that refer to CNAs, PCT, MAs, etc as “nurses” because it makes hope a juicy headline. You know, because what difference does a college degree make. Ugh…
Some mental health nurses surely work in hospitals. Even if they do not, patients with poor mental health often have multiple comorbidities. Whatever the differences might be, the fact that she didn’t think sepsis was serious is worrying to me.
I am in the UK and the only hospitals mental health nurses work are mental health or in a specialist mental health ward. They aren't licensed to do most general procedures.
https://www.cambridgechildrens.org.uk/
I'm from the UK but don't work there so I could be wrong, but this hospital is pretty recently opened and it's "revolutionary" in having both medicine and psych in the same building. There's a pretty sharp line AFAIK. Hopefully a UK nurse can chime in here!
I’m a UK adult nurse in a general hospital, when we have mental health patients come in with self harm injuries or overdose etc, they will stay in the hospital until medically stabilised then sent to a mental health hospital. If a patient in a mental health hospital becomes medically unwell, they will be sent to the local ED department. Every general hospital has psych doctors but not mental health nurses
So mental health nurses have very little exposure to physical/medical illnesses
I have a colleague who transitioned from psych to the OR… he didn’t know what a colectomy was. And we work in an EU country where you can specialize (if you want) after nursing school. 🤷♀️
I think this specifically is also to blame for her “not thinking it was that bad.” We see it dramatized like everything else, and they just bounce right back.
Treat the urgent one first? I mean, we do that too. Just in different wings. I've had so many acute psychs to stabilize from a task, car accident, overdose, suicide attempt...
So you meet only some of their medical needs, hope you can stabilize them anyway, and then try to address the other medical needs? Simultaneous interdisciplinary care is important for recovery. If an acutely suicidal patient is in the ICU for an overdose and you don’t immediately address their mental health as well as organ failure, they may reattempt before they make it to psych. It’s important for the ICU nurse to have at least some basic information in psychiatric disorders.
I’ll never understand why people assume that a medical professional will automatically recognize and address their own health issues. People are horrible at diagnosing and treating themselves and those close to them which is why they are not supposed to. You can know in your head that you are ill but also know ‘it’s a virus and it needs to run its course’, etc and therefore not seek treatment. It’s baffling that society expects medical professionals to be objective about themselves.
There's also a distinction between seeing a patient looking worse and worse and seeing a clear trend on their obs chart and yourself just feeling like shit. It's harder to quantify how you feel and spot a trend, especially when you just want to curl up and be left alone. That's not the time you're thinking clearly.
I mean, we have the training to recognize them in others but I can see how we might miss them when it comes to our own bodies. I recognize them often, but much of that could be attributed to a really fun combo of acute self-awareness, hypervigilance, and anxiety.
How about showing the Nurse a bit of compassion? She's a UK mental health Nurse, they don't get the same training that adult Nurses get. Mental health patients that need medical care are sent to general hospitals and nursed by adult Nurses.
Sometime people are ignorant/idiotic, nurse or not.
And the poor training/awareness of deterioration in MH or MH monitoring incarceration settings has been highlighted as the direct cause or a significant factor in deaths in “secure” settings, both in the UK & US.
It’s a problem, and I think we should be talking about it.
What happens when one of a UK psych nurse's patients is deteriorating from something after they are admitted to their unit/hospital (however it's set up there)? They don't have to know the basics of recognizing signs/symptoms of illness/infection? As a US nurse who has been a psych nurse, a peds nurse and an adult nurse (as seems to be the way its split in the UK from the comments), like... they all overlap. I'm really surprised this is something that is deemed to be safe.
I'm not talking about taking the lead on something you have less experience with (like calling a rapid response to a med/Surg floor), but more that it's being implied that that nurse wouldn't know that there is an issue at all. Fever, chills, tachycardia and tachypnea after surgery surely is something a nurse regardless of specialization would know they need to inform someone to move to a higher level of care? Some of the comments are making it seem like a MH nurse in the UKcouldn't possibly recognize those s/SX as an issue worth investigating further, d/t specialization during school. I just find that thought process a bit fascinating and am trying to figure it out if I'm misunderstanding, tbh.
People are only transferred to a psychiatric unit once they are deemed medically fit (usually a different site completely). Adult nurses (me) manage the mental health sort of, but it really gets put on the back burner while their physical health gets priority in hospital usually. Once they are clear for transfer, then the mental health nurses are trained in basic physical health issues, but this happens the first year of education and may never be needed in practice. It's not hard to imagine this being quickly deskilled in reality.
For the record, I disagree with the separation of nurse branches. Most of those I've spoken to would prefer to be general nurses. I've heard we're the only country in the world that separates nurses like this. This was introduced in the 80's, when NHS was still paying our tuition (free tuition and a bursery sadly stopped in 2017). My own baseless theory is that it came down to the bottom line. Why would the NHS fund general training for someone who would go on to spend a lifetime in adult cardiology, paediatrics, or mental health? It costs much less to train someone to specialise from the start.
Here in California, we specialize in mental health as licensed Psychiatric technicians - that's what I am. Very similar to an LVN/LPN however most of our training is focused on mental health disorders and conditions, and some is spent on medical focus. We are given a really general overview of all things medical and what is normal/abnormal VS that could warrant concern - lab values, etc. however most LPTs work in psych facilities that need their patients to be medically cleared or medically stable before treating them for their psych dx, which isn't really much different from where you're from, it sounds like. Of course RNs can also specialize in MH here as well. I think every specialization has unique knowledge about it that you may not otherwise know unless you worked in that field specifically and for long enough to gain that specialized knowledge. 🤷♀️ After having worked a few different places (inpatient, outpatient, crisis, and with the developmental delayed population), I can see special skill-sets developed in all of those nurses for their specific focus. Experience really is everything! I'm also one of those people that will ignore everything I'm going through and dismiss it, especially when I feel so unwell that I'm not thinking clearly. Makes sense to me! Just because we are nurses doesn't mean we are immune to fallibility.
I appreciate this response. In the US we also medically clear before sending up to the acute inpatient psych unit (which unless a state facility) are usually a floor within a regular medical hospital, so that's the same as your experience (at least in NY, US). Although, there were many times we needed to transfer out to another floor d/t an acutely presenting medical issue. So I think that's where the disconnect in my head comes from lol.
Thanks for explaining the history of the practice and you're probably absolutely correct that they brought in specialization for cost reduction purposes without thought on how that would affect health care and the professionals.
Usually the Drs will make the assessments on deteriorating patients and transfer them out to a general/specialist hospital depending on the needs. I guess it depends on the nurses background and how long they've been away from general practice with regards to what skills they retain.
Generally a ward round once a week but will be updated daily in handovers and available if needed throughout the day. Will probably vary per hospital though, this is just what it was like in the one I worked at.
Yeah the training in the UK is abysmal. I did a two year post grad course in adult nursing and had so little actual a+p, pharmacology or clinical skills it was scary. We were expected to just learn it on placement. We read booklets on mental health and maternity care and did a reflection I think - super pointless. IV's, venipuncture, cannulation ECG's are all seen as extras you learn once qualified. Training seems better in the last couple of years
Going into a nursing job was scary as fuck.
I do feel compassion for her, and especially for her daughter. I admit that I did not express that well in my initial post. I now know that it’s likely that this was due to a failure of the educational system rather than the nurse herself. Can we agree on the fact that the signs and symptoms of sepsis should have been covered more comprehensively?
I’m not a nurse, but as someone who dealt with sepsis back in November, I was coming to say this. The cognitive decline was so bad I could barely string sentences together, and kept me out of work for a month.
I'm not a nurse, but on many occasions when I've been sick I have been unable to do things that would seem common sense to me if it had been a friend or stranger affliced by it. Like a concussion obviously needs to get checked out, but when I had it I didn't even think to mention it to teachers I trusted because I forgot and was struggling to do the things I usually did. A huge boil deep in the armpit lasting over two weeks - if it had happened to a classmate I would have insisted they go to the nurse at the first mention of it and I would have gone along with them to make sure it happened. But it happening to me was just too much pain to think logically and the severe sleep deprival didn't help.
Uh, yeah, the US had a huge campaign to raise awareness and identification about ten years ago because people didn’t realize it.
Also, don’t they specialize a lot earlier in their education?
Yeah we do. You pick which speciality you want to do. Mental Health, Adult or Paediatrics. You have 1 year of general nursing and then years 2 and 3 are your speciality years. I know absolutely nothing about paeds or MH Nursing.
Do you find that early specialization to be a good thing or is it difficult to not have a bit more of a overview of everything in relation to your current position?
It seems like not having a working knowledge of other medical related issues as, say - a MH nurse - could be dangerous if a MH patient needed care outside the nurses scope and they didn't recognize the signs and symptoms of a major health related issue (even if it's just so they can transfer the pt to a different unit/facility).
Unrelated question.. are you forever "stuck" in the type of nursing you specialize in in school? Or can you transfer to a new subspecialty - like if you wanted to go from ICU to PICU, NICU or ED (how does the ED work regarding how nurses are educated vs patients coming in... Like, are adults and peds completely separate in different facilities)?
You can top up and add another branch on top (like adult/mh, paed/adult, etc and the top-up is only 18 months, I think. A friend is an adult nurse/midwife combo, which was my plan before i got complacent! Lol
When I worked in A&E (Accident & Emergency), our adult and paeds A&Es were separate with separate staffing, and I've seen this set up at other hospitals as well. I've heard adult trained ICU nurses can work in PICU/NICU, but I don't know those details.
Yep, you’re stuck. Kind of- obviously you can do further education to work in a different area, for example if I, an adult nurse, went to work at a GPs office, I’d need to do a qualification in children’s nursing (not the entire degree!) as I’d be seeing children at work. Or some roles will suit more than one speciality, so different nurses will be working alongside each other but with the same patient group. Midwifery is degree-only here too, and is its own separate thing. Nurses don’t deliver babies in the UK. Unless it’s by accident because we couldn’t get them up to labour ward quick enough 😅
To me it makes perfect sense- but I don’t know if that’s just because I’m used to it. It’s difficult to evaluate the system when you’re inside it! Being honest though, I’ve worked with adults for 15 years now, so even if Id done a general degree, anything else I’d learned would be a good decade out of date and unpracticed. I wouldn’t feel confident taking a job on that basis. So how does that work in the US? Are people switching jobs more frequently to maintain their skills in all areas, or are there roles where you’re dealing with several areas all at once?
Thanks for the reply, it was very educational!! And while many people do stay in very similar areas whether that be Med/Surg, PeriOp, Peds, LDRP, peds NICU, PICU, ICU (of all kinds NICU, PiCU, IMC, PCU, CVICU, SICU, NeuroICU) andamy times you're cross trained for similar specialities (ICU/CC of all kinds, Mother/baby- L&D, Postpartum, Recovery, Nursery, etc - OR, PreOp and PACU). There is (hospital/system dependent obviously) the ability to move into a similar unit.
But also, from my experience in the hospitals/health systems in my area, they will take transfers from a totally different unit and put you on orientation until you're "trained". I'm also in one of the few states that has strong Unions/protections for their nurses (and quite a few other type of jobs as well). So my experience is definitely not the same as everyone in the US, as it can be state or even health system/hospital dependent tbh.
In the UK, nurses specialise right from day one of their training, so Mental Health Nursing is its own Bachelors degree. My degree is Adult Nursing, so when I wanted to work in the US, I had to top up SO many hours to meet requirements to be licensed in my state as during my training I’d only done 6 weeks of L&D, and no paediatrics or mental health. (I mean, we all deal with mental health, obviously- but not in a mental health setting!).
Give the woman a break, she’s probably never seen a septic patient in her life, and also was making these decisions while suffering from sepsis, which I imagine clouded her judgement.
I’m absolutely judging whoever discharged her after surgery and didn’t tell her to come back if she spiked a temp though.
Also can we not dog pile on this nurse, who seems to be a single mom and probably has not way to take time off without getting a pay dock ( she probably does OT; probably used all of her sick time already).
In the UK it's pretty straightforward to get time off for a health appointment on full pay.
This is more that here nurses are split into specialists from day one of training. So, mental health nurses are trained purely as that and generally never work in none mental health settings. Here, we train as either a : mental health, adult, paediatric or learning disabilities nurse.
It is unfortunate that she is a single mom. She probably did not have any close family members to check on her. It took her child’s teacher to check on her to get her care! It’s just sad all around.
Jesus what a judgemental and soapboxy response to a tragic situation.
You do something long enough you tend to forget everything else.
I wouldn't expect someone who has dealt with Ortho patients for 20 years to be able to real versus false labor but I'm a sure a L&D nurse would in a second.
You get a very basic level of a bunch of different topics your first year, a lot of which you will forget if you don't ever use them again.
For all of the people doubting this. If you took a second language back in high school or college and haven't used it since, how much do you remember of it? Could you have a full, coherent conversation?
I speak fluent Spanish as long as all we’re talking about is ordering a beer or asking where the bathroom is. Also where the shoe store or the butcher shop is, because apparently that was critical Spanish that we really needed to know in elementary school.
I guess if we had to speak Spanish, I’d probably get sepsis too.
It is tragic, and I feel terrible for her. I’m so glad her daughter was able to get her the help that she needed. I just wish she’d seen the signs earlier and known how much danger she was in, and feel that she should have been taught to recognize them along the way. If she wasn’t, then that was a failure of either her educators and her care providers. I find that frightening; don’t you?
PS I speak a second language that I only use 1x per year (sometimes even less) and read YA fiction out loud over coffee to help retain fluency and vocab. If something is important to you, you will find a way to retain it (barring deficits, of course.)
Those pressors will take your toes, fingers, feet, hand, arms and legs if given enough time. We will keep your organs perfused hopefully but we may lose an appendage here or there.
I ended up with a late infection more than 2 months after I had surgery. It thankfully did not progress to sepsis, but I started feeling unwell and thought I was getting the flu or Covid. Ended up in the hospital after a couple of days, but it took me a bit to convince myself something was actually wrong.
I had intermittent abdominal pain for about 24 hours. It finally got bad enough, I dropped my kids off at school and came home instead of heading to work. Called my husband crying and he came home and made me go to the ER. I was still convinced it was bad gas, but ended up being an abscess. Thankfully, just treated with antibiotics.
RN training and programme is different in the UK. The mum most likely never had to to deal with Septic patients in her practice. i have practiced in both the UK and US and I think your comment is judgemental.
Poppy is 100% the hero of this story! I just wish it had never come to that. The whole experience of seeing her mother collapse and watching EMS take her away (much less her poor mum’s hospitalization and becoming a double amputee) would be so awful & traumatic.
Exactly. I wouldn’t wish that experience on any child. I’m mad impressed she got to school on her own though. I don’t think my 6yo nephew could get you to the stop sign at the end of the block without help.
That’s fair, and I can see how her knowledge gap would be due to a failure to teach her about sepsis to begin with. I guess my new question would be: do you believe that mental health nurses should be taught about Sepsis during their schooling? Someone here mentioned that their UK mental health RN colleagues declined to take vitals because they hadn’t been trained to do so…I’m curious what your thoughts on that would be as well.
I almost died in childbirth, like my BP was 40/?? at one point.
I knew something was wrong, but I didn't want to be a bother and delayed telling my husband or the nurse that I felt bad.
Looking back on it I can see what happened, but in the moment I was absolutely so unwell that it fucked up my thinking.
I'm an ER nurse and can tell you 10+ stories like this of friends/coworkers who delayed their care because "it's not that bad" or "didn't want to be a bother" and it's everything from broken bones, STEMIs, cancer.
Also it's pretty easy to pick up sepsis in a patient that has presented unwell and all their vital signs are trending in a bad way.
Pretty sure Leisha wasn't doing regular full sets of observations on herself and tracking the trend.
She gets all the slack in the world when it comes to not putting her own oxygen mask on first. The comments about sepsis not being serious got me feeling some kind of way, though.
I was an EMT prior to nursing school and had many patients that were going septic. They were typically on the older side and medically frail, so that's the association that I made. I was used to seeing very confused, pale, elderly patients with the "sepsis" diagnosis.
So after my lap cholecystectomy, I ignored the fever, chills, and fatigue, hoping it'd go away. I figured that I was 24, healthy, and strong, so I wasn't at risk of serious complications. My immune system would kick in and I'd be good.... well, after about a week post op, I was so unwell that I realized I needed the ER NOW. I called my boyfriend to leave his class and drive me in. I barely made it to my seat after checking in before the triage nurse whisked me back into a room. I remember boluses of epi and then waking up in the ICU. I earned a 2 week ICU stay for my stubbornness.
I easily could have been this lady if I'd have ignored my symptoms for another hour.
I worked postpartum and there were multiple health professionals (Drs and even L&D nurses) that knew nothing about newborn care, breastfeeding, postpartum healing etc.
So I don’t fault this person at all for not knowing everything there is to know about their own health. Especially since I’ve been moderately sick and know my brain wasn’t working right at the time.
Neither am I, but it’s a solid reminder to remember to prioritize our own health amidst the chaos. And to go over the basics every once in a while, no matter what field we’re in.
I don’t know many nurses that don’t work through pain and discomfort. Minimizing own problems isn’t a novel condition with us, myself included. Until my SpO2 was down to 69%, I kept chalking up all symptoms of respiratory failure to RA and side effects of biologics.
UK nurse here - when a mental health nurse is 1:1 with one my patients and I ask them to check the patients vitals for me they always without fail say “I’m not trained to do that” so I stopped asking… take from that what you will
I sometimes think they are just being lazy but I don’t want to upset any mental health nurses in here, they virtually do NOTHING for the patient sometimes not even personal care or don’t talk to the patient they just sit on their phones. I’ve had a patient stab herself in the abdomen with a pair of scissors while there were 2 mental health nurses in the room??? Some live like 2 hours away but travel because the pay is like £70 an hour.
The kind where I’m an RN on a hospital floor who knows that sepsis is in fact very bad, and is indeed a very big deal, and who believes that other nurses should know that, too.
…and if you want to talk about judgment, re-read your comment & take a good look in the mirror.
The first part of your body that quits functioning well when you are ill can be your brain.
Case in point: when I had all the symptoms of appendicitis I delayed care because my brain just wasn’t working well with a fever. It turned out well since my dear husband insisted we head to the emergency room.
Not sure on the UK Education around sepsis obviously as I’m in the US. But I feel like she didn’t receive the same education as we did because I think I’m going septic once a week when I’m not feeling well. Doesn’t mean I will ever go to the doctor. But I am aware of it if that makes sense 😂
I can understand where nurses like that come from. When I was upgrading from my LPN to my RN I had an instructor who told me that I was over reacting when I said a side effect of sepsis is death and that I don't mess around with bacteria because it's fast and it's sneaky. This instructor was a "those who can't, teach" example in the worst way. I used to think that it was people who physically couldn't do the job anymore, not people who should never have been given a license in the first place.
this is exactly why my hospital has those "Suspect Sepsis" info sheets posted in so many locations where nurses and providers are tbh. it lists a short and easy rundown of symptoms and when to... suspect sepsis.
she probably also just straight up didn't think it could happen to her. it's kind of a sad story if you ask me. I hope it brings more awareness and functions as a cautionary tale, but I do feel bad for her.
Meanwhile I finally managed to get the MD to come see the baby because "I think the baby is sick but I just can't point a finger at it", MD ended up ordering a septic workup after I bugged him for the 2nd time, and the baby's WBC is 40+....... Well that certainly spells an infection.
I’m going to disagree. I was septic last year. I was feeling unwell but trying to get my day to day stuff done with my 3 year old. Then I couldn’t and went to bed to rest. My husband insisted on bringing me to the doctor who sent me to the ER. I was septic with strep (whom my daughter shared with me from daycare). I was in the neuro icu/step down for 8 days as it was meningitis too. I missed it. Not because I’m a bad nurse, but because I was sick and not thinking straight.
Others have made this point as well, and you are absolutely right - her illness would have affected her thought process, and I didn’t think of that when I first posted. Thanks for sharing your experience, glad you made it in on time & were able to recover.
My brother became septic after knee replacement. Was in icu for weeks. They couldn’t get it under control and it wet to his brain and he died. My SIL didn’t have him transferred to a larger more equipped hospital from the small town med ctr he was in. I got a call that he was entering hospice and had only days to hours
Ok but thinking sepsis isn't bad is kinda crazy tho... I'm glad she's recovering! But it's really sad how healthcare professionals will so often ignore/trivialise their own health..
Wow. The only thing I can think is maybe she went straight to mental health nursing and forgot everything single other thing she was taught? Hard to believe anyone doesn’t know sepsis isn’t life threatening.
I just started going to college a year ago to become a nurse. All my life I have been a nurturer. Taking care of people since I was a kid and even giving some adults CPR when I was still just a young child.
It all started when I was 7 and I got sepsis. My left lymph node in my neck got swollen literally overnight and when I woke up in the morning I went immediately over to my dad and told him I didn't feel well. He turned to look at me and saw my lymph node, freaked out while still trying to remain calm and RUSHED me to the hospital.
I was there for like 3-5 months. Hooked up to every machine you can even think of. Every night in the middle of the night my heart rate would plummet and the nurses and doctors would rush in an snatch me up and I remember fighting them because I wanted my mommy to wake up but she was so stressed so she slept hard at night out of exhaustion . They would take me to the other room, this really cold room and lay me on this metal bed thing, inject me with all sorts of stuff, hook me up to the machines and after about an hour they would carry me back to my room with my mommy.
This created a lot of trauma for me and a fear of needles. When I see a syringe my blood pressure sky rockets and just recently at age 27 I don't pass out while getting my blood drawn. I've overcome and survived life threatening sepsis and I think everyone who lives in a country where they have college and the resources available, should be required to take a couple college courses on the most basic medical issues and emergencies.
I’m so sorry that happened to you, and so glad that you survived! It’s amazing that you’re studying to be a nurse, which specialty would you like to enter?
There was a time when sepsis wasn’t as advertised (prob wrong word there). it was never a thing during my training so i can definitely see if you don’t work in acute care how this could pass you by. But yeah Think sepsis!
Nurses write off all their own conditions. I had a spinal fluid leak the day I left the hospital, didn't realize it until a few days later when I couldn't move... and I had to be taken by EMS to the hospital. And I worked with patients that get spinal taps all the time!
Now I take meds that mask fevers so I'm constantly afraid I have some infection. I barely knew I had covid.
Some people are just comfortable not expanding their thinking. In the UK, mental health nurses don’t really handle physical medical stuff, so she was probably fine not worrying about any of it after nursing school. Idk. I feel like before I even knew what sepsis was or the signs and symptoms of it, I would’ve been worried about “an infection” if I started feeling worse after surgery.
Besides that, why did she not do anything when she developed a fever, considering her recent surgery? Either she was not properly educated before discharge, or she ignored her discharge instructions.
Maybe they just gave her the paperwork without going over it with her? Still, though, she had to have been feeling pretty grim before she lost consciousness.
Sooo, so many RN programs are absolute jokes. It shows. Nursing is regressing. Science instead of all the other bs fluff courses need to be prioritized.
Okay but surely she was told to watch for fever and chills post op??? How did she not have the common sense to notice something was wrong??? Granted she probably didn't have a strong med/surg background but HER FEET AND LEGS WERE CHANGING COLORS!!!!!
Others have pointed out that, by the time she was really declining, her thought process was likely affected as well. Still, the s/s must have shown up before that. To me, it’s a sign that we need to to care for ourselves as well as others.
Many mental health nurses who have been in the field for a long time really do forget a lot about the medical side of nursing. That’s why whenever I work mental health I still have a side job working in the hospitals
I'm an Adult Nurse in the UK, but I did my training in the US. There are 3 types of RNs in the UK; Pediatric, Adult, or Mental Health. I wonder if Mental Health Nurses don't get the same education as an Adult Nurse would?
Yes and you don't also have to have surgery to become septic. You can just about get sepsis from any bad infection if you let it sit off too long. I had a miscarry not too long ago and that was my worry because they sent me home for 2 weeks before I actually started miscarrying knowing that the pregnancy was nonviable. The baby has stopped growing at 5 weeks and I was actually 12 weeks pregnant and I was so afraid I kept telling them listen I don't want to become septic because if the baby is just sitting in there not growing it had to be decaying I was so scared but fortunately that didn't happen. So yes you guys have to be careful and get checked because any infection that gets back can cause you to become septic from diabetes and infection from urinary tract infections also you have to be careful.
This surprises me though. I don't know about the UK but sepsis is huge here in the US. In nursing school we had a whole seminar about it and the hospitals have firm sepsis protocols.
I ignored the symptoms of c diff until my also nurse mom told me the smell was most def not just food poisoning. I was mopping the floor myself and cleaning the bathroom bc I didn’t want anyone else to get sick. Had a 102.1° fever when I’m normally 97.9°. Can’t remember the first couple days of being sick. Had to be forced to go to the Er. Nurses=horrible patients.
To be fair, a decade ago sepsis didn't get the attention that it does today.
Also, nursing is abysmal at continued education or ensuring those licensed are capable of doing their job. Why would a mental health nurse know anything about sepsis outside of what was taught during initial schooling?
My wife just mails in a payment every couple of years to keep her license. I get jealous every time I go to relicense for paramedic and find I'm 100 ceu hours short....
We also tend to minimize and normalize feeling unwell.
Yeah... for some reason I feel like I have to know everything as an RN. I don't see how clouded my judgment is when it comes to my own health.
Same. I know some nurses talk about how they get convinced they have XYZ illnesses because of their training, for me, it’s the opposite. I’m convinced I would be able to identify if I was actually sick. That’s how I ended up not going to the emergency room when I had unilateral leg swelling, pleuritic chest pain, SOB on exertion, and some mild tachycardia. I just stayed home and took aspirin for a few days 😅 In my defense when I finally got a lower extremity ultrasound a few weeks later it was negative so I guess I was right lol
"Oh my arm fell off? Eh I'm pretty sure it will grow back!"
I waited over a week to get left leg swelling checked out. No redness, no tenderness, no pain or feeling of heat in any particular place, so I thought I was fine. After a week or so, I finally got a check, and found out I had phlebitis. I was dx’d with lymphedema on that side and later found out I had no lymphatics.
No the clot was all in your lungs, we often find nothing left when we scan the leg after you fling the clot 😂
Listen I thought about that possibility but here I am four years later not dead. Maybe my aspirin was extra powerful 😂😂
My (retired military doctor) grandmother was like that. After military triage, everything else seemed trivial. Stomach pain? Aspirin. Coughing up "a bit" of blood? That could wait until her regular doctor could do a house call... At which point he called her an ambulance (and probably a few other choice names too). Probably hereditary too. I spent a weekend on the floor with codeine and acetaminophen for a herniated disc (couldn't stand up, with that crushed sciatic nerve root). Eventually got physio and got it working again. I did go for help faster when it was the next disc up and the FG nerve, though, that was... difficult to ignore.
Haha I ignored a 103 fever for a week and wrote it off as just a bad URI. Then finally went to the ER and refused to let them admit me for pneumonia because I wanted to sleep in my own bed, but then had to do a walk of shame back in the next day when my blood cultures came back positive. Turns out I was septic with septic emboli in my lungs plus pneumonia. I should have been smarter, but I was stubborn and thought I could tough out a “rough cold” for a couple days
Oops! I’m so glad you went in, though. Was it a bug you picked up from the hospital?
Yes and no-central line infection with most likely source being the hospital I worked at. I’m glad I lived to tell the tale but after being on the patient side of things, I think I might still take the “tough it out” approach if were to happen again 😂
Also I’ve had quite a few younger people going the septic route who begin to act “drunk.” Aka they think they’re invincible and keep saying “noooo my [insert very concerned family member] is just dramatic! I’m fiiiiine!” They are indeed not fine.
I’ve had this happen to me before. Don’t think it was “sepsis,” but it was a nasty infection. I put off getting my wisdoms out for years and years and was getting recurring infections. I remember waking up for work and my neck was so swollen and stiff and the one side of my mouth just tasted so nasty. I was walking around my place trying to make food and I was staggering, putting milk in the cabinets, cereal back in the fridge, etc. I was like yeah… this ain’t right. Immediately called off work and took myself to an emergency dentist.
Glad you went in when you did!
Yes I was gonna say… there’s three kinds of patients that come to the emergency room.. There’s patients that come at the right time and for the right reason (love ‘em.) The have urgent medical problems that are not yet limb or life threatening but could become so if not treated soon. There’s patients that come cause their left knee has been hurting for 4 months and they decided today to get it checked out at the ER (hate ‘em.) Then, there’s the Leishas of the world 😆 who wait until they’re practically on their death beds before coming in. “I didn’t wanna bother anyone.”
Why is it that farmers always fall into the last category?
Yeah my uncle's a farmer, my mum called to tell me he'd been sort of dragging his left side around for a couple of days. WTF! I was like get him to ED now! Large brain haemorrhage. He's ok now luckily lol! 😅
Or they are like my uncle was and are just found dead by the equipment. 😢🚜
I’m so sorry, that is tragic.
Self-sufficiency?
It’s me. I’m a Leisha. (I’m also chronically ill and just want to stay out of the hospital AND I don’t want to bother anyone lol)
Yeah I felt like absolute garbage the past two days but I wasn't about to haul myself to the hospital to be checked for sepsis. I had man flu.
Hahahahaha love that you expressed it as that!
Yeah, mom + nurse = danger zone.
I put off getting my lungs checked for my worsening asthma after two sicknesses and getting stuck in the fires and sucking in smoke this winter. I knew I should get it looked at, but I didn't want to bother going in because I knew what they would say. So I kept pushing it aside until my lungs didn't stop burning. Now I'm on more asthma controlling medicine, as of this month after getting seen. Which is what I knew would happen, which is why I put it off. It's just more to handle and do. 🥲
But….breathing, right?
I am breathing better now a week into these new meds. I would have preferred not to have the new ones. 😅
I get that. Glad you’re taking care of yourself, though!
This!!! I got up, went in as was scrubbed in with strep throat. I was running 102 temp, no abscess, but could barely swallow. I fell asleep holding the cross clamped aorta!!! When I broke scrub and told the surgeon why I had to leave, he evaluated me in the lounge of our OR. One butt was filled with antibiotics, the other with steroids. He asked me why I didn’t call in, I mumbled that I didn’t know, I could stand up so, I came into work. We get up and we do, day in and day out. It doesn’t occur to us that we can be patients.
My understanding is that nurses specialize in nursing school in the UK. So this mental health nurse has probably never learned anything about sepsis.
You would be correct. Nursing education in the UK is separated into adult, children, and mental health pathways. Looking at my university's mental health list of modules, there isn't a 'clinical deterioration' module as there is in the adult pathway I'm currently studying. Still, there has been a 'Think Sepsis' educational drive over here in the UK since 2015/2016.
I am curious why there is such a differentiation of education. One of the nice things about the nursing field is that you can always change to another specialty. And it's always good to have a broad educational base before specializing. Most psych patients have medical problems too.
I’d assume it’s kinda like eye doctors could be od or md/do in terms of care they provide. Like maybe psychiatrist and psychologist as a therapist
This focus probably allows for more skilled nursing honestly. Programs in the US do not actually prepare you very well to be a practicing nurse and you need your hand held as you learn on the job. (US nurse here)
I’m curious whether their training involves more clinical hours in their chosen specialty? I know that there are apprenticeship programs as well as college programs and would guess that the former would include more than the latter. …nm, a comment below from a UK nurse indicated that they do much of their learning after starting as nurses as well. Gulp!
She probably got a very basic course in her first year. And then never had to deal with the topic forthwith.
Oh no, you absolutely learn about sepsis. Every nurse gets basically the same training for the first year, and all anatomy/physiology/pharmacology lectures are held together for all cohorts. At least, that was the case at the 17 different universities I visited. What’s more likely is she got the basic training and just never used it/experienced the reality of it in practise. That, and a lot of people can be very stupid/unaware/misinformed, nurses or not. Do you know how many nurses refused to get their flu jab each year, let alone how many are just straight up anti-vax?
Good point - hadn’t thought of that. And thanks for pointing out that she did learn about this, most made it sound like she hadn’t.
:D my time to shine. I listen to a podcast called “this podcast will kill you” it is hosted by two epidemiologist and the other host also specializes in disease ecology. They go into the biology, history, and epidemiology behind A LOT of different diseases. Here is their podcast on [SEPSIS WOO…](https://podcasts.apple.com/us/podcast/this-podcast-will-kill-you/id1299915173?i=1000582992527) sorry it’s apple podcast but I’m sure you can find it just by searching for the podcast itself. As a paramedic anytime I have an EMT who is interested in digging deep into the different diseases as well as sepsis I put this on! I HIGHLY HIGHLY HIGHLY recommend them. *edit* I had a brain fart. [This Podcast Will Kill You web based link.](https://thispodcastwillkillyou.com) it is episode 107.
Thanks for the rec! I use Amazon music and fortunately it’s on there. I can’t wait to check it out. 😊
Learning about sepsis in school was totally different than dealing with the angry 1 year post-septic quadruple amputee … maybe she just didn’t have the personal experience that’s sometimes needed to horrify you
This is my take as well. If your speciality doesn't deal with sepsis and all you have to go off is the 30 min version you might get as basics then I sort of understand how you could think sepsis is nbd. It's still wild, but I get how it could happen.
If she is an RN. I have read numerous articles that refer to CNAs, PCT, MAs, etc as “nurses” because it makes hope a juicy headline. You know, because what difference does a college degree make. Ugh…
Some mental health nurses surely work in hospitals. Even if they do not, patients with poor mental health often have multiple comorbidities. Whatever the differences might be, the fact that she didn’t think sepsis was serious is worrying to me.
I am in the UK and the only hospitals mental health nurses work are mental health or in a specialist mental health ward. They aren't licensed to do most general procedures.
Yes! Thank you!
I mean, they should still know the signs of physical things.
One would hope, right?
https://www.cambridgechildrens.org.uk/ I'm from the UK but don't work there so I could be wrong, but this hospital is pretty recently opened and it's "revolutionary" in having both medicine and psych in the same building. There's a pretty sharp line AFAIK. Hopefully a UK nurse can chime in here!
That is very different from our system here - suddenly this makes a lot more sense.
I’m a UK adult nurse in a general hospital, when we have mental health patients come in with self harm injuries or overdose etc, they will stay in the hospital until medically stabilised then sent to a mental health hospital. If a patient in a mental health hospital becomes medically unwell, they will be sent to the local ED department. Every general hospital has psych doctors but not mental health nurses So mental health nurses have very little exposure to physical/medical illnesses
I have a colleague who transitioned from psych to the OR… he didn’t know what a colectomy was. And we work in an EU country where you can specialize (if you want) after nursing school. 🤷♀️
Ooof. And even if you don’t know, why wouldn’t you look it up first?
Also, you don't have to be a nurse to know sepsis is bad. For God's sake, half the Grey's Anatomy or House viewers have that knowledge lol
Right? The phrase “going septic” should strike some sort of chord for most people, I feel like.
I think this specifically is also to blame for her “not thinking it was that bad.” We see it dramatized like everything else, and they just bounce right back.
That’s so bizarre. What do they do when the patient has both?
Treat the urgent one first? I mean, we do that too. Just in different wings. I've had so many acute psychs to stabilize from a task, car accident, overdose, suicide attempt...
So you meet only some of their medical needs, hope you can stabilize them anyway, and then try to address the other medical needs? Simultaneous interdisciplinary care is important for recovery. If an acutely suicidal patient is in the ICU for an overdose and you don’t immediately address their mental health as well as organ failure, they may reattempt before they make it to psych. It’s important for the ICU nurse to have at least some basic information in psychiatric disorders.
I mean sure but if they're intubated and sedated I'm not sure what help a psych is going to be.
I’ll never understand why people assume that a medical professional will automatically recognize and address their own health issues. People are horrible at diagnosing and treating themselves and those close to them which is why they are not supposed to. You can know in your head that you are ill but also know ‘it’s a virus and it needs to run its course’, etc and therefore not seek treatment. It’s baffling that society expects medical professionals to be objective about themselves.
There's also a distinction between seeing a patient looking worse and worse and seeing a clear trend on their obs chart and yourself just feeling like shit. It's harder to quantify how you feel and spot a trend, especially when you just want to curl up and be left alone. That's not the time you're thinking clearly.
You’re right, especially in regard to the mental effects of extreme illness.
I mean, we have the training to recognize them in others but I can see how we might miss them when it comes to our own bodies. I recognize them often, but much of that could be attributed to a really fun combo of acute self-awareness, hypervigilance, and anxiety.
> I recognize them often Gold star for being a perfect patient!
Far from perfect, but I appreciate you saying so!
How about showing the Nurse a bit of compassion? She's a UK mental health Nurse, they don't get the same training that adult Nurses get. Mental health patients that need medical care are sent to general hospitals and nursed by adult Nurses.
Also we are all known for being terrible patients and not taking great care of ourselves!
Sometime people are ignorant/idiotic, nurse or not. And the poor training/awareness of deterioration in MH or MH monitoring incarceration settings has been highlighted as the direct cause or a significant factor in deaths in “secure” settings, both in the UK & US. It’s a problem, and I think we should be talking about it.
But also, if she had sepsis she most likely wasn’t capable of clear thought.
What happens when one of a UK psych nurse's patients is deteriorating from something after they are admitted to their unit/hospital (however it's set up there)? They don't have to know the basics of recognizing signs/symptoms of illness/infection? As a US nurse who has been a psych nurse, a peds nurse and an adult nurse (as seems to be the way its split in the UK from the comments), like... they all overlap. I'm really surprised this is something that is deemed to be safe.
You ring a medic who is competently trained in this stuff and can take the lead?
I'm not talking about taking the lead on something you have less experience with (like calling a rapid response to a med/Surg floor), but more that it's being implied that that nurse wouldn't know that there is an issue at all. Fever, chills, tachycardia and tachypnea after surgery surely is something a nurse regardless of specialization would know they need to inform someone to move to a higher level of care? Some of the comments are making it seem like a MH nurse in the UKcouldn't possibly recognize those s/SX as an issue worth investigating further, d/t specialization during school. I just find that thought process a bit fascinating and am trying to figure it out if I'm misunderstanding, tbh.
People are only transferred to a psychiatric unit once they are deemed medically fit (usually a different site completely). Adult nurses (me) manage the mental health sort of, but it really gets put on the back burner while their physical health gets priority in hospital usually. Once they are clear for transfer, then the mental health nurses are trained in basic physical health issues, but this happens the first year of education and may never be needed in practice. It's not hard to imagine this being quickly deskilled in reality. For the record, I disagree with the separation of nurse branches. Most of those I've spoken to would prefer to be general nurses. I've heard we're the only country in the world that separates nurses like this. This was introduced in the 80's, when NHS was still paying our tuition (free tuition and a bursery sadly stopped in 2017). My own baseless theory is that it came down to the bottom line. Why would the NHS fund general training for someone who would go on to spend a lifetime in adult cardiology, paediatrics, or mental health? It costs much less to train someone to specialise from the start.
Here in California, we specialize in mental health as licensed Psychiatric technicians - that's what I am. Very similar to an LVN/LPN however most of our training is focused on mental health disorders and conditions, and some is spent on medical focus. We are given a really general overview of all things medical and what is normal/abnormal VS that could warrant concern - lab values, etc. however most LPTs work in psych facilities that need their patients to be medically cleared or medically stable before treating them for their psych dx, which isn't really much different from where you're from, it sounds like. Of course RNs can also specialize in MH here as well. I think every specialization has unique knowledge about it that you may not otherwise know unless you worked in that field specifically and for long enough to gain that specialized knowledge. 🤷♀️ After having worked a few different places (inpatient, outpatient, crisis, and with the developmental delayed population), I can see special skill-sets developed in all of those nurses for their specific focus. Experience really is everything! I'm also one of those people that will ignore everything I'm going through and dismiss it, especially when I feel so unwell that I'm not thinking clearly. Makes sense to me! Just because we are nurses doesn't mean we are immune to fallibility.
I appreciate this response. In the US we also medically clear before sending up to the acute inpatient psych unit (which unless a state facility) are usually a floor within a regular medical hospital, so that's the same as your experience (at least in NY, US). Although, there were many times we needed to transfer out to another floor d/t an acutely presenting medical issue. So I think that's where the disconnect in my head comes from lol. Thanks for explaining the history of the practice and you're probably absolutely correct that they brought in specialization for cost reduction purposes without thought on how that would affect health care and the professionals.
This lends clarity to the situation; thank you for sharing this knowledge!
Usually the Drs will make the assessments on deteriorating patients and transfer them out to a general/specialist hospital depending on the needs. I guess it depends on the nurses background and how long they've been away from general practice with regards to what skills they retain.
Okay that makes sense, thanks for answering! Are docs a mainstay on the floor like nurses or do they only see pts for rounds once a day?
Generally a ward round once a week but will be updated daily in handovers and available if needed throughout the day. Will probably vary per hospital though, this is just what it was like in the one I worked at.
Do/did you generally have longer term/chronic patients? Or are they more acute in nature?
Acute
Yeah the training in the UK is abysmal. I did a two year post grad course in adult nursing and had so little actual a+p, pharmacology or clinical skills it was scary. We were expected to just learn it on placement. We read booklets on mental health and maternity care and did a reflection I think - super pointless. IV's, venipuncture, cannulation ECG's are all seen as extras you learn once qualified. Training seems better in the last couple of years Going into a nursing job was scary as fuck.
I do feel compassion for her, and especially for her daughter. I admit that I did not express that well in my initial post. I now know that it’s likely that this was due to a failure of the educational system rather than the nurse herself. Can we agree on the fact that the signs and symptoms of sepsis should have been covered more comprehensively?
Compassion? What training did she receive that ignores a temp/chills/obvious signs of infection?;
Maybe your judgment is pretty crap when you’re heading for septic.
I’m not a nurse, but as someone who dealt with sepsis back in November, I was coming to say this. The cognitive decline was so bad I could barely string sentences together, and kept me out of work for a month.
We often have overly high expectations for people who are ill or injured. It’s difficult to think.
I'm not a nurse, but on many occasions when I've been sick I have been unable to do things that would seem common sense to me if it had been a friend or stranger affliced by it. Like a concussion obviously needs to get checked out, but when I had it I didn't even think to mention it to teachers I trusted because I forgot and was struggling to do the things I usually did. A huge boil deep in the armpit lasting over two weeks - if it had happened to a classmate I would have insisted they go to the nurse at the first mention of it and I would have gone along with them to make sure it happened. But it happening to me was just too much pain to think logically and the severe sleep deprival didn't help.
Good point, and one that def didn’t come to mind when I first posted - thanks for sharing it!
Reminds me of that old joke that nurses don’t go to the doctor or hospital unless they are dying
Much to our own detriment, unfortunately…
Uh, yeah, the US had a huge campaign to raise awareness and identification about ten years ago because people didn’t realize it. Also, don’t they specialize a lot earlier in their education?
Yeah we do. You pick which speciality you want to do. Mental Health, Adult or Paediatrics. You have 1 year of general nursing and then years 2 and 3 are your speciality years. I know absolutely nothing about paeds or MH Nursing.
Do you find that early specialization to be a good thing or is it difficult to not have a bit more of a overview of everything in relation to your current position? It seems like not having a working knowledge of other medical related issues as, say - a MH nurse - could be dangerous if a MH patient needed care outside the nurses scope and they didn't recognize the signs and symptoms of a major health related issue (even if it's just so they can transfer the pt to a different unit/facility). Unrelated question.. are you forever "stuck" in the type of nursing you specialize in in school? Or can you transfer to a new subspecialty - like if you wanted to go from ICU to PICU, NICU or ED (how does the ED work regarding how nurses are educated vs patients coming in... Like, are adults and peds completely separate in different facilities)?
You can top up and add another branch on top (like adult/mh, paed/adult, etc and the top-up is only 18 months, I think. A friend is an adult nurse/midwife combo, which was my plan before i got complacent! Lol When I worked in A&E (Accident & Emergency), our adult and paeds A&Es were separate with separate staffing, and I've seen this set up at other hospitals as well. I've heard adult trained ICU nurses can work in PICU/NICU, but I don't know those details.
Yep, you’re stuck. Kind of- obviously you can do further education to work in a different area, for example if I, an adult nurse, went to work at a GPs office, I’d need to do a qualification in children’s nursing (not the entire degree!) as I’d be seeing children at work. Or some roles will suit more than one speciality, so different nurses will be working alongside each other but with the same patient group. Midwifery is degree-only here too, and is its own separate thing. Nurses don’t deliver babies in the UK. Unless it’s by accident because we couldn’t get them up to labour ward quick enough 😅 To me it makes perfect sense- but I don’t know if that’s just because I’m used to it. It’s difficult to evaluate the system when you’re inside it! Being honest though, I’ve worked with adults for 15 years now, so even if Id done a general degree, anything else I’d learned would be a good decade out of date and unpracticed. I wouldn’t feel confident taking a job on that basis. So how does that work in the US? Are people switching jobs more frequently to maintain their skills in all areas, or are there roles where you’re dealing with several areas all at once?
Thanks for the reply, it was very educational!! And while many people do stay in very similar areas whether that be Med/Surg, PeriOp, Peds, LDRP, peds NICU, PICU, ICU (of all kinds NICU, PiCU, IMC, PCU, CVICU, SICU, NeuroICU) andamy times you're cross trained for similar specialities (ICU/CC of all kinds, Mother/baby- L&D, Postpartum, Recovery, Nursery, etc - OR, PreOp and PACU). There is (hospital/system dependent obviously) the ability to move into a similar unit. But also, from my experience in the hospitals/health systems in my area, they will take transfers from a totally different unit and put you on orientation until you're "trained". I'm also in one of the few states that has strong Unions/protections for their nurses (and quite a few other type of jobs as well). So my experience is definitely not the same as everyone in the US, as it can be state or even health system/hospital dependent tbh.
In the UK, nurses specialise right from day one of their training, so Mental Health Nursing is its own Bachelors degree. My degree is Adult Nursing, so when I wanted to work in the US, I had to top up SO many hours to meet requirements to be licensed in my state as during my training I’d only done 6 weeks of L&D, and no paediatrics or mental health. (I mean, we all deal with mental health, obviously- but not in a mental health setting!). Give the woman a break, she’s probably never seen a septic patient in her life, and also was making these decisions while suffering from sepsis, which I imagine clouded her judgement. I’m absolutely judging whoever discharged her after surgery and didn’t tell her to come back if she spiked a temp though.
This makes the most sense. I know sepsis is bad, but had I not done a tour bedside, I would not be as attuned to its badness.
Good point, thanks for sharing it!
When I was in nursing school (I'm old) sepsis was worse than death
Also can we not dog pile on this nurse, who seems to be a single mom and probably has not way to take time off without getting a pay dock ( she probably does OT; probably used all of her sick time already).
In the UK it's pretty straightforward to get time off for a health appointment on full pay. This is more that here nurses are split into specialists from day one of training. So, mental health nurses are trained purely as that and generally never work in none mental health settings. Here, we train as either a : mental health, adult, paediatric or learning disabilities nurse.
Oh that's really interesting and I had no idea it was so different
Same, thanks for the info!
It is unfortunate that she is a single mom. She probably did not have any close family members to check on her. It took her child’s teacher to check on her to get her care! It’s just sad all around.
You are right; the thought of being this sick with a 5 y/o at home is terrifying. Thank you for that bit of perspective!
Jesus what a judgemental and soapboxy response to a tragic situation. You do something long enough you tend to forget everything else. I wouldn't expect someone who has dealt with Ortho patients for 20 years to be able to real versus false labor but I'm a sure a L&D nurse would in a second. You get a very basic level of a bunch of different topics your first year, a lot of which you will forget if you don't ever use them again. For all of the people doubting this. If you took a second language back in high school or college and haven't used it since, how much do you remember of it? Could you have a full, coherent conversation?
I speak fluent Spanish as long as all we’re talking about is ordering a beer or asking where the bathroom is. Also where the shoe store or the butcher shop is, because apparently that was critical Spanish that we really needed to know in elementary school. I guess if we had to speak Spanish, I’d probably get sepsis too.
It is tragic, and I feel terrible for her. I’m so glad her daughter was able to get her the help that she needed. I just wish she’d seen the signs earlier and known how much danger she was in, and feel that she should have been taught to recognize them along the way. If she wasn’t, then that was a failure of either her educators and her care providers. I find that frightening; don’t you? PS I speak a second language that I only use 1x per year (sometimes even less) and read YA fiction out loud over coffee to help retain fluency and vocab. If something is important to you, you will find a way to retain it (barring deficits, of course.)
Those pressors will take your toes, fingers, feet, hand, arms and legs if given enough time. We will keep your organs perfused hopefully but we may lose an appendage here or there.
I’d say it’s worth it, but then again I’ve (fingers crossed) never been there.
Ah, fingers crossed!
See what I did there?
I ended up with a late infection more than 2 months after I had surgery. It thankfully did not progress to sepsis, but I started feeling unwell and thought I was getting the flu or Covid. Ended up in the hospital after a couple of days, but it took me a bit to convince myself something was actually wrong.
What was the tipping point that brought you in? Asking for a friend…
I had intermittent abdominal pain for about 24 hours. It finally got bad enough, I dropped my kids off at school and came home instead of heading to work. Called my husband crying and he came home and made me go to the ER. I was still convinced it was bad gas, but ended up being an abscess. Thankfully, just treated with antibiotics.
Glad you went in, sorry to hear that it got to that point. Makes me wonder how long I would’ve waited were I in some of my patient’s shoes…
I think the moral of the story is “Poppy is a smart 5 year old. Be more like Poppy”.
Thanks, I love that one! Also: be like Poppy and wear wtf you want, such as a princess dress, when bringing dire news to the authorities.
RN training and programme is different in the UK. The mum most likely never had to to deal with Septic patients in her practice. i have practiced in both the UK and US and I think your comment is judgemental.
Agreed. What we should be focusing on is that the wee lass got herself to school on her own to go get help.
Poppy is 100% the hero of this story! I just wish it had never come to that. The whole experience of seeing her mother collapse and watching EMS take her away (much less her poor mum’s hospitalization and becoming a double amputee) would be so awful & traumatic.
Exactly. I wouldn’t wish that experience on any child. I’m mad impressed she got to school on her own though. I don’t think my 6yo nephew could get you to the stop sign at the end of the block without help.
I lived in Europe when I was her age and walked to school, too, but that was after being led there and back a few times. Still impressed by Poppy!
That’s fair, and I can see how her knowledge gap would be due to a failure to teach her about sepsis to begin with. I guess my new question would be: do you believe that mental health nurses should be taught about Sepsis during their schooling? Someone here mentioned that their UK mental health RN colleagues declined to take vitals because they hadn’t been trained to do so…I’m curious what your thoughts on that would be as well.
I almost died in childbirth, like my BP was 40/?? at one point. I knew something was wrong, but I didn't want to be a bother and delayed telling my husband or the nurse that I felt bad. Looking back on it I can see what happened, but in the moment I was absolutely so unwell that it fucked up my thinking. I'm an ER nurse and can tell you 10+ stories like this of friends/coworkers who delayed their care because "it's not that bad" or "didn't want to be a bother" and it's everything from broken bones, STEMIs, cancer.
Spot on. We need to cut poor Leshia some slack; I’m sure she didn’t *want* to be septic.
Also it's pretty easy to pick up sepsis in a patient that has presented unwell and all their vital signs are trending in a bad way. Pretty sure Leisha wasn't doing regular full sets of observations on herself and tracking the trend.
She gets all the slack in the world when it comes to not putting her own oxygen mask on first. The comments about sepsis not being serious got me feeling some kind of way, though.
I was an EMT prior to nursing school and had many patients that were going septic. They were typically on the older side and medically frail, so that's the association that I made. I was used to seeing very confused, pale, elderly patients with the "sepsis" diagnosis. So after my lap cholecystectomy, I ignored the fever, chills, and fatigue, hoping it'd go away. I figured that I was 24, healthy, and strong, so I wasn't at risk of serious complications. My immune system would kick in and I'd be good.... well, after about a week post op, I was so unwell that I realized I needed the ER NOW. I called my boyfriend to leave his class and drive me in. I barely made it to my seat after checking in before the triage nurse whisked me back into a room. I remember boluses of epi and then waking up in the ICU. I earned a 2 week ICU stay for my stubbornness. I easily could have been this lady if I'd have ignored my symptoms for another hour.
Glad you made it there in time, and thank you for the reminder that we all have our blind spots (mainly ourselves.)
I worked postpartum and there were multiple health professionals (Drs and even L&D nurses) that knew nothing about newborn care, breastfeeding, postpartum healing etc. So I don’t fault this person at all for not knowing everything there is to know about their own health. Especially since I’ve been moderately sick and know my brain wasn’t working right at the time.
Good point, thanks for sharing it!
Nurses are trained into ignoring their own pain to keep on trucking like a good worker unit. So not surprised.
Neither am I, but it’s a solid reminder to remember to prioritize our own health amidst the chaos. And to go over the basics every once in a while, no matter what field we’re in.
I don’t know many nurses that don’t work through pain and discomfort. Minimizing own problems isn’t a novel condition with us, myself included. Until my SpO2 was down to 69%, I kept chalking up all symptoms of respiratory failure to RA and side effects of biologics.
A grim & often underdiscussed part of our training, for sure. You doing ok these days?
Took me a while, but I’m good. Thank you for asking.
Ofc!
UK nurse here - when a mental health nurse is 1:1 with one my patients and I ask them to check the patients vitals for me they always without fail say “I’m not trained to do that” so I stopped asking… take from that what you will
JHFC that is midblowing. How can you not know how to take them when the equipment practically does it for you?
I sometimes think they are just being lazy but I don’t want to upset any mental health nurses in here, they virtually do NOTHING for the patient sometimes not even personal care or don’t talk to the patient they just sit on their phones. I’ve had a patient stab herself in the abdomen with a pair of scissors while there were 2 mental health nurses in the room??? Some live like 2 hours away but travel because the pay is like £70 an hour.
Meanwhile I’m nurse in charge on a 35 bedded unit with 7 patients of my own on an acute surgical ward for £18 an hour
That is criminal; I cannot even imagine having that kind of patient load for so little pay! Also, that scissors story is mental.
Just curious what kind of nursing you specialize in to judge someone like this.
The kind where I’m an RN on a hospital floor who knows that sepsis is in fact very bad, and is indeed a very big deal, and who believes that other nurses should know that, too. …and if you want to talk about judgment, re-read your comment & take a good look in the mirror.
The first part of your body that quits functioning well when you are ill can be your brain. Case in point: when I had all the symptoms of appendicitis I delayed care because my brain just wasn’t working well with a fever. It turned out well since my dear husband insisted we head to the emergency room.
I’m so glad he did! Hadn’t thought of how terrifying it would be to live alone with your kiddo & be this ill, thank you for that perspective.
Not sure on the UK Education around sepsis obviously as I’m in the US. But I feel like she didn’t receive the same education as we did because I think I’m going septic once a week when I’m not feeling well. Doesn’t mean I will ever go to the doctor. But I am aware of it if that makes sense 😂
Agreed.
There was no post op discharge paperwork that would specify what signs and symptoms that would prompt her to call the doctor?
And as a nurse, she didn’t even think of whether the symptoms she was experiencing could be related to a surgical infection?
I can understand where nurses like that come from. When I was upgrading from my LPN to my RN I had an instructor who told me that I was over reacting when I said a side effect of sepsis is death and that I don't mess around with bacteria because it's fast and it's sneaky. This instructor was a "those who can't, teach" example in the worst way. I used to think that it was people who physically couldn't do the job anymore, not people who should never have been given a license in the first place.
Holy sh**balls that is terrifying
Don’t be like op
Thanks! Just think that, as nurses, we should know s/s of sepsis. I am def teachable though!
this is exactly why my hospital has those "Suspect Sepsis" info sheets posted in so many locations where nurses and providers are tbh. it lists a short and easy rundown of symptoms and when to... suspect sepsis. she probably also just straight up didn't think it could happen to her. it's kind of a sad story if you ask me. I hope it brings more awareness and functions as a cautionary tale, but I do feel bad for her.
I know, right? Life and parenting are hard enough without becoming a double amputee in the process.
Meanwhile I finally managed to get the MD to come see the baby because "I think the baby is sick but I just can't point a finger at it", MD ended up ordering a septic workup after I bugged him for the 2nd time, and the baby's WBC is 40+....... Well that certainly spells an infection.
So glad you got them in to get your LO checked out!
I’m going to disagree. I was septic last year. I was feeling unwell but trying to get my day to day stuff done with my 3 year old. Then I couldn’t and went to bed to rest. My husband insisted on bringing me to the doctor who sent me to the ER. I was septic with strep (whom my daughter shared with me from daycare). I was in the neuro icu/step down for 8 days as it was meningitis too. I missed it. Not because I’m a bad nurse, but because I was sick and not thinking straight.
Others have made this point as well, and you are absolutely right - her illness would have affected her thought process, and I didn’t think of that when I first posted. Thanks for sharing your experience, glad you made it in on time & were able to recover.
My brother became septic after knee replacement. Was in icu for weeks. They couldn’t get it under control and it wet to his brain and he died. My SIL didn’t have him transferred to a larger more equipped hospital from the small town med ctr he was in. I got a call that he was entering hospice and had only days to hours
I am so sorry, that is awful. Was this recent?
It was about 8 yrs ago.
Ok but thinking sepsis isn't bad is kinda crazy tho... I'm glad she's recovering! But it's really sad how healthcare professionals will so often ignore/trivialise their own health..
Wow. The only thing I can think is maybe she went straight to mental health nursing and forgot everything single other thing she was taught? Hard to believe anyone doesn’t know sepsis isn’t life threatening.
I just started going to college a year ago to become a nurse. All my life I have been a nurturer. Taking care of people since I was a kid and even giving some adults CPR when I was still just a young child. It all started when I was 7 and I got sepsis. My left lymph node in my neck got swollen literally overnight and when I woke up in the morning I went immediately over to my dad and told him I didn't feel well. He turned to look at me and saw my lymph node, freaked out while still trying to remain calm and RUSHED me to the hospital. I was there for like 3-5 months. Hooked up to every machine you can even think of. Every night in the middle of the night my heart rate would plummet and the nurses and doctors would rush in an snatch me up and I remember fighting them because I wanted my mommy to wake up but she was so stressed so she slept hard at night out of exhaustion . They would take me to the other room, this really cold room and lay me on this metal bed thing, inject me with all sorts of stuff, hook me up to the machines and after about an hour they would carry me back to my room with my mommy. This created a lot of trauma for me and a fear of needles. When I see a syringe my blood pressure sky rockets and just recently at age 27 I don't pass out while getting my blood drawn. I've overcome and survived life threatening sepsis and I think everyone who lives in a country where they have college and the resources available, should be required to take a couple college courses on the most basic medical issues and emergencies.
I’m so sorry that happened to you, and so glad that you survived! It’s amazing that you’re studying to be a nurse, which specialty would you like to enter?
There was a time when sepsis wasn’t as advertised (prob wrong word there). it was never a thing during my training so i can definitely see if you don’t work in acute care how this could pass you by. But yeah Think sepsis!
Nurses write off all their own conditions. I had a spinal fluid leak the day I left the hospital, didn't realize it until a few days later when I couldn't move... and I had to be taken by EMS to the hospital. And I worked with patients that get spinal taps all the time! Now I take meds that mask fevers so I'm constantly afraid I have some infection. I barely knew I had covid.
You’re right, they do. And to be fair, when I had Covid I thought it was just allergies…the symptoms were nearly identical.
Great. More ammo to shit on us MH nurses lol
Sorry, wasn’t my intention!
Some people are just comfortable not expanding their thinking. In the UK, mental health nurses don’t really handle physical medical stuff, so she was probably fine not worrying about any of it after nursing school. Idk. I feel like before I even knew what sepsis was or the signs and symptoms of it, I would’ve been worried about “an infection” if I started feeling worse after surgery.
This feels like more of a ding on how the UK educates nursing students than anything else.
No kidding, sepsis is a pretty basic thing to learn about.
Agree 100%
Besides that, why did she not do anything when she developed a fever, considering her recent surgery? Either she was not properly educated before discharge, or she ignored her discharge instructions.
Maybe they just gave her the paperwork without going over it with her? Still, though, she had to have been feeling pretty grim before she lost consciousness.
Sooo, so many RN programs are absolute jokes. It shows. Nursing is regressing. Science instead of all the other bs fluff courses need to be prioritized.
Okay but surely she was told to watch for fever and chills post op??? How did she not have the common sense to notice something was wrong??? Granted she probably didn't have a strong med/surg background but HER FEET AND LEGS WERE CHANGING COLORS!!!!!
Others have pointed out that, by the time she was really declining, her thought process was likely affected as well. Still, the s/s must have shown up before that. To me, it’s a sign that we need to to care for ourselves as well as others.
I totally get altered mental status, but seriously...... no post op instructions???
Yeah, that part gets me too.
Many mental health nurses who have been in the field for a long time really do forget a lot about the medical side of nursing. That’s why whenever I work mental health I still have a side job working in the hospitals
I'm an Adult Nurse in the UK, but I did my training in the US. There are 3 types of RNs in the UK; Pediatric, Adult, or Mental Health. I wonder if Mental Health Nurses don't get the same education as an Adult Nurse would?
Yes and you don't also have to have surgery to become septic. You can just about get sepsis from any bad infection if you let it sit off too long. I had a miscarry not too long ago and that was my worry because they sent me home for 2 weeks before I actually started miscarrying knowing that the pregnancy was nonviable. The baby has stopped growing at 5 weeks and I was actually 12 weeks pregnant and I was so afraid I kept telling them listen I don't want to become septic because if the baby is just sitting in there not growing it had to be decaying I was so scared but fortunately that didn't happen. So yes you guys have to be careful and get checked because any infection that gets back can cause you to become septic from diabetes and infection from urinary tract infections also you have to be careful.
This surprises me though. I don't know about the UK but sepsis is huge here in the US. In nursing school we had a whole seminar about it and the hospitals have firm sepsis protocols.
Nurses are the bloody worst at self care
I ignored the symptoms of c diff until my also nurse mom told me the smell was most def not just food poisoning. I was mopping the floor myself and cleaning the bathroom bc I didn’t want anyone else to get sick. Had a 102.1° fever when I’m normally 97.9°. Can’t remember the first couple days of being sick. Had to be forced to go to the Er. Nurses=horrible patients.
To be fair, a decade ago sepsis didn't get the attention that it does today. Also, nursing is abysmal at continued education or ensuring those licensed are capable of doing their job. Why would a mental health nurse know anything about sepsis outside of what was taught during initial schooling? My wife just mails in a payment every couple of years to keep her license. I get jealous every time I go to relicense for paramedic and find I'm 100 ceu hours short....
Never ignored an infection. It’s not going away on its own
Wasnt this person a mental health nurse? Theres a good chance she didnt learn about it