A little known fact outside of the nursing profession is that there is a lot of infighting and mudslinging in the nursing field. Nurses who work in different areas of the hospital have this “circle the wagons” mentality.

Each of the units in the hospital views themselves as being better than the rest: surgical, endoscopy, the ICU, all of them.

The medical floor is where many nurses get their start, and it is viewed as one of the areas of the hospital that require the lowest level of skill and proficiency. It’s for this reason that they struggle to be respected by other units.

Labor and delivery are seen by most of the hospital as simply wanting to play with babies. The ICU are seen as the neat freaks, the ones who have OCD and simply MUST have everything perfectly in place.

However, there is one almost universal truth- the Emergency department is seen as being the cowboys. They aren’t as methodical, often improvising, adapting, and overcoming obstacles with little regard for tradition or propriety in their quest to stabilize patients. That’s why this is funny:

To say that some nurses simply HATE nurses in the emergency department is an understatement. An even larger sin amongst those particular nurses is to have begun your career as a paramedic. The nurses who dislike the RNs in the ED reserve an all new level of hate for nurses who used to be paramedics. They (paramedics) are viewed by these nurses as being knuckle-dragging Neanderthals’ who have no business in a hospital.

The odd part is that many nurses (25% to 80%) in the ED originally started their careers as paramedics. It’s a natural progression for them, because the same skills that make them good paramedics also make them good nurses. These former medics are known as great critical thinkers, improvisers, and they usually excel at starting IV lines that other nurses can’t get. Beginning your career starting IVs in the back of a moving truck, it’s a skill that isn’t unlearned.

I had a nursing instructor tell me that REAL nurses start IV’s in the hand, and never in the crook of the elbow, because it’s uncomfortable for the patient, and movement of the elbow can cause issues with IV pumps. I pointed out to her that some drugs like IV contrast dye, and Adenocard must go into that location, so saying “never” is not correct. The unfortunate thing is that she was one of my nursing instructors, she’s a screaming liberal, and since I apparently have a biological inability to shut my mouth when I think I’m correct, it cost me some grief during RN school. The same issue is what chased me out of getting my masters degree a decade ago.

It didn’t help that we had to write a paper on this cartoon, microaggressions, and how vulnerable populations must feel in the face of white privilege. I hate it, but liberal professors are the gatekeepers. There were two things that made life hard for me. Being right, and not being able to back down when I know that I’m right. That’s why I am struggling to finish my BSN. I already have Seven college degrees, with two of them being Bachelor’s degrees. It’s the nitpicky BS that I struggle with.

Misplace a comma in ONE of the APA references in your bibliography, and you just handed them the excuse to take the paper you spend two weeks on down to an 88% ‘B’ grade. I just don’t have patience for that kind of ticky-tack BS. It doesn’t help that I am in classes where I am decades older than some of my instructors.

I will make it, because I learned my lesson ten years ago, but it still burns my ass that these professors make mouthing the commie line a required rite of passage to get a degree.


Joe Blow · October 10, 2023 at 7:09 am

I think all trades are like that? Worked in the print-biz for 25 years. Was a computer Prepress guy (graphic designers make pretty pictures. I made pretty pictures print). No matter what, the pressroom were knuckledragging neanderthals, and they thought about as much about us. Then I got to spend a few weekends working on a press. Boy Howdy, that shit ain’t easy?! Typical make-ready on a 40″ press is about 150-250 sheets of paper, then the ink is up to density, fit is in, color good, start running production sheets.
At 1500 sheets of make ready, I threw my hands up in defeat. 30 and about 60 sheets later, the instructor was running.
Honestly a truly eye-opening experience for me professionally (I might have learned something personally). I now have a lot of respect for the people toiling upstream and downstream from me. It may seem easier than your job, but walk a mile….

Jen · October 10, 2023 at 7:19 am

Nursing school is just an exercise in subjugation. You go into it to care for people, and you get beaten down by professors who are just itching to curbstomp any independent thoughts. Cross every T, dot every I, and fill out every blank on every freaking form. They just select for the meek who will take the abuse, cowtow to management and not agitate for a union when they give you 10 patients.
Also. I dropped out of my MSN program after I had a fat braless tattooed hillbilly sicc her dogs on me and chase me in her car when I walked through her neighborhood doing a mandatory ‘community assessment.’ I wrote this up in my paper, and got reprimanded for my ‘unprofessionalism.’ NFLTG.

Kentucky Headhunter · October 10, 2023 at 7:24 am

Being a male RN in the nursing profession is a serious undertaking. You are both looked down by the females for not being an MD, but also expected to take the lead in almost any situation where an MD isn’t around. Working in the ED and inpatient psych, you’ll usually have more other males around, but God help the poor guy having to work on the med-surg floor. You’ll almost never get one of the cushy, but usually more interesting jobs in one the procedural areas due the old girl’s network. If you’re not gunning for nurse anesthesia or NP job with decent hours/pay, it’s proabably best to try another career.

TechieDude · October 10, 2023 at 7:48 am

“These former medics are known as great critical thinkers, improvisers, and they usually excel at starting IV lines that other nurses can’t get.”

No shit there. I’m a “tough stick”. Every time, every.time a nurse can’t get an IV or even a blood test, they go get help, and that help 90% of the time is a dude that was a medic. The other 10 % are a mixture of women medics, and old women who have done it a million times.

This happened, as usual, when I was getting a cat scan with contrast. In comes the pro. He said “It’s deeper than it feels”. I pass that along every time. Sometimes they get it, usually not.

Grumpy51 · October 10, 2023 at 8:44 am

LOLOLOL – we have similar backgrounds

My ICU wife (newly married) asked me (ED/Flight) why Paramedics were so cocky. I thought about then replied – when you call a code, how many people come to assist?? House Supervisor, 3-4 fellow ICU nurses, respiratory, lab, XR, ED doc, sometimes critical care doc, couple of aids?? When a medic makes a code, it’s him and his partner, maybe a couple of firefighters, that’s it. It either gets done by those 2 or it doesn’t get done (intubations, IVs). So don’t confuse cocky with self-confidence. And yes, I’ve intubated people upside down, on their side, sitting up, etc while awaiting rescue to get them extricated (no airway, no bueno).

My advanced med-sure nursing instructor stated in front of the class, end of semester, “I pray to God I don’t have any more paramedics in my class!” Why?? Simply because I question things and telling me “that’s just the way we do things” isn’t good enough – especially when anatomy, physiology, and pathophysiology are lining up against your argument.

Re: classes and writing papers – I follow the Richard Marcinko thought process – “You don’t have to like it, you just have to f$$$ do it” (true word not used here for respect but listed in his book Leadership Secrets of the Rogue Warrior). I actually quoted him in my Master’s review class – admin tried to have me expelled but I quoted him and gave hime credit and stood my ground…. they backed down since they had emphasized all along about “quoting sources.”

IF I had done my masters in nursing first, I’d never had gone to any other Masters programs – it sucked that bad. BUT, since I had done other Masters first…….

Re: thinking outside the box (firefighters/Paramedics) – I still hold the record of patients flown in a single mission – 3 (all properly secured in the aircraft), 30 years later still holding…… in an aircraft limited to 2 patients….. Thinking outside the box….. and all safely done, including pilot permission.

Re: med-surg nurses – I always had the utmost respect for them as time management was critical and most did it well.

Grumpy51 · October 10, 2023 at 8:46 am

I encourage you to “just f$$$ do it” to pass and get out and excel. I do my own thing but wasn’t going to let professors (NONE of us, 16, passed our final exam – but ALL of us passed our certs; that’s how bad our program was) dictate my future.

Rick T · October 10, 2023 at 10:10 am

When I was headed back to college after 6 years in the Navy my uncle Dick gave me really good advice: the first thing you study in any course is the instructor. One high school buddy managed to piss of the sole instructor of a critical course badly enough Harry never completed his BS degree. The prof would never give Harry better than a D, even with perfect work.

My wife is an RN/RD and I worked as an orderly for a couple years so my take:
-Med Surg floors have lots of patients so routines are important to get care done
– Procedures are about processing the cases thru the system. Known workload just grind
– ICU has the sickies but has the most resources on call to help (Respiratory, Xray, etc)
– ER is cowboy time, you don’t know what is coming thru the door next or how many other cases will roll in at the same time. Jugglers and improvisers required.

Cederq · October 10, 2023 at 11:37 am

I went to a local community college for my ASN. Wasn’t too bad. I then went to Portland State University for my BSN and MSN in both Nursing and Behavioral Science. I wore my tongue out biting it and I have prominent keloid scars where the inside of my cheeks use to be. A more liberal college and area to be had. If Putin nukes DC, I want him to specifically target PSU, during the day, when most of the admin and instructors are present. It seems we all had the same problem. I started schooling in 1980, after 5 years in the Army as an MP. I had to learn to put up with lack of any real discipline. Female behaviors were rampart. I too worked all the nursing disciplines listed and some others not listed except ICU and juv psych. I did that to gain skills, techniques to make my job and floor better. I was a Charge Nurse, Med/Surg/ Urinary and that time spent in other units paid dividends. I at least spent one extra shift in ER a week. It was enlighten and actually fun in a perverse way. Yes, I got real good with IV starts and learned it by the pros, the EMTs and Paramedics.

Stealth Spaniel · October 10, 2023 at 7:56 pm

Thank God, my mom went into nursing in 1953. She did 2 years at Good Samaritan Hospital in Dayton, Ohio for her “full” training. She was expected to be able to do bed pans, IV’s,wrap wounds, sew folks up-if no doctor (not necessarily a surgeon), help the doc set a leg or arm, and 5000 other everyday occurrences. Including deliver babies. The fact that “nursing” has morphed into this horse💩 overloaded paper memory test is not serving us well. While there have been major changes in medicine since 1953, nurses are no longer able to use common sense, intelligence, hunches, or simple human kindness. There is always some non medically trained money pusher who is overseeing their work. What a disservice to patients.

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