Vitals Stable, Nurse Not: ICU Diaries Vol III
Millennial nurse diaries from the blurry edge of professionalism, burnout, and full moon charting chaos.
📎 Before You Proceed, Read This:
Disclaimer: These entries are fictionalized, satirical reflections inspired by real-life nursing experiences. All identifying details have been changed or merged beyond recognition in full compliance with Swiss law and nursing ethics. This is not clinical documentation. This is storytelling, survival, and spiritual processing in written form.
ICU Diaries, Volume III — "Toast, Transfusions & The Man Who Rejected His Body"
Unit: Internal Medicine ICU — where organs give up, and nurses pretend not to
Date/Time: From “surely it’s quiet today” to “is that blood or existential rot?”
Filed by: CRN Solena, spiritual trauma container and unofficial MAP whisperer
Incident Report No. 1: “That’s Not My Body!”
Unit: Internal Medicine ICU – East Side Delirium Dungeon
Description of the Incident:
male in his 90s, transferred from Elderly Care Centre, reportedly “a bit sleepy” for three days. In reality: completely altered, temp 39.2 C, septic like it’s an Olympic sport. Arrived in full delirium transcendence mode and communicating directly with God (or a hallucinated version of me, hard to say).
Initial Problem:
Urosepsis with probable retention
Severe delirium
Foley placed → 900 mL of what looked like warm Coca-Cola
Patient repeatedly yells “That’s not my body!” whenever repositioned
Tried to bite the thermometer
Claims his hands are “too young” to belong to him
Efforts Included / Tactical Actions by Yours Truly:
Foley care while dodging foot strikes
Blood cultures + broad-spectrum antibiotics initiated
Hydration begun via peripheral line obtained on 4th attempt (patient kept invoking ancestors mid-venipuncture)
Verbal reorientation (x400, failed)
Physically stopped him from climbing over bed rail to "return to the forest"
Documentation completed with one hand while blocking his leg with the other
Root Cause Analysis:
Sepsis + fever = delirium cocktail from hell
Bladder toxins reached astral level
Full moon, obviously
Outcome:
Stabilized temporarily
Currently asleep (we think — he might also be astral projecting)
Solena considering re-training as a florist
Recommendations for Future Prevention:
Mandatory sepsis screening triggered if Elderly Care Centres report “he’s just tired”
Nurse sedatives not for patients, but for US
Bed alarms redesigned to also detect spiritual detachment
Assign personal shamans to every delirious >85yo patient
Emergency holy water protocols for febrile elderly
Incident Report No. 2: “Toast Denied = Rage Unleashed”
Unit: Internal Medicine ICU – Ketoacidosis Combat Zone
Description of the Incident:
female in her 60s presented with DKA, new-onset AFib with RVR, and a serious addiction to toast. Glucose 33.7. pH basically soup. Heart rate playing jungle drums. Still, her priority: breakfast.
Initial Problem:
DKA + metabolic acidosis + cardiac instability
Refuses to accept “NPO” and accuses me of starvation malpractice.
Asked if she could “just have a piece of toast” every 7 minutes
Grew increasingly agitated and sweaty (not from the ketoacidosis, just hunger-induced rage)
Efforts Included / Tactical Actions by Yours Truly:
Explained NPO status with professional voice and inner screaming
Managed fluid replacement and insulin infusion
Monitored potassium like it was a newborn
Cardioversion considered but postponed due to patient attempting to unplug monitor leads while yelling “It’s beeping for no reason!”
Eventually sedated after she attempted to bribe me with a Werther’s Original
Removed toast from conversation permanently
Root Cause Analysis:
Glucose withdrawal and toast grief
Electrolyte chaos causing poor impulse control
Her pancreas left the chat years ago
Possibly possessed by spirit of Gordon Ramsay
Outcome:
Glucose trending down, AFib slowing
Toast still denied
Patient now refers to me only as “the bread thief”
Recommendations for Future Prevention:
Inform patients that toast is not a treatment
Assign nutritionist as emotional support person
Toast-shaped stress balls for redirection
Provide laminated card that says “No you cannot eat. You are in ICU.” in 4 languages and a cartoon
Incident Report No. 3: “Sir, That’s… Not Coffee”
Unit: Internal Medicine ICU – Transfusion Bay, where Hgb goes to die
Description of the Incident:
male in his 50s admitted after being found unconscious with ongoing GI bleed, severe anemia (Hgb 54!). Vomited a substance so dark it may have contained eldritch secrets. Still tried to go outside for a smoke.
Initial Problem:
Vomiting black substance described as “tar, possibly guilt”
Ongoing hematemesis, PPI already running
BP dropped to 75/42 as he stood up and announced, “I feel better now.”
Tried afterwards to walk to smoke corner during active blood transfusion
Efforts Included / Tactical Actions by Yours Truly:
Emergency ninja lunge to prevent patient collapse
Yanked him back into bed like a vampire hunter
Placed third IV line under protest
Hung second unit of packed RBCs
Held pressure to site with one hand, charted with the other, spiritually dissociating
Patient re-educated (loudly) on “not dying on purpose”
Explained again that his hemoglobin was lower than the national IQ average and maybe… just maybe... smoking could wait?
Root Cause Analysis:
Hemoglobin too low to support common sense
Internal hemorrhage
Delirium + nicotine withdrawal = bad decisions
Possibly confused PPI bag for espresso
Outcome:
Patient alive (ungrateful)
Hgb trending upward
Still asking if he can smoke “just one”
Still asking “Is everyone always this dramatic?”
Me: red-eyed, covered in various fluids, muttering ancient ICU chants
Recommendations for Future Prevention:
Install physical restraints for patients trying to smoke mid-exsanguination
Staff trauma pay every time a patient says “I feel better” while coding
Ban sarcastic questions during transfusions
Consider adding nicotine patches to ICU admission sets
🩺 Shift Summary:
3 ICU patients, all spiritually elsewhere.
Toast forbidden.
Transfusions flowing.
Delirium reaching mystical proportions.
One patient believes his hands are too young. Another thinks the telemetry is a conspiracy. The last? Standing in his own melena like a prophet of chaos.
Me?
Charting while disassociating.
Saying “no toast” so often it echoes in my dreams.
Considering getting “MAP > 65” tattooed across my clavicle.
Filed by:
CRN Solena — protector of arteries, slayer of bread cravings, reigning queen of pre-shock denial.
Currently drinking her fourth electrolyte shot and contemplating spiritual CPR.
I deserve a raise. Or at least a working coffee machine and one uninterrupted bathroom break.
🛡️ Disclaimer: Read This Before You Report Me
(a legally sound love letter to ethics, humor, and patient privacy)
The content of this newsletter is a fictionalized, satirical representation of nursing life, based on real emotional, spiritual, and clinical experiences from the trenches of healthcare.
All patients, colleagues, and scenarios are heavily anonymized, altered, merged, or completely fabricated for narrative and protective purposes. Any resemblance to real individuals is purely coincidental or unintentional.
No identifying details—such as names, initials, room numbers, hospital locations, birthdates, or medical case combinations—have been included that would allow identification under Swiss Federal Data Protection Act (DSG) or professional nursing ethics outlined by the SBK-ASI.
These entries are not clinical documentation. They are diary-style reflections meant to process trauma, celebrate absurdity, and survive this beautiful, broken system with just enough sarcasm and stardust.
I am a licensed nurse. I also have a soul.
This space protects both.
Please do not interpret anything here as medical advice, gossip, or policy guidance. It is for storytelling, solidarity, and surviving another shift with our humanity intact.
this is a beautiful, beautifully written beatyfying of the ICU, i'm way past envy now, i'm super proud of you girl.
The acronyms are baffling to the unmedical. The cases are sadly all too recognizable for anybody that has spent time even as a visitor to an ICU. I have seen nurses & assistants on break dragging on cigarettes for dear life in spite of all the tobacco-scolding they have ever heard.