Tattoos and Telehealth

Inside The Pitt

• Nik and Kelli • Season 2 • Episode 4

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A single shift can hold a lifetime. We dive into The Pit and why its hour-by-hour format nails the rhythm of real hospital work: the long minutes, the sudden crises, and the way a calm voice can hide a racing heart. From the first punch-throwing scene to the last hallway sprint, we map those moments to our own time in the ICU and OR, where the stakes were just as high and the fluorescent lights just as unforgiving.

We get honest about violence against healthcare workers and the uncomfortable double standard that excuses assault when it happens in a hospital. We break down clinical realism—chest decompressions that actually relieve pressure, ribs that crack during effective CPR, drips stacked ten high—and the terrifying truth that two patients on similar meds can meet very different fates. We also talk about returning to bedside care during COVID, walking through waiting rooms full of families who couldn’t enter, and saying goodbye through iPads before heading home to pack lunches. That’s the part TV often misses; this show doesn’t.

There’s heart in this story too. The charge nurse who runs the unit like a battlefield composer. The patient who coded three times and later walked back to say thank you. The spinal cord injury survivor who stood when no one expected it. Even a telehealth message that brightened a whole week: “I never thought I could feel this good.” We compare small hospitals with level one trauma centers, unpack the heroes-to-zeroes whiplash after COVID, and ask for a kind of compassion that outlasts the news cycle. If you want a candid, grounded look at the craft, chaos, and quiet heroism of modern care, press play and join us.
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Nicole:

Hey everyone, welcome to another episode of Tattoos and Telehealth. I'm Nicole Baldwin. This is Kelly White. We are both board certified nurse practitioners and we are chatting it up. This podcast does not constitute a patient provider relationship, and please don't consider this medical advice. We are just talking about whatever. But today we are going to talk about Kelly. Last week we had talked about the show on the at the end of last week. We talked about the show, the pit, and Kelly had not seen it. And so I want to get her intake on it because I know you at least got a few episodes in.

Kelli:

I binged watch 11 episodes in a week, which, guys, for a nurse practitioner like us that works literally all the time, that's a lot. Like if you can binge watch that many shows while you're still working all the time, that's a lot. Let me tell you, shit went down. Shit went down.

unknown:

Yeah.

Kelli:

I did like, so we had we had a guest on our show that we talked about this with who said that he really liked how they broke down each episode to be each hour of their shift, which it is. So you know that's really cool because you get to really see what happens hour by hour by hour. One hour. Yes. And how that can drag on and feel like freaking forever. Because it does.

Nicole:

Yeah. So you like essentially like you could bench it and it's just one shift, and you feel like you've watched like a whole series of like a novel.

Kelli:

And you're like, how is it possible that all these things can happen in one hour? And we are here to tell you that shit can happen in one hour. And it does. And it does. And it does. Like, um, you know, the so when the nurse gets punched, I okay. So my husband and I had a long, long talk about this because he was like, no way, like that doesn't really happen. Like, absolutely, actually, it really does. You're talking about the charge nurse outside, right? When she was going outside. It actually does. It actually does. When I was a baby nurse in the ICU back in my early days, we won't talk about how long ago it was. We I had a patient who was uh attempted to end his own life and was angry when he woke up alive on the ventilator, mad that it did not, he did not succeed, and mad that he was intubated in the ICU. And shit got real all day. And it was like angry, hitting, kicking, all the things till we could finally get him. I thought we get him extubated, he'll settle down. Oh no, we got him extubated, it got worse. Curity got called, like he kicked me in the head, punched me, spit on me, all the things. It was quite the rodeo. So these things happen, y'all. And I just want to take a second to talk about violence in healthcare. I think truly, it's a thing, it is the only place that you can physically assault another human being and get away with it. I truly do. Because if you go out in public, like you walk into your local coffee shop, I won't name names because we can't, and you just decide that you're gonna have a bad day and you're gonna punch someone, you're gonna get the cops called and you're going to jail. But if you're in the hospital, you get a pass. Somebody tell me why that's fair. You can kick, hit, spit, pee on someone intentionally, and you get away with it. Why is violence in the healthcare space acceptable? I don't get it. It's a thing. It's a thing. And that's just from patients, guys. That's just from patients. We won't talk about the number of physicians who have thrown charts at me, kicked buckets of water at me in the OR, thrown instruments at me.

SPEAKER_01:

Like we won't talk about those things. Nicole knows. Yeah.

Kelli:

Some of the stuff that they come across. I also like how She's not wrong. I also like how a lot of the some of it I'm just like, oh wow. But I also like how a lot of it is so realistic to what we actually see. Like it you like my husband would look at me and go, Are you serious? I'm like, yeah.

SPEAKER_00:

Yeah, that really happens. Yeah, that really happens.

Nicole:

Yes, this patient walks away and this patient dies, and they're doing the same drugs. And yes, we poke a hole in your chest and yeah, yeah, and the blood, and the blood spews out.

Kelli:

Yes. And yes, we break it up when we do CPR. And you know, I I also want to point out that uh the the part of this of the show that I think I want, I would love for my loved ones to embrace is the impact of the emotional trauma that healthcare providers go through on a day-to-day basis when you go from room to room to room. You lose a patient, maybe it's a child, maybe it's you know a traumatic loss of a patient. You are quite literally expected to fix your face, check your attitude, and go to the next patient like nothing happened, and do it for a 12-hour shift and then go home and pretend like life is okay because now you got to go be a wife, a mom, a dad, a sister, a brother, uh, whatever, and live life.

Nicole:

Day after day for 20 years. That's what Noah Wiley had said. And I want to say, and I'm paraphrasing, he had spoken about, you know, I touched on it last week about how he'd had no idea that it was going to impact the world in a way that thank you for showing what we really go through. But his mom was a nurse and he said something to the fact like, Mom, you would go through all of this and then come home and cook us dinner or to help us with homework. And she's like, Yeah. Like, like, what are you supposed to do? Like, what are you supposed to do?

Kelli:

Yeah.

Nicole:

Like I had my daughter in uh uh September and in January, three months later, I started nursing school. So she was by the time I got done, she was like, you know, three or four, four, she was four when I got done. So it was like I had a little kid at home, you know, and it's like if I had a family.

SPEAKER_01:

Yeah.

Nicole:

Like, what are you what are you gonna do? Like, you yeah, yeah, I coded three people today and maybe they lived, maybe they didn't. But I gotta go home and make lunches for tomorrow. Yeah, and be a mom and pretend like so like when he goes in the room where his his the black guy that was his superior, it that that passed away during COVID, it was his the person he looks up to. What is the word I'm looking for? Uh his mentor. Mentor. He went in the room with the kids' stuff on the wall. And it implies that that's the room that he died in, his his mentor, and he really looked up to him, and he really was having a hard time that he lost him during COVID. But they do flashbacks, and Kim asked me last night because she's catching up too, and she said, Who is this and who is that? And I'm like, it the guy you see on the wall is is like his mentor, like that's his person, and he lost him during COVID. And when he has these flashbacks of being in these ET suits and not being able to do anything because the virus just takes no takes no names, right? Uh she's like, Oh, I get it. I get it now, now I now I kind of I'm I'm putting it together, but that's why he has a meltdown.

Kelli:

You know, I love how so I think that, you know, there's a couple of schools of thought here, right? So we have Hollywood for entertainment, and then we have Hollywood for real life. And I think Hollywood gets it right with the pit. I really do. They get it right. Of course, a lot of it is, you know, it's fiction and it's a show and it's for entertainment, and some of it is probably, you know, exact exaggerated, and it's meant to because it's trying to get a point. And the point is that we went from being healthcare heroes at the height of COVID to zero quickly because people were angry about the repercussions of the virus and the things that were happening politically. Um, and none of which was our fault as healthcare providers, none of which. We just suffered the repercussions of all of it in a lot of ways, in a lot of very impactful ways. Emotionally, we were traumatized, we were physically exhausted, we worked hours that were impossible. We lost loved ones, we lost other healthcare providers we worked alongside because we were tirelessly giving and giving and giving, trying to save lives. And then I love how the how they have these flashbacks with Noah Wiley, but then they show him now he's still doing it. He he had to go forward, he had to keep on, and he's still doing these exhausting, you know, moving from room to room to room, to case to case to case, and each one being very different and traumatic in its own way, while he's in a leadership position trying to keep ahead of residents and interns and medical students and each with its own little layer in and of itself. And I'm like, that's real. That's real life, you know, and it's real life in a lot of ways. And I think that we can take that even to just day-to-day life, just with people in general, and look at how we approach things just in life and how we can be more compassionate to one another and how we can be more understanding of each other's own roles. It's like, I think that we take stuff like, you know, we're told growing up, you can't say something nice, don't say anything at all. But I think that we could take that a step further now and say, we have a new appreciation for what each other has been through post-COVID, because we all went through something. And now, four or five years later, fast forward, we've we're living in a world that's very different. It's very different because we've carried this baggage of what we went through. And I love how Hollywood gets it right by showing what he continues to go through in the world of healthcare, which is a very real constant state of crisis when he walks in the door every day, to these flashbacks of what he had to endure, taking that with him and how that affects his daily life. It's it's insane. Hollywood got it right.

Nicole:

They did, they really did. And Kelly and I were in the hospital during because we weren't doing telehealth, we weren't protected by the screen. We were in the hospital. I would go in one day, have it have an assignment because I took a leave from being a nurse practitioner in orthopaedic trauma to go back to being an ICURN because I knew I could run a vent. I knew I could do that, right? So I felt like I had to do what I had to do. So I actually went back to the bedside, took a contract, and uh to see if I can find some pictures of our big mask on and stuff, but I would go and take care of patients and they would talk to their loved ones on an iPad because nobody was allowed in. Uh, there would be patients that I would be talking to one day, and I would say, okay, I'll see you tomorrow. And I would come back and they would be in a bag.

Kelli:

Yeah, they were gone.

Nicole:

Yeah. Because it just is quick. It's just that freaking quick.

Kelli:

I did the same thing. I was so I was working in neurosurgery at the time, and you know, we did the same thing because our hospital, our, you know, we have a tiny, I say tiny hospital, it's really not, but our our city services 19 counties. And so whenever we, whenever COVID hit here, we shut down our OR because we needed the space and we needed the beds and we needed the nurses. No elective cases. No elective cases. Well, neurosurgery, believe it or not, neurosurgery is mostly elective. Unless you have a traumatic brain injury or a traumatic spinal cord injury, most of what we do is elective. I know it seems um emergent to you as the patient, but it's truly an elective case. It can wait. So we were shut down. And if you're not operating, you're not making money in the world of neurosurgery. So I furloughed from the office just like you, and I went back to the ICU bedside because I could. Um experience. And so I took a contract in the ICU and I went back to the bedside. And the other thing that we're not telling you guys is that ICU bedside nursing looks different when you're 40 than it did when we were 20.

Nicole:

It looks way different.

Kelli:

I'm like, holy smokes, this is just I went down there thinking, I'm a nurse practitioner now. I've got all this knowledge and training. I got this. I did not got this. Let me tell you, those nurses, I loved them. They were running circles around me. They had so much more energy than me. They were younger, they were faster, they were quicker. And I'm just like, let me get my feet. Okay, here we go.

Nicole:

It was hard.

Kelli:

It was hard. And it wasn't hard because I didn't still have the knowledge. It was hard because I walked into a world of extreme chaos and unknown and fear and anxiety and stress and death as a 40-year-old, not as a 22, 23, fresh out of college, ready to hit the ground running. And it looked different. It looked very different. Um, especially because we were in the height of a pandemic and nobody, nobody knew what was going to happen from one day to the next. And like Nicole said, families, family and loved ones weren't back there. And I don't know about you, Nicole, but every day to get to the ICU, we had to walk through the waiting room. There was no back way in. We have to walk through the waiting room to get to the ICU to go on shift. We had no back way. Now, as a nurse practitioner who worked in the OR, I could get in the back way because I could go to my office and go in through the through the OR and sneak in the back way. So I didn't have to do that. But the ICU nurses had to walk through the waiting room. So they had to see these family members who were sitting there day after day sleeping in the in the waiting room, were not allowed to see their families, and they had to walk through that every day to go see their to go get their assignment and take care of their patients. And I think that's another layer of anxiety. And I can't, I just can't fathom. You know, we had, like you said, you would walk in and and Mr. So-and-so embed this that you tucked in the night before, you're like, okay, I'll see you in the morning, wasn't there. And like, no, he coded and he's gone.

Nicole:

Or we just had a conversation 12 hours ago.

Kelli:

And I I mean, I was used to I was used to running three, four, maybe five drips at the same time. No, we had towers of drips. You've seen those memes with nurses that can do 10 drips at the same time. That's what they were. They were 10. It was. Oh, it was 100%. Always like my first task every morning was to go in and check all of the tubing and all the all of the drips and make sure all of the meds were still looking good and none of the tubing was expired and needed to be replaced. And like, that was my first task was to check all of those drips because that's problem number one. Like make sure nothing ran out. Ran out. And while you're before you go get report, everything was gonna look good for the next 30 minutes while you get report. Because that's all you got. It was crazy. But I think I think the I think Hollywood got it right with the pit.

Nicole:

I think they did. I do too. It's good, it's it's really good. And season two, you have to let me know when you get into that because there's a there's a pain in the ass in in season two, and I just want to choke her out. And uh is it the same one that's in season one? Nope.

Kelli:

That little med suit, and I swear I want to slap her. I'm just like, can you just shut up and mind your own business to take care of patients? Like, yeah, yeah, just mind your own business.

SPEAKER_01:

Not that she doesn't have some good point, but there's just times when I'm just like, why did you have to do that? Just sh stop talking, go see patients, shut up, you know, like just stop talking. But again, in reality, there's always that one.

Kelli:

There's always that one, there's always that troublemaker. And that's real life.

Nicole:

So there's always that person that just can't stay out of things. But the point is, is that it's not exaggerated. I mean, you can go to a small hospital in a small community and they're not gonna be cracking the chest open, but down the street, you you can go to a trauma center, and that's exactly what they're doing. So and you walk into a level one, and that's exactly what's happening. That's exactly what's happening. So that's the difference in a small town hospital, bread and butter, you know, I have a cold, I have a, you know, I broke my foot, whatever, whatever. But when you go down the street to a trauma center or the nearest whatever, that is what it is, it is not exaggerated.

Kelli:

That is exactly what you see. Or, like, you know, in Texas, that would be that hospital in Texas is probably the equivalent of Parkland, UT Southwest. Huge, giant teaching hospital, medical center, you know, where they have tons of medical students and residents and and interns running around. I picture Parkland every time I watch that show, you know, thinking that's exactly what that trauma center probably looks like on a daily basis at any given moment. Any given moment. Oh, before we part ways, I have to, spoiler alert, what were your thoughts on the stolen ambulance?

SPEAKER_01:

The kid that jacked the ambulance.

Kelli:

So I was not I was not on the bandwagon of a fraternity prank. I was not.

Nicole:

I was not on that wagon.

Kelli:

I thought it was gonna be a drugie who was gonna go sell it for parts so he could buy drugs. I did not, I did not clue in on the fraternity kid.

Nicole:

I did not. I did not, I did not. I did not. How many more episodes do you have? You said you'd watched 11, so you have two more.

Kelli:

Oh, um, yeah. I I don't know how many episodes were in the first season, but I just I finished season 11 or episode 11 last night.

Nicole:

Okay, so I think there was like two more.

Kelli:

I think when I finished up last night, um, Noah Wiley and the head nurse were standing outside, and they had just announced that there was an active shooter at the concert that his son was at.

Nicole:

And that's why there's some pretty good stuff that's gonna happen in the next episode or two. There's some pretty eye-opening things you're gonna be like, didn't see that.

Kelli:

Yeah, it's like that almost every time, though. And that charge nurse, holy crap, y'all. I love her. You just have to watch it. I love her, she reminds me so much. Okay, so I don't know if my old charge nurse is listening to this or if she's even still around. God, I hope she is. Her name was BJ, Becca Joy, they called her BJ. That woman was my ICU charge nurse when I started as a baby nurse in the unit. And that woman, she knew it all. She could do anything, she told the doctors what to do. She checked everything behind you. And if you didn't have your crap together, she would walk in there, crack the whip, throw you out of the way, and start it for you. I mean, she was just that woman. And she was just like, she was just like this charge nurse in the pit. Like every time I watch it, I think of BJ.

Nicole:

And that is, and that is exactly they're they're hardcore. They know what's going on, even if they're not looking, and they smoke a pack of Virginia Slims.

Kelli:

And you don't question them, not for one second. Because if you do, they will slap you and keep going.

Nicole:

If you watch the pit, you know why she smokes.

SPEAKER_01:

She doesn't smoke because she wants to smoke. She's got to get outside so she don't kill somebody.

Kelli:

That's her. That episode where she's like, I'm done. That's it, I'm done. I oh God, I started tearing up because I felt that in my core. I know. I'm like, no, you're not, no, no, no, we're not gonna do that. I felt that in my core because and I looked at my husband and I was like, the day I left in person care, the day I walked away from bedside, the day I left the hospital, knowing that I was never gonna go back as a as a provider in that hospital. God, I felt that to my core. Because I was like, I I feel you. I get it. There comes a time. It's hard. It's really hard. Guys, I say all of this to say that, and it's not that Nicole and I are complaining or anything. We love what we do. God, we love taking care of our patients.

Nicole:

But yeah, best best day of best days of my life, absolutely, have been these that's why we function best under pressure. Yeah.

Kelli:

And it's it's those days that you just look back and you go, how did I get through that? But for me, you know how I got through it? It was for the days when the man who spent two weeks in the ICU coded on me three times that didn't think was going to live, six months later walked through the doors of the ICU and hugged me. It's those days. Or the girl who had a traumatic spinal cord injury who we never thought was going to walk, rolled into the office in her wheelchair and stood up and walked over to me and hugged me. Those days. It's those days.

Nicole:

And they're rare.

Kelli:

They're rare, but they will absolutely keep you going. They're one to a thousand. They are. But it's and it's the smiles and it's the times when patients say, I never, you know, I had and it, and it's and it's all the time. And it's the little things. Like, you know, Nicole and I both see this even in telehealth. Even in telehealth. Like I had a patient message me the other day, and she goes, Kelly, I never thought I could feel this good. All over hormone therapy, all because of hormone therapy. Somebody listen to her and get her started on hormones, and she messaged back. She's like, I never thought I could feel this good. Thank you. Those are the days you're like, Yeah, that's why I still do it.

Nicole:

Yeah, for sure. Absolutely. Yeah. So we love it. Not a complaint session. This is completely just this is this is what it was. It is what it was. And it was, and it was, I would, I would do it all over. So all right, guys. Well, thank you for joining us today. We'll see you next week. And who knows what the topic will be because we are winging it and flying by the seat of our pants. So we will see you next week. Have a good day.

Head Shot

Nicole Baldwin, APRN

Host
Head Shot

Kelli White, APRN

Co-host