Pushing drugs for the Man bother anyone?

[somebody]

Hello All.

I'm a newbie taking prereqs for a BSN.

I just have one big nagging concern keeping me from fully committing to the program. I want to help people, but I feel that the western allopathic way of surgery/drugs is often very harmful (although sometimes needed in cases of trauma etc).

Does pushing drugs for the giant pharmaceuticals bother anyone out there in the nurse world? I just don't know if I could live with myself doing it all day when I know that many problems could be solved simply by diet change etc.

Please enlighten me!

[nursemike, ASN, RN]

It's a sad commentary on our times--or maybe it's just my times--that The Colbert Report and The Daily Show on Comedy Central are fast becoming my most trusted source for news, but one of them recently interviewed a doctor who'd written a book advocating a blend of Western and alternative medicine. A lot of what he was saying was very much in keeping with nursing values. When I assess a closed-head trauma patient, bowel motility may not be my highest priority, but it's one of the things I'm looking at, along with skin integrity, respiration, and every other system. Nurses really do treat the whole patient, and from what I've seen, a lot of today's doctors are more attuned to that, as well.

I work in a not-for-profit, teaching hospital, which in many ways seems to be the best environment for hospital nursing. Even so, we are very much dependant on Medicare, and what they are willing to pay has a profound effect on our bottom line. We can't lose money indefinitely, so we have to look at cost.

The OP's link to youtube told of some pretty alarming statistics. I don't know that I totally believe them, but I agree with the general principle that a lot of patients are getting less than adequate care. I don't see this as a result of some great conspiracy--I think the biggest single problem is nurses and doctors who are overworked. Patients could relieve some of that by taking better care of themselves before they become patients, but demographically, we are an aging society, and as boomers become seniors, we're going to see a lot more people needing treatment.

I don't think the OP is completely out there. There are real problems in healthcare, and one of them is that we're so slammed with acute care that most of us have precious little time for primary prevention. We're up to our butts in alligators. But, as a working nurse, I can't discount my experiences, like giving a scheduled dose of Coreg and watching a telemetry monitor go from a little worrisome to like the pt was on a pacemaker. Or seeing Ativan break a seizure. Or seeing doctors and fellow nurses working hard to save a patient I thought I was about to lose. I have advocated with doctors to get a patient more meds, not because someone gave me a pen, but usually because the patient was in intractable pain, or a couple of times for BP, and sometimes because the patient knows what they've been taking and what's worked best for them--for example, you learn pretty quickly to listen to diabetics about their home schedules, since some of them are really on top of their conditions (not all, but some).

It really is a shame we aren't more successful with primary prevention, but speaking from my own experience, it's very often not that the information to promote wellness isn't available. I think most Americans know what they should do to be healthier. Unfortunately, the time to begin is when you are young and immortal. Crap you seemed to get away with (like my sig line) when you're under 40, comes back to haunt you when you're over 50. So, by the time many of us in acute care see people, our focus has to be managing the immediate crisis, then working on secondary prevention, to avoid or delay the onset of complications and co-morbidities. And meds play a big part in that.

A lot of the measures to prevent a second MI are the same as to prevent a first MI, but aspirin and metoprolol can help, too.

In my practice, I see a lot of strokes--mostly ischemic. A couple have been young women who used birth control pills and smoked. Rather more have been guys my age whose main exercise was bowling. But most are people who've lived 70 years or more in decent health, then thrown a clot r/t chronic A-fib, or a DVT after a broken hip. Many of these people can benefit from anti-coagulant therapy. It's not about making money, it's about extending lives. And making money.

[Bicycleboy]

I I can see how you might be concerned. A large part of nursing school is brainwashing. You do learn a lot of stuff, but the more you learn the more you see that the health care world does not really serve the patient. It is more about serving the people who are in it.

If you don't like the idea of pushing drugs you don't have to. There are areas of nursing that are removed from the hospital and the bio-medical model, which are focused only on sicknesses. You could work in the community using a socio-environmental model which promotes health of the person by trying to improve factors that contribute to health, instead of blaming the victim and only focusing on illness. Take a look at a population health promotion model. It looks at inter-sectoral collaboration and the determinants of health, as well as other factors that contribute to well being of the individual, and the environment that they live in.

As a nurse you do many things that will help improve health that have nothing to do with pushing drugs. There is a way to change but you need know what it is like on the inside. You may start out in a hospital with the best intent to help people, but in the end hospitals are a business and would not exist if people were not sick. In this way it is in their best interest to have a bio medical approach that is only concerned with illness as the focus. If it were not this way, there would be a lot of hospital corporations out of business, and many more nurses working with the community to make the places where people work live and play much more conducive to health.

[Agnus]

I I can see how you might be concerned. A large part of nursing school is brainwashing. You do learn a lot of stuff, but the more you learn the more you see that the health care world does not really serve the patient. It is more about serving the people who are in it.

I do not mean this facetiously. You are still in nursing school! If this really is how you feel you can find another line of work where you are not compromising your values. Or are you really after the bucks too;).

Seriously thought think about it. You have not invested very much yet in this you might consider a better match. How can you be so sure that you won't ever get caught up in the part of this you don't approve of?

You are already likely putting yourself in debt to this profession, with the cost of your education. It gets worse.

You made a remark about needing to see it from the inside. You are not seeing it from the inside as a student.

[Spidey's mom, ADN, BSN, RN]

I just finished Atul Gawande's book "better" A Surgeon's Notes On Performance where he discusses many aspects of health care. One of the last chapters is on the financial aspects and how that affects medical care.

His earlier book "Complications" is even better.

steph

[nursemike, ASN, RN]

I I can see how you might be concerned. A large part of nursing school is brainwashing. You do learn a lot of stuff, but the more you learn the more you see that the health care world does not really serve the patient. It is more about serving the people who are in it.

At my school, I'd say there was a little bit of indoctrination, along with a lot of education, and what indoctrination there was had little to do with promoting the status quo. Rather, we heard about the issues that were of interest to our instructors, as nurses. This included nursing activism (to promote better conditions for nurses, which in turn leads to better outcomes for patients), holistic care (medical model vs. nursing model) and even alternative medicine. My instructors were very excited about community health and primary prevention, and some of our clinical rotations reflected that, but the majority of our clinical experience was focused on bedside, acute-care nursing--and rightly so. There are many directions one can go in nursing, but med passes, dressing changes, skin integrity and ADL's are, IMHO, where it all starts. Generally speaking, the people who need nurses are on the way to the hospital, in the hospital, or recently out of the hospital.

It's very hard for any nurse dragging his/her butt out the door after a hard shift to hear that it's not about the patient. If I couldn't make a decent living in nursing, I'd have to do something else, but if all I cared about was making a living, there are easier ways to do it.

I still have enough radical in me to be wary of The Man. I'm practical enough to realize that our healthcare system is far from perfect, even though I'm by no means sure how to make it better. It is a business, but again, if it was only about the money, there are easier ways to make money.

[cardiacRN2006, ADN, RN]

Uhhhh...my husband is working as a handyman while finishing up his 5 year Master's in Engineering program. Nothing wrong at all with being a handyman. He makes as much money as I do, and he's working part time. Just a thought.

Sorry, I was just having fun using the phrase "for the man" again. Had nothing to do with the actual profession.

[Almabella]

As a person with a loved one who is terminally ill, I have a deep respect for allopathic medicine, including chemo and radiation, surgery and pain management.

However, my desire to become a nurse was to work in areas of prevention and public health. I knew this going into nursing school, and throughout nursing school. I respectfully disagree with those who state you shouldn't be questioning our current health care system or practices as a nursing student, and that if you are, nursing is not the field for you. We need more people in nursing who question current practice. This includes, but is not exclusive to, overuse of pharmaceuticals.

Prior to nursing school, I worked as a CNA in a hospital, and briefly as a nurse in a hospital after school. I was miserable, so I got out and into public/community health as fast as possible. Not because I don't believe in acute care, but because it wasn't where my heart was a nurse. Unfortunately, I bought into that whole "you need one year of med/surg" thing...but working in that environment did make me question my career choice. Acute care is not for everyone, and hey, we need all kinds of nurses in this world.

On the other hand, I have always been very drawn to NICU, and perhaps one day when my little one is older, I will try my hand at it. Of course, allopathic medicine plays a huge role in NICU, but there are also the indisputable benefits of things like feeding a baby breastmilk, and kangaroo care, and parent education and support.

Anyway, I digress. As has been reiterated throughout this thread, there is definitely a time and place for pharmaceutical use and allopathic medicine. There is no denying, however, that misuse of certain pharmaceutical (like antibiotics) have lead to greater public health problems (like MRSA and MDRTB), and who knows what the future holds.

So, newbies - question away, and welcome to nursing! One of the best things about this profession is the incredible diversity!

[SuesquatchRN, BSN, RN]

I respectfully disagree with those who state you shouldn't be questioning our current health care system or practices as a nursing student, and that if you are, nursing is not the field for you.

No one has stated that, or anything similar. What has been objected to is the blanket statement that nurses are automatons who never question and just "push drugs for the man."

[Almabella]

I do not mean this facetiously. You are still in nursing school! If this really is how you feel you can find another line of work where you are not compromising your values. Or are you really after the bucks too;).

Seriously thought think about it. You have not invested very much yet in this you might consider a better match. How can you be so sure that you won't ever get caught up in the part of this you don't approve of?

You are already likely putting yourself in debt to this profession, with the cost of your education. It gets worse.

You made a remark about needing to see it from the inside. You are not seeing it from the inside as a student.

Well, I guess that's how I interpreted this post. No offense Agnus; I'm not trying to pick on you. I just disagree with this sentiment.

[Almabella]

I just finished Atul Gawande's book "better" A Surgeon's Notes On Performance where he discusses many aspects of health care. One of the last chapters is on the financial aspects and how that affects medical care.

His earlier book "Complications" is even better.

steph

I've been meaning to check this book out. I heard him speak on NPR and it was really fascinating. Thanks for the reminder!

[Virgo_RN, BSN, RN]

somebody,

You take yourself way too seriously. You are making assumptions about a profession that you know nothing about. My moral compass may not point in the same direction as your moral compass....or maybe it does (you don't stop spouting your point of view long enough to listen to those around you and see things from their point of view). Regardless, it is not your job to tell me where my moral compass is supposed to point. That is what I find offensive about your posts. As far as questioning the current medical system, I do not find that offensive. I do it every day. The difference is that I am in the trenches and you are not.

I think part of your problem is that you think you are the only one out there thinking about these things, and that it is your job to "shake things up" and "get the word out", and in doing so, you are putting people off.

I love discussing these issues with fellow nurses with a basis of mutual respect between us. But being hit over the head with the ideas of someone who knows nothing about nursing and shows so little respect for the body of knowledge that nurses possess and the range of experiences we have as a whole....that has no appeal to me. It is a huge turnoff.

You came in here from day one with a judgmental attitude. You already have your mind made up. You are not here to learn. You are here because you are so arrogant that you think you are going to "educate" these people, these nurses who are the cannon fodder in the war between providing medical care to human beings and the business of medicine. You have not been there. When you graduate from nursing school and are working on an acute care unit, please come back and ask your question again.

As I've said to all of my hippy friends who wonder why I'm working in a hospital instead of at some holistic clinic in the community, I believe in what I am doing. These people in the hospital who are sick either because of their own lifestyle choices or because of their bad luck, they need help NOW. They do not need someone judging them for their choices or pointing out what they did wrong. They need relief from pain. They need relief from suffering. They are hurting, they are frightened, and some of them will die from their illness. I help these people. I am passionate about that. When you come on this forum criticizing the nursing profession without any experience to back up your assumptions, yes, you're going to piss me off.

If you want to try to change the world, I'm all for that. But if you want people to listen to your message, I suggest you work on your delivery.

[caliotter3]

In your BSN program you will be provided with the basic tools to provide patient education and alternative options for care. In the hospital, it is sometimes very difficult to provide patient education to someone who has a short stay. But should you go into home health, you will have plenty of time to do patient teaching. This is where you have a chance to make a difference. Even if you don't convince someone to make any changes in their lifestyle (if needed or helpful; and all patients have the right to make their own decisions about their care), at least, you will have presented the information. Don't get discouraged before you even start.

Added thought: Remember that your nursing license will not give you the green light to force anything on your patients, badger them, or act toward them in a judgmental manner. Nagging anyone about anything never helps any situation.