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SICU Queen 12,864 Views

Joined: Jan 28, '02; Posts: 571 (22% Liked) ; Likes: 505

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  • Oct 28 '09

    I can tell you based on the people I know at two boards of nursing that both say if you are working with narcotics in your system, then you are working illegally and subject to the disciplinary or rehabilitation committee's decision.

    Despite what the most recent study says (constant same dose long term pain meds may not impair, after all), there's no way to know if someone is going to binge amidst a steady dose. For patient safety (and we are treating the general public) most families do not want a nurse on narcotics caring for their loved one's. I wouldn't want it, either given the choice. If it's PRN, you're definitely impaired. If it's constant and chronic where the taker feels no effects at all (no "high" feeling) then they may not be impaired and also may not work as a nurse (based on these two BON's).

    Because 5-18 percent of nurses are eligible for discipline (higher on units with high abuse incidence like the SICU), the board is required to default on NO and protect the public, as they have been charged to do.

    Also knowing people who have gone the attorney route, etc. I can say because of this public charge and the default of NO narcs at work and political support regardless of party to the highest levels, one case cannot be the exception to open the floodgates of those balancing the fence.

    I would consider this a career ending condition; just like a football player and their drug rules alike (unless you can get a nerve block and come to work clean).


    Based on your condition, I would seek another career, as this condition seems to have limited your ability to work licensed in most states. It's no different than a football player who had a devastating injury who can no longer serve. They cannot work under the influence of any drugs, either.

    For those taking meds off work hours, be sure it clears your system because you don't want to come up positive for a random or "with cause" drug screen. Most boards make this clear and if there are any questions, call your BON and ask for the disciplinary specialist (they know the process and can recite all the laws or they can bring your concern to the board for discussion).

    I would never risk it; it's not worth a career ending mistake.

  • Oct 28 '09

    Your best bet due to your medical condiditon is to find a position with little on hands patient care if any. Even though you are on prescribed medication I have known employers to report to the BON the nurse was "impaired" resulting in IPN, license suspension, etc. It's a very difficult situation as I also have chronic pain and require pain medication although I know I cant take them while doing patient care. It's a very fine line. Many nurses think that the BON cant take action if medication is "prescribed" legally and this is just very untrue. With your experience you may seek areas such as worker's compensation medical case management or other areas in the insurance industry. Chart review/auditing/coding maybe. I would never tell an employer my medications for this very reason. The first time an error or alleged error happens then it will be on you to prove you werent "impaired". Keep in mind you dont have to make an error to be report all they have to do is suspect you may be impaired during work. Hang in there.

  • Oct 27 '09

    Why is it okay to require health care workers and not require teachers, restaurant personnel, people riding the subway, school children, or anyone who comes into contact with large numbers of the general public on a daily basis to take the same shot? Maybe someone should be stationed at the entrance of every mall in the county and require that anyone entering show proof that they have been vaccinated. If they haven't then they must be vaccinated or go home. LOL Sounds ridiculous doesn't it? So does forcing health care worker to take a vaccine because the general public is paranoid. Please don't flame me....I am not serious about forcing others to take it. I do not believe that it should be required that anyone take the vaccine. People should be allowed to educate themselves and made an informed decision.

    I understand that we work where there are sick people, but those sick people are normally walking around sharing their illness long before we see them.

    People are afraid of H1N1 and the media is not helping. Instead of playing on peoples fears they should take the opportunity to educate them.

  • Oct 27 '09

    Quote from Purple_Scrubs
    So, you refuse your yearly TB test too?
    The PPD is a (purified protein derivative) used to see if a person has been exposed to TB. Its not a vaccination.

  • Oct 27 '09

    Quote from Purple_Scrubs
    So, you refuse your yearly TB test too?
    Yep I do refuse and therefore get a CXR in lieu of same. I disagree with anyone "forcing" me to have something I dont want injected into my body. Pt's have the right to refuse so should I. If I show symptoms then send me home till I'm cleared. I was "forced" to do this in the military and became very ill during the last Swine Flu scare in the mid 70' only to find out later we were the guinea pigs before it was released to the public. It should be my choice not my employer. I am over 50 and not as high a risk due to age in relation to the H1N1 according to the CDC recs at this time either. I shouldnt be forced. Personally I think the media is overdoing it. It's one thing to be cautious but panic is another issue.

  • May 2 '09

    Quote from NomadMomma
    I lost my daughter two years ago to anencephaly . . . she lived for 33 days. Despite knowing what the diagnosis meant you do hope . . . hope that somehow you can fit a lifetime of love in a few hours or days. Her passing was not in a hospital bed but on my chest as we slept at home. I have not lost hope though . . . I will see her again.
    Mine was born 25 years ago, and she lived for just seven hours..........long enough to leave an emptiness in my heart that I pray will be filled one day when Jesus meets me at the door of Heaven, holding my daughter in His strong arms and saying, "Look who's here, Melissa, your mamma's home at last!"

    What a sad, poignant, beautifully told story. Thank you for sharing it with us.

  • May 2 '09

    I lost my daughter two years ago to anencephaly . . . she lived for 33 days. Despite knowing what the diagnosis meant you do hope . . . hope that somehow you can fit a lifetime of love in a few hours or days. Her passing was not in a hospital bed but on my chest as we slept at home. I have not lost hope though . . . I will see her again.

  • Jan 5 '09

    I recently had to go head to head with a doc regarding my father. He was a DNR. Resp 48 on 100% O2, cdiff, end stage COPD, third spacing all fluids. Even with him being a DNR AND the doc being notified that I was his health care proxy and KNEW my dad's wishes, he still gave me a hard time. I finally had to tell him, "If you are not comfortable with end of life care, then transfer dad's care to another doctor who isn't. The ONLY thing you can order is Morphine, if he's in pain". He was still ordering ABG's, when he knew we weren't intubating and CT scan of he abdomen to rule out perforation from the c-diff....belly flat with + bowel sounds. He made an already stressful situation much worse.

    Dad passed away 12 hours later, with dignity.

  • Jan 3 '09

    Thank you all for your responses. Could someone please explain the difference between a "at "versus a "right to work" state. I read all the responses and still do not quite understand the difference. We are working on a plan now for her. The whole thing disgusts me. This is a wonderful nurse. She comes in at the drop of a hat to help out. She takes a personal interest in her patients and has a real big heart. She has helped so many homeless people..buys them clothes and purses and slippers before their discharge. The nursing instructors always ask for her b/c she is so thorough with patient care. She does no sugar coat anything and sometimes someone will take offense to that. I never have b/c I too am that way. I do not want her career to end on such a bitter note b/c she does not deserve this....so we are preparing with information and a plan.

  • Jan 2 '09

    hi

    i am an old nurse!! i'm 63 yrs old. i've worked for 42 yrs as an rn.
    the problem---peripheral neuropathy. as the years have gone by, it has gotten progressively worse--even tho i keep my sugars under 95 almost 100% of the time.

    i work as a bedside nurse on a very busy chicago hospital---i work night shift; i have worked nights for almost 33 yrs. or so. i am certified in oncology. we are a teaching hospital.

    well, since i can no longer really feel my feet, i need to use a cane. i had been using it everyplace but at work, but now i can't do without it at all.

    well, since i can't really use the cane while doing pt. care, i was at an impass.

    finally, at the end of november, i decided to file for disability at work. they pay 75% of your base pay when you are on disability. however, you can also do restricted duty, if the md certufies you.
    so, in dec. i started restricted duty. this means i work 0900-1730. mon-fri.
    i am doing paper work---nothing that requires walking. i do chart audits & other audits.
    also, i am writing out some formal discharge instructions for post chemo pt's.

    it's really different from what we usually do; plus working days is really different!!

    so what's the problem????????????????? in my mind,. i guess i feel like i have lost my whole identity. i can't seem to shake it. i sit here & know there are things i should be helping with, but can't any more.

    oh well. i know---people have said--"enjoy, you have paid you're dues". well, easier said then done--------lol

    plus, this can only last for 9 mon. there will be about 5 months or so before i will be ready for medicare, so i need to find something i can do that will have insurance benefits.
    any ideas?? any sites you all know of where nurses with disabilities can find job listings.
    like jobs you can do sitting down??

    thanks, friends!!

  • Dec 30 '08

    "It's about the basic right of the most vulnerable patients to be treated with dignity," Gara, D-Anchorage, told the House Health, Education and Social Services Committee last week."

    This burns me up. I've got to find this person's email and inform her that this male nurse already treats all patients with dignity. You can't legislate that. How about the female nurses that rip the sheets of the male patients and do a total bed bath with them lying there completely naked in bed, all the while talking on their cell phone or a fellow nurse about their kids or husbands, leaving them exposed when others enter the room, or when they leave to get linen or do something else. Let's legislate that.

  • Nov 29 '08

    Today we lay to rest the husband of one of my coworkers. The news of his death haunts me, and brings back memories of my first patient having a major heart attack.

    I was fresh out of nursing school, working my first nursing job in a large emergency department. I was with Marie*, my preceptor, a wonderful nurse. She managed to be strong and got her job done quickly and well, but yet was gentle and had a huge heart. It was late in the evening- we get the word from our charge nurse, Jessica*, that we would be getting the chest pain patient in our room. I still remember the room (48), the layout. The lights glowed brightly overhead.

    The local EMS squad flew into the ambulance bay, and ran the gurney into the room. The EMTs and paramedics were themselves drenched in sweat, breathless as they gave report.

    I glanced at our new patient. A large man, although young, maybe in his early 30's. His bare chest was damp with sweat. We struggled to get the cardiac leads to stick to him as he squirmed about the stretcher, trying his best to catch his breath and find a position of comfort. I glanced at the monitor- tombstones. Another nurse started an IV and drew blood, and registration worked on getting his information. The doctors studied his EKG as the charge nurse called to get the cath lab crew called in.

    Before I knew it, it was time to go. The cath lab team was setting up the room. We hooked our patient to the portable monitor. The patient looked at my Marie, panic in his eyes as he said "Please don't let me die". My heart sank, as I knew then, he probably would die. We unhooked IV bags from poles, unlocked the stretcher, and began to roll down the hall.

    Although I was pregnant at the time, I was still able to push stretchers. I began to push his stretcher, when his wife and daughter rounded the corner. I don't even remember if I stopped completely, but I did slow down. He told his wife and daughter he loved them, and they kissed him and said their "I love you" as well. Jessica began to yell at me to "GO! GO! GO!". I picked up the pace, and we rounded the corner to the cath lab. We gave report, and came back to pick up the pieces.

    Jessica came up to us about 15 minutes later. Our patient coded, and they could not save him. This son, husband, father- gone, only memories left.

    My heart swelled as I thought about it more. Did the thirty seconds I slowed down to let my patient and his family speak, kiss, and share their love cause his harm? I doubt it- the damage was done, and a few minutes later he would be gone. Yes, I got yelled at, and yes, it made me mad, made me want to cry, made me want to leave for that quick moment. I realized them I gave that family a moment they'll never forget. That was the last time they'd see their loved one alive, and had I kept going, it never would have happened.

    Today, as we lay to rest another son, father, husband, I pray that my coworker was able to have that moment as well. I hope someone slowed down enough to let love shine through, to let the last memory be a joyous one.

    Tonight, I'll go home and hug my husband and daughter tighter, and say "I love you" more than they can imagine, because I fear we won't have that last slow moment together, and we never know when it will be.

    *Names Changed

  • Nov 7 '08

    Quote from uscstu4lfe
    when people are sick they go the hospital. you are the nurse. it's part of the job description.


    Yes, it is part of the job; however, some people are not designed to deal with these aspects of the job. If that is the case, they need to do something else. Things we take for granted every day may terrify other people. No shame in admitting this and doing something else. In addition, some things may bother us while others are left unscathed. I thought I had experienced everything and there was nothing that would not bug me. Then, I experienced some situations overseas that made me think "holy crap I hope this does not keep me up in the middle of the night 15 years from now." In addition, I do not agree with the "your not a kid get over it attitude."

    Oncology, what is your question or statement? Your post seems to indicate you are in some type of distress; however, it is quite vague and perhaps you could clearly state your problem or concern.

    If you are truly at a point where the emotional baggage from your work is causing serious problems, get out and do something else. Perhaps all you need is a break or time to regain perspective. Possibly, you need to do something completely different. You may need to talk to somebody with professional credentials as well.

  • Nov 6 '08

    If you weren't allowed to say anything, an obvious violation of your rights to confront an accuser, then laughing at them would have been the apprioprate thing to do.
    If confronted about laughing, you could have said that you thought it was a practical joke because no professional would have to put up with such garbage.

  • Nov 6 '08

    The letter is too long and small print for me to read in its entirety, but I get the gist.

    I'm wondering, if you didn't intend to actually send it, why did you write this lengthy chronicle of your resentments toward your MIL on your email instead of as a Word Document? And then, to 'accidentally' send it to everyone you know?

    That's a classic Freudian slip if you ask me...


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