Content That rngolfer53 Likes

Content That rngolfer53 Likes

rngolfer53 3,389 Views

Joined Sep 13, '08. Posts: 687 (53% Liked) Likes: 975

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  • Feb 12 '14

    Quote from Sam J.
    The pain is 'horrendous', yet the Roxanol is 'as needed', and yet OP is asking for pain control advice (medical advice) in a nursing forum, without indicating that same OP has advised the patient's physician that her/his patient is in 'horrendous' pain? Hmm.
    Have you never seen poorly controlled pain in oncology before? It's really not that uncommon, even when physicians are well-apprised of the fact.

  • Jul 7 '13

    I disagree re acls and pals I was specifically ruled out for several positions because I did not have them. Where I live there are 800 new grads coming into the market at every semester completion with all the JC university and private school graduations. Competition is very very stiff for new grads and every certification you can get behind you will keep your resume at the top of the stack .. Around here anyway. Maybe there really is a nursing shortage where you are and these things don't matter. If so that's awesome for you!

  • Jul 7 '13

    Quote from mclennan
    I also now sit on 3 hiring panels with my current company, we hire urgent care & case management nurses. We DEFINITELY prioritize candidates who already have their ACLS/BLS/PALS. I don't understand this whole mentality of "don't bother, your employer will pay for it." We don't want to hire people who are going to cost us money right up front. You want to be a full package, ready to work, with all your training & certifications ready to go! What makes you think we'd be more inclined to hire someone we'll have to spend more money on, who isn't prepared?
    Thank you for this! You have no idea how many of my peers say, "It's a waste of money - the hospital will pay for it." To be honest, I almost fell into that mindset before a few nurses from Kaiser told me to get it, as it shows you want to be more knowledgeable. I always compare it to buying a car (the car being the person seeking employment): "Do you want a car that requires you to buy headlights?"

  • Jul 7 '13

    I got a public health job right out of nursing school, working in a position that involved both clinic nursing and home visits. M-F, 9-5. Then I moved into case management, again M-F, 9-5. I've never worked 3 12's or in a hospital at ALL, and it's been 7 years. Think outside the hospital box.

    I also now sit on 3 hiring panels with my current company, we hire urgent care & case management nurses. We DEFINITELY prioritize candidates who already have their ACLS/BLS/PALS. I don't understand this whole mentality of "don't bother, your employer will pay for it." We don't want to hire people who are going to cost us money right up front. You want to be a full package, ready to work, with all your training & certifications ready to go! What makes you think we'd be more inclined to hire someone we'll have to spend more money on, who isn't prepared?

  • Jul 5 '13

    I have a patient who's family is administering his chemotherapy at home. I don't think they can read above a 5th grade level, but they are doing something I was never permitted to do because I lacked the necessary certifications, lol. Just because we don't allow people to do things inside the system doesn't mean they couldn't be taught to do it perfectly safely. It isn't necessary to have a Dana Faber Oncology Fellow hook up one's chemo. If I needed it, I would like to consult a Dana Faber Oncology team for my treatment plan, but I think I'd just assume be at home and let my partner hook it up and puke in my own toilet, all other things being equal.

    I'm not sure what point you are driving at, Lvdovicvs.

  • Jul 5 '13

    gypsyd8 - I am sorry that you feel offended by my comment towards MSN nurses in our area but it is true for us. I have had my MSN for three years now, but only for teaching. I can say to you that I hope that you make positive changes in an administrative position. My simple point and it seems that many agree with me, is that administration tends to disconnect from patient care in many areas of the country. If you can figure that out you will be a good leader. I have actually recommended to our board that clinical coordinators and directors have mandatory patient care hours in a months time. In that time they can actually see if decisions they are making actually work on the floor. To me this is common sense, not challenging administration.

  • Jul 5 '13

    Quote from MessyMomma

    Have ypu noticed that patients complain of less pain/discomfort when the topicals are used? These are not available in my hospital, but I am very curious as to how it works.

    Also---do you have to wait a little nit for the anesthetic to work? Or just proceed as if using plain KY?
    BIT, not nit!

    If I see nits down there, we got more problems! ;-)

  • Jun 17 '13

    I doubt I would have "wasted" so much time with explanations. Your job is to steer the boat. They need to learn that. If you have to justify every decision you have to make I can see why they think browbeating will work. I am not saying you were wrong. A great deal depends on the backing you have. Since the director was making decisions I suspect I would have used that power as part of the decision making process to explain. Knowing me I probably would have ended the conversation with "the decision has been made." "I suggest you have your attending make an appointment with the director so we are clear in the future about the use of rooms."

  • Jun 17 '13

    Would've told her to **** off.

  • Jun 17 '13

    I no longer work in ER, but things like this **** me off. The ER and EMS should not be used as a dumping ground for other organizations who refuse to use common sense and take responsibility for patients, or residents in this case.

  • Jun 17 '13

    How would that 911 call go anyways.
    "what is your emergency? "
    " an adult woman decided against breakfast today. "

    That policy just seems strange and an abuse of emergency services.

  • Jun 14 '13

    It has really become a problem in our culture today, which many in the field of medicine feel that everyone that comes through the door is drug seeking and unfortunately, they treat everyone that way and it's dead wrong. I do understand that there are many that are, but it reflects badly on the professional that cannot discern the difference in between those who are from those who aren't. It is tantamount to having a horrendous bedside manner if you mistreat those who come to you for care, by overtly suspecting them of seeking drugs, when they are in fact sick, in pain and in need of treatment and relief not remonstration and reprimand. If you wanted to be in Law Enforcement, you should have made that decision long ago, not when you are standing in front of a patient seeking treatment for an illness or acute pain.

  • Jun 14 '13

    Quote from FMF Corpsman
    Some might suggest vital signs, but that isn't always a true indicator of elevated pain levels.
    I agree one hundred percent. I actually kind of have a personal thing with people who claim if it's real pain it will be reflected in vital signs; you don't know the physiology of their pain or how it will truly affect them.

    I have several men in my family who deal with pain amazingly. Just because my dad smiles and shakes your hand doesn't mean his RA isn't killing him at the moment.

    And just three weeks ago, a triage nurse in the ED dismissed my husband's RLQ pain since "you're not sweaty or anything and your vitals are great." We had to sit in the waiting room for four hours. Finally, a doctor came out and tore the nurse apart. It was painful to see but I hope she learned from it. He had read our story and came out personally to get us. He got us immediately to CT, but my husband's appendix had already burst and he went in for emergency surgery and a 9 day stay afterwards.

    My husband could have gone septic because someone deemed his vital signs the end-all be-all of his pain indication.

    Sorry. I'm still mad about it.

  • Jun 14 '13

    One thing I think we all need to remember is that we are not DEA or any other sworn LEO’s. We are professional nurses here to take the best possible care of our patients. It is our job to determine if our patients are suffering from pain and if so, to relieve that pain by administering prescribed medications. We are not gatekeepers, we do not get to decide that our patients are not really suffering enough by our standards and therefore not worthy of his or her prescribed medications. Many nurses claim to worry they’ll “turn their patients into addicts if they ‘overmedicate’ them,” which is in fact, a load of bunk, because most patients aren’t hospitalized long enough for that to happen. At best, you’re going to end up with a satisfied, pain free, patient who doesn’t spend his days or nights on the call light the entire shift. I’m not suggesting that everyone gork their patients, simply medicate them appropriately, according to the Doctors orders and the patients request. If a patient asks for his or her meds, I give it to them, they know better what is going on with their body than I do. Until someone invents a machine that can adequately display pain levels within the human body, it’s the best we have to go with. Some might suggest vital signs, but that isn’t always a true indicator of elevated pain levels.

  • Jun 14 '13

    If a patient says they have pain, they have pain, medicate them. It is worse to not medicate someone with pain then to medicate someone that has no pain. I have had many "drug seeking" patients who turn out to have gall stones, panccreatitis etc and because RNs, Drs are so afraid to get these people "high" they wont medicate them properly and I think it is wrong. Just be direct and ask!


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