Content That ixchel Likes

ixchel, BSN, RN 50,240 Views

Joined Jun 3, '11. Posts: 5,160 (75% Liked) Likes: 19,846

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  • Apr 29

    Quote from SmilingBluEyes

    Again, I say, everyone in health care should be required to have continuing education, at least every 1-3 years, on addiction and diversion of medications. So many misjudgments and much misinformation among our profession is dangerous. To be able to recognize when a coworker may be in trouble, and possibly save a life, critical. This OP was not interested in anyone's wellbeing. She was being a busybody.
    I completely agree with this. I have a sibling that suffers with a substance use disorder and there is A LOT of misinformation/stigma out there even within the healthcare community.

    The NCSBN offers a FREE online cours on Substance Use Disorders in Nursing. It's 4 contact hours and I thought it was REALLy good. It's provides current research on addiction, what signs may be present if a nurse is using on the job, the proper way to report concerns, and the resources various state boards provide to help any nurse with this brain disease. I highly recommend ALL nurses take advantage of these free contact hours and go through this course.

    Here's the link: Understanding Substance Use Disorder in Nursing | NCSBN

    Suzy

  • Apr 29

    And what about the alleged user's safety?

    This has gone far enough.


    :deadhorse:

  • Apr 25

    Quote from ixchel
    I am responding to the OP only, without reading any comments first.

    OP, last year I developed persistent insomnia that at its peak, ended in me going into a psychosis at the end of a shift, complete with hallucinations. Instead of taking seriously the report I'd made to my manager on two prior shifts stating that I'd been dealing with sleeplessness (and me calling out in between those two shifts), the man assumed I was actually high. I received no medical attention whatsoever. Instead, I received a drug test. My manager received the results before I did, and I was fired before proof of one controlled medication validly prescribed was requested.

    That is just the BEGINNING of how my life was ruined by a person assuming I was on drugs. That was more than a year ago, and I am still knee deep in the massive pile of crap that dealt me. All they had to do was get me a doctor.

    You do NOTHING. Absolutely not one damn thing.
    Wow-----so sorry....so sorry.

  • Apr 25

    Quote from ixchel
    I am responding to the OP only, without reading any comments first.

    OP, last year I developed persistent insomnia that at its peak, ended in me going into a psychosis at the end of a shift, complete with hallucinations. Instead of taking seriously the report I'd made to my manager on two prior shifts stating that I'd been dealing with sleeplessness (and me calling out in between those two shifts), the man assumed I was actually high. I received no medical attention whatsoever. Instead, I received a drug test. My manager received the results before I did, and I was fired before proof of one controlled medication validly prescribed was requested.

    That is just the BEGINNING of how my life was ruined by a person assuming I was on drugs. That was more than a year ago, and I am still knee deep in the massive pile of crap that dealt me. All they had to do was get me a doctor.

    That's horrible! I am so sorry this happened to you. I sincerely wish you the best in righting this wrong done to you.

  • Apr 25

    Quote from ixchel
    I am responding to the OP only, without reading any comments first.

    OP, last year I developed persistent insomnia that at its peak, ended in me going into a psychosis at the end of a shift, complete with hallucinations. Instead of taking seriously the report I'd made to my manager on two prior shifts stating that I'd been dealing with sleeplessness (and me calling out in between those two shifts), the man assumed I was actually high. I received no medical attention whatsoever. Instead, I received a drug test. My manager received the results before I did, and I was fired before proof of one controlled medication validly prescribed was requested.

    That is just the BEGINNING of how my life was ruined by a person assuming I was on drugs. That was more than a year ago, and I am still knee deep in the massive pile of crap that dealt me. All they had to do was get me a doctor.

    You do NOTHING. Absolutely not one damn thing.
    Ixchel I am so sorry you are going through this.

    OP: I worked with a nurse who was accused of diverting meds (it was a serious and active issue at the facility I worked at). She was fired, reported to the BON and crazy as this sounds, they never asked for a urine drug screen on her. The only evidence they had was she was "flighty". well, yes, she was a bit flighty, but she was a good nurse. Her behavior had not changed since the day she started. The person who was most vocal about her suspected drug use DID have a major behavior change, but admin just wanted to a scape goat. the nurse (A) was eventually cleared (by the BON) but she had a hard time getting a new job.

    There were no complaints about her quality of work, families and residents had no issues with her, she was doing her job, and pretty much leaving everyone else alone. Except she was flighty. Fortunately, A has gotten a new job and is doing well.

    You can seriously ruin someones life this way. If you see this nurse with a needle in his arm, or joint in his mouth or his taking meds you are 100% sure are narcotics(and he is on duty), by all means, report it. But all you have is speculation. That's all it is. You have speculation and suspicion.

    Ask yourself this: how would you feel if someone accused you of drug use with flimsy evidence? How would YOU feel if it went all the way to the board? How would YOU feel if someones ruined your life? Start worrying about your own nursing practice.

  • Apr 25

    Quote from ixchel
    I am responding to the OP only, without reading any comments first.

    OP, last year I developed persistent insomnia that at its peak, ended in me going into a psychosis at the end of a shift, complete with hallucinations. Instead of taking seriously the report I'd made to my manager on two prior shifts stating that I'd been dealing with sleeplessness (and me calling out in between those two shifts), the man assumed I was actually high. I received no medical attention whatsoever. Instead, I received a drug test. My manager received the results before I did, and I was fired before proof of one controlled medication validly prescribed was requested.

    That is just the BEGINNING of how my life was ruined by a person assuming I was on drugs. That was more than a year ago, and I am still knee deep in the massive pile of crap that dealt me. All they had to do was get me a doctor.

    You do NOTHING. Absolutely not one damn thing.
    Ixchel, there are no words. I'm so sorry.

  • Dec 9 '16

    Haven't seen the recent thread, unless this is the one, so my entry goes like this:

    Having ixchel as a friend is a great help and relief especially when you're feeling low. Literally. LOL.

  • Sep 17 '16

    Quote from LadyFree28
    Keep posting palliative care information! Your posts are very valuable in terms of making those who don't specialize but encounter end of life issues have extra tools in the nursing toolbox!

    Thanks for letting me know that you find those posts helpful!
    I am invested in re-integrating palliative care into primary bedside nursing and want bedside nurses to have the tools they need to provide end -of - life care. We will see much more of that in the future as our population ages and lives longer (not necessarily with more quality of life though...).
    The other day I thought about a palliative care round up once in a while here for nurses who want to stay up to date in all things palliative and hospice.

  • Sep 17 '16

    LadyFree, I think you are awesome. You and I have much in common. I'm worried about you because of the giant banner at the top of our page.

    Know that I admire you and enjoy your posts. I'm glad you got to post this.

  • Sep 17 '16

    Quote from nutella
    I learned why so many projects fail how to initiate and start projects with all the science that is actually present. I also learned how to calculate costs /budgeting for projects, stakeholder management. Now that I have more solid knowledge about how to really plan and execute a project I hope to use that for some quality improvement project I am planing.

    I learned that there are still physicians out there who believe that palliative care is only appropriate "when the patient is ready and there yet" - meaning basically 2 days to live. Never mind that it is not the same as hospice care and focuses on prevention of suffering, increasing the quality of life in serious illness, and tries to help patients to align the goals for care/care plan with their values and wishes.
    And - how is it beneficial to say "Hi - the doctor told you that you have 2 days to live - what are your wishes and goals?"

    When talking about serious illness a conversation method that is not so much focused on the medical detail but on the patient values and goals is more effective and the rest will usually follow. But - those conversations need to happen earlier in the disease, more, and better according to the research from the Ariadne Lab

    Clinicians learn how to talk to patients about what matters most and be change agents for better care | Ariadne Labs

    If you have time and are interested in child birth /maternal care or improvements in surgery or end-of-life care check out their webpage !
    Their training and workshop has transformed the way my team approaches serious illness conversations.
    We started to use this conversation guide for those conversations though have to adapt it for acute care as patients may be sicker and in crisis :

    Redesigned Serious Illness Conversation Guide supports more, better and earlier conversations about what matters most | Ariadne Labs

    What was especially important for me to learn is that there is a huge difference between saying "I am concerned" (more of a medical jargon) and "I am worried about you / I am worried that your time might be shorter than you think it is" (empathy and emotion focused). I learned that the effect is different. I had a hard time to say " I am worried" - it does take away some distance and signals that something serious is going on plus a person cares.

    And I would like to also put out that as palliative care team we do not see a patient with a set agenda. I learned that a lot of healthcare workers still think that our job is to "make that patient DNR/DNI" or "make that patient CMO" or that if a person has not changed their mind about their code status to what the nurse thinks is the "right code status" for patient after seeing palliative care I have not achieved anything. There is no set agenda!!! The goal is to explore the goals and values, discuss what is going on, what is important, identify palliative care needs, sometimes symptom control. If it also happens that somebody decides to change code status fine but if not that is also ok. People need time to process things.

    I learned that due to my age fitness kickboxing is pushing it at times... as a martial artist I like the fitness kickboxing stuff because I do not have time to focus on martial arts right now and I am too old now for any sparring or competitions. The fitness aspect is great though and I have gained back a lot of strength and mobility. Not to mention that exercise is good to relieve stress.

    I have signed up for American Sign Language to build some basic vocabulary. I probably wrote already some while ago that the appropriate pain scale to use in non hearing patients is usually Wong Baker.

    Looks like most of my writing is related to palliative care (again).
    Keep posting palliative care information! Your posts are very valuable in terms of making those who don't specialize but encounter end of life issues have extra tools in the nursing toolbox!

  • Sep 17 '16

    Quote from OrganizedChaos
    I don't know if I want to get back into nursing in the future. I didn't renew my license & I don't know if I want to. I have awhile to decide but the thought of working at a job I hate or going back to school is just so unpleasant.

    Any input would be appreciated.
    Don't let your license lapse, please Cheerios!

    Please. You never know.

    *hugs*

  • Sep 17 '16

    Quote from OrganizedChaos
    I don't know if I want to get back into nursing in the future. I didn't renew my license & I don't know if I want to. I have awhile to decide but the thought of working at a job I hate or going back to school is just so unpleasant.

    Any input would be appreciated.
    I think at least keeping your license active while not working is a better advantage to letting for lapse.

    You are also in a position where you are about to bring another life into the world; once they start school and are settled into their studies, you may find yourself at the kitchen table too doing homework.

  • Sep 17 '16

    I learned why so many projects fail how to initiate and start projects with all the science that is actually present. I also learned how to calculate costs /budgeting for projects, stakeholder management. Now that I have more solid knowledge about how to really plan and execute a project I hope to use that for some quality improvement project I am planing.

    I learned that there are still physicians out there who believe that palliative care is only appropriate "when the patient is ready and there yet" - meaning basically 2 days to live. Never mind that it is not the same as hospice care and focuses on prevention of suffering, increasing the quality of life in serious illness, and tries to help patients to align the goals for care/care plan with their values and wishes.
    And - how is it beneficial to say "Hi - the doctor told you that you have 2 days to live - what are your wishes and goals?"

    When talking about serious illness a conversation method that is not so much focused on the medical detail but on the patient values and goals is more effective and the rest will usually follow. But - those conversations need to happen earlier in the disease, more, and better according to the research from the Ariadne Lab

    Clinicians learn how to talk to patients about what matters most and be change agents for better care | Ariadne Labs

    If you have time and are interested in child birth /maternal care or improvements in surgery or end-of-life care check out their webpage !
    Their training and workshop has transformed the way my team approaches serious illness conversations.
    We started to use this conversation guide for those conversations though have to adapt it for acute care as patients may be sicker and in crisis :

    Redesigned Serious Illness Conversation Guide supports more, better and earlier conversations about what matters most | Ariadne Labs

    What was especially important for me to learn is that there is a huge difference between saying "I am concerned" (more of a medical jargon) and "I am worried about you / I am worried that your time might be shorter than you think it is" (empathy and emotion focused). I learned that the effect is different. I had a hard time to say " I am worried" - it does take away some distance and signals that something serious is going on plus a person cares.

    And I would like to also put out that as palliative care team we do not see a patient with a set agenda. I learned that a lot of healthcare workers still think that our job is to "make that patient DNR/DNI" or "make that patient CMO" or that if a person has not changed their mind about their code status to what the nurse thinks is the "right code status" for patient after seeing palliative care I have not achieved anything. There is no set agenda!!! The goal is to explore the goals and values, discuss what is going on, what is important, identify palliative care needs, sometimes symptom control. If it also happens that somebody decides to change code status fine but if not that is also ok. People need time to process things.

    I learned that due to my age fitness kickboxing is pushing it at times... as a martial artist I like the fitness kickboxing stuff because I do not have time to focus on martial arts right now and I am too old now for any sparring or competitions. The fitness aspect is great though and I have gained back a lot of strength and mobility. Not to mention that exercise is good to relieve stress.

    I have signed up for American Sign Language to build some basic vocabulary. I probably wrote already some while ago that the appropriate pain scale to use in non hearing patients is usually Wong Baker.

    Looks like most of my writing is related to palliative care (again).

  • Sep 17 '16

    I learned that there are 92 days, 5 hours, and 3 minutes until nursing school graduation.

    (Not that I'm counting or anything)

    I also learned:

    (1.) That balancing two clinical rotations is challenging. I have one day off to study ... and somehow see my family in there too . With 3 classes, and one a grad class, and 4 day clinicals, I'm beat. I feel like I'm failing the "I'm a decent mom" category, as I missed the first day of school (at clinical), 3 soccer games (at clinical, at class), 2 cross country meets (clinical, studying, class), and a trip to NYC (had to stay home and study). I suck.

    (2.) School nurses are superheroes. Being a former teacher, I already had great respect for them. But as one of my rotations is school nursing ... good gosh! She barely eats, kids come in all the live long day, and the parents - gah. Yet she still comes in every day with a smile.

    (3.) There are 92 days, 5 hours, and *2 minutes* until graduation ....

  • Sep 17 '16

    Hi all!


    I have gotten permission by ixchel to host WILTW. I feel EXTREMELY honored to keep a thread going that inspires, and helps many of us who want to work or work in this business.

    This week, has been the most SOCIAL week; with enjoying the last week of summer break behind me and celebrating labor day as a unionized employee at work, the rest of the week was exciting with the increase of social cases, and my ever frustration with how social services is fragmented, in trouble, and fails the kids and the families that I see, along with actual lateral violence-not amongst nurses by the way-in my face, and support for a issue arise, it hasn't been a bad week!

    So, without further preamble what I learned this week:

    1. Nurse who are out of work or at their undesired job due to the nursing surplus in my area that want to be Peds nurses could MOST likely run social services much more efficiently and effectively.

    2. Being recorded is NOT such a bad thing when you see a trauma fellow screaming and pushing nurses during a trauma, twice in the same weekend for two different traumas.

    3. That I enjoy sedations; and this is another option when I plan my pre-semi retirement.

    4. That I will be a part of learning to be a educator on sexual assault, assault collections; we play an important part of collecting to ensure that DNA is not compromised; even if not discovered immediately, anything and any part of the process where I can assist in protect the public's health and safety, then I can be confident in supporting that justice.

    So, what have you learned this week?


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