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I understand that those who don't have medical experience dont understand some things. You don't know what you dont know....I get that. But sometimes I get so irritated by the converstions i have with my husband. He was seen in our clinic and was prescribed antibiotics. He reads his bottle and takes his pills and goes on and on about how his dose is "500 mg" and that's alot and he must have a really bad case and yada yada. I simply say "thats a pretty standard dose". And he's like "but its 500mg"! I try to explain by saying "you took 1000mg of tylenol the other day and it didn't touch your headache, but if you took 10mg of morphine you'd be flat on your @ss. " I get blank stares most of the time.....
The very first time I met my husband's family was when we had been dating about a year and were out of state for a cousin's wedding. I walked into the house and got pulled to the side and into a room where his cousin pulled up her shirt and ripped off the binding from her stomach to ask me "does this look infected???". She had lost a lot of weight and had gotten a tummy tuck and boob lift (both of which I got a full view of) and was about a week post-op. I said that yeah, she should probably see her surgeon. I THEN learned her name. 😉
To HER credit, she did go see her doc and got antibiotics.
Turns out the techs (I thought they were LPNs) didn't know the difference between mg and mL, didn't know what a PRN order was and didn't know what a range med order was (she could have a range of the morphine, she was getting the smallest dose and they kept telling me the mL vs the mg). I ended up having to look at her MAR and write out a med schedule (she also had Ativan, a med they didn't know about or understand). Turns out there are a couple states where you can give meds after a 4 hour class.
I live in one of those wonderful states that hires people off the street and gives then a course about 'medication observation' right there in the facility by their own staff (although for some reason I'm thinking it was eight hours for the facility that I was working). Scary stuff and sometimes the rules were bent to keep the resident there (if state knew they'd fine the heck out of them). They aren't supposed to administer medication, but 'observe the resident taking it'. Basically they take out the pills listed on the 'MOR' (not a typo) and hand them to the resident with a glass of water and watch the resident place the medication in their mouth and swallow. I had seen many going to the point of crushing, mixing with applesauce, and spooning it to the resident. (or placing a dropper in the residents mouth) This actually would require a licensed nurse to give the med. They also were not allowed to work in a skilled nursing facility but rather assisted living communities. I almost had a stroke when I overheard a tech tell the resident that he was going to give her "the rest of her meds for the night" with her 5pm meds. One of those pills was Ambien. I quickly stopped that dose that night but it turned out that it had been done for months. Well, now we knew that she wasn't sundowning around dinner, she was drugged. There were many other scary mistakes that were caught but this one was probably the one that I had the hardest time believing-come on, who doesn't know what ambien is used for (besides that med tech)? And no, they aren't required to know what they are giving to the resident like nurses are required to know. Funny thing was, going through employment at this type of facility was what finally got my butt back in school. No way was I going to be able to handle working for places like this for the rest of my career, and that's where things seem to be heading:no:
I had a pt (who's mother is dying in hospice care and has a fractured hip) complain about us re-positioning her, but didn't want us to cut her pj's up the back so we wouldn't have to lift her whole body off the bed to put her clothes on. " Because mom would be mad if we cut up her pj's", mean while after getting a bolus from the nurse and watching her mom cry out during re-positioning she's like " I'm sorry they hurt you!".
Consider alternative:- kiddo whining and hurting all over after a good sports training session? Go take shower, pasta for dinner for your carbs, take Motrin AFTER dinner, mom will do massage, then go to bed and please be gone till morning. Done. Yes, I know what I am doin'.
- weather changed, synuses hurt like ****, you got this meeting at 7 AM tomorrow? Go take SMALL ice bags, put them over where it hurts, through a towel. Take two Tylenol synus, I said TWO, not four. Go finish what you were doing, then go sleep. Done. Yes, I know what I'm doin'.
- again ate something that was not intended for consumption by a normal human being, let alone YOU? Here is Pedialite, drink it... yes, more, more, then some more... ok, I'm off for Imodium and Pepsid, will be back in 15 min. Drink it. Done. Yes, I know...
- yeah, I got a reaction again. Local, don't worry. I took everything I need. No, no Epipen this time. It will be done tomorrow. Yes...
The universal responce on all that:
- is it really so simple? SO easy? Are you sure? Will we better off going to that urgent care, or I need to call 911? How it comes you just KNOW it is ok?? (and so forth till problem disappears).
RN/BSN wife vs. two hard science advanced degree husband
is it not the truth, mine is a mechanical engineer
dont get me started......
The NEXT DAY he grabs some celery to eat. I grabbed it and threw it out. Seriously?!? I am learning why nagging is a thing. How in the world do they survive on their own for so long?! [emoji13]
LOL[emoji23]
My husband has sleep apnea but will not wear his CPAP with any regularity. Despite being aware of:
A) How much more rested he feels when he wears it.
B.) The long term risks to his health.
C.) That he snores like a freight train and literally stops breathing for like 5 to 10 seconds at a time. (He's seen the video I've made at his request and he was appalled).
D.) That I can't sleep when he snores.
Despite all of this he STILL acts positively shocked every time I wake him up because he is snoring. Here's how every night goes:
Me: Shaking him, "Will, wake up. You're snoring."
Him: "I was??????!!!!!!!!!"
Me: "Yes. And snorting for air. You didn't breathe for like 10 seconds."
Him: (With his Southern drawl) "Awe, sheee*****t!!!"
He is shocked and surprised EVERY time. No exaggeration. Just wear the ding da dang CPAP. (Whom we have affectionately named "Pappy")
I've honestly thought I'd have to start rescue breathing on him a few times.
Oh the stories I could tell about my husband. Any symptom, any illness must be cancer. The man is terrified of cancer and if he has a sore muscle after playing football, it must be cancer. If he has a cold, it must be cancer. All headaches must be brain cancer. Any lump or bump also must be cancer. To top it all off I'm an Oncology nurse, LOL.
My sister, a lovely woman, is a psychiatric nurse practitioner. We have clashed many times over our parents care. Of course 'she knows better' because she had an advanced degree and I'm only a BSN. I usually just let her have her way unless it's really serious.
My father had angina and needed to go to the ER. He and Mom lived on a farm, 9 miles from the nearest town. He called me (two time zones to the west) at midnight.
"I'm having chest pain. What do I do?"
We had discussed this many, many times. "Are you nauseated or short of breath? Does the pain radiate? What does it feel like -- sharp or dull?" We established that he had dull, left sided chest pressure radiating to his left arm and jaw. He was also nauseated, short of breath and felt as though his heart was skipping beats. "Call 9-1-1," I tell him, knowing that the neighbor who are volunteer fire fighters will get the shout and get there a few minutes before the ambulance can get there from nine miles away.
"No," he says. "Your mother will drive me. She knows CPR." And he hangs up before we can discuss the logistics of Mom doing CPR while driving.
I'm wide awake now. Fifteen minutes later, Mom calls me. "He's in the ER, they took him right back. Is that good?"
No, Mom. That's a very bad sign. But of course, I can't tell her that. It's midnight, my husband (who has to work at 6AM) is sleeping and my suitcase is in the closet. I start packing it with off-season clothes from the spare closet so I don't wake him.
At 1:05am, I get a phone call from Dad. "My heart keeps skipping beats, and they want to do an EKG. What should I do?"
"Let them do the EKG, Dad."
At 1:30, he calls back. "I've got one big, fat beat and a couple of little skinny beats and then one big, fat beat . . . They want to give me a medication, what should I do?"
"Do what they say, Dad. And let me talk to the doctor."
I talk to the doctor. Dad's having unstable angina, trigeminy and his oxygen saturations are low. We discuss the plan, and I agree with it. I'm a CCU nurse, I know a little about unstable angina and ventricular arrhythmias.
I get Dad back on the phone, tell him I agree with the plan and he should do what the doctor says.
"Oh, no," he says. "I've got to see what your sister says before I do anything."
My sister is a Gucci nurse who hasn't been near a patient since 1982. You need a plan for nursing management, for eliminating RNs in favor of unlicensed personnel, she's all over it.
Why even call me and keep me up all night if you're not going to follow my advice?
My father had angina and needed to go to the ER. He and Mom lived on a farm, 9 miles from the nearest town. He called me (two time zones to the west) at midnight."I'm having chest pain. What do I do?"
We had discussed this many, many times. "Are you nauseated or short of breath? Does the pain radiate? What does it feel like -- sharp or dull?" We established that he had dull, left sided chest pressure radiating to his left arm and jaw. He was also nauseated, short of breath and felt as though his heart was skipping beats. "Call 9-1-1," I tell him, knowing that the neighbor who are volunteer fire fighters will get the shout and get there a few minutes before the ambulance can get there from nine miles away.
"No," he says. "Your mother will drive me. She knows CPR." And he hangs up before we can discuss the logistics of Mom doing CPR while driving.
I'm wide awake now. Fifteen minutes later, Mom calls me. "He's in the ER, they took him right back. Is that good?"
No, Mom. That's a very bad sign. But of course, I can't tell her that. It's midnight, my husband (who has to work at 6AM) is sleeping and my suitcase is in the closet. I start packing it with off-season clothes from the spare closet so I don't wake him.
At 1:05am, I get a phone call from Dad. "My heart keeps skipping beats, and they want to do an EKG. What should I do?"
"Let them do the EKG, Dad."
At 1:30, he calls back. "I've got one big, fat beat and a couple of little skinny beats and then one big, fat beat . . . They want to give me a medication, what should I do?"
"Do what they say, Dad. And let me talk to the doctor."
I talk to the doctor. Dad's having unstable angina, trigeminy and his oxygen saturations are low. We discuss the plan, and I agree with it. I'm a CCU nurse, I know a little about unstable angina and ventricular arrhythmias.
I get Dad back on the phone, tell him I agree with the plan and he should do what the doctor says.
"Oh, no," he says. "I've got to see what your sister says before I do anything."
My sister is a Gucci nurse who hasn't been near a patient since 1982. You need a plan for nursing management, for eliminating RNs in favor of unlicensed personnel, she's all over it.
Why even call me and keep me up all night if you're not going to follow my advice?
Geez that makes me SO mad. I can be a little b-word though so I might've cussed my sister out and told my dad that he's not listening and when his body gives up on him I'll still be there for him but I will be thinking "I told you so!"
Actually, my dad started smoking at 40 years old, has a beer belly, was pre-hypertensive and pre-diabetic but is currently in chronic hypertension and DM2. He is getting worse and I know that kidney failure and COPD aren't far off in his future. MEN!! smh.
LOL[emoji23]My husband has sleep apnea but will not wear his CPAP with any regularity. Despite being aware of:
A) How much more rested he feels when he wears it.
B.) The long term risks to his health.
C.) That he snores like a freight train and literally stops breathing for like 5 to 10 seconds at a time. (He's seen the video I've made at his request and he was appalled).
D.) That I can't sleep when he snores.
Despite all of this he STILL acts positively shocked every time I wake him up because he is snoring. Here's how every night goes:
Me: Shaking him, "Will, wake up. You're snoring."
Him: "I was??????!!!!!!!!!"
Me: "Yes. And snorting for air. You didn't breathe for like 10 seconds."
Him: (With his Southern drawl) "Awe, sheee*****t!!!"
He is shocked and surprised EVERY time. No exaggeration. Just wear the ding da dang CPAP. (Whom we have affectionately named "Pappy")
I've honestly thought I'd have to start rescue breathing on him a few times.
It took several years before my now husband would wear his cpap. I've never heard such bad apnea. He shook the whole bed when he restarted breathing. He was apneic and choking for 30-45 seconds at a time (I timed him a few times). I bought a portable pulse ox but decided I just didn't want to know. I had a CODE PLAN for him! And the plan was hope help gets here because he's too big to pull off the bed and you can't do compressions on a mattress (not to mention he's a big guy and I could probably never compress his chest). Finally an RT friend found nasal cannulas for him to use. I did not think they would work but hallelujah they did! I was fully imagining us living in separate bedrooms....on the other side of the house.
It took several years before my now husband would wear his cpap. I've never heard such bad apnea. He shook the whole bed when he restarted breathing. He was apneic and choking for 30-45 seconds at a time (I timed him a few times). I bought a portable pulse ox but decided I just didn't want to know. I had a CODE PLAN for him! And the plan was hope help gets here because he's too big to pull off the bed and you can't do compressions on a mattress (not to mention he's a big guy and I could probably never compress his chest). Finally an RT friend found nasal cannulas for him to use. I did not think they would work but hallelujah they did! I was fully imagining us living in separate bedrooms....on the other side of the house.
My husband is not your stereotypical apnea pt. He is a pretty thin guy so I could probably pull off the bed onto the floor if I had to initiate an emergency action plan.
My husband has been through several different types of delivery methods. He's got a little nasal mask type thing now that's pretty noninvasive. It doesn't bother him too much. He just gets lazy and falls asleep without it.
Your husband's apnea sounds frightening. I'm glad you found a solution :-)
I live in one of those wonderful states that hires people off the street and gives then a course about 'medication observation' right there in the facility by their own staff (although for some reason I'm thinking it was eight hours for the facility that I was working). Scary stuff and sometimes the rules were bent to keep the resident there (if state knew they'd fine the heck out of them). They aren't supposed to administer medication, but 'observe the resident taking it'. Basically they take out the pills listed on the 'MOR' (not a typo) and hand them to the resident with a glass of water and watch the resident place the medication in their mouth and swallow. I had seen many going to the point of crushing, mixing with applesauce, and spooning it to the resident. (or placing a dropper in the residents mouth) This actually would require a licensed nurse to give the med. They also were not allowed to work in a skilled nursing facility but rather assisted living communities. I almost had a stroke when I overheard a tech tell the resident that he was going to give her "the rest of her meds for the night" with her 5pm meds. One of those pills was Ambien. I quickly stopped that dose that night but it turned out that it had been done for months. Well, now we knew that she wasn't sundowning around dinner, she was drugged. There were many other scary mistakes that were caught but this one was probably the one that I had the hardest time believing-come on, who doesn't know what ambien is used for (besides that med tech)? And no, they aren't required to know what they are giving to the resident like nurses are required to know. Funny thing was, going through employment at this type of facility was what finally got my butt back in school. No way was I going to be able to handle working for places like this for the rest of my career, and that's where things seem to be heading:no:
Yeah, this was the first I had heard of it. And they aren't med techs. Shoot, when I got my CNA, it was an 8 week, full time course 5 days a week. And we didn't give meds.
My 19 year old cousin had worked at this care facility. She gave meds too. She didn't understand why I was so upset that they were giving heart medications and insulin and narcotics with no knowledge of them including indications to hold them. She goes "but we're allowed to." She's now taking pre-reqs for nursing school. I'm hoping she one day realizes how scary it all is and how lucky she is that nothing went wrong (that she knows of). And for family members they would never think to ask. I even thought they were nurses. I'm sure they can say "nurse on site" because the manager is an LPN, but she's only there 8-10 hours a day.
WoosahRN, MSN, RN
278 Posts
We realized husband must have an allergy to celery. Happened a few years ago where he ate some that were a side from wings so we weren't sure what it was. His lips swelled up and he got bumps all over his face. He even did admit to feeling some breathing issues.
So at Thanskgiving there was a veggie platter and he eats some celery with leftovers. Within seconds he goes "haha! It's happening." Lips swelling and bumps. Thankfully no breathing issues. But I had to nag him to take Benedryl and even then I have to physically go get it and watch him take it. The NEXT DAY he grabs some celery to eat. I grabbed it and threw it out. Seriously?!? I am learning why nagging is a thing. How in the world do they survive on their own for so long?! ðŸ˜