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ok2bout 873 Views

Joined: Jun 23, '01; Posts: 7 (29% Liked) ; Likes: 6

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    RNdreams23, OkieeRN, and martinalpn like this.

    My hospital does not care how you officially list your name. Some write is as John Doe, RN, BSN while other write is as John Doe, BSN, RN. Most list their certifications afterwards, such as John Doe, RN, BSN, CEN. I did notice a comment earlier about many nurses that go back and get their BSN is so that they eventually will end up behind a desk in an administrative position. My hospital encourages and reimburses up to 90 percent for those nurses who pursue their BSN. Many hospitals are now requiring nurses to have a BSN and there has been talk for many years that this become the standard. Personally I believe you do not need to have your BSN to be a great nurse, although I must admit that I learned alot when I went through my bachelors program. If you are content with not having a BSN, then I say continue what you are doing and be proud of the fact that you are a RN. One last note, stopped being so mean to one another. As nurses, we should set a high standard and treat each other with the highest professionalism.

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    I dont think most people responding here are saying that all people with the dx of FM are drug seekers are that there pain is real. But when theses pt's are continuously utilizing the ER for pain control there definitely is going to be a red light that these pt's may be drug seekers especially when you see these pt's have insurance and could be managed outpatient.....pain centers and other specialty centers. Also there have been many times in my experience that some of these pt's come into our ER and do not disclose their complete medication list and then when we contact their PCP we find out they have been taking oxycodone, oxycontin, dilaudid, and some other heavy duty drugs that they just happened to forget they have been taking. Most pts' with real FM are being managed by their PCP's. The ER should be utilized in servere cases, such as when pt's are traveling, their PCP send's them to the ER, etc. FM should not be managed by several weekly visits to an ER. This is the case for any chronic illness and unfortunately many pt's with many chronic illness continue to use the ER as their PCP for these disease processes. I believe that most of the people responding on this web site are educated and compassion, but you also gain alot of experience after seeing these pt's over and over and you are able to make your judgements based on experience and history. My advice for you iCatnip is if your are dx with FM then have it managed outpatient, use the ER in emergencies, and try to get yourself as educated as you can about FM. I dont think were are labeling our pts drug seekers who have only had a few ER visits its the long term FF that we have to be a little more concerned with.

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    If anyone hears of a real solution to this problems...please let me know. I work in an ER that tx's close to 100,000 pt's a year, thats about 300 pts a day. There is another local hospital less than 1 mile away that tx's on an average of 40-50 pts a day and the other hospital tx's around 30 a day. So as you can see were are extremely busy...were are often on divert, we does absolutely nothing b/c you can not tell your pt's coming in through triage and 99% of your pt's coming by ambulance dont care and still want to come to our ER. Fortunately we have an area of our ER that has 14 beds, 2 family practice MD's, 3 nurses, a unit clerk, and 2-3 NA's. Pt's tx in this area are fractures, sprains, strains, migraines, URI, back pain, lacerations, ear/tooth pain, most kids, etc. These type's of pt's are usually turned over very quickly and normally your able to keep this area running pretty quickly. This takes a huge burden off the main ER where higher acuity pt's can be seen quicker. Even with this system, we have pt's in hall bed's daily. Last week we had a pt code in a hall bed, unfortunately this can happen in any part of the ER. What frustrates me is the frequent fliers that we see weekly that refuse to follow up with a PCP. Many of them are drug seeking, but unfortunately it easier for the ER doc's to medicate them and move them out of the ER than to deal with their drug issues. We will usually see these pt's over and over until one of our doc's finally confronts the pt and they move on to another local hospital for several months and then back to our ER. I dont have the solution to the overcrowding and especially to the pt's utilizing the ER as their PCP. I think better education is needed for these pt's. The other day I noticed on my radio station that pt's who had Gateway insurance were being encouraged to call an 800 number before going to the ER for minor problems....too many to list here that they were addressing. I think if insurance companies started to aggressively address these types of people for abusing the ER before contacting their PCP by denying their claims just may start to educate pt's. Just maybe other insurance companies will get wise to this and start requiring their pt's to contact their PCP's before running off to the ER for minor problems that are not emergencies. I feel we have come to the point that we are no longer an ER just an extension of the health system. Some times I feel I just working for the local clinic with the types of pts I see all night. I went into emergency medicine to tx sick and emergent pt's which is rare lately.

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    I dont doubt the pain is real to most of these pt's. However most of the ER doc's agree that many of these pt's were ones that were chronically seeing their FMD or utilizing the ER all the time and after extensive workups everything came back negative, so after awhile the MD's needed to make a dx and this is where many have been give the dx of fibromyalgia just for the sake of given them a dx. I work in a ER that treats close to 100,000 pts yearly and the number of people in the last year coming in with this dx is ever increasing. I have often heard that many times ER nurses doubt these pt's pain, and I have to be truthful, I am often one of those nurse's. One of the reasons is we often see the repeat pt week after week utilizing the ER for pain control....morphine and dilaudid....why are these people not being followed by their PCP?, and many times we find out these pt's have been utilizing the 2 other local hospitals and have been getting morphine and dilaudid. It's these type's of pts that abuse the ER that make ER nurse's a little skeptical of pt's coming to be seen for fibromyalgia. And unfortunately this is the case for any dx where pt's are abusing the ER and utilizing it for their primary care.

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    What a great article. This describes my life as an ER nurse. I had to print this out and share it with my fellow co-workers.

    In this day and age where we are holding pt's in the ED overnight b/c there are no beds in the hospital, pt's in hall beds, people waiting for hours to come back from the waiting room, being on divert, staff shortages, trauma's, and the list goes on and on it surely was nice to see something positive and motivating.:spin:

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    I agree to some extent. This is one of the reasons they require day time hours every other weekend.

    I think that evening hours are benificial in that it gives students some hands on skills with getting their patients ready for bed.

    Students who attend only day clinicals do not get to do this very often.

    Besides, most nursing positions start off with the grave or evening shift anyways.

    It might not be the perfect answer to the shortage, but anything will help at this point.


    Dan

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    With such a nursing shortage, why dont colleges offer the clinical part of the course at night.

    Lancaster General will be offering a part time evening clinicals, Tues and Thurs evenings and every other weekend during the daytime.

    I think more colleges need to consider doing this.

    I will be entering my clinicals next fall, without a evening option it would be quite difficult for me without having to quit my job and work nights.

    Many adults returning to school for nursing have enough responsiblities to attend to in the day time hours that evening courses will allow these people to return to school.


    Dan



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