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CASTLEGATES, ASN, BSN, RN 7,475 Views

Joined: Aug 27, '09; Posts: 433 (40% Liked) ; Likes: 492

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  • Dec 11

    I was enlisted for 5 years and once I got my RN, called the Army nurse Corps main number and they connected me with a recruiter. So much easier than a mall.

    The transition was simple and mindless but the cultural change was vastly different.

    Remember you NEVER "enlist" as a nurse; you choose to accept and are "commissioned." Commissioned means you pay for your food, your uniforms and you have lots of out of pocket expenses. It's not like enlisted at all. You're expected to lead and if anyone does anything, you're at fault but the problem is many units have no one to lead; they're all officers who still don't know how to salute or march so leading like that will get you no respect (sometimes blatantly so). Going longer term if at all possible makes the transition better (longer training courses, volunteer for "extended duty" or go full time otherwise the idle time will be crazymaking).

    I went no where except to a nearby army base when I was commissioned-they even let my brother come and swear me in (he was eligible).

    Once sworn at I self scheduled for my basic course.

    If you're 28 or older and do enlist, you'd be a PFC by the end of basic training (if you had NO education) and move up rapidly. If you're an RN, you'd start higher if enlisted is your thing. You never see oldsters at the bottom. One of the 3 promoting requirements they consider is age. If someone told me I "HAD" to be deployed tomorrow, I'd take an enlisted LPN position (I'm an RN). This way uncle sam would have all the out of pocket expenses and people would give me respect immediately. Stripes stick together; they're the backbone of the military (as they say).

    Serving both, my stripes days were my most rewarding. Money wise, it's a wash with all the officer expenses (depending on rank). Guage both carefully!

  • Nov 16

    Recommending we withdraw care on a patient we flogged for about 2 mos, weeping edema, poor cardiac output, exuding odor from browned extremities, infections in every invasive site. We were on the fence, communicating with family but I had enough. Several of us were pushing with ethics and Dr's to call it and withdraw care.

    This very man returned, walking into our unit bringing all of the staff a nice lunch tray 6 months later, thanking us for saving his life and never giving up. I quietly slipped off to the bathroom and doubled over, gagging. I couldn't eat! I couldn't believe what just happened. I felt so undeserved of the very air he was breathing. I felt incredibly small.

  • Oct 15

    Recommending we withdraw care on a patient we flogged for about 2 mos, weeping edema, poor cardiac output, exuding odor from browned extremities, infections in every invasive site. We were on the fence, communicating with family but I had enough. Several of us were pushing with ethics and Dr's to call it and withdraw care.

    This very man returned, walking into our unit bringing all of the staff a nice lunch tray 6 months later, thanking us for saving his life and never giving up. I quietly slipped off to the bathroom and doubled over, gagging. I couldn't eat! I couldn't believe what just happened. I felt so undeserved of the very air he was breathing. I felt incredibly small.

  • Aug 22

    I give everything and anything TOGETHER for these people who are in the throes of withdrawals. It's only for a few days, 'till their system clears. None of those meds mentioned are addictive, or they would be scheduled meds. It's amazing the stuff people can write and not be questioned. Phenergan is not addictive! Hydroxyzine isn't, either! Please look it up and recheck abuse statistics. Better yet, study and take the CARN exam! Make it your business to UNDERSTAND addiction, not treat it as a moral deficiency.

    I slam them with everything my judgement allows, because after all, they're not my own personal supply of meds (so why act like it)? Why be so stingy with them? We recently had a nurse FIRED for not doling out meds as ordered and requested. It's not my job to try to talk them out of their PRN's. Addictions nursing is a field for the very few who truly understand the disease of addiction. Others should move to straight psych wards. Many get into hot water for not giving meds as prescribed and requested (that's a dangerous game with your license being played). Our nurse who was fired did not give the meds the patients were requesting that the providers were ordering! If they say they're sick, then they're sick. The old saying that addicts are bad goes against the very fact that addiction is a diagnosis, not a moral deficiency (so don't treat them by controlling them; work with them)!

    Imagine throwing someone in jail (who has diabetes) for eating a cookie because they had a craving for one! It's just that simple and these meds are there to reduce cravings, help them sleep or feel more relaxed so they can cope. It's a horrible disease and you want to keep them there so they don't leave AMA and potentially die (relapse is a dangerous time when they may, or may not make it back). The reason they don't add other diagnoses for ANYONE in the throes of withdrawals are because withdrawals can mimic schizophrenia, panic disorders, phobias, bipolar, and explosive disorder. We, as med nurses can't expect to "fix" them by controlling what they take in the moments we interact with them. Why not give Trazodone and a little this and that? Why not give a couple, or a few meds at a time? I throw meds at these guys 'till the cows come mooing home and they appreciate my efforts to helping them feel comfortable. Upon admission, I go through their list of meds with them, discuss what effects each of them have, then we decide on what's most likely to snow them (if they're opiate addicts and it's night time). If an ETOH addict is uncomfortable, I throw benzo's at them to stay ahead of the game, so I'm not chasing withdrawals (I'm more careful with the ETOH and benzo's, though but I always stay ahead).

    The nurse who was fired was investigated by the board and found guilty of playing this dangerous medication withholding game. If it's ordered and the patient requests it and the patient says they're having symptoms (the kind we cannot see), then that's a legal basis for a complaint and a case. Anxiety isn't fun, neither is addiction or withdrawal. If I were uncomfortable, I'd play whatever games I had to, in order to gain some relief! It may turn into a game of getting through the med nurse-barrier between me and the meds my prescriber ordered. If I'm comfortable, then I'm more likely to be precontemplatiive about addiction versus sobriety. That's where I need them to be.

  • Jul 5

    if they've had it before and the same dose as before, slam it within the hosp policy or your guidelines and be done. Hospital admissions where the treating diagnosis is not addiction; nurses have no standing to try to treat and control narcs if a patient is in pain. Hanging it in an IV? I'm happy I'm not there!

    If I'm in pain, give it to me over a minute or slam it or whatever...who cares?

    So they get a high feeling at first; big deal. That's what narcs do!

    Hanging it in an iv to avoid a high is an asinine policy. Push it and watch em and if they get a high feeling, you know it's working. Treating addicts is no big deal if you know how to deal with them but it's apparent the label has more power than reasonable treatment. My guess is a place like that is weaning them day one postop if they've got a tolerance. When it comes to pain relief, I don't mess around. If they say they're in pain or an addict that's in pain (addicts have pain, too) then I don't delay, give whatever it takes within the standing and scheduled orders enough to stop their voicing pain. It's soooo easy!


    If they need to address their addiction it will be initiated by them when the time is right and that's where I come in. Post acute admission is the time to address their addiction. Controlling narcs like control freaks in a physical acute setting WILL create more anxiety and therefore more pain. They should read the pain control guidelines. Pain is subjective but when they're obviously calmed, they bother me less then on discharge day we can address their plan for addiction treatment and instruct them how to wean down at home before addiction treatment.

  • Jun 30

    Their first impression will be when you walk into their office, and it's nursing not HR you need to impress to get hired (unless you're new to the field and can't read people terribly well). Rather than doing all the things suggested by a brand new nurse, change your name on your social media accounts to a nickname. Case closed. No HR at any hospitals Ive worked at have made any hiring decisions based on a FB account. (it was a new nurse that wrote the article, most likely reading articles online versus interviewing the hiring deciders themselves--none of it mentions anything about actual hiring decisions, so I don't see any real valid points).

  • Jun 3

    I give everything and anything TOGETHER for these people who are in the throes of withdrawals. It's only for a few days, 'till their system clears. None of those meds mentioned are addictive, or they would be scheduled meds. It's amazing the stuff people can write and not be questioned. Phenergan is not addictive! Hydroxyzine isn't, either! Please look it up and recheck abuse statistics. Better yet, study and take the CARN exam! Make it your business to UNDERSTAND addiction, not treat it as a moral deficiency.

    I slam them with everything my judgement allows, because after all, they're not my own personal supply of meds (so why act like it)? Why be so stingy with them? We recently had a nurse FIRED for not doling out meds as ordered and requested. It's not my job to try to talk them out of their PRN's. Addictions nursing is a field for the very few who truly understand the disease of addiction. Others should move to straight psych wards. Many get into hot water for not giving meds as prescribed and requested (that's a dangerous game with your license being played). Our nurse who was fired did not give the meds the patients were requesting that the providers were ordering! If they say they're sick, then they're sick. The old saying that addicts are bad goes against the very fact that addiction is a diagnosis, not a moral deficiency (so don't treat them by controlling them; work with them)!

    Imagine throwing someone in jail (who has diabetes) for eating a cookie because they had a craving for one! It's just that simple and these meds are there to reduce cravings, help them sleep or feel more relaxed so they can cope. It's a horrible disease and you want to keep them there so they don't leave AMA and potentially die (relapse is a dangerous time when they may, or may not make it back). The reason they don't add other diagnoses for ANYONE in the throes of withdrawals are because withdrawals can mimic schizophrenia, panic disorders, phobias, bipolar, and explosive disorder. We, as med nurses can't expect to "fix" them by controlling what they take in the moments we interact with them. Why not give Trazodone and a little this and that? Why not give a couple, or a few meds at a time? I throw meds at these guys 'till the cows come mooing home and they appreciate my efforts to helping them feel comfortable. Upon admission, I go through their list of meds with them, discuss what effects each of them have, then we decide on what's most likely to snow them (if they're opiate addicts and it's night time). If an ETOH addict is uncomfortable, I throw benzo's at them to stay ahead of the game, so I'm not chasing withdrawals (I'm more careful with the ETOH and benzo's, though but I always stay ahead).

    The nurse who was fired was investigated by the board and found guilty of playing this dangerous medication withholding game. If it's ordered and the patient requests it and the patient says they're having symptoms (the kind we cannot see), then that's a legal basis for a complaint and a case. Anxiety isn't fun, neither is addiction or withdrawal. If I were uncomfortable, I'd play whatever games I had to, in order to gain some relief! It may turn into a game of getting through the med nurse-barrier between me and the meds my prescriber ordered. If I'm comfortable, then I'm more likely to be precontemplatiive about addiction versus sobriety. That's where I need them to be.

  • Feb 22

    Recommending we withdraw care on a patient we flogged for about 2 mos, weeping edema, poor cardiac output, exuding odor from browned extremities, infections in every invasive site. We were on the fence, communicating with family but I had enough. Several of us were pushing with ethics and Dr's to call it and withdraw care.

    This very man returned, walking into our unit bringing all of the staff a nice lunch tray 6 months later, thanking us for saving his life and never giving up. I quietly slipped off to the bathroom and doubled over, gagging. I couldn't eat! I couldn't believe what just happened. I felt so undeserved of the very air he was breathing. I felt incredibly small.

  • Feb 21

    Recommending we withdraw care on a patient we flogged for about 2 mos, weeping edema, poor cardiac output, exuding odor from browned extremities, infections in every invasive site. We were on the fence, communicating with family but I had enough. Several of us were pushing with ethics and Dr's to call it and withdraw care.

    This very man returned, walking into our unit bringing all of the staff a nice lunch tray 6 months later, thanking us for saving his life and never giving up. I quietly slipped off to the bathroom and doubled over, gagging. I couldn't eat! I couldn't believe what just happened. I felt so undeserved of the very air he was breathing. I felt incredibly small.

  • Feb 7

    I give everything and anything TOGETHER for these people who are in the throes of withdrawals. It's only for a few days, 'till their system clears. None of those meds mentioned are addictive, or they would be scheduled meds. It's amazing the stuff people can write and not be questioned. Phenergan is not addictive! Hydroxyzine isn't, either! Please look it up and recheck abuse statistics. Better yet, study and take the CARN exam! Make it your business to UNDERSTAND addiction, not treat it as a moral deficiency.

    I slam them with everything my judgement allows, because after all, they're not my own personal supply of meds (so why act like it)? Why be so stingy with them? We recently had a nurse FIRED for not doling out meds as ordered and requested. It's not my job to try to talk them out of their PRN's. Addictions nursing is a field for the very few who truly understand the disease of addiction. Others should move to straight psych wards. Many get into hot water for not giving meds as prescribed and requested (that's a dangerous game with your license being played). Our nurse who was fired did not give the meds the patients were requesting that the providers were ordering! If they say they're sick, then they're sick. The old saying that addicts are bad goes against the very fact that addiction is a diagnosis, not a moral deficiency (so don't treat them by controlling them; work with them)!

    Imagine throwing someone in jail (who has diabetes) for eating a cookie because they had a craving for one! It's just that simple and these meds are there to reduce cravings, help them sleep or feel more relaxed so they can cope. It's a horrible disease and you want to keep them there so they don't leave AMA and potentially die (relapse is a dangerous time when they may, or may not make it back). The reason they don't add other diagnoses for ANYONE in the throes of withdrawals are because withdrawals can mimic schizophrenia, panic disorders, phobias, bipolar, and explosive disorder. We, as med nurses can't expect to "fix" them by controlling what they take in the moments we interact with them. Why not give Trazodone and a little this and that? Why not give a couple, or a few meds at a time? I throw meds at these guys 'till the cows come mooing home and they appreciate my efforts to helping them feel comfortable. Upon admission, I go through their list of meds with them, discuss what effects each of them have, then we decide on what's most likely to snow them (if they're opiate addicts and it's night time). If an ETOH addict is uncomfortable, I throw benzo's at them to stay ahead of the game, so I'm not chasing withdrawals (I'm more careful with the ETOH and benzo's, though but I always stay ahead).

    The nurse who was fired was investigated by the board and found guilty of playing this dangerous medication withholding game. If it's ordered and the patient requests it and the patient says they're having symptoms (the kind we cannot see), then that's a legal basis for a complaint and a case. Anxiety isn't fun, neither is addiction or withdrawal. If I were uncomfortable, I'd play whatever games I had to, in order to gain some relief! It may turn into a game of getting through the med nurse-barrier between me and the meds my prescriber ordered. If I'm comfortable, then I'm more likely to be precontemplatiive about addiction versus sobriety. That's where I need them to be.



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