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Joined: Oct 26, '11; Posts: 127 (60% Liked) ; Likes: 332

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  • Jul 9 '14

    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.

  • Jul 9 '14

    Quote from Jaquada
    I see what you're saying but, I also see it differently. Yes I agree medicine & nursing are different. But it's not impossible nor unheard of to start from the bottom and work your way up.
    And I understand what you're saying. Just be careful referring to nursing as "the bottom".

  • Jul 2 '14

    I can't choose either answer to your poll as neither one fits.

    This decision doesn't mean women will not have access to birth control.

    Hobby Lobby only had issues with four of the 20 contraceptive methods approved by the FDA, specifically those that are proven to interfere with uterine implantation of a fertilized egg, such as hormonal contraceptives like Plan B or IUD's. Because of the belief that a fertilized egg is the act of conception and therefore stopping the egg from implanting into the uterus causes the death of that embryo, a human being dies.

    Viagra is not the same thing as this at all. An erection and a fertilized egg are simply not the same.

    People can certainly disagree about when human life begins. However, in order to understand why people think the way they think, understanding where they come from helps us all.

    The ACA (Obamacare) doesn't guarantee that health plans cover it - Obamacare would never have passed with such a guarantee. And this is based on the Religious Freedom Restoration Act passed overwhelmingly by both houses of Congress and signed by Prez. Clinton:



    The high court's decision in the Hobby Lobby case refocused attention on the Religious Freedom Restoration Act that passed Congress overwhelmingly in 1993, with the support of some lawmakers still serving in both the House and Senate. The statute requires federal laws to accommodate individuals' religious beliefs unless there is a compelling interest at stake that can't be attained through other means.
    Supreme Court's Hobby Lobby Ruling Ignites Debate Over Religious-Freedom Law - WSJ


    This doesn't stop women from being able to get contraception. That's hyperbole.

    I'm in favor of what the Supreme Court did here.

  • Apr 25 '14

    Quote from IrishErin
    One of our emerg docs is also a cardiologist, and happens to practice acupuncture... He uses it frequently on people with migraines in emerg and the patients love him/it. I don't think it's a load of crap and I'd be happy to see someone tell him they think he's practicing nonsense!
    A doctor is practicing acupuncture in the emergency room ?

  • Nov 27 '12

    Quote from deann52
    She did not have "dispoable income" as a CNA. She was getting handouts from the govenment. Now she has a job that gives her enough to pay her own bills so I don't have too. Sorry, but that whole paragraph with the income breakdown is a big fat welcome to the real world and grow up.
    I once read a statistic that 70 percent of lower income workers in the U.S. receive one or more forms of public assistance in the form of food stamp cards, childcare assistance, Section 8 housing, etc.

    I totally agree it is best for society as a whole if the single mother in my aforementioned example is self-sufficient enough to support herself and her children without public assistance.

    However, the focal point of the paragraph with the income breakdown was to illustrate to the unwashed masses that many nurses are not fountains of endless cash. Once the reasonable bills (housing, food, gas, electric, childcare, insurance) consume a person's income, the 'good money' ain't looking so good after all.

  • Sep 27 '12

    1 Nursing school is a guide but not reality.

    2 You are not really expected to know everything.

    3Listen to others experiences but develop your own practice.Every nurse has something valuable to offer including you!

    4 Remembering the phrase "Everyone is doing the best that they can in this moment with what they have,
    (This will lessen your judgement of other staff,pts and most importantly yourself! )

    5 Don't strive for super nurse. You are enough as is (that took me 10yrs!!! )

    6 Frustration is normal tomorrows a new day.

    7 Choose to be kind.

  • Sep 13 '12

    Quote from Midwest4me
    Well, speaking from a Christian point of view, IF you apply and IF you get the job, my guess is that God is truly LEADING you TO that job! He has reasons for all He does. May you hear His voice in the choices you make!!!!
    I don't mean to be rude do sorry of this comes off that way. But as a non believer I respect every ones right to practice any religion they choose and It's their right to have your own believe system whatever it may be with out others judging them or telling them their wrong. And for people like you to push their beliefs on others and disrespect their belief system is not in any way ok. You are exactly the reason this person is skeptical of taking a job at a Christian facility. We don't come up to your face and tell you god isnt real, don't get in ours and imply in any way that "god" has any part is her life or this decision. Learn to be more tolerant and accepting of different beliefs, and to keep yours to yourself.

  • Sep 13 '12

    Quote from Midwest4me
    Well, speaking from a Christian point of view, IF you apply and IF you get the job, my guess is that God is truly LEADING you TO that job! He has reasons for all He does. May you hear His voice in the choices you make!!!!
    I'm sure you meant that kindly, but the OP has already told us she's an atheist. Even if you didn't already KNOW she was an atheist, this would be annoying but since you DO know, I cannot help but wonder why you would expect her to hear the voice of something she doesn't believe in. I'm not an atheist, and this annoyed me.

  • Sep 4 '12

    It's All About Women

    A sweet lesson on patience.

    A NYC Taxi driver wrote:

    I arrived at the address and honked the horn. After waiting a few minutes I honked again. Since this was going to be my last ride of my shift I thought about just driving away, but instead I put the car in park and walked up to the door and knocked.. 'Just a minute', answered a frail, elderly voice. I could hear something being dragged across the floor.

    After a long pause, the door opened. A small woman in her 90's stood before me. She was wearing a print dress and a pillbox hat with a veil pinned on it, like somebody out of a 1940's movie.

    By her side was a small nylon suitcase. The apartment looked as if no one had lived in it for years. All the furniture was covered with sheets.

    There were no clocks on the walls, no knickknacks or utensils on the counters. In the corner was a cardboard
    box filled with photos and glassware.

    'Would you carry my bag out to the car?' she said. I took the suitcase to the cab, then returned to assist the woman.

    She took my arm and we walked slowly toward the curb.

    She kept thanking me for my kindness. 'It's nothing', I told her.. 'I just try to treat my passengers the way I would want my mother to be treated.'

    'Oh, you're such a good boy, she said. When we got in the cab, she gave me an address and then asked, 'Could you drive
    through downtown?'

    'It's not the shortest way,' I answered quickly..

    'Oh, I don't mind,' she said. 'I'm in no hurry. I'm on my way to a hospice.

    I looked in the rear-view mirror. Her eyes were glistening. 'I don't have any family left,' she continued in a soft voice..'The doctor says I don't have very long.' I quietly reached over and shut off the meter.

    'What route would you like me to take?' I asked.

    For the next two hours, we drove through the city. She showed me the building where she had once worked as an elevator operator.

    We drove through the neighborhood where she and her husband had lived when they were newlyweds She had me pull up in front of a furniture warehouse that had once been a ballroom where she had gone dancing as a girl.

    Sometimes she'd ask me to slow in front of a particular building or corner and would sit staring into the darkness, saying nothing.

    As the first hint of sun was creasing the horizon, she suddenly said, 'I'm tired.Let's go now'.
    We drove in silence to the address she had given me. It was a low building, like a small convalescent home, with a driveway that passed under a portico.

    Two orderlies came out to the cab as soon as we pulled up. They were solicitous and intent, watching her every move.
    They must have been expecting her.

    I opened the trunk and took the small suitcase to the door. The woman was already seated in a wheelchair.

    'How much do I owe you?' She asked, reaching into her purse.

    'Nothing,' I said

    'You have to make a living,' she answered.

    'There are other passengers,' I responded.

    Almost without thinking, I bent and gave her a hug.She held onto me tightly.

    'You gave an old woman a little moment of joy,' she said. 'Thank you.'

    I squeezed her hand, and then walked into the dim morning light.. Behind me, a door shut.It was the sound of the closing of a life..

    I didn't pick up any more passengers that shift. I drove aimlessly lost in thought. For the rest of that day,I could hardly talk.What if that woman had gotten an angry driver,or one who was impatient to end his shift? What if I had refused to take the run, or had honked once, then driven away?

    On a quick review, I don't think that I have done anything more important in my life.

    We're conditioned to think that our lives revolve around great moments.

    But great moments often catch us unaware-beautifully wrapped in what others may consider a small one.

  • Sep 1 '12

    Years ago I accompanied a very distinguished OB doc to do a vag exam on a grand multip (her 11th baby) also this patient was rather large. Outside it was a raging thunderstorm, just as the doc started the vag exam a clap of lightning and boom, the lights went out. Without missing a beat I heard this very quiet little voice say, "Oh my God, I've fallen in." I thought I would die laughing. Even the patient and her husband thought it was hilarious. I never looked at that rather stuffy, dignified doctor the same after.

  • Aug 24 '12

    Quote from Jeweles26
    Unfortunately, I don't think your butt-kissing HR departments would be real happy with it!
    Sadly, you're right. They placate idiocy.

  • Aug 19 '12

    Quote from SC_RNDude
    Another poster has mentioned that Paul Ryan has proposed a plan that cuts the same amount from Medicare. Yes, this is true. However, it should be realized that 1) in acting as a leader, he has a plan (which can be debated and modified) and is putting his name to it, and 2) there actually is a plan, in contrast to Obamacare in which the plan is to have someone else who is immune from the voters come up with the plan.
    In other words, Ryan plans to rid our nation of Medicare. Just like he plans to rid our country of Social Security. The only thing I like about Ryan is the fact that he is honest about KILLING OFF Medicare and Social Security. The thing I dislike about Romney and the rest of the GOP that agrees with Ryan, is the fact that they water down their words to sound like this is not what is in the plan in order to get elected or re-elected.

    In addition, Ryan is not a good leader. There is nothing innovative about reading past economic processes that worked in the 1800s to target the poor and working-class in order to protect the rich from paying his/her fair share in taxes that actually benefit them too. Rather it is harder to take on the rich given that they are the ones with more influence and power in this country.

    By the way, your definition of "death-panels" is alive and well in private insurance companies. Private insurance companies make decisions on who they will or won't insure, how much we will pay to ensure that sick people cannot pay, and if they are willing to cover various treatments or medications, surgery, etc. all the time. Of course, this is not a problem to you since they are not government run.

  • Aug 19 '12

    Quote from SC_RNDude
    ... By law, a panel of government officials will be empowered to make changes to Medicare ...
    My best guess is that you're referring to the "ethics panel" myth that circulated a while back. Turns out, it's completely false. Panels to deny tests/treatments/procedures for "rationing" purposes are not part of the ACA (Obamacare), nor were they even in earlier versions. An overview of the myth: snopes.com: Seniors Beware

    What's interesting about this myth is that it is favored by those who also favor protecting the right of private insurers to indiscriminately ration care.

    Back to the OP's question; Health Reform in Action | The White House

  • Aug 19 '12

    Good answer, Online.

    However, melly asked that question over 2 1/2 years ago and hasn't visited AN.com for nearly two years.

    I wonder if melly ever found out the difference or is now a practising Nurse continuing to confuse Wellness and Promotiuon nursing Dx.

    Perhaps we'll never know...

    *sigh*

  • Aug 18 '12

    Quote from JBudd
    You can't fix stupid.
    But you can sedate it


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