boggle

I always felt that " not given at scheduled time" or " nurses judgement" needed some follow up charting to explain why. Sigh, more work. (i always wished for an option to click on that said " meds arrived on time, given late because patient in bathroom. )

"The way we've always done it..." is a dangerous basis for nursing practice. I think we nurses have been bedside researchers and scientists for decades, but now we finally have easy access to studies that support what we do....and we can cite it too. I commend you posters who are seeking out the answers from manufacturers and infection control studies. Please share your results with us!

Also, does anyone know how to post the image of the dvcipm.org pain rating tool here. I didn't know how to attach it to my above post. thanks.

delphine22, I agree that verbal description can be helpful with the pain number rating system. I've heard so many patients say they just don't know what number to say. Where did you get you verbal descriptions? Are they a particular standard? ive been working with some returning veterans who are using a multi image and verbal description scale. It's from the the Defense and Veterans Center for Integrative Pain Management (dvcipm.org. The pain rating scale listed under the Clinical Resources tab, as well as others.) This is getting favorable reviews by my hospital, and is beefing considered as an additional pain assessment tool.

OP, I totally understand your dilemma with poo. It's a visceral reaction. I've been in bedside nursing for decades and can comfort, and clean a patient through any mess the body can make, But if I HEAR the sound of RETCHING.... I'm done for....I start retching too. (Why must the ear be connected to the stomach? Some cruel joke of evolution? ) While you explore your career options, I recommend those strong MINTY BREATH STRIPS like Listerine brand. They come in pocket packets. Two of those in your mouth are so overwhelmingly powerful that your eyes will water, and all sense of smell will be side tracked. It may help you get through the tough times. (It's really so strong and unpleasant that it may side track your emotional response too) I feel for you with your dilemma. Don't let any embarrassment or worry about it get you down. Just let your caring shine through. Good luck.

I do not want my well being (life?) put at risk because the nurse is left to guess what that squiggle on the order sheet says. Really now, if the doc was the pt and I said this is the med/dose I "think"your doc wrote.....? Sometimes I think they are covering up for not knowing how to spell...... So PRINT already

Forgive my silliness here, but I've been with a group of preschoolers all afternoon. I just felt like blurting out, " ABG time isn't for another 15 minutes. It's quiet time now. Heads down on the mats everyone". Sorry, couldn't help myself :)

Your hands are clean, but the faucet handles are dirty. So grab a dry paper towel to turn off the faucets. A wet towel or bare hands just allows the contaminants on the faucet to deposit themselves right back on your hands.

With the "pt satisfation scores" emphasis put on pain rating and relief, I feel we are pressured into the quick fix ( no pun intended) of pain meds. We are rushed as it is...now also pressured about how the floor rated this month. With that pressure, I see less time spent, ( less time available too), on other measures to control pain and increase pt comfort. Pain is real, but made worse by fear, anxiety, muscle spasms, ..... I long for the time to stay a minute or two with a pt, after medicating, to reassure, to teach and explain what effect to expect, to see if adjusting position would help, and all those other measures that really lead to a comfortable pt, and a Satisfied Customer. Chronic pain is awful. A person's own goal may be to get down to a 3/10. At a 6/10, you may not see a wince or frown. You can't judge by the way they look. Just listen to your pt please, even if they don't look like that frowny face on the pain scale page. I know I am much more emotive, emotional when I have acute pain then when dealing a chronic pain issue. Acute pain...I get scared and feel vulnerable. When in acute pain, i get the eye roll, she's overacting look. When my chronic pain becomes an issue, i get the skeptical look and questions. I don't show that pain much. Don't take it personally. Just treat the pt. Thanks for letting me vent a bit here.

I have tactfully removed a roommate, directed to an activity, while administering enema, fecal disimpaction. The resident being cared for was totally oriented, and was embarrassed enough to e to go through the procedure. Sparing the roommate from the odor, and the roommate from further embarrassment seemed the kindest thing to do at the time. Hmm, after rereading this, I guess enemas/ disimpaction isn't really considered "routine" care. It just feels like "routine" for some residents on some days. Boy we need more hydration and fiber around here. :)

Back to the question of how to assure the meds are destroyed so the patient in pain can obtain a new prescription......OP, how did this work out? Pain clinics nationwide must face this same dilemma .

You have been on a long and EXHAUSTING journey! Each step of your journey has been challenging. That, plus your ongoing sadness makes it understandable that you'ld have trouble seeing the future. So many of us have traveled the same rocky path. Please go to the counseling center at your school, today. (You've already paid for it as part of tuition). You have strengths that have helped you through trials before. Let the professionals help you keep moving forward. My love and prayers are with you.

Oh, and there's nothing like spilling a cold drink in your lap to keep you wide awake for the ride! :)

I rotated to nights for a month at a time, then back to 2 months of day, for many years. The one hour commute each way was always a challenge. The singable, foot tapping music did help, as others suggested here. A crunchy snack worked very well, like popcorn or pretzels or such. That really saved me. It was rough on the waistline though. Wish I had thought of the cup of ice to crunch. I wish you safe travels.

Annmariern.....I'm speechless