JMBnurse

This is an old post, but reading it makes my blood boil and also makes me proud to be a nurse. The pride comes from the unanimous compassionate and educated responses. This situation happens all the time in hospitals every day and the attitude is not only reserved for addicts who abuse illegal drugs, but also handed out regularly to those with a history of chronic pain who are prescribed and have taken opiates for years. What gives a nurse working on a surgical floor or in an ER the right to decide that the practitioner who has been prescribing pain medication to this patient for years or decades is wrong, has purposely turned the patient into an "addict" and it is THEIR job to fix it or "not enable" it? A nurse who thinks like the Tylenol nurse should leave the profession and he/she should be reported to the nursing management at the hospital and the patient's doctor. I have seen patients, who I know personally, denied pain medication after surgery in this type of scenario and it turned out the surgeon was not aware the nurse had done this. It must be reported. Nurses like this need to be educated promptly or removed from their position. As was mentioned earlier, a post-op patient in uncontrolled pain is not healing properly and their post-op path has just been extended. It is the responsibility of the doctor to order the pain medication and the job of the nurse to administer it, period. If a patient who is addicted to whatever- street drugs or prescribed opiates, is in the hospital and their pain is unbearable, they will contact someone from outside to help them. No question about it. Is that what we want? Patients taking drugs that we don't know about when they are in our care? Patients who have had their pain disregarded by holier than thou sadistic nurses will also be permanently scarred by this experience and may avoid important healthcare they need at any cost. Very scary... An addict in recovery who does not wish to take pain medication after surgery will tell the doctor or the nurse if this is what they want. They are aware of the potential problem. We do not need to make that decision for them or debate about whether the decision to medicate them will undo all of their hard rehab work. That is not our business. That is the patient's decision and it is their business. Nurses who administer pain medications to patients are never "enablers". We are doing our job.

This is true for my hubby, too and it has concerned me. We live in a fairly small town and we have an uncommon last name. My husband is self-employed, so he believes that he can say whatever he wants on Facebook. I stopped posting political comments on FB years ago because even if I wasn't in danger of being fired, do I want my boss, who may be completely politically opposed to my opinions, judging me and having it affect my job? No way... I assume anything I post on FB could be seen by anyone. I have asked my hubby to delete some of his more controversial posts for fear that someone from work would see it and recognize the name. Except for a couple of close friends, I don't FB "friend" people from work and never, ever would I friend a supervisor or manager. I don't identify the company I work for on my FB profile. I did not join the FB group for the company I work for. I have all of my settings set to extremely private. I only friend people that I actually know and are friends and family. I no longer post anything political. I don't ever, ever discuss politics at work and if the subject comes up, I change it or politely excuse myself. These days, people can judge each other so harshly over political beliefs and we are all human. Expressing opposing political beliefs has destroyed some families and lifelong friendships over the past year.

When my daughter was in 3rd grade, she came home one day with lice. As a nurse, I discovered it and had not received any warning or notification from the school. I promptly freaked out and proceeded to boil the entire contents of our house and everyone in the family was treated. I told the teacher that I had discovered the lice and treated everyone. To my knowledge, the other parents were not notified. No letter sent home. About a month later, I discovered my daughter had lice again and again I freaked out and repeated the whole treatment process again. Not long after that, my mother and I were attending a school program and my daughter and her classmates were sitting together on bleacher seats and we were across the gym and I was recording the program. As I looked through the video camera lens, focusing on my child, she was sitting next to her friend and their heads were right up against each other as they were reading the program. I kept recording as I watched this other little girl reach up and scratch her head every few seconds. I elbowed my mother, also a nurse, and said, "Well, that's how she keeps getting exposed". We educated my daughter not to put her head against another person's head or share hats, etc. unless she wanted to keep going through the lice shampoo treatment and the nit comb over and over again. Again, I told her teacher, but was surprised that a letter was never sent home to warn other parents. Thanks goodness, we never had to deal with lice again, but that is at least one way it happens, head against head... Great, now I'm itching...

I met my husband when we worked at the same hospital 17 yrs ago. We've been married for 11 yrs. He was a nurse in the ER and I was a nurse on the M/S floor. My first impression of him was that he didn't dress pediatric IV's appropriately. He eventually won me over In our case, it all worked out well, but I think that is probably the exception. Those 17 yrs ago when I was single, I certainly was interested in some of the men I met through work. We spend so much time there, I think it is only natural to end up dating.

If the patient is relatively stable, as they should be coming to a M/S floor, I am okay with a brief, just the facts ma'am report. I'm also okay with looking up some of the information, if you are slammed and the patient is stable. If you tell me that the patient is 25 yrs old being admitted for seizures and has no past Hx of seizures, get prepared for some questions. We are going to have a talk. I've had too many what turned out to be unstable patients and patients admitted to the wrong level of care sent to me. If you tell me they are in four point restraints, we are going to chat about that for a few minutes, too.

OP... How interesting... You took the conversation to another room and everyone followed. Wonder what that says? I have read quite a few of the posts and I find the debate interesting. I have been a nurse for 19 years and I still feel it was a calling for me and the day I think that this is "just a job", is the day I will want to quit. My husband recently had surgery and he had some wonderful nurses and some, not so much. I wonder if the latter were those just doing their "job". Obviously, you will burnout if you take all of your patients' problems and issues home every day, but you would be inhuman if you never did. You will take some of this stuff home with you and you will think about it when you are not at work. It is worse when you are a new nurse. What changes is how you learn to deal with it and trust me, you will. You will develop confidence in your abilities and decisions and you will have experiences to draw from. You will not question yourself so much. After that, what you will take home are the grateful expressions on the faces of the patients you care for and their family members. You will think about the kind things they said to you and the respect you will begin to earn from your co-workers and Physicians. Of course, I don't know any Nurses who are volunteering, so yes, we do get paid and it is a job. I think of it as a great job with some benefits that aren't listed on my paycheck stub. I hope you keep as much of the attitude you have now for as long as you can. If you do, you will be a great nurse with a great job.

We are all real nurses no matter where we work. I worked in acute care for 13 years after graduation and have worked the past 6 yrs in Case Management. I may be a little old school in believing that new graduates should work in acute care for at least one year before moving on to other areas. I think it's best to have that experience under your belt and then you can find the right area that's perfect for you and not look back. It's highly doubtful I will ever work in acute care again, but I don't think I would be the nurse I am now or have the position I currently have without that experience. That is just my opinion for the best path, but as long as you like your job, you are definitely a "real nurse".

I wouldn't do this again. This sounds bizarre. Most doctors I have worked with talked to the family at length and then wrote the DNR with progress notes detailing the conversation with the family. Some docs would prefer to have a nurse in the room as a witness to the discussion with the patient or family, but that's it. I have witnessed countless DNR discussions and orders and never remember a problem and have never even heard of anything like this. I have seen more problems with running a code when the patient was supposed to be a DNR. Now, Power of Attorney, that's a different story.

This sounds like just a slight revision of our current system. This sounds to me like, again, it would only benefit the wealthy and college graduates with good jobs. The working poor who are not eligible for Medicaid would struggle with this type of system. They would pay higher premiums if they have a medical condition/s? And if they miss a payment, their coverage can be cancelled? I also think this would lead to a decrease in receiving primary care. We desperately need "affordable" health care for all. This will improve our outcomes.

This article outlines a study done on preventable deaths in the US and 18 other industrialized countries with data from the World Health Organization. The study was done for 1997-1998 and updated again in 2002-2003. I believe the final data from the update was published in 2008. The US ranked last and showed less improvement than the other countries from 1997-2003. Measuring The Health Of Nations: Updating An Earlier Analysis The 18 other countries in the study were: France, Japan, Australia, Spain, Italy, Canada, Norway, Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, UK, Ireland, Portugal. "The rate of amenable mortality is a valuable indicator of health care performance, say the authors—one that can point to potential weaknesses in a nation's health system that require attention. "[T]he findings presented here are consistent with other cross-national analyses, demonstrating the relative underperformance of the U.S. health care system in several key indicators compared with other industrialized countries."

I am not sure what you mean as my point was that Mississippi is the poorest state in the Union. I read something recently that said obesity has had a huge impact on their economy. They are 3rd in the nation. However, I'm sure it is comforting to Mississippians to know that this is not their fault and they are wasting their infinite resources. Economy of Mississippi statistics - StateMaster.com Thank you so much. It is my hope that soon this will be shared by all Americans.

Wow, where were all of you flu shot supporters when I was getting pummeled on one of the other threads!

Thank you to our Canadian friends for coming here and offering your opinions on healthcare and assisting in our debate, even though as they say where I'm from, you don't have a dog in that hunt. Please know that not all Americans feel the same. About half agree with you and have fought hard for this for a long time. Those who oppose Universal Healthcare would like to inflate their numbers and use statements like, "most Americans", but like most every political issue, this country is divided right down the middle. If you add to the supporters' column those that may not like the ACA, but know that we must have reform, it becomes less than half for those who oppose reform of any type. We struggle to get so many problems solved in this country because of the sharp division. I find it very interesting the number of people here and politicians who say that healthcare should be left up to the individual states. I find that interesting because I live in one of the few states that has tried this. The conservatives here in my state and others across the country have whined and complained that it is a terrible system and does not work. Many, in fact, hold up my state's healthcare system as an example of how terrible Obamacare will be. That's kind of funny in a sad ridiculous sort of way. Once again, is it because those who say this live in wealthier states? Should Mississippi be left on it's own to provide healthcare for those who live there? Hmmmm....Have you even been to Mississippi? I lived there for 8 years. I think not.

If you don't want to pay taxes at all, well good luck with that. If it were up to me, I would prefer to take the taxes we already pay and instead of using all of that money to buy more "uniforms" we don't need, use it for healthcare for our citizens.

Sorry, CountyRat, we have been hashing out whether or not healthcare is a right for almost 3 weeks now, so the discussion has expanded a little from time to time. I believe that you are correct- Healthcare is a need. I also believe it is a human right. I believe for too long now in this country it has been a privilege and therein lies the problem. I believe that healthcare should be attainable and affordable for all, not just wealthy people and people who graduated from college and have good jobs like most of the posters here. I am not as worried about the poor as we have provided healthcare for them. I am more concerned about those who work hard every day and still do not have access to affordable decent healthcare. I think that is a travesty. As a nurse and a mother, I worry about parents debating whether to take their child to the doctor or an emergency room because they don't have the money and it may be something serious. I don't spend a lot of time worrying about abusers and people who play the system as I believe that is a small percentage and it will be there no matter what we do. Thank you for your response.

Thank you. I don't know if he has tried to purchase individual coverage, but I will ask. He has Addison's disease, so I don't think they can refuse him, but I'm not sure if that will make the premiums much higher. Insurance premiums and taxes hurt, I know, but have any of you ever priced a CT scan or MRI without coverage? I'm not talking about a routine physical or routine labs, here. Some people need special labwork, tests, scans and procedures that are outrageous without insurance. The steroids he has to take every day for the rest of his life are also expensive and I think he goes without sometimes. If he doesn't take his steroids for awhile, he can all of a sudden become severely hypotensive, disoriented and incontinent. Someone will call an ambulance or rush him to the ER and he ends up in ICU for days. He's 27 years old. The above scenario happened to him twice before he was diagnosed. He was lucky then, he was covered by his father's insurance. If this happened to him tomorrow because he struggles to pay for his medication, guess who foots the bill then? I've never known him to have his nails done and he doesn't own a smart phone. I think he's more concerned with paying his share of the rent in the apartment he shares with a roommate, gas for his old battered car, food to eat and his community college tuition. I'm pretty sure any leftover money he has from his full-time job he uses to buy his steroid tablets.

That post was not about the Affordable Healthcare Act, it was in response to your post about "negotiating". Many years ago, I was told that if you had a hospital bill, either with or without insurance, you could just talk to them and "negotiate" and make whatever payment you could afford, even if it was "just $50.00 a mos." and that was true....then. Not now. I had a $4,000.00 hospital bill 6 years ago and they would not negotiate any payments. They wanted the full amount right then and there. I had to put it on a credit card. This was just a month after discharge. If I had not paid the full amount on the credit card, they would have turned me over to a collection agency. So, I'm just saying that if negotiating and making payments worked for you and yours, consider yourself lucky. Not the case for everyone. I support the mandate and single-payer.

Wow, that's great. Your friend and daughter are very lucky. I worked with a Unit Secretary who was paid just a little over minimum wage and was in a car accident a few years ago. She was brought to the hospital where we worked and treated. Her stay was brief, maybe 24 hours. She tried to negotiate a payment plan because she had two children and again, was earning very little. She had insurance through the hospital, so most of the bills were paid. 6 mos. after the accident, the hospital took her to court and sued her for the remainder of the bill she owed and was making payments on. This was the hospital where she had worked for years. I know several people who have been turned over to collection agencies just a few mos. after incurring a bill and trying to work out payments with the hospital. In my experience, hospitals, clinics, physicians, labs, etc. no longer negotiate. They want the full amount you owe today. Sometimes, they will give you a deal if you pay the bill in full today in cash.

They could afford the health insurance premium. It isn't offered where they work. They already pay taxes. They can afford premiums and taxes taken out, they cannot afford hundreds of dollars in cash up front for office visits, medications and tests.

We already have free healthcare for the poor. Have for a long time. The Affordable Healthcare Act strives to provide healthcare for those who do not qualify for Medicaid, but cannot get private insurance. It will not be free for everyone. Currently, and for a long time, we have been paying for the healthcare of all people in this country without coverage. In the future, we will hopefully spend all healthcare dollars more efficiently with the ultimate goal of coverage for everyone. Not directed at just you, CountyRat, but what should Americans who work full time and can't get insurance coverage do? Should they quit their jobs and apply for Medicaid? Should they ignore medical issues because they can't afford to pay up front to see a doctor? A young person with a full time job and health insurance not offered where they work may not be able to afford even a visit to the Health Dept., much less a specialist or any tests because they have to pay for rent and food. I know many people in this situation. Some with medical conditions that require medication and regular follow-up care and they don't receive it because they cannot afford it and they do not qualify for Medicaid. What should they do?

It's not a choice I would ever want to make, but if I had to choose between temporary and possibly limited "paralysis" and permanent heart muscle damage or permanent heart failure, pulmonary fibrosis or permanent hearing loss, just to name a few, yes, I would choose the temporary and possibly limited "paralysis". GBS is rare and the worst case scenarios are even rarer.

Pesky CDC statistics. Did you work at "The Guillain Barre Center"? If so, my apologies. If not, then that statement is false. The CDC classifies healthcare workers as one of the specific sets of populations that should be vaccinated yearly. Guillain Barre Syndrome is rare. There are risks in almost everything we ingest. As an Oncology nurse, I pumped dangerous toxins into the bodies of patients every day. Their side effects were a lot worse than GBS, but they didn't seem to mind. They knew it would save their life. I was always more of a chemo nazi than a vaccine nazi.

First of all, you are saying that your physician wrote a note saying the flu vaccine was "contradicted" for you, when it is not? Wow. I hope most physicians would refuse to sign that note as it sounds unethical to me if the true reason is that you don't want to take the shot. Secondly, I have been a nurse for 16 years, working in Med/Surg and Oncology and I have never taken care of, seen someone admitted for or known anyone with Guillain Barre Syndrome. The reason for that is because it is rare. You can also get GBS from the flu itself or many other illnesses and infections. See link below from the CDC, discussing the rarity of GBS. CDC - Seasonal Influenza (Flu) - Questions and Answers - Guillain-Barré syndrome (GBS) Thirdly, I don't know in which areas of nursing you have worked, but to say that more patients are admitted with GBS as their primary diagnosis than the flu is completely false. Every year all over this country, many patients are admitted with influenza or flu related illness and many die. The numbers of people who have or die from GBS are comparatively miniscule. “Last summer, the U.S. Centers for Disease Control and Prevention issued a report showing that over 20,000 people a year die in the U.S. as a result of influenza. About 90% of those people are over age 65, even though people over 65 make up only about 15% of the population.” These numbers do not even include those that are admitted and treated, but don't die. See link below for the numbers of Americans who die every year from the flu. With 90% of U.S. Influenza Deaths in Elderly, New High Dose Vaccine Seeks Lower Mortality, Morbidity Rates If you don't want to get the flu vaccine for whatever reason, then don't get it. If you don't work in a place where it is mandatory, then congratulations, that works out good for you, but please don't perpetuate myths and scare others from receiving a vaccine that has been proven to save lives and prevent the spread of illness.

Obviously, I'm a proponent of the flu vaccine. I guess it comes from years of nursing and seeing elderly and compromised people die from influenza. One who came as close to dying as a person can was my mother who caught the flu at the age of 53 and it progressed to bilateral pneumonia which lead to ARDS which lead to 2 months in ICU on a ventilator and at one time involved 5 chest tubes inserted at the same time. I guess that may have helped develop my strong opinion on the subject. I do want to say that I have never thought nor told anyone that the flu shot is 100% effective. I also still wash my hands as I always have and encourage my patients and family to do the same all the time. I also don't believe that my insurance company would pay for everyone to have flu shots so pharmacies can make more money. I believe they pay for it because it saves them money on the other end from people getting really sick with the flu. Don't ask how much my mother's hospital bill was. You don't want to know. I'm not a scientist, but I have always been told that they develop the flu vaccine for the upcoming season based on studies of the influenza strain that is in other parts of the world in the months prior to our flu season. It was my understanding that if you get the vaccine and are then exposed to another strain, yes, you may develop the flu, but your symptoms will not be as bad because of the vaccine you received and you will recover quicker.

It's true, you can sue for just about anything in this country, but you will be unlikely to ever get in front of a judge for the dismissal phase because unless you have money to waste, you will not find an attorney who will take that case. I agree with Jory, it would be next to impossible to prove a specific nurse exposed a specific patient to influenza when they can be exposed anywhere. This is why I don't believe hospitals make the mandatory flu vaccine decision based on fear of litigation or liability. No doubt, it's poor PR to have your staff hacking and sneezing all over patients, but I don't think that's the reason. I believe the main reason is the financial impact to the hospital from sick employees for 8 months of every year. It's a huge burden to have half of your staff out with the flu during a time of the year when the census is highest because half the patients have flu related illness. I've worked during those bad times in the middle of winter when the census explodes and staff are calling in left and right every shift. It's a nightmare. I see why they do it. I still can't understand why anyone would want to risk getting that sick and exposing their loved ones and patients to the flu when one shot can prevent it and you can get the vaccine for free and usually without waiting. The public stands in line sometimes for hours waiting for the chance to receive what the hospital begs us to have and gives us for free at our convenience.