SICU Queen

Vicodin has NSAID properties? It contains hydrocodone and acetaminophen - is there some sort of filler that makes it an NSAID? There IS an ibuprofen and hydrocodone version, Vicoprofen, but I don't take that. If Vicodin's an NSAID then that might explain my continued GI issues... and my pharmacist needs to clarify, because I have a "NO NSAIDS" on file at my pharmacy. I'll have to check that out more thoroughly. I CAN tell you that the months of ibuprofen use after my injury and while I was on light duty (taken so as NOT to be taking pain meds while working) left me with a severe case of gastritis. The post-op Naprosyn did me in, so to speak, with GI bleeding, and my doc said no more. A total hip is not going to do me any good. The joint itself has been repaired and is perfectly fine. The issue is with the soft tissue - cartilage, muscles, scar tissue, etc - as well as nerve damage. I really don't think it's an addiction issue. I have a very close friend, a psychologist who happens to work in the addiction field with heroin and other addicts, and I've talked with him extensively about what I take, when I take it, etc. My husband eyeballs things, and I've been hyper-aware as well. I'd LOVE to see a pain management specialist, but the approval wheels turn slowly... Damn, I sound like a mess! I promise I'm not a total freak just making excuses. I WOULD like to find my way back to some sort of gainful employment, AND be pain-free (or close to it) at the same time, near some level of my previous income. Surely that's not too much to ask... At any rate, to prevent further boredom for all - I will wrap this up by saying that I had a very lengthy conversation with my BON today and that answered a LOT of questions in regard to my situation. It's way complicated, but I will explain it all if anyone's interested. Just PM me, or ask in here. Thanks so much for all of your replies. I appreciate the candor.

So as not to violate TOS, I made a concerted effort to phrase my post in such a manner that I'm not seeking advice (legal or otherwise) as to what *I* should be doing, so I'm not sure why the questions can't be answered? I'm not asking people to interpret my experiences or give me advice about what to do - I'm asking about their experiences and opinions in regard to either with working while on pain medication with management being aware of such, or working with someone who was in that situation, so that I have some sort of a frame of reference in regard to me trying to find a job. Surely those who are willing to share can enlighten me with what they have experienced? As to posting details, I am comfortable with what's been posted because it's nothing but the truth and is information that all parties are completely aware of anyway. If you feel my queries or any part of my posts are out of line, then please delete the thread. I've been hanging around these parts for nigh on 8 years and certainly don't want to cause a problem at this stage in the game! :)

So you don't think it negatively affected your ability to care for patients? What do you think management's response would be if they'd known? Thanks for the response, and OMG I remember the pain of gallbladder disease... oy!

Congrats, Lindsey - I can feel your enthusiasm! Two thumbs up... :)

First, for the mods, let me clarify that I am NOT looking for legal advice. I have an attorney and I've also currently got a request for info in at my BON. My legal advice comes from my attorney. Rather I am looking for personal experiences to compare with my own. Long story short, I was injured on the job almost two years ago while working in the SICU. My hip cartilage was torn, resulting in hip surgery and months of PT, off and on (when I could get Worker's Comp to approve it). I did return to work in a somewhat less strenuous position but after a month was in a LOT of pain. I had an Rx for pain meds but was told by my manager that I could not work and take pain meds at the same time because I had patient interaction. I am unable to take NSAIDs due to gastric issues from long term ibuprofen use in the months after my injury, and Ultram is not an option because it is contraindicated with another med that I take on a daily basis and that cannot be changed - so those options were out. I worked, and suffered, for three more months until I could no longer stand it, and my ortho took me out until I got "control of symptoms". My job fired me 4 months later. I remain out of work due to pain issues and the inability to walk for any extended period of time, or to sit upright for more than 15-20 minutes - both cause severe hip pain, despite me using a cane 24/7 when ambulating. With an attorney's help, I am battling WC for things like a TENS unit, PT, pain mgmt doc, etc. It's a total nightmare. (OT a bit - but I do recall several of you telling me long ago to get an atty ASAP, that I'd get screwed - silly me should've listened!) My questions are this: Have you ever done patient care (either bedside, or something like phone triage) while taking prescription pain meds, like Vicodin - and had management aware that you were medicated? Have you ever worked with another nurse that was legally medicated with pain meds while caring for patients? What is your opinion on nurses actively taking pain meds while caring for patients, either at the bedside, or in any type of position that the nurse is in direct contact with the patient regarding their health care? Thanks for your opinions, and any other info you care to contribute!

Here's a link to another: http://www.ololcollege.edu/Accelerated_Nursing.html I don't know anything about either of them, other than the OLOL students do clinicals where I work, and I also work with one of their grads - she's awesome.

Oh, it's not her. She's already told me that she will figure it out, that she doesn't want us to worry about it. She's truly a "big" girl in all respects. I just feel like crapola because her father and I talked about what we most wanted to do for her for graduation and this was it (in addition to the little things we got her) - it would allow her to buy furniture and whatnot. I know it won't be the end of the world if we can't do it, but it sure does disappoint me super bad. I'm so proud of her and wanted to reflect that in our gift to her. Thanks for you words of advice in regard to finding an advocate. I am thinking that an attorney would be best suited to that - but I'm so nervous about taking that step.

Hi everyone, I know this is long and I'm sorry, but I'm really at the end of my rope and could use some advice. I injured myself last November '07 while working in the SICU (I was a Clinical Supervisor but took patients). I was caring for a very large, vent-dependent, combative patient who was FOS from neck to ankles. While cleaning him, he kept trying to roll over onto his back and I had to push against him while trying to wash, and my coworker was having a devil of a time helping me out. I didn't notice anything was wrong right away other than a slightly sore back, but a few hours later I noticed that I had some pain in my left groin. I didn't pay any attention to it but it got much, much worse over several days. I filled out an incident report, went to the hospital's designated ortho PA, and he diagnosed me with a hip flexor strain. I got 5 weeks of PT and light duty. Well, after 5 weeks I was no better. He wanted to do diagnostic steroid injections into my back (insisted my hip pain was referred), and I said I wanted an MRI of my hip. I got it, and it showed an anteriolateral labral tear and an effusion. Meanwhile, I was in terrible pain, walking with a cane, and was taken off of work completely in early February. I'd also been fighting with Worker's Comp to get PT. I finally saw an ortho surgeon in the middle of February '08, who then ordered more PT. Six weeks later at my follow-up appt (after being denied PT and not being able to get in to see him sooner) he reviewed my hip xrays that had been done in January and told me that I had femoral-acetabular impingement syndrome in both hips which predisposed me to the labral tear, and he couldn't help me. He referred me to another surgeon at another hospital. That surgeon declined my case. Finally, I found a surgeon on the internet that could do something for me, and I had hip surgery in May of '08. I had the tear repaired, bone shaved, and also a bursectomy. Immediate post-op pain was just horrible. I followed that surgery with 11 weeks of PT. I was still in pain but it was much decreased and I'd gotten to the point that I could walk about 10 blocks without an increase in pain, and without assistive devices. Exactly 11 weeks to the day after my surgery, and the day before a follow-up appt with the operating OS, I got a call from my Emp Health Nurse who told me that I had to be released to full-duty or I would be fired. I had been trying to find another less physically strenuous position in my hospital while I was in recovery, and had interviewed for a transplant coordinator position (among others) which I thought was mostly a desk job with two half-day clinics. I told her that my surgeon would not release me to full-duty for ICU but that I thought I might be offered the coordinator position. So I went to my appt and asked him to release me to full-duty for the coordinator position, and it was offered to me. I still had 2 PT visits left that week, but was told that I had to come to work the next day or be fired. SO, in I went. My surgeon had ordered 6 more weeks of PT but as soon as I went back to work it was denied and they said I had no deficits. The job was not what I anticipated. It required a LOT of walking. I had to round on our patients in three different ICU's as well as the floors. They also increased the clinics from two half-days to three. We had/have no assistant - the RN does it all. I spent the first month back at work in a LOT of pain, and I had muscle cramps so severely that they awakened me from sleep several times a night. I just dealt with it. In late September I had a really significant increase in pain, and went to the operating OS. He said I had a sartorius strain and ordered 6 weeks of PT. Only 3 weeks was approved. I was told by my PT that I had to start using my cane again, as my right hip had progressively gotten worse over the months from compensating for my left leg weakness. I was put back on light duty in October. In November I had steroid injections that were minimally helpful. On December 15th I saw the operating OS who said he could do nothing else for me. He referred me back to my original OS to talk about a hip resurfacing, or a hip replacement. On Tuesday I went to see him. After a lengthy discussion, xrays, and me bursting into tears while telling him about how miserable I am and have been, he basically told me that I am too young for a THR, that he didn't think a hip resurfacing would be much better at this point in time, and that I need to pretty much resign myself to managing symptoms and "hobbling along" until such time as my hip(s) is/are bad enough to warrant a replacement. He took me off of work until I complete 4 weeks of aquatic therapy and massage (IF its approved), and I will be reevaluated after that. He said if I'm not improved then we'll have to make modifications to my current position at work, and that I may ultimately be looking at a disability situation. The highlight of the visit? I FINALLY GOT SOME PAIN MEDICINE. Thankfully this doc listened to me when I told him how badly I was hurting. It's been pretty severe lately, to the point that I just cry and cry. I went to give my manager the bad news. She asked me (in a rather skeptical tone, so I thought, but maybe I'm paranoid), "Are you just going to go home and basically be on bedrest?" I answered her in the best way that I knew how: I told her that for the past year, "I haven't lived my life fully. I can't clean my house, I can't garden - my mother drives down once or twice a week and does all of that for me. I can't walk with my husband in the French Quarter. I can't go to the Art Market and the festivals that we enjoy. When I DO go somewhere (usually to the coffeehouse), it's only because I'm married to an angel and he drives me up to the front door and drops me off, and then we leave shortly thereafter when I can't take the pain anymore. On a recent trip to Oklahoma to see a dear friend, I had to be wheeled in a wheelchair from gate to gate in the airports, and given special priority boarding due to my mobility issues and loss of balance, and I basically spent the entire visit on her couch and taking a ton of Advil. When I'm at home, I am either in the recliner or laying in my bed. When I DO sit on my porch, or attempt to cook, I pay dearly for the activity with a major increase in pain. I have become severely depressed to the point that I am now on an anti-depressant. I've taken so much Advil and Naprosyn that I am now on Protonix because my GI tract is so torn up. I have extremely painful callouses on my left heel from walking incorrectly. So yes, basically I'm going to be at home on bedrest, and if I DO manage to go somewhere, I will pay the price for it." After she picked her jaw up off of her desk and we said our goodbyes, I went to my office, cleaned up my desk, put a vacation notice on my email, forwarded my phone, and came on home. Now I've got to figure out how on earth we're going to live with more than half of my income being gone again. I am also anxious about an upcoming trip to Tulsa to look for an apartment for my oldest daughter who just graduated from college and is going there to do training for her new job. She's counting on me and her daddy fulfilling our graduation gift of setting her up with rent and deposit, and that's going to strap us severely because in two weeks I'm not going to have a paycheck. (Worker's Comp pays me 60-something % of my pay, but with a cap of $522 a week - LOTS less than I make.) I'm worried too about how I'm going to get around the airports. Wheelchair again, I suppose... but I'm also in a lot worse shape hip-wise than I was when I went to OK earlier in the year. Once I'm there I will be okay as I can rest a lot; it's the getting there that I'm fretting about. I'm stressed too that I will again be threatened with termination - or what may even be worse, that I'll have to go back to work in the same amount of pain and just have to deal with it some more. I don't know that I can do that - but what choice do I have? I've got to earn a living. I've also got to come to terms with the fact that I may be stuck with a cane for the rest of my life. I'm very distressed about it all - seriously distressed. A nurse friend who's done Case Mgmt told me that I need an FCE. Has anyone ever had one of those? She also said that I should get a lawyer, but that doing so would "change things" between me and my employer, and honestly, what would a lawyer do for me? If anyone has been through this, I'd sure appreciate some words of advice. Thanks so much. :redbeathe

WOW, get the heck outta there as fast as possible - and be sure to request an exit interview. No one should have to work in that environment.

Yep, it's been this way for years and years, in every facility I've ever worked. I like to think of it as "potty training" - but it's as effective as sleeping with a book under my pillow, IMO. I've never been one to read while on the toilet at home - why would I do such at work?

They don't have a choice BUT to cover it! It happened while you were at work, therefore it's a work-related injury. Period. I suggest you seek legal advice, at least to let you know what your rights are. I was injured on the job in November of 2007, and someone on this forum suggested the same to me. I chose to ignore that advice, thinking that my injury was fixable and that I'd be back at work in no time. Well, here I am a year later - and I'm wishing I'd have taken that advice because I'd be in a lot better position. Do not let them walk all over you. Get what you deserve.

You've gotten some excellent advice so I won't repeat what's already been said, but I do want to tell you that you did a great job - you "get" what it is that nurses do. The deaths don't get any easier (they haven't for me) but I have learned to mostly deal with the emotional aftermath. I talk to my co-workers, have talked to counselors and clergy, and even my husband. It helps to decompensate; make sure you do it. :icon_hug:

Leo here I worked SICU for many years and am now working as a heart transplant coordinator. For the record, I don't love nursing anymore and haven't for a long time. (My patients don't know that, however!)

Yep, night shift worked best for me when the kids were little. I got home in time to get them off to school, slept while they were in school, and was up for homework, dinner, etc. There was only a couple of hours between me leaving for work and bedtime. If you can do two nights a week and get away with it financially, then that's even better. As to the husband, well... he sounds like he needs a swift kick in the butt. No mom should ever have to worry for her children while she's working - especially from the other parent!! That's a bunch of BS. (The frownie face up there to the left is for your husband.)

I've come to that point a few times in my career... and I'm there now and have been for a few years. Sad to say, it's the money that keeps me doing it. Don't get me wrong - I still smile and provide excellent patient care (both physical and emotional), but my heart's just not in it. I'm crispy-fried burnt out... to the point that it's painful at times. Good luck in whatever you decide to do with your professional life, and try not to feel too badly about your choice. I wish I'd had the gumption to walk away a long time ago.