AZ Nurse

OK....I am a nursing faculty member. At our school if it isn't in the syllabus then it isn't going to happen - so we couldn't lower the passing score as our syllabus states what passing is for the course. The syllabus is a contract between you and the instructor. I don't know what happened that allowed this prof to do this. You will be a better nurse for having to repeat and achieve a higher grade (yes, I know this sounds corny). Would you want someone caring for your loved one who only had 78% of the knowledge needed to care for them well? I would challange the college not on your failure but on the fact that the instructor changed the criteria from what was posted in the syllabus. Good luck.

Do you know how to prepare a professional portfolio so you present your skills and experience in the best light possible? If not, get online and do some research - a run of the mill resume often doesn't do it anymore.

The best reference for pain management information is a book by Chris Pasero and Margo McCaffery called "Pain Assessment and Pharmoacologic Management". It is what I call the bible of pain management. You have identified a real issue - pain vs drug seeking. When the person has addictive disease that complicates the issue. There is no sure method of weeding out the drug seeking from real pain. The addictive disease patient may have real pain and then it is even harder to treat often as their tolerance is even higher. Try looking in this book under chapter 2, page 32. The other thing you can do it go to the American Society for Pain Management Nursing site (www.aspmn.org ) and click on "The Organization" then look on the right hand side for a shaded area with a list of topics. Toward the bottom you will find "position papers". That may be of help. Finally, the ASPMN list serve is a wonderful tool and I don't believe that it is limited to members - join that (directions on that site) and ask this same question of the pain management professionals on that list serve. Good luck.

I think we work in the same place! I too believe that nothing really replaces the person to person discussion about a patient prior to transfer. Guess they will wait till there is a "event" until they change it.

Ask the "new" doctor for evidence based literature to support his/her position, that of claiming the test done by the specialist was invalid. Then be prepared to show him/her the literature that supports the test that the specialist has done (calling or emailing the specialists office should get you information on this). Then be prepared to present your case on continued following based on the recommendations found in the literature. This takes some work on your part but should enable you to present your case in a professional/competent manner. Good luck.

Pain Assessment and Pharmacologic Management is the name of Chris & Margo's book. As I said before, they cover everything.

Pain management is my passion in nursing. Some of the best information I have received has been from other pain management nurses. Go to the American Society for Pain Management Nursing website www.aspmn.org and click on 'organization'. Then go down the list to position papers. You will find a wealth of informaiton there. Some positions papers are written jointly with the American Pain Society. The other thing is that you should purchase the Pain Management book by Chris Pasero and Margo McCaffery. They cover EVERYTHING you would ever want to know. They also have extensive bibs at the end of their chapters which will provide you with evidence based material to back up the ifnormaton. Lastly - become a member of ASPMN and join the listserve. You can put out a request for anything you want and pain management professionals from all over the US and Canada will be happy to share policies/procedures etc. I have learned tons from just reading the listserve. Good luck.

Isn't nursing grand. And we pay money to go to school and learn how to care for these people! I still wouldn't do any other job even though I have had similar patients.

You might want to go to the universities and find what credits would transfer for a BSN. It may not take you as long as you think. There are still ADN employment opportunities. As a new grad you may not get into the exact area you want but you can usually get on board with some facility...put in a 6mo or a year and then try for a transfer (if you still want another area) after that time.

You post is several months old....but if you haven't already found it try going to the American Society for Pain Management Nursing site ( www.aspmn.org) and they have an email list serve that has thousands of pain management specialists throughout the North American continent on it. They are usually very willing to share all sorts of information.

Ask your administrator if they are aware of the successful lawsuits that have been filed for inadequate pain management. Maybe that will help!

At this September's national convention of the American Society of Pain Management Nursing Margo McCaffery received recognition for the 40th (yes, that would make it 1968) anniversary of the definition we all know that she created: Pain is what the patient says it is and exists when the patient says it exists. Heron is exactly right - all the information in this post has been around for a very long time. She also threw out a term that I am sure many don't understand...."pseudoaddiction". We as healthcare professionals create pseudoaddicts. If you don't know what this is then find a book on pain management. I HIGHLY recommend Pain: Clinical Manual by Chris Pasero & Margo McCaffery. Most everything that has been discussed on this discussion forum is covered in that book.It is a great reference to have on hand. My copy is quite worn so I am thrilled to hear they are working on a new edition.

:yeah:Wow - you are a nursing instructor's dream. You really got the whole purpose of the exercise!

Sorry if I offened with my post regarding placebos. As you can tell that is one of my "buttons". Being a pain educator I know that placebos have been a HUGE issue in medical care. Litagation, ethics etc! I would hope that no nurse or physician would be giving placebos outside of a clinical study with informed consent. Now with this said I admit that many eons ago, as a new grad, we had docs who prescribed placebos and they were given....yes, by me also. That was the 'dark ages' of nursing (yep....I remember crank beds and three bottles for chest drainage) and since that time it has become a point of study in nursing and medicine. We have come to recognize that giving a placebo will produce the 1/3 rule....1/3 will have good response, 1/3 will have limited response, and 1/3 will have no response. The bioethicists would be very upset over the thought of use of placebos in pain management as this is no longer accepted standard of practice. On another note there is a M*A*S*H episode where they give placebos in the Korean war. I cringe when I see it (and I love MASH). As I stated earlier...in the 1950s, when we were fighting in Korea, this was still accepted practice. It was in the early 70s when I was new to nursing. It isn't now. That is the 'take home point'. Again...sorry if I offended some :uhoh21: but wanted to get the point out there as I am sure the person who posted the comment isn't the only one who is unaware of the ban on placebos outside of studies.

"We can give placebo meds" NEVER give placebos:no:. They are not scantioned by any professional organization unless the client is enrolled in a study and has given informed consent and is aware that they may receive placebos as part of the study. If you want more please go to www.aspmn.org (Am Soc for Pain Management Nursing) and read the placebo position statement that was developed in conjunction with other professional organizations (yes, some of them were physician organizations!).