creature

We have been doing this for awhile. We came up with our medication reconciliation form. It gets started in the ER. The nurse writes the patient's home meds, the doctor goes over each and checks continue, hold or d/c, then on admit he will order meds as reconciliation. The nurse then has to write all meds out on order sheet. Upon discharge the nurse writes any new meds on this same form, the doctor goes over it and marks the ones he wants them to be on at discharge. It has worked out pritty good for us. Creature

I do UR and IC the last 3 years, so I'm not up on my ACLS, but do they still give Lido for this if symptomatic? Creature

My 37 year old brother was recently diagnosed with Hep C. He has been on interferon and ribavirin for about four weeks. He is having horrible muscle cramps in his legs, anorexia and fatigue, which isn't that bad from what I know. Get this, he went to donate blood and they told him he couldn't because he was on the registry for hep C. He's like "what?". Come to find out he had back surgery 8 years prior where he had to donate some of his own blood for the surgery. That is when they found out he had hep C. Eight years ago!!! Nobody bothered to notify him. How does that happen? He has contacted a lawyer, but they told him theres nothing he can do because it has to be within 2 years. He told them that he didn't know two years ago, so what could he have done. He spoke to several other lawyers and they told him the same thing. This doesn't seem right to me. He put his wife and children in jeoperdy (that spelling doesn't look right;) )for the last 8 years, not to mention he could have started treatment then. He is so depressed and worse now with the treatment. I feel really bad for him, but I think he's brave for taking the treatment because it doesn't sound pleasant. His livers are a little high, but not too bad considering. They never did do a liver biopsy which I found strange. He is seeing an infectious disease specialist so I hope he knows what hes doing. He was a heavy drinker until the last 5 years when he cleaned up, so thank God. Not sure how he contracted it. He did use IV drugs and has tattoos. Don't get the wrong impression - he is a good person who went down a hard road and brought himself back - so I'm proud of him. Anyone with any insight into all this, please post. Creature

Sorry about that. There are alot of arrogant doctors out there who think they can talk to nurses any way they want. I wouldn't talk to my dog the way some have talked to me. I had a doctor throw a chart at me. What makes them think they can get away with this? Because we let them. We have to start sticking up for ourselves and not taking their crap. I used to do ER with a doctor like this. He would mumble purposely so I would look stupid having to ask him what? What? After a while of this, I started to ignore him. Boy did he get mad, but he started talking clearer. I thought every time you swear at me I can sure understand it. Don't let them get to you. Creature

Thanks for suggestions. I have talked to her about cleaning and wiping front to back. Her problem is she wears nylons constantly and also showers once a week and in between washes up. I have talked to her about this, but she is set in her ways. Creature

Hi everyone, I called his office and asked about getting lytes done and he refused. I then scheduled her an appt with her regular doc. What a joke hey? Her last culture showed E Coli so he went by that seeing she had just finished Macrobid which never did clear it up - put her on Cefzil. Her UA that day did show infection. No shes not on any prophylactic antibiotics, but thats another thing I'm going to bring up to her regular doc. Shes been taking the quinine and her daughter who is an RN also told her to take Magnesium and vitamin C. The cramps are less, but still there. Regular doc couldn't get her in for 2wks? What? I'm so frustrated, worse than before. Creature

Thanks everyone for your advice and support. I'm getting pumped up to quit now. My quit date is this Friday. It's probably a good thing its on the weekend. My boyfriend, who I've been with for the past 21 years(I'm 35 so you do the math;) ) doesn't smoke and he hounds me every day to quit, so I suppose thats good. It will shut him up! I haven't smoked in my house in a long time, because I hate the smell of it. Our hospital is going smoke free May 1 so that is also a big incentive. Also I have quit before and I know how good I feel when I'm not smoking. I don't want to be one of those poor old ladies with COPD fighting for every breath. I have been alittle nauseated and tired with the Chantix, but I would like to hear from anyone if they have had bad experiences with this drug or if they have found it interacts badly with another med. Thanks again everyone and with me luck. I'll keep you posted on my progress. Creature

I just started taking the new drug Chantix 4 days ago to help me quit smoking. They say the usualy SE are nausea, constipation, weird dreams. Since I have been taking it I have been extremely tired. I mean tired. Has anyone else tried this drug? What SE did you have and did it help you quit. I have been smoking for over 20 years and I have tried everything else. I want to quit and I am ready, but it's just so hard. Any advice would be helpful. Creature

Thanks to the Doctor rbrice and congrats on graduating. I have always been afraid to go to a chiropractor since I had the lumbar fusion because of the hardware. I don't want to be any worse off you know, but if I knew of a really good one I would consider it. I live in the Upper Pennisula of Michigan so if you know of any good ones there let me know. Thanks for the advice and concern. What are your thoughts on a combination of chiropractic, acupuncture and massage?

Thanks Greg and Jenny for the advice. I live in a small rural town and the hospital jobs are very limited. We don't even actually have an ICU. We have a monitor bed unit which the med/surg nurses take care of. When I worked nights I was charge nurse for the med/surg and LTC floors plus I covered ER. So I'm actually lucky this job came up. I know if I moved away I could probably find a job with hands on care that I could do, but I don't want to move. I guess it's just one of those things you have to accept. I am seriously going to look into accupuncture. I have been going to massage once a week and that helps. I'll let you know how it goes. I'll try anything. I've done the steroid injections, meds, TENS, PT numerous times, etc. Thanks again.

Are there any nurses out there who have had an on the job back injury? I would like to hear your experiences. Mine were not so good - almost lost my job. I was on a lifting restriction and was told I could no longer do patient care - which I love. I ended up having a lumbar fusion which didn't help too much. Now I have three bulging discs above the fusion. Needless to say I have pain everyday. I would have lost my job if a desk wouldn't have come up at just the right time. I now do utilization review and infection control. I hated it at first I think because I was forced to take it, but now its not so bad. I can live with it, but the sitting for 8 hours is horrid. I had a really bad experience with workers comp. Do they have to go to some kind of training to be mean and heartless. Not everyone out there with back problems is faking it, but I know there are those out there who ruin it for everyone else. I hope there aren't any comp nurses out there that I may have offended. Maybe I just had a bad experience. I would like to hear from anyone who has been in the same boat. This all started when I was 28 and I'm 35 now, so it's been a long, hard road. Also, anyone who has any ideas for chronic pain - I am all ears.

Go for it. This world needs caring people who love stress and working long hours. Ha! But seriously, try it. There are so many aspects of nursing. If you don't like doing one you can try another. I worked acute care and ER for 7 yrs. I loved the acute care, but the ER was pritty stressful for me. Alot of males do really good in the ER for some reason, so theres a thought. Now I do Utilization Review and Infection Control, but I sure miss the hands on nursing. Good luck to you and welcome to allnurses.

I just want to know how other people feel about this. Maybe I'm just a chicken, anyway... I took my grandmother to the doctor yesterday because she has recurrent UTIs and also she was complaining of muscle cramps in her arms, neck and legs. He prescribed Cefzil for her UTI which was fine, but when we asked him about the cramps he showed her stretchs to do with her legs and told her to drink a gin and tonic because the tonic has quinine? This isn't her regular doctor by the way. He didn't order any lytes like I thought he should have. I left there feeling frustrated. It seemed like he totally blew her and me off. I should have suggested the lytes, but he is the type of doctor to get very offended and not order what you suggest anyway. I know I should have my grandmas best interest at heart. I feel terrible about this. I just called his office and spoke to his nurse about this and she's suppose to call me back so wish me luck.

The nurse patient ratio for that kind of care sounds very dangerous. Why don't they have more nurses? You have wonderful experience that would get you hired anywhere. Look around for something else. Your license is on the line. I don't think you can give the proper physical and emotional care for that many critical patients. I would be stressed too. It's not worth it.

I think I would allow them to do any procedure as long as the nursing instructor was there by their side to make sure they didn't screw up. Have things changed or doesn't the instructors observe and walk you through procedures anymore? I graduated in 1996, so its been a while.

That is the craziest thing I ever heard. I never knew such a thing existed. What happened to the sternal rub? I don't understand how this could even happen. So if it was a male patient, would squeezing his testicles be considered acceptable? The thought of this just blows my mind. I would consider this sexual assault. If I ever found out while I was unconscious someone squeezed my nipple to see if I was responding to painful stimuli I would be pissed. Wow!

I just hope there is a caring, compassionate nurse around when and if I ever need my butt wiped. It's annoying to hear that some nurses just go into this field for the money. Treat each patient as if they were your parent or relative. That has always been my motto.

My grandfather was in a long-term care facility and he was allowed a shot of whiskey everyday, which the family supplied. This was the one thing he looked forward to everyday. The bottle of whiskey was kept at the nurses station and it was dispensed like a medication. It made him happy. They have rights too.

I had a heck of a time getting through nursing school. You know what got me through, I would say to myself (they may sound crazy) you can always quit. The last year I was saying that alot, but thats what got me through. Hang in there. It's worth it in the end. I also had two good friends going to school with me so that helped. Also I feel like I just started learning once I started working after graduation. Just take it a day at a time and do the best you can.

Being a new grad, I think it sounds perfectly normal to feel a certain degree of anxiety. I felt that way through school and the first year of my job. Straight out of school, I got a job in a rural hospital where you worked the med/surg floor and did Er. I was doing charge and er after 6 months, so I know all about anxiety. It sounds like you are having actual anxiety attacks though. It wouldn't hurt to see a counselor and possibly get on a medication for anxiety. It shouldn't be affecting you like that when your not at work. Good luck to you and write me if you need to talk, that helps. annie

I worked ER for six years and have taken care of all kinds. Yes its hard, but you have to put your personal feelings aside. Believe it or not, everyone is human. My philosophy is to treat everyone as if they were my family member. I remember taking care of a Level 5 Maximum Security Prisoner and I was scared to death because they are either murderers or rapists. Well I treated him like any other patient. A few weeks later I got a card at work addressed to my first name and night shift nurse with the hospitals address. I was appalled. I couldn't understand how they could let that go through. I opened it and it was a christmas card saying he wished me and my family a merry christmas and he wanted to thank me for treating him like a human being. I found out that even the most frightening people who have done horrible things are human. I don't have to like who they are or what they have done, I just need to do my job the way I always do and not pass judgement.

That would have scared my half to death and I'm not sure I would have jumped right in the middle of all that either. Like the others have said police are trained in CPR and I would assume would have initiated it if was needed. Don't be too hard on yourself, but I can understand how you must feel.

Dear Maolin, I feel for you. Luckily my parents are fairly young and free from any serious health problems, but I do take care of my 87 year old grandmother who still drives, plays cards, goes to church daily. She has more of a social life than I do, but boy things can sure turn around fast. She has chronic UTIs and she gets a little fever and goes bonkers. I am so glad I have gotten to know her more in these last few years though. I guess it's all worth it in the end. You just have to take them with a grain of salt and do the best you can. Sometimes they will frustrate the heck out of you, but just hang in there and know that nobody could be taking better care of her than a nurse and a daughter.

Should have went right to ER. Any chest pain is considered an MI until proven otherwise in my book.

It sounds like you need a change of pace. Why don't you look into a different aspect of nursing. I had a back injury 4 years ago an am no longer able to do direct patient care because at our hospital we have to be able to lift 50lbs, so I ended up with a desk job doing Utilization Review. I hated it at first I think because I was forced into it, but now that I have been doing it for awhile and have just taken on Infection Control as well, I really enjoy it. I work 5 eight hours shifts a week, no forced overtime. I don't work holidays or weekends and it's alot less stressful. Think about it.