Clearly, none of the examples I posted, other than the first b/c I didn't explain why he was admitted, were not simply "frequent flyers." And I would have had no problem if the med student would have tried twice, or even three times to insert the IJ; however, after the third time when the pt had a seizure and was clearly extremely uncomfortable, IMO, it was time for the doc to say enough is enough and I will insert it.
I suppose I need some advice when it comes to advocating for the pt's in real pain, whether addicts, not frequent flyers, or not, need it. I am a bit timid at this point, as I am still in orientation technically, to say more than the situation at hand, when speaking with a doc. Many of the docs I talk to are new also, as we are a teaching hospital.
I don't know. I think the hardest part of the transition from student to nurse, so far, is that things are not as they should be according to school. I know an extra dose of such and such pain reliever is not going to cause detriment to my pt that is writhing in pain, but I cannot seem to do a darn thing about it. I want the ivory tower ideology when it comes to my pt's or anyone else's for that matter.
Keep the comments comming... I really appreciate all responses.