Katie91

BCgradnurse, Thank you for your reply and I do respect your stance on the subject. It is certainly all of our responsibilities to do what we feel is best for the patient and quite frankly, the licenses we've worked so hard for! Listening to our gut is always the best bet

BC Gradnurse, A few of your comments concern me a bit, so I would like to address them individually. -The patient you have described walking at a fast pace into your clinic may have a chronic pain issue. Please forgive me if I am wrong, but as you know, if this was the case, their bodies acclimate to the pain to some degree and they are much more functional than those who are in acute pain. There are minimal, if any, VS changes, no text-book facial grimacing, etc. -You said that you try to be as objective as possible. I do hope, as a nurse, that you meant subjective. It is not our position to be judge and jury, as many of us have stated in this thread. The patient's word, more often times than not, is gospel, especially when it comes to pain, as we cannot feel anyone else's pain. -I do, however, understand your frustration because of the drug problems you have in your community, but even in suburban *gasp* and rural communities, drug abuse abounds. Perhaps we should let law enforcement do their job, and we just stick to doing ours. You are not contributing to the drug problem in your community by prescribing #90 vicoden or percocet. And you can insist upon not writing the "10's", write the "5's" and you may see that your "repeat offenders" may just not bother coming back to your clinic so that you need not worry about your own contribution to the drug problems in your community.

I agree with you on all points! However, tort reform has kept the frivolous law suits at bay... somewhat. It's still out of control, but not as much as 10-15 years ago. And yes, we should counter-sue and we CAN instead of going into the fetal position and sucking our thumbs if we are depo'd.

Anne, I just want to say thank you for your post ~ you are very brave for sharing your personal experience with us. Hugs to you!!

We can't feel another person's pain...period. Particularly in the case of chronic pain, we can't count on physiologic s/s (ie. high B/P) because the patient has acclimated to the pain over a long period of time. If the pain med is ordered, I give it. I am no one's judge nor jury.

How horrible!! It's really come down to the "inmates running the asylum". We have NO rights. My guess is that the complaint came from a drug seeker not getting her dilaudid RTC on the dot like he/she thought he/she should. I'm just sayin'. What ever happened to Tort Reform to abolish frivolous law suits??? A lawyer is certainly in order.

pharmacy = $$$ But it depends upon what her personality is. That's a tough decision! How about nursing with a minor in Marketing so she can become a pharmacy rep??? Now we're talking BIG money!!!

Bless your heart :redbeathe I've seen way too many nurses become DE-sensitized and it makes me really sad. When that happens, it's time to move on to another field ~ when we stop feeling others' pain, we become ineffective. Not a good situation!!

10ML syringes only. You can control the negative pressure easier without risk of collapsing the line

This happens ALL of the time in my facility and yes, we all find it rediculous. If the pt has no signs of active infection and their MRSA of the nares is neg on the current admission, why exactly are we doing this??? I did look up the protocol on the CDC website a few months back (after being infuriated with having 4 out of 6 pts on iso for a Hx MRSA the day prior) and it states that there must be 3 consecutive neg nares screenings to keep the pt out of iso. I would love for the Powers-That-Be at the CDC to spend a shift gowning and gloving every time their pt(s) have lost their call light, need their pillows fluffed, etc.. I guarantee the protocol would quickly change.

Hi chessie9, Prayer is such a personal thing. And no, you shouldn't do it if you're uncomfortable with it, and you should ALWAYS ask the pt's or families permission before you pray with them, or it can turn out to be a real awkward situation! End of life issues, just like some psych issues I'm sure you've encountered, are oftentimes heart-wrenching for us nurses. The nurse who doesn't show any emotion simply has no business being a nurse any longer. But you chose to be an oncology nurse for a reason ~ you'll be just fine and you'll instinctively know what to do. Always trust your gut. :wink2:

Hi chessie9, I believe that your psych experience will be extremely beneficial to your new position. Cancer pts need a lot of care, patience and understanding. :redbeathe As far as recommending a book to read, look to your psych texts and focus on the more spiritual needs of your pts, if you're comfortable with that. Check your hospital's policy and procedures about praying with your pt's. Some facilities are dead-set against it and I don't want you to get in trouble!! Also, look for a good chemo drug book. You may want to look at the American Cancer Society web site. There's a TON of info on it for pts and medical personnel. As far as what to bring to work, yes, you listed the basics, but never leave your heart at home!! :loveya:

The question is does the patient with significant familial hx for CA choose NOT to have the diagnostics done, perhaps out of fear, or is it an insurance not covering the tests issue?? Also, I never catagorize pts related to their dx; ie., not all stage IV's are "tough as nails" and not all "basic anemia's" need to be babied. I hope things are going better for you at your clinic this week :wink2:

That's a great idea! I hadn't thought of that. I will have to look into it, as I would imagine my years of prior USN service should be taken into consideration. Thank You!! And please, don't take what I said personally. I truly didn't mean to hurt your feelings, and if I did, I am very sorry. :icon_hug:

Scatty, did you mean employers? Where I used to work, they did have mandatory courses they required you to take yearly, prior to your yearly review. If they were not completed within a certain time frame, the consequences could be not getting your annual raise, suspension and even termination. These were very basic courses, Nursing School 101, if you can imagine, but hey ~ we got CEU's for them to be used toward our license renewal CEU requirement.

Oh Suzanne, whoops, there you are again I truly appreciate your input, but I fear it is a bit negative and redundant. Did you Naturalize to Spain? If so, would you please share the steps you had to take to get you there? Time spent? Money spent? Thank you for taking the time to post!!

I wanted to take a moment to thank you all for your replies!! I scanned through all of them, but I want to take more time to really absorb what you've said and click on the links you have so generously provided. One thing really stuck out, though, and I must respond. The MRSA and C-Diff issue as well as other monsters like VRE are out of control over here. I hold certification as an ID nurse (maybe this will help in the UK?) which is rewarding and frustrating at the same time. Thanks to all of you again and please, keep your replies coming. I'm certain I am not the only one who needs this info. :flowersfo

Hi all, I finally watched Michael Moore's "Sicko" yesterday and it had a profound effect on me, to say the least. I would like to begin researching how to obtain citizenship in the UK and I was curious to see if anyone on this forum has actually taken the plunge across the Pond. Any advise given and experience sharing would be very much appreciated!

I'm so sorry to hear you got sick after this experience. We truly allow these things to effect us somatically. It is very difficult to "leave it at work", as our Patients have such a profound effect on our psyches. Hillarious!!!

I know this may sound a little strange, but what a wonderful experience you had!! This night will be one of many you'll remember and share with co-workers for many years to come. I can totally relate to your story, as I was once night shift charge for many years. It's been my experience that once a patient reaches that state of acute psychosis, the adrenals kick in with the fight/flight response, so anxiolytics and anti-psychotics rarely work. This is evident with your patient who had 11mg of ativan on board. What I have found to work is exactly what you did; agree with the patient using a soft tone to your voice. Tapping in to your inner psych nurse will have a positive effect on the health and safety of your patients. I'm not advocating having a text book therapeutic conversation here (spare the psycho-babble), but it's all about common sense. I'm not sure I agree with the sheet/pillowcase thing. This sounds very unsafe to me. I would maybe chose a duck bill mask for a spitting patient ~ you know how tight they are, and unless he/she can get their tongue up to the bridge of their nose, it would be extremely difficult for the patient to get it off. I would alter it a bit by cutting small holes in the mask to allow air in, but away from the patient's spit zone.

Hi spicychicken, Yay!! I'm so happy for you!! Yes, we may be randon strangers, but really, we are not, as we have all been in your shoes at one time or another.

Hi grannynurse, Out of all of the nurses I have worked side by side with, my absolute favorites to work with are the diploma nurses and the LPN/LVNs. The reason being is simply the experience you gained in the hands-on, clinical setting. You can't get that kind of training in a classroom. I have only come across a handful of BSNs who demonstrate clinical excellence. That's just my personal experience, but... I would entrust the diploma, LPN or the ADN to be at my or my family member's bedside. Thank you for being you :balloons:

I recently happened onto a site for Adult Children of Alcoholics (ACOA). I find the forums to be very loving, welcoming and informative. I was amazed at how many people are out there who are just like me. I thought I was living this nightmare all alone, but quickly found that I am truly not alone. Here is a web add'y for Al-Anon (one of many, but it's a start): http://www.sobercircle.com/?gclid=CLWi-JPRopACFShsGgodqCZu9A :flowersfo

YES! What evilnightwitch said .... These compliance lines are agencies not related to the institution, so there is no bias as far as they're concerned. Once they get a complaint, corporate compliance is obligated to report the complaint to the hospital's risk management department, and risk mgmt has a certain amount of time to report back to them with what they have done to correct the incident. Do go through your chain of command first and document (in your own journal w/ time, date, incident, whom you reported the incident to and so on...), as many on this forum have suggested. Keep your nose clean and CYA. You can keep the call anonymous, I would suggest you do, as unfortunately, the witch hunt could on you.

Hi spicychickensandwich (I LOVE that!!), I agree with Caliotter3 regarding checking with the institution's protocol about re-takes. Although if you are pulling straight A's in all of your other pre-req's, your GPA will be lower, of course, because of the C. But, when I was in doing my pre-req's, it was an unspoken rule that we must have nothing less than a 4.0 GPA, as getting into the program was so much more competitive back then, there was a waiting list to get accepted into the program. I would also suggest that you speak w/ your A&P Prof about giving you some extra credit assignments to help boost your over all grade. Good luck and let us know what happens :)