RNCCMMS

I thoroughly enjoy the responses to nasty docs lol lol lol

I'm confused about the push to use Tramadol. My pharmacist told me that it is usually only given postop if you have received a dose in the immediate postop setting-because the side effects are major-seizures, decreased respiratory status. And it is for moderate to severe pain and is short term. What happened to the pain steps- starting with the nsaids, and working up to the narcotics, unless it is immediate postop or injury related. If we start out with the opiates to treat pain from muscle pulls, osteoarthritis, etc, and they stop working, where are we going? The current heroin epidemic is being blamed on codeine addictions. When police officers have to carry Narcan, it's a sad day for us.

Talk to a financial person. When I was in high school, nursing school, and first working, no one talked about pensions, 401ks, etc. Back in my early days of working, everyone assumed nurses were going to marry doctors (lol), so no one offered pensions. If I had started in my 20s, putting money into an IRA, I would have a hefty retirement plan by now. As it is, I finally have a pension-but only in the last 15 years. My plan is to work as long as my health is good to make up for my inept money management. Paying off student loans is important, but so is putting money away now. Ask if employees where you work have access to financial advice. If one of your parents served in the military, you might be eligible to participate in USAA. They give great financial advice. Good luck!

1. Geographic location NJ 2. Pay rate $34.00/hr 3. In which area / specialty do you work? Clinical Quality auditing 4. What type of license do you have (RN or LPN)? RN 5. What type of degree and/or certification do you have? MS, CCM 6. How many years of experience do you have? 40 7. Are you full-time, part-time, or casual / per diem / PRN status? FT, medical benefits, pension, 401K (though the pension/401K is only in the last 15 years) 8. What shift do you work? Days-M-F, no holidays or weekends-(finally!) 9. Do you receive any shift differential? N/A 10. Are you a manager or supervisor? Neither currently though have done so in the past(don't want the headache)

The original poster was referring to taking a prescription drug, not tylenol, advil or maalox. I wonder what the Board of Nursing would say to this discussion.

Honesty and integrity are important, period. Stealing is stealing, period. It is a violation of the state nurse's practice act, period. If a fellow employee is ill, they can go to employee health to request assistance.

It seems this conversation veered off topic. The issue that concerns me is the suctioning with NSS..that ceased to be a standard of practice years ago. There is no evidence to back it up. Do RTs not adhere to the same standards as nursing?? I think the manager/head nurse/supervisor or whatever the title should be talking directly to the head of RT to work this out. There should be a hospital policy for the unit on suctioning which everyone should be following.

This thread is a hoot! I often wondered how some mds made it through med school, too :-)

Did anyone yell at House about compassion and treating people with respect. My husband would laugh and say "you know you're talking to the TV, right?"

I agree with Imarisk2. It's hard to care for patients who become friends. There is always the chance that the relationship offer is not what it seems. Hate to be so cynical, but years of life teach me to be careful. And she gave you an out "if it was appropriate with your job". FYI-It's hard sometimes to care for friends who become patients, too.

DeLanaHarvickWannabe I like your quote at the bottom of your post!

The ombudsman in your state would be the first place to start. You can research the state laws to see what the state says about the situation. Be positive with your comments. You don't want to be in a postion that anyone can retaliate against you for speaking up. Best of luck!

Reading some of these posts sure brightened my day! I have always thought I had 2 different personalities. My work one was kind and caring to my patients, not so much coworkers who didn’t pull their load or care for patients the way I felt they should be cared for. I used to tell my staff: “How would you want your mom, dad, or grandparents cared for? That’s how we treat our patients.” My home personality was kind, loving and caring for my children (even with a migraine headache); spouses not so much. My spouse would say “Do you treat your patients that way?” It’s always on the tip of my tongue to sarcastically say, “No, because they are truly ill whereas you complain about every little ache and pain”. Lol So, I guess a mental health person would have a field day with me. haha

If you have the opportunity, try to take a course in motivational interviewing. It's a great help in learning how to communicate with patients. I can understand asking financial questions but in the context of, "are you able to afford your medications?, do you have difficulty paying for your utilities?"..these are quality of life issues...then there is the questions about family, as in " if you need help at home, who would you be able to call?" It might help to preface your questions with "I am not trying to pry, but we want to make sure you have the resources and support you need upon discharge home". It's very important to learn how to set limits when comunicating with patients. If the setting is set that this is in relation to their plan of care, then you can gently say, " I would like to talk about you and your health care needs." Good luck in school!

I believe if you have a patient who signs a form preoperatively that they are aware they must have someone to drive them home post procedure and you have documented their cognitive status upon discharge, you should not worry. You can check with an attorney if you want to get a legal opinion.