june2009

Here's what I can tell you about the PA-NHP. Don't mess up. They are no PNAP. I had a recent issue. I did not use any mood or mind altering substance, and have been clean for almost 5 years. I am active in the recovery community. I'll admit I've become a little complacent but I'm getting back on track with the help of my sponsor and my people. So anyway I had a recent issue. I am told by the NHP I have to go to inpatient rehab! They only inpatient rehabs they approve are in GA, NC, FL, AL and one on the eastern part of the state. 5 hours away from me. That's it. But remember, I didn't even pick up a drink or a drug... it was a behavior that I'm in trouble for. I have had several UDS this month to prove that I'm clean. I have a plan with my sponsor and I'm not refusing treatment, I'm just refusing inpatient. I'm going to lose my license because I won't go inpatient. I thought about getting a lawyer but I can't afford one. Just know NHP is not our advocate like PNAP was. Don't mess up. I'm not trying to scare you but just warn you.

This is my first post in a long time. I was offered a position with a very large provider of dialysis services. I'm super excited for this position, I've wanted to be a dialysis nurse for a long time. My brother was a dialysis patient for about 4 years before he received his kidney transplant. I'm supposed to start working for this company January 3rd. I was very transparent in my job interviews and told all of my interviewers that my license was active but on probation due to it being suspended back in 2017 for drug diversion. I had it reinstated January 5th 2022. During the time it was suspended I have been working steady and volunteering my time. So when my background check was done, my license was flagged and now there is a chance I may not be able to work for this company. I am not Medicare or medicaid excluded. My questions are: 1. Has anyone ever had a license on probation and been employed by one of the large dialysis providers that are out there? I'm in PA if that helps. PHMP/PNAP/DMU. 2. If I am fortunate to be hired, do you have any advice for a first-time dialysis nurse? Thanks.

I've been out of PHMP for a few years now but I feel like it still follows me and here's why. Two weeks ago My boss pulls me in to her office and asks why there were 2 oxycodone left in one of my patient's medication drawer. I stated that I pulled them in anticipation that the patient would want them as he frequently does. When I askd him if he wanted them, he refused them. I put them in my drawer to return to the med-dispense later. I forgot to return them and they were in the patient's drawer when the next nurse took over. When that happens, apparently the policy is to do a drug investigation, complete with urine drug test. No problem, I took the drug test. It turns out positive for hydromorphone. I had a script for hydrocodone for some screwed up teeth. I took one norco a few days prior to the drug test. One of the metabolites of hydrocodone is hydromorphone. I did not take hydromorphone. I have been doing extensive research from scholarly journals and it appears that it is possible to test positive for hydromorphone. The occupational health doc says I should have either hydrocodone or norhydrocodone in my system. I only have hydromorphone. Has this ever happened to any one else? I've been clean almost 5 years! THere wasn't even missing meds, there were extra meds. If I was using, wouldn't I have taken the stupid oxycodone and not left it in my patient's drawer? I can't believe this.

Last night my patient with end stage muscular dystrophy on vent at hs but weaning for 12 hrs during the day. Only cardiac history htn. Cardiac rhythm sinus tachycardia for days 110's to 120's. All of a sudden goes into what I thought was svt with a rate of 200-210, sustained. Called Dr and gave adenosine 6mg . . .pause...Then back to sinus rhythm and after about 5 minutes back to sinus tachycardia rate 110's - 120's. That's where he stayed. Of course we got an EKG but it was after adenosine so it just showed ST. Consult cardiology, troponin normal, all other labs except crp normal. Crp increased from 0.6 to 1.6 in one day. Nurse reliving me says it's wasn't svt. You couldn't see p waves but the r waves were so close together the p waves could have been hidden. The rate was regular but like I said the beats were so close together it was hard to tell that too. The nurse who relieved me was an er nurse for 20+ years. We work in LTAC, this nurse thinks she's a little better than us lowly LTAC nurses. (Then why are you now working LTAC now right?). The way I see it it could have been afib with rvr, paroxsismal atrial tachycardia, or possibly junctional tachycardia. Either way they are all svt and adenosine was appropriate . . . Yes? The patient had no history of afib. This got me thinking how do you tell the difference between those three rhythms? I went back and looked through old books but they really only show textbook examples that look perfect... Thank you for your input.

So we must be in the same class for 6001. I'm really nervous about 4001. I took research in my previous bsn class and failed😞. I was really excited about the class but when we started learning about the different types of studies I just couldn't not grasp it! Quasi-experimental and all that stuff...right over my head. I hope this class goes better. "See" you in class!

You said your drug addiction is "not relevant at this point in time.". Your drug addiction is always relevant. While I agree with everyone else that I would answer no, keep in mind that you always have to be vigilant in your recovery. You will be working with narcotics every day and that can be tough. Like Hppygr8ful said work your program and hit some meetings. I don't mean to sound like gloom and doom but I have seen nurses relapse with more than 8 years clean. Congratulations on staying clean and keep up the good work!

Msa9179, I started June 1st as well. What classes are you taking? I'm in nurs-6001 and nurs-4001 (research) 😫

If I can be a positive voice in the gloom and doom....I relapsed during my contract and did not have my contract extended. I was honest about what I did and took responsibility for it.. wrote a letter to my case manager stating what I did and how I would prevent future relapse. The only thing I had to do was another "90 in 90" I had to quit working too until my 90 in 90 was done. I'm in Pennsylvania.

I'm doing Walden's ADN-MSN NP (diploma-MSN NP in my case). No BSN awarded but if you take a few more classes it's an option. I just know that I have no use for a BSN so why spend the money to obtain a degree I will never do anything with. The end goal is ACNP so that's what I'm doing.

That would be awesome!

I'm in the adult/ gero ACNP program starting Monday. I got my class plan and they transferred 85 credits! I don't have to take any classes except for the nursing classes. This semester I will be taking the foundations of graduate study and research. So far, it has been smooth sailing but I haven't actually started class yet. I'm pretty sure I'm on track to complete in two years. Keep in touch!

I'm starting the ACNP on Monday. I just got my acceptance letter yesterday. I have started a thread to try to get Walden students to do a "role call" so we can all keep in touch and compare notes on how we're doing. I can't wait! Michelle

What kind of stipulations are you talking about? In PA, if a nurse still has narcotic restrictions I think makes sense to not hire a nurse on a floor that has a lot of pain medications. I know that even when I worked LTC it was difficult for the other nurses to have to pass my medications. They had to stop what they were doing to pass my narcotics. Or, worse yet, the patient had to wait for the other nurse to be free before getting their prescribed pain medication. Sometimes they had to wait as much as an hour. This could be considered a delay in treatment.

I know that when I was in PNAP we had to make arrangements to find a test site wherever it was that were vacationing. We still had to call in every day.

What's the Nursey website? I've never heard of it.