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long-term-care, LTAC, PCU
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june2009 has 13 years experience and specializes in long-term-care, LTAC, PCU.

Currently employed in LTAC (Select Medical) as a staff nurse.

june2009's Latest Activity

  1. june2009


    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.
  2. june2009

    AFib with rvr versus PAT

    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.
  3. june2009

    Walden University - the latest on the FNP program

    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!
  4. 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!
  5. june2009

    Got my acceptance letter today...whew!

    How's everyone doing so far? So far I'm a little overwhelmed. I'm sure I'll settle down. I'm interested to see what other Walden students have to say?
  6. june2009

    Walden University - the latest on the FNP program

    Msa9179, I started June 1st as well. What classes are you taking? I'm in nurs-6001 and nurs-4001 (research) 😫
  7. june2009

    Positive alcohol test

    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.
  8. june2009

    Goal is NP. ASN>BSN>MSN -or - ASN>MSN???

    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.
  9. june2009

    New FNP student at Walden University.

    That would be awesome!
  10. june2009

    New FNP student at Walden University.

    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!
  11. june2009

    Walden ACNP program

    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
  12. I just received my acceptance letter from Walden today for the June 1st start date AGACNP. Nothing like waiting till the last minute! I'm transferring in 85 credits. I figured I would be accepted but was a little worried these past few days since I wasn't hearing anything. I'm super excited! I know I've come across a few people who are also starting Walden's NP programs June 1st but I was thinking we could do a role call so we can all keep up with each other. So, if your going to Walden university for an NP program, speak up and we can compare notes so to speak. Michelle
  13. 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.
  14. june2009

    Taking a vacation while in TPAPN

    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.
  15. june2009

    too late for PHMP? 2nd chance?

    What's the Nursey website? I've never heard of it.
  16. june2009

    too late for PHMP? 2nd chance?

    Did the institution you diverted from press charges? Have you been convicted of a crime? What kind of issues have you had getting a job...I mean what are the potential employers stating as the reason for not hiring you? If there have been no actions against your license than I don't see how any employer could know that you diverted. I know a nurse who quit PNAP and then later decided to go through the program. She was able to sign another contract but had to start all over again, including going to rehab again, IOP, nurses group, everything. To be honest I don't know if she was able to do the VRP or if she was in the DMU the second time around. Did you have other issues while you were in PHMP? I'm not sure what you mean when you say that PHMP closed your case. It seems odd that they would close your case just because you missed a meeting. You can be sure that if you don't contact someone from PNAP, your license will be suspended. Sometimes it takes a while, but it will happen. I also advise keeping copies of everything you send in and keep a record of every conversation and/or email you have between yourself and your case manager. Stuff gets lost on occasion and they take NO excuses. If you want to keep your nursing license, realize that it's their way or the highway. I successfully completed with PNAP in October of 2013 and would be happy to answer any questions you might have. Keep us posted and good luck with whatever you decide to do. Michelle