RedhairedNurse

I've posted on FB to communicate with family when I've been sick, I could pick up the telephone instead or shoot over an email but sometimes its easier to make a quick post on facebook. Oh, I wasn't barfing at that particular moment which I'm sure my computer was happy about. JK. I don't see why its such a big deal, unless of course one might have tattling coworker to try and blow it out of proportion. I just have close friends and family on my face book so I don't worry about it anyway. Furthermore, I've even gone to WebMD to check out certain s/s or to learn more about medication my doctor may have put me on. Just because I'm sick doesn't mean I can't have my laptop. I like to sleep a lot when I'm sick but I can't just totally shut myself off from every thing. My thoughts........Just don't have coworkers as friends on face book. Its no one's business but our own as to what we choose to do when we're sick!

What? Seriously? I'm posting on all nurses and facebook and I'm unable to work, the details of my illness are private, but i will say that I CAN put a laptop on my lap and still type and read. If not for the enjoyment of FB, AN, and an occasional game of Wii, I would be going stir crazy about now. BTW, co-workers are not part of my facebook account. I like my co workers, but business and pleasure do not mix in my opinion! For those who choose to keep co workers on their face book more power to ya. But I for one do not feel like I should "self police" myself! I type and post what I want!!! Merry Christmas every one!

Your post doesn't really say what exactly you're having trouble with. Is it staying late to chart? Or do you just feel overwhelmed with everything? I get my vitals when I'm passing meds, this is also when I do my assessments. I'll peek in on my pts once I've received shift report to make sure of no immediate needs, then I'll go to the computer and try to enter most assessments. I may have to tweak a liitle on the computer assessment after I've done the head to toe assessment on my pt. I find that staying ahead of my charting really helps keep me on track. Plus i like to get to the med room before anyone rise to pull all my meds, or before a long line of nurses gets in there. If i wait till later to pull my meds it will back me up the rest of the day, seriously. You'll find what works for you. It just takes a little tweaking here and there to get down what works for you. And sometimes the most experienced nurse has to stay late.

You gave the morphine at 0800, as that can be given q4h as ordered. Two hours later, the patient can have the lortab, the pt can have the lortab an hour later (at 0900) if warranted, it's nursing judgement and depends on the severity of the pain. These pain med orders are two separate orders. The morphine can be given q4h and the lortab can be given q4h as written. The only thing is, you CAN NOT give 2 pills of the 7.5/500 q4h as that would exceed the acetaminophen limit of 4g per day. Most doctors do not pay attention to this and therefore they do not write the order correctly. If the pt needs 2 pain pills q4h on top of IVP morphine as ordered, then the pain pill order must be changed to Norco 7.5/325 which you can give 2 pills q4h. Like the above poster said, some doctors will write parameters to give 2 pills if the pain is 'moderate' in intensity or greater than 7/10. The way this order is written, if the timing is right, the patient will be able to get pain meds every 2 hours. For example: morphine at 0800, 1 - lortab at 1000 morphine again at 1200. However, if the lortab order doesn't get changed, with that amount of acetaminophen, you can only give 2 pills every 6 hours. Hope this helps.

Well most of these addicts that I speak of usually have some sort of chronic problem or something that has probably led to addiction and/or opioid tolerance. I don't work in our ER but I'm sure they have such a "list." I'm mainly talking about something like this for example.....Take a sickle cell crisis patient that has the crisis resolved after a few days of treatment and is ready for discharge but still continues getting that 2mg of dilaudid q2h. Then, I'll see a fresh post op patient getting something like 2mg of morphine q4h laying in bed crying needing more pain relief, nurse calls the doctor to try to increase pain med with no success. Another example.......pancreatitis patient with only slightly elevated enzymes, again resovled and almost ready for discharge and still getting the strong stuff like 1-2mg of dilaudid q2h, again while the room mate, brand new post op, is just getting 2 of morphine q4h. I guess It just depends on the doctor, who knows. At times, it's scenario's like this that get very frustrating, because there are some patients that are in a lot of pain. And, I'd say approx 95%, or more, of my pts that can get oral or IVP pain meds q2-4h, whatever the time frame may be, will ALWAYS want it spot on each and every time, on time, regardless; they say they are in pain and they want the drugs! And most pts want the pain med to be automatically taken to them without asking, happens a lot even after explaining to them the need for further pain assessment prn.

Yeah, you have a point. But I always heard that cops were on OUR side, guess that's not true! And I'd think a cop would understand a nurse being tired....

What? I know you're serious but this sounds totally unreasonable on the laws part! Just curious, where did they collect your urine, surely not on the roadside! lol This just doesn't seem fair. I take a benzo at times, one with a very short half life, but one that I take regularly and would probably show up in urine. That would be so NOT right to tell me I'm driving under the influence.

Wrong!!

I'm sure this is the case. But sometimes it gets so frustrating knowing that someone suffering down the hall needs the pain meds so bad but can't have anything yet, but someone, say, post op day 4 still gets the hard core stuff. This is county hospital, I'm not sure if it's like this at every hospital.

Not where I work, the drug addicts (seekers) seem to get what they want, it's amazing the way doctors will give the addicts 2mg of dilaudid q2h but the ortho pt only gets 4 of morphine q4. Doesn't make sense but I see it all too often. I've heard that some doctors do this just cause they don't want to listen to the addict gripe! It frustrates me to no end!

this post is so accurate that I just wanted to bump it

Watching a very seasoned nurse try to ram a Yonkers down some one's throat! Yikes!!!

I'm so sorry.