Hospicegal90

Forgot to add her quote for my above answer.

I was actually writing my story on that very subject earlier today. Hopefully I'll get it finished by tomorrow. Just seems so long already---covering many years.

What happened to the term and state of being 'dependent' along with 'tolerance' and skipping straight to 'addiction'? Huge difference, and addiction carries with it a special set of lifestyle issues, changes, loss of normality compared to their life before opioids, with a complete loss of control, choosing these medications over everything else. Is every patient of yours that has been prescribed opioids 'months out of surgery', an addict? You are also judging thier pain. I agree with starting low and going slow. This just seemed like a very important step was stepped over. This is is an issue I am so tired of reading about and seeing the judgement by nurses, no matter what our specialty. If you ever find yourself on the other side, you may (quickly) look at this in a very different light.

Nursing is unique in that we all can refer to ourselves as nurses, yet what we do on a daily basis varies greatly. I prefer direct patient care whether it be a hospice job, a home care or having the same patient each day. Yes you are a nurse. You are providing care to a patient that needs and deserves your nursing expertise and sounds like she gains great social skills as you go through your day together. I admire what you do for the very reason that you doubt yourself. Too many times I see nurses questioning themselves and their roles simply because they are not on the floor at a hospital. As nursing takes a leap to employers demanding more training than ever before, (BSN's, MSN's) etc., what happens to the population of patients that require the care of a nurse yet do not need advanced degrees? As baby boomers (me) age, who will care for those who are able to stay in their own homes? My heart is with these patients, they need us and we make a huge impact on their lives. I'm an older, old-fashioned nurse who went back for my RN only to have my father need me as he was on hospice dying from colon cancer. I quit school (had to) and have been a happy LVN since. I tell you this because I believe that experience with him, and my mom a few years earlier, taught me that where my heart lay in nursing is exactly what I should be doing. I'm IV certified and have gone neck to neck with some nurses with more training & higher degrees. But in the end, it comes down for me to the patient who may be lonely, away from society, and to see us walking through their door can make their day. It's not about losing my skills or worrying about what other nurses are doing in their chosen profession. I also love the closeness we get to have with our patients families. Hospital nursing and some other fields just can't give us the time for that. Stick with what makes you satisfied at the end of the day. Life's too short to do anything else.

I was a student in the ER when a young man came in after a motorcycle accident less than a mile from the hospital. That was my first time doing CPR. A decision was made after a certain amount of time during the code to continue CPR and treatment to keep his organs viable while the transplant team flew in. His family arrived and after much discussion, refused to allow his organs to be harvested. The doctor called it and the silence in the room was deafening. Seasoned nurses were in tears. My teacher wrote for a nursing magazine back then (1991) and described these events in an article. This was before 'donor' was placed on drivers licenses or before the donor registry. Things have certainly changed.

The average amount of times a victim of DV leaves an abuser is 7-8 times before leaving for good. This means returning to an angry, controlling environment. There are the stages of Tension, The Abusive Incident, followed by the Honeymoon stage. As time passes, the time in between stages shortens. Sometimes the Honeymoon stage where the abuser shows remorse becomes non-existent. I also experienced my abuser become more abusive when I was in a vulnerable place. Whether it was physical, monetary or emotional, that was when it got worse. Abusers wear their victims down, then play on that weakened spirit. Being able to think straight when constantly walking on eggshells and focusing on their next move is exhausting.

Ruby has written from her heart how hard it is to leave. Thank you for sharing your experiences Ruby. I've been following your other thread too and appreciate your honesty. Leaving IS the most dangerous time. The abuser can feel it, so staying silent is key. I understand that many if not most times that planning isn't possible. I left when my abuser was gone. Grabbed a few clothes, my photos and drove away. I had known the day was coming---the tension was so high I could barely breathe. I was physically unable to leave when I wanted to as I was recovering from surgery. I used that time to plan my escape the best I could. Confusion is common in victims of DV, but I knew I had to use that time to work towards leaving. I paired down my photos into one box. I kept my spare car key with me at all times-- Id left in a rush before after an abusive incident and forgotten my extra car key-- he found where I was, climbed over parking gate topped with barbed wire, unlocked my car, filled up the front seats, back seats & trunk with heavy boxes of my nursing textbooks & other odd items. Even after I'd left he desired control. I gathered all important papers & kept them in my car. I had to be very careful & do these things when he wasn't home. My heart would pound that he'd drive up and see me. The one thing that gave me the guidance and final amount of courage to leave was calling the National Domestic Violence Hotline. It was their expertise and reassurance that I was not crazy, that I was doing the absolute right thing by leaving ASAP and that gave me the ability to put my plan into action. Leaving is scary. It's dangerous. It's certainly not simple or easy in any sense. Yet it is what saved my life. That night I changed my phone number, blocked him on FB and had instructed trusted friends and family to not respond if he contacted them. The next day I got a restraining order. If you're reading this and you think you may be in an abusive relationship, I encourage you to call The National Domestic Violence Hotline. 800-799-7233. You can call them every day if you need to, they will listen, not judge, and give you referrals to shelters and DV advocacy organizations in your area. Making that call gave me the courage to leave. I am eternally grateful to them.

Thank you Nurse Diane for your reply. I understand what you are saying and because I've been away from nursing I have a 'Polyanna' view of how my pump may be received. I value your years of expertise and have rethought how I will go about this. You're correct--some things are private and need to be kept that way. Im finding that most nurses do not have any concept of how an intrathecal pump works. That the dose is 1/300 of oral dosages. But the word narcotic is an instant judgement and for that reason I will keep this to me and my physician. Appreciate your wisdom!!

This interests me greatly as I too, have been away from nursing for 6 years due to a medical issue. Thanks to advances in treatment I have been given my life back! My saving treatment was the implantation of an intrathecal pain pump. I am finding that other medical professionals are quite interested in the device and my story. I have talked to quite a few peers who agree with my take on this issue. I am going to be 100% honest about my absence and tell potential employers about my history of severe pain stemming from multiple spine surgeries and the miracle that is this pump. My doctors nor I foresee any problems related to having this pump as far as performing my job duties. Also I would test positive on a drug screen and I want to be honest about the source. I've lived my life by the honesty is the best policy motto and it has served me well. I believe there is a place for me again in nursing. I'm older and also battled cancer this year. But I still have a lot to offer and I'll be smart by starting out part-time (if possible of course). Also I will be concentrating on clinic nursing, nothing super strenuous. The days of being on my feet for 12+ hours are now past. Happy to feel able to work again and proud of what I've gone through to get to this point. :)

Great nursing DX, we all need to watch our habits, especially at work!! Any nurse knows how hard it is to eat right...it just takes a little time in planning at home to bring those healthy snacks to work....easy to just flop down on the couch and not move until it's time for another shower and more scrubs, run out the door, and realize OOPS I forgot my healthy snacks at home, (that I never prepared!); that is the key--to have a few easy-to-grab-prepared fresh veggies, or fruit to grab on our way out the door. Great post--Well done!! Gentle Hugs----

I was an LVN student in 1990-1991. I remember those first clinicals like it was yesterday! Now, looking back; I realize that the PLACE we were sent for that first round was understaffed, and happy to have us there to answer those call lights, yet they did not really show that happiness to us! That left many of us feeling unappreciated and lost. I concentrated on learning everything I could, and getting in on the patients that needed the extra help. That seemed to make the boring days more interesting. Realize that all you are learning will definitely be used in your nursing career, no matter what you specialize in. I always put myself in the place of the patient, and tried to think of what would make ME feel more comfortable in the midst of a lousy situation. That empathy helped me to accept anything I was asked or required to do. It is a good thing though that you question your true desire to be a nurse. It is always good to question yourself. For therein lie the truth. Nursing is the most rewarding career I think that anyone can have, especially if it is something that you truly love. Give yourself a chance. At the end of your schooling, you will look back on these days and realize how very important they were!! Whether you choose to stay in nursing, or move on to something else...you are giving of yourself, and learning valuable information. Good luck and let us know how you are feeling about your clinicals!

Dearest Sarah, First, I am SO glad to see a NEW post on this thread!!! I have been a member here for awhile, but always had trouble logging on so I basically gave up. Now here I am! I have been a Nurse for 16 years and am back in school again...there is always something more to go for in Nursing! I also have suferred with Chronic Pain since I was in my early 20's, I just turned 49!! Mine is located in my Thoracic Spine, the most unusual place for the back to have injuries/disorders, etc. Usually it is the lower back or neck, as they are the most 'moveable' of the spine. I've had 2 surgeries and about 30 Procedures. I had to leave nursing for awhile, and was able financially to do so. Now, I have to get back to work. I adore Hospice nursing and will be looking at that, although for some reason am being pulled to do some travel nursing, but still stay here in CA. Enough about me, except that I write a Blog about my life in pain, @ http://shaunaslifeinpain.blogspot.com and I think you may find a few things that could possibly help, the main focus is if I reached just ONE person that was in CP, I had done my job. Feeling alone and being in Chronic Pain has to be one of the worst things out there! If I could only touch fingers with someone, I say to them, and let them feel what I do, then they would truly 100% understand. The most understanding I have gotten has been when my family or friends have a back injury for a few days or a week off thier feet and in acute pain, they ask me, "How do you DO IT every DAY?" How can I answer that? I take Narcotics as part of my pain management therapy. I was blessed to find a good Pain Clinic at a World-renown teaching hospital that I live by, and was with them for about 4 years. I left b/c the new students would come in, (well, new doctors-residents), and be there for their rotation for 6 months, and I'd see them first, then my regular doc, thier teacher. Then in 6 months, a new face would walk in and I'd have to re-tell my entire story to them. I just got tired of that. I was then blessed again to find a Pain/Rehabilitation Hospital, and I have been seeing the Medical Director for almost 5 years now! He is an in my life. He beleives my pain, and has worked WITH me to find a regime that works. I still have pain regardless of the meds, although they will take it down (some days) to a 1-2. Here is what you said that stood out to me the MOST. "Anyway through trying all those different meds I ended up on the one I thought took care of the pain the best, Methadone. After trying all the others this med was a miracle 'cause it pushed my pain from about an 8 all the down to a 1 or 2 for the most part." You said THE most important thing! You said that something had helped your pain go down from your 8's, to a 1-2 kind of as I feel. Honey, you really must find a pain doctor. Someone who has trained for this, has love for what they do, and most of all, belives in their patients report of pain. As you know, when we are pain patients, we do NOT feel the 'high' that the addicts do. For we are not addicts, and our receptors are busy at work to help with the pain, not to get us high. I do feel some side-effects at times from my meds but for the most part, I am fine mentally. I suffer from depression, which came first? Pain or that? They do go hand in hand. But to hear you worried (not good for Chronic Pain Patients!) that you are going to be either weaned off against your will, and I am so so sorry that your doc moved, that is always SO hard, and you have a new one that seems to be moving too fast....That is not cool. In any sense of the owrd. It does not matter if you are 20, or my age to be in pain hun. Pain is pain. Just b/c yours has not been diagnosed yet, means nothing when you say very seriously that you are in pain. I'm sure the non-diagnosis is so hard for you too. I've had an undiagnosed condition unrelated (?) to my back problems that has not been given a diagnosis after 2 years, and it is making me crazy. enet to UCLA and thought, ok, they are the TOPS, my Family doc sent me there and said they would examine me from head to toe. Ummm, NOT!! Never looked at my back, where this problem 1st started. I had to keep up with the obvious rush they were in, didn't get a chance to tell them all I HAD to, and I had to tell them, "Look at this, my scalp", when they had no intention of doing so. The ooooed and aaaahed when they saw what I was trying to show them, yet I walked out with NOTHING. Not that I expected a diagnosis that day. I did expect lots of tests. But they had no answer to the question as they are all walking out, "Well, can you tell me of a shampoo or ANYTHING TO HELP MY ITCHING, as I stood everywhere in that office itching my head like a monkey, they blankly stared at me and said, NO. HUH?????? So, your predicament is one that must be handled by a Pain Specialist, or an Anesthesiologist who treats Chronic Pain. If you'd like, look at my profile, and you can write me directly, or just answer here as it would be a great way to keep this thread up to date!! I live in Southern California, and would be more than happy to help you in finding someone where you live. Just remember, the one thing out of many that caught my attention in your post was when you said your pain had gone down. THAT is THE #1 thing that you need! AT your young age, it is easy to let others put too many 2 cents in, but you and your hubby sound strong and I agree with him that you should stay on your meds. Oxycontin was a horrid mind-freak for me. Fentanyl pathches changing from Morphine was the worst 14 days I have gone through. It gave me the feeling of what it would be like to live without pain meds. I can't do it. I now know that I will be on them the rest of my life, and I am certainly ok with that. If my pain keeps getting worse as the pieces of bone growing from everywhere on my spine keep sticking into my spinal cord, if my DDD keeps getting worse with age, if my spinal stenosis (narrowing of the cord), keeps getting worse, (which they all will), then my meds go right along with them!! And that is that. I hope this gave you some hope, just to know I am out there, a fellow pain person that truly understands you. Gentle hugs, and I wish you a low or no pain day, Shauna :typing Oh cr** there's no spell check here????