hereigoagain

Oh, I feel so bad that you had to go through that. I am intimidated by the nurses that say "who are you to know what pain the pt has?", but I hate Dilaudid. One morning I had to give one my pts Narcan...it was horrible, they put a pain pump in her and they forgot to take her off Methadone...I found her in respiratory depression at the beginning of the shift (thank you, RT, the respiratory therapist saved my ass, G-d bless her for ever, I thought that the pt was just drowsy from sleep when I checked on her the first time that morning), G-d gave me strenght and I had the Narcan close by, it was HORRIBLE (everybody was freaked out, doctors included, but I stayed calm and gave the Narcan and dealt with the exorcist look of the reaction, vomiting, drama, hyperventilation, craziness...run to ICU and the pt made it and thank us for it, but it was just DUMB luck, we could have all been in court because of it and loose sleep because someone died in our arms). Screw the drs orders, I use my own discretion when giving those poisons. I am a chronic pain sufferer and I don't take anything, I pray, I cry in pain...but I would not take anything. People on Dilaudid are just living for that, it seems.... I thank you for sharing your story. I hope you are OK with your license.

very nice video!!! you are one nurse that really loves her patients. good job!!! how about going into teaching? we need instructors so bad and you would be exceptional.:heartbeat

HAHAHAHAHAHA...:chuckle:chuckle:chuckle

If you read what the post says, your reply does not make any sense. The post is very clear, read it again...did you have a long shift or something? Yeah, let's beat up on each other...are you controling the thread or something? Be nice.

I never refused to push the Dilaudid (even if I did not agree with it and even the dr. didn't deep down, but the patient just wanted it so bad and the chaos that pts addicted to Dilaudid can make in an ER is just something else...so I do not blame the docs and I am not judging the pts pain either) and my point is...I had patients that just came to the ER saying that they take Dilaudid and they need some...just as plain as this and the tired doctor just gave it to them, so we can open up the ER for the real patients (yes, I said "real patients"), that needed help so bad (head bleeds, trauma, PE's etc. you name it). Everybody talks here how it is unfair to keep a patient from getting pain medication and that we can not judge someone else's pain...blah...blah...blah...but the reality is, when you see a patient who's whole life revolves around getting the next dose, you have to say something that might snap them out of the Dilaudid seeking madness. And again, please don't confuse the seekers with the patients that have trauma, cancer, fractures etc. Dilaudid seekers need a good dry out in a mental facility, so they can become regular people again, contributors to society (none of my Dilaudid seekers were working adults), enjoy their life and stop making their families life MISERABLE with their disease that's curable. And when they are too much deep into their didease to realize that their behaviour is distructive, who the hell is suppose to pay to their attention that they have an addiction problem, who else than us, the health care providers? So let's be honest and just say that we are burned out of trying to make them realize that they need help...it is not that we don't want to give it to them or whatever. I will continue to say something when I consider necessary. That is what I chose to do.

I just had a health scare with my daughter just a few days ago, so this post is very close to my heart right now. She has celiac and her Dad did a double whammy when she spent the weekend with him (her dad was charged with child neglect in the past, so he's not exactly the best dad there is, but that's a story for another forum and I should know better not to trust him with watching our daughter)...feed her gluten, in a restaurant that I did not ever go to, the meat was undercooked and my daughter also told me that he did not want to get out of the house to get food, so she ate some old chicken from the fridge...we ended up in the ER twice in 24 hours (by EMS the second time, because her heart rate was 150 at 12 yo and shge started having chest pain...at the hospital she was throwing PVC'c and A-Fib for 8 hours and she does not have a heart condition, but she might have one now after all this), she got three!!! liters of fluid and she's still not 100% (resting heart rate is still 100). I was just devastated, I adore her and she suffered like a dog because of the food poisoning. I wonder if it was the undercooked meat, or the gluten or all of those faux pas together. She had a WHITE bowel movement, I have never seen anything like that in my whole entire life of taking care of sick people...that is a sign that your gall bladder is blocked...blocked with what? With parasites, as far as I know from years of reading about parasites, she can not have any gall stones yet (she absolutely did not have symptoms of gall stones)...my mother's instinct is telling me that she ate infested meat and that's what caused the white bowel movement. Anyway, think deep about parasites, even if we are in a developed country, that does not keep us safe from parasite infestation...I will keep taking my herbs and watch my daughter, so she does not have to go through that again...

I have read extensively about parasites. It is very delusional to think that we DO NOT HAVE parasites. I only take the herbs recommended by Dr. Hulda Clark for parasite cleanse, because they grow in North America (except Cloves, but cloves are safe also and medicinal) and I know what they are and I feel they are safe and effective (I am going to start a controversy in here). Every time after I take it I feel really healthy and full of energy. It is not a placebo effect. It is what it is, we do have parasites. This is my firm opinion (and nobody has to agree with me). I am cooking very carefully and try to avoid eating out. You don't have to eat out to be happy. There are ways to avoid parasite infestation. We should follow what people did for thousands of years before us, they had some good habits and one of them was fasting and taking herbs to get rid of parasites periodically. I know that we have better medicine now, but we have very poor habits. I gave the herbs to my dog and I was shocked what came out of him, G-d rest his soul.

I just LOVE your post. So logical and true, but so funny!!!! You made my day, I will show your post to all my nurse friends and maybe even a doctor would laugh a little (allopathic I mean, not one of those doctor poets). PS I am editing, I forgot to say, I laughed my ass off...thank you!!! I just love your sense of humor and smarts.

Arrogance, arrogance...I want to become a nurse practitioner and I will and I know I will be able to take a good care of my patients, maybe better than some of the allopathic doctors...thank you very much, I became arrogant myself.

This is so funny...hahahahahaha...

wow...i don't really understand your post...can you elaborate? are you a doctor? i think that this thread is more like a way of nurses expressing sorrow/worry at the miseries of dilaudid that to bash doctors...maybe you should reconsider...

I would have never thought that you were just "drug seeking" (I don't even like this term). I did hear that pain from fractures is terrible. And not treating this kind of valid pain is just dangerous for the patient's well being. I hope that you are not feeling judged by anyone here. There is validity of using Dilaudid and there are situations when it is just used with no discretion. I had a friend that was taking Dilaudid for a very severe pain caused by surgery on his spine. The withdrawal symptoms I saw I don't wish to anyone... I think he's off Dilaudid now, I hope that you are able to cope with your pain in the safest and healthiest way possible. I am not just talking from my head, I had a major accident and I have been through intense pain for a year, but G-d is great, I was able to keep my sanity, I am drug free and I feel much better now. I even wrote a letter to The Dalai Lama and I begged Him to pray for me, that the pain will go away, because it was killing me slowly and guess what? His secretary answered and he assured me that they will pray for me. I know that the pain will always be with me and I know that I might get re-injured, but in the same time, knowing that I survived the first one, I know I will survive the second. Hear out the message of the post, I am glad that nurses are actually worried about how strong and dangerous Dilaudid can be. Nobody here is judging you and I appologize for the ones that took your pain for granted and denied you the help you needed. All the best and I am hoping for the same miracle of your pain getting better that happened to me.:redbeathe

I totally agree with you, that it is not done enough to address emotional and phychological issues (but I do my part every time, I make time and talk to the patient even if I risk of getting in trouble, because the truth is very hard to handle sometimes). But it is much more done in US than at least one other country I know, lived/raised in and worked as a nurse and trained for four years in med school. In my country of origin, Eastern European, alcoholism is a big problem and at the time when I left the country (1995) there was NO help for that, as far as I know. No mention about it in the nursing school, no mention in the four years of medical school. People were just wasting away, including my own Mother, one of the most beautiful women and humans I ever met...just no help. When you are the family member, it is awkward and sometimes dangerous to start those conversations with the ill person (I would not recommend that to anyone). I was a child and I told my Mother that she drank too much and that worried me that she was going to die and all I got was a good beating (I am talking about physical beating until I could not catch my breath anymore) and many more to come...my Father did not know about the abuse until a few years ago. So what we can do as nurses is intervene...they will listen and you never know, the time when you tell them might be the time when they realize that there is hope and help...I will not give up on doing it. I learned my mental health resources from dealing with substance abuse with a member in my own family (unfortunatelly) and I am using it. You never know...they might just snap out of it and get help.

I worked in a very well respected ER and I had to push a lot of Dilaudid. I did not like it then and I do not like it now. I don't like this drug and I do not like this idea, to give liberally to everybody, only so we can have "peace" and the patients moved out of the ER, out of sight... In the lunch room, I was constantly made fun of, that I am the one that wants to help "everybody"...so the addicts are not even considered people anymore. I spent a lot of time with the patients that I considered addicted and I advocated for mental help (I am a professional and I am trained to recognize abuse and I am not shy to intervene). I think that in two cases out of dozens I tried so hard to help, I maybe hit home, a former pharmacist and a young lady probably went on to get help. {I gave so many mixed meds to that lady pharmacist, that I was thinking, "my G-d, you can kill a horse with those", but it didn't do ANYTHING to her...I had a very strong conversation with her and her brother and both of them were crying and they thanked me, the lady said that nobody was ever honest to her about her drug problem and the brother said that nobody ever even started a conversation about that...EVER...so they both decided that they would work together to get her professional help. I was crying too, but in my heart, I have a family member that is wasting his life in drugs, so I know the helpless pain to watch someone waste away their potential with meds abuse, that's why I don't want to just turn a blind eye to situations like this} Risking to be very unpopular, I did my best to help them. I was called by a doctor "compassionate" that I took as an insult first, he also added "we need people like you, too"...like I was some kind of weirdo being compassionate. But I know he meant good. I will not stop being honest and caring. I want to be able to sleep well at night. A story related to Dilaudid: A few days ago, I started my shift with a near code. I found a patient overdosed on Dilaudid and Methadone. For some strange reason, the patient was on those two meds in the same time (and a few more and I said to myself when I read the med sheet..."HELL NO!!!", probably miscommunication? (I was not even considering giving her so much stuff and such crazy combination, even if she would have been bright eyed and bushy tailed; I found her like that in the beginning of the shift). She just had a pain pump with Dilaudid implanted the day before, the pump was on and she just got overdosed during the night. She had very deep respiratory depression, still arousable, but had to be commanded to take every breath. We gave Narcan and her respiratory status improved at once, but the withdrawal symptoms kicked in so bad, that she needed to be transferred to ICU. Thank G-d we were all there at the right time, the doctor was very fast and agressive in treatment, the RT was wonderful, the charge nurse, everybody was just wonderful. I checked on the patient later in the day in ICU, she was very grateful to be alive, the pain pump was turned off, she was very scared and depressed, but well for being so near to stop breathing and all. Just another sorry Dilaudid story...and I have so many others...

Keep it up!!!!

Roy, very good post!!! It should be in an ER manual, like "Survival Guide for New ER Employee".

I went from ED to med surg and believe me, I felt like a new grad. It is only about how much you like what you are doing and how willing your co-workers are to accomodate/teach you. It is normal how you feel and it is great that you have med surg experience, you will know what to ask the ED docs to order for the pts that go upstairs and stuff (prn's etc.), you will always give good/useful report to the floor, because you have been there. And the rest, you're learning now. Enjoy emergency room, there is nothing like it. My friend that's a nurse for 18 years told me about the ER: just take care of one patient at a time and prioritize...she must know what she's talking about. I had my own strategy in ER: "keep your eyes on your patients at all times". I did feel that I didn't have enough time with them, but thinking retrospectively, I did. And I even meet a couple at the grocery store and they told me that I was so good to them...see, they remember you. A doctor at another facility embarassed me, he told me in front of the whole trauma team that I was the nicest RN at WBH, because I taught him how to draw blood...it made me blush. You will be OK. Don't chicken out! That's how you say it? I am a foreigner and I don't want to say funny/innapropriate things. Do your certifications as soon as you can, they say at least 6 month, but if the hospital doesn't want to pay, you pay for it, be smart. TNCC etc. and just take one day at a time. If you love it, stay!

It is so great that you made it!!! One more good person to take care of the ones in need!!! May you have a long happy career and a strong body!!! I know your mind is strong!!!

OK, you made me cry...you reminded me of all the memories that I carry with me but try to act like they were just a bad dream, in another life, in another country (I was a trauma nurse in another country). I can't remember a single name of a trauma patient that didn't make it, but I sure remember them...and it's been 12 years... Very good essay, you are a talented writer!!! You should publish this in many places!!! It really moves hearts.

This sounds like a dream job! I have came across a job recently in Kentucky, where they say nurses don't want to be, because it is a small place, but I would have been so happy to go there, I like having responsability just like you describe at your job. Of course, I couldn't get the job, it was a rapid response assignment and someone else got it. Where is Madison Valley?

I love your post!!!:redbeathe

I don't know the answer for your hospital, but when I hear "staffing", all I can think of is my last shift I worked (actually more than one shift I had this kind of ratio), FIVE patients on vents (some weaning, so needing even more attention, pulse ox is really not the answer for oxigenation in some cases), tube feedings (all of them), IV's and all the other good stuff, all conscious... and me, with one brain, two hands and a broken back taking care of them to the best of my abilities (with one CNA that was exhausted of how many patients she had, so I just left her alone, I didn't "delegate" anything on her, out of fear that she was going to have a meltdown and just collapse, I already saw her crying that day)...what were they thinking? I mean the people that gave me the assignment. I forgot to say, I also "covered" one LPN, that had 30 years experience...so I actually felt embarassed that I had to cover her, but rules are rules. In some cases it is just pure evil greed not to assure adequate staffing, I know a lot of nurses that are not working right now, because of the economy and it would be as simple as asking us, the nurses, for extra staff (we can call in our friend nurses to help when we are shortstaffed), but no, let's suck the juice from the limited number of nurses we have:bugeyes:...who cares about what can happen to the patients or the nurse?

I am very sorry that you lost your Grandma, at Christmas also...that manager will get hers, just feel sorry for her...what a ... When I lost my last Grandma in 2006, I found out at work, at Providence Hospital (I was a tech then), in the morning, I had a "little" panic attack (I could not stop shaking and crying), they sent me in the chapel to talk to the priest and after that they send me home for three days, nobody even asked me for paperwork and my Grandma was on another continent...later I worked so hard there, that I collapsed two disks in the same day and they let me rot with no medical help for one year, on Work Comp that didn't pay after one month...diferent things, different behaviours (good with me when I lost my Grandma, but very cruel when I lost my health, working hard for them). In between that job and today I became a nurse, I have seen so much disappointing stuff, that it makes me sick to my stomach. I have changed jobs, in order to avoid covering up and acting like other people, but basically it is the same thing everywhere...there are just two places I didn't try yet (two major medical systems), but they can't be any different. I am an exemplary woman, mother, nurse...but those are not qualities that they are looking for. I am doing agency now and I had my share of disappointments here, also...a funny thing...at Christmas, patients kept giving me candy, notes etc. the other nurses hated my guts...you get the idea...and I never mistreated any co-worker in any way and I am just myself with the patients, I never kiss up, I just genuinely care about everybody and treat them with utmost care and respect. Forget what the manager did and if you like your unit, stay...it is not a good time to move around. It is the same everywhere, the rat cage syndrome...the way we shoot ourselves in the foot in the medical field, it is not enough that there are not enough nurses, but the ones we have, let's treat them like garbage, so they can quit and we can be even more shortstaffed. Stay in your unit, if you like it, it is almost the same everywhere...

Beaumont Royal Oak EC was the most disappointing experience I have ever had as a nurse. I almost died there as a patient and years later I ended up working there...the lies, the gossip etc. of only a few people destroy the whole atmosphere... and made me quit. I would not take my dog there...sorry to say that. Crappy insurance, retirement, everything was just bad, nothing like the comercials on TV and radio. I miss the nice people, the wonderful 480 people (aprox.) and still I am glad I got away from the miserable 20 nagging nurses that made working there hell with their terrible attitude. The doctors were very nice. The pay was one dollar higher than any other place...but again, who wants to lose their sanity just to say that they work at Beaumont EC?

If it has been an internet email chain, you better believe it, by now there are a lot of cute Le-a cute babies. Because the spelling is pretty creative. lol Something unrelated to this thread, I have had the absolute ROUGHEST year of my life as a first year nurse (it is never patients, patient load or doctors, but it is always the few disgruntled nurse co-workers that seem to hate their life, I am sorry if I am offending anyone). When I found your website and read a lot of the stories I felt a little better about everything, so thank you, fellow nurses, I know I am not alone. I took a few decisions in the last few weeks, like going back to school, graduate this time. But I know now that I will survive the rest of the time as a nurse, because I really love doing it. Thank you everyone!!! :redbeathe