rninmi

This has come up a couple of times at my acute unit....Amio is hepatically cleared. I am told it does not dialyze out by several physicians. Including pharmacists. The problem is it seems as though it does at times. Pt's on amio gtts are on it for rate control and rhythm control.....may have chf, myopathy, valves etc...usually unstable pts to begin with....so........put them on tx, try to uf a little bit and bam.....v tach, ectopy, hypotension the works. So it begs the question: is it b/c some of the Amio dialyzes out or b/c the pt allready has a bad heart and cannot handle the stress of dialysis???? One option that has worked on SOME PT'S is to try crrt/sled txs??? If the rhythm stabilizes and you are able to pull fluid than that may be best for these pt's. Good topic, like I said it has come up a couple of times where I work.

I work for an acute facility in MI. It is Davita. We get paid hourly. I am at the top of scale at $35.50. Pay per tx is risky....I have seen people make 100K or 40K...all depends on how fast you are, the census, and length of tx.... Fresenius has a contract at a smiliar size hospital in this county and they paying peanuts....actually insulting to their nurses. I know because we just hired 2 of them. They were paid per tx, and it avg. out to like $25/tx. Sad. Very sad.

Sorry, been off the site for a while...so what happened? As for your question of inpt vs iop....like everyone has said...each case is different. Typically with a relapse (which you have had)...they "up" the level of care. In your case it would mean inpt....DON'T LET THAT SCARE YOU!!! Let us know what happened???

I live in Michigan as well. Was diverting..got caught (everyone does inevitably). I did not deny it though when confronted. My suggestion is to call your employer, ask if you have a eap and admit what you have done. From there, your hospital may suprise you and work with you if you are willing to get help. Mine did. If not, then go self report with hprp (the monitoring in MI). The phone number is 1-800-453-3784. The website is www.hprp.org. Some things to expect when self reporting. They will probably want a inpatient stay, then 8-10 weeks of iop. It is typically a 3 year contract with drug screens, group meetings the first year, quarterly reports from worksite monitor, addictionist, and sponsor, narctic and overtime restricitons for usually 6 mos. The good news is you do what they say, when they say, how they say and you are able to work! Your license is safe, no record at all...as long as you are being monitored by hprp. I believe hprp destroys their documents after 7 years also. It sounds like alot....and it is....but trust me, it is so much better than the life you were living. Please call them TODAY.....you can continue to work and dodge the state but it WILL catch up to you. Get help today, I promise you, one addict to another, you cannot do this alone. I hated, I mean hated the program, but it saved my life and my career. Without it I would be on heroin, homeless or dead. In retrospect, now I see it was allot easier then the lying, manipulating and conning I did for years supporting my addiction. Let us know how it goes, good luck and God bless

Had an incident today that kinda has me freakin out! Need to vent.....A little HX....I have been clean for 5 years this fall. I went through my state's monitoring program and have completed all the requirements. I work for an acute dialysis program. Now the scary thing...I get a call from a pharmacy asking why I called in a RX for Norco on a pt "x" under Dr. "Y". I have never heard of this pt. I do work closely with the doctor. However we 1. do not call rx's in in the acute setting and 2. I do not know his DEA number! The pharmacist had a caller ID from where the call came in and gave it to me. I, of course, called it and the voice message identified it as the same last name as pt "x", different first name. Allot of things don't make sense....1) How did this person get my name: "Andy from Davita". 2) How did they know this doc's DEA number. What bugs me most is I am finding myself defending myself even though I didn't do anything! I feel really weird now considering I diverted massive massive amounts of dilaudid from several hospitals in the state in the past! I immidietely called my boss and the doc. The doc did not recognize the pt, and we searched all of our chronic units and that name did not come up????? Should I be worried, why do I feel weird? Any suggestions? Thanks.

I work for Davita...Worked in 3 different hospitals in ER/Critical care over 10years before going to dialysis. Davita is a "for profit" company. It is on the NYSE and is publicly owned....so it is what it is. The budget is the bottom line, PERIOD! I get paid more than any, I MEAN ANY OTHER of my other colleagues by quite a bit. I have looked at the other local hospitals and have talked to recruiters and I could not come close to making the type of money I am making right now. So....short answer is that most of what you have heard is true. But take it for what is worth. If you want to work third shift, every other Sunday and most holidays then go to a hospital. If not, try it! Lastly, one piece of advice (i know you did not ask for it) is why dialysis right out of nursing school? You really should develop and experience a more rounded field (floor, icu, ccu, sicu, er....) Dialysis is .....dialysis! You will only learn dialysis! Good luck

If you feel comfortable, can you tell us a little more about what happened? I personally do not know what "ipn" is? I am sure others do. Is it your state's monitoring program? In MI it is called HPRP. Share what you are comfortable with. This is a great site and people will share their strength, experience and hope I am sure!

Jack, I like this better than the Betty Ford definition. Good question though...what is recovery? For me it meant 1. Abstinence from all mood altering substances (including etoh and/or rx'd drugs) 2. A change in the way I think! I don't have a drug problem, I have a thinking disease.....Every night I thank my higher power for keeping me clean today, then I take my 10th step inventory and see how I responded to people, places and things...how could I have done better, what will I do to change???? I can tell you this that after a short 5 years my response, the way I view people, myself and "things" have changed dramatically. Because of "recovery" I have completely "overhauled" my brain. I see things differently now. And because of the steps I learn something new every day. I make mistakes and I hurt today, I laugh, I cry and I experience raw, life emotions....I get to experience "life on life's terms" WITHOUT the use of a mind or mood altering substance to help me get "numb"...that is recovery for me! :wink2:

I agree completely, good point. I think that is why my friends have not been able to get off of it. That is the only tx they are pursuing! You have to pursue your recovery in EVERY Aspect. Thanks for that good point.

I'm just gonna throw this out there....Not intended to start an agrument or anything...but this is my thought. I completed my 4yr contract about 5 or 6 months ago. I have considered a job change at times and have "daydreamed" about the interview process and how nice it would be to interview as a "normal" rn and not divulge my past mistakes as I did when reapplying after losing my er gig for diverting.............. I don't see the validity in divulging my addiction/recovery with the HR department??? Why???? We treat this as a disease, and I believe most everyone on this site would agree it is a disease....if i have diabetes, or htn or whatever... should I divulge that? Now, the answer could be..."yes but those diseases do not have the ability, or potential let's say, to impact patient care"........I would agree....however if my disease of addiction is currently in remission and I am currently receiving the recommended tx to keep that disease in remission, then am I a threat, or better yet, is my disease a threat? I say NO! I just don't see the point of divulging this info at THIS STAGE (INTERVIEW STAGE)....Now, once hired and once relationships are established if I am comfortable with sharing my recovery, my strength, experience and hope with those I TRUST, then my all means I will, (and I have)..... Am I "ashamed" of my past???? Good quesiton! I stole, I lied, I manimpulated, I denied patients.....let's see.... some shame, YES! Do I allow that shame to haunt me, to impact me? NO!!! I am in recovery, I am clean today and I have made ammends to those whom I could...... Good luck.

I love it!

"yet...." That is what I would always say at meetings when talking or saying something like that. We need to relate, not compare with other addicts. The end result is the same....."jails, institution or death" or....thankfully "recovery". I would find myself saying things like "I never stole money to buy drugs" or "I never bought drugs off the street..." Someone helped me by finishing those statements with the word "yet".....Eventually I would have done those things! Left unchecked addiction knows no boundaries and will cause us to do anything to anyone to keep it going.

My last reply was removed because it was taken as an "attack"....for that I appoligize. I used a term...that term was not meant as an attack...rather I was using it in its purest definition. Allow me to rephrase. The above statment indicates to me that you have a "lack of knowledge or information or are uninformed on a particular topic" (the dictionary definition of my original "attack"). My no means am I attacking your character....rather It appears that some people do not understand addiction and how the addict needs help. Loosing their job "forever" is not the answer! Countless recovered nurses (myself included) have proven with rehabilitation and close monitoring we can and do recover!

I love it....I love the fact you give thanks to God still 17 yrs later....I am approaching 5yrs clean and hope I still remember who took my addiction away....I relate to your prayer....So many days I would actually walk the aisle, kneel down and beg God to help me not to use only to be in the bathroom w/a needle hours later that same day! It wasn't until I surrendered.....I mean really surrenedered on a bathroom floor in a detox unit in between the shakes and vomitting...I finally met my God. I finally surrendered and started a relationship with a very very very real compassionate God who was just waiting for me. I had to my work, I had to not pick up, go to meetings, and start repairing the relationships I destroyed...but God was there I felt Him and He eventually took the overwhelming desire to use drugs away. Thank you for you gratitude and for your post! Congratulations

I think it is all individual...I experienced the exact same thing you are going through...shame, guilt, self pity, resenments....I also worked for 10yrs in ER.....Now today, 5years clean would I go back and work ER? Not sure...honestly I am scared to find out! I LOVE ER...I MEAN I LOVED IT!....but is that worth my soberiety? Not just er....any setting with access to narcotics. It required allot of humility to admit I was not "the man"...no longer one of those cocky er nurses....but it was a huge part of my recovery....after about 3 yrs I learned my job does not define me! I would like to think I could do it and honestly, probably could....but I have found a job that pays well, I get to use critical care skills (not as much, but still do sometimes) and has awesome hours. So for me I am not ready to risk going back to that setting, working midnights or second shift, having time alone away from support system.... I watch the helicopter land all the time as I sit in the icu and dialyize my pt....I get bummed out, start feeling guilty, and sorry for myself, then I look at my tattoo with my clean date and realize it's not worth the risk.... Think about dialysis.....not the chronic setting....try acutes....that way you are in the hospital and will still get to see sick patients (occasionally)....it pays well, hours good, and always a demand. It is one of the more "recovery friendly" fields.......