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medical floor RN

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  1. BluegrassRN

    Life and Death

    The OP is writing from a surviving friend/family perspective; not from a suicide attempt survivor's perspective. Since nursing includes caring for the patient and their family, it's a valid, if incomplete perspective. A close family member attempted suicide recently after months and months of debilitating depression. As she describes it to me, it wasn't about punishing anyone or about how awful it would be to her family and friends. She seriously was so severely depressed, she couldn't eat, she hadn't slept more than 3 hours a night for months, she said it was like this black fog followed her everywhere, engulfing her and sucking any joy and energy out of her. She said she attempted suicide after she'd tried to reach out and get professional help, but the help didn't make her feel any better. Her mental pain and suffering became too much to endure, and she literally could not imagine it ever getting better. She couldn't think about how her actions would hurt others, she really just wanted the pain to end. I used to think suicide was selfish, but after her attempt, and my involvement with her recovery, and my own reading and research, I've come to conclude that it is not. It is an act of deep and utter misery and desperation. If I allow myself my own selfish moment, I think "how could she have done that to me and my family? Didn't she know how terrible that would be for us?" The answer is that,no she didn't. Just like someone with horrible physical pain can only concentrate on that, and can't (and shouldn't) be worried about the emotions of others, those with mental anguish truly cannot see beyond their pain. The family and friends of suicide completers are experiencing a similar pain and guilt that the family and friends of other people who have died, particularly those who died in a violent or self induced manner. It's not any better or any worse than the pain felt by the families and friends of the victims of the Boston bombing, of those who die in war, in car wrecks, of etoh poisoning, of drug OD. It's simply painful to lose someone you love, and when you feel like the death was senseless or preventable in some fashion, it hurts all the more.
  2. BluegrassRN

    The Slow Code: Justified?

    I feel like a slow code is a myth similar to "pillow love". I have not actually ever smothered a patient with a pillow, and I have never given less than 100% in a code. I may utter the phrases "pillow love" or "slow code" under certain circumstances (making a macabre joke with coworkers, for example, out of hearing of any patients), but the idea that anyone actually does these things is completely unbelievable. I don't believe a slow code happens with any more frequency than the murder of a patient by a nurse. Now, I have participated in codes that didn't last very long, because it was obvious the person wasn't coming out of it. But even the shortest code I've ever seen lasted over 10 minutes.
  3. BluegrassRN

    Do Nurses Earn Big Money? You Decide.

    I have the best income and job security amongst my peers. No, I don't make 6 digits. I do have a few friends who do or have made the true "big money". Two are now out of work (insurance industry), one of whom has lost their home and is close to financial ruin; and two work 60-80 hour weeks in the investment industry. I work three days a week. If I worked 10-12 hours days 6 days a week, I'd make a 6 digit salary, too. I don't want to work that much. My only acquaintances who make more than me either have more advanced degrees (with larger debt) and/or have a job where they work longer hours, or have an unstable employment situation. So, yes, in the grand scheme of things I think I make big money. I certainly make enough money to have a decent home with a modest mortgage, drive decent cars, not worry about where the next meal is coming from, live debt free (except for the mortgage and that will be gone in 12-15 years) and I've put some away for retirement and for my kids' college.
  4. BluegrassRN

    Nursing Interview Questions (Part 2)

    See, now, I think there are more of us women who appreciate this sort of personality than you realize. I'm blunt, I'm low drama, and I don't particularly care what people think about me. I mean, I'd prefer that patients like me, but mainly because that means they are more likely to do what I ask them to do and not be difficult. I am definitely a Ron Swanson type of gal. So if someone came into an interview and said something like; "A weakness I can self identify is that I have a blunt, up front, low drama personality. I know this can come across to some patients and coworkers as uncaring, and I know most people expect their nurses to be touchy-feely types of people. I am not that person, but that doesn't mean I'm uncaring. I know, though, what my patients are expecting, and I have been working on my communication skills. I do care, and I have been working on showing it when I communicate with my coworkers and patients." I'd hire that person over the one who says her greatest weakness is that she cares too much. Barf. Nursing units have too many martyrs and too much estrogen as it is.
  5. BluegrassRN

    Appropriate questions.

    I also just wanted to add that I worked for several years in a women's health office that was well known among the lesbian community as accepting and supportive. While some people may have lied or felt uncomfortable with the question, I suspect most were honest. I know some were relieved to have preference neutral language on the intake forms and to have their orientation treated as a matter of course, not as something strange or weird. Questions in the physician's office are going to sometimes be private and occasionally of an uncomfortable nature, but that doesn't mean they are invalid or improper.
  6. BluegrassRN

    Appropriate questions.

    High risk sexual behaviors are okay on a permanent medical record, but sexual preference is not? I agree that assessing high risk behaviors is important, but I think it's also important for a provider to ask sexual preference. Gay or lesbian does not equate high risk; but as a provider it's important to know. For exame, it's a waste of time to introduce or educate a lesbian on birth control. Gays, lesbians, transgender and bisexuals have some different health risks than their hetero counterparts, and part of treating clients appropriately is knowing their sexual orientationandpreference.
  7. BluegrassRN

    Asthma care question?

    What are some causes of poor air quality in the home? While some of these may not be modifiable, particularly for low income clients and renters, others are.
  8. BluegrassRN

    "Noting" orders in an EHR does it have to be done?

    I don't understand the point. Our doc enters the orders, and pharmacy verifies all med orders. This then *becomes* the EMAR. There is nothing to note. The physician order and the pharmacy verification are one and the same. There is nothing to note. There is a "confirm" button for the nurses, but it's merely to make us aware of new orders. Either the hospital administration don't understand their own computer system, or the computer system is set up so poorly that there are two separate sets of orders being generated, which defeats the purpose of having a physician actually responsible for his own orders. Either way, what a waste of time.
  9. BluegrassRN

    ER doc describes Joplin tornado, aftermath

  10. BluegrassRN

    Drug seekers

    Drug seekers? How many drug seekers are addicts, and how many have uncontrolled or minimally controlled pain? What constitutes a "drug seeker"? Do you think people who abuse the system now are footing their own bills? Do you think all abusers of the system are "drug seekers?" What sort of free health care are you speaking of? Medicare? Medicaid? VA benefits? The poor who use the ED as a primary provider? Taxpayers and people with insurance always have and always will foot the bill for those who cannot or will not pay. Nothing new there. Addictive behaviors are your job security. I'd wager food and nicotine addictions count for more admissions on my floor than drug addictions. If people didn't smoke and weren't fat, we'd have far fewer nursing positions. I honestly don't see many drug addicts. I see many people with chronic pain. I see a whole slew of COPDers, most of whom smoked until diagnosis, some of whom continue to smoke. I see a lot of diabetics and heart failure pts who continue to be noncompliant with diet and/or behaviors such as smoking and exercise, resulting in repeated admissions. Shrug. It's human nature, and the nature of your chosen profession. Humans are complex animals, and it's difficult to be so judgmental when so few of us are perfect creatures. Good luck in your future profession. I hope you continue with the critical thinking and dialogue, but lose some of the judgmental ideas, or at least develop an appreciation for the complexity of treating pain as well as addictions.
  11. BluegrassRN

    Need Opinions on Med Bar Coding Systems

    HANDHELD!!!!! Sorry, I've done clinicals/worked at places that had COWs and/or computers in every room, but in my opinion, handheld is the way to go! I don't know the brand we use, but it's the same that FedEx uses.
  12. BluegrassRN

    Do you interrupt report to give pain meds?

    We just started it about a month ago. Patients really like it, and most staff likes it, too. It has actually shortened report time for me...I don't care what the pt's diet is, how old they are, all that repetitive info that some nurses like to give but I can get out of the chart faster than they can say it. I just need to know what happened that shift, and any major issues. I also have already eyeballed my pts and let them know to call if they need anything, so I don't feel so rushed in that first hour to get in to see everyone. As to the original subject, no, I do not interrupt report to give pain medication. If I interrupted report every time the call light went off for some request, it would be a very long and fragmented report, which is *not* safe. Since we give bedside report, if the pt calls before I go into their room for report, I'll take it at that time. If the pt calls after I've gotten report....well, if they weren't in pain 3 minutes ago when I was in the room and asked if they needed anything (and I always specifically ask if they are doing ok on pain), it's not that urgent and can wait another 10 minutes.
  13. BluegrassRN

    Sharing Prescription Drugs

    Okay, I was thinking "Skelaxin" not something like ativan or valium. Still, 5 or 10 of ambien is quite a bit different than a valium. And you're right, nothing like a benzo showing up on your drug screen!
  14. BluegrassRN

    Sharing Prescription Drugs

    Really? Well, report me and mine. Back when zyrtec was prescription only, sometimes on really bad days, my hubby would take one of my daughter's zyrtec pills. I hurt my back and had ultram for the first couple of day, and hubby took a left over ultram when he had a migraine. Knocked him out, he woke up great. Hubby had knee surgery and only took 4 of his 12 lortab 5s. They're in the back of the closet, in case anyone turns an ankle (We're a very active and sporty, but very clumsy family). When my brother suddenly announced that he and his wife were splitting up, and the next day my grandma got admitted to the hospital for sepsis (she had pneumonia and UTI), I ordered my mom to take one of my dad's xanax and go to bed. She had an appointment in two days to see her doc for depression, but she needed some sleep right then. She wasn't in danger... she just needed to calm down and sleep. She took, on my recommendation, a total of four xanax in the two days prior to that appointment. She shared that with her doc, as well as the fact that my dad usually just takes one or two a month, and the doc told her to just use my dad's supply unless she feels like she needs more than a total of 5 in a month; then she needs to call and get a script for her own. So I guess you better turn my mom's doc in, as well. People need to understand that meds all have corresponding contraindications, side effects, and interactions. But really, people share meds all the time. Rather than freak out, it's best to educate people on their meds, what they do, why they're prescribed, and why it's best to typically not share them. Sharing does occur, however, all the time. No need to burst a vessel or wring your hands over it. Mainly, your friends probably needed to know that ambien and a muscle relaxant are two completely different medications, and the effect on your friend who forgot her ambien might not be the effect she was looking for!
  15. BluegrassRN

    I hope I don't offend anyone, but....

    NO! It cracks me up every time I see it. Turd Ferguson was my father's "catch all" name. If he were frustrated at someone, he'd refer to them as Turd Ferguson, as in "The doc told me I needed to stop smoking and lose weight. Tell me something I don't know, Turd Ferguson!" He'd also use it in place of "Joe Blow" or simply "someone," usually in a bit of a pejorative manner. "I was getting gas, and Turd Ferguson drove off without disconnecting from the pump. G^%$#(* gas sprayed everywhere. " "I was driving down 24th St, and Turd Ferguson ran the stop sign at the corner. Then he had the nerve to yell at me when I flipped him the bird!" When I was little, I thought there was some jerk in town named Turd Ferguson. I was probably 10 before I understood how my dad used the term. I don't know where the phrase originates, but I'd completely forgotten about this little characteristic of my dad until Turd started posting here. Don't change your user name!