leyaussie LPN

Pain med administration, OH what a subject. Having been a nurse for 38 years it is quite clear, if it's ordered by the physican, the pt. c/o pain, the proper nursing assesment is made and vitials are WNL I administer the medication as prescribed leaving all personal judgements about addiction aside. It is not or has never been my job to prescribe the medication, therefore I administer as ordered and requested by the patient. If a pt's need for pain medication is questioned, as many times myself and my co-workers have discussed, assessment and documentation are a must. Many times a pt. will request increasing or decreasing a prescribed dose. As we all know we can educate the pt. reguarding pain med administration and titration then document our findings, this will ultimetly assist the physician in making the decision in what is best for the patient. That is what we all want as medical professionals, that which is best for our patients. For me personally the comfort of my patients is a primary concern, especially in an area of rehab. The more comfortable and pain controlled the patient is, the greater cooperation and recovery. I have even encouraged a pt. to take his/her prescribed pain meds to enhance their participation in therapy, therefore many times expiditing their recovery. On the other hand I have seen aquaintences, Dr. shop or make unnecessary trips to the ER to obtain pain meds. This ticks me off. Not only are they wasting the medical staffs precious time, but they totally make fools of themselves. The ER staff pretty much know who the frequent flyers are and those who are only there to seek pain meds. I have seen many a pt. leave the ER in a huff when they are not given the meds they wanted when they came in. When the so called patient is in the ER, VS WNL, sitting up, asking for food because they have been there for hours and not given anything to eat then when asked what their pain is on a scale of 1-10, and it is "10" I have to laugh to myself. But then too communication and documentation is key. The look on their face when nothing is found and they leave the ER with a recommendation for APAP q4 or a script for Motrin is PRICELESS. In any event, as much as we all hate all the documentation we have to do it and do it well...documentation is our friend, and can protect us in questionable situations!

If you've been waiting since June 20yh, I'd say it is time to move on. You didn't mention where your from, but in some parts of this country jobs for LVN/LPN's are hard to come by. Are you really afraid of losing your "skills" by not working? I would say to accept a job, do it to the best of your ability and gain the skills you will need to eventually become a seasoned professional. As a new grad you have many skills yet to learn...

Even a temporary per diem will add to your experience and look good on a resume. What's more is that these types of jobs enhance your organization skills, and your ability to think on your feet. It also increases your "contacts"in the medical field. Give it all you got, don't be afriad to ask questions and become part of the team! Congratulations, your journey has just begun!

Now I'm going way back to 1975, my 1st job in an SNF. I had a patient who only spoke German and suffered from advanced Dementia. Us nurses had to be very creative when giving her Insulin. This poor woman would bite, spit kick, punch and swear at you in German! As I greeted her when I entered the room, explained in English that I would be giving her insulin, I quickly uncapped the needle and proceeded to give her an sc injection in her left arm. Before I knew it she had my arm twisted, call me a Swinhnund (sp? Dog in English)& while spitting on me, grabbed the syringe out of my had and stabbed me with it. Needless to say after all the "needle stick" protocol, we all had a good laugh!

I have been a nurse for 35 years. You can imagine my shift routine has slowed down a bit over the years. But, I was taught you NEVER leave until your work is completed no matter how long it takes. I work in a Rehab, connected to an SNF. The daily routine changes with admissions, discharges, family questions/requests, PT/OT family meetings etc...You can be 100% sure when I leave, ALL my work is complete.