BobbieJo

I guess I did not state my question very well. This particular patient I am talking about had several prn meds. Just because the doctor ordered all of these particular meds and the pharmacy has placed them on the MAR does not give us the right to give them a hand full of prn meds at one time just because they requested them right? I understand that this patient has probably built up a tolerance for these medications. Isan't it our responsibility to not overdose our patient knowing the affects of these prn meds. I am accountable and responsible for my patient even though the doctor has written numerous prn orders. So am I not liable for my patient when respirations are 8 per min due to all of the prn meds as long as I only give as ordered?

I am struggling with some ethical issues of administering large amounts of pain medications and muscle relaxants to pill seekers. I know we have been taught to not judge others pain. I am sure almost all nurses have experienced that patient who knows each and every med they receive and when it is available. They are on the call light constantly requesting one medication after another. Due to my personal feelings, I find it difficult to continue to administer multipule pain medications with muscle relaxants and CNS depressants. I know some people have built up a tolerance for certain medications. How do you set aside your own ethical feelings and do what the doctor and patients want. I worry about my patient coding. I have educated my patients on the effect of the medications on HR and respirations. These particular patients have already heard the lecture and continue to request what ever is available. I feel like an enabler. I have worked with nurses who say "give them what they want."

I was an LPN for two years and I am graduating in just a few days with my RN. I definately learned so much more of nursing in my RN program. It was more difficult then the LPN program. The LPN gives you the foundation but the RN program had you look deeper as to the question "why". My critical thinking skills, organization skills, and just my overall thought process has improved. It was difficult working, raising a family and going to school. I finally had to reduce my working hours. I believe it is going to be well worth it.

Thank you everyone for your encouraging words. You are definately right that at my age, I actually know where my passion is. I have been told by others that it is hard to get into a specialty because the turn around is minimal. Very difficult to find an opening. I think I will keep my current job while applying for openings in labor and delivery and the nursery. If nothing turns up in the next six months, I can always start out in the med surg to obtain better assessment skills. Thank you all again. Sincerely, Bobbiejo

I am an LPN and I am just about to finish my RN is a few weeks. I work at a Rehab facility, mostly ortho. I have always wanted to work with newborns. I thought I would be delivering babies. Talking to other nurses, they say it is important to work a few years to get the med surg experience. I am almost 38 years old. Is it so important to get this experience when I believe I want to work in a certain area for the next 25 years? Is it a bad thing to specialize in one particular area. I would love some advice. Thanks. Bobbiejo