grannyrn65

You must have been taught the same thing I was 'pain magically disappears when the broken bone is set':lol2:. Unfortunately it was a big lie, as we learn :crying2:. Have faith, the pain will resolve itself. GrannyRN65

I think your comment about the dilaudid is right on point. I was a nurse for more then forty years. And I am sick and tired of nurses appointing themselves as the final arbitrator in determining if a patient has pain or not. Everyone copes with pain differently. A patient may be able to smile and joke and still experience pain at 10 out of 10. Or may not have the changes in vital signs that so many seem to rely on. Pain is what a patient says it is. You do not have a role of deciding in pain medication is warranted or not, especially when you use all the subjective signs that so many nurses do. If the patient is drug seeking, so what. You denying him a drug that is ordered is not going to suddenly make him stop seeking drugs. If I sound like I have a vested interest, I do. I avoid going to the ER for any type of pain relief. I found out, a long time ago, my peers sit in judgement of anyone who comes into THEIR ER for pain medication. Unless they have a broken bone, multiple lacerations, with bleeding or an acute belly, they are going to be labelled as drug seekers. I suffered a badly broken ankle sometime ago. I fell in my home, had to scoot on my rear end out from my bedroom to my living room, to get to the phone to dial 911. Then I had to wait all most one hour for a rescue squad to become available. The local cops arrived shortly after I placed my call and they helped me to focus on things other then the severe pain I was in, thank them very much. The paramedics came, started a line, gave me MS and transported me. The physician head of the ER, ordered more MS, before having me transported for x-rays. I went home, in a cast and very mellow and not suffering from any pain until several hours later. Heaven keep my peers who think they can determine the degree of my pain, far, far, far from me. And other patients. No, your comment is quite on point. As for those who believe they are the gate keeper or have some divine guidance in determining if a patient is truly in pain, hope you some day experience what you so freely dish out:yeah: GrannyRN65 ducking down behind you-you make a bigger target them me:)

I live in SW Florida and my primary care physician and his group practice have ine for their patients. They get a finger stick and adjustments in dosage are made. I went for a year. Their clinic made my life simplier. GrannyRN65

I am not a CDNE but I have been on insulin, for ten years, treating my Type 2. It depends on how 'brittle' the person is, as to whatever or not you give the four units. Unless the patient is extremely brittle, I would give the insulin and monitor the patient. If the reesident said 'what do you think', I'd tell him to check with the attending. GrannyRN65

Private rooms are the exception rather then the rule in my community. Private rooms are limited to patients with infections or immune-suppressed. I don't view semi-private rooms as invitation to cross contamination. If someone acquires an infection, while an in-patient, there is a break down in universal precautions, which can be traced back to the staff and/or physicians. Sorry but this is true. And without a statistical study, performed by the infectious disease nurse, I doubt the truism of less infections when in a private room. I have shared my experiences as a patient and the number of times I had to ask everyone to wash their hands before touching me. Not only do physicians fail to follow correct procedure but so don't the RN's, LPN's and CNA's. So a private room would offer little protect. Shift changes occurs at 7AM or 7PM. If there are visitors, they are asked to leave the room during report. The physicians that care for me, as well as other physicians,all make early rounds. It would be nice to have a private room. But then I wonder if administrations wouldn't use the less patients to lessen the number of staff they employ? Given the fact that baby boomer's are now hitting retirement and Medicare eligibility, as well as the expected impact of the health care reform bill, I think more beds will be need, rather then fewer. And not that many facilities can afford the capital expense of major expansion. GrannyRN65

I haven't ever had a physician swear at me but I did have an attending act rudely to me, in front of my staff. I did accompany him to see his patient, then asked him into the break room. I told him that I didn't appreciate his rude behavior towards me. And informed him the next time he acted in such a manner, I and my staff would ignore him. He apologized for his behavior.:) If I ever had a physician swear at me, I would have told him when he improved his lanuage, I would be happy to assist him. Swear back or acting inappropriately just drags a nurse down to their level IMHO. GrannyRN65

My Primary Care physician has admitting privileges. I knew he would be out of town over the holidays. When I was admitted, I expected one of the other partner's to see me. I was surprised when the hospitalist showed up in my room. Apparently the office staff of the practice was surprised as well. They were informed that a hospitalist would be taking care of any admissions until January 4, 2010 ( I was asked by them how he did). My hospital is in-network but the hospitalist is not. They do their own billing, separate from the hospital. They finally paid a portion of his claim. I paid what I figured was fair. He has objected.

Last Christmas I was admitted and my entire stay was managed by a hospitalist. In general, I have no complaints about his care. And it made it simpler for the nurses to contact him when I need medication or my condition worsen. My Primary Care is a member of a seven physician, two NP's practice. Previously, who ever took call came into the ER to admit me and write orders. My stay was covered by who ever had call that week. I also had no complaints about them. I did have a complaint about was their billing practice. I am covered by PPO Medicare. Humana does not cover a hospitalist or so I was informed when I first contacted them. Then they said they would cover at out of network rates, which left me holding the bag for a hugh hunk of change. I finally got them to agree to pay in network rates after telling them I had no choice in the matter, the hospitalist was covering the practice. The hospitalist billed me for what was left but I only paid him the percentage I would have had to under Medicare. He is still after me for the rest. Hope he gets it. I am not looking forward to this Christmas. I was admitted because of an asthma attack. I went to my daughter's that morning and she has cats, triggering my attack. I had been in a disagreement with Humana because they will not authorize my singulair, which stops my attack in it's tracks. She still has the cats. Humana still will not authorize the singulair and I am looking forward to spending Christmas afternoon in the ER. If admitted, I'll be under the care of another hospitalist. I had all ways worked in teaching hospitals with residents. Down here, outside the major teaching centers, there are no house staff. I view them as being a means to an end. Providing in house care at the expense of the patient's pocketbook. I am assuming they don't fee split because it would violate regulations. I do wonder how they bill Medicaid?

To answer the question about the packing, which my daughter did ask, 'it was falling out, it would have continued to do it.' end of explanation. When I worked on a floor, I never removed a dressing, an IV or a foley, unless I had an order. The exception to the IV was when i was infiltrated, it was removed and restarted. I do admitted I pulled a foley, re-inserted a new one; started two IV'; drew a number of labs; ordered two stat x-rays, while I was waiting for the attending to call me back. I knew him, I trusted him, and I knew he would give me the necessary verbal orders. I did it to a male patient who was a direct admit from home and who was circling the drain as I worked on him. I did it thirty years ago and have not done it since. I have never met a physician I could trust as much as this one. What happen to my daughter happens, sometimes with too much regularity. Nurses and physicians are rude, to patients, to families, to one another. I can accept rudeness from a patient and a family. I cannot accept it from other nurses or physicians. As I posted, I do not suffer fools well, especially when they are caring for me or a love one. I will let a student practice starting an IV or passing a foley or a nasogastric tube. But if a peer causes me pain and continues, after being asked to stop, I will not lie there quietly and suffer. No patient has to tolerate or accept sub par care and treatment. Nor should patients be label because they are upsetting us for some reason. I left my problems at home. I expect my peers to give me the same courtesy. I learn a long time ago that I cannot satisfy everyone but I can sure try, as long as I am the one providing the care. GrannyRN65

No, you are sharing your experience. And an illustration as to how one'sa words and actions can be misunderstood. GrannyRN65

I also have been a patient, as well as a staff nurse (including the one my daughter was in). I have received a wide range of care, from excellent to 'I wouldn't let them take care of my pet cockroach's broken antenna (also in the same hospital). I didn't jump to any conclusion, mainly because I have been a patient in all three hospitals in my county, in two in another and in one in a third. And my admissions covered a twenty year period, with multiple admissions for surgical, as well as medical problems. My daughter has been in the hospital a total of five times, in three separate states, in four different hospitals, with the exception of the birth of my grandchildren. There have been times when both I and my daughter have been label unco-operative or extremely demanding. And there have been times when I deserved such a label but more often then not, I did not. I have also been label a frequent flier, which I readily admit I am. Asthma tend to make you one. But I do not suffer fools easily and neither does my daughter. Explain what or why, if it is reasonable, you get our immediate co-operation. It was something I learn as a young nurse, patients will accept a reasonable explanation. And there are a few that will not. Those get passed to a supervisor or their physician, after I explain my reasons-it has saved me a lot of problems. And I make sure I chart the incident. Regarding the patient with the complaint about the IV. I have had K IVPB. It burns like **** and it is barely tolerable. If she was complaining because she couldn't wear her bracelets, you will never change her mind. Chart it and be done. And make sure you tell the powers to be. I don't believe my daughter was unreasonable. I think some reacted to her questions for an explanation. She did not take her issues to the nurse manager or supervisor, but she also felt she would not get a response to her issues. Her surgeon questioned her as to why she had demanded the removal of the IV and foley. They nursing staff apparently did not share her complaints, only her demands. I take issue with the staff for doing this. When she had a problem with one of my nurse's during a hospitalizations, she took her concern to the supervise and spoke to the DON, as well as the nurse manager. In general, the nurses at this hospital are good to excellent. They provide explanations and attempt to resolve issues. There are a few, who do not. And they apparently are all on the surgical unit. Nurses who failed to meet their patients needs, generally patients go home without complaining. They do complain to the members of their community. And those people come in, watching for mistakes. And they get label. It becomes a vicious cycle. There have been threads where nurses complain about their facilities make sure there is customer satisfaction. They and their facilities fail to see that those problems can be satisfactorily resolved if staff worked with their patients, instead of expecting everyone to follow their directions without question. GrannyRN65

I am not sure what you mean. If one is upset and angery about something, generally they may speak without thinking. My daughter attempts not to do this, really. The only time she made a demand was upon her discharge and for removal of the foley. Had I been there, I would have requested a nurse intervene, by deflating the ballon and pushing the foley more gently in(the neck of the bladder can cause painful spasms). Or checked the taping of the foley itself. If I were ignored or reponse delayed, I would havegone to the station. My daughter is writting letters. Her anger is very much in control. And she will be specific as to her complaints, as well as to her suggestions on making improvements. Not only is she my daughter, she was once a nursing student. For a variety of reasons she changed her occupational goal. GrannyRN65

She was not admitted to short stay but to the surgical unit. She was not suppose to be discharged until approximately 4PM the following day. She told them to get a discharge order or she would sign out. The order was gotten from the surgeon. She has informed me she will return to her for one post-op visit then never again. She, the GYN, never called her SO, who had to be in Court for a hearing. She had been given his cell phone number. She never learn that the ovary removed had a cyst the size of a baseball growing in it, something that had not shown up on the ultrasounds done previously. This surgeon did female surgery on me. She did not impress me as someone who welcomed in-depth questions from her patients. I saw her twice and never returned. I pay out of service fees, rather then see her again. I disliked her so, I had put her name out of my mind completely. I never made the connection til after my daughter's experience or I would have advised her to go to someone else. I have lived in this county for almost thirty years. The orthopods are excellent but I would not allow any other surgeon here near me. I have travel out of county, for surgery, to avoid them. Unless I am at death's door, I have told my daughter, take me out of this county if I need surgery, other then orthopedic. Don't get me wrong, my FPP is excellent, as is my pulmonary and renal physicians. And the physicians who took care of me during an unexpected stay in ICU, which included renal, pulmonary, GI and I.D. were all excellent and willing to talk to my daughter about my illness. Surgeons are an entirely different story. I talked to my daughter today going over the time line, looking at the IV site, looking at the small incisions, making sure she had no unusual discharge. Her IV was definitely infiltrated, it is still hard and quite swollen. I have put her times in my answers to your questions. I know my daughter can be a difficult patient but I do not think she was. Her roommate had a student and her care was very different, of course. To everyone else who has responded, thank you. I didn't think her care was that good but was willing to see what others thought. And to ignore my own prejudices. GrannyRN5

This past week my daughter had to go into the hospital for some female surgery. I didn't accompany her because her husband was able to and because she had been scheduled for 12:30PM. I called her, at 9AM to wish her luck, when my oldest granddaughter told me, her surgery had been moved up to 8AM. Unless something bad happened, I expected to talk with my SIL in the evening. Before saying anything more, my daughter does not like to stay in hospitals. She always ask for the earliest possible discharge time. She was admitted overnight. She saw a nurse when they made rounds to change shift 7PM. And when she asked for the foley to be removed. No one check her op sites or her packing. And when it half dropped out, the nurse grabbed it and jerked it out. She did have an IV but it was never checked. It inflitrated and she had to call for someone to remove it. Needless to say, by 10:30AM she was ready to flee. I haven't worked on a surg. unit in twenty years but I am appalled at the lack of care she received. Because this hospital is a for profit I am encouraging her to write a letter to corporate headquarters. I was a patient, in the same hospital last Christmas. And I received excellent care. My status was assessed several times a shift. I saw my nurse regularly. My care was excellent. Is the norm for a surgical unit or an overnight patient? GrannyRN65

Unless this patient had given the poster permission to post what she did, the poster is in violation of HIPAA regulations. Just because a person is open about health problems, this does not mean thatt she has given blanket authorization to any health care worker to post anything about her on a board. She cannot even ask if the woman was in her ER, she is revealing confidential, protected information. GrannyRN65