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Munch

Munch

Med-Surg/Neuro/Oncology floor nursing.
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Munch has 10 years experience and specializes in Med-Surg/Neuro/Oncology floor nursing..

I work in an inner-city teaching hospital in New York City. I work Neuro med-surg. I have previous experience working oncology and regular med-surg.

Munch's Latest Activity

  1. Munch

    100 mile commute. Worth it?

    If the commute is your only concern I would take it. 50 miles isn't so bad. I commute daily from the suburbs to the city 45 minutes to an hour each way. Most of the time I take the train though do to traffic. But on days I take a PM shift I drive in and its not bad I actually find the drive enjoyable.
  2. Munch

    "Safe Injection Houses"- What's This?

    Enabling? You think not having a supervised injection site around is going to keep drug use down? They will just use in pubic restrooms or in the park or wherever. Having a place to do drugs is the last thing on an addicts mind. These places just have medical help standing by in case of an overdose. They are handing out Narcan now at Rikers Island to inmates upon discharge. Until better solutions come about the only thing we can do is make sure these addicts don't spread disease and stay alive long enough to make the decision to get clean.
  3. Munch

    "Safe Injection Houses"- What's This?

    I haven't read all of the responses yet apologies if I am redundant. I am all for harm reduction. As a nurse anything to help keep a person alive can't be a bad thing. The idea that safe injection sites or needle exchage programs encourage drug use and cause people who don't use to start using is preposterous. Actually most needle exchange and supervised injection sites also provide resources to addicts who are ready to get clean. In Manhattan at one needle exchange program they have a bathroom with an intercom in it and if someone goes in there they are required to check in every 2 minutes or so and if someone stops responding the door is unlocked and someone is standing by with narcan. They have saved 25 plus lives since implementing this. Its not a supervised injection site officially but same concept. Addicts lives are worth saving just as much as anyone else's. Until some better solution comes along people are going to do drugs. No getting around that.
  4. Munch

    Was it verbal abuse? Y/N or maybe?

    Definitely NOT verbal abuse. Part of being a nurse is to EDUCATE our patients which is exactly what you did. You didn't say anything that wasn't true and while I wasn't there it doesnt seem like you said anything in an inappropriate manner. Telling people the possibly negative things that can happen if they aren't complaint might motivate them to be more vigilant with their treatment.
  5. Munch

    This is not what I thought it was

    Jeez I'm so sorry no rest for the weary when it comes to nursing huh? I really had to adjust when I first started with my medical problems. I had a craniotomy that fixed the original problem but left me with scar tissue and nerve damage causing excruciating headaches and facial pain. I was also in a bad car accident(my mustang flipped) I thankfully only suffered a slipped disc in my neck. So pain is nothing new to me. A low dose of extended release morphine(mscontin)has been my friend on the job since it doesn't cause any impairment(my employer knows this and approved it and the chief of neurosurgery is in charge of my care). Also of course the obvious like IBU and sitting down as often as possible(to chart and do admission paperwork for example) helps a lot. Of course I like my job which you state you don't l..have you thought of another area of nursing where you don't need to be on your feet all the time?
  6. Munch

    Was I wrong?

    Me too I would never want her as my nurse either. Thankfully the patient I was talking about will be going home tomorrow. A good friend of mine that floats on that unit often told me the patient is going home tomorrow on her oral regimen that they tweaked a little bit. It was oxycontin 40mgs q8hrs with OxyIR 15mgs q6hrs for BTP they bumped up her oxycontin up to 60mgs q8hrs and her oxycodone 15mgs q4hrs prn. So that should help her and hopefully prevent her from having to come to the hospital for crisis pain. As for this nurse my friend said a lot of the patients have been complaining about how she is being stingy with pain meds, not getting them in a timely manner if at all. The charge nurse is going to have a talk with her so hopefully the situation should resolve.
  7. Munch

    Did you contract anything from a patient?

    I had a couple of co-workers get stuck with needles one from a HIV positive patient and one from a Hep C patient. Luckily they both came back negative. Both of them left direct bedside care as they were freaked out like your co-worker. I think both of them actually became school nurses. As far as other things like a cold or the flu how can it be traced back to a patient for sure? When I've gotten a cold I was more likely to blame it on my train commute than any of my patients.
  8. Munch

    Should nurses be able to listen to music at work?

    I'm the same way. It drives me nuts when I hear people singing or humming especially because more often than not its off key and out of tune!
  9. Munch

    Was I wrong?

    Thank you for that information! We see such a huge population of sickle cell patients in my hospital as well. Actually when I came on that day I was covering I found it odd the patient wasn't on a PCA. When we get med-surg overflow on my floor(which actually we mostly have more med-surg patients than Neuro patients on my floor at any given time) we get a lot of sicklers and they always come up from the ED with a PCA order. If not and they require q1hr or q2hr narcotic doses then we get a PCA ordered right away. So I was just doing what was standard on my floor by getting her a PCA.
  10. Munch

    Was I wrong?

    I totally agree with what you are saying. I am a big believer in harm reduction and while I DO NOT think we should be giving every addict that walks through their doors a fix but we aren't going to cure addiction in an acute care setting. Also my hospital serves a lot of underserved people with addictions so I see the outcome the war on drugs has created(a different discussion all together). Not to mention with this patient..addiction or not she has a painful condition that requires narcotics regardless. Withholding pain meds from her is not productive. Even if she admitted she was an addict and got her into detox its counterproductive she is going to need narcotics sooner or later.
  11. Munch

    Was I wrong?

    I was reading an old thread about a patient that was an addict and was prescribed something like a Vicodin for a really painful condition and the Vicodin wasn't working. One of the nurses on this thread replied that maybe they should think about the consequences of their drug abuse before they go using. As to say well you're an addict too bad. I was talking to my friend about the co-worker I was covering for and she said she is always the first to comment about a potential drug seeker and never gives anyone the benefit of the doubt. Its really scary to think she has been a nurse for all these years. I reported the incident to my manager. I sure hope something is done. Pain should be treated as real until proven otherwise..bottom line.
  12. Munch

    Was I wrong?

    I was reading an old thread about a patient that was an addict and was prescribed something like a Vicodin for a really painful condition and the Vicodin wasn't working. One of the nurses on this thread replied that maybe they should think about the consequences of their drug abuse before they go using. As to say well you're an addict too bad. I was talking to my friend about the co-worker I was covering for and she said she is always the first to comment about a potential drug seeker and never gives anyone the benefit of the doubt. Its really scary to think she has been a nurse for all these years. I reported the incident to my manager. I sure hope something is done. Pain should be treated as real until proven otherwise..bottom line.
  13. Munch

    Was I wrong?

    That's the thing though the patient didn't really show signs of being a drug seeker. She had maybe one or two admissions to the hospital since 2016 and maybe 4 or 5 visits to the ED since 2016. She isn't on the radar at all before 2016 actually. After the ED visits she was okay for discharge. She also doesn't seem to have a HUGE tolerance to narcotics at all. The 50mcgs of fentanyl made her feel a bit better and 50 mcgs of fentanyl is equal to about 5-6 of morphine. These are doses used actually on naive patients. I think this nurse was just being very judgmental and is jaded. Being the inner-city hospital we are we DO get A LOT of addicts and drug seeking patients, A lot of patients trying to scam the system to get a warm bed to stay, people using the ED as their own private drug store(people come in for pregnancy tests and for RX of Motrin so they don't have to pay for it) The thing to remember is not to paint every patient with the same brush.
  14. Munch

    Was I wrong?

    Yes the whole diverting theory is all speculation and is nothing more than a theory. I would never report her unless I had hard evidence she was diverting medications. She has been working at the hospital for quite a while and my guess is if she is diverting it will show itself soon enough. I'm just glad the patient is doing better. Within the next day or two they are going to start to PO narcotics and discharge her home once they get a PO regimen that works established.
  15. Munch

    Was I wrong?

    Yeah I am definitely in agreement. She really did overreact. The thing is I don't have any hard evidence and making an accusation like that with little to no proof can really have damaging consequences to her career if for some reason she isn't diverting I don't know her I don't work with her normally so I don't know her well enough I was just doing her a favor by covering for her that day. I did get to talk to my manager about what happened and I did check on the patient before my shift started and she still did have the PCA and my friend who works on that floor said that the patient was doing good and is going to be discharged soon.
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