jennyanydot

Is it legal for a hospital to tell RNs after they have completed their shift that they cannot go home but must stay at the hospital but NOT get paid. Sounds like a hostage situation. How can this be legal.

Looking to see if anyone can tell me the name of the paralytic drug that begins with the letter 'V'. Thanks!:typing

to bradley rn i'm a little confused. did you think i wrote this post? i didn't; it was written by gomer42 i spent all day yesterday in the icu and i do have one med question for anyone who can answer it. what is the name of the paralytic drug that starts with 'v'. thanks to anyone who comes back with an answer. bradleyrnre: certified medication technician originally posted by gomer42 i think cma's would be useful if they had more extensive schooling. a lot of medical professionals are intimidated by their existence. it births a lot of bashing and credential throwing. we are not "intimidated" by the existence of a medication aide. we are outraged! it is a greed driven practice! according to the institute of medicine of the national academies, medication errors are among the most common medical errors, harming at least 1.5 million people every year. studies indicate that 800,000 preventable drug-related injuries occur each year in long-term care settings. every month, one out of ten ltc residents suffers a medication related injury. when doctors and nurses are putting up these kinds of numbers with years of training, it is a slap in the faces to all elderly people to pass off the use of medication aides as a safe practice. what is next, firing squads? administering medications is a serious task. it isnt bashing medication aides to demand that elderly people get the same quality care as the rest. it is bashing the greedy imbeciles who conceived and approved such a dumb idea. if they had "more extensive schooling", then they should go on and become an lpn so they will be an actual nurse. that would solve everything. if you are not a medication aide, and you defend their presence, then you are misinformed.

GOMER42Re: Certified Medication Technician It takes a lot to remember all the information about meds. I think CMA's would be useful if they had more extensive schooling. A lot of medical professionals are intimidated by their existence. It births a lot of bashing and credential throwing. Excellent post. It is always good when someone comes up with possible solutions and stays away from bashing and putting other down. The medical field is growing everyday and we need educated, dedicated people involved in caring for the sick.

There are a few bad apples in every bunch. If we measured the whole bunch by them, then we would be throwing out a lot of good produce.:) Thanks Bradley RN!! You are so right and I have had such absolutely dedicated, smart, compassionate nurses. For me now what scares me is not knowing what your going to get. I don't care if I do get one who is not so nice as long as I am not coming out of surgery and need help. I usually get along with everyone no matter what. My daughter-in-law just received her R.N. and she is working in a PICU. She is a wonderful, compassionate, caring, intelligent person and I know who ever gets her for their nurse is very, very lucky. And I do know there are many, many more out there like her. I see when reading these post. Keep up your good work because you are very important to us.

I very much appreciate your understanding. I would do anything not to feel this way. I always had such positive experiences with great people and it makes me so angry to think one person has destroyed the wonderful trust I always had.

Post Script to my recent post. I was in severe pain and left that way in the PACU for over an hour That was 'severe' pain, Level 10 and recorded as Level 10. I think what bothers me the most is me begging her to help me please. Asking 'why' aren't you helping me..., etc. And getting no answer as I watched the two nurses stand behind their counter in the PACU. It would have been comforting if she at least came over and spoke to me about the pain!! Three hours later after my daughter in law insisted on seeing me she did make sure she gave me medication and waited 20 minutes for it to take effect and then let my daughter in law in to see me. She even told my DIL that I had been in severe surgical pain from the time I entered the PACU. My question is who wants to be at the mercy of that kind of person? Previous operation (maybe 2 weeks prior) great PACU nurse - no problem!!! Subsequent operation 4 months later (regional block)- great staff, fantastic anesthesiologist, etc.

Next time you find yourself in an emergent situation, you're in severe pain or trauma... I was in severe pain and left that way in the PACU for over an hour; then another 3 hours at Level 5/6. Many a day I worry that something will happen to me and I will be at the wrong person's mercy. Never had a problem before and I have had major surgery. I have since had surgery via regional block and that will always be the way I will want to go; I will not have to rely on someone helping me with the pain. My post was not to say that a CMA is better or worse than an RN. It was simply that anyone can make an error in judgement. I have been blessed with excellent doctors and extraordinary good nurses for many years this one was just not good and she happened to be an RN. She had options...

To Skyseeker: Just finished reading your post. My hat is off to you!!!! You laid it out the way it is!!!! I actually copied your post into a Word document. After many hospital stays and operations throughout my life I never had a problem or issue therefore I was always confident and trusting going into surgery. However, not too long ago because of one R.N.'s 'assessment' regarding meds I will do everything in my power to NEVER go under general anesthesia again. I would NEVER trust myself to the mercy of an R.N. unless I personally knew him or her and what kind of person they were. (Asked for my records and they were checked by an anesthesiologist who concerred it should never have happened). It's like a box of chocolates...

cmatobe Commenting only about you as a CMA, I think you will do an excellent job. You sound like you have a great attitude along with your sincere desire to be of assistance to the nurses. I hope you are able to work with some good one. I am very sorry your circumstances didn't permit you to actually become an R.N.

Medication is a hugh responsibility. I need to know a lot more about this issue before I can comment on it again. However, I did come across the word 'assessing' which I have a LOT of questions about. Anyone interested in this as a thread please respond. (I will not be around for the next couple of days but will check here early next week). As always thanks for all the info I get from this site. It's great for patients/clients. :typing

definitely, you did the correct thing (in my opinion). hard to believe someone would go to such lengths to justify their actions for such an obvious mis-step. six to nine months is not a lot of experience no matter how much schooling you've had. i'm sure you all agree that many things come up on the job that you were not exactly schooled for. she should have been grateful for the correction and knowledge for the future. the only thing i disagree with is the martyer bit. as a patient, no one wants to be labeled a 'pest' so we (patients) refrain from ringing the buzzer (but not quite 4 hours!). i have been in rooms with patients who ring it constantly for what i call 'maid' service and therefore i am myself always reluctant to ring for anything (only recently when one arm was tied up and the other hoisted up high on an iv pole and i could not reach it to release the velcro so i could go to the bathroom - i pushed the botton and in came the male nurse with more attitude than i felt well enough to deal with). so sometimes it is just reluctance to hit that button because you don't want to be stuck in a place where people are annoyed that you did push the button). sorry, just my recent experience and again, i totally agree you handled the situation correctly - she/he just didn't like being corrected.

Someone like you would be great but I think it is the 'others' you mentioned that would make it dangerous. They need to come up with a very through test that would 'weed' the unqualified out. Good luck to you and my compliments for hanging in there all these years.

Humanity is pretty revolting. I will still be a great nurse. I am intelligent, and one of the top students in my class. That is the scariest statement I have read thus far and I have read them all. My daughter-in-law left a very well paying job to go into nursing. She started as a CNA. One day she was telling me about a very angry, uncooperative patient on the floor she was working. I told her that more than likely under all that anger was a tremendous amount of fear. She then took care for this uncooperative patient keeping in mind that fear may be the reason. By the end of her next shift, she was the only one who had this patient smiling, more relaxed and completely cooperating with her. A nurse who cares enough to see a patient beyond their outward behaviour has the winning combination of intelligence and understanding and be a GREAT nurse!

Listen to Clementina's last bit of advise!!! I was totally vulnerability for a total of 8 hours in surgery and PACU and wound up feeling betrayed and abandoned. Never had a bad experience before and I had over a dozen surgeries. It's all up to your doctor and nurse. So please heed his advise! And thanks!

I think it is probably true that in the past people went into nursing simply because they had a desire to help people. It was different then. Most men were the bread winners and if a woman wanted a career it was seen as an extra not a necessity. Today it is entirely different and choosing a career that is going to allow you to support your family is certainly not a crime. Some do it because they want to be involved with helping humanity in some way. Others because they want to be able to take care of their family. Some are highlyh intelligent; some are not. Some care about the 'whole' person who is in their care and others feel only responsible for 'doing a good job' at despensing the correct meds, and carrying out procedures and documenting correctly and not making errors. Every nurse is different; every patient is different. To me I am my doctor's customer and I am my nurses patient. We all want to be good at whatever we choose to do. I've had patient/nurse relationships many times over the years and only had two nurses (oops, maybe three) who didn't belong in the profession. But I've had nurses who greatly contributed to the healing process simply by being concerned. To me there are people who are just good people who care, whether they are doctors, teachers, nurses, law enforcement officials, etc., and there are people who are not particularly nice people and it shows when they are at their jobs. Personalities and character comes through in any job. Keep smiling, do the best you can for the patients in your care despite the politics. We truly do depend on you! P.S. I was in for a three hour surgery; two surgeons, anesthesiologist, physicians assistant, scrub nurses, circulating nurses, etc. From 6:30 a.m. until 7:45 a.m. while waiting to be put under, not one person said one word to me except for ONE of the nurses. I still think of her and am very grateful to her for that 'human' contact at a time when I needed it.

Okay, I admit I'm lost. Do I understand it correctly that people who are not RNs or LPNs will be reading doctor's med orders and administering these meds to patients? Or do you have to have your RN or LPN to take the course and this just gets added to your resume? If, it is for people other than RNs and LPNs, a few things come to mind to me as a lay person. Not taking sides, just some thoughts and observations. More times than I want to know, nurses catch doctors writing meds that are going to interact badly with what the patient is already taking or writing meds that are just wrong. Also, if (or when) there is a reaction to some of these drugs which are not termed 'potentially harmful' drugs, I think it would take a nurse with all her training to know what and how to turn the situation around and get the patient out of danger. Am I way off? Just need some education on this one please.

i'm not a nurse but have been a patient many times. i came to this site almost a year ago (may28) to try to understand why a nurse i had in the pacu (4 hours) acted the way she did. instead i found nurses who care very much about their patients and their patient's pain, etc. i have been a loyal reader ever since. and it stopped me from changing my opinion about nurses just because of one rotten apple. i thought of all of you this week and wanted to wish you not just a happy nurses' week but a year blessed with the 'support' you need and 'deserve'. whenever you get discouraged, remember there are those of us who appreciate your intelligence, compassionate care and kindness.

As a former patient I applaud and thank you! Administration had better wake up and will only do so when more nurses take a ground of issues such as this. Sounds like you need to ALWAYS do paperwork for documentation, though. Good luck to you. And maybe give a thought to some of the great surgical centers around your area. These professionals are always happy and pleasant and work as great teams with the doctors.

I certainly appreciate your input. If I only listened to the ortho doc I would think what happened should be something I just 'click my heel' and wish it away. At work today I called the billing department for the anesthesiologist that work at the surgical center and one of the girls gave me the name of one that she said is nice. I am going to call the surgeon's office tomorrow and tell them I will sign another consent form for just the CT procedure (which I hear is nothing) and they will have the other consent for both procedures in case something can be worked out with the anesthesiologist for the second procedure being done with a Axillary block or Interscalene block for post op. Otherwise, just the CT procedure and I'm out of there. A friend at work said her husband had just the external fixator on and had the Interscalene block (I'm guessing it was that one because it was in the middle of his upper chest) didn't feel anything for days and the anesthesiologist was great - said, "call me Ted and here is my cell phone number if you have a problem." Can you believe that? I had the ext fix put on in April so I know it is only a 20 to 30 minute procedure and I had the BEST PACU nurse in the entire 550 bed hospital. She pumped in 2 mg of Morphine until I said, "that feels better". And that is what she noted!!! Love to be able to thank that angel and let her know how often I think about her even though wouldn't know her if I knocked into her at some store. No, never took any drugs - BIG chicken. Always thought they would work well for me if I didn't take anything. Well... I'm ready to throw that theory in the trash. Please, please do not give up on going for the CRNA. I had a great experience the one time I got one. This is such a growing field and one where really good people are needed. I don't know if earning 3 contact hours on peripheral nerve blocks for post op is beneficial to you but it is a Home Study by AORN Journal that is on the Internet (sorry no url to give you). Thanks once again. I'll let you know if I went through with both procedures or saved one for 'TED'. :rotfl: P.S. Loved the Percocet comment. If I am offered Percocet, I'll probably think of what you said and laugh!

started to read this thread. My sympathy to all of you who have been in a position where you needed understanding and comforting and found only annoyance and in some cases down right meanness. What I was going to ask your opinions on was having surgery but now I think I will tell you what happened starting in April. (I've had several surgeries and one being a TAH w/removal of ovaries due to pre cancerous cells. Surgery and recovery (4 days in hospital) went great. Okay, now April 2004 I fall OFF (not down) my second floor staircase and crush my radius and wrist. I am admitted and an external fixator is put on in the OR. PACU nurse was super kind and I was given 16 mg of Morphine until I felt better. Next, followup showed (doctor was pot luck emergency guy) my wrist bones going out the ulnar side of my wrist and I was told by this Ortho doc I would need to go to the hospital for him to fix it because he could do it in the office it would hurt too much. So, never having had a problem with surgery I say, "Okay, as long as you can control the pain." Oh, we'll take good care of you, don't you worry. Next day, I walk into ambulatory care no more anxious than going to the dentist. No one says anything to me while I am in holding tank for the OR except a goofy looking guy comes over and says, "any allergies?" I say no and off to the OR. The OR nurse was so nice and she spoke to me and we had a quick but fun conversation. Neither surgeon or anesthiologist say 'boo' to me. Not even the usual, okay, now your going to go out. Just put me out. 11:36 I am brought into the PACU and I am sedated but very reactive with excrusciating pain. At 11:37 bozo (anesthesiologist) starts to write orders. He orders Versed before I even get an analgesic. It's on the orders along with 0.5 Dilaudid 4 x PRN. He knew he already lost the battle of controlling the pain and probably ordered the Versed so I wouldn't remember the pain (ha!). At 11:40 I get 0.5 Dilaudid (my PACU nurse charts severe operative pain 10) art 11:45 I get another 0.5 of Dilauded - whoopie do a loading dose is 1-2 mg. !!!! He could have ordered Fentynal which is quicker acting since the pain was already OUT!!!! But no, Dilaudid which takes 20-30 minutes. I feel sick to my stomach from the pain still raging at a 10/10 and am given 12.5 Phenergan.at 12:50 Now, I am nuts with pain (logged as 'agitated' - actually murderous!). The nurse at this point is probably saying to hell with the other mg. of Dilauded I have the Versed I can give her and shut her up. I kept saying why arn't you giving me any Morphine. What is wrong with you people? Why arn't you helping me? etc. Versed at noon. Doctor walks in at 12:07 and sees me dozing and orders my arm put up on the IV pole. He leaves and my arm is hoisted up at 12:15 as I involuntarily let out screams. So embarrassed! Well folks this went on for 4 hours and I was told I was not going home because they could not control my pain. Family was a little worried after waiting from 7:30 a.m. till 3:30 p.m. Oh, yeah, the operation which he made sound so easy was 3 hours from incision till closing. Ext Fixator off incision on both dorsal and volar side of wrist with arm in tourniquet for 2 hours. Internal plates and locking screws put in and bone graf added. And neither the surgeon or the anesthesiologist gave one hoot about how much pain I was going to be in. Never had a plan for managing it properly. Too much dependence on amnesia and versed, I think. Okay, now here is where I need your thoughts and opinions. I have to go back to have a constricted median nerve relieved (CT) due to the operation. This is fine but at the same time I want the hardware out as it is bulky and popping out of my skin on my wrist. Doctors agree it can come out with no problem. My dilema ... the doctor wants me to have GA and I am afraid of waking up like that again. He said I won't the pain will only be around a 3 or 4 unless I am a wimp. And he said he would give me percocet - WOW!:rotfl: I spoke to an anesthesiologist on the Internet and showed him my records from the May operation fiasco and he said I was under medicated and should have at least had something that was faster acting. He said for taking the hardware out he would suggest an axillary block (docs don't want you awake) So my surgeon says, nah you don't want that the tourniquet is too painful. Yeah, yeah... Well, now I haver wrestled with this a 100 ways and I am thinking GA for the surgeon and block for me so I don't wake up in severe pain. I was never afraid before but I definitely was traumatized in May and I too cannot shake it. As soon as something like another surgery comes up I keep reliving May and the awful feeling of pain, betrayal (doc) and abandonment (no relief). I just don't want to wake up like that again. And reading your threads made me realize although my surgeon in exasperation said okay you had a very traumatic experience (someone told him I was in a lot of pain - probably the nurse in the PACU), but you have to come to terms with it. I can if I don't have to have anymore surgery or if I can be awake and not go to sleep. I can deal with pain better when I have my wits about me. Sedated I am confused and do not deal with the pain as well. Surgeons do not want you to have blocks. God forbid your awake when they work! Anyway, you guys see it all. How do the people do on blocks??? Is tourniquet pain all that bad. If it's only a Level 3 than that is better than what I would be waking up to. Isn't it just pressure discomfort? Remember, I was traumatized not only by the pain but the lack of care, the dishonest surgeon never warning me and about the Versed for amnesia. It's a sneaky way of trying to cover up a mistake. I have versed all the time for over a dozen procedures but after surgery with 10/10 pain in place of decent pain medication??!!! I never want amnesic drugs AFTER surgery again. Remember just having a ext fix put on (April) I received 16 mg. Morphine in 30 minutes (in patient!) but with the 3 hours of trauma surgery (May) I received less than half of its equivelent with Dilaudid 1 mg. in 30 minutes. You haved seen it all so please I welcome your suggestions for this surgery and what I should do and ask for. Promise, I'm not a wimp. But I am still angry over May and how it has taken away my confidence in 'the system'.

started to read this thread. My sympathy to all of you who have been in a position where you needed understanding and comforting and found only annoyance and in some cases down right meanness. What I was going to ask your opinions on was having surgery but now I think I will tell you what happened starting in April. (I've had several surgeries and one being a TAH w/removal of ovaries due to pre cancerous cells. Surgery and recovery (4 days in hospital) went great. Okay, now April 2004 I fall OFF (not down) my second floor staircase and crush my radius and wrist. I am admitted and an external fixator is put on in the OR. PACU nurse was super kind and I was given 16 mg of Morphine until I felt better. Next, followup showed (doctor was pot luck emergency guy) my wrist bones going out the ulnar side of my wrist and I was told by this Ortho doc I would need to go to the hospital for him to fix it because he could do it in the office it would hurt too much. So, never having had a problem with surgery I say, "Okay, as long as you can control the pain." Oh, we'll take good care of you, don't you worry. Next day, I walk into ambulatory care no more anxious than going to the dentist. No one says anything to me while I am in holding tank for the OR except a goofy looking guy comes over and says, "any allergies?" I say no and off to the OR. The OR nurse was so nice and she spoke to me and we had a quick but fun conversation. Neither surgeon or anesthiologist say 'boo' to me. Not even the usual, okay, now your going to go out. Just put me out. 11:36 I am brought into the PACU and I am sedated but very reactive with excrusciating pain. At 11:37 bozo (anesthesiologist) starts to write orders. He orders Versed before I even get an analgesic. It's on the orders along with 0.5 Dilaudid 4 x PRN. He knew he already lost the battle of controlling the pain and probably ordered the Versed so I wouldn't remember the pain (ha!). At 11:40 I get 0.5 Dilaudid (my PACU nurse charts severe operative pain 10) art 11:45 I get another 0.5 of Dilauded - whoopie do a loading dose is 1-2 mg. !!!! He could have ordered Fentynal which is quicker acting since the pain was already OUT!!!! But no, Dilaudid which takes 20-30 minutes. I feel sick to my stomach from the pain still raging at a 10/10 and am given 12.5 Phenergan.at 12:50 Now, I am nuts with pain (logged as 'agitated' - actually murderous!). The nurse at this point is probably saying to hell with the other mg. of Dilauded I have the Versed I can give her and shut her up. I kept saying why arn't you giving me any Morphine. What is wrong with you people? Why arn't you helping me? etc. Versed at noon. Doctor walks in at 12:07 and sees me dozing and orders my arm put up on the IV pole. He leaves and my arm is hoisted up at 12:15 as I involuntarily let out screams. So embarrassed! Well folks this went on for 4 hours and I was told I was not going home because they could not control my pain. Family was a little worried after waiting from 7:30 a.m. till 3:30 p.m. Oh, yeah, the operation which he made sound so easy was 3 hours from incision till closing. Ext Fixator off incision on both dorsal and volar side of wrist with arm in tourniquet for 2 hours. Internal plates and locking screws put in and bone graf added. And neither the surgeon or the anesthesiologist gave one hoot about how much pain I was going to be in. Never had a plan for managing it properly. Too much dependence on amnesia and versed, I think. Okay, now here is where I need your thoughts and opinions. I have to go back to have a constricted median nerve relieved (CT) due to the operation. This is fine but at the same time I want the hardware out as it is bulky and popping out of my skin on my wrist. Doctors agree it can come out with no problem. My dilema ... the doctor wants me to have GA and I am afraid of waking up like that again. He said I won't the pain will only be around a 3 or 4 unless I am a wimp. And he said he would give me percocet - WOW!:rotfl: I spoke to an anesthesiologist on the Internet and showed him my records from the May operation fiasco and he said I was under medicated and should have at least had something that was faster acting. He said for taking the hardware out he would suggest an axillary block (docs don't want you awake) So my surgeon says, nah you don't want that the tourniquet is too painful. Yeah, yeah... Well, now I haver wrestled with this a 100 ways and I am thinking GA for the surgeon and block for me so I don't wake up in severe pain. I was never afraid before but I definitely was traumatized in May and I too cannot shake it. As soon as something like another surgery comes up I keep reliving May and the awful feeling of pain, betrayal (doc) and abandonment (no relief). I just don't want to wake up like that again. And reading your threads made me realize although my surgeon in exasperation said okay you had a very traumatic experience (someone told him I was in a lot of pain - probably the nurse in the PACU), but you have to come to terms with it. I can if I don't have to have anymore surgery or if I can be awake and not go to sleep. I can deal with pain better when I have my wits about me. Sedated I am confused and do not deal with the pain as well. Surgeons do not want you to have blocks. God forbid your awake when they work! Anyway, you guys see it all. How do the people do on blocks??? Is tourniquet pain all that bad. If it's only a Level 3 than that is better than what I would be waking up to. Isn't it just pressure discomfort? Remember, I was traumatized not only by the pain but the lack of care, the dishonest surgeon never warning me and about the Versed for amnesia. It's a sneaky way of trying to cover up a mistake. I have versed all the time for over a dozen procedures but after surgery with 10/10 pain in place of decent pain medication??!!! I never want amnesic drugs AFTER surgery again. Remember just having a ext fix put on (April) I received 16 mg. Morphine in 30 minutes (in patient!) but with the 3 hours of trauma surgery (May) I received less than half of its equivelent with Dilaudid 1 mg. in 30 minutes. You haved seen it all so please I welcome your suggestions for this surgery and what I should do and ask for. Promise, I'm not a wimp. But I am still angry over May and how it has taken away my confidence in 'the system'.