PunkBenRN

The answer is, like most HIPAA answers.... it's complicated. There are a lot of factors that play into it. Is there audio transmitted as well? Is the recording stored, or is it just visible from another location? Who is watching the camera?

It doesn't have to be diluted; it's so dense that it hurts if you don't. It's like maple syrup. It also gives you more control over how fast you push it if that's an issue.

Bingo. Typically, when I have seen fluid used in these situations, it is from a concern of potentially bottoming out the pt's blood pressure. An ounce of prevention is worth a pound of cure; it is much easier to give fluids first than to wait for them to drop and try to get them back up.

Thanks for explaining

Ha, I got called a creep for even entertaining the notion of a solution. https://allnurses.com/nurse-colleague-patient/foot-rub-769071.html Dr. Scholl's work great for me.

I'm confused about how that is anatomically impossible; is it an issue of the mesentery, or diaphragm? What is in the way? How does crepitus develop? The pressure on the nerve makes sense in this instance. I have also had patients switch sides before, good advice

The patient gets pain meds when they ask for them. Period. I would rather overmedicate a junkie than undermedicate someone in legitimate pain. Most patients that are believed to be junkies are in fact not. Sometimes its an issue of poor pain management, other times its because the person is very sensitive to pain or has high expectations from the hospital (such as first surgery or childbirth). It is incredibly subjective to assign this title and dictate plan of care accordingly without all the facts present, and I've found calling people 'med-seekers' will only be a detriment to their care. Once the health care team's mind is made up, they stop investigating route causes, they stop treating, and they blame the patient for the problem. Don't get me wrong, they are out there. They are very cumbersome and annoying, I will give you that. But research suggests that number of legitimate med seekers is much lower than what health care professionals estimate it to be. Besides, even junkies have pain. Treat it. Edit: I guess I should have read through the thread first, I suppose a lot of people agree with me. Great to see, thank you all :)

You mean you don't take the brother in law's cousin's wife's daughter's opinion seriously?

I think the poster is referring to the gas related to laproscopic procedures, not flatulence after surgery. When a laproscopic procedure is done, they employ cameras within the area; in an abdomnial procedure, it is necessary to "inflate" the area, so the lense isn't constantly covered. What results are gas pains after surgery, typically in the shoulders/neck, as the gas forms bubbles and rises. Some patients, I have found crepitus even. As far as what to do about it, I've tried a few things but nothing reliable enough to promote. Honestly, the best thing for it is time - if they can bear it, a day or two it tends to absorb back into the body.

Haha, I am very happy to hear I am not the only one who has done this. I feel like an idiot when it happens. That awkward moment when you walk by a room and hear the MD giving discharge instructions to the wrong patient. (It was the patient next door, he got mixed up. haha. Well, not so much instructions, but talking about discharging. You know what I mean!)

Not to be a jerk, but does anyone else find it odd to make it through a Master's degree without addressing this issue along the way? I can understand post-grad jitters, but if you are this uncomfortable with nursing, how did you make it through the clinical component? What were you doing before looking for a nursing position? Why were you not interested in pursuing a ARNP job before your husband's disability? In terms of your husband making a full recovery, how long do you expect that to be? I'm sorry if this is rude and OP is legit, but after reading the Munchausens by internet article I am skeptical of what I read online. I am having a really hard time understanding the dynamics of this situation.

I cannot believe some of these replies! Enough with the self-depricating nurse who not only allows this behavior, but expects it as part of the job! You need to stand up to people like this; you wouldn't let them talk to you like this outside the hospital, why is it ok when you come to work? Where do you draw the line (swearing, slurs, violence)? 9.99999 out of 10 times, management will 100% back you up. Don't take this the wrong way - you won't be supported if you come back at them with the same childish attitude or fervor. Just be professional and establish firm boundaries. You should not be subject to insult and redicule, and if you don't set boundaries the behavior continues, and who knows how many people they talk down to this way. When it comes to personal insults and racial slurs: absolutely unacceptable. If someone raises there voice, this is also unacceptable (regardless of context). It is within your power to tell them that it is unacceptable. I'd say about half of the time, people don't realize they are doing it and would normally not speak this way - tempers/emotions flare and people get a little nuts. It happens. When you call them out on it, they will apologize. People are not inherently evil. If you are not coming across to the family, get security involved. Its what they do. Being in the room with the patient is a privilege, not a right. My concern is my patient, and if family is interfering with that, then they are gone. If you don't work in the hospital or don't have security (or the situation has escalated out of control), threaten to call the police. I don't quite understand why people feel they have diplomatic immunity when they come into the hospital, but they are subject to federal and state law like everyone else. If they are disturbing the peace, make it known to them. If the threat of calling the police does not de-escalate, then follow through and call the police. The police are on your side, and I have never had an officer be rude or condescending when calling from a nursing home or hospital. If this abuse/inappropriate behavior is coming from the patient, you are well within your right to set boundaries. Make it known that the behavior is inappropriate. If it continues (and pt is of right mind, or course), tell the patient that you will notify security/police if it does not stop. If it continues, notify security/police. Also, if you see someone else taking this kind of abuse, step in and say something. It is not always easy to stand up for yourself, and being the third party grants you power. You have a second person in agreeance with you, which gives you confidence. It is also not your direct situation, i.e., not a patient you have to see the next 12 hours. It can be really uncomfortable doing patient care with someone you were just arguing with. When management asks what happened, your story can be verified by two people (very important for many different reasons). I don't know why nurses feel they have to fall victim to this. It is not in your job description. Even someone who is confused has no right to treat you like that. If you have self-confidence issues or self-esteem issues, do some soul searching. Practice what you would say when someone is unreasonable. Write down how you would respond, it will help you gain confidence when the time comes. And most importantly, if your manager will not back you up in a situation like this, is this really somewhere you want to work? It will make a hell of a story in your next job interview

Honestly, sounds like she is doing her job. Its not a fun job, but these questions are what management are there for. Its nothing to worry about, I'm sure everyone on here has dealt with these questions/demands before. She is not going to judge you for something out of your control; what she will be watching for is how you deal with the information presented to you. As long as you follow up with whatever she asks you to do, you will stay on her good side. Remember, she is not being vindictive, she is just a manager.

The question is a bit unclear. You are allowed to be concerned with any Pt, what are you being held back from doing? Big concerns would be injuries to the hands, face, and legs. These tend to affect many ADLs.

When I worked in a nursing home, we had MNAs (Medication Nursing Assistants). This is essentially what you are talking about; CNAs that can pass meds after a brief course and test out. First of all, MNAs are a godsend, and especially in SNF/Nursing Home setting (beyond Assisted Living) they are incredibly safe. Food for thought: Any mistake an MNA can make, an LPN/RN/ARNP/MD can make. Med errors are universal, and even with the background and education to prevent them they continue to occur. It is unfair to assume that MNAs will inevitably make med errors because they don't understand what a beta-blocker is. As far as dispensing narcotics -- Yes, they can dispense them. No, they can't hand out PRNs as they feel. Anything that requires an assessment (i.e., pain meds and BP meds) has to be ok'ed by the RN before being administered. Most MNAs are very good about checking with you first. If you need a BP checked before administering Metoprolol, just write it in the freaking MAR so the MNA/LPN/RN knows to. Working with an MNA, I am free from the incredibly elaborate and tedious med pass - I can focus on assessments, dressing changes, etc. Before every shift, I would still thumb through the MAR, just to be aware of what is going out during the day. My two cents.