NayRN

This is an interesting topic-and one I am considering for a masters thesis. I think it could be a really awful thing if meds such as benzos or narcs aren't provided and prisoners go into withdrawals in jail, among other ethical issues. Anyone else have anything to add? Because I'd really like to hear...

I think complete bed rest for a DVT was going down the tubes when I was on the floor, too. I dunno. Kinda miss floor nursing sometimes. Sort of. Been away for 1.5 years now.

As far as the career path you should be on, I can't help you there. But if it makes you feel better, I am in Loyola's MJ in health law program and it is $1220 an hour. So feel happy about the $800! I about fell over when I saw the tuition!

In a lockbox in a locked cabinet or locked room would solve your double locking problem. As far as regs for med disposal and tracking go, I'd check your state regs. for what they want.

Yeah, I don't qualify for Obamacare subsidies-income is too low. I live in a state that didn't expand medicaid. But the good news is I am also exempt from it and from the penalty. Yay.

the hospital i used to work at used to bug me with this as well. we had c diff and mrsa patients going out to smoke. the thing is that you can educate until you turn purple, but a patient can claim that they were falsely imprisoned if you won't let them out of their room. you can't restrain them, you can't legally keep them in their room. there are a lot of legal issues with this one, but i tend to agree-the right of one patient to freedom of movement shouldn't trump everyone else's right to a clean environment.

Interesting pay situation-I suggest you go to your union, since you have that option. So many of us don't. They are also the ones who negotiated the pay. I worked med-surg/tele on a 40 bed unit for 4 years. Our patient ratio was 6 or 7:1, sometimes we got a separate charge nurse, sometimes not. On day shift we'd sometimes discharge all 7 and get a whole new team, for a daily load of 14 patients. I started as a new grad at $17.50/hr with a max raise of 2.5% per year. No union. I'm back in school now, hopefully on to bigger and better things.

So, I was sitting at the pharmacy yesterday waiting for my scrip to be filled, and a lady came up to ask a question. Lady: "My husband is supposed to take a baby aspirin every day, but all the ones I have found have saids in them. Do you have any without saids, because they say saids are bad for you." So I overhear this, and although I let the pharmacist field the answer to that one, my thoughts went from holy cow, and these are the people voting and reproducing to wow, we are really doing a crappy job educating these people if we can't get across that aspirin belongs to a class of drugs called NSAIDS and you can't have NSAID-free aspirin like you can have fat free pretzels. Then again, look at the media we are up against. I had a lengthy discussion with my mother in law recently because she was taking way too much ibuprofen because she heard that tylenol was bad for her. Patient education is so important, but does anyone else feel like it's really an insurmountable task to get patients to trust and listen to their nurses and docs more than they trust and listen to commercials for law firms? It took the pharmacist a second to figure out what the was actually talking about, (saids? oh, you mean N-S-A-I-D-S) and I'm not sure he did the best job explaining the issue to her (aspirin is an NSAID, you can't buy them without. The bad effects they are talking about is when NSAIDS like ibuprofen and Aleve are taken in large doses over long periods of time). Pretty sure the lady is going to go home without the NSAID-filled ASA (but I really need them without, my husband is so particular about what's in his medicine). Sigh.

My issue would be that a nurse is probably acting outside their scope of practice if they are giving medical advice to patients.

When I did my home health rotation the nurse I rounded with didn't even wear scrubs for safety reasons. In some of the neighborhoods he visited home health personnel wearing scrubs had been robbed at gunpoint by people looking for drugs. Logo on the car would be just as bad, HIPAA violation aside.

Generally speaking, unemployment benefits are only available to those who were fired without cause. Like in a layoff or downsizing situation. If you were fired with cause, your employer can dispute your unemployment claim. File and see what happens.

I have been fired twice. The first time I had a complaint, it was a patient who was extremely unhappy about her clear liquid diet (so unhappy, in fact, that she threw her jello, in the dish, at my nurse manager when said manager heard her yelling from across the hallway and came to see what was wrong) but she really liked her dilaudid. Thank goodness I had seen this one coming and was very careful to give her prn meds very close to on time and document pain reassessments religiously. I also had the house sup start an IV so she could have the pleasure of meeting this patient and the charge nurse checked on her several times as well. So when she complained about my inattentiveness, it was a matter of going through the chart and looking at each and every time I had laid eyes on the patient. Plenty of notes, plenty of witnesses. I wrote a narrative to legal and included all of this info in it, and I never heard another thing about it. Moral of the story? Document everything. Use your resources. The second time, I was fired by a notorious nurse-firer. I actually did pretty well and made it until 10:00 on day 2. Other nurses made it mere hours. The wonderful family member of this wonderful patient threatened violence regularly and convincingly and it came to the point where we would never enter the room alone so that we always had a witness and/or backup, then it came to the point where we would have security enter with us every time. Which only delayed the percocet longer to give security time to get to the floor. I got a bit of satisfaction from that anyway! It was not too terribly long after this patient that I quit nursing. I have better things to do than deal with people like that.

Oh, not if you saw my Sallie Mae account you wouldn't! But thanks :)

I have a BS in business as well, so that was enough to get me into my grad program. It is not nursing specific. And yeah, to other comments: This was a pretty normal refund for me-I have received this much back for previous semesters, so I didn't think it was an over payment. Apparently since it was a 5 credit hour summer session instead of 6, I wasn't eligible for that much aid. You would think they could have figured it out since they didn't apply my financial aid or refund me until 3 weeks into the class. And yes, I spent it in less than a month-prepay the $800 in day care so I could do my 90 clinical hours, towing my truck back home and fixing it when my fuel pump gave out when I went to my first on campus day 100 miles away ($577), and paying a couple months rent and poof! $2300. I'd love to pay it back. Anybody want to give me a loan :)

I let nursing in October of 2012 after 4 years working med-surg. I was becoming burnt out and I tried to get another job, but after 5 interviews and a year and a half of putting in applications and still nothing, I lost my confidence and decided I needed to try something else before I either messed up at work or had a nervous breakdown. So I am now a stay at home mom of 4 and I just finished my BSN and started a grad program in health care law, so I've not been idle. I tried to go back to a nursing home last summer part time, but I made it through 3 days of orientation and realized that I had quit bedside nursing for a reason, and those reasons are still there. I do miss parts of it-the critical thinking parts, the education parts, and my coworkers, but when I really think of what the day-to-day was like on my floor, I don't regret quitting at all, and I don't anticipate going back to hospital-style bedside nursing ever. Maybe home health or hospice. I fell in love with public health and the legal aspect of health care, and I figure I can bring a unique skill set to a new career with my nursing training and legal training-not just a legal nurse consultant certificate, but actual legal training. Maybe risk management, board of nursing, health department or something else where I can work on the bigger picture. I'd like to solve some of the problems I saw with bedside nursing both with the nursing work environment and the patients by advocating for nurses and working on policy changes to make our communities healthier. I'm excited-I think it'll be great! Now, if I can just figure out how to make actual money in public service...maybe I'll end up working with lawyers on cases for a while and save the world in my spare time?!

Yeah, mine did something similar. I took a 5 credit hour course over the summer-my final class for my BSN, and they refunded me $2300 too much. I had never had that happen before, and so when they asked for it back a month later, I didn't have it anymore, it had gone for living expenses. So I won't be able to graduate until I pay them their money. I'm a stay at home mom in a grad school program, so they'll be waiting a while!

I've got some of the same issues as the others have: benzos are chemical restraints and drugging a person "for their own good," especially in their own home/outside of acute care (she's not in ICU trying to rip out her ET tube) has some ethical implications. What is her activity schedule like? She's in her own home with caregivers and family? Is she taken to outside activities and for walks around the neighborhood (in her wheelchair). She's obviously strong enough to get out of the chair, but fails to maintain an upright position-have we checked orthostatics? If she's one on one with a CNA all of the time, what is the CNA's job description? Is she there to care for the patient's medical needs or is she there as a housekeeper? Is she supposed to be cooking and doing laundry? Maybe this job description should be re-evaluated. What part does the family have in her care? Can't they take care of the laundry and food prep so that the CNA can focus on the patient's care?

pressure ulcer prevention, pain control, patient satisfaction, decreased fall risk, med errors, nosocomial infection rates, readmission rates, discharge follow up compliance, discharge teaching in general, proper meds prescribed and tests performed in a certain order/timely manner for suspected pneumonia, MI, etc. Just a list, now you figure out why!

My initial response is no, nursing is not for you. May I ask why you put in the time to become a nurse? Or are you even a nurse yet-have you taken boards? To answer your other question, yes. I am a nurse who is going into law. I graduated with my ADN and worked med-surg for four years. I completed a BSBA last October, and my BSN this summer. In 2 weeks, I will begin a master's in jurisprudence in Health Care Law. This will not make me a lawyer, but I hope to work in administration or as a patient or nurse advocate when I am done. I believe that my four years of floor experience is/will be absolutely essential in the career I hope to have once I complete my masters. Nursing school is not easy, but in my opinion, one must actually experience bedside nursing in order to understand the essence of what it means to be a nurse. Too many administrators do not take the time to experience this before getting those higher level jobs their degree allows. Maybe that leads to some of the low-esteem in which nurses are held of which you speak. During my four years as a nurse, there were times I felt like I was low-man on the totem pole, but that was mostly because of inexperience, and that will happen in any new career. When I knew better, I did better, and I gained confidence. I earned the respect of the rest of the healthcare team. Yes, nurses deal with the most base human needs on a daily basis. Life and death are pretty raw and naked. If bringing a glass of water to a dying patient makes me a handmaiden, then I suppose I am. I am not currently working as a nurse. I quit to reevaluate my life and career and spend some time with my kids. I am returning to school because through my nursing experience I did identify many things I didn't like/agree with, and I decided to go into a field that would help me to hopefully correct some of the injustices that I have identified. However, I would not have known of these issues had I not "paid my dues" as a floor nurse. I have the utmost respect for floor nurses. The ones that have been there for years and years do what they do out of love and compassion for humanity. No, that is not for everyone. Burn out is common. Compassion fatigue is common. But those who do it for the right reasons, man, they are really something special.

And, may I add, although I am an RN I imagine it will be the same principle-Yes, nurses are expected to have the same basic knowledge base across the board, but curriculum will differ because in the end it doesn't matter if you know the name of every bone and muscle in the body. What you will be tested on in your board exam is how to apply that knowledge. They will want to know "if your patient wakes up with heart palps in the middle of the night, what lab values should you look at/be aware of before calling the doctor?" Yes, you need to have an inherent knowledge of muscles, heart condutivity, and electrolytes to answer this question. Don't focus too much on the memorization, except, of course, for nursing school testing purposes. I personally like the "made incredibly easy" or "for dummies" books. Get chemistry, electrolytes, A&P, pathophysiology, and pharmacology to start. Get a nursing drug book and look up every drug you come across. Start applying it to everyday life.

Yeah, cross contamination-what goes into a patient's room stays in a patient's room.

My online BSN included 180 clinical hours, face to face lectures, and group projects, including a presentation. I had to visit the campus once per semester, and twice during one semester. A lot of these types of degrees are somewhat hybrid, with the majority being done online.

Me too-it was time for me to go, I'd been there 4 years and 5 months, to the day. My first nursing job. Got a lot going on, my family needs me more, so I quit. Yesterday was my last day. I'm the sole income earner for a family of five, my husband has a fledgling business I'm going to help with, and I'm going to look into grad school. I won't be idle, but I won't have to go back to that darn place EVER again! Cashed out the 401K, going to coast for a while and see what happens. Wheeee! (very freeing, but a bit scary at the same time!)

So, devil's advocate here, As many have mentioned, Americans have a right to life, liberty, pursuit of happiness also right to bear arms, speak freely, gather peacefully, etc. So, lets say we amend the constitution to include the right to have access to health care. Fine, now it's a constitutional right. There are limits on these other rights. If they are abused, they are taken away. A criminal can have their freedom or even their life taken away. They can also lose their right to bear arms. In certain cases, such as in public forums, the right to free speech may be censored to protect certain audiences. But these guys still get health care? How can they lose access to the most fundamental of human rights but still obtain health care services? Sooooo... What kind of limit could we place on the "right" to health care. Could we begin to call things what they are and cut off abusers of the system? The habitual, weekly ER visitor with vague abdominal pain who is allergic to all but dilaudid (fast push, please)? The repeat drunk driver in with their third car wreck this year, this time with liver lacs and TBI due to an accident that killed a family of four? The violent ETOH abuser, in at family's request for detox, who, last time they were here spit in a nurse's face and broke another one's nose? The diabetic who, despite excellent access to needed supplies, repeated attempts at education, and declined offers of home health services continues to be readmitted to the hospital in DKA because they "didn't have time" to check their blood sugar and treat it? I mean, can't we place these guys who don't follow the rules on health care probation or something? I understand that some may lack the mental capacity to understand their health condition and treatments. Yes, we should be compassionate and do everything we can to help. But for the ones who simply will not follow the rules or decline every attempt we make to help them, shouldn't we re-distribute scarce resources to help those who are willing to accept it?

I like the part about taking the wheelchair from the elderly lady. Was the lady actually IN the wheelchair at the time? Or was this in clinicals and it was not actually in use and you borrowed it? If she was in it, did you make her get up and sit somewhere else, or just leave her standing there? I mean, I've "borrowed" wheelchairs, walkers, IV poles, and other hospital equipment, wiped it down and used it if I needed it quickly and it was available. I then wiped it down again and brought it back or got another one when time wasn't a pressing issue. Your post leads me to believe that the part about "broken English" was correct. I found it difficult to understand your train of thought.