Keysnurse2008

you will learn a tremendous amount of valuable information and gain insight on alot of disease processes. it is one thing to learn about chf in a book. it is quite another to see how that actually manifests in the ekg strip. you can see the low qrs voltage waves...maybe afib....long qti...different things in diff patients. chf results in a big enlarged floppy heart ( basically)....and all the abnormal conduction issues that go along with it. you will learn about the effects of digoxin and see it....you will learn about the effects of beta blockers and see their effects......cardizem when the rate runs high and see how it affects things. it is just an incredible opportunity for you.....so.....good for you! this is great!

1. your doctor is a jackass....most of his patients die . some from neglect.....some from just purely ignorant crap he does to them. have a good day. 2. please tell us what really happened...you keep showing up with injuries that dont match your story. dont you realize you have value and worth? that you deserve so much better in life than to stay with the jerk who keeps himself plastered to you each time you come in the er to simply make sure you never utter a word to implicate him?:heartbeat

hmm....dont know quite where to begin. here goes- take a vacation.....and then get another job. to be good at something...you have to like it. to be great at it...you have to love it. if you feel you are emotionally drained....then take a break please......and then look for something that sparks your interest. bc...patients will sense your lack of interest and empathy.....and it will show. they will be less likely to frankly discuss health concerns....and it will impact them. just showing up....and not being 100% there...available isnt ok. find that area that sparks your interest.......but first.......please take a break and recoup:twocents:

hmm.....i hate to even say this....but....is she getting adequate pain control? too many times patients, esp the elderly.....are not having their health concerns addressed adequately. if she is still asking for pain meds...after she has gotten them.....then maybe the major problem isnt her memory...but the fact that she isnt getting adequate pain control.

i am pretty niave when it comes to this stuff.....i admit it. jack said he thought that i should perhaps see a counselor to see why it bothers me. i dont think i really have to do that. a counselor might tell me i have trust issues bc when i was a child my dad said he was going to take me fishin and then he didnt. but.....that isnt it. in the er....and the pods( critical care) ....we all are very close.....like a family. we trust each other . and ....we all .....i have 10 coworkers reading this everyday with me and some tidbits ...are from me and some are from my coworkers. but....we all feel guilty. we are like a second family....and we didnt notice that things had gotten this bad.....we all didnt notice a problem. so...we all feel a huge amount of guilt...bc he is calling all of us several times a day....and we understand how out of control and upside down his life is. but...for me.....i am distancing myself somewhat till he is further along in the program....and calmer. i have a busy busy life, just found out my mom has cancer ( monday)...my son got in a wreck over the weekend and is in pt rehab...my bettter half wants the living room painted and the garage...my daughter is moving back home ....and my coworkers.....are not working. they are busy breathing down my neck reading this thread over my shoulder. go back to work now!!!!!!!! now......this thread....has helped alot of us here. i have 10 coworkers standing here reading this with me everyday. some comments are from them...some from me. but we all feel the same. he is part of our dysfunctional second family here. .....and we all feel guilty to varying degrees...that we didnt notice...that there was a problem...tilll....it almost cost him his license. that.....is where all this is coming from....in all of our comments. we are all very tight nit.....we know everything about all of each others lives....and we trust each other. he lied to us......but we let him down. we didnt recognize there was a major issue...till it slapped us in the face. and the bathroom deal......i have 10 people reading this thread......and nine out of 1o of us said if we saw a coworker making multiple trips to the bathroom we'd think uti, renal calculi...etc...not drugs. only one said they'd think drugs....and jack....i am sending her for a drug screen now. lol. but....we all.....feel like we let him down. he will still have all 10 of us there for him....some more so than others depending on whats going on in our own lives...and we all plan on going to one of the alanon meetings at the end of teh month. our unit secretary is looking for one of the ones listed as "open " for us. but.....speaking for me....and my unit of cohorts that have posted here under my name.....thank you for sharing your insights, your knowledge and your links...and your own personal stories. it helped. what is behind our posts....jack.....is good old fashioned guilt. we are a dysfunctional functional family here at work. quirky personalities,...19 degrees between all 10 of us.....and we didnt even notice there was a problem till it slapped us in the face and he almost lost his license.

hmm...i dont understand. what do you mean? being stressed out can cause you to become an alcoholic or addicted to drugs? i mean.....i guess stress may play a part....but i am not sure what you mean. from what i have read their is a big physiological component that kinda gets activated if you are predispositioned for addiction. i dont understand what u mean......just bc people go to the bathroom alot...nobody thinks there on drugs.....hell id think they had a uti before id think they had a problem with drugs or etoh.

right now...i think...he just needs to concentrate on him. so...i am just going to leave him be for awhile. let him sort stuff out and in a few months or weeks....try to see whats up. i mean..until everybody sees what he is going to do....we cant help. whats that old saying? god helps those who help themselves...so hopefully he will see this as a way to a better life.

I keep trying to wrap my brain around it...and I dont understand it. Part of me...can see maybe how some of this works,..but it still doesnt make sense. I feel like I was lied to ...bc I was lied to. Now...I listen when he calls....I listen when his kids call...and when his mom calls.....and I am now thinking he is feeding us all a line of BS and maybe ....they have to deal with it. But I ...just dont. So...I think....until he does get it together Id be better off just cutting off the ties until he deals with this stuff. I dont even think he can establish a relationship with his mom and kids till he deals with all this stuff...so I am just probably feeding into his pity party. I know you guys have probably had alot of friends kinda walk away out of your life when things kinda got rough.....so ....I guess.....while I have learned a tremendous amount from you guys......maybe......I can help you can understand WHY some have walked out of your life too. You guys were and still are successful, smart , well educated , personable......and we dont understand. I ...probably like alot of your friends, wonder if I am still gettting manipulated or lied to. When I asked my friend if he had a problem....he made me feel guilty or bad I had even asked. then when I found out he TRULY did have a problem...I felt lied to....and then felt like I had to question everything he said...or everything he tells anyone to screen them for lies. I know all this stuff is so complicated.....but when you feel like you are having to internally screen everything for truthfullness...it cant be healthy for anyone. So.....I know he is a good guy. But....I think....it would just be better to just stay away for a few months till he gets more of a grip with his life. Then maybe he can deal with his kids,...and then his family....and when he is more sober...add friends back to the mix. And I have heard from a few people ....that had hard feelings bc friends just scattered by the wayside after your "intervention". I hope you guys realize...maybe they just didnt want to complicate things,...and that they probably didnt want to make things worse for you...and that maybe....they felt like I do. That you'd be best left to sort through your problems and primary family members issues befor eyou added friends to the mix. I want to thank each of you....while I still dont fully understand this stuff...I do have a bettter idea of it. I want to thank you for sharing your stories and insight. If my friend was as far along as you guys are in your acknowledgement...Id stick around.....but he isnt. So I cant see myself helping him ...so I think I am going to do the best thing I can do.....leave him alone to sort out his issues.I dont want it to seem like I reported him and then walked away...it isnt like that. I feel guilty...really guilty I reported him. But...I cant make his get control of his life....what I can do.....is walk away and let him focus all his time and energy into dealing with his issues. And maybe .....this is what happened to some of the people in your lives too. And now....that you have reached the point in your recovery....I bet they'd like to hear from you.

I think I am just going to step out of his life for awhile....and BTW...jack/...you said I cant help my friend by becoming obsessed by learning everything in a couple weeks. I want to clarify....I didnt know anything before I started asking questions here. I am sorry if my questions seemed" obsessed". I was actually trying to just educate myself. The case manager person...I havent spoke to since a day or so after I reported him. The information I have gotten is from him or his family and I have no idea if it is accurate or not. That is why I have asked questions. This is just too much....I think I will stop taking hi s calls. I have no idea what is the truth anymore and I dont want people thinkin I am obsessed bc I wanted to help a friend. Thank you all for the information you provided...and for sharing your wisdom, insight and personal stories.

ok...first of all i am not his anything.i am one of the few..actually the only friend that has stuck around. i talk to him daily...or his family. secondly...i am not a moron. i dont think he'd have to be falling down drunk to have relapsed...or that he'd have a glass in his hand. he actually hid his drinking very well at work. nothin even seemed amiss till he showed up dog ass drunk. i mean...he chewed halls cough drops alot.....but his behavoir at work never seemed drunk till this last time. nothing tipped us off...so i dont think i agree with the fact that you said i could recognize that he had relapsed bc he'd have a drink in his hand and he'd be drunk...bc that...is not how he was before. i can see why some friends do walk away. i am here trying to get some insight to help somebody that is a friend. so....i am sorry that you think all the nurses and doctors that worked with him for years are idiots.....by not recognizing he had a problem. i am sorry i get accused of being something more than a concerned friend. i take his calls. i take his family's calls. i take his kids calls. now how much of it is 100% true i dont know.but...i take their calls. this is why i was asking about him being able to visit family out of town. geez.......maybe you didnt mean it like that but 1. i am actually a decent person trying to help a friend...nothing else. he doesnt have alot of support and when his family leaves it will be even less. didnt know i was going to get accused of all kinda things bc i was trying to get info. i am not a moron. and...this is a good guy. has always helped people. patients with no money come in......and the kids are there with nothing to eat...he goes to mcd's and gets them food. pregnant pt comes in with no money to get home after a abusive husband gets carted off to jail for breaking her ribs...he buys her a cab fare home. and from what i have read.....it seems like this is always a struggle. so your demons dont ever go away....they just hibernate....and hopefully never awake and that is what i meant. not that they are struggling each day not to relapse....just that it is probably good to have someone who is educated on the topic.....and not having hibernating bears to deal with.but again...i am not a moron....nor were the other dr's and nurses.

thank you so much for sharing all your insight. i guess it makes sense to have case managers etc that are not kinda fighting their own demons. this...is complicated stuff. i am still kinda sorting all this stuff out in my head exactly how it all works. i guess that helps the bon members alot,...having you guys at this conference to keep them in touch/ ground them. i see patients all the time in the ed trying to get something...they come in with a plan and over time we have learned their behavoirs,...at times we even know what complaints they will have , what they really want and what they need. what they want and need are seldom the same thing. at this conference.....do they ask you guys alot of questions? or do they come thinking they are going to educate you? see...the case manager i spoke with seemed very wise to say the least. they told me that what my friend was doing was manipulating me when i told them he had a way of making me feel bad i had even asked if he had a problem. ok...this is probably the last question i have for you guys. how can you tell if someone has started to reuse? is the initial behavoir re-exhibited? or do you see other things ......i mean tehy way you guys describe this is like a rollercoaster that you have to be on for a while till you see the ride end. so...you cant just say because they are disheveled/ dont care about their appearance that they are using...bc it kinda sounds like hell. it sounds like your body proabably feels like it has been on the spin cycle so you might not have energy........and i dont think id be able to reconize if he was relapsing...bc hell i wasnt 100% sure he had a problem till it slapped me in the face. i see that this is his great hope...he feels like it is the end of the world. it isnt.....but with such deceitful behavoir...dont know how to help ...or maybe id be doing him a better favor to just stay away till after a few months.maybe this is why alot of people walk away.....we just dont know how to help and dont want to make things worse.

lol...the reason they do the 12 oclock to 12 oclock nipple twist is to check for response to central pain stimuli. they probably would do sternal rubs if ...if they only had one patient. but most of the trauma docs and neurosurgeons have 10-20 patients with profound neuro injuries and if they wont respond to voice.....well if they did 15 sternal rubs twice a day their knuckles would be sore as hell. difficult to operate on patients when it hurts to flex those fingers. so a 180 twist on the nipple or...the chest wall is the standard to check for central pain response to see if they withdraw or extend. otherwise they 'd be walking around with raw inflammed knuckles bc they not only have your 1 or two patients, but also every patient that lands in the er , every mva with a chi ....and every patient in the unit or the hospital that has a neuro incident. stay around long enough and you get desensitized to it, and keep in mind....they arent doing this if they respond to voice or touch...at least...i hooopppppeeee they arent!

I am suprised that they dont have people that have successfully completed the program on the panel that reviews complaints. I mean .....that would be the equivilant to having me on the panel that reviews them. And ....I apparently am pretty gullable. I still cant completly grasp everything you guys are describing. I almost fell for his shennanigans again the other day when he told me what was in the contract. I dont consider myself easily manipulated....but I have been. So there is no way to compare the knowledge I would bring to a review panel with what one of you guys would.So....that suprises me ...that they dont have recovering nurses on there. What about leaders for these peer group meetings....and the case managers....?

if you guys could change anything about the way the bon, or the board of medicine attempts to help what way would you change it?

i guess i am still looking at this as if it is something easily controllable....and it isnt...i get that. it is hard to understand...but....i guess i am lucky i dont understand. i have actually ordered 2 of the books you talked about. i love to read...and as i still dont understand alot about this it might help. i do have one question though.....with the tpapn contract being so rigorious....is there any data available on the success rates? i mean....like...exactly how many can complete the program from begining to end without a violation? and also how do you guys handle it when you go on vacation....if you are oit of state as his family is?you call the number each morning...and there has to be a lab nearby? i know he is trying to wiggle out of signing the contract...which is sounds like is par the course. and i was suprised when he showed me the things he has to do. but....it looks like nothing else has worked. he acts like his case manager is going to be a real hard a**, but...i cant help but think that they will work with him if he wants to travel to see his family out of state. that was the big issue.