dtweed

Some of us in LTC are working on pain as a fifth vital sign also. We just implementated a pain management policy in the facility I work in. We have a long way to go, but it is very necessary. When we cognitive impaired individuals we need to learn torecongize pain and treat it. We also need to treat pain in the dying. My mother-in- law died in March of 1999 and her pain in LTC was treated very well with duragesic patch and then IM morphine. My mother passed away in February 2000 and her pain was not. They died in different facilities and with different doctors. Pain mangement is something tha is close to my heart becausse of it. The staff where my mother was afraid morpine would surpress her respirations. She hadn't eaten in three days by then, surpressing respers was the least of there worries. She had made the decision not continue to live housebound on home oxygen any longer. When people make those decisions we need to support them and help them be as comfortable as possible. I know I have alot to learn yet but I want to make a difference.

A real Nurse is anyone who takes cares of patients. I have seen some very good CNA's, LPN'S, AND RN'S. And i have seen some not so good. I have worked acute care, critical care and now am in long term care. LTC nurses do much more than pass meds and do treatments. They usually are in charge of everything that happens in the facility when "management" is not there. They are always faxing or calling Doctors for orders. They hold hands of the other staff when a resident has died. They intervene with staff disputes. they call in staff when someone calls in or doesn't show, while passing meds to 40 to 60 residents. They help families adjust to placing a resident in the nursing home or to the illness, or death of a loved one. They help all departments to get along. Then they make sure all the regulations are followed so that no one gets in trouble. Many of these nurses are LPN's. They do a great job. There are amany degress a real nuse may have. I am an ADN who had been a Lpn for many years. I now work as an ADON. I feel like I am a Paper Nurse more than a real Nurse. What I do is important, but I respect those nurse who go out on the floor every day and do what they do. We need more of them and less of us paper nurse's.

lIn one facility I worked in, they adopted a whole book of medical abbreviations. On very, very slow nights, when all the extra cleaning was done, we would make up stories using the abbreviations. The best one was bthoom. It stands for "beats the hell out of me." Dctors were able to use this for a diagnosis. I think we know some doctors who used this all the time because thay didn't have a clue. But their are some great docs out there also