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SNF, Home Health & Hospice, L&D, Peds
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katfish67lpn has 27 years experience and specializes in SNF, Home Health & Hospice, L&D, Peds.

I am an LPN with 27 years of experience. I have experience in Acute Care, L&D, Pediatrics, Home Health & Hospice, SNF both Skilled & LTC units as Charge. Have additional education in wound care & rehab.

katfish67lpn's Latest Activity

  1. katfish67lpn

    Manager wants me to alter documentation on expired patient

    It is actually a good thing to chart that pt. has no BP/P, which of course you have to check before documenting such findings, as well as pupils are fixed & dilated. I have seen (once) a patient "pronounced" in a LTC facility when in fact that pt. was not deceased. The nurse on that unit had not checked BP or pupils and stated she didn't hear a pulse. This pt was actively dying so she just assumed she had passed. The nurse had to then tell the family that she wasn't actually dead yet..."Oops sorry for calling y'all in (as they requested) at 11:00 at night but umm, no she hasn't passed away." I always check BP/P & pupils and document my findings.
  2. katfish67lpn

    BSN is a joke

    I worked with a new grad RN BSN and I was charge nurse and needed to change a foley. She asked if she could watch because she had NEVER put in a foley.I guess what they don't think BSN's will ever need to place a foley??!?
  3. katfish67lpn

    When Your Doctor Doesn't Listen

    Well don't you know many of them think because they went to medical school it gives (some of) them the ability to make those decisions without really listening to what a patient is saying. Like when my son awoke with a fever of 105.0 with vomit and diarrhea spread from one end of his crib to the other. I took him to my regular pediatricians office and saw a fill in doctor who acted as if I was a hysterical, irrational mother and told me "if it takes three of us to hold him down, he is fine". It btw did not take three of us to hold him down. My husband was in the room but certainly had no part of the exam so wth he was talking about I didn't know but he told me my son was fine. I foolishly thought he knew more than I did and we brought my son home. Hours later his fever believe it or not had gotten higher. He was on fire and screaming between the vomiting. I called the local Children's Hospital and spoke with the triage nurse who told me to get him there NOW!! She said I shouldn't have waited so long, he should have been seen before now. I didn't have the time to tell her he HAD been to the pediatrician a few hours ago WHO TOLD ME HE WAS FINE!! When we got to the hospital they started IV fluids etc... They asked me if he had ever been on antibiotics to which I said "Yes, just once, about a month ago for an ear infection". They told me it was a long shot but since they just so happen to be doing a diarrhea study they wanted a stool sample and they found he had C-DIff. They told me really that most likely it since he had only been on antibiotics once and it had been a month ago, C-Diff wouldnt have been something they normally would have checked for. Anyway he started on Vanco and made a quick recovery. But I KNEW my son was sick! Further medical intervention was delayed because I listened to a doctor who didn't have the time to actually listen to me and because I thought "he must know more than I do...He is a doctor". I, from that moment on, have always listened to my mothers intuition and it has never let me down!
  4. katfish67lpn

    prescription drug addiction

    *Quote form BostonFNP*: In practice, I do need to make a judgement call, and I do that to the best of my ability/training/experience. My point above wasn't that a patient came in with a pain scale of 0 asking for Percocet, it's that their expectation is to be 0 on the pain scale,and the seek medication to get it to a 0. As an outpatient (and probably inpatient too, though I handle it differently there), the pain scale is nearly useless to me: it is too variable and too subjective. Pain is pain. If patient A can be functional at a reported 8/10 then my goal is to treat them to an 8/10. If patient B can't be functional at a pain scale of 4/10 then I need to treat them to less than that. *Quote* You maybe need more experience behind you (?)and (GOD forbid) some pain of your own! Maybe your provider will say to you...you're functioning at an 8/10 so that will be our goal. Are you kidding me?!! Just because one can function, and by that I mean barely survive, but hey I guess you're surviving, so you're good, is so devoid of actual understanding I can not begin to comprehend that thinking. Also if someone comes in expecting to have a goal of 0 out of 10 pain then possible some patient teaching may be in order, depending on the diagnosis. I have and do go to pain seminars and keep abreast on the subject however, as I said, it is individual and thats where I am leaving this conversation. It is exhausting tbh!
  5. katfish67lpn

    prescription drug addiction

    I could not agree with you more! Pain and a persons tolerance to and for pain is absolutely individual. Until you have had pain, severe, intractable, debilitating, acute or chronic pain you just wont understand. For those of you who have been lucky enough to never have been through that type of pain, count your lucky stars!.
  6. katfish67lpn

    prescription drug addiction

    As a lay person I cant say I would expect any different. Sounds like some patient education was needed at that moment.
  7. katfish67lpn

    prescription drug addiction

    Listen of course I dont expect to live my life without any discomfort. I am realistic enough to know that to think I or anyone else is going to go through life never having a ANY pain or discomfort isnt going to happen. I am speaking of so many patients, friends, family that have legitimate pain issues that affect their lives significantly that for whatever reason can not get their pain controlled adequately...lets not get so literal. What you think is adequate to function may not be so for someone else. Also when we ask a patient to rate THEIR pain on a scale of 1-10 ~ 0 being no pain and 10 being the worst pain THEY have ever experienced that is just what we are asking...in their experience. I, in my 30 years experience, have never seen or even heard of someone having an opioid script for 0 pain! If you have that is more than mind boggling and if it is something you have only heard or read about I would say more investigation should be done because I just don't think it happens. But I digress, Pain control is so individual for TPTB to now say that everyone must be under a certain, and btw arbitrary, MED per day is utterly ridiculous. As to your last question well personally I dont really care but I would like to see where exactly you have acquired that data however, I would hazard a guess that it may have something to do with the US being a compassionate country. I find you and I have very differing opinions so I will say we need to agree to disagree because I have no desire to go back and forth with you any longer.
  8. katfish67lpn

    prescription drug addiction

    Just because one takes opioids does not mean they are "going through life sedated"
  9. katfish67lpn

    prescription drug addiction

    Ugghh! Of course people want to have pain relief for crying out loud. I am so sick of nurses who decide they are the police of morality or whatever their opinion is about patients giving pain meds. I have seen nurses delay or refuse to give patients their PRESCRIBED pain medication because of their own, misguided beliefs! I had all 4 of my wisdom teeth out at once. I was prescribed Tyl#3. for pain however, when I got home I went straight to bed. I was in so much pain but was able to go to sleep...yes patients can actually sleep whilest in pain, sometimes it is the only relief they get. WHile I was sleeping the oral surgeon's office called and spoke with my sister. My sister came and woke me up and gave me my pain medicine because the oral surgeon's office told her if I didnt take it now the pain would be unbearable soon. I took the medication and I was really shocked how much relief I had received from the medication. For the most part people want to have pain releif period. Sometimes until you are out of pain you don't realize how much pain you were in.
  10. katfish67lpn

    prescription drug addiction

    What I find hard to understand is why in this day and age anyone has to live in pain...period! Not to mention haven't we as health care providers been mandated to assess patient pain and treat pain as if it was the worst offense if we did not treat the patients pain as they said their pain was? Now all of the sudden they say, now too many people are on opioids and we must do something to combat this!? What a bunch of bs! I believe in managing a patients pain. I have seen so many patients with under treated pain in my career and I for one was so happy to see the tide turn in favor of prescribing more freely. I am just so disgusted with the about face and the act as if they have no idea how this all happened!
  11. katfish67lpn

    How do you feel about having other nurses as patients?

    I have been a nurse going on 30 years now (which I find hard to believe lol) however, I have been very ill and hospitalized as well. I was so sick I was unable to think as a nurse... I was a patient a very sick patient and I didn't want them to assume I knew anything at that point, although the staff knew I was a nurse. Being hospitalized is no ones best "hour" and thinking is not always clear or rationale for patient or family because health issues do cause much stress and fear. So for me, yes, I prefer to have everything explained as you would to other patients and if I am able to formulate the thought to ask questions (i.e. specific lab values etc) I will do so. Although after I had my oldest child I tried to help with making my bed up and the nurse told me to sit down and take it easy, I wasn't on the clock and she would do it for me lol old habits die hard. With my youngest I foolishly allowed the nursing assistant to assist me in walking to the bathroom before my epidural had completely worn off and even after I heard the nurse tell her not to try to walk me to the bathroom alone. Im not sure why I allowed it and then when the nurse came back and saw that she had assisted me alone, after she had JUST told her not to, I jumped in and said I had been fine, which I actually wasn't. Im not sure why I defended her either because I heard what the nurse said to her and logically knew it wasn't safe. That is what I mean by our nurse minds dont always work as they would as our normal work mode nurse minds do.
  12. katfish67lpn

    Unable to endorse my license

    I understand her situation. I just was surprised by how different the process for filing for reciprocity of a license is in different states. Thank you though for the clarification.
  13. katfish67lpn

    Unable to endorse my license

    I am originally from Washington and I have filed for reciprocity of my license in Maine and Oregon. It took a little paperwork, and about $150-200 and I had my Maine license in 2 weeks. Oregon was a whole other story...it took paperwork, having my nursing school transcripts sent to the OR BON, proving I have worked something like 900 hours in the last 5 years, fingerprints, background check and finally about 45 days later i finally received my OR license. So it really depends on the state, because in Maine they didn't need any of that, of course I had to give my WA license number but really besides money not much else. Good luck to you.
  14. katfish67lpn

    Outgoing LVN refuses to do a Narc Count

    I had the same thing happen but I was working over until 3am (from my 3-11 shift in SNF) and the oncoming nurse (again at 3am) refuses to count with me...I finally had to call the on call nursing supervisor, who said "why would she do that?" Which my reply was "I have no idea." because I truly didn't and still don't. So the nursing supervisor asked to speak with the refusing nurse and she acted like she had no idea why "she had the bother you"!? She did count with me after the call but dang I mean really, it is MANDATORY. I don't do the "I counted and everything is fine". I really do "make" the oncoming/off going nurse do the actual count...I've seen too much in my years to do otherwise.
  15. katfish67lpn

    NG insertion Doctors VS nurses

    I am an LPN with 26 years of experience and I have placed many NG's I have done many on my own and actually no X-ray to check placement just aspirate and auscultation were my verification.