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scottaprn

scottaprn

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scottaprn's Latest Activity

  1. scottaprn

    FNP > RNFA (DNP question)

    You need to focus on finding a clinical experience that will give you want you want. It sounds like you want some OR time so look for a rotation with a surgeon. The only way you are going to learn these skills is to do them repeatedly. I learned to first assist in a clinical for the surgeon I work for now.
  2. scottaprn

    Thoughts on pain med with a range

    Yes I am proud to be an advanced practice nurse. And if you think that is vague I will be more than pleased to help you with your reading comprehension. Wouldn't it be prudent (prudent means acting with or showing care towards the future) to actually know something about the patient (like an assessment, diagnosis, past pain control treatment and their efficacy would fall under "actually knowing something about the patient") before making a blanket statement about their pain medication regimen (For example expressing a belief that there is a magical level at which everyone needs to be on a long acting opioid). Hopefully, knocking it down a few grade levels will allow it to be less vague for you. Here is the thing. A patient who is in pain needs to have their pain assessed and treated in the manner that is correct for them- that is the basis of pain management (something I supposedly know nothing about per the poster). Treating the patients pain may mean long acting opioids or it may mean short acting opioids or it may not mean an opioid at all. The decision does not belong to a keyboard warrior with imaginary powers- whether they are a hospice nurse, a nurse practitioner or a physician. For the poster to tell me I don't know anything about pain management because the poster believes the only correct treatment for the patient is a long acting opioid based on no knowledge of the patient at all is absurd. For all the poster knows the patient may have failed a trial of long acting opioids- but the poster doesn't know that because she doesn't know anything about the patient. If a nurse calls me about a patient and they haven't assessed them I tell them to call me when they have made an assessment. This is as bad as Terry Schiavo being diagnosed by physicians on CNN off a ten second video clip. Let me reiterate that no professional pain medicine guidelines suggest interventions or changes to interventions without assessing the patient. Period. End of story. Yet the poster tells me I don't know anything about pain management when she is making recommendations with no assessment. She has proven herself the fool. And if you think I am dismissive to nurses who show ignorance like was just demonstrated you are correct. It is an embarrassment to the profession when a nurse suggest interventions and claims to be an expert of pain management when she doesn't think it is necessary to know things about the patient before recommending a treatment plan. I can't think of a way to harm the profession more than to publicly demonstrate ignorance. Do you ever wonder why nursing doesn't advance as a profession at a faster pace? Part of the reason why is because we tolerate and accept stupid statements like the poster made. At least when the resident says something stupid in rounds they get corrected. On the nursing side we get other nurses supporting stupid ideas. And if you don't think that the physicians are every bit as dismissive as I just was to baseless suggestions get a badge to the surgeon's lounge and hang out and see what stories you hear. So just to hit the highlights so we aren't to vague. ASSESS THE PATIENT BEFORE YOU MAKE BLANKET STATEMENTS ABOUT HOW THEY SHOULD BE CARED FOR. Also, don't claim that someone doesn't understand a topic on which they can run circles around you.
  3. scottaprn

    Thoughts on pain med with a range

    Well don't I have the best luck that I can learn about pain management from someone as knowledgable as yourself. So please enlighten me, oh wise one, from where you received your pain management certification. I am assuming a cracker jack box since I can't think of a single respected pain management certification or plan that doesn't have assessment of the patient as the first step. For that matter can you name a single medical intervention that should begin without assessing the patient? I can't wait to hear about your extensive pain management education and experience that has taught you that it is not necessary to know anything about the patient before prescribing a pain management protocol. That way I will know to avoid wherever you learned this knowledge like the plague so that I can continue on with actually assessing patients and treating their pain appropriately for THEM. Argoff & Silvershein Mayo Clinic Proceedings 2009
  4. scottaprn

    Thoughts on pain med with a range

    I would have no problem with you giving the medication in the manner you describe and it wouldn't violate the policies of the facilities where we admit patients
  5. scottaprn

    Thoughts on pain med with a range

    Wouldn't it seem prudent to actually know things about the patient and situation before making a blanket statement about their pain medication regimen?
  6. scottaprn

    NCLEX - It must be all a myth.

    Congratulations and you are correct. Almost all the stories about the Nclex are myths. But they are harder to kill than almost any horror movie ghoul
  7. scottaprn

    Screwed Over by My School

    Rereading the post I do think the poster may have a legal claim against the school with damages in the amount of lost potential salary. The real question for the OP to consider is whether or not it is worth pursuing those damages. I don't see how the media or anyone besides an attorney would be helpful. The best course of action may be to contact your local bar association for a referral to an attorney to discuss your options with. They may tell you it is worth pursuing or they may tell you it isn't worth dealing with. Based on your posts you seem angry enough that you probably need resolution so that you are able to move forward. A conversation with an attorney would probably be the best way to get resolution from an outside source. Sometimes you can't fight city hall- but sometimes you actually can.
  8. scottaprn

    plagiarism??

    I thought the entire purpose of an EMR was to make copy and paste easier. As always I turn to gomerblog.com for further understanding. Surgery Resident Successfully Writes an Entire Consult Note Using only Copy-and-Paste | GomerBlog (Yes this post, just like gomerblog.com is satirical in nature)
  9. scottaprn

    Tough point in my life

    The only thing that matters in this entire situation is YOU. Not "you the nurse" or "you the coworker" or "you the worker". It is YOU There are always other jobs (better than one we have ever imagined) other hospitals (with sicker patients who need our help) and basically a world that can be better in everyway than your current world. But if you aren't there for that exciting new world it means nothing. You need help right now. Please get it. Call a local crises hotline and get started on your way to better health. If you have no other way to reach out to someone please let me know and we will find a way to get help to you. When you are better physically and mentally come back and we will help you figure out your career.
  10. scottaprn

    Screwed Over by My School

    Ehhhh I agree with there probably being not much to do at this stage but the loss of 3 months of potential income would have me upset. I doubt the BON would care but you might find a sympathetic ear in career services or the President's office.
  11. scottaprn

    Report me???

    If you have looked it up like you said and BON doesn't prohibit it why are you worried about it? Print out the sheet of paper from the BON and hand it to the nurse who has no reason to be in your business and tell her to kindly get lost. Then quit talking to people at work about things unless you want them broadcast everywhere. There is no such thing as private conversations at work as long as there are busy bodies with nothing better to do than stir up trouble. You will find this is an over represented class in nursing.
  12. scottaprn

    Attorney contacted me about lawsuit

    It was merely an example and just like EVERYTHING it is state specific since each state has it's own practice act. For that matter in some states an RN can declare someone in hospice care dead but the same RN could not declare someone dead on an acute care floor. Since you work in hospice your scope of practice may differ greatly from a majority of other nurses- again depending on the state and situation. Now if you will look past those trees you got caught up in you can see the forrest which was the purpose of the post.
  13. scottaprn

    Nurse Practitioner Restrictions

    I work in a tri-state area and practice in three states. It is amazing the difference that a couple miles makes in what I can do in practice. Luckily none of the three states are among the more restrictive nationwide but I don't believe in any restrictions that keep me from practicing at the limits of my education. Lobby your state government. Your state senators and state representatives represent fewer people compared to our congress in Washington and it is much easier to meet and talk with your state representatives (who will ultimately be in charge of your state practice act). Take your time to educate your state representatives. I deal with one state rep who always wanted to talk about the role of my "supervising doctor" and lump NPs and PAs together. I stopped him every time and reminded him that a PA signs a supervisory agreement with a doctor but I have not ever, nor will I ever sign a supervisory agreement. Nurse practitioners sign a collaborative agreement with physicians because we are independent health care providers who work in collaboration with members of the healthcare team, including physicians, but the physician does not supervise me. Focus on the fact that you want the state practice act to allow you to practice at the fullest level of your education. You are not asking the state legislature to turn you loose in the OR to do a CABG. You are asking them to let you put into practice the knowledge you have gained through structured education- Nothing more and nothing less. Never concede that physicians are better equipped due to more hours of training. Anticipate that they will trot out the same story about how physicians have x amount of hours more training compared to x amount of training for an NP. Every time they bring it up ask them for the study that has shown the number of training hours necessary to be competent to be a practitioner. No such study exists. Does anyone think that the orthopedic surgeon I work for is a better orthopedic surgeon because of his rotation through the medical ICU as a resident? Give me a break. Language matters when speaking to your patients as well. You are never "just a nurse practitioner" if someone says that (gently) correct them. You are a highly educated and skilled healthcare provider and not "just" anything. OK off my soapbox now.
  14. scottaprn

    Attorney contacted me about lawsuit

    Do you really think if you get called as a witness you are going to get away with only answering things in your scope of practice? If the case is about the MDs failure to diagnose/treat you will be asked about your nursing assessment, changes in the patient's status, interactions you may have witnessed between the patient and the MD, the behavior of the patient, the behavior of the patient's family etc. etc. etc.. If the attorney asks you if the patient was alive are you going to decline because it is outside of the RN scope of practice to declare someone dead? Not only that but one of the first questions you will be asked is if you discussed this case with anyone. The answer to that question is yes. And when they ask with whom you will get to tell the court that you posted about the case in an online forum. Any attorney who is worth anything is going to pull up this thread where you talk about appearing in court "in scrubs and sleeping" and the limits you are going to put on your testimony. A good attorney is going to put you in a negative light very quickly. You are correct that without a subpoena you don't have to go and answer anything but if you get subpoenaed you will wind up as a case study for staying off the internet when it comes to talking about litigation.
  15. scottaprn

    Attorney contacted me about lawsuit

    You can make your own decision about wether or not to speak to the attorney now or risk getting called and being forced to do it later- Which one do you think would be the more pleasant experience? And just a quick word. Having RN after your name is a big deal. It shows you are a professional licensed healthcare worker with your own scope of practice. It means you are held to a standard. You are not subservient to MD, NP or PA. We can't demand that we be given the respect we deserve in the nursing profession and then act like our professional designation doesn't matter.
  16. scottaprn

    Buying my 1st stethoscope!

    Used a classic Littman 2 all through nursing school so I think you would be fine with either. That said if you can afford a classic Littman 3 I would take it in a heart beat. There is a pretty big difference in what you can hear easily.