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  1. SobreRN

    Failed nclex 11 times.

    I agree, I worked very hard and absorbed everything in college then took NCLEX straight out of school. Although I am book smart it was work, not luck.
  2. SobreRN

    How long does it take to get gate clearance?

    Sure, I will PM you!
  3. SobreRN


    What is 'Christmas break'?
  4. You are new and this is normal. Patients are much higher acuity, when I was new they stayed 3 days for a chole and I felt overwhelmed all of the time. Try to take it a day at a time and know it gets better.
  5. SobreRN

    Extreme nurse burn out need help please

    I would have called the cops and done everything in my power to get him indicted for assault likely to cause great bodily injury. I would have attempted to move Heaven and earth to get those charges to stick if it meant being the DA's #1 pest. I'd also sue him in civil court, if hospital did not back me up I'd sue them. I'd do this after contacting security at the facility leaving a paper trail of his actions. For someone who is in that bad a shape he sure sounds as if he can dish out abuse. Glad I work in state prison, custody does an excellent job of protecting us!
  6. SobreRN

    Quit first hospital job after less than 6 months

    I would have fled in less time; that 1st year was most stressful of my life. Book smart and street smart but no idea walking in the degree of responsibility and constant exhaustion working nocs. I'd been a waitress for years, any mistake could be redeemed by a free mousse/ drink etc... I had a lot of tenacity and, more importantly, a preceptor who did not eat his young and I was being eaten alive. A few were quite open about it and while I had a tough youth I went into that 1st job so blindsided I was a wreck; on a good night I'd make it all the way to the car to have a sobfest, a few nights I just stopped for a sobfest on the floor prior to report with abject dread over what the shift would bring. They thought I was an unhinged basket case and I was. And I was, if preceptor hadn't been kind I would have turned around. I used one person as the glue to hold it together and stuck by him as my protection; shelter from the storm. My luck we became friends and he had a codependent side. So I stayed and it got better, took awhile. I finally went to days as I never adjusted to nocs. Worst part was no longer working with the colleague/friend I'd come to rely on to protect me from any/all ugliness staff could dish out but I became stronger. In reading this I feel urge to sing "I will survive"! And that is the way I felt, even as a ball of insecurities wrapped up in fear with a nice bow of angst wrapped around it I suited up and showed up no matter what although I think I became a bit too thick-skinned in process never letting my guard down. Survival instinct as there were still some sadistic colleagues and managers out there, it made me a kinder person in the long run. I wish you well! Remember it does get better but it takes time.
  7. SobreRN

    Opiates Are Not for All Pain

    300 mgs of Gabapentin HS for that pain; why not just go with a placebo? Seriously and no snark intended, having worked past in oncology to this day longer than any other speciality made me a patient advocate for treating pain, I have seen some horrible deaths. Most people fear dying in pain more than they fear dying and how much time can a 90 year-old have left. As the 90 year-old would be tested for her Rx which I completely agree with given she cannot advocate for herself she'd be testing positive, if this were my mother I'd run to another clinic. It would be different if all of this were related to med side effects only but if that were they case there are a host of meds elderly patients would not be receiving. All blood thinners, all chemotherapeutic agents, a host of various anti-hypertensives and the Ibuprofen we hand out like candy on Halloween. I'm not stating this is the case with you but in the general we are not treating pain for #1 primary reason being 'the war on drugs; part two', I remember part one in the 1980s wherein inner city kids were tossed in jail forever over crack cocaine while the well-heeled snorted same drug off of discotheque tables. As for the same inner city folks they've always had heroin addicts as well, they did not go anywhere and they still OD. Yet every 'cautionary tale' involves white people so we had to declare a crisis. We even renamed it 'opiate use disorder' for them and push Suboxone like candy in spite of the fact it has an opiate. I actually don't fault providers as their fear of the DEA is well-founded, providers make easy targets; they don't shoot back and keep good records but, as with most things when the pendulum swings it swings to polar opposite with every well-heeled parent of a white OD wanting a new law after lil white Bobby/Susie. We give massive doses of methadone to heroin addicts and hand out 5/325 mgs Norco to cancer patients. I do not see the equity in this and working in corrections the vast majority of inmate withdrawing from methadone/Suboxone also use heroin, they tell me it's quite easy as methadone clinics just test for opiate metabolites which they will have (they don't get methadone in jail; very few controlled drugs in jail due to contraband misuse.) But I digress, the elderly frequently have the most chronic pain and are the most undertreated due to everyones' concern for side effects on this specific class of drugs. So...we make sure we treat that HTN and A-fib in the interest of extending everyones' life without regard to their quality of life.
  8. SobreRN

    Opiates Are Not for All Pain

    Death from respiratory depression from oxycodone TID? Not likely unless she already has one foot in the grave and the other on a banana peel in which case she should be under hospice care. And 'high' on PO meds? Have not seen any patient get high on POs and you show your hand with that comment. I don't use anything more mood altering than coffee, I also do not take inventory of others. If said 90 year-old were looking for a buzz I'd think she'd have a bit of a history with ETOH; you know, that widely accepted drug which only purpose is to alter ones' mood and which many of the more self-righteous imbibe in freely. I pray I do not live to be 90 with providers basing most of their decisions on fear of the DEA rather than fear of the patient functioning.
  9. SobreRN

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    "What if there was not a culture of expediency, to get the job done at all costs, and hurry up?" Spot on! I grew to loathe techs until I came to conclusion that someone was pressuring them to get er done stat for non-emergent situations. I believe I cited this as one of the factors in deciding I no longer do floor nursing. When I did one would think I could throw wings on and fly the patient 4 stories down for a CT/MRI/PET etc...what was the big rush on this PET for? That and I am surprised that anyone pushing versed would not know generic name? I worked many years in oncology; needed chemo cert but not ACLS, I did not push versed until years into my career + adding ACLS. That was some time ago, do not recall even pushing morphine on an opiate-naive patient without monitoring them.
  10. SobreRN

    Verbally Abusing a Nurse

    THAT would be reason #1 I do not work in hospitals anymore. Among my 800 reasons when CMS wrapped up patient satisfaction into reimbursement I saw this coming. Alert/oriented patient tantrums. I had one manager who: patient freaks out because they are not getting their drug of choice administered stat when they don't yet have an order for it and manager in room also having a tantrum over same. I've worked everything from high end hospitals to county and the entitlement attitude is alive and well among the wealthy and the poor. I don't buy it that not feeling good is all it is. Feeling lousy should not give one carte blanche to be an abusive tantrum-thrower and those who abuse hospital staff, I suspect, are same ones who abuse retail etc... staff. When I switched to working corrections some years back I actually found the majority of patients to be quite polite. If they are rude they go back to their cell, that and they generally appreciate medical staff over custody staff. Amazingly most people can behave if they have to.
  11. SobreRN

    Reminder why the seven rights are important

    I does not sound like an emergency to me either but when you have for tests be they non-emergent MRIs/CTs/PETS crawling up your a** and hounding you in the interest of sticking to their schedule it is stressful. Reason # 43 why I do not do hospital nursing anymore; having tech browbeat and just get generally obnoxious over having that patient at whatever test area on the DOT on their schedule. Last hospital I worked at had a 'hands-off' thing which had nurses timed to the nanosecond having that patient down for their test. More than a few times I was pushing that 1000 pound stryker bed solo as whatever department DEMANDED I drop everything in the interest of getting that patient to whatever test with only reason being they needed a test prior to DC. I grew to loathe techs although in all fairness they are likely being pressured by someone else to not fall a nanosecond behind schedule. I never assume anything in the hospital is non-emergent; just because the patient is non emergent does not mean the hospital is not pressuring everyone to get 'er done stat particularly if the test is all they need to DC them so they can shovel them out and get an admit. Granted not the same as adrenaline running high but that, in itself, could lend itself to a bit of complacency. Last time I was involved in a RAT with an emergent intubation I called out the med I obtained and was giving; glad I did since another nurse who did not call it out was about to give the propofol I was also about to give. I hate to 2nd guess on why h/she was not looking up versed under midazalom? Brand names have not been used in acute care or anywhere else for quite some time. Perhaps h/she was pressured and thought looking under 'v' would be a shortcut. Not all nurses, myself included, have worked with paralytics but most experienced nurses know what versed looks like but this may have been a new nurse. New grads were not hired on to critical care in years past but that is not the case any longer. Med errors are not new but sensalitionaling them on social media is and, as others have cited, this yellow journalism in pointing out same drugs are used in lethal injections is included for what reason?
  12. SobreRN

    Reminder why the seven rights are important

    I agree, this has nothing to do with death row and that is not what the drugs are usually used for.
  13. SobreRN

    Reminder why the seven rights are important

    Why the hyperbole in pointing out that these medications are used in death penalty cases when they are USUALLY not?
  14. SobreRN

    Vent/rant on Nature of public forums:

    They most certainly suck money out in rehab industry but that does not bother me as much as the enforced 12-step meetings. When I became clean and sober as a young waitress I had no money and no insurance (also no arrests) I had popped in and out of 12-step from an early age. It was the last house on the block and I love 12-step to this day but forcing nurses' in diversion and people who have DUIs into 12-step only serves to leave them with impression that 12-step is 'punishment'. Those who go willingingly are, in my observation, true alcoholics who hit bottom while those who got a DUI for being just at legal limit are all too often 'normies' who had 2 glasses of wine. Same with nurses who are popped on 2 drinks, I used to hold the attitude that normies should 'know better' given they are not so impaired but changed my thinking on that. I now suspect that 'my people' are more sneaky and adept at taking side streets, watching our speed etc...as we know we are over legal limit when we fall out of bed in the morning and put more thought into avoiding the police. I just do not like 12-step, the only non-profit, to be used as punishment.
  15. SobreRN

    Baby nurse doo doo doo doo....

    Depends upon the other patients. Everything went great but if you have another patient who has stat needs the extra help from rapid would be good.