Pushing drugs for the Man bother anyone?

[somebody]

Hello All.

I'm a newbie taking prereqs for a BSN.

I just have one big nagging concern keeping me from fully committing to the program. I want to help people, but I feel that the western allopathic way of surgery/drugs is often very harmful (although sometimes needed in cases of trauma etc).

Does pushing drugs for the giant pharmaceuticals bother anyone out there in the nurse world? I just don't know if I could live with myself doing it all day when I know that many problems could be solved simply by diet change etc.

Please enlighten me!

[bagladyrn, RN]

Some really good serious answers here, but for myself, I can't help but envision what would/will happen if the OP makes such a statement to a tough old nursing instructor....

[David's Harp]

FWIW, the OP has obviously been thanking some of the harsher responders for their time!

Anyway, an interesting can of worms is opened here, albeit one which could've been worded a lot more graceously ("pushing" indeed!). Yes, there are large corporate interests that get served even with the best of our intentions, but as has been pointed out repeatedly, the lesser of two evils has to prevail sometimes to treat an acute situation. A lot of these situations were not brought on by modifiable behaviors, either (IDDM, congenital heart anomalies, heck even just the effects of aging on our vasculature). Many of the available remedies are, at their root, natural ones (digitalis plant, PCN, others), for one thing. For another, it's important to remember that we do not cure, we care.

Part of caring does involve administering meds, but part of it involves everything else we do for patients including listening, nonpharm pain management, controlling environmental stimuli as best as we can, ensuring that Johnny NPO has a tray ready when he returns from his stress-test, ...a million things, including holding medication that we find is either erroneously prescribed or is rendered inappropriate by the patient's present physiologic state. These are the things that someone unfamiliar with nursing practice doesn't tend to notice, so it's no surprise that the original post didn't factor them in.

As for the preventability of some problems, remember that at one point relatively recently we had no problem with lead-based paint, lard as a staple cooking ingredient, cigarette smoking, asbestos as a construction element,...the list goes on. Then again, there's the guy who smokes 25 bags of crack, the guys on "Jackass", folks who base-jump...

My take on the OP is that here is a nursing student with a conscience, and boy do we need more of them! Whatever you end up doing (primary level of care may interest you more, who knows?), keep asking the uncomfortable questions. I'm pretty new to the field myself, but I hope ten or twenty years out I'm able to hear a newcomer's questions and think to myself, "Hmm...how DO I feel about this? Am I totally okay with it all?"

-Kevin

[time4meRN]

Sometimes it does, we have drug reps come into the ER, they give us nice dinners from nice places, pens, note pads and the list goes on and on. I started telling the reps they could keep their dinners and save the money for little old people who couldn't afford their meds. At first other nurses looked at me like I was nuts but then it started to catch on.

[FireStarterRN, BSN, RN]

Don't forget though, these wonderful drugs come at a price. Brainiac scientists have to be paid for research and most research is fruitless. Laboratories are expensive, testing trials timeconsuming, none of this is free. Capitalism is usually the most efficient way to do this. Communism, although noble in theory, isn't as practical as the profit motive.

[Suninmyheart]

The OP sounds naive to the realities of nursing, not really like a troll. And her/his post welcomed us to "enlighten her/him". I was reading on and becoming quite amazed at the defensiveness cropping up and then it even got a little rude by making fun of the outdated choice of words. The numerous "thank you's" evoked an image of all the miffed readers chosing sides and ganging up. If I was the OP I would have felt blasted and perhaps disappeared also.

The OP did submitt a thank you to motorcycle mama but was probably feeling too ganged up on to be willing to say anything else.

Before I had any nursing classes I too questioned whether I wanted to work in such an allopathic environment as I have always been into complementary and alternative therapies. I had no idea what nursing was really about (and still have a lot to learn as I am a very new RN). I am soooo happy I chose nursing and I encourage the OP to keep an open mind. Yes, there is a lot of unethical practice in the drug industry but there is a lot of good. Just like anything else. Just because you are questioning allopathic medicine doesn't mean you need to close the door on nursing and go be a masseuse. In your first semester when you learn about nursing theories and process you will see there is room for everyone and you will find a niche.

Welcome to Allnurses!

[somebody]

Here I am, the OP, back to respond (for you impatient doubters).

First, excuse me for being a hippie....man!

I think I will be able to live with the pharmy issue, since it is obviously only a small fraction of the potentially positive avenues for doing good for people in need. Also, as I said, there is definitely a need for drugs in some areas (many responders seem to completely ignore this statement). My question was in regards to the drugs that are of questionable value or clearly harmful as some gave great examples of.

Oh and I should have said "passing" rather than "pushing". Sorry, big diff in connotated intention.

I especially thank the very wise, insightful, and kind replies of a few including Kevin (David's Harp) on p.4, and Sunnyeyes on p. 5. I hope I am lucky enough to get assigned with people like you when I become a nurse.

Looking forward to nursing now.

Great forum here!

Doug

[zenman]

What if you lived in a very poor country where many lives could be saved by western allopathic medicine and big pharma? It is easy to reject when you are in a position to do the rejecting.

I live in one of the poorest countries, Bangladesh, and many people are saved by immunization. That's one view of the picture. Now, what do you do with all the "saved" people and the problems associated with overcrowding, lack of jobs, etc.? It's kinda like the man who had ten kids so he would have someone to take care of him when he grew older, yet who died early from trying to feed all ten kids.

One problem I have with big pharm is that they will spend millions on research to change one molecule of an excellent drug that another company has so they can trademark and market it and make a profit. This new drug is usually not any better than the other company's drug.

[BBFRN, BSN, PhD]

Here I am, the OP, back to respond (for you impatient doubters).

First, excuse me for being a hippie....man!

I think I will be able to live with the pharmy issue, since it is obviously only a small fraction of the potentially positive avenues for doing good for people in need. Also, as I said, there is definitely a need for drugs in some areas (many responders seem to completely ignore this statement). My question was in regards to the drugs that are of questionable value or clearly harmful as some gave great examples of.

Oh and I should have said "passing" rather than "pushing". Sorry, big diff in connotated intention.

I especially thank the very wise, insightful, and kind replies of a few including Kevin (David's Harp) on p.4, and Sunnyeyes on p. 5. I hope I am lucky enough to get assigned with people like you when I become a nurse.

Looking forward to nursing now.

Great forum here!

Doug

Thanks for clarifying, Somebody. I think you'll find that as a nurse, you'll evaluate the risk:benefit ratio of every drug you give as part of your assessment to you patients' response to those meds. If the risk is greater than the benefit, then you have a conversation with the Dr. about that. Unfortunately, you will also come across those poor elderly/frail patients that you thought would've been better of without having had a particular surgery, etc. The best you can do in those cases is to optimize recovery, and support the pt to the best of your ability.

I am a big fan of Dietician, Diabetes Educator, and PT/OT consults for those that need them. Consulting these resources are usually within your scope of practice as a nurse (at least it is in my state), and at least you know your patients will get the benefit of what can be taught by them. In some cases, they're not utilized enough, IMHO.

[queenjean]

I get where the OP is coming from. I have similar feelings.

Somebody, I think you will find that for people who are interested in and willing to use lifestyle changes and diet for therapy will do so outside of the medical setting, or with very little encouragement from the medical setting -- think someone who gets back really bad cholesterol labs from their doc.

By the time most people enter the acute care setting, they are in need of interventions that are going to help them now. As others have said, while this is not the time for only holistic interventions, this is the perfect opportunity for nurses to help them understand that meds can't work independently--that diet and exercise play a huge role. Of course diet and exercise can't get rid of your type I diabetes. But appropriate diet and exercise can reduce your risk factors for a lot of the comorbidities that accompany a diagnosis of type I diabetes, no?

And there are many offices where physicians are in agreement with you. I worked for many years in an office where we handed out far fewer scripts and did a lot of more nutritional and lifestyle counseling. It was a bit depressing to go into a 30 minute lifestyle evaluation for weight loss, and at the end of it have the client say....."Yeah, but can't I just get a pill?" Most people said something like that. But at the end of the day, there were always a few who took the information to heart and make healthy decisions that will positively impact them for the rest of their lives.

I think you will really enjoy nursing. It *is* possible to be a nurse and to not buy into the entire industry. Many (possibly most?) nurses feel that way. We all recognize when we see a nursing home patient come into the hospital with four pages of meds that this is not appropriate. We see the over use of medication and technology on a daily basis. What we unfortunately *don't* get to see is when people make positive changes to their lifestyle--because they dont' come back!!!

Ex: we had a huge lady, in all the time for diabetes and cardiovascular complications. We stopped seeing her come in to the hospital, and figured she'd either died or moved into a nursing home (at the age of 43) due to her obesity and her inability to care for herself. Nope. Her daugher had had a baby, and grandma realized she was too fat and unhealthy; her daughter had told her that she wasn't going to let her watch the baby, because how could she take care of the baby when she couldn't even take care of herself? Grandma took it to heart, got on a diet program, went to PT and later to a personal trainer, and lost almost 200#. The only reason I know this is because I saw her in the grocery store. I didn't recognize her, she recognized me, approached me, and told me her tale. I couldn't believe I was looking at the same woman.

So those positives happen; but because they are positive, we don't get to see it!!!

Good luck in your career--we need all types of nurses, and you sound like you'll be an asset to our ranks. Always need more thoughtful, energetic nurses to light a little fire under us old, cranky cynics!

[Almabella]

Truthfully, the holistic approach nurses take to patient care is one reason I chose nursing school over medical school. This approach is more aligned with my personal beliefs and philosophy on health.

Because of this philosophy I've always worked in a public/community health setting, where the focus is more on prevention of disease or the complications that develop from them.

I work with one physician who prescribes herbal and homeopathic meds for our patients, and we have a affiliated alternative med clinic. As a result, we draw an interesting mix of patients, including those who do not believe in vaccinating their children. Now, I have a real problem with this, as I fully believe in immunization and, as stated above, prevention. Nonetheless, as an RN in the clinic I have to respect these parents decision not to vaccinate. (this is just an example, please don't turn this into a debate about immunizations -- been there done that!)

Also, I would like to point out that herbal/homeopathic meds not used properly can also be harmful to one's health. Many people have the misconception that because something is "natural" that it's not harmful.

The best approach to health is to prevent disease, but this is not always possible as many factors weigh in such as environment, genetics, and mental health. If you do decide to pursue nursing, you will find your niche, but that does not mean you won't be faced with issues that go against your moral grain. good luck!

[SuesquatchRN, BSN, RN]

The OP sounds naive to the realities of nursing, not really like a troll. And her/his post welcomed us to "enlighten her/him". I was reading on and becoming quite amazed at the defensiveness cropping up and then it even got a little rude by making fun of the outdated choice of words. The numerous "thank you's" evoked an image of all the miffed readers chosing sides and ganging up. If I was the OP I would have felt blasted and perhaps disappeared also.

Well, one's choice of words does form the frame of reference and one's reaction.

BTW, I was taught that it is rude to call others rude, or comment on their behavior.

Kettle/pot.

[somebody]

Ah...that's better. More who see where I am coming from and are trying to help me figure out if I can find a happy niche as a nurse given my holistic slant.

I can't control the wind, but I can adjust my sails.

Ultimately, I realize it is futile to try to drastically change the system. Expecting that would only frustrate me endlessly. All I can change is myself, be an example of good health, and try to help others as much as I can. I mostly wanted to see if there are others out there who feel like I do and are still not too frustrated to love nursing. And I see that there definitely are. I feel very encouraged now. Thanks again!

Ok...open fire!