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Nola009 Nola009 (New Member) New Member

So, as a nurse it's my #1 priority to serve your narcs on a platter...

Medications   (13,097 Views 59 Comments)
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You are reading page 3 of So, as a nurse it's my #1 priority to serve your narcs on a platter.... If you want to start from the beginning Go to First Page.

Agree with Esme whole heatedly. It's not your job to decide whether or not someone needs a particular med. Live in chronic, horrible, pain for even a week and we will see how pleasant you are. Wake up with pain, all day live with it, you can't sleep because of it. It can drive someone insane I tell you. It is the doctors job to deal with it and prescribe, not yours. If you can deal with it, find another job.[/quote

Ok, glad you two agree. And I agree with you in that I should have another job. The SNF with the haught, demanding patient families who threaten to sue just bc their mom's pain med was a little late?! Yeah. That's not for me. Hey--- I have 25 other pts who Alll want their own pd nurse.

Hey, guess what? This is every SNF everywhere. And hospital. And clinics. Good luck. Deal with managing people's pain, demanding patients and doctors who throw pills at people who won't shut up, or find another profession.

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See... I would have said 'for what?!! Prioritizing appropriately?!' That's what gets on my nerves. Of course we give pain meds. Of course. But the sole function of my education, hard work, and licensure IS NOT to be your narc (or eye drop) waitress. Omg.
NOT if you wanted to keep a great job with good staffing and benefits, you would not. After years of beating your head against this wall you get the point where you realize it's not about YOU and YOUR FEELINGS. Then it's like a weight has been lifted off your shoulders. It's freeing. You can burn yourself out quickly by personalizing your patient's healthcare until you accept that you can't make anyone do anything. You can tell them once the right thing to do, document it and walk away. And learn the art of the "non apology apology"

We all have triggers-I never did well with (what I perceived to be) futile care pushed onto end stage dementia patients. I now realize I can only explain the optiosn to these family members in a language they can understand and then I have to let it go.

I wish I could get back the energy I used up over this years ago...

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Playing devils advocate, from a point of view of "been there done that more times than I care to admit!", don't you think it's possible that after surgery when the patient is mostly laying in bed with not much exertion, they don't have high pain med needs. Then, when they are transferred to rehab/SNF for therapy their activity increases and their potential for pain increases as they begin to work more on range of motion, weight bearing, ambulating...the list goes on and on. As they work with therapy more and more their pain med requirement might increase at the same time to keep up with PT's demands. Eventually in their recovery, pain will start to diminish, but all you notice at first is "this patient needs more pain meds now two weeks post op then they did right after surgery."

Also, remember that it is beneficial to patients AND their nurses to give pain meds when due (or asked for if PRN) so that pain does not become unbearable to the point where you end up "chasing" the pain. If you let the pain get too bad the patient will be less able to participate in therapy, get out of bed, etc. because the pain is so severe. Unless there are more urgent things going on, pain meds should be a priority (over just finishing a med pass, etc.).

Good luck. I would suggest finding another job seeing as you find this particular SNF not a good match for your personality.

Pt's are placed on a CPM machine for knee replacement, in the recovery room. They're up and walked by therapy the following morning post op. They're up to void. No bedpan allowed. They get in and out of bed for meals.

I guess every hospital has their own protocol, but our post op orthos don't lay around in the bed and vegetate. Your explanation for the need for more pain meds in SNF, as opposed to acute care, just doesn't wash.

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There is new thinking about long term management of pain. Narcotics are recommended for short term use. I believe they don't work well long term and you may be medicating withdrawal. Maybe you could google "Long term pain management." And then talk with the prescribers..

Where did you get this? I've had a lot of education in pain management, was mentored by a pain management specialist, and have been keeping up to date with the current trends in pain mgmt. I haven't seen what you said.

May you never be condemned to have a long-term pain condition, then on top of that be stuck in a facility with surly nurses who have no compassion for your pain.

I would rather die than be in a nursing home.

Oh, and evething Esme said.

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Where did you get this? I've had a lot of education in pain management, was mentored by a pain management specialist, and have been keeping up to date with the current trends in pain mgmt. I haven't seen what you said.

May you never be condemned to have a long-term pain condition, then on top of that be stuck in a facility with surly nurses who have no compassion for your pain.

I would rather die than be in a nursing home.

Oh, and evething Esme said.

So, exactly what is the latest and greatest on the subject of pain management? Please enlighten us...

Oh, and if you have never worked in a Skilled Nursing Facility caring for 25 pts per shift, please don't dismiss us as being surly people who lack compassion.

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All this discussion about surly nurses who withold pain medication from suffering patients and addicted patients demanding narcotics just because they can seems to be all beside the point. The real issue seems to be that it's impossible, physically impossible to give narcotics to 10 or 15 or 25 patients all exactly when "they're due." And trying to do so detracts from the ability to do any other sort of nursing care.

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Looking at the message the OP posted once again, and digging though replies on this thread, I am led to the opinion that Nola has come upon a fundamental roadblock in caring for his/her current patients. It is time to get out. Find a new job, find a facility that you practice in and agree with, and find some room for yourself to breathe.

While patients can be demanding and rude, reality is that your job really DOES revolve around them, their needs, their meds, and their demands. If you are that cynical and jaded as a PRN nurse, I would caution you against going full time.

My humble advice is to look at what you are doing, decide if you want to keep doing it, and then figure it out from there. Addiction is rare- really. We assume everyone who "needs" a pain med is addicted, but in reality that isn't the case. What you are experiencing is a huge shift in practice philosophy and environment.

If you have problems regarding the giving of a medication, please take that info to the doc/prescriber. That information is valuable. And yes, we all have bad nights and crappy patients and families. Let this part go, apologize for the lateness and move on. If you can't...it's time to rethink working there and with that particular population.

Edited by Dude,RN
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Looking at the message the OP posted once again, and digging though replies on this thread, I am led to the opinion that Nola has come upon a fundamental roadblock in caring for his/her current patients. It is time to get out. Find a new job, find a facility that you practice in and agree with, and find some room for yourself to breathe.

While patients can be demanding and rude, reality is that your job really DOES revolve around them, their needs, their meds, and their demands. If you are that cynical and jaded as a PRN nurse, I would caution you against going full time.

My humble advice is to look at what you are doing, decide if you want to keep doing it, and then figure it out from there. Addiction is rare- really. We assume everyone who "needs" a pain med is addicted, but in reality that isn't the case. What you are experiencing is a huge shift in practice philosophy and environment.

If you have problems regarding the giving of a medication, please take that info to the doc/prescriber. That information is valuable. And yes, we all have bad nights and crappy patients and families. Let this part go, apologize for the lateness and move on. If you can't...it's time to rethink working there and with that particular population.

If you really believe that you can ascertain how well I perform my job by merely reading a few threads/ postings, then you have bigger problems than I do... either with reading comprehension, being presumptuous, etc etc. I certainly didn't.ask for you advice on what to do in regards to my career. Just seeing if others have experienced what I have as I am a new nurse. Btw I almost ALWAYS get direct or indirect compliments from my patients, do you??

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All this discussion about surly nurses who withold pain medication from suffering patients and addicted patients demanding narcotics just because they can seems to be all beside the point. The real issue seems to be that it's impossible, physically impossible to give narcotics to 10 or 15 or 25 patients all exactly when "they're due." And trying to do so detracts from the ability to do any other sort of nursing care.

Yes!!! You get what I have been trying to say!!!!! All I want is to be able to do my job which includes, but is not limited to giving pain meds. I come to AN because I am the only nurse on at this facility during my usual shift. Have comparatively very little trouble at my other place of employment, a LTC (yes, I give narcs there too of course).

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If you really believe that you can ascertain how well I perform my job by merely reading a few threads/ postings, then you have bigger problems than I do... either with reading comprehension, being presumptuous, etc etc. I certainly didn't.ask for you advice on what to do in regards to my career. Just seeing if others have experienced what I have as I am a new nurse. Btw I almost ALWAYS get direct or indirect compliments from my patients, do you??

OUCH! Ok- let me try this again. I didn't judge you. Nobody here did. I came here to have a conversation with you- same as everyone else. And I didn't ascertain how you did your job. Looking through the posts and replies, you agree that you needed a new job, had a bad night, etc.

As a new nurse, I am giving you some advice...from someone who has been there. I speak from experience when it comes to practice philosophy and taking stock of where you want to work and done. I've been in burnout mode and things like that. Been there, done that, and switched specialties and moved states in order to combat it. Nursing is a lifelong profession...and one I hope to be in for quite a long time.

I'm just trying to help you out, my sincere apologies if you don't see it that way. Best of luck to you and I hope your shifts go better from here on out.

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One day while doing staff relief at a SNF, I was called a C--N--., by a drug addicted, walkie talkie, young, resident. He wanted his oxycontin, and he wanted it now. I know exactly what the OP, is talking about. I don't agree with alot of your replies. Pushing a med cart in SNF, and trying to pass meds as fast as you can, but you can't give everyone their meds first, it's impossible. OP, I feel your pain, and come here and vent anytime you need to. How about some family members give the nurse some consideration. Appreciate that there are other residents, not just their family member to give meds to. We all are nurses, please respect other nurses, concerns.

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OUCH! Ok- let me try this again. I didn't judge you. Nobody here did. I came here to have a conversation with you- same as everyone else. And I didn't ascertain how you did your job. Looking through the posts and replies, you agree that you needed a new job, had a bad night, etc.

As a new nurse, I am giving you some advice...from someone who has been there. I speak from experience when it comes to practice philosophy and taking stock of where you want to work and done. I've been in burnout mode and things like that. Been there, done that, and switched specialties and moved states in order to combat it. Nursing is a lifelong profession...and one I hope to be in for quite a long time.

I'm just trying to help you out, my sincere apologies if you don't see it that way. Best of luck to you and I hope your shifts go better from here on out.

I apologize if I misunderstood the sentiment behind your post. And thank you for taking the time to.share your experience. I have another job (just part time) and have comparatively few problems when I work there. I will be honest in that I always wanted and expected.to work in an acute care setting after school, just because I FEEL stretched too thin when I'm in a situation where I have 20-25 pts, about half of them being new from the hospital. I want to be able to do a good job. I don't think I'm burnt out, I'm feeling disillusioned. All of my nursing clinicals were at hospitals. I often wish the hospitals in my area would hire new grads...

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