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Bum the Sad
Aug 25, 2002
Hell Gem

JibbaJabberwocky posted:

This is kind of a weird RN question but hopefully some of you might know the answer to my quandary. Roughly twice a year I have a bout of esophageal spasms related to my GERD, usually if I forget to take my drat Omeprazole like I did last night. Something about how the muscles interact mean that I have really intense head, neck, and chest pain if I'm either a. standing or b. lying down. Sitting seems fine. Obviously this is an issue because I can't just stay in a sitting position for 2-5 days at a time. Unfortunately OTC pain meds don't do a lot for the pain. So my first question is this, if I take some Oxycodone I have that is like way hella expired (like 5 years since it was prescribed) and the medication itself was prescribed for post-wisdom tooth surgery pain, is that legal? The bottle just says 1 tab q4/6 hr for pain PRN. I only ever take like 1/4 a tab at a time so in a year would take maybe 2 whole 5/325s. If that's legal, then when in relation to my shifts am I allowed to take it? I have no idea how long that poo poo stays in your urine either so don't even know when it would show up on a drug test. Obviously I can't take it at work and not right before a shift but if I take it the night before is it okay or am I putting my license in jeopardy? Should I try and see if I can be prescribed a muscle relaxant instead or would I run into the same issues?

Any legal advice y'all have related to this would be great.
From what I've been told your right to take a prescription narcotic lasts until the expiration date on the bottle which is generally one year after it was dispensed.

Edit for clarification: After that expiration date they should still be legal for you to own but now if you take one you're no longer taking it as prescribed by a doctor since your prescription is expired. Therefor you'd be hosed if you failed a drug test as you were no longer taking it under a doctor's supervision.

Basically if it said take 1 a day for 10 days you'd be hosed after those 10 days. If it just says take as needed you're hosed after the expiration date written on the bottle.

Bum the Sad fucked around with this message at 18:41 on Jun 2, 2016

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Bum the Sad
Aug 25, 2002
Hell Gem

Roki B posted:

The volume of essentially uneducated nurses being handed the title of NP via online school is diluting whatever reputation of quality they once had.

Blame diploma mills I suppose. If I had the capital I'd be trying to get in on NP tuition dollars too.

Dude. These fuckers get into these programs and then have to go find their own preceptor and clinical site. poo poo makes me ashamed to be an APRN. CRNA programs have their own issues too though... allowing clinical sites where MDA's hamstring the students practice/training who then graduate being unable to compete with them.

Bum the Sad
Aug 25, 2002
Hell Gem
Ambien and Xanax.

Bum the Sad
Aug 25, 2002
Hell Gem
I'm at my CRNA school graduation right now. I'm better than all of you.

Took and passed my boards Thursday too!

Bum the Sad
Aug 25, 2002
Hell Gem

Roki B posted:

No you're not, you're a tremendous dweeb who lives in a trash state and now barely makes more than me with more debt gg no re ;-*

The jealousy is palpable. ;-*

Bum the Sad
Aug 25, 2002
Hell Gem

LoveMeDead posted:

I have one exam left in my FNP program. I'm nervous as hell that I'll fail it.

How quaint.

Bum the Sad
Aug 25, 2002
Hell Gem

Dirp posted:

I just had a CRNA school interview this morning. It went really well!

trauma llama posted:

In other news, I've got my own CRNA interview this week. We'll see how it goes.
Stop copying me.

Bum the Sad
Aug 25, 2002
Hell Gem
Yeah do not become an LVN.

Bum the Sad
Aug 25, 2002
Hell Gem
Yeah there's a huge difference. Basically it boils down to you never having any upward mobility as an LVN. You'll never work in anything close to an ICU you'll never be able to go into management, you probably won't be able to get into odd jobs some nurses do like research. Basically you'll be at the bedside your entire career. Oh and that bedside will probably be at a nursing home.

There are some exceptions but being an LVN basically pigeon holes you into being a med passing monkey. An LVN always had to be supervised which really limits their desirability.

Bum the Sad fucked around with this message at 23:15 on Dec 20, 2016

Bum the Sad
Aug 25, 2002
Hell Gem

trauma llama posted:

Honestly? Everything.
Limited scope of practice.
Job availability.
Pay.

Remember, community colleges also have ADN programs, and while I don't really recommend it, you will receive similar pay to BSN's in the same field and will have more job opportunities. I have a few friends who recently graduated with their ADN. One works in an office and the other is now in a shift lead position at an infusion center. So there are definitely a ADN opportunities that aren't in nursing homes.

Yeah you can get most any job as an ADN just fine. Most big systems these days just want you to start working on your bachelors after you get hired and will usually help pay for it.

Bum the Sad
Aug 25, 2002
Hell Gem
loving student. Go set up my room.

Bum the Sad
Aug 25, 2002
Hell Gem

Annath posted:

Really? What's different between the scope of a Nurse Practioner with a Masters versus a Doctorate? They sit for the same exams AFAIK.

There's none what so ever.

Bum the Sad
Aug 25, 2002
Hell Gem
Yeah I mean they can be pared.... Until they can't, which will probably happen at 2am.

Bum the Sad
Aug 25, 2002
Hell Gem
It has fantastic synergy with general anesthesia. Give just the right amount and they wake up like you gave them 6 of dilaudid. Little too much at the end there and they will be obtunded for about 15 minutes postop after all your gas is off... They will still breathe though. It's a great drug, the mistake assholes will try and do in the ICU would be to try and use it as a sole anesthetic it's got great synergy but it's garbage on its own.

Bum the Sad
Aug 25, 2002
Hell Gem

trauma llama posted:

Like Bum said, and he's really the expert here, it has great synergy and it is an awesome drug.

It is absolutely a kick rear end adjunct to anesthesia. It has analgesic properties and doesn't jack your respiratory drive as hard as narcotics.

I've been reading a lot of research lately that shows leaving someone on a precedex drip post op will reduce their overall narcotic pain med demands and while not loving up their respiratory drive and allowing them to wake up and be more functional. This is great for all of those obese people with OSA.

The other mistake people make with precedex in the ICU is using it to manage ETOH detox. They will turn the Ativan drip way down or stop it and just snow the motherfucker on precedex instead. This totally defeats the purpose and does not treat their withdrawal.

Yeah I love the stuff. When I was an ICU nurse I thought it was garbage because they would try and sedate agitated intubated patients with it and it alone. It's a loving fantastic adjunct though. When you get to clinical you'll see how potent it can be, give it up front or run an infusion because if you give too much too close to the end you'll end up "deep" extubating your patient when you hadn't planned on it, since they won't loving wake up.

Bum the Sad
Aug 25, 2002
Hell Gem
I do three tens and a twenty. Suck my dick.

Edit: Actually more like an eight a ten a twelve and a twenty.

Still suck my dick.

Bum the Sad fucked around with this message at 02:50 on Jun 6, 2017

Bum the Sad
Aug 25, 2002
Hell Gem

Roki B posted:

Look at you. You made a list of jobs, well done.

Now try putting the alphabet blocks in order.

You're alright Roki

Bum the Sad
Aug 25, 2002
Hell Gem

Dirp posted:

Finally got into CRNA school :toot:

Only 6 more months of being a bedside nurse, thank god.

Welcome to thunder dome bitch

Bum the Sad
Aug 25, 2002
Hell Gem
More like SRNGay.

Bum the Sad
Aug 25, 2002
Hell Gem

djfooboo posted:

Why would you canulate anything in a hospital setting in anything other than sterile fashion? :iiam:

Have you never heard of an IV cannula. No one does those sterile and that’s the most common kind.

Bum the Sad
Aug 25, 2002
Hell Gem
Glad I could help.

Bum the Sad
Aug 25, 2002
Hell Gem

trauma llama posted:

You know know you’re a night shifter when you’re up at 0100 messing with the anesthesia machine for your machine check practical tomorrow (today?)

What’s a machine check?


Edit: Oh wait. It’s that thing where you look and see if the APL valve was accidentally left at 70 which means maybe the tech pressure checked it when he changed the circuit.

Bum the Sad fucked around with this message at 15:29 on Feb 28, 2018

Bum the Sad
Aug 25, 2002
Hell Gem

trauma llama posted:

versed and precedex in preop didn’t touch me.... propofol took 385mg to get me down...

Hey I too became an alcoholic in anesthesia school. Strong work!

Bum the Sad
Aug 25, 2002
Hell Gem

icehotels posted:

I took the NCLEX today. The test cut off at 75 and then there was a special research section. I've heard that's good or I completely hosed up the test. I feel like either is possible right now.
This thread (and the other healthcare thread) reminds me that my confused patients are not far off base. I thought there was something going on this week.

If it cuts off at 75 you either passed or are the worlds biggest idiot. If you felt like you knew a even third of the questions you passed. I don't even know if its possible for it to fail you at 75.

Bum the Sad
Aug 25, 2002
Hell Gem

Nice and hot piss posted:

I agree with this. When you look at the curriculum between an ADN and BSN it's honestly no where near the 18 months or whatever they state it takes to get a bachelors degree. It doesn't help that Magnet status and the requirement for any sort of upward leadership/management mobility in the ranks of nursing requires a bachelors degree, thus allowing for these online schools to gouge students (again, possibly).

It’s been ten years since I got my BSN but if I remember correctly the only real difference in the curriculum was a community health and a management course.

Bum the Sad
Aug 25, 2002
Hell Gem

trauma llama posted:

On my nursing Ob rotation I was told that I didn’t have enough compassion to be a nurse and that I should have gone to med school instead. My clinical instructor made me visit her office to watch a bunch of the cliched compassion videos that they have people watch in hospital orientation.
It was really just that Ob nursing bored me. I love ob anesthesia though.

They were probably right because nursing is for dumb chumps who get paid in compassion feels instead of money. Now you’re in anesthesia school. Godo student.

Edit: yes Roki I know you’re doing great in your socialist utopia

Bum the Sad
Aug 25, 2002
Hell Gem

Roki B posted:

hahahahah beat me to it

😘

Bum the Sad
Aug 25, 2002
Hell Gem

Epic Doctor Fetus posted:

Chud-state nurse: "We don't want a union! Unions are BAD!"

Same chud-state nurse: "This is the fifth shift in a row where I haven't gotten a lunch break. Ah, well, maybe I'll have time to grab a snack on the way to my second job, that I have to work because I only make $20/hr in this chud-state."

Yup, people in the south are dumb as gently caress.

Bum the Sad
Aug 25, 2002
Hell Gem
You aren’t salaried, never loving work for free.

Bum the Sad
Aug 25, 2002
Hell Gem

Fun Times! posted:

Mentally preparing to shave my beard off if it hits the fan in the coming weeks/months. Only one PAPR in our ER so my pale face will have to reuse the same N95 I've never been fitted for that I will keep in a paper bag with my name on it. Maybe I'll doodle something on the bag.

The outside is gonna get colonized with Corona you dope

Bum the Sad
Aug 25, 2002
Hell Gem

Dirp posted:

Two weeks left of CRNA school. I'm going to be loving pissed if I get this dumb poo poo while I'm doing anesthesia for free.

What you too? I thought it was just Llama, I am the forums CRNA, go to hell.

Bum the Sad
Aug 25, 2002
Hell Gem

trauma llama posted:

Update: my cohort is freaking the gently caress out about getting the covid, our program director is (probably) using us for political gain within an specific organization and part of that is keeping us in clinical. To be fair, I do not disagree with some of her points or her purpose.

Meanwhile, we probably have graduation requirements that will gently caress us and delay our graduation if people whine too hard.

It is all crazy bullshit and I just want people to have a reasonable, metered response. I’d also like to graduate and start my job.

You’re gonna get it. Be thankful you’re under 50.

Bum the Sad
Aug 25, 2002
Hell Gem

combee posted:

I started nursing school a few weeks ago. Classes were paused after the first week and now we’re fully online, no labs will be held this semester. We were meant to have our first clinical placement mid year but that will most likely be postponed till end of year.

Oh no how you gonna learn to make a bed with mitered corners now!?!

Bum the Sad
Aug 25, 2002
Hell Gem

Dirp posted:

Crawled through the river of poo poo that was CRNA school and have now come out clean on the other side.

No

Bum the Sad
Aug 25, 2002
Hell Gem

Dirp posted:

Took them yesterday and found it to be much easier versus apex practice exams.

I assume that means you passed. Congrats man. Welcome to the club. :toot:

Bum the Sad
Aug 25, 2002
Hell Gem

loopsheloop posted:

Has anybody quit nursing? What did you do after?

Anesthesia

Bum the Sad
Aug 25, 2002
Hell Gem

rosenritter posted:

Would it really look bad on my resume if I quit my job without anything else lined up? I'm so tired and defeated after being expected to do so much with so little. I'm burnt out. I'll have about four years of med-surg experience in January. It's never going to improve.

No. Just quit and get a traveling gig making $100/hr. Do it right now before it dries up.

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Bum the Sad
Aug 25, 2002
Hell Gem

B-Mac posted:

I honestly don’t understand anyone defending Radonda and I don’t see how how the verdict is terrifying. She could have done about one of thirty different things different and not killed the patient. She gave a god drat paralytic instead of versed. Look at the medication vial before giving a drug and you won’t make the same mistake she did. Five rights of medication administration y’all.

She paralyzed a fully awake patient and then left immediately, what an awful way to die. Even if she gave the patient versed she should have stuck around to see how the patient tolerated it. I’m completely fine with the charges and verdict. Please don’t just focus on the nurse, the patient Charlene Murphey needs to be thought of too.

Now I think it’s bullshit Vanderbilt seems to be getting off without any charges for the coverup. Whoever helped cover it up needs to be hit with charges as well.

The craziest thing is which no one has mentioned even if she somehow missed every single warning and confused the drugs, skipped every warning, reconstituted the powder which is never done for versed. The order was still for 2mg.

The vial said 10mg of vecuronium.

She still gave FIVE TIMES the ordered dose even it was the right drug.

Just open palm slammed a vial.

Grandpa might have been weak and gasped from 2mg of Vec.

Bum the Sad fucked around with this message at 03:46 on Apr 3, 2022

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