Then who runs the ICUs and pain clinics?
I always assumed that American Intensivists were like ours- anaesthetists with a special interest in intensive medicine.
Here the anaesthetists (who are doctors- we don’t have anaesthesiologists) do the anaesthetics in theatre, manage airways and access, are in charge of the ICUs and post-op areas, run the pain clinics, do unstable patient transfers and are some of the most high powered docs in the hospital.
We literally couldn’t do anything without them, replacing them with nurses would be fairly unthinkable here.
There are places in Montana exactly like that, especially in the east. Cut Bank, for example.
I don’t know about ICUs, but pain clinics can be run by a CRNA who has gone on to get extra training in pain management, like I alluded to above.
If you want to look up how things are done in Montana, I’m sure you can, either on your own or with a good GQ thread. I will tell you that it takes periodic court cases to ensure the professional independence of CRNAs here (the old “opt-out” battles) because, every so often, the MDs attempt to reassert themselves in the field here.
I broke my wrist when I was 13. The doctor who set it decided not to give me anything (even a local) because it’d be very quick and just told me I’d have to “be a man” when he said this. He had Mom hold my chest and a his nurse hold my legs to restrain me. He should’ve restrained me better (or at least had my shoes removed); one of my legs got free and I kicked his nurse away (in addition to screaming and cursing loudly enough for other people in the office to notice). He started to scold me and I kicked him in the family jewels. My mother insisted on a different specialist for all my followup visits. Oh, and the nurse was the mother of a friend of mine, but she never told her son that I kicked her up against a wall.
I was comparing notes on dentist visits with my brother and sister. All of us agree that the sadistic SOB who was our childhood dentist never allowed enough time for us to really get numbed. All of us dread going to the dentist, not surprisingly, even though we’ve found great dentists.
different specialties, different degree levels/career tracks doing different things; in Spain the only time I’ve had a doctor take a sample it was the gyne, in the US I’ve had docs extract blood samples (and charge “doctor took sample” fees).
Travel books should have a chapter dedicated to “and this is what you have to do if you get sick there”… it’s one of those things which vary from country to country and even at lower admininstrative levels, but which we tend to assume “everybody does it like back home”.
Re. the OP, does anybody know whether the nurse risks jail time or is likely to get off on account of something like “first time offense”?
Huh! The second one is pretty awful. The nurse sexually abused an adolescent victim of sexual abuse, in major depression, and admited in the hospital following a suicide attempt. :eek:
Yes, that one was horrifying. Many of the disciplinary actions are “accepted” (helped self to) “gifts” (bribes, stolen items) from clients, or lied about going to home care clients, things like that. That was so disturbing, a few of my collegues were talking about it for a while, especially among my psych nurse cohorts.
The really sad thing is often you will see that the nurse also had a similar allegation made 5 years ago.
Hopefully Minnesota’s Board of Nursing self-regulates like Ontario’s and this nurse-anesthetist will loose all priveleges of working as a nurse permanently.
As for the legal system, I don’t know how strongly the “well she’s an addict, have merc,y it is a disease” defense will carry her. (Addiction is a disease, but in my mind mercy stops when you can no longer be merciful to your patients.)
The latest news I’ve read is that the nurse is denying everything. Her lawyer claims that the publicized account is inaccurate and that she was being made a “scapegoat” in a suit against the hospital. So they’ll have to go through the whole factfinding thing before anyone can decide on what charges if any would be appropriate.
Yes but he thoughtfully gave her “hands on healing” first. shudder He brought MASSAGE OIL TO WORK TO GIVE A MINOR WITH SEXUAL ABUSE ISSUES, DEPRESSION, SUICIDAL HISTORY, A GOOD RUB DOWN BEFORE HE ASSAULTED HER.
Yeah, that disciplinary action didn’t satisfy me enough. I don’t know if his wife dumped his sorry ass, if he’s been thoroughly cornholed in prison, and if the girl is now getting therapy somewhere nice like Fiji.
A rub-down. An icky older guy leering nurse massaging a sexually abused seriously messed up teen. Exactly as disgusting as it sounds.
Massage isn’t really part of Nursing, except maybe in some physical rehabilitation scenarios, and it certainly isn’t part of any psychiatric nursing intervention I’ve ever been aware of.
I had a few massages when I was in rehab, but then again I was having serious issues with charley horses and back spasms. A good massage will work out knots post rehab quite nicely.
Massages are part of physical rehab in many places, but it usually isn’t a nurse giving them: it’s someone with a title like “physical therapist” or “massage therapist”.
Massage *is *within the scope of practice of an RN (Registered Nurse) in the US. It is taught in nursing school (although, oddly, the massage I was taught in nursing school is not like the massage I was taught in massage school - I argued with my nursing instructor for 20 minutes that moving in circles from the shoulders down to the sacrum was moving against the venous return and would *increase *pain and edema, only to be told that was “just how we do it!” Grrr…)
However, in the real world, most hospital nurses don’t have *time *to do much massage, and it’s a much lower priority than medication administration or paperwork or patient education, so most of them don’t do massage a lot once they’re out of nursing school.
And, I hope it goes without saying that sexual massage is right out, and that nurse was a total idiot and asshole for what he did to that patient.
And psych nurses barely ever touch their patients who are capable of self-care. I mean unless you are hauling an abusive patient into seclusion or something. Any of the good, caring, kind, “reasonable and prudent”* male psych nurses i know basically do not touch female patients, at all in any way. Unless there is another female nurse in the room with them. But then they would usually let the female nurse do any necessary touching.
*Reasonable and prudent nurse" is usually the criteria for juding the actions of a nurse. Did you do what a reasonable and prudent nurse would do in the same situation. Yes? Ok then you probably made a mistake and will be judged and disciplined accordingly. But if you weren’t acting as a reasonable and prudent nurse, then something is wrong and things will not go well for you.
This is a horrible story, but if she is an addict, then it’s understandable. She couldn’t NOT do it- addicts do what they need to do to get what they need, period. You can call it evil if you want to, but it’s like slavery. There may have been no place in her thought process at all for the patients pain.
I’m not condoning it- I hope she is sanctioned to the fullest extent possible. I know that here in CA, nurses with substance abuse issues have to jump through incredible flaming hoops to keep even a minimum license, such as “you can still work but no patient care & you don’t touch a single med, not even aspirin.”. The process can take years.
BTW, chances are that you have been treated by a nurse or other staff member who was high. Seriously- ask QtM what the average addiction rate is among medical folks with access to the drug closet.
But the disease tends to progress a bit faster with medical folks at times, due to the greater availability of really potent drugs. We tend to hit bottom perhaps a bit faster than average as a result.
By the way, I never diverted drugs from a patient into me during my active addiction.
Know why?
I’d like to claim the moral high ground and say I’d never stoop that low, but for me the craving and opportunity never coincided (for which I’m tremendously grateful). I fear what I might have done if my next fix had ever required a patient do without.
I have some empathy for the pitiable and incomprehensibly demoralized addict who betrays everything they ever held dear to get their next fix. But patients must be protected.
I don’t buy that. Not for one second. There is *always *choice. I’m sure most child molestors are just hard-wired to be attracted to prepubescents: that doesn’t mean they can’t not rape children. And this nurse decided that whatever cravings or withdrawal pains she was having were more important that the pain her patient would be in, going into surgery with insufficient anesthesia.
Addictions and compulsions are not the same thing. Do you know what the difference is?
Yep. A completely evil, obscene, inexcusable, depraved, abusive, illegal, fucking BONKERS action. But that’s addiction. Reason–and by extension, rational choice–have very little to do with it.
That’s what addiction is.
The NIH, FDA, American Psychological Association (in the DSM-IV) and most all other gov’t agencies and medical institutions and experts, including the American Society of Addiction Medicine, define “addiction” as involving things such as “impairment in behavioral control,” “inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships.” (This exact language comes from the ASAM, but there is similar language in all these institutions’ definitions. The upshot is, the addict cannot stop using even “despite severely negative consequences.” Why do you think so many addicts end up in jail, or dead? It’s because they can’t control it.
Trust me on this. I’m an addict in recovery, myself, and I’ve done some pretty horrible things, that just aren’t me.