A Nurse's Experience with Fibromyalgia and Pain Medication

As part of the nursing experience, we are taught that pain is the fifth vital sign right behind body temperature, heart rate, respiratory rate, and blood pressure. We are taught not to question a patient's subjective statement of pain. If a patient says he or she is experiencing 10 out of 10 pain, we do not question even if the patient was just having a raucous conversation on the phone with a friend.

When we leave school and start practicing our new profession, we become aware of how narcotic pain medications are administered very freely at times. Possibly you have rolled your eyes when a certain patient presses the call button on the dot around-the-clock when they are "due" pain medications. Maybe you have even used the term "frequent flyer" for those patients who are routinely hospitalized for "unexplained" pain.

Pain was a very foreign concept to me for the majority of my life until I arrived at the age of 45. Sure, my knees hurt once in a while after a very long shift on my feet, but for the most part I had no experience with the pain complaints I took care of every day. This made it especially easy for me to roll my eyes at the perceived pain of others. "Why can't these people just develop a thicker skin?", I would think. That is, I would think that way until July 31, 2007.

Isn't it funny how the most life-changing events can occur on the most unassuming and typical of days? I began the day with a feeling of "coming down with something." As the day progressed, I began to feel worse and ended up visiting the emergency room that evening with a generally achy feeling and awful malaise. I was sure I had the flu or maybe a secondary bacterial infection somewhere. After a battery of tests and x-rays, I received the diagnosis that would become all too familiar: "We can't find anything specifically wrong with you." I was given a liter of fluids IV and sent home.

"We can't find anything specifically wrong with you." I learned to dread these words. As the achy feeling of July 31 progressed into throbbing pain in my hands, arms, neck, and back, my quest for a definitive diagnosis also progressed. Beginning with my primary care physician and then through my adventures with rheumatology, neurology, chiropractic, massage, acupuncture, physical therapy, gallons of blood work, and 80,000 CTs and MRIs, my pain persisted and even increased.

This constant discomfort was accompanied by insomnia. I had never had a problem with that before. I'm a nurse. We fall asleep the instant our heads hit the pillow, fatigue, numbness in my extremities, headaches, and a difficulty concentrating that I now know by its familiar name, "brain fog." Yet, the diagnosis was always the same, "We can't find anything specifically wrong with you."

This pattern continued through the rest of 2007 and most of 2008: new doctors, more tests, no diagnosis (lather, rinse, repeat). Then, in mid 2008, a physician finally decided to deliver an official diagnosis, but it was not one I was especially fond of. A physician had come to a conclusion about my condition, and I will never forget when he muttered the "F-word". The dreaded diagnosis that most health care professionals consider to be a fake illness, an illness that is tossed around freely, mostly by those who hope to obtain pain medications. The F-word is Fibromyalgia. My spelling checker does not even recognize it as a valid word.

I literally cried when I was given that diagnosis. Have you ever wished that you had a "respected" disease so that your co-workers would understand why you can't work? "I'm sorry, I can't come in today. My rheumatoid arthritis is flaring up." That is an explanation they would respect. However, "I'm sorry, I can't come in today. My fibromyalgia is acting up." Yeah, that flies like a lead balloon. The typical reply would be "Oh, I'm sure you're just fine. You need to come in because we are shorthanded. Besides, you sound fine."

Maybe this treatment is payback for my own attitude. How often had I, as a nurse, rolled my eyes at a patient requesting pain medications because his or her fibromyalgia is acting up? I can recall thinking, "If you were really in pain, then the x-rays, CTs, or MRIs would show something. You are obviously just a drug seeker."

The most humbling nursing experience of my life was being diagnosed with the very condition that I had discounted and dismissed as a fake.

So what is a nurse to do? My health was so unpredictable that I couldn't possibly keep a set schedule. Fibromyalgia has been defined as being similar to a bank with regular deposits and withdrawals. Every so often generous deposits of "energy" and "well-being" are made to your account, and you can feel almost normal on those days.

However, you can also expect the inevitable withdrawals, and when they occur, that sense of well-being is taken away. The problem is that you never know when a withdrawal is going to take place. You can have an account full of energy one day, only to find your funds depleted the next, with no explanation, no warning. It's like the Bank of Fibromyalgia keeps its own hours, and this unpredictability made it very difficult to work in my chosen profession. There is no feeling like having every penny withdrawn from your energy bank and looking forward to three 12-hour nursing shifts in a row. I knew that I couldn't go on this way for another twenty years until retirement. Also, I had no desire to be dependent on pain medications in order to function. This is another story in itself as I did go down that road for a time. So what is a nurse to do?

I went back to school. In three-and-a-half years I was able to work through an online BSN program and a MSN program. This is not an easy task when you suffer from an unpredictable brain fog, headaches, and incessant body aches. However, through some dogged determination I was able to graduate. I have never regretted it. Since it was no longer possible for me to consistently work in my former areas of practice, my education has afforded me the ability to work in the capacity of a nurse educator. I will begin my Ph.D. program within a few months  again online.

I may be one of the first Ph.D. nurses with a certified case of "brain fog," but I certainly will not be the last. More and more nurses who are experiencing this debilitating disorder are turning to education as their lifeboat in foggy, turbulent, unpredictable waters. And as we move forward, we take with us a new-found, hard-earned respect and empathy for those who suffer from in tractable, unexplained, and under-respected pain.

Source: nursetogether

Ethics in nursing: how strong is your moral courage?

It wouldn’t be wrong if we would say that nurses are a major element in keeping the healthcare foundation strong and functioning. Even in the absence of a doctor they continuously monitor their patient’s health and at times of emergencies, they may take a holistic approach to improve their patient’s health.

Apart from improving and saving lives, nurses are also given the responsibility of patient’s advocacy. They are the ones to educate their patients about how the treatments work and about the necessary procedures. They are also responsible to protect their patient’s interest when they are unable to do so because of their medical condition or insufficient knowledge about the healthcare terms and procedures. However, most of the nurses face challenges when practicing ethics due to inadequate education and other restrictions based on ethics.

The Dilemma

The problem aggravates when there are no proper or continued educational resources available on ethical challenges faced by these nurses. Even while they are being formally educated, the courses they are taught does not properly shed light on all that there is to ethical problems. Realizing the crucial need for nurses to stand up and advocate in their patient’s interest, many nursing schools are now teaching “Moral Courage,” as a subject.

Case In Point

Jessica is a registered and practicing nurse for almost 20 years now. She knows more about how things work at her hospital as she is the charge nurse for her shift too. Last week, Jessica was told by a Doctor on duty that one of her nurse named Brianna has been interrupting within her work procedure about a patient.

Brianna, who is also a competent and experienced nurse, when asked about this, told Jessica that she has been asking the doctor to increase sedatives because of the patient’s medical condition. Jessica was then presented with all the objective data of the condition and she also monitored the condition using the SBAR technique (Situation Background Assessment Recommendation). It was quite apparent that it would be in the best interest of the patient needs more sedation. However, knowing the nature of the doctor both, Jessica and Brianna were unable to approach the doctor and communicate for the best interest of their patient.

Patient Advocacy

Many nurses, find it hard to come forward and present their views in light of their patient’s care and better wellbeing. The gist of patient advocacy lies in the support and protection of a patient’s interest. However, while doing so, nurses often find themselves in a complicated situation where their professional and personal morals are at stake. There are often questionable situations where patient’s rights are violated and they are unable to demonstrate their moral courage in preventing the rights of the patient.

Moral Courage

Moral courage needs to be established and developed among nurses to help them identify what action is required when your patient’s interest is being compromised. Therefore, moral courage is correlated to practicing virtue ethics in a way that it enhances the importance of your subjects’ needs and rights rather than just performing the duty out of professional obligations. The practicing of virtue ethics involves resolving conflicts through proper understanding of what is in the best interest of patients.

Obstacles in Practicing Moral Courage

Like Jessica and Brianna, many nurses undergo similar highly conflicting situations in their nursing career. They either find some peer support, develop the courage to speak or just keep doing as told by the doctor. The third scenario is the most common and is worst of them all because not being able to speak up for their patient leads to suppressing their opinion and further causing stress and depression. This discourages them from upholding to their ethical standards and questioning their own loyalty with the patient. Many healthcare organizations and practitioners, deject nurses from advocating for their patients. Seeing this, nurses themselves circumvent from showing their moral courage.

Here are a few barriers that were commonly seen in most of the healthcare organizations:

Most of the times it is the organizational culture that can set a code of ethics that involves considering the opinion of a nurse if she is speaking in favor of his/her patient. An organizational culture can either set some standard to encourage moral courage. Nurses should also be given the power to report unethical behavior of a doctor or those senior to them.

Peer support plays a crucial role in practicing moral courage. If in a healthcare organization, don’t support those that are morally courageous can result in reluctance by those who are willing to take necessary actions.

Due to a suppressing code of ethics many nurses somehow tend to accept the unacceptable, due to the fear of losing their jobs or other professional problems.

The importance of moral courage and patient advocacy is far more crucial for health care practitioners than for any other professions. Sometimes, the emotional and cognitive actions needed in critical times can be challenged by the individual not knowing what action to take and how. It is high time that our nurses are trained and educated to deal with such situations without having to compromise their ethics or their profession.

By Zyana Morris

Nursetogether

FROM THE PRESIDENTS DESK



SEASON'S GREETINGS TO YOU ALL
GREAT STUDENTS OF SON LUTH!!!
 It is my pleasure to welcome you all to study block after a long period of break(though to some it may have been a short one). I hope we all milked enough funs of the season into our reservoirs because the opportunity in its best choice comes twice in our period of training(3years). And for those that did not go on break, do not feel bad as you still stand chances.
  Sure it may irk us that the break is over but I want us to come to terms with that and embrace our fate. So with Great Joy! I once again welcome us back as I vehemently trust that we are not behind closed doors to the fact that we have resumed to embrace challenges in ''stronger force''.
 Perhaps you may say ''I have entered higher institution' I have arrived.... So let me relax briefly''(for part1 students) ''l passed Year 1 without ref....so I deserve a fleeting break...at worst I may have a ref'' (Part2) ''If I was able to walk over the most-believed-tidious year two what then is in year three'' (Part3)......…''MY DEAR BE WISER''
  It is certain that the higher we go the tougher it becomes and we would not say we cannot go higher because we would not want to encounter toughness... So we are invited to be more cautious, observant and strong footed.
Also, it is believed that at the end of every dark tunnel there is a bright light. So I ask......will it not be unwise to turn back at the sight of a bright light when one is uncertain about his location in a journey through a dark tunnel?
 As we have resumed, we should expect such pressing tasks which might still be strange to some but have become routines for majority, as
Daily attendance to classes
Mandatory assignments
Reading for both tests and exams
Presentations
Reading before classes otherwise you may stand out for wrong answers.
Participation in NISONM Games.
If you are an exco ...more works.
For all these tasks which come almost in succession, :''success is not an option but a necessity ''
 It may amaze you to hear that the key to this SUCCESS lies within your abode.
Your orientation and perception about things engineer your way to success.
So change your orientation and perception about situations to positive and if you are there ''BRAVO!!!
An optimist sees an opportunity in every difficulty..... Be an OPTIMIST.
Discipline cannot exist in the absence of laws or principles.
Set principles for yourself and do not lower standard to please anyone.
Below are some steps which I targged ''DEAR BE WISER''and some motivational quotes by Brian Tracy to assist;
Starters
Those already on the journey
And those that have derailed,
to make good starts, retain their stands on the track and retrace their steps respectively as they journey on the path that moulds them as nurses.
Devote time for leisure
Expect more fun than you planned
Avoid being distracted as to forget your purpose
Recall your dream and focus.

Be God fearing and have self acceptance.
Engage yourself each day with something new.

Withdraw from friends whose dreams are far out of line from yours.
Invite those that will help your dream, make friends with them and practice what they did.
Shut off from distraction at some points and have quiet time to asses your stand
Encourage yourself in both success and failure.
Remain strong and resilient. Restart when you fail.
MOTIVATIONAL QUOTES BY BRIAN TRACY.
.The way to get started is to quit talking and start doing.
Do not be afraid of falling . The more you fall the higher you bounce.
The man who has confidence in himself gains the confidence of others.
It is not whether you get knocked down. It is whether you get up.
The future belongs to the competent, so be good, get better and be the best.
Hence I urge you ''DEAR BE WISER''
The future is in our hands
With determination we can achieve success
Great student nurses!!!
Long live SON LUTH!!!
From your President
STN OKOLIE C J

PERSONALITY OF THE WEEK

The personality of the week is designed to recognize individuals that have shown exceptional  character worth acknowledging.

This week's personality has been one of the easiest decisions to make.  He is a person of good rapport, good conduct, sporty and the man that has held on to the title of Master S.O.N for two years.

 Oluwole and Nelly had the privilege of interviewing him today. Enjoy.........

Question: can you tell us a bit about yourself
Response: My names are ONIBUDO ISRAEL ABIODUN, born on the 24th of December to the family of Mr&Mrs AFEEZ and MARY ONIBUDO. Am an indigene of OGUN STATE. Also like to be called BUDOMARS at times. A lover of football and athletics, a Christian and I like the colour blue. Well that's just a brief summary about me.

Question : You are the current Mr S.O.N ,how have the journey been so far
Response: Well the journey has been good and smooth so far. Being Mr. S.O.N has been fun but that doesn't mean that I shouldn't be focused. So far with GOD'S help, I have been able to devote maximum time to my studies and also create a steady relationship with people both inside and out S.O.N. I have made friends in medilag and places outside LUTH.


Question : where do you see yourself in 5 years
Response : In the next 5years, with GOD by my side I should a B.sc holder trying to get my Masters degree. If GOD says I would still be in nursing, no problem. If not, GOD knows best.

Question : if there is something you will change in SON what wil it be?
Response : I guess that would be the student-teacher relationship in S.O.N.

Question : your best moments
Response : "smiles" that would be NISONMG GAMES and when I won Mr. S.O.N. Yeah, those were great moments.


Question : worst moments
Response : none to remembrance

Question : in any relationship?
Response : not at all, but I have someone who is very dear to me. But am not in any relationship now.

Coughs!!!
Question : Any challanges

Response : none at the moment. When I have any problem, I have people I go to who will surely give good advices that can help out.

Question : How do you spend your free time
Response: With my friends. We play games, make jest of ourselves, sing at times, play football or volleyball and do other fun stuffs to sha.

Question : who has made an impact in your life throughout this journey?
Response: I would say everyone have met right from my very first day till this present moment.


Question : why did you choose to be a nurse?
Response: To be frank with you, I never had nursing in mind. When I was young I never knew a profession like nursing existed. But have come to accept nursing now, I have foun peace with nursing and am ready to move forward after S.O.N

Question : Do you have a favourite quote?
Response: I actually came to accept this quote as my favourite quote now that " the journey of a thousand miles begins with that determined step".

Question : can you describe yourself in three words?
Response: simple, honest and easygoing.

Question : Any advice to our readers?
Response: Be yourself, put GOD first and learn to tolerate others because we are not perfect.

ALERT

Dear Readers,
the admin will be giving out recharge cards to the people who post the best comments on this blog. It serves as an act of appreciation to our readers.

SON-LUTH CHRISTMAS CAROL 2016

The 20th December 2016 was a memorable day for both the entire staff and students in this great institution. As a tradtion of the school before leaving for Christmas break, the first and final year students visit  the wards ,special clinics ,theaters, local nursing homes and invite the residents to join them in singing Christmas carols. The patients were given gifts and in turn they showed signs of appreciation. 

The members of the S.U.G wishes the entire student of this prestigious institution a  merry Christmas and a happy new year in advance.

FRESHERS PARTY 2016

The Freshers party 2016 tagged ignite the session was an amazing event for the part one student of this great institution.The Freshers’ Party was a night filled with talent, music, excitement and enthusiasm. This unique event was organized to formally welcome the first year students. The event began with cheerful participation of the staylites and the new batch of students. Events like talent round, question and answers, riddles and jokes were held during the event. A lot of freebies were also given out.
Mr & Miss Fresher and Mr & Miss Best dressed of the evening were selected. This year  Freshers’ Party a boy and a girl were nominated for the prestigious title of Mr. & Ms. Fresher and for that they had to go through 3 rounds of different competitions, i.e. Intro Round, Talent Round and Q & A Round. This year the Titles were grabbed by Mr Sadiq Raphael and Miss Inweh Nkem.
 Mr. Onibudo , Ms. Ajayi , Ms. Anyanwu Ms. Onosanya, were the judges of the Mr. & Ms. Fresher competition, which included some fabulous performances. Under the guidance of the student union government the event was very successful. It was a platform for the new batch of students to introduce themselves and to show their talent.
 The occasion was graced by the presence of the graduating class October 2013 set, past and present master & queens and also the new face of the school. Pictures of the event will be posted soon..............