Archive for February, 2010

Legalization of Marijuana, comment

February 15, 2010

As a hospice nurse, I learn something new everyday. My patients are the most incredible teachers. The use of medications to manage the symptoms of the dying process can be very effective when administered in the appropriate dose dose at the appropriate interval. There are those time, however, when even extremely large doses of opiods and adjuvant analgesics seem to fail. It is disconcerting, to say the least, to witness a traumatic death. It leaves a scar on all who witness it, and brings to mind the ever unanswerable question, "WHY?". Legalization of medical marijuana is yet another mechanism and medication to be utilized to provide comfort to the dying. We are a culture that does not embrace death as part of living. We do not encourage open discussion of the dying process for it places us outside our comfort zone. Consequently, when faced with a difficult death, that is, a death where symptoms are difficult to manage, families of course want everything done to make their loved one’s passing a comfortable one. Morphine carries a stigma that is at times insurmountable to make patients and their families understand its efficacy. I daresay that "smoking a joint" to provide pain relief will be readily embraced by the general populace or on hospice units even as legalization of marijuana occurs. Marinol is already being utilized to stimulate appetite, and has gained acceptance within the medical community. However, I believe that unless an alternative formulation of marijuana is found, resistance will be met and, sadly, the drug will be underutilized; despite the fact that it has proven to be effective when other drugs have failed.

Original Post
November 6, 2009
Title: Legalization of Marijuana, comment
The debate over the legalization of marijuana has been a heated one for decades. Most recently a ski town in Colorado – Breckenridge – voted to legalize marijuana by a greater than 72% majority rule. The ruling will allow adults 21 years and older to have in their possession up to one ounce of marijuana. While this is a symbolic triumph for advocates of legalized marijuana – possession of pot in the state of Colorado remains a crime for individuals without medical clearance. Although there are many credible resources, outlining the scientific research detailing the pro’s of medical cannabis – I think there has to remain stringent government regulations allowing it’s use. It may not be as addicting as alcohol – but as I think back about 20 years to a college dorm room…can we really argue that someone under the influence of such a substance would make a good school bus driver, medical practitioner, teacher, truck driver? Medical use is one aspect – recreational use is quite another.

Original Post
November 2, 2009
Title: Legalization of marijuana
I was reading my local paper today and there was an article about the legalization of marijuana written by a former police officer. He was fully supportive of such an endeavor. He made great points about how difficult it is to close down an illegal drug dealer but how much easier it would be if we made them legal dealers and had some control over their operations. The government could make billions off of legalization of marijuana. If we take the power of money away from the illegal dealers it will not hold the same draw for them. Alcohol, which is legal and a billion dollar industry, causes many problems for those who use it. Marijuana is not physically addicting like alcohol but it is still illegal. I used to be surprised at the extensive use of marijuana in our society. If we know it is not physically addicting and no worse than alcohol why is it taking our society so long to decide that it is helping a lot of people.

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PRN Medication Administration Within Correctional Facilities

February 15, 2010

PRN medication administration presents a unique set of challenges in Correctional Facilities. Working within the confines of the Department of Corrections regulations, (hereafter known as DOC), the limitations set by the physical environment, subjectivity, manipulation, the prison culture in general, all of these obstacles create an environment that can be difficult in providing symptom management to Inmates. Of particular concern, is the management of pain. Chronic health conditions, acute illness, or surgical procedures, all predispose the Inmate to pain. Since medication administration times are strictly scheduled, obtaining medication for "breakthrough" pain is difficult. Opiod analgesics, such as codeine, are frequently utilized. While the abuse liability is high, the maximal pain relief is low; additionally, without the ability to administer the drug on a prn basis, Inmate’s symptoms are poorly controlled. Stronger opioids were not stocked in medical units. There is a delay in procurement of Class II narcotics which in turn, creates an environment where pain is uncontrolled, subsequently taking twice as much time and repeated doses of medication to manage a symptom that could have easily been managed had the medication been administered within the appropriate time frame. What I frequently found were the medications that the inmates were permitted to "Keep on Person" (hereafter known as KOP) were abused in an attempt to control unrelieved pain. Those medications, usually Acetaminophen, Ibuprofen, Ultram, even Diphenhydramine, were utilized in excess since the pain medication was not being administered within the suggested time frame. This in turn created issues with disciplinary action to the Inmate for abusing KOP privileges, loss of ability for the Inmate to manage even his/her minor pain, creating an atmosphere on non-compliance directed toward the Inmate, and perpetuated a negative feedback cycle with no possible resolution. And in the end, pain was unrelieved. If we as Clinicians are to effectively treat pain, proper administration of medication is mandatory.

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How Forensic Nursing Relates to Everday Nursing

February 11, 2010

Identification of trauma (assessment) Investigation (planning) Documentation (history)/pertaining to the incident (intervention) collection of evidence (specimens) postinvestigation review (evaluation) The forensic nurse also provides traditional nursing interventions such as crisis care as they interact with victims, offenders, and their families. These skills may also be extended to various disciplines and colleagues with whom they interact throughout the investigation of trauma and deaths.

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The Symbol of Forensic Nursing

February 11, 2010

As we have discovered through our readings forensic nursing is a combination of many different disciplines involving social science, nursing science, and legal sciences. The symbol in the center of the integrated practice model which reflects the legal, forensic medical, physical, psychosocial, and nursing sciences components, is composed of the scales of justice, the bundle of public service, the caduceus, and the eternal flame of nursing. The flame shows the enlightenment of humanity and perpetuates the challenge in the nursing to continue to evolve and expand into new roles as societal trends demand. The caduceus represents medical science, The scales of justice emphasize the notion that patient care must require consideration of legal as well as human rights. In total the model demonstrates attention to the concepts of person (victim, suspect, offender, human, behavior), health (healthcare, institutions, nursing sciences, individuals, and groups), nursing (nursing science, forensic nursing), and environment (experience, societal impact, and healthcare systems), as well as to internal issues (clarification, expectation, and behavior) and external components (sociology and criminology; social, cultural, and political factors; and education).

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Nursing and the Law

February 9, 2010

Now that the average criminal no longer uses rocks and fists to commit crimes, law enforcement must also advance. Hand in hand with the medical field they must teach us everything they know. How to handle evidence as well as victims and criminals. Evidence is how cases can get won or lost. The medical field and first responders are the first on the scene. Knowledge is their best weapon. Their assessment skills need to be honed to the finest.

Forensic Nursing Online Certificate Program

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Crime Progression

February 9, 2010

As crime progresses so does Forensic nursing. An enlightened healthcare system must be oriented toward change. We must be open to new ideas. To be willing to use our doctors and nurses for more than just what they are trained for.

Forensic Nursing Online Certificate Program

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Interesting reading

February 8, 2010

Review of Forensic Nursing, by Virginia A. Lynch.

I found it interesting in chapter 3 when they stated forensic pathology lays the foundation for all clinical medicine (why people die). Forensic psychiatrists, behavioral scientists, and criminologists who study and evaluate crimes and criminal behavior (why people commit crimes) lay the foundation for the prevention of crime. I found this interesting to think we could prevent crime. If we could truly get inside a criminal mind we could prevent crime. Could science take us that far? Maybe one day!

Forensic Nursing Online Certificate Program

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The forensic nurses role

February 8, 2010

 Review of Forensic Nursing, by Virginia A. Lynch.

The forensic nurse’s role according to our book includes such skills as the following: -identification of trauma (assessment) -investigation (planning) -documentation (history) pertaining to the incident (intervention) -collection of evidence (specimens) -postinvestigation review (evaluation). In other words not only will the forensic nurse interact with the patient as a regular nurse would, they will have to go beyond in all aspects of crisis. Their skills of assessing, planning, intervention and evaluation must be finely honed. They must be able to look passed the obvious.

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Graduate and Post-Graduate Education

February 8, 2010

The education available today is astounding. Courses such as firearms analysis and blood spatter analysis just to name a few. All this to help mesh the medical and legal fields into a fine tuned piece of machinery. Less evidence to be lost and more to be preserved. More criminals put away and more victims stood up for. Standing up for our patients is that not what we became nurses for. A nurse who says he/she knows it all is truly not a nurse. A true nurse goes out everyday and learns for their patients and with their patients. It is an ever changing field. I entered this field with the knowledge that I could move forward and each day a new door opens.

Forensic Nursing Online Certificate Program

Forensic Nursing Online Introduction Course

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William Eckert the father of “living forensics”

February 8, 2010

Forensics when it first began as we well know only cared about the dead. But as time grew we found out thanks to people like William Eckert, that the living have much to offer in the way of evidence. By studying the living both victims and criminals alike we can make headway into the criminal mind so that maybe we may prevent crime. The living have so much to offer.

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