Content That Joe V Likes

Joe V Admin 83,334 Views

Joined: Feb 27, '07; Posts: 7,994 (33% Liked) ; Likes: 6,202
Software Engineer, Programmer, Strategist; from NJ , US
Specialty: 20 year(s) of experience in Programming, Software, Web Architect

Sorted By Last Like Given (Max 500)
  • May 24

    beautiful! thank you for sharing.

  • May 24

    Wow just wow.
    You are so inspiring.
    Thank you for sharing your journey with the rest of us.

  • May 24

    Right after the bottom fell out in the booming housing business in 2008 I found myself single, middle-aged, and looking for another job, after working in a building materials center for 15 years. They began laying off left and right as the sales plunged to rock-bottom. Our local tiny hospital was hiring, and I lucked out by getting a full-time registrar position. My HR guy saw in my resume that I had gone to nursing school after high school but never finished and convinced me to go back to school, as there is always a shortage of nurses, including at this hospital, and no matter how old I was I could always land a job somewhere. I had not been in school for 25 years, and I was terrified. I knew I would have to take all the classes I was scared to take in high school like chemistry and advanced algebra. But I decided to take one semester at a time, and if I did ok I would take another semester. I worked during the day and went to school at night or online, while raising my last child who was in high school. We were taking many of the same math and biology classes and it was fun to be learning alongside my youngest son.

    The journey back to school was amazing! Not only was I able to complete the courses, I learned what I was good at. I excelled at algebra, got an "A" in chemistry, my papers in English won me a trip to Weber State University to read my research paper on Internet addiction in front of other students all over the country, including Harvard students. I did not even know I could write until I was in an environment that required me to do so. The journey was phenomenal. I found many other middle-aged people were also going back to school, and I was not always the oldest person in class. Occasionally, I was even at the top of my class. Then came nursing school.

    After 3 years of working full-time and getting my prerequisites done with all A's and B's, I entered the RN program. I began going to school full-time and working only part-time on the weekends. Still 7 days a week of work and school but I knew it would only be for 4 more short semesters. Was I wrong. RN school was grueling. Our class started with 51 students, 26 graduated. Each semester more and more of us were failing out, and I just hoped I was not the next one to go. I began my student-loan journey at this time due to my hours being scaled back at work, and the debt was piling up fast. RN school at my college is roughly $5,000 per semester. I struggled with test anxiety the most. The clock ticking down on these grueling tests had never affected me before like they did in RN school. I kept passing them, however, and by the time I reached 4th semester I thought I was home free. Was I ever wrong.

    In 3rd semester most of my class was on Xanax. I was going drug-free. By 4th semester a nurse in one of my clinicals gave me the test bank from my college and told me the only way to pass the grueling tests in 4th semester was to cheat. Her class had all used it and it was the only way to pass since the tests were so difficult. I found out that many of my fellow classmates also had the test bank. Five years of grueling schoolwork, working and going to school 7 days a week, came down to me cheating to pass the tests. I refused, and I failed out, 10 weeks before graduation. In our school you must submit several clinical skills videos and pass a test to get back in, and then you only have one more shot. I got back in, and while getting ready for the fall semester had my annual mammogram, which ended up showing I had stage III breast cancer.

    I do blame the stress of nursing school for the cancer to be at a stage III as I was laser-focused only on school for so long. The instructors warn you there is no life outside of school, and they are right. I was in shock with the stress. I began chemo and had to delay my reentry to the following spring. I entered school wearing wigs and my classmates would just stare at me at all I was going through to try to become a nurse. Many of them knew me from several semesters prior when my video for female catheterization became a training video for several semesters behind me, yet here I was.

    After I failed even more miserably the 2nd time around I found out with my situation I could have had special accommodations like being in a room by myself, instead of a huge computer room with the distractions of my classmates getting up from their seats after finishing their test to leave the computer room. I could have been allowed to have more time on the clock since I not only had chemo-brain but severe test anxiety as well. The instructors cannot tell you this. But a doctor's note can make all the difference in the world, and I did not find out until it was too late. I was ready to throw in the towel and stay a registrar for the rest of my life, or at least until we were replaced with electronic robots, which were coming. Robots can certainly be used for check-in purposes, though I doubt a robot can ever replace a good nurse, at least not in the near future. Then a nurse friend changed my mind.

    Jo was a traveling RN working in our ER. She had a southern accent and an exuberant personality. She had also moved right next door to me and we quickly became friends. She convinced me that I had had too much schooling to just give up and I should get back into school to get my LPN. She was right. The next day the LPN program accepted my application and put me in their accelerated program, and 6 short months later I got my license. I now am a licensed nurse, work at a fabulous facility, love what I do which is patient care, make double what I was making, and can pay off all my student loans and other debts I acquired during schooling. Oh and the cancer? Though I am now flat-chested, the cancer was beat up and spit out, and is becoming a fading memory.

    The point is to never give up. We will all get older. At age 70 what will be your biggest regrets? That you tried and failed, or that you never tried at all? Get back on that horse, live your dreams, at least try. There will be doors that slam in your face. Take a crowbar and break the damn door down. Be who you were meant to be, not what people or situations think you should be. Obstacles happen, that is life. But live fully, and honestly, there is never a reason to cheat, or take short-cuts, especially when you are dealing with a patient's life. Face life head-on, stare-down cancer. Someday we may be on that nursing home bed hitting our buzzer for a pain med or waiting for someone to take us to the bathroom. But in our thoughts, we can look back on a great life, and that we lived it to our fullest potential.

  • May 24

    I have wanted to write this article for some time and was pulled back to it after a statewide march at our capital for teachers and school advocacy. One of the major points focused on our lack of school nurses. In the southeastern state that I live in, each school system works with their nurses differently. The county I live in has ONE school nurse shared between THREE schools. I am gonna let you think on that for a bit and revisit this point again later......

    As a "sickly little asthmatic kid" in the early 80's, my school nurses and I were best buds. At that time, school nurses did physicals, hearing and vision screens, lice checks, gave medications, nebulizer treatments, assess for fever, broken bones, bandage wounds and teach classes on healthy habits, puberty, cleanliness, and how babies are made (more importantly, how NOT to make babies). They kept our shot records and medical history in a tidy file cabinet in her office. In my school, she even had a shower for the kids who, for whatever the reason, needed one. The school nurse was an invaluable part of the team/ community that helped raise and mold us as kids.

    Fast forward to my current stage of life as a mom of 3 children in public school as well as a nurse by trade (and spirit). My wonderful sickly asthmatic traits were passed on to our oldest son, whom I also should mention is our most accident prone of the three. No joke, he will manage to trip and fall in the middle of an open field. Oh how I worried myself sick sending him off to school when kindergarten came around. Who was going to watch over him like I do? Who was going to know when he was having an asthma attack starting so it could be controlled before getting to bad. He is also anaphylactic to peanuts.....what more can I say. You get the idea. As a parent you have to trust that your child will be cared for by teachers, administrators, school nurses and support staff during the 8 hours 5 days a week that they are not under our watch.

    True story here....The very first day of school for our oldest and I am at the gym exercising my worries away when I get a call from the school. Instant's his teacher. "I just wanted to let you know that your son walked into a wall and has a pretty big goose egg." I wasn't joking...he is a genius with absolutely no sense of personal surroundings. So of course I asked if he was ok and she said that she thought so but that his head hurt. I asked if the school nurse looked at. That was when I found out that "our school only has a nurse one day a week and she is primarily responsible for keeping up with the kids medication records, shot records, physicals etc, not really working with the kids". WHAT??? So who decides when my son needs the Epipen and who gives it? Teacher. The school nurse educates the teacher when a student is in their class that has chronic needs. Ummmmm.....this did/does not sit well with me.

    So, I have my 4 year degree in nursing with some extra certifications and 20 years of experience as well as being a mom to these children for the past 12 years and I will say, that many many times, I am not sure what to do with childhood illness and issues. (I am not a peds nurse as you can tell). The burden of making judgement calls regarding health and physical welfare of our kids is now in the hands of the teacher. It should not be. They are teachers...educated on educating, not nursing. They already have waaay to much stacked against them in the classroom with class size, lack of supplies and funding etc, and now we ask them to care for the fragile type 1 diabetic child with an insulin pump that needs adjusting numerous times per day??! NOT OK.

    Funding has been cut drastically in many states for school nurses. We as health professionals and parents need to speak up. I know of times in our school system where, a child's heart stopped on the playground due to a congenital abnormality that no one knew about. I have been at the schools during episodes of new onset seizures, heat stroke, broken bones, teachers with severe hypoglycemia etc. We need our school nurses back. Each school needs a nurse on site everyday. The kids, teachers and parents all deserve this. The health and safety of our kids should not be a, "we just don't have the money in the budget for school nurses" option. Many children lack quality healthcare, food, and sometimes unhealthy and unsafe living conditions. The school nurse helps to fill in the gaps for these kids. He/she is the child's advocate, the eyes and ears for parents who send their kids to school. He/she keeps important record of illness and accidents, and at times abuse situations. This information may be the proof needed to remove a child from an unsafe environment. They may help the physician with diagnosing, mental and physical health diseases based on patterns noted during the day. He/she can assess when my breath holding child passes out during his math test and figure out whether further care is needed...if there was a seizure, hypoglycemia, hyperthermia after a hot day on the playground, dehydration...or just his normal anxiety during a test.

    I just want to say that I can not advocate or speak enough about how important school nurses are to our community. They are such an integral part of raising our next generation. Our children, teachers, parents, and schools deserve to have ONE school nurse per school. To have actual hands on care not only with the children within the school but the visitors, staff and parents when needed. School nurses are perhaps the foundation for community health and with all that is going on our ever changing world.....this foundation needs to be a solid and strong one!

    I would love to hear how you communities and states manage the cuts in funding for school nurses. How has your school worked with this??

  • May 24


  • May 24

    As nurses, we are bound by our oath to provide quality care for every patient. This means holding hospitals and other healthcare facilities accountable for sufficient numbers of experienced nurses to ensure patient safety and support inexperienced nurses. Unfortunately, this is often not the case.


    "I don't know how to do that" is something that experienced nurses are hearing more often from new hires, float pool and travel nurses. To their surprise, hospitals and staffing agencies are employing nurses with less than two years of experience more often than those who are more seasoned. In fact, some nursing units have up to 75% under qualified nurses, which pose many patient safety concerns for two main reasons:

    1 ) Less experienced nurses do not possess the nursing skills needed to handle the physical, mental and emotional demands of the job. Not even the best nursing programs can take the place of real-life, practical experience. Without the opportunity to gain real-life, practical experience before beginning a new nursing position, new hires often feel "thrown to the wolves", and this poses a major issue for retention and job satisfaction.

    2 ) Burnout rates are increasing among more nurses. As the overwhelming need for training, coaching, and mentoring consumes much of the time and energy of the bedside nursing staff, seasoned bedside nurses are forced to take on a greater workload for insulting pay rates and a lack of additional incentive. At the same time, new hires who are in desperate need training and mentorship are finding themselves abandoned and without skilled guidance.

    According to The American Nurse, "Research indicates that staffing numbers alone don't always tell the whole story or assure positive outcomes for patients in the absence of other considerations. Other factors related to staff expertise, including RN education level, employment status and skill mix, as well as collegiality of nurse-physician relations exert a positive impact on select patient outcomes, such as 30-day mortality and hospital readmission rates."

    The Joint Commision echoes these concerns: "Nurses are the front line of patient surveillance-monitoring patients' conditions, detecting problems, ready for rescue. Spread too thinly or lacking the appropriate skill set, the nurse is at risk of missing early signs of a problem, or missing the problem altogether."


    There are several contributing factors that lead to nursing staff with inadequate nursing skills. One major factor is that hospitals continue to have strict budget constraints, which creates freezes on nurse salary increases, and low starting pay rates. Without room for growth, in terms of opportunity to learn new skill sets, and higher pay, more experienced nurses might look for work elsewhere. This results in increased job vacancies which are soon to be filled by lower paid, inexperienced nurses.

    Another potential cause is poor efforts by facility administration to improve nurse retention. Without innovative nurse retention efforts, high staff turnover rates will continue to plague these facilities. If experienced nurses don't feel valued by an institution, they are less likely to stay at that particular job. In a recent article that highlights nurse retention efforts, it was stated that the average hospital loses $5.2 million to $8.1 million due to RN turnover, and each percent change in RN turnover costs or saves a hospital an additional $373,200. So why wouldn't hospitals be on board with improving retention efforts?

    The bottom line is that nurses report that low job satisfaction is primarily related to heavy workloads, an inability to ensure patient safety, and insulting salaries.


    Many national healthcare efforts are in the works to enhance nurse retention programs and increase salaries and incentives for their nursing staff. Here are a couple solutions already in progress:

    The Nurse Residency Program. To enhance nurse retention, many institutions have begun implementing nurse residency programs. Research shows that nurse residency programs are an essential strategy to retain new grad nurses. These programs are significantly longer than traditional orientation programs , which can range from 6-12 months or more, and involve much more mentorship and guidance from experienced nurses. Unlike the two day travel nurse orientation, or the two week new hire orientations that most facilities currently provide, they cover in-depth training that focuses on strong connections among workplace colleagues and work-life balance. It is also shown that other studies that focus on skill mix provide strong evidence that when nursing staff members do not have adequate time or training to carry out their work, patient safety and patient outcomes are put at risk. Understanding this fact by all parties involved in making staffing decisions is critical to assuring the effective, safe and reliable delivery of nursing care.

    Nursing wage and incentive increases. The American Nurses Association has created a Bill of Rights, which states nurses have the right to fair compensation for their work, that is consistent with their educational preparedness, knowledge, experience and professional duties. As a result, many nursing leaders have begun research initiatives to prove that higher salaries for nursing will result in better outcomes for everyone. According to an article published by NCBI, staff of direct patient care nursing roles in hospitals and nursing homes have reported dissatisfaction with wages, as well as non-wage benefits such as: health care, tuition reimbursement, and retirement benefits. Wage rates and distribution should match nursing staff skill levels to encourage entry into the profession and retention within the institution. Competitive wages, combined with good benefits will recruit adequate numbers of nurses to meet the ongoing care demands of the upcoming decades and prevent cyclical shortages that have defined the past half century.
    As a result of such healthcare initiatives, you may find salaries and bonuses for nurses to be back on the rise as hospitals strive to attract more longevity within their nursing staff.

    As we push forward in working hard to correct the disproportionate nursing skills within our healthcare facilities, I am confident that our devotion to upholding the highest standards for patient safety will lend itself to creating positive change for all.

    Best Wishes!


  • May 22

    This is very helpful!! Thank you. I was wondering why I could not send private messages

  • May 22

    So if I post 15 comments total then I will be able to pm?

  • May 22

    Quote from Gray_lover03
    So if I post 15 comments total then I will be able to pm?
    Yes, as long as they are quality posts. You can not post a response like " Good" or "I agree" in 15 posts and have the admins unlock your PM feature. They need to be at least a sentence each.

  • May 22

    I am a relatively new nurse. I have a patient who is in the process of dying and is experiencing a low grade fever. I was getting a tylenol suppository for the patient and someone stated to me that the fever was just part of the process of dying and the fever would continue to go up until death occurred. Is this correct? Thanks for the help!

  • May 22

    Short back story: I have a bachelors degree in sociology...did horrible all but the last year and a half. Graduated with a 2.4 gpa...finally realized what my desired...nursing. Of course I'm not competitive with a 2.4 gpa right? First round of nursing apps...denied!

    So I spent the last year taking nursing pre-req' my standards I was killing it (grade-wise), all a's and b's. Applied for several more programs...all came back as a no, but one! I actually had an interview...and then was put on their waitlist. It was my last semester of pre-req's and I believe they were trying to see what my final grades would be (making sure I had indeed turned my academic life around). Until (insert music for dramatic purposes) the last month, during my last semester of pre-req's I ended up homeless because of a ****-poor roommate situation! Anywho...did not do well on my finals, ended up with 2 c's and a b. Who would take me now???? That waitlist school, Denied!

    So what now? Apply again? Sure. What happened...same as the previous two times.

    So what happened today?!?!?! I was accepted to a bsn program!!!!!!!!!!!!!!!!

    I spent all summer researching programs with lower gpa requirements, because I am willing to relocate anywhere on the planet Earth! What I found was that my 2.4 hindered me a lot when it came to 2nd degree/accelerated programs.

    Everyone here probably would love to become an RN, and take the quickest course to get there, however, that was my problem. I was limiting myself and my opportunities by looking at only 2nd degree programs...but once I accepted that slow and steady might win me the race aka: tried looking at transfer programs, etc. I found programs that I would actually have a greater chance at being accepted.

    And an extra side note: don't get caught up in a school's name/prestige... Because there are plenty of excellent schools out there (a lot in the middle of no-where-ville), which are not only accredited, but will mold and adequately prepare you with the same title that comes from more 'notable' institutions---> RN!!!!

    With that said: I applied to d'youville college (granted I did something I had never done before) I wrote an additional letter addressing the decline in my last semester's grades, why it had happened, why it was unlikely to happen again, why I hoped those last few grades didn't completely influence their decision because I am capable of maintaining long-term academic success...etc. And today, after stalking the mailman through the blinds, I seen it! A big, white, acceptance letter!!!!!

    Maybe all those who are looking for someone to give them a 2nd academic chance with have a chance with d'youville college in Buffalo, New York as I did!!!! Something fantastic about this program?!?! Once you are admitted to the school, you are automatically admitted into the nursing program! No 2nd application, no waitlist, (and in my case) no interview!

    There's soooo much I would like to say/write...but this is getting ridiculously long, so feel free to respond with any comments and I will try to answer to the best of my knowledge!

    A tad bit of extra program info that I have come across recently:

    • if you have a previous degree (any subject) with at total gpa of 2.5, and complete specific pre-req's; you have an amazing shot with remington college of nursing (Orlando, FL)
    • Have a 3.0 overall? Or will have one soon?? Or willing to take extra courses (even filler courses: aka: art, poetry, etc) to improve your gpa to a 3.0?!?! I highly advise you to look into Oklahoma city university. Accepted into the university = automatic acceptance into the nursing program. Why'd I mention the 3.0? This is what their website says: "because of the severe shortage of nurses, all applicants who meet the eligibility criteria and qualifications are accepted. Kramer school of nursing has no waiting list." "How many students are accepted into the program each year? How many students are currently in the program?" "as many students are accepted as qualify. During the 2011-12 school year, ksn anticipates approximately 500 students total."

    What are the admission requirements?
    • A 3.0 cumulative gpa or higher
    • grades of c (2.0) or higher in prerequisite science courses
    • english proficiency
    • not more than 9 credit hours of general education courses remaining

    If you are like me, and know that you are more than capable of excelling academically, and are given a 2nd chance to do so: let's do so this time around! Because this is probably our last time to show that we have what it takes to be good student nurses!!!

    Also, those of you who were admitted to, or ran across similiar programs that gives lower-gpa students a chance, post them!!!! Don't hold on to that valuable knowledge!

    Good luck to all, I wish your journey's all the best!!!!


    p.s. All programs listed above are ccne or nlnac accredited

  • May 22

    First, I'm not an ER nurse. I'm a FNP in primary care.

    I recently found out that our local ER routinely uses ice packs on kids with fever over about 102. I'm not talking about heat stroke, fever of 106, febrile seizures, or anything unusual; I'm talking about the kid with fever from otitis, UTI, viral illnesses, whatever.

    My question: is this common practice??

    "Back in the day" when I was in the hospital- including a stint in Pedi ICU- we only used cooling blankets with very high fevers (over 105) or in patients with head injuries or brain surgeries who were having fever from hypothalmic dysfunction. That's been a while back so things could have changed.

    I was taught that using ice packs or cold water to try to reduce fever would produce shivering and could actually raise core temperature.

    I did a google search on ice packs for fever and didn't find anything to support their use except in case of heat stroke, but it wasn't an extensive search and maybe I've missed something.

    I hope that some of you ER folks can help me out with this. Thanks!

  • May 22

    My hands are absolutely SORE ! I was showing a co-worker my hands and asked her , "What do you think is causing these little tiny cuts on my fingers? and Hands??"

    She said it is because my hands are so dry. The soap dispenser at work is very harsh.

    Anyone carrying around a soap squirter from Home?
    I must wash my hands 40 times in 8 hours...maybe more.

    What kind of hand cream are you all using?
    Anyone else got this problem?

    My hands hurt/sting/burn////

    I think I might start wearing gloves 4-5 hours out of eight.

    I see lots of nurses who walk into EVERY patients room putting on a pair of gloves. They never take them off.

    Until they leave the room. And they do not wash their hands.
    They return to the desk or med room and do whatever chore it is they were doing and put on another pair of gloves when in the pts. room the next time.

    Maybe this is best. Especially for me. Handwashing would be a hard habit to break. But I know I am at risk with all these broken area s on my hands.

    What do you all do?

    And which lotion/cream is best to buy?

  • May 22

    Could someone tell me the difference if there is any? Any different care of either? Mostly thinking of patients who have them at home. Thanks in advance for your help.

    Learn about the different types of feeding tubes

  • May 22

    How does this sound?

    Dear Mr. .......,
    Thank you for taking the time out of your schedule to interview me about the registered nurse position at the..........Regional Medical Center. I highly appreciate your time and consideration. After speaking with you, I believe that I am a great candidate for this position, offering adaptability and strong desire to learn. I value how you manage your units in a combined fashion, making teamwork a strong priority.

    I am very interested in working for you, this institution and caring for its patients. I look forward to hearing from you in the near future. Please feel free to contact me at any time if anything further information is need. My phone number is 000-000-0000. Thank you again for your time and consideration.

    I changed things for identity purpose. The last line is something specific from the interview to make it more personal. The interviewer is the manager of four units (small hospital) and he told me how he operates them together so they are able to help each other with staffing and such so does that line make sense to any of you?