mmt4 2,832 Views
Joined: Apr 23, '09;
Posts: 138 (11% Liked)
; Likes: 24
I have always been drawn to the medical field and always wanted to be a nurse, but was fearful of the schooling required and didn't think I was smart enough. So I worked in medical offices and wished for a better life.
Fast forward to the last seven years. I have three boys and two of them have been diagnosed with different kinds of cancer. My youngest had a brain tumor and is doing well, but needs a large amount of medication to function as a "normal" child. He was 5 when diagnosed and is 12 now. After that, my oldest son was diagnosed with acute myeloid leukemia. We ran the whole gammut from diagnosis to remission to relapse. Ultimately he had a bone marrow transplant and passed away at the age of 13 from complications. That was three years ago.
He had wound up on a ventilator in PICU and I got very close to the nurses caring for him there. We are still friends to this day and they kept telling me what a wonderful nurse I would make. When we were told there was no longer any hope of survival off of the oscillator, we had to make the agonizing decision to turn off the machines and let Joseph go. We each had our turn to say goodbye to him, and in the struggle of doing that, I found myself reviewing all he had been through, all the courage he'd shown for things he was afraid of, all the ways he struggled, suffered and fought. And I thought of all the dreams he would never GET to pursue now....and it just hit me. I had no excuse for avoiding being a nurse because I was afraid of working hard or not being smart enough. It was MY dream. So I promised him in that moment of saying goodbye that I would go to nursing school, that I would become a nurse and that I would remember him and what we went through together and use it to be a better person.
He died in January. I started my pre-requisites in May. I applied and was accepted on my first try, and doing this has been the most healing thing I could have done for myself. I will graduate nursing school the same year he would have graduated from high school. He would be turning 17 on May 26th.
And that's my story.
Rn to BSn can be done online; and/or part time.
There is no RUSH for it. You should do it--it's the path to all nursing careers..but don't sacrifice your family for it.
That's going to get you in the end. Balance is the key to everything.
Have you considered taking the BSN program online via Phoenix or something. At least you will do this at the comfort of your home with your family around.
I do not sense urgency to work in a hospital setting. Your family obligations are overwhelming and you have to consider your husband too. You should discuss this with him and come to a decision that is mutually agreeable. More than likely you will need to stay with the home care position until you are in a better position to be flexible with your hours. You will probably be happier if you can devote yourself to your family. The hospital will be there when you are ready.
You can't have everything... once you accept that fact, your next move will become clear. You want time with the kids, husband and to pursue a challenging job, but it will all collapse like a house of cards because it just will not be sustainable. Kids get sick, they perform in plays, they get awards and they want you there.
Do yourself a favor and take the flexible route, just like piperknitsRN recommends. This way you compromise on the job challenge but you can always come back to this in the future. Give your children what they need now, and your marriage what it needs now.... the stress of doing otherwise is really not worth a line on your resume.
Hospitals do not generally offer per diem to new grads; it costs a great deal of money and time to train a new grad, and some hospitals even require new grads to sign a contract stating they will be responsible for committing to at least a year of full time employment, with various consequences for choosing not to do so.
Overwhelmingly in this post I am hearing you say that you wish to be at home with your children, and that the demands of child-rearing, lack of family in the area to help, and incompatible--or at least less than ideal--scheduling issues with your spouse will not allow you the option of full time employment at present.
If this is the case, I would choose the more flexible job (home health care job), continue to study, gain certifications and CEUs, and revisit a hospital job when you have more time to devote to training and, ultimately, a full time job.
It sounds as if you already have your plate full, and hospital nursing, 12 hour shifts as a new grad can be overwhelming and very exhausting. Please don't stress yourself out any further if you're feeling "tapped out" even before starting.
My advice to you is to revisit "hospital nursing" when you have more flexibility with your schedule and require less time commitment with your children. Hospital jobs will be there in the future, and for now, remember you do have an employment option that sounds like a much better overall fit for your current lifestyle, and invest your time and energy in that specialty (it sounds like you enjoy it--a huge bonus for a new grad!)
This is amazing, actually.
To enter target cells, HIV-1 requires both CD4 and a coreceptor, predominantly CCR5. Blocking of the preferentially used CCR5 receptor by inhibitors or through gene knockdown conferred antiviral protection to R5-tropic variants.13,14 The homozygous CCR5 delta32 deletion, observed in approximately 1% of the white population, offers a natural resistance to HIV acquisition. We report a successful transplantation of allogeneic stem cells homozygous for the CCR5 delta32 allele to a patient with HIV.
Although discontinuation of antiretroviral therapy typically leads to a rapid rebound of HIV load within weeks, in this patient, no active, replicating HIV could be detected 20 months after HAART had been discontinued.15 This observation is remarkable because homozygosity for CCR5 delta32 is associated with high but not complete resistance to HIV-1. This outcome can be explained by the behavior of non-CCR5-tropic variants, such as CXCR4-tropic viruses (X4), which are able to use CXCR4 as a coreceptor. The switch occurs in the natural course of infection, and the proportion of X4 increases with ongoing HAART.16 Genotypic and phenotypic assays can be used to determine the nature and extent of coreceptor use, but the presence of heterogeneous viral populations in samples from patients limits the sensitivity of the assay.17 When genotypic analysis was performed in two laboratories applying WebPSSM and geno2pheno prediction algorithms, X4 variants were not detected in the plasma of our patient. To determine the proportion of minor variants in the plasma, we performed an ultradeep sequencing analysis, which revealed a small proportion of X4 variants before the allogeneic stem-cell transplantation.
Even after prolonged HAART, the persistence of HIV-1 populations in various anatomical compartments can be observed in patients without detectable viremia.18 In particular, the intestinal lamina propria represents an important reservoir of HIV-1, and genomic virus detection is possible in patients without viremia.19 In this patient, a rectal biopsy performed 159 days after transplantation revealed that CCR5-expressing macrophages were still present in the intestinal mucosa, indicating that they had not yet been replaced by the new immune system. Although these long-lasting cells from the host can represent viral reservoirs even after transplantation, HIV-1 DNA could not be detected in this patient's rectal mucosa.
It is likely that X4 variants remained in other anatomical reservoirs as potential sources for reemerging viruses, but the number of X4-tropic infectious particles after transplantation could have been too low to allow reseeding of the patient's replaced immune system.
The loss of anti-HIV, virus-specific, interferon--producing T-cells during follow-up suggests that HIV antigen stimulation was not present after transplantation. This disappearance of effector T cells was not associated with a deficient immune reconstitution, as shown by the absence of relevant infection or reactivation of other persistent viruses, such as CMV and Epstein-Barr virus. Thus, the absence of measurable HIV viremia in our patient probably represents the removal of the HIV immunologic stimulus.20 Antibodies against HIV-envelope antigens have remained detectable, but at continually decreasing levels. The sustained secretion of antibodies might be caused by long-lived plasma cells that are relatively resistant to common immunosuppressive therapies.21,22
In the past, there were several attempts to control HIV-1 infection by means of allogeneic stem-cell transplantation without regard to the donor's CCR5 delta32 status, but these efforts were not successful.23 In our patient, transplantation led to complete chimerism, and the patient's peripheral-blood monocytes changed from a heterozygous to a homozygous genotype regarding the CCR5 delta32 allele. Although the patient had non-CCR5-tropic X4 variants and HAART was discontinued for more than 20 months, HIV-1 virus could not be detected in peripheral blood, bone marrow, or rectal mucosa, as assessed with RNA and proviral DNA PCR assays. For as long as the viral load continues to be undetectable, this patient will not require antiretroviral therapy. Our findings underscore the central role of the CCR5 receptor during HIV-1 infection and disease progression and should encourage further investigation of the development of CCR5-targeted treatment options.
I've heard of nurses getting screwed at work.
It's usually when management gives you too many patients when management couldn't be bothered to find a replacement for someone who has called off.
There is more to life than sororities, and you will make close friends in nursing school that won't hold you back like partying will. Concentrate on nursing. The happiness you will have invested in will be in becoming an RN with a good job who can then afford the finer things in life! (including the friends, nice dinners, and parties) Trust me - I took shortcuts, which led to more shortcuts, and now all my friends are well established and well-off and I am still trying to get my career established.
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