djaychris 2,853 Views
Joined: Apr 30, '09;
Posts: 20 (40% Liked)
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Greetings! I'm an MSN with experience in the online RN-BSN teaching environment (in the TA role). I'm wondering what everybody's experience here has been? What are the best (and worst) RN-BSN universities/programs to work for in the online environment?
I'm an active and practicing RN in PA who was recently hired by an online company for online teaching assignments. I've been given my first assignment, and it is for a campus which is physically located in Ohio. I'm told that I'm required to apply for a teaching permit/temporary license from the Ohio Board of Nursing before I can start teaching. Does anybody know if this is fairly common in all 50 states, or if this only applies to certain states?
The growing shortage of medical doctors, which will be made much worse by health care reform, will mean more and more patients are cared for entirely by "nurse specialists" and nurse practitioners, instead of physicians. Nurses are lobbying for increased prescribing privileges and for the right to be addressed as "doctor" in health care settings.
To be honest, after my first couple years on the job I never gave it any more thought. These days the field of nursing is not quite so "female dominated", at least not in certain units. The one major downside to being one of the few guys in a unit that does have mostly females, is that you are often expected to act as "the aide/orderly". I got so tired of hearing "can I use your muscles" from all my female coworkers when I worked in the cardiothoracic ICU. There was an unspoken expectation that I was to assist every female around in moving their patients, getting their patients changed, out of bed, into bed, and ambulated....every day. When I needed physicial help caring for my assigned patients (who were often "coincidentally" some of the largest and most labor intensive), help was often nowhere to be found. This resulted in large amounts of frustration on my part, as well as lots of enjoyable pain down my left leg. I eventually left that unit, and the unfair expectations were a part of the reason. If you find that your're in a job that is boring you, change it. I speak as somebody who has worked in everything from disaster medicine to Med/Surg to ICU to ED and beyond. Your job is what you make of it.
I think tattoos are great when they can be hidden. You do not want your potential employer examining your tattoo of a flaming skull on your right forearm while you are telling them why you would make a GREAT unit manager (and earn $80,000/year while your at it). Many will say they don't discriminate against tattoos....to that...I call B.S. Ask yourself this, "Is this giant tribal symbol I want to tattoo on my lower arm going to seem nearly as cool to me in 10 years? Will I still want the world to see it down the road when I am attempting to advance my career to a higher financial playing field?". If you are unsure of the answer, place the tattoo on an area of your body that can be easily covered with a t-shirt or standard scrub top.
Keep the facial hair. I have been fortunate enough to work in many different settings in many different facilities, and my trusty goatee has never caused me any problems. It you have a giant beard down to your chest with yesterday's french fry crumbs in it, you may want to consider doing something about that. I think the nurses rolling around with sleeves of tattoos climbing up and down their necks and arms have more to worry about during an interview than those of us with simple/well trimmed facial hair do.
The answer to your question would be......don't sexually harrass/assault anybody.
Seriously though, almost every male nurse I know who's even been accused of sexual assault deserved it. I'm not saying that wrongful accusations don't occur, but I doubt it is the danger you are perceiving it to be. There are many males in the field these days. I make sure to treat my female coworks with respect....no winks...no addressing them as "honey" or "pumpkin" (yes I have heard my male colleagues do so), no back rubs, no comments about how great they look. Treat your female colleagues professionally, and they will likely do the same for you. As for the women who direct wrongful accusations at innocent males, there is a special place in hell for them. Being subject to a sexual harrassment accusation can be INCREDIBLY damaging for somebody regardless of their innocence. It is often associated with a stigma that does not easily go away.
**EDIT**I see you are referring to patient accusations and not coworkers (duh!). In that case, much of the advice on this thread is sound. I have always outright refused to take part in OB/GYN exams, and most hospitals will only allow a female to do so anyway. If I am caring for a psych patient who is making inappropriate and/or sexual comments, I will not even enter the room without another female present. If you are ever in doubt about how a patient is handling a situation, bring another nurse (female) with you. It is your right to refuse to put yourself in a potentially harmful situation.
Hyperbarics is certainly a tiny but exciting speciality. I run a tiny hyperbaric center with monoplace chambers. I have been considering pursuing certification, but it is not easy for those of us who don't live near large bodies of water. It would seem that all the classes and courses are offered near coastal facilities. This means most classes are often cost prohibitive by the time you pay for travel costs, lodging for an entire week, and course registration and materials. Then, once your ready to take the exam, it can be tricky to even find a place to test in certain states. This can mean additional travel expenses to test out of state. I've found that my center is unique in that it offers critical care capacity, which many do not. Managing an intubated patient with an arterial line on multiple drips inside a mono-place chamber can be quite challenging, but I absolutely love it. I do believe that in the future there will be a higher demand for nurses who have a background in hyperbarics, and even higher demand for those that have experience treating critically ill hyperbaric patients. Good luck to you.
This thread has some good information. I am an experienced RN who keeps hearing about "the nursing shortage", although I haven't seen it yet for myself. The ED I presently work in is overstaffed and nurses are having their hours cut short and being forced to "flex". Although I have not experienced any effects from a "shortage" lately, having it explained as a shortage for "experienced RNs in certain areas" makes alot of sense. A young girl I'm friends with just graduated nursing school, and she cannot find a single open position anywhere in the PGH area (WPAHS/UPMC combined). It is a sad way to start a career when you entered school because of "the shortage" and "all the job opportunities". I think there is much misinformation being given to prospective students thinking about entering nursing school right now, and I don't know where all these fresh grads are going to go to work. I think that nursing is a great profession though. You will likely work with other nurses who are unpleasant or downright rude, but if you're diplomatic, you'll survive. You will also have the pleasure of working with many compassionate and intelligent nurses who will be more than happy to share what they've learned with you. All in all, it's a great field, if you can find a job.
Yes, you can do this. One of the hyperbaric staff here treated a woman with a compromised skin graft. At the time she arrived for treatment, the woman had "maggot therapy" in place. The staff member got the "ok" from the supervising physician. She treated the woman, and the maggots did well. In fact, the maggots said they felt "invigorated" when interviewed after the treatment.
The poor grammar that today's society uses disgusts me. Before I start my rant, I'll admit that I'm guilty of the occasional grammatical error. English and grammar was not my strong point in high school. Despite my shortcomings, even I know that the word "you" is not spelled "u". I refuse to use numbers to replace words (example: "4" instead of "for"). It has become socially acceptable to text message and type like an idiot. Many people today have gotten so used to texting "shorthand", that they will also type emails and papers like this. It amazes me how many people send out work emails that show the spelling and grammatical skills of a first grader. It is hard for me to take these emails seriously, no matter what information they may contain. I think people don't realize that when they send out poorly written letters or emails, they discredit themselves. "end rant"
-Yes, I'm sure I have some grammatical errors in this message.
ED triage is not something to take lightly. It also depends on what kind of triage system your ED has. In the first ED I ever worked in, triage was run by 1 nurse. That nurse had to assess the patient, decide whether they were appropriate for the ED or quick care, then decide whether they could wait, or whether they needed rushed back. The triage location was located outside the ED, and the RN was on their own. During busy days in this ED, I sometimes saw waiting times as long as 8 hours. On days like this, it was terrifying to be the triage nurse. If you misdiagnosed a patient in triage, bad things could happen in the waiting room (and they did). If you ran every patient back because you were unsure of yourself, you would jam the ED and anger the charge nurse. That ED required 1-2 years experience before training a nurse for triage. The ED I currently work in has a "no wait" policy. All patients are brought back immediately, regardless of complaint or ED volume. In a situation like this, much of the responsibility of triage is lifted from the RN's shoulders. If you are considering working in triage, make sure that department gives you enough training. Triage is a unique environment for the RN. Mistakes made in triage (under extreme circumstances) can potentially cost a patient their life.
That was a transition I made. I went from full time at a busy community ED, to full time in the biggest and toughest CT-ICU in my region. What it showed me, was that I did not know nearly as much as I thought I knew. I had no idea how to handle the ICU patients. There was tons of equipment I'd never seen (IABPs, VADs, Primsa, multiple kinds of swans, tons of drips, EVD's, ECMO, etc.etc.etc.) I had to learn hemodynamics. Not BP and pulse ox, but SVR, PA pressures, Cardiac Index, etc.etc.etc. It was a great experience, and one of the best decisions I ever made. I left that ICU a different nurse, and it has only enhanced my ED abilities ever since. The thing to keep in mind if you transition from ED to ICU, is be prepared to find out how much you don't know. In ED you know a little bit about everything. In a focused ICU, you know everything about one or two systems of the body.
In my opinion, ICU to ED is one of the toughest transitions a nurse can make. I speak as a nurse who worked Med-Surg, then ED, then ICU, then ED. I have worked full time in the ED while working casual in the ICU, and vice versa. Before I knew ICU, I knew ED. ICU nurses are trained to be creatures of routine (forgive me for generalizing). Most give their patients their bath at the same time every day. They start their mornings the same way every day. There is a time to review labs, a time to document on care plans, a time to meet with the CCM for rounds, etc.etc.etc. ICU nurses must do a TON of charting, they have to be extremely thorough. They are also strong critical thinkers, and often diagnose and treat the patient themselves based on pre-determined protocols. Most of this goes out the window in the ED. There is no routine. Every day is different. You cannot spend hours diagnosing and attempting to treat all the patient's problems. You deal with the most pressing issue, then get them out of there. You chart just enough to get by, and no more than that. You must deal with emergencies with no warning, and often with aging/broken/missing equipment. That is the problem I see with alot of ICU nurses. They wish they had more time to spend with the patient. They cannot get all the charting done. They are shocked by monitoring a critically ill patient with only a bp cuff and pulse ox (no swan, no art line, etc.) They feel like they really didn't get to "fix" the patient. In my experience, I find that most ICU nurses feel that their job is way tougher than an ED nurse. Most ED nurses feel that their job is way tougher than an ICU nurse. After doing both extensively, I think that neither one if tougher. Each one presents their own challenges and required skill sets. Transitioning from a controlled (but extremely difficult) environment like the the ICU to the madness of a busy ED can be extremely traumatic (no pun intended).
-Just my humble opinion, I'm not trying to offend anybody.
Hyperbaric nursing is a tiny specialty that I have fallen in love with. I run a tiny hyperbaric department with two mono-place chambers. I do everything in the department, from training a few casual staff, to billing, to insurance, to administering treatments. This job challenges me in many different ways. In my humble opinion, a hyperbaric facility that deals with sick/emergent patients needs a STRONG critical care nurse. Althought hyperbarics often appears easy, the critical thinking element of it is not. The nurse needs to be confident to make decisions for the patient when they are in the chamber. Because it is such a small specialty, the hyperbaric staff member must often make important decisions on their own. They will often find that available physicians have no idea how to handle the situation. In a small department like mine, I have no co-workers. I have to rely on my experience as a nurse, as well as on-the-job training I had from the prior nurse, to make the right decisions....every time. Safety is also incredibly important in hyperbaric nursing. A nurse must use top notch assessment skills before treating their patient. I find this to be an incredibly exciting....but tiny field. My department is not located in a coastal region, so we don't see much decompression sickness. We treat both pediatric and adult medical indications (some emergent). For questions about what hyperbarics can be used to treat, visit UHMS.ORG or HBOEVIDENCE.COM
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