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JBMmom, RN 7,489 Views

Joined Jun 24, '09 - from 'CT'. JBMmom is a Nurse. She has '4' year(s) of experience and specializes in 'Long term care; med-surg'. Posts: 396 (36% Liked) Likes: 496

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  • Sep 23

    Quote from kakamegamama

    Sometimes, I am reminded of the book "Eats Shoots and Leaves" on this site. (Sorry, I can't find the underline function on my computer, or I would have underlined the title.)
    That was the book that brought me and my husband together, many years ago. That, and our shared love for the Oxford comma.

  • Aug 30

    Interesting thread. This topic has been debated vigorously on the APRN and NP forums.

    All available evidence indicates that NPs without RN experience are as likely, or more likely, to succeed in MSN programs. In addition, some studies indicate NPs without RN experience have superior clinical skills as evaluated by NPs and MDs. Not one single study has demonstrated that NPs without RN experience have worse patient outcomes. In addition, I fail to see how RN experience in an acute care setting helps in the primary care arena. Many primary care and outpatient specialists have told me they have no interest in hiring an NP or PA who only has acute care experience. Finally, ironically, this is similar to the MD vs NP debate. We all get frustrated with MDs arguing against full practice authority for NPs even though over 100 studies have shown NPs provide the same, or better, quality of patient care. So now we have RNs and NPs arguing that RN experience is necessary to be an NP, but without any supporting evidence.

    I do believe we should have NP residency programs for new grads and the AANP, ANNC, and state level NP organizations should lead the way in helping us with policy, legislation, and funding to support this. It would be great if there was funding for residencies in underserved areas and NPs choosing this route could get tax breaks or some student loan forgiveness.

    Online programs deliver didactic content online. Clinicals with preceptors are still required. There are many reputable online programs such as Frontier Nursing University.

    With regard to online courses – if it is just lecture, then who cares? In fact, the advantage of an online lecture is you can listen to it as many times as you need, whenever you want. The only value to an in-person class is if there is substantial class participation and Q&A. Only a few of my MSN classes had that, and I went to a top school. There are online learning platforms that do provide for real-time student participation and allow the instructor to call on individual students. Online education is the future of education.


    References

    El-Banna MM, Briggs LA, Leslie MS, Athey EK, Pericak A, Falk NL, & Greene J. (2015). Does prior RN clinical experience predict academic success in graduate nurse practitioner programs? Journal of Nursing Education, 54(5):276-80. doi: 10.3928/01484834-20150417-05.

    Rich, E. R. (2005). Does RN experience relate to NP clinical skills? The Nurse Practitioner, 30(12), 53-56.

    Rich, E. R., Jorden, M. E., & Taylor, C.J. (2001). Assessing successful entry into nurse practitioner practice: A literature review. Journal of the New York State Nurses Association, 32(2).

  • Aug 21

    Providing in-home care for a vent-dependent toddler with the nicest family ever. Night shift, and from day one they trusted me to care for their child. Mom and I just 'understood' each other from the get go.

    Fast forward: he is off the vent, decannulated and rides the bus to school every morning. Just like all the other kids! And mom has a job providing support and resources to NICU families.

  • Jun 3

    Point / Counter-point...

    I've been a nurse for 7 years, following almost 20 years as an engineer.

    My only regret is that I didn't choose nursing 20 years before I did.

    Are their crappy bosses and crappy organizations? Of course, as in any field.

    Are their crappy customers? Yep, just like every field.

    Are their crappy co-workers? Yeah, there sure are... no different than any consulting firm or plant floor.

    Is every nursing job well-paid? Nope. Of course, there are dead-end engineering jobs, too.

    Nursing offers an amazing array of options throughout a career... far more than any other single discipline that I'm aware of.

  • May 5 '16

    Overuse of these medications can lead to CDiff. We get almost 100% of patients from the hospital on a PPI. Unless they have an active diagnosis of GI bleed, we ask the PCP to discontinue the med. People take far too many medications as it is.

  • Jun 2 '15

    Quote from HelloRN00
    I felt like it was my fault and that I did something wrong.=(
    Since my conscience is not terribly active, I generally do not blame myself for things that go wrong in the workplace. Guilt is not a part of my emotional repertoire, and it is less stressful living this way.

  • Apr 26 '14

    Nola...I designed the orientation myself. I think it's part of my job to assure my new nurses, especially the new grads, have a positive experience. We don't give 3 days and send them off on their own. Most of the new grads have orientations that last at least 6 weeks. They learn the med pass first, then we add on the treatments...they are never alone while they are learning. They then spend time with the desk nurse so they learn the procedures for writing orders, ordering labs...and that is never done on the busy sub-acute unit even if they are eventually going to work there. It's too frantic an environment for someone new to long term care to try to absorb everything.
    They then get an orientation on the shift they'll be working. Either the SDC, the ADON, or I check in with them almost daily to make sure they are getting what they need. So yes, I'm SURE the orientation is good.
    I've called around to other facilities...our pay is more than most are offering. Our benefit package is better, and we are better staffed.

  • Sep 4 '13

    HAHAHA! Yeah....I never wear make-up. My philosophy is just to keep expectations low!!

  • Aug 21 '13

    I attended a lecture a few years ago who touched on the interesting fact that when we ask people who they are, something like 98% of them will answer with their names and their occupation in the same breath.

    Long and short of it: people introduce themselves based upon what they call their "active role".

    So it is not unheard of or strange for your identity to be associated with your job. And as one who, due to a physical malady, has had to bow out of a role that was not only something I loved dearly, but was how I identified myself, I can appreciate where you are in your grief and anger.

    Because remember, that is all part of this process of changing and assimilating identities, limitations, and goals. Before one can move on, one must first grieve. So take your moment and make your peace all in due time.

    As far as fulfillment and job ideas, I know that many here have had suggestions. You could always check into doing pre-admissions screening for a hospital OR or perhaps work in a central scheduling office. As far as fulfillment goes: Volunteering works wonders on the soul for that one. There are so many places where you can go, from nursing homes to hospitals to veteran's centers, and truly make an impact.

    Quote from VivaLasViejas
    We'd gotten the great news from the university hospital about hubby's stage IV pancreatic cancer being treatable after all.
    This, Marla. This.

    In spite of everything that is going on, I really wish that this one little fact would eclipse all others.

    Perhaps it is time to rest the mantle of asskickin' nurse and instead become immersed in the life that exists outside the doors of the hospital. It is time to rewrite your active role.

    I don't have to ramble to you about the frailty of life or the downright insanely amazing news that you have been given in regards to your husband's condition. I know you know.

    Rather than wondering where you go from where you are now, I think the more fitting question is the following:

    You, yourself, stated that you have just been given a new lease on life (such a rare and precious opportunity)--

    How do you plan to make the most of it?

    With kindest regards and sincerest belief you will find your way,

    ~~CP~~

  • Aug 16 '13

    We sent two of our chronic babes to children's rehab today! Best feeling in the world when you have former 24 weekers who have had every single complication known to man, end up trached and with GT's and with a gloomy outlook , who end up very appropriate 8 month old babes! My co-workers and I have empty nest now! Good luck out little sweeties!!!

  • May 7 '13

    When it comes to nursing, I respect the profession for what it is, what it has been, and where it is headed. Am I proud to be part of the profession? Sure, in a subtle, I'm proud my hair is long kind of way.

    I own no nursing paraphernalia. I do not announce what I do readily at meet n' greets or reunions. I prefer to refer to myself as a Frustrated Carpenter or a Confused Ninja.

    Ever since stepping foot into the profession, Nurse's Week has always been a tough pill for me to swallow.

    You see, I'm used to flying under the radar. I do what I do because it needs to be done. And that's the truth. I am here because I choose to be. I could be pastry chef or a crotchety stay at home couch warmer content to spend her days writing scathing letters to the editor while snorting Cheeto powder.

    But no. In my professional life, I'm a nurse.

    And for the record, I'm not a hero. Never have been one, never will be one, don't want to be one. That is way too much pressure. I look at what I do as getting paid to do the right thing. Hey look, you're not breathing. How 'bout some oxygen?

    It's nothing special. It's just the right thing to do.

    My patients know I exist because when they wake up, their IV sites have mysteriously migrated, the gaping holes in the abdomen are miraculously closed, and, if you are a peds patient, you may have a new stuffed bear friend dressed in scrubs to keep you company.

    It took me a while to get used to the idea of never being seen let alone remembered. And now, my thanks comes daily in the form of self satisfaction and appreciation for the little things. When a tubed trauma patient gives me a thumbs up before going to surgery and a middle finger when I assess his pain as he wakes, I'm doing something right. When a surgeon saves an especially naughty joke just for me and tells it with an excited gleam to his eye like a kid on Christmas morning confronted with a gaggle of puppies, I know that my work has been noticed. And when my coworkers creep up to me mid case to bump shoulders, stand close and communicate with sidelong glances and hidden smirks, I know it's all fine.

    And those are the things that keep me going.

    Not the brunches offered by guilt obligated physicians or luke-warm lunches served by begrudging Nurse Managers. I don't need their approval. I don't need their recognition.

    And when the nation decides to herald nurses in random clips on the news, it causes a bitterness to surge unbidden to the fore.

    You want to thank me? You want to honor nursing?

    To management/corporate leaders: Then lower nurse to patient ratios so I and my brothers and sisters in healthcare can truly do the job to best of our abilities.

    To the Government: Offer clinics that can be accessed by all people in a way that makes sense and for once removes the terrible choice of food or healthcare. We send so many resources overseas, which is all fine, but what of our folks here at home? Research more than the Cancer "flavor of the day". For the love of all thing sacred, stop denying reimbursement funding based up on greater, more ridiculous parameters.

    To patients/families: Remember that time you called the Nursing Supervisor to complain because I sheered the britches off your child's shattered femur and then had the audacity not to escort you to the coffee shop before taking said kidlet to surgery? Yeah...not cool. Kindly learn what to truly complain about. Better yet, respect the fact I helped save his leg or something.

    To the fellow healthcare workers: Treat each other with dignity and respect. Thank each other. Recognize each other. Why do we need a week or a day at all?

    My feeling: if you truly need a day to give you a reason or remind you to show someone appreciation, be it your mother, your spouse, etc, then something is amiss, don't you think?

    I had a doc try to worm a thank you out of me for a lunch his group provided. My answer was simple, "One sandwich does not make up for a bunch of distressing conversations. You made my orientee cry last week, in case you forgot. Perhaps in the future you can treat us all decently as people and I will thank you. But for now yes, the sandwich was tasty. I appreciate the effort."

    He seemed affronted. Surprise.

    I let him mull it over as I waddled off, diet soda in hand, to go settle before having to scamper off to another case.

    Perhaps my refusal to kowtow and play nice in the sandbox makes me a bad person. I don't know. But I think I'm alright with that.

    But I suppose it's time to get to the point, isn't it? Tick-tock, CheesePotato, we don't have all night.

    In summation: Thank me as one person to another, for what I have done and not because of the letters at the end of my name. Thank me genuinely and at the moment it happens.

    And I shall be sure to return the favor.

    ~~CP~~

  • May 4 '13

    Read ANY of the posts on other forums and you'll see nurses dissatisfied no matter where they work. I've been in long term care for years....I wouldn't trade my career for anything ( ok...so I'd trade it to be a movie star, but...)

  • Mar 26 '13

    There are times though, when patients ARE on their lights too much. Their families tend to their every whim in day to day life, and now it's YOUR turn.

    "Oh, straighten the wrinkle out of the lower corner of the pillow. Nooo ... the other side!"

    "Okay, wait, don't go away .... give me a minute to see if that's okay."

    NO!

    Here's your Percocet, it's time for you go for a walk in the hall. When you get back, brush your teeth and sit in the chair for a FULL HOUR to do your coughing and deep breathing.

    I know, that's not the case every time, but there are times when you need to lay down the law. It's your job to help them get better, and if it's a kick in the a** they need ... then that's what you give them.

    When they've done their part, then I'll give them a back rub. Not before.

  • Jan 4 '13

    My facility requires that I wear a certain shade of blue. Not navy, not ciel, but a bright blue. They give every new employee two sets of scrubs. Cherokee is what they stock. So far, I like them. I don't know about being scratchy or anything as I wear a long-sleeve compression shirt underneath. But I also like Landau. I know that I need cargo pants as the pants they gave me only have regular pockets. I don't like carrying my BP cuff in my shirt pocket, but in a cargo pocket would be fine.

    I recently found out that Carhartt is making scrubs. I would love to get a set, but they don't come in a color I can get away with at work. They do, however, come in black, which is what I'll need for nursing school, so I may end up with some.

  • May 16 '12

    I am as anti-fat as I am anti-anorexia/bulimia, anti-smoking and anti-riding a donorcycle without a helmut, anti-unprotected sex, anti-failing to wash your hands, etc. I counsel all my patients that smoke, I counsel all my patients that have high BP, high cholesterol, and too high or too low BMI, etc. It is my professional responsibility to discuss the risks associated with unhealthy behaviors. I have probably lost patients over it. I don't care. They don't get tacit approval for ignoring risk factors just because they are embarrassed about it.

    People need to separate the emotional component from the facts. As BMI increases over 25, risks go up. As pack years smoking history increases, risk increase. I have a cardiologist friend who will not treat smokers. You either quit, or find a new cardio. He sees them as just wasting his time. I think that's extreme, but I do get frustrated hearing "my knees hurt, gimme medicine" from people with BMIs over 35. "I smoke 2 packs a day and I'm SOB, gimme medicine, FIX IT!" It gets tiresome.


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