Content That tokmom Likes

tokmom, BSN, RN 37,740 Views

Joined Aug 20, '09 - from 'Somewhere in the USA'. tokmom is a CMSRN. She has '30' year(s) of experience and specializes in 'Certified Med/Surg tele, and other stuff'. Posts: 4,651 (61% Liked) Likes: 8,583

Sorted By Last Like Given (Max 500)
  • 5:20 pm

    I think we're still our own worst enemies. Missing breaks and not billing for the time, charting off the clock, etc. are some ways we continue to do this to ourselves. Not speaking up in staff meetings (or keeping silent while one vocal person goes out on a limb), coming in on one's own time to complete "mandatory" education modules. Not belonging to the union.

    I used to encourage my coworkers to be better advocates for themselves; one martyr hurts all of us. It used to show up on my evaluations that some people didn't like my "conversations".

    We can publish all the studies we want. Most of us don't need studies because we already know how we are affected. Most administrators don't care. We're seen as overhead, not profit. Until we're ready to step up and speak up, nothing will change. Patients will have poorer outcomes and we'll get admonished for not smiling enough. The public sees us as angels, not professionals. Advocating for ourselves is seen as unacceptably mercenary. We have a long way to go, baby.

  • 5:12 pm

    Sometimes doing "nothing", is actually everything. (It reminded me of this article I wrote about withdrawing care several years ago:

    This story brought tears to my eyes. It is patient-centered nursing care at it’s finest.

  • Jan 17

    I completely can relate to this, and I am not even a nurse...yet. I have been a teacher for almost 7 years now and have been through most of the challenges described in the article. On average I have had 37 students to be responsible for, with never-ending assessments, tracking progress, lesson planning, PDs etc. I was expected to do more, more, and more every time my principal stepped her foot into my classroom. I would also eat through lunch, holding a lunch sandwich in my left hand while grading papers with my right one. Using the bathroom? Forget it! I would have to hold it for hours in a row, while allowing the students to use their bathroom every 5 minutes, hearing their constant complaints how bad it felt for them that they could no longer hold it! I can go on, and on about the nonsense that is abound in the teaching profession. But like other poster has noted, such nonsense exists pretty much in every profession. We need more unions, and laws across the country that will allow for safe assignments and reasonable nurse-to-patient ratios.

  • Jan 17

    Thank you for all the suggestions. I found the list of approved out-of-state nursing programs.
    Just in case anyone is looking for online programs here is the list.

    Thank you everyone

  • Dec 23 '16

    Students can be both a blessing and a curse for any clinical instructor (CI). We relish the days when we see the light blub turn on when a student connects the pieces from what they learn in class and applies it to their practice. At the same time we struggle when students tell us that they think clinical is not important or that we do not try hard enough to make the clinical experience worth their time. I love being a CI and most days I would not change it for anything in the world but here are a few harsh realities I wish that I could share with students.

    What students think...
    In addition to working with your peers at the college/university and at the clinical site, another challenging aspect of being a CI is that students tend to make some assumptions about CI that are completely off base. Here are a few examples...

    I personally developed the assignments (care plans, concept maps, process recordings, public policy presentations, concept analyses, etc.) that students complete in the course.

    Most likely the CI did not come up with any of the assignments you have to do, and we probably hate grading them more than you actually hated writing them. If I never have to read another half-baked care plan about “disturbed energy fields” I would be thrilled beyond belief. But seriously, are your assignments completely pointless and a waste of your time? No, because they were made to develop your critical thinking skills and learn that nursing is more than just the completion of tasks. Are some of them redundant and unlike what you will see in clinical practice? Absolutely, but nursing school is not just about procedures or checking boxes on an electronic medical record (EMR). It is about becoming a functioning professional member of the healthcare team, and because you are responsible for people’s lives, it requires a solid theoretical and practical knowledge base. It is not just about knowing what you need to do, it is about knowing why you need to do it.

    I personally know the entire full-time nursing faculty at the school and remain close personal friends with them.

    This largely depends on the school, but in many cases, the CI are adjunct faculty and may have only met a few of the full-time faculty members briefly or only communicate with them via email. However, when you meet with students, they will drop names of other faculty and assume that you are close personal friends with every teacher they have ever had. I sometimes have to remind students that I may not even know who some of the other faculty are because it is a large department and I am only on campus on a limited basis.

    With that being said, many times we know who the best and worst faculty are of the department and probably agree with some of the assessments made by students. While I may know some of the “worst” teachers and agree that their methods are off base or otherwise not in touch with reality, that does not mean I will ever share this with students or verbalize criticism how another teacher runs a classroom. I have had times where students have approached me about serious problems with other teachers and it puts you in a tough spot. I will ask students to discuss their issue with the teacher first, and if they feel like the situation was not resolved, then they should discuss it with the department chair. Depending on the severity of the problem, I usually contact the department chair privately to let her know that it might be an issue that she will have to address.

    I am not a moron so please don’t treat me like one by lying to me.

    This is pretty straightforward so we do not need to spend much time on it. I have only been teaching for a short time and yet I have heard some stories from students that rival major works of fiction. I understand that being a student difficult and sometimes the work gets to be overwhelming and then you get behind or make a mistake. Just tell me the truth and I will help you but do not insult my intelligence by telling me that you (a) have a flat tire every week, (b) left your assignment in your dorm room... again, (c) were sick with a GI bug all weekend (while I just overheard you tell your classmate about how you spent the weekend drinking/partying), (d) replied to my e-mail but it must have got lost (although you were able to e-mail me earlier in the same day asking for a grade on an assignment).

    If you do not pass the class it is because the CI had some sort of vendetta against you or wanted you to fail.

    I can tell you that I want each of my students to pass the class and be successful. I have no personal vendettas against students and to be honest the process of failing you is much more difficult than giving you a passing grade. CI, for the most part, do not have some sort of hidden agenda to make students suffer or fail. We become teachers because we love to teach and genuinely want students to be successful and go on to become competent, professional nurses.

    I am kind and fair to my students, but I will not pass someone just to pass them, and if they are failing to meet the minimum standards (even after I have met with them and tried to help them) then I will be forced to issue a failing grade. Students do not realize that the process to fail a student is daunting because it impacts us emotionally and the paperwork required is usually extensive. Students rarely ask themselves why they have earned a failing grade and never consider that their behavior or competency is what has caused this to happen. I am never going to expect a student to thank me for failing them but I also ask that they consider the impact of their actions if they choose to accuse a faculty member of discrimination (e.g. gender, race, age, sexual orientation, etc.) in response to a failing grade. Once you have been accused of discrimination, it is a bell that cannot be un-rung and even if the accusations are unfounded it still has a lasting impression on a teacher’s career. I have a family too and I do not deserve to have my reputation and career tarnished because a student is not academically ready to handle the rigor of nursing school.

    I am not saying that there are not cases where teachers have discriminated against students but in most situations, the student has failed to meet minimum competency requirements and should not be allowed to pass the course. Thankfully failing is uncommon and most nursing students are driven to pass and can do well with a little bit of support.

    Because we are not in the formal classroom setting it means that we can keep it casual, fun and speak like close friends.

    I get along really well with most of my students, I live in the real world and understand that nursing is not what you read about in books or see on television. During downtime I can engage in small talk with students and sometimes discuss pop culture, but sometimes students forget that CI are not their friends, we are still their teachers. We can have frank discussions about nursing and the current state of healthcare but that does not give you permission to swear in front of me or tell me about how wasted you got over the weekend.

    How you behave only reflects on you and if the staff of the clinical site do something then its fine for you to do it too.

    Your behavior at the clinical site reflects on you as a student, but it also reflects on the school and me as your teacher. Many times CI are also employees of their clinical site, and when students display unprofessional behavior it makes the CI look bad and it jeopardizes the viability of the clinical site for future students. When students are well dressed, prepared, helpful and speak in a positive, practiced method it reflects well on all of us and can lead to future employment opportunities for themselves and other graduates of the school’s nursing program.

    There are a countless number of other thoughts that CI wish we could share with our students, but these are some of the big points. If you are a teacher or CI and have some other ideas you wish you could share with students feel free to post it here! I love hearing feedback, comments, and further questions as well.

  • Dec 18 '16

    I've had RN coworkers as a patient. It was fine. It was nice to not have to explain stuff to them .

  • Dec 18 '16

    Quote from purplegal
    When I see RN after a patient's name, it almost makes me intimidated, even though I'm an RN myself.

    Does anyone else have this issue?
    I can't say that I do. For about the first year or so after graduation I would often feel a bit nervous /self-conscious around nurse and physician patients, but that feeling has gone away as I've gained experience and confidence in my abilities as a nurse. These days I'm comfortable with the vast majority of my patients and the few that I'm uneasy around don't share a common profession. Whatever it is with those patients that make me react/feel differently has more to do with their personalities or values than their occupation.

    Actually I find that most of my nurse and physician patients have more realistic expectations than many other patients do, so I usually find it relatively easy to care for them. One thing that I have noticed though is that some find the loss of control /role reversal challenging as they are more accustomed to being at the other side of the "bedrail". I consider being able to make them feel comfortable despite this; rewarding.

  • Dec 18 '16

    Quite frequently, I find myself caring for patients who are nurses or who are former nurses, or those who have family members who are nurses. I have to say that these people make me a little more anxious than those who are not and those who do not have any family connection to nursing. When I see RN after a patient's name, it almost makes me intimidated, even though I'm an RN myself.

    Although I'm not sure what, exactly, causes this anxiety, I think part of it has to do with feeling the necessity to perform to perfection. Not that I give substandard care to non-nurses, but I feel like I have to be especially mindful when I'm caring for a nurse. After all, they know what is going on, and will likely know if I'm doing something wrong or am missing something.

    Does anyone else have this issue?

  • Dec 11 '16

    I haven't seen The Family Feud since the 70's....

    Family Feud: What would a nurse want to do to a hot male patient-familyfeud1-jpg


  • Dec 8 '16

    We still had to have another RN sign off on our project, but you did that at the end. I guess it will be beneficial for many to extend it.....but I thought it was 1 of the more enjoyable classes and time wasn't really a factor....since it was enjoyable, I didnt find myself struggling to get motivated to work on it,lol. GL

  • Dec 8 '16

    January 2016 the capstone for RN-BSN was 5 weeks long.

    Quote from 4mranch
    Just finishing up Nursing Research now - not a bad class, it did make me rethink my PICO for my Capstone. For those that have completed the program - how long was your Capstone class? I thought it was 5 weeks, but I just got a call from GCU about coordinating a preceptor for the Capstone class and they said the class was 10 weeks long.

  • Dec 8 '16

    Just a note in Perrla...... I ended up using Perrla complete this year, I think it was $30 a year, and it's been awesome. It's like the regular Perrla program, but I've found it easier to use, and it's online, so you can log into a computer anywhere and work on your paper there. I hate change, but this was actually easy to learn and I find it better. Here's the website: (not an affiliated link or whatever, I'm not schilling, just sharing.)


    That's weird, don't know why it did that. anyway, it's www.perrlacomplete . com

  • Dec 8 '16

    I love working at small hospitals and will avoid going back to a large one if I can. My patients aren't much different, I just enjoy parking right outside of the entrance. It's nice to not have to worry about getting stabbed on the way to my car.

  • Dec 8 '16

    These are the types of people who say that unless you become an acute care nurse in med-surg, you are not a "real" nurse. They probably also say that we all have to live life the same way. This is totally untrue. Working in a smaller hospital gives you a different experience, that's all.

  • Dec 8 '16

    It's no more true than the debates about ICU nursing vs. med/surg nursing, ER nursing vs. floor nursing, acute care vs. ambulatory care nursing. You know what they say about opinions, right?

    "No one can make you feel inferior without your consent." -Eleanor Roosevelt