Latest Comments by mrmedical

Latest Comments by mrmedical

mrmedical (3,298 Views)

Joined Nov 2, '09 - from 'Florida'. He has '9001' year(s) of experience and specializes in 'Oncology'. Posts: 103 (45% Liked) Likes: 163

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  • 2
    Altra and janhetherington like this.

    TBQH the only reason this event blew up and got big press because a lot of kids died. Thousands of kids die every day in ways more violent and prolonged. The only reason the populace cares is because it was catered to them on an emotional level and the victims were children. If an IED blew up a school in the ME or some other 3rd world hole no one would blink an eye. Search your heart - you know it to be true. But alas, we as society are so masochistic that we love to suffer along with each other.

    It was a freak occurrence, although planned and calculated by a mentally sick individual. However tragic it may be (most arguments are made from emotion because they were children) doesn't detract from the fact that these mass shootings are rare in the United States and are only brought to public light through the media.

    Firearms used against criminals by responsible firearm operators or in self defense almost never make it to the airplay, and these events happen daily. As a nurse I don't see any moral or ethical qualms in killing another individual if I am assaulted and my life is in danger: it's the biological response of fight or flight and self preservation.

    Those that argue the purpose of a gun - specifically semi-automatic rifle - aren't really within any credibility to establish what their primary use is. At the end of the day, it's a simple machine that slings lead and supersonic speeds at a target: and that target can be many things NOT exclusively people, as some are so disillusioned and keep persisting. And quite frankly, it is my belief that no other American is entitled to tell another citizen what they should or shouldn't have, especially that the MAJORITY of gun owners are rational and safe individuals who do not go on shooting rampages which constitute less than 1% of total firearm owners in the United States.

    Mass shootings are freak occurrences and have happened in the past and will continue to happen. Humans can be violent and unpredictable animals. No amount of banning those scary guns is going to stop this problem. It's a knee-jerk response that bleeding hearts cling to in order to fulfill the need to "do something" regardless of how ultimately useless it is.

    Seemingly, as a culture we are so polarized on blaming objects, institutions, society than the individual themselves. But we don't do that be cause that would require some actual investigation and critical thinking to solve a serious problem rather than a spontaneous outburst of hormone induced drivel and whimpering, "but... but, think of the CHILDREN!" and "something bad happened, BAN SOMETHING!!!".

    If push came to shove, I'd much rather have the rare occurrence of a shooting spree in some insignificant part of the country happen than be disarmed to the point where if that threat ever approached me, I would not be able to defend myself or my loved ones.

  • 0

    You all are getting trolled, it it wasn't already blatantly obvious.

  • 1
    anotherone likes this.

    I work 3 nights a week (granted 50% of the time I dread working) and pull 50k+ a year. Not too bad for being able to get in with only a two year degree, feeding patients meds, buttwiping, charting, and the occasional important task.

    We might not be making Richie Rich status, but the nursing profession is comfortably seated in the middle class income levels and is far superior to most baccalaureate and associates level professions of similar standing in terms of cost-to-return rate.

    The value is really more based on how much the individual nurse can actually stand doing the work: those that hate it will think they're underpaid and those that love it would do it for free.

    No, for the most part it's not 70k+ per year (+/- for location and experience) but then again nursing is not a prestigious or autonomous profession; it's more akin to labor (at least bedside nursing). It think once more nurses realize that, perhaps they'll see their well compensated relatively speaking to other vocational careers.

    Would I love to make more $$$? Of course, that's why after I finish my BSN, I may get out of nursing and may seek a different career (maybe even out of healthcare: it's not longer the golden goose egg it once was, too many lawyers and politics want a piece of the pie). But as it stands, I feel that we are well compensated on the basis of 36 hour work weeks and 3 days a week of work (others mileage may very depending on their schedual and how poor their work enviroment is - but those aren't exactly intrinsic to nursing itself).

  • 4
    Jules A, ivyleaf, Cauliflower, and 1 other like this.

    As far as schools are concerned look for a DO school or MD school in the US. Residency spots are tight right now, and with many more FMG (foreign medical grads) who generally have a better education than Caribbean grads are getting those spots, leaving many Caribbean MD students in the dust with no residency, a ton of debt, and wasted 4 years of their life.

    Some Caribbean students DO get a residency, but their most likely top of their class, from the top 1-2 schools in the Caribbean, and generally go into Family Medicine, Internal Medicine, or Pediatrics or some other lower ranked and less competitive specialties, so keep that in mind if you want to get in to a more prestigious specialty.

    I suspect, that we will never see MD/DO incorporated into NP education because that would demand that NP education be regulated and held to the standard of the Boards of Medicine and not under "advanced practice nursing" where they can have more leeway in expanding (for good or for bad) their scope of practice as they see fit without medicine oversight.

    I also think on the physician side of things, they are getting more resentful towards ARNPs (at least newer and younger physicians) because of fear of mid-levels taking over their specialties and the demands to be made primary care providers at the expense of less actual education and training as a provider with only a handful of studies done that do not examine long term out comes and have poor qualitative methodology. What was once meant to physician extenders and physician assistants are now vying for the same privileges and billing authority.

    Several med [student] friends that I have express disdain for mid-levels if only for the reason that they feel their encroachment is insulting do to the fact that they have put in so much through academia, time, and money only to have the same privileges granted to those who have a fraction of the expertise and then have the audacity to call themselves 'doctor' on top of it.

    I feel a lot of this resentment has come from the large increase of NP schools and those that are willing to accept students without clinical experience and no/low barrier to entry (GRE's, admission tests, ect) though, arguments could be made if floor nursing really effects APN competence.

    Plus, keep in mind that most current schools of nursing have a big philosophy of showing everyone how they are not like medicine and not like other fields of healthcare. As a FNP graduate, I'm sure you've been parroted that "nurses care more" and are "more holistic" a million times throughout your nursing career, and students just eat it up.

  • 0

    I'm kind of in the same spot you are. Been working the floor for a couple seasons now, and it's not enjoyable at all and I never feel at ease or comfortable. I mean I could do nursing in my sleep, but it isn't fufilling. I started my college career with the intent of going into medicine. I've been considering the NP route, but I don't think I'll be satisfied unless I become a doctor.

    In the future NPs might get to bill and even get full hospital priviledges, but like you said their is a certain honor in being cream of the crop ie medicine and really having the best clinical basis in knowledge that you probably wouldn't get as an NP. Right now (as my feelings have changed about it many times) I'm thinking about going to a DO school because they seem to be more friendly to nontraditional students or second career students.

    I just have to take biochem and physics then I can sit for the MCAT. I'm just worried that if I don't do this I'll regret settling for less later on in my life.

  • 1
    loriangel14 likes this.

    I think MA's have a certifying or diploma to recognize competency. While many of the skills overlap, MA's have been bred to meet specific criteria for doctor's offices.

    They do some skills that nursing students and even nurses do not do such as take radiographs, blood draws (depending if your hospital has phlebotomis, I haven't seen a nurse to a blood draw unless it's from a PICC, in several years), local anesthesia (under the MD l), and some dermal procedures.

    Again, you'll have to shop around. Maybe in your part of the country they'll just do on-the-job training and hire you so who knows.

  • 0

    Can't you moonlight somewhere as a shadow or in a non-program affiliated fashion. At least you would get the experienc and exposure, and I'd wager that would count for so much more. I'd be time consuming, but you'd be doing yourself and your patients a service by trying to aggregate that experience.

  • 2
    jbhaktidog and Cauliflower like this.

    Hey Cauliflower,

    I've only an RN now but have been considering advanced practice in the future. Realize that at this point the DNP merely a suggestion by the AACN and is not the requirement for entry to practice; that which is set by your states nursing board.

    In my opinion, I agree with you. DNP curriculum seems to have diminishing returns for the cost and I'm not convinced that it improves patient outcomes any better, but rather serves as a vehicle for universities to score some grad-school level tuition off returning students. That is to say, at this point in time the value added for the DNP isn't enough to justify it's time, expense, and possible earnings that you could be recieiving while working within a MSN level NP capacity at that point.

    I've always thought if someone wanted what the DNP gave, just go for an MBA as it'll probably prepare you just the same for administrative tasks and a lesser expense as well.

  • 12
    Guttercat, tokidoki7, jtmarcy12, and 9 others like this.

    In my observations, state schools and reknown nursing schools that offer online RN-BSN curriculum are seen by my coworkers and the general hospital environment as equivalent in status as the same didactic in-class version of the courses. Nursing is in an interesting position in that it is considered a professional level degree, where in contrast to other four year degrees, can be completely mostly online.

    On the other hand, schools that are addressed as diploma mills, shopping mall schools, or are new nursing schools that don't have any history or legacy of producing nurses (ie: UoP, Keiser, Kaplan College, South Univ., ect) are seen with less prestige. I think most people understand that others choose these routes for a number of reasons such as convenience, affordability, low barriers to entry; but don't hold them to the same level of preparation as the prior mentioned curriculum. Personally, I think if you're seeking higher education, you're doing yourself a disservice in choosing a lesser caliber of schooling at the expense of convenience (if that is what is important to you - some people just want to get their BSN done; and that's fine as long as you're honest with yourself). I do think it would be foolish to say that they are the equivalent level education as a better ranked BSN program. You get what you pay for.

    In my opinion, it's folly to say that a BSN = BSN, because BSN education is not standardized from state to state, and from accrediating instititution to accrediating institution. There are very many colors of the spectrum here; from very poor to excellent.

    It's leaves a different impression when someone tells you oh I graduated from Obscure-Schools BSN program versus John Hopkins School of Nursing. One is objectively better than the other and the consistent production of top tier graduates.

    BUT! It's not limited to nursing in that regard. Criminal justice majors from diploma mill vs state school get the same flak. Same for education, management, and IT. People want to work with people who know their stuff, and intially when you're starting a job with new people, the way they measure your competency is based on how difficult the curriculum of your education was and how well you succeeded in it.

    I think we are going about this the wrong way, instead of trying to not hurt every one's feelings and telling them it's an equal playing field, we should be encouraging our coworkers and fellow RNs to pursue quality education for both themselves and the nursing field. We should also focus concerns on diploma mills that lower the bar for nursing and have them step up on a state and national level.

    That's my opinion. Sorry if I offend, I just feel as nurses that we can do better in regards to our education as it stands.

    </rant>

  • 0

    Bump.

    Yeah, both certs I'm definitely going to be pursing in the near future (or at least when I aggregate enough experience).

  • 0

    Hi all,

    Long time reader, first time poster on this board. Apologize in advance for redundant questions.

    A little hx about myself: 23y/o M with ASN, working on my BSN with 1.5 semesters remaining. I got a new job in med-oncology this past August. After doing some serious soul searching, I've decided that I want to commit to commissing in the AF Reserves and hoping to get in to a flight nurse spot.

    The I've was a JROTC cadet all through high school, got to SSG (not that it really counts for anything - but I wanted to note relevant exposure) so it's not completely foreign to me. Several members of my immediate family have also served, but not as an officer.

    Back to my career track, would it make me a more marketable candidate to get my TNCC/CCRN prior to commission? I do understand I should talk to a healthcare recruiter for definitive answers but the closest one is several hundered miles away and I won't be commissioning for ~2 years from now if all goes well.

    Secondly, does the military offer in-house training for BSNs who want to go to NP (I understand AF has an ACNP MOS, which I am more interested in over FNP). I'm still on the fence about this as I expect the market to really become saturated with NPs over the next couple years, but I would like to keep it an option although I think I would be completely satisifed with flight nursing (fixed wing).

    Finally, say I commission in to the AF Reserves and my contract runs out - say I love the lifestyle so much - can I recommision into another branch whether it's active AF or Navy with having to do COT/OCS again and keep my rank, or do I start back at O-1?

    Thanks for the response.

  • 0

    I just got my HepB updated an Tdap in my R and L arms and the lady who did mine was awesome. I made sure my muscles were relaxed, and she darted me and injected the vaccine. Could hardly feel it. Less time in the muscle the better. As long as they're not emaciated I don't see a reason not to dart them. It's not like your inserting the needle to the hub, so I unintentional intrathecal injection is rare.

    I would even go as far to say don't even worry about aspirating in the deltoid in a healthy individual if you know your landmarks, because there is no major arterial supply on the lateral deltoid and the gauge of the needle is too small for serious concern of arterial infiltration.

    Current evidenced based (CDC's on board with this) practice and IAC (immunization action coalition) actually suggest it is best practice NOT to aspirate for vaccinations: IAC Express Issue 891

  • 3

    Just my opinion, OP, as I feel that I was once in that same boat.

    Have you considered PA school? It quite more scientifically oriented compared to nursing and is a masters level preparation. Bedside nursing isn't really that intellectually stimulating for the most part (in my opinion, I hardly consider myself an expert), even in the ICU; once you see the most common presentations you kind of know what to expect.

    Like elkpark mentioned, if you really want to pick up stuff, a lot will be independent study and self teaching. Is it great that you memorized the anatomy and function of the brachial plexus and it's dorsal roots and innervations? Sure! Will you ever get to use it outside of impressing your coworkers? Probably not.

    To be honest, I think nursing is one of the low end of the spectrum when it comes to medical science, most offer basic coursework in anatomy and physiology, and may or may not even require biological sciences.

    Looking at curriculum for professions like RT, PT, Pharmacy, Speech Path, they generally have a broader scientific base: probably because they stem from the medical model. Heck, even seasoned paramedics (in my experience at least) are more well versed in emergency management explaining the WHY behind it than my RN colleagues (paramedics always seem to teach ALCS), myself included at times (I attribute this to our knowledge base being so broad, but lacking depth - this is where self study could come in).

    At the risk of sounding like that I hate my profession (I don't), I think you will be disappointed if your seeking some kind of stimulating sustenance from it. I remember graduating 3 years ago and we still had professors lecturing on holistic nursing about stuff like "chakras" and "reflexology". I stopped taking them seriously after that lecture.

    As a clinical nurse, at the end of the day your main goal is feeding your patient medications and making sure they don't start decompensating. Is there some challenge in recognizing these changes? Yes, lab values, symptomatology, ect... But after a while it is monotonous and you're not really calling the shots anyway.

    My advice, if you going to pursing nursing and want those incentives, go get your CRNA or ACNP. I would personally consider the PA profession as well, as being bachelors prepared you probably have all the prerequistes completed (good science GPA, good overall GPA) anyway and just take the GRE and send all your results in through CASPA. Look at the coursework for the different programs and decide if it's bunk or if it interests you. My opinions stated above are really only how I feel about bedside nursing (my only exposure thus far).

  • 0

    Just something to consider, it's getting as hard if not harder to get respiratory therapist jobs than it is a nursing job. Especially that hospitals hire so few in comparison to nurses.

  • 0

    Quote from BlueDevil,DNP
    I've been doing back to school physicals for the past two weeks, including a lot of college and community college students. I have had several young ladies (no men) tell me all about their plans to be FNPs, CRNAs, cure ebola, autism and cancer. I just smile and say good luck. I know full well most of them won't make it through prereqs. Of those that do, and actually complete a BSN, statistically, 1 in 10 of them will get a masters degree and 1 in 100 will get a doctorate (those are old and approximate figures, and I hope it is better than that by now and continues to get better)...
    Very true! When I was in school and the post-grad reps came in EVERYONE raised their hand that they wanted to do ARNP. It didn't help that faculty told every student to go get MSN/DNP prepared (even the less that adept students). Now that I'm actually working, many still don't have a job and those that do are working medsurg or a "low" acuity floor, and maybe <10% is actively enrolled (including myself, class size n=45) to get their BSN preparation currently. Life get's in the way: classmates are getting married and moving putting that kind of thing they thought they would be doing on the backburner. In my experience, most will never actually fulfill these wishes when hit by reality unless they really want it bad.


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