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Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care NP. Posts: 4,626 (61% Liked) Likes: 11,132

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  • Feb 18

    Quote from brownbook
    Wile E Coyote Could you please sight your source for this statistic?

    The above is a quote, I can never use the quote function correctly!

    Sorry, no I can't. I am pretty certain that most violence is committed by someone the victim knows personally as in a close personal acquaintance or relative.

    I am sure you can find cases of psychiatric patients stalking, even killing, their care provider after they have been discharged.

    I am sure you can find cases of medically ill (no psychiatric diagnosis) patients stalking even killing their care provider after they have been discharged.

    I have no statistics but I believe these cases are extremely rare.

    Fearing mentally ill patients is perpetuating a stigma that professional medical health care workers should be striving to end.

    It is exactly the same as fearing all Muslims or any "group" you want to label as dangerous.
    A simple Google search can be enlightening.
    Violence toward mental health staff has been receiving national attention in the face of diminishing resources to treat what appears to be an increasingly violent patient population. Assaults by psychiatric patients against mental health care providers are both a reality and a concern, as the effects of violence can be devastating to the victim. Some staff rationalize that violence is an occupational hazard and believe that they are equipped to cope with it. Despite these beliefs, these victims suffer from many of the same physical and psychological sequelae as victims of a natural disaster or street crime
    Violence Against Mental Health Professionals: When the Treater Becomes the Victim

  • Feb 16

    There are many conspiracy theories out there, if this is one you want to follow and choose to fight against that's great, like I've stated before everyone should and has the right to choose their fights. A couple points I'd like to make though.

    The only thing I've found about an aircraft carrier was this:
    Flu Sickens 3 Sailors Aboard U.s. Aircraft Carrier - tribunedigital-orlandosentinel
    While it states "flu" as title, the article says "stomach flu" and I don't see anything about vaccination. I was able to find:
    Influenza Outbreak in a Vaccinated Population — USS Ardent, February 214
    Which is on a minesweeping vessel with a crew of 80ish personnel. This one does state that the sick individuals were tested and came back positive for the actual flu. It also states that the crew was 99% vaccinated. So 1 person, maybe 2 depending on rounding could potentially get the flu. We know the best way for many illnesses to be transferred is in small confined spaces; meningitis in dorms, and TB in old folk homes. Yes pretty much all of these people were vaccinated, but we should know that vaccination=/=immunity. Vaccinations help the immune system identify and fight off organisms that could, given adequate time, would overwhelm the defenses of the body and cause illness.

    Quick explanation:
    How many individual virus are needed to start an infection? Will 1 flu virus be enough to make you sick or do you need many more than that? - Quora

    So 1 person on your ship didn't get vaccinated, stepped out into town and brought it back. Yeah everyone else was vaccinated. Maybe they get 1-2 influenza on them and their body kills it readily because of their vaccination. Now maybe you've been hanging out on small ship for a week with the one guy and his flu. He's been breathing and coughing touching everything the filtration system spreading it throughout the compartments where you sleep, eat, rest, and work. Can your body fight off all the influenza virus being introduced? Is your immune system fast enough? Now add the next guy that get sick who's immune system was weak to begin with. Maybe you have a few people walking around fighting off the flu but not actually having symptoms because their immune system is strong, they still have the virus maybe they wipe their nose...don't wash. You get the picture. Vaccination isn't Immunization.

    About the doctors. While doctors may see more patients in a day, who takes care of those patients for the rest of the day? Who does the intake, questions, vitals, discharge. Who is there 24/7 if they are admitted? It is not the doctors. Why would a doctor say he'd get it done by his own staff?, his office gets to bill for it. As for the ones that don't want it...well before I became a nurse and it was mandated I didn't want it, didn't want to pay for it. Now it's part of the job.

    Before getting all conspiracy theory remember microbiology and how infection and immune systems work. People are not carbon copies of each other, but basic principles can still apply.

  • Feb 16

    Quote from mrl3fnp
    LOL. Come on mrl3fnp I know you can Google, but here:

    In case you don't feel like reading, CANADA, where the nurse won the suit, does NOT have at will employment meaning there has to be plausible reason for termination. With a few exceptions many states in the US are considered AT WILL meaning you can be fired or quit without reason. There are exceptions for "isms" and for retribution for reporting or implied contracts. Unless you're in a union though you can pretty much assume you are an at will employee.

  • Feb 14

    Ah man I love studies, especially ones where there are so many variables that it's pretty much a guessing game and you can say whatever you want with the numbers I said, guessing game. That article states it would take 6k-32k HCW getting vaccinated to potentially prevent one death. For a research study that number has quite a large interval. Base on 2015 estimates of number of nurses, mind you just RN nursing and not advanced practice, if every one of them was immunized according to the study could be preventing anywhere from 86-460 lives.

    We know the flu shot has the potential to prevent the flu. Yes some years it works and others it misses the mark. Unless we take lab verified flu victims and put them in rooms with vaccinated people and purposefully try to inoculate those people for the sake of science there isn't going to be a study that shows what people want to see related to the vaccine. Do all the people that die of sepsis have the flu or did they come in with ILI and people assumed it was the flu? How many people "cry wolf" as in have flu like symptoms, get ILI and CLAIM to have gotten the flu after receiving the vaccination? I work in a rural hospital, many of the patients here get "the flu" but it's never lab verified so there's no way to determine if it was the flu or not.

    My argument is that it only takes one nurse. One nurse to determine whether a patient gets the flu or not. One nurse to decide they want to help protect themselves and those around them. We cannot control those around us as much as it makes us sick to our stomachs at times. We can chose for ourselves. If your choice is to not receive the flu vaccine I say good for you, stand your ground and do what you think is right. Know either way you choose you will be judged; whether you are the one with the mask on and people think "ah why didn't they get the flu shot" or you're the one without the mask and others are thinking "I can't believe they caved and got the mandated shot". While many religions state we should not judge it is NOT a right to not be judged, make your decisions and live with the consequences.

  • Feb 10

    I was on a path like yours nearly 20 years ago. Same goals. Similar plan. Two weeks before starting an NP program with financial backing from my employer, I made a decision I have NEVER regretted. I decided to keep on being "just a nurse" -- an ER RN staff nurse -- and I hold my head high every day because I'm really good at what I do. Nurses who used to work beside me are now the PA's and NP's who blast through a two minute assessment before rushing back to their computers to put in a predicable panel of orders that I will carry out. Suturing (which you probably did as a combat medic) is the only thing they do that I actually envy. The vast majority of the hands-on, make-it-happen stuff in the ER falls to the staff nurses. Staying at a staff RN level does not mean you are failing in career advancement. It may mean that you keep getting better and better at the skills that will determine whether the patient lives or dies. Just throwing this out there, Non Sequitir. When you get into nursing, try the ER, and two decades from now you might just be passing on the same story.

  • Feb 7

    Quote from BostonFNP
    You haven't seen a "unbiased and financially uncurrupt" influenza vaccination study because you chose to call every study that is at odds with your point of view both of those things
    I do understand the frustration with the efficacy of the influenza vaccine. Some years it has really missed the mark. I fully admit to having blown it off a few times here and there (I've never been required to get the vaccine by any healthcare employer). But I must agree with this part of your post.

  • Feb 7

    Quote from BostonFNP
    scientific vigor.

    Keep going - I'm enjoying this exchange.

  • Feb 6

    Quote from Ruby Vee
    Aww, thanks!

    I've pretty much stopped clicking on the articles because the quality of the "articles" has descended to this kind of nonsense. More and more often, I'm opening "Allnurses" and seeing very little BUT these articles. I think the new owners of the site are making some poor choices in content.
    If make the effort I can be articulate and I have substantial experience to pull from but I still think I might not be able to create a meaningful well written *article*. I don't know if I'm too modest or if some are just that confident but my idea of what would qualify as an article respected by my peers is much different than what often I see makes the cut here.

    On this site with such a large membership as well as passers by, these articles represent our profession, our level of sophistication, intellect, attitude and experience, potentially to a wide audience. I imagine though they are mostly read by fellow nurses, still not good if they impact our standards.

    Another way to explain myself, I expect them to come from a perspective of expertise and/or of high emotional intelligence.

    Not that I don't enjoy some saucy entertainment but I wouldn't classify them as articles.

  • Feb 5

    Quote from myoglobin
    At the same time the standards for becoming an NP have both increased and become standardized.
    I still don't see where you're getting this "standards ... have both increased and become standardized." Please provide some actual evidence or documentation, other than your opinion, that it has become harder to become an NP than it was 20, 25, years ago. Those of us who have actually been in nursing, and advanced practice nurses, for many years can assure you (as we already have, but I guess you know better) that the standards have dropped significantly, thanks to the proliferation of low-quality schools that make it possible for anyone who wants to, regardless of their aptitude or potential (even those who aspire only to being mediocre ), to get into nursing graduate school. Ditto with standardization. Those of us who are actually living and functioning in Advanced Practice World know that "standardization" of nursing graduate school curricula has largely meant standardization to a uniformly low level. There are still strong, great programs out there, but people have to know to go looking for them (and know what they're looking for). Schools are, like any other business, responsive to the needs of their "customers" (students), and the large majority of aspiring nursing students seem to be primarily interested in finding the easiest, most convenient program possible -- so many schools, unfortunately, are supplying that.

    Completing a nursing graduate degree used to really mean something. Now, it's on its way to becoming sort of a joke. Certainly nothing special or remarkable. And, has already been noted, the studies showing the strong positive outcomes for NPs were conducted on the "old school" NP population -- it remains to be seen what the results of similar studies would be once advanced practice nursing is flooded with the "I mailed in enough box tops and got a degree" crowd.

  • Feb 4

    Quote from RN/WI
    . I find in rude that others don't respect everyone's right to not be vaccinated against the flu as well! Imho
    You and your words lose any creditability when you start calling everyone 'sheep'.

  • Feb 3

    Quote from BostonFNP
    There is a bit of irony when a rant about rude, catty, backstabbing, bad attitude coworkers is riddled with insults of the coworkers in question.

    Its a bad work environment not NETY. NETY doesn't exist. Change jobs.
    Succinctly stated!

  • Feb 3

    Anyways, to get to my rant, the nursing home wasn't so bad. I actually was OK with it. The problems came with the employees. I worked with nothing but ratchet nurses that talk behind your back and CNAs that did half ass work due to their c/o "we gettin paid minimum wage so this place gunna get minimum wage work". The attitudes were horrible.
    What is a "ratchet nurse?" It sounds like a putdown. With your nasty attitude toward them, I'm not surprised that they talk about you behind your back. Your rant about the CNAs is horrible. I don't know your workplace or your colleagues, but you're complaining about THEIR horrible attitudes makes you look pretty toxic yourself. Surely there must be some nice folks there, some people you can respect even if you don't actually like them. And almost everyone has some likable aspect to their personality. If you have to work with these folks, it would behoove you to find something to like about them, then focus on that.

    The CNA turn around rate was also horrible. Always working under staffed and under paid. My relief even started making a habit of calling in at the last minute, leaving me there till a new relief could come. Nobody has any body's back in nursing. I became friends with a CNA and we became kind of close. We were close until she stole something from me and lied about it. I get stolen from a lot on my unit. I guess that's normal, right? On top of that aggravation, The family of the residents are always complaining because their loved ones ADLs are hardly ever completed due to the staff's attitude and under staffment. It's just so much stress being a nurse.
    The turnover rate for CNAs in general is horrible. They have a very difficult job and they get very little respect and the pay is inadequate. I've found that when I genuinely LIKE the CNAs I work with (and some of them ARE harder to like than others) and appreciate their contributions, they work harder and our teamwork improves. Maybe it isn't "fair", but it's up to the RN to show a little appreciation to the CNAs and strive to improve your relationship with them. If you're unwilling to do that, teamwork will suffer.

    As far as someone stealing from you, that's not right. But are you SURE that the person you're accusing is the one who actually IS stealing from you? If you leave your stuff unattended in the workplace, it does sometimes get stolen. I've been in workplaces where the thief was fellow nurses, janitors, bio-engineering, pharmacy techs, physical therapists, patients and visitors. At one job, the manager was stealing and at another, I swear it was the chaplain. And of course stethoscopes are constantly being lifted by the medical residents and even an attending or two. (OK, "constantly" is a slight exaggeration.) Perhaps since your relationships with all your co-workers are so negative, that is why you're finding so many of your things going missing. People are apt to catch on to how you REALLY feel about them.

    After a year and a half, I feel like it's not necessarily the work load that makes me hate my job, it's the stress of managing my unit and accepting the things that I can't control. I've changed as a person; I think I've even lost hope for the human race like it's gotten that bad. I've never met so many rude, catty, backstabbing, selfish people in my life. I don't know if it's because nurses are all stressed out or if it's me. I don't even know how some of the nurses that I work with even passed high school, much less have a nursing license. One nurse that I work with had to write an incident about a resident that fell on the floor. She literally documented "res found on flow."
    If you run into one rude, catty, backstabbing, selfish person in your day, that person is a jerk. If EVERYONE you run into is rude, catty, backstabbing and selfish, the jerk is you. Please do some self-examination to determine what you are bringing to all of these negative interactions. You cannot change the people you meet, but you can change yourself and how you interact with them.

    I just can't deal. I don't know whether to forward my career and become an RN, or work in a cemetery where there's no complaining. Did I mention that one of my older nursing co workers tried getting me to over dose my hospice patient. Oh his respirators are 9? Give him morphine he's going to die anyway. The saying that "nurses eat their young" is so accurate. Do you know what that makes nurses? Cannibals. Oh you passed your NCLEX? Congrats. Next step? Try not to cry too loud while your co workers eat you alive for their own amusement.
    Your attitude toward your colleagues is completely toxic. Nurses don't eat their young; nurses aren't cannibals. But it seems as if you have some real problems in getting along with your colleagues in your work environment. That's on you. You can change jobs if you like, but wherever you go, there you are.

  • Feb 2

    Quote from myoglobin
    Still she has done nothing but succeed, and although I'm surely biased I continue to be blown away by the quality of care that she supplies to her clients in terms of medicine management (she doesn't do counseling). .
    How exactly are you certain she is an excellent prescriber? Not saying she isn't but as someone who isn't a psych RN, NP or psychiatrist and who I can only assume hasn't reviewed charts or seen outcomes how can you be so sure? I go home and describe single handedly saving lives and stamping out disease on a regular basis to my husband who I bet thinks I'm good but the truth is he has no clue. I've also seen NP students and especially patients who think someone is a great Dr, NP whatever when the truth is they suck.

    Something we all should consider is in the case of NP students they learn to prescribe at the side of whoever they end up with as a preceptor. I personally know of several NPs who have graduated within the last year and are already precepting. It is especially concerning because one of the schools has in its handbook they require 3 years of NP experience prior to precepting which is clearly BS. This is the same school that doesn't require peds hours if the student is unable to find a preceptor which I find disgusting. Interesting how nursing schools can bend the rules and change all that "matching requisite education" necessary prior to board certification to suit their needs.

  • Jan 31

    This is a very timely thread as I turned 50 yesterday and spent the whole weekend in the ICU (not as a patient, I hasten to add!)!

  • Jan 29

    [QUOTE=myoglobin;9322154]Most people have to work full time in the course of obtaining their Master's or Ph'd throughout the majority of the program (as did my significant other). Most schools that provide preceptors also dictate your schedule making the difficult or impossible. One of the reasons that I owe nearly 100K is that I went to such a school for my ASN and borrowed money to support my family (in addition to tuition) in order that I didn't have to work. It is a blessing that schools like the University of Southern Indiana provide an online opportunity to earn an NP in the $300.00 per credit hour range. Also, they will help me find a preceptor IF i want to come to Indiana (but I live in Florida). Thus, my original point it's a challenge, but also a blessing.[/QUOTE

    Wow. I'm in shock that anyone in $100,000 debt just signs on for more debt
    Blown away.