Latest Comments by libby11

libby11 3,691 Views

Joined: Oct 11, '11; Posts: 84 (24% Liked) ; Likes: 30
RN, Case Manager in Pediatric Home Care; from US

Sorted By Last Comment (Max 500)
  • 1
    LoneWolfRN2010 likes this.

    Using nicotine in your time off is legal on a federal and state level, but hospitals can still require you to be tested for it and refuse to hire you if you test positive (and this is a growing trend hospitals are moving towards). Compare it to that instead of drinking.

  • 1
    tkg123 likes this.

    Agree with previous posters--CO is tough on NEW nurses. Once you get some initial RN experience (from what I understand), it's better. Most of the hospital jobs posted say "BSN required." A ton of them say 'no new grads' or the careers section will say something like 'new grads may only apply to jobs that specifically say new grad in the title,' and 1 out of 50 jobs would be titled as such. And with how competitive it is here (very desirable location, many magnet status hospitals), I think for newbie nurses, when you look at 50 BSNs and 50 ASNs applying for 1 job... IF they hire a new grad with no experience, it's probably going to be the BSN.

    P.S. I'm also new to Colorado working as a RN Case Manager in Pediatric Home Care. I probably applied to somewhere between 50-100 jobs. Not a single hospital contacted me for interview or pre-screening. I'm starting my BSN in February!

  • 0

    Does anyone have some great evidence-based resources on whether or not it is best practice to suction after meals. Most sources suggest to suction before meals. A few sources suggest to avoid suction after meals (but they are not necessarily scholarly sources worth quoting).

    Scenario: Mother of 14 month old trach/vent Pt requests home care nurses suction after each meal. (Company policy is never suction on schedule... after each meals seems like 'on schedule'). I have suctioned the patient after meals and no secretions were returned. I have suctioned the patient after meals and returned large secretions (when classic gurgle is also heard). I have never returned food particles upon examination of the tubing after suctioning, so it's not as if we're suctioning to remove trapped food.

    Thank you for your resources and thoughts!

  • 1
    NurseDirtyBird likes this.

    What state do you live in? That changes everything as far as LPN/RN/BSN. For example: Colorado, I would say go straight for BSN and work as a CNA the entire 4 years of school. Wisconsin: ADN, work as a CNA; get a job after graduation then start BSN. If you were thinking doing LPN (depending on your state), I would say you almost may as well just go to an accelerated 2 year ADN program and start with your RN.

    The one thing I would say is absolutely get your CNA NOW! You can probably do that while you are still in high school or over the summer. Some CNA programs are 2 weeks (8am-5pm M-F). Some CNA programs are a few months but you only go once or twice a week. Some hospitals have CNA programs (you usually have to apply at least 6 months in advance), but they might cover the entire cost and you're hired at the end. Get a job immediately after getting your CNA license, even if it is only part time! This is the best advice I can give to any pre-nursing or current nursing student. Get your CNA license and WORK as a CNA.

    I recently got turned down for an RN job because I had 11 months of CNA experience and they wanted 1 year, per their policies--that is what they told me when informing me they could not hire me.

    If you put two equal RNs next to each other at interviews and the only difference is one has CNA experience, guess who is getting hired? You learn so much as a CNA, just about interacting with me people when it comes to something so private as health, sickness, life, privacy, etc.; but also about procedures and medical processes and lingo. CNAs definitely have an advantage in nursing school, especially your first clinical semester. And CNAs working at hospitals often have an advantage over those working in long-term care. You can also start building your professional network. Many hospitals will offered healthcare related tuition reimbursement and be flexible and understanding of your scheduling needs. If you are working in a hospital as a CNA, these are often the nursing students that get internships and PAID externships/graduate nurse positions while in their final semester of schooling and waiting to pass NCLEX (it can take about a month after graduation to get your license, sometimes a little bit longer).

    Good luck. Be well. Keep us updated.

  • 1
    bagface likes this.

    You have an incredible point of view to share and its up to you how to translate that professionally to this population.

    You are obviously very brave to share this with us, and it's probably not something you would be sharing with patients, but it is part of who you are and can make you an excellent nurse in this clinical.

    At clinical you are the nurse; you have emotions, but you don't wear them on your sleeve. It's not about you, it's about the patient, no matter how difficult that is. The patient includes both the mother, child and family. You have to treat them all, and you can. At home, share with your husband and your friends how you're struggling and growing. I'd also encourage you to be up front with your clinical instructor and discuss your situation privately beforehand. Many clinical instructors can be very sensitive to these issues and give you support and guidance or find opportunities on site that fit you best.

    Best wishes, be well. Keep us updated.

  • 0

    I've recently graduated, but saw a lot of leadership changes while in school, so I was curious if it is common that schools have difficulty retaining a Nursing Program Director.

    How long has your Nursing Program Director been in position? What type of college do you attend--Public, Private, For Profit, Not-for-Profit, Hospital Based Program, Community College?

  • 0

    Prevacid can usually be held. Facility likely has a policy or standing order on the unit for holding insulin/what scale to use when client is NPO. If no policy or standing order, hold (depending on client's current BS) and call Physician for clarification.

  • 0

    My boyfriend (of two years) and I broke up during the second semester of nursing school (and my first semester of clinical)... still not sure that the two aren't directly correlated.

  • 0

    This is just what I have found initially, but it sparked my interest and I will likely dig a little deeper.

    Here's a bit of a snippet about the value of BSNs compared to ADNs in terms of reducing patient mortality. A few studies note reduced mortality of patients when an increased presence of BSNs exist. Is it a direct correlation to the BSNs present or the type of facilities where BSNs are found in increased numbers? More research is needed, but if this holds true through numerous large studies, and can be proven to be a direct correlation, then a BSN should be paid more than an ADN.

    "A growing body of research documents that hospitals with a larger proportion of bedside care nurses with BSNs or higher qualifications is associated with lower risk of patient mortality. Aiken and colleagues (2003) in a paper published in the Journal of the American Medical Association(JAMA) showed that in 1999, each 10 percent increase in the proportion of a hospital’s bedside nurse workforce with BSN qualification was associated with a 5 percent decline in mortality following common surgical procedures. A similar finding was published by Friese and associates for cancer surgical outcomes (Friese et al., 2008). Aiken’s team has replicated this finding in a larger study of hospitals in 2006. Similar results have been published for medical as well as surgical patients in at least three large studies in Canada and Belgium (Estabrooks et al., 2005; Tourangeau et al., 2007; Van den Heede et al., 2009)." and "In Aiken’s JAMA paper, evidence was presented to show that the mortality rates were the same for hospitals in which nurses cared for 8 patients each, on average, and 60 percent had a BSN and for hospitals in which nurses cared for only 4 patients each but only 20 percent had a BSN (Aiken, 2008; Aiken et al., 2003)."

    Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine; Institute of Medicine. (2011). The future of nursing : Leading change, advancing health. Washington, D.C: National Academies Press.

  • 1
    Esme12 likes this.

    I am curious, you say you've tried on at least 30 people? Realistically how long did you try? 5 seconds? 10 seconds? 1 minute? 5 minutes? The reason I ask, is because I wanted to say it is OK to take 5 minutes to find a pulse--especially if you're new. Taking 5 minutes to find it, is better than not finding it or pretending you found it. Yes, you might feel like an idiot palpating someone's foot for 5 minutes--it is actually a really long time, BUT you will demonstrate integrity and eventually learn to find those pulses!

    I agree with many of the other comments about palpating too deeply or not deeply enough. For me, I often was pushing down so hard that i was basically stopping the blood flow and would be unable to feel a pulse. I know other students that touched so lightly, they wouldn't feel a pulse unless the patient was bounding or had paperthin skin.

    It is typical to feel for a pulse with the index and middle finger, you can also try variations such as ring and middle OR pinky, ring and middle, OR ring, middle and index. When I first began and was struggled a teacher suggested to me to use ring, middle and index; this helped me for a while until I got really comfortable. There were times I really couldn't find it until someone showed me right where it was. Even when they place my hand exactly where it was I couldn't feel it. They asked 'Can you feel it?' I wanted to just say, 'yes.' I knew I'd never get anywhere doing that and that someday I'd be on my own and couldn't fake feeling a pulse. They teacher wiggled my hand around, said 'push harder' and 'don't push so much.' It seemed I'd never find the pulse. It felt like forever had gone by each time, but I found the pulses eventually. Most of the patients were nice and now I find them in just a few seconds--usually.

    Keep trying & keep us updated.

  • 1
    LoriRNCM likes this.

    Agreed. CNAs cannot TEACH. They can encourage. They can remind the patient to use it or watch and say, 'good job' or 'here, maybe try holding it this way.' They cannot teach; which would be telling all of the steps to use it, the process by which it works, the advantages and disadvantages to using it, etc. etc.

  • 0

    Thanks for sharing. I hope to start on my BSN at WGU in January 2014. I haven't gotten my transcripts evaluated yet (sent them in, waiting for report), but I'm thinking I'll need around 35 credits too.

  • 0

    I graduated in August of 2013. I got my license on October 22. I moved to Colorado on October 24. I took the first job I was offered, 2 weeks and 1 day after moving to CO (from WI), November 8. It is not the last thing I wanted to be doing, but also not the first--I'm doing pediatric home care (full time with benefits after 60 days). And, even though I've just done training so far (slow process, long story), I was already offered and signed the paperwork for a promotion. ADNs with no true RN experience will struggle to find a job in CO. It is NOT impossible. I found a job after 2 weeks of being in Colorado and seriously applying. (I'm an ADN with 11 months CNA experience). I had to accept a position in home care, yes, but I have a full time job to start on loans and my BSN and get my RN experience.

    Hospitals reject you pretty quick, not a single hospital contacted me for interview. I interviewed with 1 home care agency and was turned down because 11 months of CNA experience was not enough--they said 'per regulations,' they needed a year. I interviewed at a nursing home; they never contacted me back. I was contacted by two other nursing homes to interview, but turned them down because I had accepted a home care position (the 2nd home care company I interviewed with). I also was contacted to interview with a nursing home/rehab center that's part of a national chain where I had done my time as a CNA. They set up the interview, then cancelled because I had no RN experience. I am pretty happy with the home care agency that I accepted a position with. It is a smaller company and they work with Children's Hospital pretty closely. I probably sent between 50-100 applications/resumes total. It is not necessarily my first choice of what I wanted to do, but it is an RN job and I will work towards getting where I want to be. I start my BSN in January.

    That is my story. Look for a job before you come to CO or before you graduate, network as much as you can. If you can get a year or two of acute experience (and a BSN wouldn't hurt) before you move here [I know a lot of people are looking to move here from out of state], you'll be in a better place. A first job as an RN in Colorado is NOT impossible, but it's not going to be easy. You are going to need to be flexible. Look at smaller companies, nursing homes and home care. You will have a better chance of getting a job in a rural market. Get as far away from Denver as you can, if possible. Good luck!

  • 0

    I took the first job I was offered. It is not the last thing I wanted to be doing, but also not the first. ADNs with no true RN experience will struggle to find a job in CO. It is NOT impossible. I found a job after 2 weeks of being in Colorado and seriously applying. (I'm an ADN with 11 months CNA experience). I had to accept a position in home care. Hospitals reject you pretty quick, not a single hospital contacted me for interview. I interviewed with 1 home care agency and was turned down because 11 months of CNA experience was not enough--they said 'per regulations,' they needed a year. I interviewed at a nursing home; they never contacted me back. I was contacted by two other nursing homes to interview, but turned them down because I had accepted a home care position (the 2nd home care company I interviewed with). I also was contacted to interview with a nursing home/rehab center that's part of a national chain where I had done my time as a CNA. They set up the interview, then cancelled because I had no RN experience. I am pretty happy with the home care agency that I accepted a position with. It is a smaller company and they work with Children's Hospital pretty closely. I probably sent between 50-100 applications/resumes total. It is not necessarily my first choice of what I wanted to do, but it is an RN job and I will work towards getting where I want to be. I start my BSN in January.

    That is my story. Look for a job before you come, network as much as you can. If you can get a year or two of acute experience (and a BSN wouldn't hurt) before you move here, you'll be in a better place. A first job as an RN in Colorado is NOT impossible, but it's not going to be easy. You are going to need to be flexible. Look at smaller companies, nursing homes and home care. You will have a better chance of getting a job in a rural market. Get as far away from Denver as you can, if possible. Good luck!

  • 0

    ADNs with no true RN experience will struggle to find a job in CO. It is NOT impossible. I found a job after 2 weeks of being in Colorado and seriously applying. (I'm an ADN with 11 months CNA experience). I had to accept a position in home care. Hospitals reject you pretty quick, not a single hospital contacted me for interview. I interviewed with 1 home care agency and was turned down because 11 months of CNA experience was not enough--they said 'per regulations,' they needed a year. I interviewed at a nursing home; they never contacted me back. I was contacted by two other nursing homes to interview, but turned them down because I had accepted a home care position (the 2nd home care company I interviewed with). I also was contacted to interview with a nursing home/rehab center that's part of a national chain where I had done my time as a CNA. They set up the interview, then cancelled because I had no RN experience. I am pretty happy with the home care agency that I accepted a position with. It is a smaller company and they work with Children's Hospital pretty closely. I probably sent between 50-100 applications/resumes total. It is not necessarily my first choice of what I wanted to do, but it is an RN job and I will work towards getting where I want to be. I start my BSN in January.

    That is my story. Look for a job before you come, network as much as you can. If you can get a year or two of acute experience (and a BSN wouldn't hurt) before you move here, you'll be in a better place. A first job as an RN in Colorado is NOT impossible, but it's not going to be easy. You are going to need to be flexible. Look at smaller companies, nursing homes and home care. You will have a better chance of getting a job in a rural market. Get as far away from Denver as you can, if possible. Good luck!


close