barnstormin', MSN, RN 7,162 Views
Joined Mar 8, '12.
Posts: 323 (65% Liked)
We need MD's we need NP's, we need RN's we are all spokes on the wheel, different overlapping supporting roles.
Welcome to AN Trolly McTrollerton!
Perhaps I am having a brunette moment this morning, but I need a question answered. Does Benadryl have the potential for abuse and I never knew about it?
I'm concerned that you pulled Benadryl "just in case" and the high probability of "not finding anyone to waste with."
Not everything is an emergency-I understand achieving pain relief in a pt, but it just seems highly unlikely that you couldn't find anyone to waste with.
I may be incorrect, but since you pulled Benadryl "multiple times" and they are questioning leads me to infer you didn't put them back.
You also state you have a "better" job; are you making sure you have wastes properly witnessed?
If this is truly a performance issue, then you need to make sure your practice is competent consistently; you MUST have witnessed wastes and my take meds that are not of necessity, or you will find yourself in front of the board, even if you are not diverting.
Let me know how the 2 year online Master's NP does with your pituitary tumor resection.
Should US Medical schools and physicians be phased out in favor of an NP driven and lead healthcare system?
Let me know how the 2 year online Master's NP does with your pituitary tumor resection.
Welcome to Allnurses. I see you joined 25 minutes ago. This is ludicrous to suggest replacing our current medical system of physician providers. You obviously underestimate the education & knowledge of physicians. Statistics can be twisted & misinterpreted in many ways. As a NP and a nurse for almost 40 years, I know that my education is not at the level of physicians. NPs have a role & a place in healthcare but no we can not replace physicians & and anyone who thinks it can be done does not understand the healthcare system. As to "so many states gaining autonomy" only about 22 states currently NPs have independent practice. I live in New Mexico where we have had Indy practice for about 23 years. We are a rural state & many areas lack providers of any type. Have you heard of the AMA? They are pretty powerful. As for you NP peers suggest you pick up an MCAT exam book then decide if you have what it takes to "replace a physician". Have any of your peers ever worked in a teaching hospital? I'm thinking you are trolling!
Yea, you might want to sue yourself, for questionable thinking, poor performance, and unprofessionable behavior....you deviated from your nurse practice act....
Oh hell no. That is where the line is drawn. I'm sorry but I am so sick and tired of MA's calling themselves nurses.
There was a time when nursing and medicine worked together. Then as medicine incorporated science and became more organized they were able to get laws in every state that everything related to medicine and surgery was under the board of medicine. Psychologists has to fight to do psychotherapy.
I went to a physical therapist who diagnosed a knee problem and she told me that for PT's diagnosing is fairly recent thing. Only the doctor ( meaning physician) could diagnose.
For us to diagnose and prescribe we are in territory that has has historically belonged to medicine by law. We had to lobby to be allowed to do these things. Part of the lobbying is arguing that our education prepares us to diagnose and prescribe within our specialty
And yes we need more eduction. Science continues to advance. And some say they are not comfortable with the basics.
Unifying the APRN profession is a recent state-by-state initiative.
I encourage people with ideas about improving curriculums become active on committees. Look into the Robert Wood foundation. They financed the APRN initiative. Having ideas is easy. Implementing ideas is hard.
I am neutral about how separate we should be from medicine. There is a large overlap of nursing and medicine as it is now . But I can't imagine being regulated by the Board of Medicine.
I love the APRN role and I learn from my patients and continue to study.
I did my first BA in Psychology and volunteered as a house supervisor at a homeless shelter and did internship hours at a hospital that involved shadowing and direct patient care work. Because I'm possibly some kind of work masochist and start to decomp when I have too much free time - I did research assistant work in a white collar crime lab with the department of criminology and did internship hours that culminated in an independent undergraduate research project in the field of alternative sentencing (A hybrid between corrections, Addictions and Psych) that was nominated for an award and presented at my University's research symposium. At that time I was a full time university student and also enrolled doing community college classes doing nursing prerequisites (it was my back up plan in the event I didn't get accepted to graduate school for social work).
After graduation I applied for multiple graduate schools for social work and one ABSN program. I got accepted into most of the MSW programs and the ABSN program. I decided to pursue the ABSN because it seemed like the better option (I didn't want to do the 2 year MSW degree and 2 years supervision in order to sit for the Social Work Licencing exam).
Upon completing my ABSN I went into Forensic Psychiatry and worked in maximum security behavioral stabilization. I had almost all the autonomy in the world working there, pulled 60 hour work weeks, and after about 6 months I started working as charge and doing the code team. Then I was witness to an assault that left one of my staff members brain damaged - I was using my weight to hold one patient's door closed (he swung at one of my staff, missed an I talked him back in the room and was waiting for the code equipment to arrive so I could take him to our seclusion room) and another patient busted out of a room about 10 feet away from me and started assaulting one of the 2:1's and the other 2:1 ran - leaving that staff to get hit about 30 times in the head. All I could do was watch and scream for more staff - if I left my post, that first guy would bust out and then we'd have an even bigger problem. I took a hiatus in the OR after that because I knew I would have a hard time being therapeutic unless I worked through that experience.
The OR for me lasted not so long - I really, really hated it. I am not a medical nurse and definitely not an OR nurse; but it was much less stressful and gave me the ability work through my stuff - which is what I needed the most at the time. I returned to Forensic psych on contract - hoping to do medium security or transition while I figured out where I wanted to go with my career (I was thinking management or education). It didn't really work out like that as they kept pulling me off orientation to float me to max - like they hadn't even reinstated my computer access and the staffing office and education office had some big fight about it (I did finally get my orientation days figured out).
The psychiatrists I worked with encouraged me to go for PMHNP so I applied to a graduate program out of state and was accepted. The nurse manager of behavioral stabilization snatched me off the float pool for full time capacity as charge nurse - knowing full well that I was leaving for grad school - to basically do floor training/education for new grad nurses and run the code team. Which was a great experience because I love training/teaching people and I want to get new grads passionate about psych nursing.
I'm 1/2 done with my PMHNP program and hope to graduate with intent to return to forensics. I still work as a Psych RN in acute care (which compared to forensics is really relaxed). I go offered a great internship position for clinical, doing 20 hours a week of community outpatient that works in conjunction with a major academic teaching hospital/medical school and get to rotate through and attend lectures and journal club with the M3/M4 and PGY1's. I also have mandatory rotations in inpatient, psych ER, CL, geriatrics and peds on top of the 20 h base outpatient rotations and a bunch of elective rotations (Eating disorders, Corrections, Maternal Psych ect) that are available. I can take call with my attending if I want to. Plus I get to be part of a focus group on Psych NP education - I mean I couldn't say better thing about the clinical portion of my training. It's hard and in combinations with work + class (on-campus program) I have very little free time but I'm getting my money's worth and will have close to 2000 hrs worth of clinical time by graduation.
What would I have done differently? Nothing really. I'm really happy with how my career came together. I would have liked to have spent some time working as an ER nurse because it seems like a great job with a lot of autonomy and you get a mix of medical and psych patients (I do think my med skills are not as strong as they should be and I spend a lot of time trying to supplement that knowledge with theory/self motivated education - but theory will never be as good as practice).
To the APRN hecklers, critics and malcontents.Many of you say that your MSN nursing education has too much “fluff”, referring to classes like cultural competency, and management that have no relevance to your jobs. I have read very little about how you will address this with the people that accredit NP curriculums.
I am not sure of the credentialing process at all but I did find the American Association of Colleges of Nursing on the web and this seems like a place to start. In 2013 they developed NP competencies in which we are all expected to be proficient.
These competencies expect cultural competency, trauma informed care, as well as all the things you complain there is not enough of such as pathophysiology, pharmacology, physical assessment. I have been in nursing since the early 80’s and have been through a few transitions in health care and in my own nursing career. Now I just try to keep up. I have no venom to toss at nursing leaders. I am very grateful to the nursing profession for my livelihood. I work locum tenens as a psychiatric APRN. My advanced practice nursing skills allow me to find work in interesting settings on a limited basis. This semi nomadic lifestyle is mine by choice. Everyone wants to hire me permanently.
The APRN role exists because of the dedication of nursing professionals with advanced degrees who have done the hard political work of fighting for the opportunity for all of us to practice to the full extent of our education. This means that our education prepares us to diagnose and treat illnesses in our respective specialties. We have a record of patient outcomes similar or better than MD’s. We are not MD’s and we are not junior MD’s, we are nurses. If we were MD’s we would be regulated by Boards of Medicine, physician extenders of some sort. As nurses, regulated by Boards of Nursing, we are eligible in many states for independent practice. There is an overlap between MD’s and NP’s and this is where a lot of NP’s and MD’s practice: Seeing patients one at a time in inpatient or outpatient settings. Since we are doing the same job as MD’s in many cases we do need to catch up on their rich science background and the intense mentoring they get in residency.
Or we can wonder how much education do we or they really need to do this job? We probably do not need nursing theory at this stage of our development as a profession though I did like my theory classes. We probably do not need healthcare management classes though I learned in those classes also. In today’s day to day NP jobs we need to keep our diagnostic and prescribing skills sharp to give patients the best care that we can. We often have MD role models and some are surprised we are doing the same jobs as them and many are happy to consult on cases and make use of their intense education. To my colleagues who are angry with the nursing profession that benefits you, I would encourage you to review the history of nursing (we were housecleaners one hundred years ago), and as science developed nurses had to fight the AMA to be professionals as opposed to handmaidens or servants.
At one time only an MD could take a blood pressure. Now we are fighting for the right to practice to the full extent of our education. We are nurses and we need to continue to define ourselves differently from physicians. That we are different from the medical profession has benefited us politically and gives us the responsibility to self-regulate our profession.The people with the energy and aptitude to criticize should learn to become political. Start by looking up the website I note above and figure out how to have input into curriculum development. You might have to join a committee. This is how hard work often starts. As in today’s general politics it is possible the nursing leadership is losing touch with its base.
Those who see what needs to be done would benefit all of us by becoming active and help to maintain and improve standards and influence the direction of the nursing profession.Best wishes.
I've been married to a nurse for more than a quarter of a century, and let me tell you, nurses are not what you expect (and I don't even care what you expect, because you are wrong)!
Let's begin by tearing down some of the more famous assumptions about nurses right off the top:
The Nurse as Sex Kitten:
Any man who lived through the early seventies or has made it a point to rent such famous videos as "Night Duty Nurses" or "Student Nurses" or "Night Duty Student Nurses" or any one of several dozen nurse-centric skin flicks will mmediately believe that all nurses have heaving bosoms, just millimeters away from popping out of skin tight white uniforms. You will also believe that nurses always wear white garters, fishnet hose, and stilettos. This, of course, is a handy dress code because movie nurses spend *a lot* of time hopping in and out of patient's beds.
The reality is that most nurses wear scrubs - Shapeless, draping hunks of cotton that could cause you to breeze past Pamela Anderson without a second look. Shoes are white and chunky with blobs of things on them better left Unexplored. Socks replace white hose and garters, and when is the last time Anyone saw a nursing cap? Graduation, perhaps?
The Nurse as an Angel:
If you want to hear the latest gross jokes, just find a nurse. Some uninformed males seem to think of nurses as angelic creatures: demure and loving, a cross between a nun and their mom. Well, hate to bust your bubble, guy, but as a group, nurses are some of the rawest folks you'll ever run into. I don't care how sweet and demure they may look on the outside; inside is someone who has seen things that would gag a maggot, break your heart, or Drive a normal person nuts. So most nurses develop a very wicked sense of humor squarely lodged in the black-to-sick side of the scale.
Also, in case you are looking for angelic sympathy for the little boo-boo you had in the shop, forget it! Let's say as a typical male klutz, you manage to saw your finger off. You go running to your nurse wife who is on the phone with a nurse friend of hers. As she continues to talk to her friend, she gives the stub a good eyeballing, slaps a towel on it, takes out a baggy to put the severed digit in, and tells you to get some ice while she is explaining to her friend that her dummy husband just sawed his finger off. As you stand there bleeding profusely for 15 minutes she calmly finishes her conversation as though nothing is going on until finally she says, "Well I guess I better get him to the hospital."She hangs up the phone, looks at you, sighs and calmly says, "Let's go."
You have just learned an important lesson. On the nurse scale of emergencies, yours is about a minus 9! As my wife has told me, "when you are on a ventilator, with six drips running, your head down and your feet up, then you're sick. Anything less than that isn't worth getting excited over!"
The Nurses Mutual Benefit Network:
As a male either dating or married to a nurse, you should realize one important thing. There are nurses everywhere. That, in itself, is no big deal. The fact is, every nurse knows other nurses who know more nurses, so that by the time you are finished, a nurse on the Island Nation of Chuuk who observes you doing something you shouldn't has the immediate capability of getting word to your wife. This system is way more reliable and efficient than the Internet and has existed for a much longer time. Take it for
granted that your nurse wife will know about anything you have done, good or bad, before you get home!
Your Social Life with Nurses:
Nurses hang out with other nurses and soon you may find that all your friends are married to nurses. The reason this happens is because in situations where nurses mingle with nonmedical folks things can get ugly. For example, you are out to dinner with your nurse wife, another nurse couple, and two civilian couples. The nurses sit and chat, discussing fun things like bleeding bowels, open sores, how much fat was sucked out of some patient, projectile vomiting, traumatic amputations, etc., all over a nice pasta dinner. The nurses carry on talking as the civilian couples turn funny colors, make faces and suppress their gag reflexes (and this is if the nurses don't have any really gross things to share like the homeless guy with maggots in his bleeding sores)!
After several dinners and gatherings like this, you will soon find your circle of friends has shrunk significantly. The key to avoiding this is to do the following: Never go out in mixed groups with more than one nurse. A lone nurse is OK. The trouble starts when you have more than one, and when that happens, keep the regular folks away. Also get used to the idea that some friends and neighbors will take advantage of the fact that your wife is a nurse by calling at all hours of the day and night for advice. This may include male friends "dropping by" to show your sweetie his rash. The best
advice I can give is to just deal with it and hope it isn't contagious.
Nurse: The Health Ramifications
Most nurses have been described as having the constitution of horses, which isn't true because I've been around horses and they get sick more often. The reason for this is pretty simple. After about 3-5 years on the job, nurses have been exposed to so many bugs that they either end up dead or full of every antibody known to mankind. (If you want the ultimate booster shot, just get a blood transfusion from a nurse who's worked in a hospital for 20 years!) You don't have all these antibodies, though, so when she does come home with mild sniffles, a week later you're flat on your back with the worse case of the flu of your life!! Oh, and if you are the least bit squeamish, don't even think about the bugs she brings home on her clothes. It will mess with your mind as she talks about her Resistant TB patient, the patient full of body lice, or the one with poison ivy in his mouth! So don't
Ah such mysterious, wondrous creatures are nurses.
You know, they really are and I thank God every day for my nurse!
My heart goes out to you, she who cares .
At times like this, my mantra is "My happiness is not a result of what others do or say or what happens around me. My happiness is a result of being at peace with myself." If we do the very best job we can do under any given circumstances, then we can be at peace, and subsequently happy, with ourselves.
"The world isn't changed by quitters" also comes to mind.
We can fight the Good Fight and attempt to divert the Mainstream into righteousness, but our endeavors often feel like we're shoveling sand against the tide- an exercise in futility.
You must decide the path you wish to take. If nothing else, your decision will be a learning experience which you will use in future endeavors.
I could relate similar circumstances that I, too, have experienced, but my recalling would be: "Except for the names and a few other changes, the story's the same one".
I am happy with who I am because I did what I felt was right, damn the torpedoes. I didn't make a lot of Friends, lost some jobs, helped a few People, and sleep very well with myself.
As Richard Bach wrote, "Your conscience is the measure of the honesty of your selfishness. Listen to it carefully."
The very best to you, she who cares!
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