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Joined Jul 2, '05 - from 'Exactly where I want to be!'. He has '8' year(s) of experience and specializes in 'NICU/L&D, Hospice, and back to Mom/baby!'. Posts: 812 (10% Liked) Likes: 176

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  • Feb 12

    Ugh, I just typed this long reply and hit the "leave a comment" button on the bottom right. Wrong button.
    I took my training from someone who lives in No. Cal. and she has been a foot care nurse for 17+ years, mostly on her own. Hopefully someone from cali will chime in here and give you particulars since I wouldn't want you to rely on my info.
    I live in Idaho and I work within my scope according to our BON. I am providing for activities of daily living, for which I was taught to do in my general nursing education and I have gained further education to provide for this specialty. I have my own clinic (still working on an opening date though) and provide home care. My business isn't completely off the ground yet, but I expect some problems with Dr.'s questioning my scope. I'm prepared. I want to work along side them, not against them, so we will see how it goes when I go out and market myself to other Dr.'s and podiatrists. That will be a big test. I need pods to refer to though, so hopefully they will accept this nursing venture and come to realize that it is the way of the future!!!
    I highly recommend that you get your CFCN and save up to buy the appropriate tools/instruments. If we want to be taken seriously, we must be as professional as we would expect someone to be for us. Most pods don't even use the podiatry drill that I purchased. They use a dremel which is really not appropriate for health care. I give my clients the best of the best. I have nothing to hide! Good equipment, good instruments (well...those could be better but man nippers are expensive), and good products. People love nurses!

  • Sep 22 '16

    When my MIL was admitted for N/V with terminal brain cancer (days before going on hospice), I brought in pictures of her and put them on the dry erase board in her room. I wrote a few things about her that were fun parts of her personality. I wanted them to care for who she is not just N/V.
    I now work in hospice and on my first visit I engage with the family with their photos on the walls so that I know the whole person, not just how they now present at the EOL.
    I can't imagine how it would make me feel if I was ill and the nurse talked to me like I had no clue what was going on. I don't need them to talk to me in nurse talk, but I can't fathom being talked to like I was a child.

  • Aug 29 '16

    Our family planned our move to Boise for the entire 2 years I was in nursing school! We have been here 5 years and still feel like we are on vacation!! We moved here because of the schools and relaxed attitudes (came from Vegas) and we don't regret it for one single second. Our kids have had some fantastic teachers and we have made some really great friends.
    The pay was low for what I would have started at in Vegas as a new grad. I worked at St. Luke's (highly recommend it...awesome hospital) and started just below $20/hr before diff. That hurt, but the move was for our kiddos, so it was worth the paycut. I just left West Valley (in Caldwell) mostly because I felt extremely underpaid at just over $23/hr (and I worked there for almost 4 years). I am now venturing out on my own (yes...it's possible!!) as a Certified Foot Care Nurse.
    We live in Meridian and love it!
    Car registration is super low, gas seems about 15 cents higher than Nevada, we are taxed on groceries , we have state income tax, car insurance/homeowners is much cheaper than where we were. We have 4 mild seasons, tons of outdoor things to do (going jet skiing today!) water parks, go kart tracks, Meridian Speedway race track (my 13 year old races a real car there!) and sports.

    Good luck to you and your family! Idaho is awesome!

  • Jul 12 '16

    I scored a 124. I used the study guide by MacDonald. Excellent book--uses old test questions. My advice is to keep track of time. I ran out of time on the 1st section and had to quickly mark "C" all the way to the end (to not leave any blank and possibly pick up a few "right" answers. This was the reading portion, the one I scored the lowest on. Still ended up with a 124! We had to have a composite of at least 100 in order to be considered.

    Good luck!!!

  • May 9 '16

    My unit director told me that a fellow RN had gone to the CNO to lodge a "few" complaints about me. First one: You spend too much time with your patients. (I was a L&D nurse and we almost always were 1 to 1 care). I told her that I don't just run in and run back out. I talk to them, I chart in their room, and I do all these things because they're IN LABOR and have come to the hospital so that we can monitor their labor/delivery! She said the nurse's complaint was that if there were an emergency, they wouldn't know where I was. Really? I thought you just told me where I was...in my pt's room! If I have one labor and I'm not sitting in the nurses station...you can probably guess where I am.
    Second one: She complained that you go into the nursery and close the door. Hmmmm.... I thought we were SUPPOSED to do that! You know...infant security? She said...well, yes, you are.
    Third one: She said that you act like you know it all (not the exact words she told me, but meant the same thing...just can't remember how she phrased it to me). Well, yes, I am the only NICU trained nurse here and everyone still does care as though it is 1975. I told her "I thought you wanted me to help with evidence based practice" and she said, yes, but that the RN was complaining about me trying to "teach" her (basically she didn't want the help to be up-to-date with her nursing knowledge). I said "fine. I won't bring anymore of my knowledge to this hospital since it is bringing complaints." She then IMMEDIATELY asked me if I knew how to do the Ballard Score". I told her yes and she asked if I would teach it to the RN's. UMMMMMMM......NOPE! Thank you for wasting my time though with this ridiculousness!

  • Apr 26 '16

    I ditto the field of foot care! Although I do not use a dremel drill (I use podiatric drills) so my start up costs were just under $10K, but that includes everything, right down to my business cards and bandages. You definitely can start out at less than that but $10K will get you all the tools and training you need to provide up-to-date care and the best tools for the job. Foot care needs will never go away and the more we get out there as nurses, the better our odds are of being a big provider in this awesome field!

  • Apr 25 '16

    My unit director told me that a fellow RN had gone to the CNO to lodge a "few" complaints about me. First one: You spend too much time with your patients. (I was a L&D nurse and we almost always were 1 to 1 care). I told her that I don't just run in and run back out. I talk to them, I chart in their room, and I do all these things because they're IN LABOR and have come to the hospital so that we can monitor their labor/delivery! She said the nurse's complaint was that if there were an emergency, they wouldn't know where I was. Really? I thought you just told me where I was...in my pt's room! If I have one labor and I'm not sitting in the nurses station...you can probably guess where I am.
    Second one: She complained that you go into the nursery and close the door. Hmmmm.... I thought we were SUPPOSED to do that! You know...infant security? She said...well, yes, you are.
    Third one: She said that you act like you know it all (not the exact words she told me, but meant the same thing...just can't remember how she phrased it to me). Well, yes, I am the only NICU trained nurse here and everyone still does care as though it is 1975. I told her "I thought you wanted me to help with evidence based practice" and she said, yes, but that the RN was complaining about me trying to "teach" her (basically she didn't want the help to be up-to-date with her nursing knowledge). I said "fine. I won't bring anymore of my knowledge to this hospital since it is bringing complaints." She then IMMEDIATELY asked me if I knew how to do the Ballard Score". I told her yes and she asked if I would teach it to the RN's. UMMMMMMM......NOPE! Thank you for wasting my time though with this ridiculousness!

  • Apr 2 '16

    Visiting the newborn in L&D, as the nursery nurse, I was happy to comply with the family's request of waiting 2 hours from birth for bonding. I arrived a few minutes prior to 2 hours (parents were accepting of vitK but not erythromycin) to give the VitK in our standard 2 hour time frame, as well as newborn assessment/Ballard/etc. I had prepped the VitK, ready to give, and the doula walked in between me and the infant (on the warmer) and coo'd over the infant for at least 2 mintues while I stood there with an exposed needle. The warmer is in a confined area in the room, so I could only feel that it was intentional. The rest of the family did the same thing repeatedly during my assessment. I was hoping to get it all done quickly so they could continue with the bonding, but my assessment ended up taking about 45 minutes with all the "stand in front of the RN while she is working". It was frustrating. In the end, the family thanked me for not taking the baby off the breast and allowing for bonding. No harm, no foul, but my interest is that the baby is transitioning well and I need to assess that. That is what we do in a hospital environment. The baby is just as important as the mother.

  • Mar 23 '16

    Two days before she passed, she had a seizure (only time she ever did). At that point, she transitioned to active dying. When we got her into bed, after calling hospice (which took multiple tries...getting voicemail but it didn't allow you to leave a message) I made the quick decision to open the kit. Her seizure was at 3am and it was about 6 am before the OC nurse arrived. He said "who opened this kit?" I told him I did (although I didn't use anything, just got it ready and looked to see was in there). He said "well, I don't know if there could be any legal ramifications for you since there isn't an order for those meds." I told him I didn't care. I couldn't get ahold of them and she was non-responsive. He was a really nice RN, but that just hit me weird. Then next night, when she was in a large pain crisis, I called the oncall (this is after her CM wouldn't come and open her kit). I asked her, when she called before making the visit), if I had permission to open the kit. I was told no. It took over 3 hours for them to arrive. So, while waiting the 3 hours, I opened the kit. If they weren't going to take care of their hospice patient, I certainly was. I pulled out enough morphine for 3 doses, giving her one, and fridging the other syringes. Taped the box back up, and put it in the fridge. I made this decision after I was told the OC nurse was in a town 1.5 hours away and wasn't done with that visit yet. So unacceptable.
    I really did see my sister's death as being something more peaceful and spiritual, but it was the opposite. I will struggle with this for a long time, I'm sure. This went against everything hospice was supposed to be.

  • Mar 23 '16

    Sorry for the confusing way I typed this. As you can tell I was a little angry. I have been a hospice RNCM and have worked for two really good hospices. Unfortunately, my young sister went on hospice (in another state) and this is the story of her death. No one would open the dang kit! I was so mad! It would take 3-5 hours to get the oncall RN there for a crisis at nighttime. Her CM refused to come over and open the crisis kit when I called and asked her to please come and do this. Her response was to crush what can be crushed and give her MsContin rectally (they don't supply gloves or lube, even though they supplied suppositories PRN).
    So, in a nutshell, my intent was to ask if any of these situations were ok and I was just being out of line by requesting them. The whole hospice experience for my sister's death was a horror story. (They wrote on FMLA paperwork that her hospice dx was brain cancer, and CM verified it with me when I questioned it, only to tell me a week later she didn't have it but offered not one glimpse of an apology for what that did to our family. She discussed her "next pt visit" with the SW while sitting at our table during the visit, mentioning how difficult the pt was.) There is SO much more that is even worse than these examples, but I'm not going to mention all of it, cause it would just be a rant. Thanks for your reply. It is greatly appreciated

  • Mar 17 '16

    Two days before she passed, she had a seizure (only time she ever did). At that point, she transitioned to active dying. When we got her into bed, after calling hospice (which took multiple tries...getting voicemail but it didn't allow you to leave a message) I made the quick decision to open the kit. Her seizure was at 3am and it was about 6 am before the OC nurse arrived. He said "who opened this kit?" I told him I did (although I didn't use anything, just got it ready and looked to see was in there). He said "well, I don't know if there could be any legal ramifications for you since there isn't an order for those meds." I told him I didn't care. I couldn't get ahold of them and she was non-responsive. He was a really nice RN, but that just hit me weird. Then next night, when she was in a large pain crisis, I called the oncall (this is after her CM wouldn't come and open her kit). I asked her, when she called before making the visit), if I had permission to open the kit. I was told no. It took over 3 hours for them to arrive. So, while waiting the 3 hours, I opened the kit. If they weren't going to take care of their hospice patient, I certainly was. I pulled out enough morphine for 3 doses, giving her one, and fridging the other syringes. Taped the box back up, and put it in the fridge. I made this decision after I was told the OC nurse was in a town 1.5 hours away and wasn't done with that visit yet. So unacceptable.
    I really did see my sister's death as being something more peaceful and spiritual, but it was the opposite. I will struggle with this for a long time, I'm sure. This went against everything hospice was supposed to be.

  • Mar 17 '16

    Sorry for the confusing way I typed this. As you can tell I was a little angry. I have been a hospice RNCM and have worked for two really good hospices. Unfortunately, my young sister went on hospice (in another state) and this is the story of her death. No one would open the dang kit! I was so mad! It would take 3-5 hours to get the oncall RN there for a crisis at nighttime. Her CM refused to come over and open the crisis kit when I called and asked her to please come and do this. Her response was to crush what can be crushed and give her MsContin rectally (they don't supply gloves or lube, even though they supplied suppositories PRN).
    So, in a nutshell, my intent was to ask if any of these situations were ok and I was just being out of line by requesting them. The whole hospice experience for my sister's death was a horror story. (They wrote on FMLA paperwork that her hospice dx was brain cancer, and CM verified it with me when I questioned it, only to tell me a week later she didn't have it but offered not one glimpse of an apology for what that did to our family. She discussed her "next pt visit" with the SW while sitting at our table during the visit, mentioning how difficult the pt was.) There is SO much more that is even worse than these examples, but I'm not going to mention all of it, cause it would just be a rant. Thanks for your reply. It is greatly appreciated

  • Mar 15 '16

    When I was an L&D nurse, I would always advocate for my pt. Docs would come in and want to AROM the pt and up the Pitocin. The pt would just nod in agreement. When the doc would leave, I would tell my pt "you don't have to have your water broken. You can let this go more natural. All you have to do is tell the doc that you want to wait for interventions." The pts always expressed gratitude but allowed the doc to AROM them. Nurses need to really be strong and not worry about what the doc thinks. I always advocated for my pts. After that, it was their decision. Of course, this means that I have gone head to head with a few docs. I don't care if they don't like me. I have seen too many poor outcomes from wanting to deliver in the 9-5 world.



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