LittleWing21 4,130 Views
Joined Jul 13, '05.
Posts: 171 (20% Liked)
I'm currently taking Statistics through FNU. I've applied to CNEP Class 103 which goes to Frontier Bound the second week of June and begins CNM classes in July. I was told by FNU that there is the potential of being accepted to Class 103 and going to FB, but then would not be able to register for CNM classes if I did not successfully complete Statistics.
It is also less painful if you dart the needle in quickly rather than slowly pushing it in. That way you are piercing the underlying tissue rather than tearing it as the needle goes in.
She knew what she wanted.
She'd watched her husband of 52 years die on a vent, and followed his wishes to remain a full code. But she knew that was not what she wanted for herself.
So, she wrote a Living Will, had it notarized, gave it to her personal physician, told all her friends and family what she did not want. She wasn't eligible for a DNR, as she was a healthy 89-year-old, but she knew what she wanted.
"I do not wish my heart to be restarted through usage of any chemical, mechanical or physical intervention..."
Of her 6 children, one fought against her mother's decision, and it was this child, this one desenting voice, who found her mother collapsed on the kitchen floor.
"I do not want any external device to be used to maintain my respiration if my body is incapable of sustaining it on its own."
The daughter told EMS her mother was a full code, and they intubated her on the floor of her kitchen. Once at the ER, her heart stopped, CPR was performed, and her heart was shocked back into a beat. Under the hands of those trying to follow the daughter's wishes, the woman's ribs cracked and broke.
"I wish to die a peaceful, natural death."
She was then sent to ICU, where her heart tried to stop 3 more times. Each time, the broken ribs jabbed and ripped into the fragile muscle and skin as CPR was performed. Electricity coursed across her body and her frail heart was restarted a 4th time. By this time, the other children were there, but the act had been done, over and over. No DNR was written, and the Living Will fluttered impotently at the front of the chart.
"I do not wish artificial means of nutrition to be used, such as nasogastric tubes or a PEG tube."
Her swallowing ability was lost in the storm in her brain that had left her with no voice, no sight, no movement. A scan showed she still had brain activity; she was aware of what was being done to her. Including the PEG tube sank down into her stomach, and the trach in her throat.
"I wish nature to take its course, with only medication to prevent pain and suffering."
The daughter who wanted the mother to remain a full code also refused to allow narcotics to be given, stating she did not want her mother sedated, since she would "wake up" when the correct medical procedures were performed. Her nurses begged the doctor to write a DNR, and he said, "the family can't get it together, and I'm not getting into the middle of it."
"Allow me the dignity we give to beloved pets. Let me die in peace."
I met her one Tuesday night, and spent that night pouring Jevity into her tube, only to suction it back out. Her legs were cool and mottled, her bowel sounds were non-existant, and her blue eyes stared blindly at a ceiling she could no longer see. The MD refused to terminate feedings, but I held them since there was no digestion taking place. The woman was turned and repositioned every 2 hours, and each time, she moaned and gurgled as her lungs slowly filled with fluid. I whispered my apologies as I did the very things to her she tried so hard to prevent.
Suctioning improved her lung function, but would make her body tremble. Over the next 2 nights, she slowly died, all while the daughter demanded more interventions, and maintained that her mother wanted to be a full code. We had read the Living Will. We knew better.
"Thank you in advance for helping me in the last moments of my life to have a gentle, peaceful passing."
She had another stroke, and went back to the ICU, where she was coded until there was not enough surviving heart tissue to maintain a beat. Finally her heart was broken.
And so was mine.
I understandabout the family distant thing. My husband is military so I don't have any family near me either. I just applied to the program and we will see how it goes. Best of luck to u!
Ok so I am not a midwife, but I am a doula and midwife assistant (home births) for now and will be going to midwifery school soon. Hope you don't mind me adding some advice here.
I think the best thing that I have done is to have family/friends on call for childcare....while that isn't always possible...I have made it a point to become friends with other doulas, midwives and assistants that also have children. We casually rotate child care. It works out perfectly because we don't pay for care because we just trade off and it so much easier to be able to call someone in the middle of the night for childcare when they are familiar with the crazy schedule. Yes, it can get tricky sometimes because everyone is on call, but most of the time we keep each other aware of due dates and as soon as there is some signs of labor we call around to see who isn't at a birth and able to watch kids if need be.
Hope that helps a bit.
I'm considering it!!! Just trying to figure out the timing...Anyone know what their acceptance rate is? Good luck to all who apply!!!
I tried to apprentice with a licensed midwife (DEM, not a CNM) a few years ago, but I couldn't make it work. I've been a single mom for several years, but found child care was too expensive when I needed someone who was on call all the time. It's a whole different ballpark from traditional childcare for a job with stable hours. With only one exception, most of the midwives I've known are married. They are able to rely on their spouse at times, using other family or on-call babysitters less often.
I also couldn't make it work financially because I need to work to bring in income. It's one thing to take out school loans to be able to pursue a degree full time. It's another thing to have to balance a real job with the irregular and unpredictable hours needed to attend births. Of course, as a CNM that is your "real job", not an apprenticeship. Many CNM's work in practices where they take turns being on-call.
I worked as a "clinic"nurse for years and always felt "less than" a "real" nurse. We moved out of state and I applied at a hospital. I have been there 3 years now. Oh, yeah..I have learned skills I hadnt done before. Truthfully? I learned and did more as an office nurse than I am doing as a hospital nurse. In the clinic I worked side-by-side with physicians. I gained so much knowledge from them. I aquired their trust and respect and they taught me things. In the hospital environment, only a select few are trusted and respected by physicians. I dont get to spend quality time with patients....its almost factory like... "production" .... continuing education is offered, but the only people who can attend are those who are on light duty and are not able to work anyway. No, I used to be on of "those" who thought a clinic nurse was not a "real" nurse. HAHA....No way.....Clinic nurses work hard..we get to use our brain..(YES...hospital administrators and arrogant physicians..NURSES DO HAVE BRAINS!)... interact and really help our patients I am going back to the clinic. Just as soon as I find the right fit.
I believe it is not a nurse issue. It is an issue that happens that is negative amongst people. I hate to say this but many women (who are insecure, unhappy, and or negative) are threatened by each other. This happens in nursing, the business world, and other professions where there is competition.
It happens but not the majority of the time (thank God). It happens when management lets it happens. Sometimes it suits a managers ego or needs when there is a devide and conquer attitude.
Been there (in those negative environments) and moved on. How do I deal with it? I refuse to be a part of it. One day at a time I embrace my colleagues, nurture where I may be of assitance, and look for ways to keep myself nurtured and positive.
Hey, this year will be my 3rd year as a camp nurse and I'm the only nurse at camp. I actually prefer it this way! I put a little board on my door saying where I am if I'm not in the infirmary. I also carry a walkie talkie and counselors will radio me before sending any kids down. That way I'm able to make my rounds through the activities and join in if I wish. The only thing I feel I can't do is any water sports because if there is an emergency I need to be able to run asap! I've spent a lot of time at arts and crafts!! I love being a camp nurse, I can't wait to go back this summer! For "uniform", I wear what ever I want. This usually means a tanktop and shorts for me. I wear the camp staff t-shirt on check-in days with a name tag.
If you have any more questions, feel free to email me at danacharlee[at]gmail[dot]com
Enjoy spending time with the kids at the camp activities when you can. Whenever I go to an activity that involves all or most of the camp, I take my "go bag" with me. I keep alot of things I might need so that I don't have to walk back to the infirmary. Things such as bandaids, epipen, tylenol, tums, benadryl, throat lozenges, gauze, cold pack, stethoscope, etc and a little notebook to write down anything I might do. Seems like I dip into this bag almost every time I go along with the camp. Makes things much easier. This is also the bag I grab when called to the field to see a camper so I don't have to think what to grab on the way.
Love being a camp nurse, can't wait for summer to start.
I think that a lot of it depends on the individual nurse, but I think a minimum of 6 months hospital or LTC experience is the least, better to have 1-2 years of general nursing experience. The rationale for my opinion: Nursing school generally does a good job of preparing you to sit NCLEX and gives you just enough knowledge of Ivory Tower Nursing to land a beginning job. It does not generally prepare one to be a independent provider. In that beginning job, you hone your skills, benefit from the experiences of your coworkers (good and bad), and develop your independent judgment. You learn how to manage your time, your attitude, and how to negotiate interpersonal relationships with other nurses, aides, therapists, physicians, etc. You learn when something just isn't right and you learn what things you can let go of and which you need to hold dear. Most facilities provide an extensive training program on policies and procedures, since few students run into every conceivable P&P during school.
Home health, on the other hand, is *not* a beginning job and requires a very independent practitioner. You usually will not have someone right there with you to whom you can turn and say, "What is this funny heart sound?" You have to be able to trust your judgment and your skills and sometimes your intuition. You need to have experience with assessing patients of all kinds, in all kinds of situations. And to me, a big part of it is that when you've had experience in hospital, you know what sorts of care the patient is likely to have received--and not received. As hospital nurses, we do the best we can, but in areas of patient education, there's almost never enough time. Because of time constraints, the stress of hospitalization, med changes, etc., few patients come out of an acute stay with the kind of patient education that they need. That's a big gap that home health fills. Then there's the supervision angle. Unless you've had supervisory experience in your previous career, you need to learn the delicate art of supervision other nurses and nursing assistants. A couple of years in hospital or LTC can help prepare for that. There's a lot to home health, and I would suggest that anyone who is interested in it might try to see if they can shadow a home health nurse for a day or two, to get a good idea of the mix of skills required.
So that's my two cents' worth, do with it what you will.
I just happened across your thread. I'm glad you found a clinic job, they're not always easy to find. I've been working in a large clinic for six years now, and I like it a lot. When I started, I didn't think I would ever get to know the patients; after all they're just in and out, and it took forever to remember which was which, or to be able to really visualize who I was talking to if they called on the phone. But eventually you do learn them all, and after repeated, repeated visits you do gradually get to know them, and on a more personal level than during a one-time stay in the hospital. One of the things I like best, honestly, is weekends and holidays off, and not having my phone ring begging me to work on my day/shift off. Yay! Mine is a hospital based clinic, so we're employees of the hospital, not the docs we work with, which also affords a lot of protection; you don't have the risk of being subject to the whims of some doc who is not necessarily a good boss. Plus I get hospital pay. I thought that, being a nurse, the hospital might bug me to work on the floors sometimes when they're short and I'm off duty, but they have not bothered any of the clinic nurses about it, except for the few who want to work on their weekends off.
Sounds like you were working in a dangerous area, so it's really great that you found a place to work where you feel safer and happier. Sometimes I think other nurses feel that clinic nurses don't work hard or have a lot of skills, but you and I know different- it's a different kind of work, but multitasking out the kazoo; problem-solving, using your critical thinking and problem-solving skills constantly, and having to deal with the not-so-uncommon emergency or crisis.
In the hospital I had 10-14 pts with little to no help. I love the fast pace of the clinic and the hours. I feel like I work in a safer environment. In the clinic, I've had the chance to get to know my patients and their families.
I know exactly how you feel because I have been on my unit for 3 months and recently decided that the clinic environment would be best for me. A lot of my classmates have been experiencing the same anxiety and depression that you are going through and most of them are trying to stick it out. I was not happy at the end of the day and believe that life is too short to be miserable. So do what is right for you and weigh the pros and cons of both settings. There are so many opportunities in nursing so just remember you are not stuck; you are not trapped; and you do have OPTIONS. Good Luck!!
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