ChryssyD

Well, I won't mince words. Yes, you should have called the MD. You clearly had concerns (rightfully), and yet you chose not to inform the doctor. Never be afraid to kick a problem upstairs--there is a reason doctors make so much more money than nurses do. They are expected to make hard decisions. Maybe a fever and cough is a run-of-the-mill virus. Maybe it's the flu. Maybe it's pneumonia. That's not the nurse's call--it's the doctor's. Let them deal with the unknowns. Your job is to alert them to possible problems, not diagnose illness. You aren't sure it's pneumonia? So what...let the doctor make that call. That's his/her job, not yours.

The answer to your question is in the phrasing of the Board's query: "...which may impair or interfere with your ability to practice safely and in a competent and professional manner." If you believe that your illness will not impact your practice, you can honestly answer this question with a "no." At the end of the day, the Board has no right to know your medical history. For heaven's sake, don't tell them anything they don't need to know. They are not your friend--they are simply looking for reasons to reject or monitor you, in the name of "public safety." Bollocks. They're afraid of lawsuits. Treat them like the cowards they are--give them as little information as possible, because they can't handle the truth.

Well, I have to admit that phone triage is something I've never done. But it seems a pretty sweet deal. These businesses generally have protocols, procedures for nurses to follow. You just tell people what you're told to tell them. As for the rest, sitting all day is what many people do. There's no reason you can't stand up to take a call. And what you do in your time off is at least as important as what you do at work. As for rotating day to evening, that's no big deal. I have worked day, evening, and night shift in the same week. That's hard on the body. Day to evening is not that rough. You'll adjust. And yes, each call is a challenge. So is an irate family member, a bleeding post-op, an infiltrated IV, and numerous other things that nurses deal with all day, every day. Nursing in general is nothing if not challenging. Rise to the occasion! Wherever you work, you will be challenged and tested. People can be difficult in the best of circumstances; sick people are especially difficult. Nursing is hard. If you didn't know this going in, I'm here to tell you now. Best of luck to you. Nursing is never easy. Ever. But the rewards are inexpressibly wonderful. Find your niche and love your work!

Let them inside to sleep along with you. Dogs are pack animals who want to be with the pack leader (hopefully you!). Letting them inside will greatly reduce their anxiety, and then they will stop barking. It's so comforting to hear your dogs snoring alongside you--their mission in life is to love and protect you. Let them!

PRN4U: Relax and try not to panic. Tell us why your license was suspended, so we can help you understand what might happen in future. But, first, just breathe. As stated by Oogie, any Board proceeding is going to be slow. Get as much information as you can. And then, based on the information, decide whether you need an attorney. Most people advocate for an attorney when facing the Board, but lawyers are expensive; whether you should invest in an attorney depends on the charge. Those of us who have had run-ins with the Board can relate--the Board sucks. Remember, it is NOT your friend, its responsibility is to the public, not nurses. Makes you wonder. Keep us posted. We are here for you!

Sour Lemon: Amen! Mmathieson: Shame on you, sugar--you need to learn and figure this out for yourself. That's why we go to school, to learn! Open those books and edify yourself! Best of luck. :)

Rini1995: You are right to be uncomfortable with a boss who blames you for patient falls. They just happen. There are lots of things we can do to lessen the risk, but falls will still happen. The idea here is not to blame the person but the process. What changes could be made to policy and procedure to help prevent these things from happening in the future? If there is ice where your patient is walking, perhaps your facility should improve its inclement weather procedures or forbid patients from being outside the building when there is ice or snow. When patients need assistance with transfers and toileting, perhaps policy should mandate 2 staff to assist--with 2 staff present maybe you could have gotten the patient more fully onto the toilet seat (this really is something you need to be aware of, but it's much easier to recognize as well as handle when there are 2 of you). Harassment, no. Blaming, yes. Not a good sign. Consider seeking new employment--good managers don't blame, they look for solutions. Don't feel bad. As I said, falls just happen. Best of luck. :)

Rose Queen: Yes. When I worked PICU, we were scrupulous about covering our scrubs when we left the unit for lunch or a smoke break (breathing treatment). The idea was to minimize contamination of our clothing to help protect our little patients. Of course, I had 3 dogs and 2 cats at the time, so it was kind of silly of me to worry about additional contamination when I was coming from a germy, super-allergenic environment to start with. But when I would don an isolation gown to go outside, at least my heart was in the right place. :)

Sorry, but I have to disagree. Bed alarms may be your only indication that patients are trying to get out of bed. They may be upsetting and disorienting, but if they help prevent falls, that's OK. There really isn't any foolproof way to keep anxious, antsy patients in bed. I wish there were. Talk to the doctor about sedation, increase the frequency of checks on the patient, and don't be afraid to institute 1:1 monitoring if you feel it's necessary. Falls, and their consequences (broken bones, mainly), are a major cause of litigation. Do whatever you have to do to prevent falls. And, if you find yourself in an impossible (poorly staffed) situation, tell your supervisor about it and make note of it. This is your only protection when staffing is woefully inadequate. Good luck, and hang in there. Better opportunities are out there, but I know that I cannot abandon my patients just because staffing isn't ideal. But if you must, move on--not all facilities are chronically short of staff. Do what you have to do for you.

Know the article well, and also be aware of any possible discussion points, any controversial or questionable points in the article. You need to show your knowledge, but you also need to show your openness to criticism and conflicting points of view. You should also consider the impact of whatever the article is discussing on nursing in particular--in what way does the information inform nursing practice? Best of luck to you. Based on your post, I feel you will do well. :)

No worries, you can still have ice cream. :) You can't have anything cooked with wine or liquor, though, and you can't have a casual beer or glass of wine with dinner. And you definitely can't have any narcotics or weed. Bummer. My program didn't require checking in on the weekends, which is good, since I live in a relatively small town. The local drug-testing place would have accommodated a weekend test, but I'm sure not every business would be willing to do that. If I had to drive to a big city testing center on a weekend, especially if I had to work that weekend, I would have been really hot. I really don't understand programs that require checking in and testing on a weekend--that seems totally unrealistic. You could call your case manager and ask if checking in on the weekends is required. Always go to your case manager with any questions you have. Best of luck to you, and hang in there. These programs are hard and merciless, but they are only trying to help, hard as that is to see. You can do it--I believe in you!

I'm going with those advising a good lawyer who might be able to mitigate the DUI. A DUI conviction will almost certainly get you hooked into a monitoring program, which will be humiliating, intrusive, and oppressive, as well as severely limiting your employment opportunities when you finish school. Seriously, put whatever money you have into fighting the DUI. It is definitely worth it. But, if it doesn't work out, welcome to the world of monitoring! It's not so bad, just really obnoxious. You can do it. Best of luck!

I'm sorry you feel so uncomfortable with Christians. They should not be making you feel uncomfortable. Christ taught that all who are not against us are with us. This is significant for atheists and pagans--whoever is not anti-Christian is under grace as well, and is not counted as an enemy of God. However, there is no need to try to draw people away from God--if you do not believe in God, that is OK. We Christians need not force our belief on you, and you need not force your beliefs on us. Atheism is OK, but you should not push it on others, just as you would not wish religion of any stripe (I'm assuming) pushed on you. This is something that many are unwilling to confront--pushing religious beliefs is wrong, but pushing atheism is perfectly OK. Double standards? Be fair. That's all I ask.

Well, last evening I worked as a med nurse (LPN, in my facility), but when necessary during any shift I toilet or dress patients, feed them, supervise baths, do dressing changes or other treatments (LPN duties, usually), pass snacks, brush teeth, clip nails, hand out tissue, or hold hands. In other words, I do it all. I get the idea of not wanting to work extra in something other than your usual role. It's uncomfortable. But if you're a nurse, CNA duties are within your scope of practice. And you can't be too good to do it. Too tired, though, I get. I've had many days when I'm too tired to haul another patient on and off the toilet--I'll ask one of the aides for help. I'm not Supernurse. But I will participate. I'm not proud--I'm a nurse; pride is pretty much out the window at this point--fart, vomit, drop a BM on the floor, sneeze a wad of snot on my face, it's all good, no problem. Nurse life. Short-staffing sucks. We are chronically short-staffed. But again, nothing new. I've worked in badly-staffed situations for decades. You get used to it. I walk in to work and automatically go into hyperactive mode; I move fast, I talk fast, I have little time to talk to anybody, including patients; and when you work in psych, that's a problem. But that's modern nursing. I do the best I can. It's all anyone can do. Nonetheless, don't feel bad that you didn't want to work extra in a role not your own. Feel bad that society values healthcare so little that it won't prioritize nursing--the backbone of modern healthcare--enough to esteem and pay nurses and nurses' aides what they are really worth. That is the real problem.

Yes. Speech has been commoditized. According to the Supreme Court, money is speech, so the right to speech may soon cost money. So many people around the world can make their views known for little money, or even for free. But if the Trump administration has its way, speech over the Internet will require fees, money--this is intolerable. The wealthy of the world have no more right to express their opinions than anyone else. We cannot allow this travesty to play out--money is no measure of men (or women). All must have a voice. We must be able to speak to one another, unfettered, uncensored, unrestrained. It is only in freedom of speech that we can find truth and reality. We must NEVER let the voices of ordinary people be silenced! End of rant #2. :)

As a former smoker I can tell you that there is no such thing as too cold to smoke. The addiction to nicotine will enable you to endure almost anything--freezing temperatures are not a deterrent. So the aides will just have to suck it up and supervise the residents, no matter how cold it is. It isn't fair, but as long as smoking is considered a right (as it should be, much as I hate to say it), we'll just have to accommodate it. Me, I work in a state facility where neither staff nor patients can smoke. Smoking is legal, so I'm a little uncomfortable with the situation, but, again, as a former smoker, I'm not totally unhappy. Smoking is bad. It really is. But, as long as it's legal, can we really forbid people their right? I don't know...

I don't know about satisfaction surveys. There are so many variables in what "clients" rate as good service. Is it a nurse popping up 2 seconds after you press your call bell? Is it how hot your supper is? Is it how often you got pain medication, or how quickly? All of these things are important, but some things are more important than others. Hospital administrators know this, but they don't care. When you have a fresh post-op bleeding, or a COPDer gasping and wheezing, or a bloated CA patient vomiting all over creation, getting that juice to 209 or the Vicodin to post-op day 5 in no acute distress just isn't first on your list. Sorry (not sorry). Nursing is not a service job. Nursing is a helping profession. And help goes to whomever needs it, not to whomever demands it. And that is a fundamental difference. The heck with service. Let us do what needs to be done, not what patients think should be done. Patients often think only of themselves, which I understand--they're sick. But nurses have to think about all their patients, have to balance their needs. Patients can't be expected to understand this, because they are sick. But administrators should; yet they don't. It truly boggles the mind.

I don't discuss my faith with my patients unless they specifically ask, and even then in only general terms. Boundaries! Personal faith is another matter. There is a range of interpretations regarding the meaning of hell, whether it is literal or figurative, so you needn't take the smoke-and-brimstone talk of Christian fundamentalists seriously. Unless you want to, of course. You don't have to fear God. God is good. I know the Bible is confusing, because so many Christians thump the Old Testament. But Christians live under grace, which is God's love and forgiveness. You are free to reject it--that's OK. God is bigger than we are. He has room for all kinds of people in His house. Even atheists, I think. :) Peace.

How about something I have encountered in psych? Medication administration without patient knowledge or consent--putting medication in food/drink. We don't do it often, and we always obtain family or judicial consent, but I still feel a little uneasy giving medications to people without their knowledge. Meds have side effects, and I strongly feel people should know what they are taking and the possible side effects/long-term effects, but if they don't know we're giving them these meds then of course they don't know about those side effects. That seems a little wrong to me. I know we need to treat them, but the right to refuse treatment seems rather basic to me. Immunization as an ethical issue seems to me something that should come down on the compulsory side, much as I hate to say it. If too many parents opt out, herd immunity suffers and one sick child can infect many others--it's not fair to allow that kind of irresponsibility. However, medicating people against their will is much more of an ethical dilemma--can we really force treatment on people who don't want to be treated for mental illnesses they don't believe they have? Just a thought.

Do some more research. I know that Longwood's pass rate for Boards was 100% for the past 2 years, which is pretty darn good. I know next to nothing about Lynchburg College, so I can't help you there. Longwood is in a lovely town (Farmville, very quaint, very safe, with some interesting history), so I can't complain about that. The students from Longwood that we get at my hospital seem very interested and engaged, and the instructors seem competent. I'm not biased in any way, but Longwood is a good school. Keep doing research on the two colleges and make the decision based on objective data and subjective issues such as cost, travel, convenience, and preferences--for example, Lynchburg is a medium-sized city, whereas Farmville is a town, which means shopping and entertainment are much more varied in Lynchburg. Whatever you decide, best of luck to you, and thank you for choosing nursing! We need more nurses! You are awesome! :)

Mmm. It sounds like you're just having "intuitions" about your patients, which is totally normal, especially in hospice. Almost every nurse or CNA with more than a year's experience starts to develop intuition about his/her patients. This is the unconscious mind noticing things that the conscious mind does not. And it's totally normal! Now, if these feelings are causing you anxiety, you need to deal with them. You should not be anxious about your patients. But if you are just having "feelings" about them that are strange but not anxiety-producing, you are just developing the normal intuition of an experienced CNA. It's all good. Hope that helps. :) .

Rural areas are wonderful, I think, but healthcare-wise, there are real problems. In an area with no major trauma center, no university medical center within an hour or more's drive, few--if any--walk-in clinics, and limited medical specialists, I think you could rightly call a rural region a healthcare-deprived area. I, myself, live in a rural area, after decades in big cities, and the difference is more than noticeable--it's stark. I love rural life, don't get me wrong. I have a horse I can ride pretty much anywhere. My dog can run free in the neighborhood and no one calls the pound. But there are disadvantages, and one of the most obvious is the healthcare system. There just isn't enough money to care for people in rural (poor) areas, and this has major consequences. It is no coincidence that the poorest and most rural of America's counties are disproportionately affected by obesity, diabetes, hypertension, and other preventable or modifiable health conditions. Living in rural America is great in many ways--I haven't locked my doors in years, and nothing has happened. But there are problems that need addressing, and they truly have nothing to do with location and everything to do with money. It's high time the poor stopped getting shafted for being poor. It's called a social contract, people. We care for others who lack because one day we might lack and need others to care for us. Let's step up, OK? Peace, all.

No. Buy the staff some popcorn or pizza--they will definitely appreciate it. No one should expect you, as an facility employee, to contribute to monetary staff bonuses. That is the facility's job, not yours. Merry Christmas!

Use a TB syringe if you're concerned about exact dosing. As far as rounding up or down, consult the MD or pharmacist on the exact, appropriate dose if you have questions . There are many drugs that need exact measurements--less than a tenth of a cc can make a huge difference. Don't take this on yourself--kick it upstairs. It could make a significant difference. Peace.

Well, there's socializing with people you like, and there's attending events full of people you don't really know and couldn't care less about. I will be the first to admit that appearances can be more important than reality. That being said, if you REALLY want these people to think you care about them, their power, and their feelings, by all means go to the event. Sadly, it does make a difference. But, if you're like me (not a schmoozer or social butterfly), you can always make some excuse and skip the event. Best of luck.