cinnyluvscats

The last time I saw an orthopedic surgeon for my back was back in 1994 after I delivered my youngest. Was having tailbone pain and wanted to get checked out. Other than having 1-2 broken wires at the very bottom of the fusion, I was fine. Hope your scoliosis doesn't interfere with your nursing career. Cindy

I've had scoliosis since I was 14 years old. Had corrective surgery when I was 18 (Luque wire technique). Orginially, my curvature was about 60-65 degrees top and bottom (S-shaped curve) that's been corrected to about 40 degrees. I have worked on and off for 20+ years as an RN and gave birth to 4 kids lady partslly (not all at once). I've used my experience as a patient to improve my ability to care for others. In fact, it was my hospital stay for the surgery that helped me decide to become a nurse. Good luck with your situation! Cindy

I'm glad to read these posts about earning an online MSN degree. Thanks to the person who posted the scholarship websites! I've checked into St. Joseph's and Wheeling Jesuit and would love to hear from anyone who is either currently in 1 of these programs or is a graduate. I'll also check out the Wyoming school since I'm wanting to focus on education. Any advice on doing this part-time? With 4 kids (3 still at home), a part-time job, and volunteer work, my time is limited. Also, what is the GRE like? I'm nervous about taking it since my pitiful math skills are extremely rusty! Thanks to all, Cindy

Things that have helped me with giving immunizations to kids: 1. Know thy stuff - Parents hear all kinds of truth and fiction about shots, so it really helps to reassure them if you can answer the more common questions and know where to look up the uncommon ones. The "pink book" from the CDC is a great resource as well as your immunization consultant from your state health dept. "Epidemiology and Prevention of Vaccine-Preventable Diseases" is updated each year. It also helps to watch the satellite/webcast of the same name from the CDC that's done starting in Feb. of each year. 2. Make sure kids are securely held during shots - Nothing's worse than having a kid jerk while giving a shot, or getting kicked in the chest, or smacked. We have the parent be at the kid's head and hold their arms. A staff member holds the legs and the nurse only has to worry about "shooting". If the child is really out of control, don't be afraid to say, "I don't feel that it would be safe to give these shots unless he/she can cooperate." 3. Refer parents to the VIS forms - the most commone side-effects from shots and what to do about them are always listed on the back. I point those out to parents so they have a resource at 10:30 pm and have a feverish kid. VIS=Vaccine Information Statement that's given to parents for each shot at every visit. There's more, but these are the 3 "biggies" in my mind. Good luck! Cindy

Thanks to all of you for sharing your feelings and opening your hearts to all of us. Even though I left OB 10 years ago, I still remember the patients that experienced losses of their babies. One aspect that I think needs mentioned is support between the nursing staff for each other as we deal with our feelings. During my orientation, we had an awful delivery (back in the days of delivery rooms that resembled OR's) and the baby had Trisome 18 (Edward's Syndrome). The mom was bleeding heavily, so they rushed her to the OR upstairs, the entire staff left to care for her, and I was left holding the dying baby with a HR of 36. Fortunately, I remembered what I'd read in the manuel earlier and finished cleaning him up while I cried. (We had tried resusitating him, but the OB doc told us to stop when he recognized what the baby had.) I held him and kept checking his heart until it finally stopped. I had already had my son by then, so I poured my maternal feelings into caring for him in place of his mom, who physically couldn't at the time. To make a long story short, it was very difficult to deal with on my own and after I had a short cry in the locker room, I tried going back to work. Once I got on my shift of 3-11, we would talk among ourselves about how we took care of these patients and our feelings. We'd discussed what seemed to help the moms and what didn't, share ways to care for them physically, and orient new nurses on what to do for the baby (pics, locks of hair, bracelets, etc.) Obviously our patients and families come first, but let's not forget to take care of ourselves and our fellow nurses. By doing that, we can become better nurses for all of them.

It depends on what type of public health nursing you want to do. I work as an RN at a city health dept. and administer an immunization grant. I have my BSN, which is enough for this position. If you want to become specialized, such as bioterrorism, epidemiology, etc., you may need an advanced degree. My thoughts for the asking. Good luck! Cindy

I am in a similar boat with you. Just got diagnosed with Type 2 last week myself. I'd had the classic symptoms for about a month and decided that denial wasn't working. I drank like a thirsty camel and lived in the bathroom! My job is at a local health dept. with super staff who have been really supportive. Fortunately, I can eat and drink as I need to most times. Any general advice from fellow diabetic nurses? Thanks! Cindy

I've been an RN for 20 years and have taken care of diabetics, especially gestational diabetics after working 9 years on OB. I'm now on the threshhold of being diagnosed myself. I'd been having the classic symptoms. 2 separate FBS were done at work (local health dept.) and were 131 and 147. Just had blood drawn today for venous FBS and A1C level. Had father and both of his parents who were diabetics - type 2. Was diagnosed with Syndrom X and hyperinsulinemia in mid-90's and was placed on Glucophage. Then got off of it when my endocrinologist left town and the internist I switched to didn't think I needed meds anymore. Add to all this bilateral knee replacements back in Nov. '05 and being way overweight and you get the picture. (plus other health issues like corrective surgery for scoliosis, osteoarthritis in multiple joints, etc.) What's a girl to do? Any advice, words of wisdom, etc. would be greatly appreciated. I don't want to face all this but I also want to be around to see my grandkids and to keep working. Cindy

To find out what type of community/public health nursing is included in your local BSN program, you'll probably have to call them and ask. You might want to try and talk to one of the clinical instructors. I graduated in 1986 and my first exposure to community health was at a homeless shelter in downtown Toledo, OH. It also doubled as my psych clinicals. This was about the time that the homeless issue was in the national news and the issue of what to do with all this former psych patients that had been released from state institutes and were supposed to be monitored at community centers, but weren't. My senior practicum was at the Ottawa County Health Dept., which is about 1 hour away from Toledo and I had 3 full days/week there for a quarter. Did a little bit of everything - shots, infectious disease follow-up, home visits, clinics, etc. Good luck with your career decisions! Cindy

Kudos to you both for recognizing that you need a better "fit" with your nursing careers! I've been an RN for almost 20 years and have worked a variety of places. Did my senior practicum in community nursing at a health dept. 3 days/week. I've worked in several areas of public/community health, such as school nursing, home health, and 2 different health depts. I, too, enjoy the teaching aspects and disease prevention, whether through lifestyle changes, vaccines, etc. I don't think a BSN is required for most public health positions, but it probably depends on what you'll be doing. I'm the only one with my BSN at work, but I think experience counts for much more. I believe that if you have at least 1 year of general experience in a hospital, that should be a good foundation to build on in another specialty. You might want to consider school nursing, especially if you like working with teens. I did this for a year and for the high school students, it was more psych nursing than anything. The home health that I did was primarily with elderly patients, with a few young adults and 1 baby in the mix. With health depts., you can see all ages and do a variety of things from satellite immunization clinics to inservices to advocacy for bike helmet laws to newborn visits to food-bourne illness outbreaks. I'll warn you that the pay usually doesn't even come close to hospital nursing, but the trade-off is that the hours are more conducive to family life. I really enjoy working as an immunization nurse and I encourage anyone to check it out! Pardon my ramblings - my enthusiasm overcame me! Cindy

My understanding of these 2 types of nursing may be limited, but I'll tell you what I do know. Home health nurses visit patients in their home. I did this for about 3 months and it was hard work! You have to be a creative problem-solver and a good listener so you can adapt your care to the patient's needs and wishes. Lots of miles get put on your vehicle. Many times, being on-call is required as well as week-end and holiday working time. The pay can be decent if you're with a hospital-affiliated agency, but reimbursement for driving may not be so great. Public health nursing is having an entire community or segment of it as your patients. A example would be working at a health department. Home visits are part of the job, but so are clinics and education. Disease prevention, vaccines, STD and infectious disease follow-up can be challenging. The pay is less than hospital nursing, but the hours are much better - primarily weekday hours, with occasional evening meetings or week-end events. I'm starting my 2nd year as an immunization nurse for a local health dept. and I really like my job there. Hope this helps you! Cindy

There's unsafe, as in "is that a joint on the table or a hand-rolled cigarette?" and there's unsafe, as in "will I get my car out of this mud-hole of a driveway?" I've been to both. My clinical manager emphasized to me that anytime I feel that it's unsafe to do a visit, to just call the office. For the 2 months I worked there, I felt very supported. (Had to leave due to dual knee replacements, but that's another story for another post.) Cindy

I've worked in 2 different health depts. for a total of 2+ years. I just returned to public health nursing. Paperwork for clinics is similar to physician offices. Infectious diseases have some paperwork, but in Ohio, most of the info is stored on the computer. Immunizations require a fair amount of both computer work and paperwork. Clinics and "shot days" are hectic, but the rest of the time it's not bad, as far as a typical day goes. The schedule seems more flexible as compared to a hospital, but some days are crazier than others.

I was a home health nurse for all of 2.5 months, but had to leave due to getting both of my knees replaced. (permanent restrictions basically ended that position.) If the agency's staffing is decent, you should be done during regular "business hours". I was almost to the point of seeing 4 patients/day, but the charting was a headache! Admissions take FOREVER. One of our "managers" had an arbitrary standard of 5 patients/day, but she didn't take into account any driving or case managing. Be prepared to put lots of miles on your car if you live in a rural area. Suburbs or urban areas don't have the miles, but you can get into some sticky situations. Never go out for visits on less than 1/2 tank of gas and get really good directions to the home! The independence is really nice, you can really sharpen your skills, and unless you get stuck with alot of "on call" time, it can work nicely with kids. Pay sounds about right, especially if this is an independent agency. Hope all this helps and good luck during the ride-along! Cindy

I have been an RN for 19 years and have worked a variety of fields, the latest being home health. I had both knees replaced about 3 months ago and just found out from my surgeon that he has put permanent limitations on me, such as no standing for long periods of time, no heavy lifty, no squatting, no kneeling. Since I'm only 43, he and I both want these implants to last as long as possible. My question is, what now? What nursing fields can I go into that will allow me to baby my knees? He recommended administration, which is a viable option since I have my BSN. Any other suggestions for my fellow nurses, especially if you've been there-done that? Thanks, Cindy

I just applied to become the director of home nursing and hospice at a local hospital. I've worked there for almost 6 months as a staff nurse, but I have been an RN for over 19 years. Being in the trenches, so to speak, has provided me with a unique opportunity to see the dept.'s problems first hand. I'm looking for advice for the interview. What type of questions were any of you asked, especially regarding management situations? Since I have no "official nurse manager" experience, it may be hard to answer those in a practical way. How did you land that first managing position? If I get the position, I'll be back to ask more questions. I've enjoyed reading the previous posts and seeing the challenges and successes that all of you have talked about. Thanks, Cindy

Not sure what happened in this case, but I have seen precipitate in an IV line. I was a new RN on a med-surg floor. I think I was giving Dilantin IV push and the line instantly turned a crystal white from the injection port on down. I immediately shut off the IV infusion and ended up re-starting the IV in his other arm. This is a similar situation. You know how we're supposed to pull back in the syringe when giving an IM injection to check for the rare instance that you've hit a vein? I had that happen to me, coincidently in the same year at the same job. Was giving a post-op patient some Demeral and the syringe instantly turned red! I pulled the needle out without giving the drug and got her another syringe. Pretty freaky! Cindy

After reading these posts, it seems that the times for peak and trough draws vary a lot. The best advice was to check your agency's policy and procedure manual; that's the standard that will be used in case of a problem, law suit, etc. What jumped out at me was the nurse using the PICC line for the lab draw. Our home health agency strongly discourages using the PICC line for lab draws (not sure of the exact reason). We only use them if we can't get a stick anywhere else. Cindy

At age 14, I was diagnosed with scoliosis. Wore a back brace for 3.5 years, but ended up with having back surgery anyway. The nurses were super-nice to me, especially since I was an 18 year old stuck in a children's hospital! Orginally went to college as a pharmacy major, but lasted 6 whole weeks - math and chemistry just weren't my things. My best friend and my boyfriend's sister-in-law were involved in nursing, so I though I'd try that. My dad and a family friend gave me grief about it and I had a nursing instructor tell me to get out of nursing; all of which made me try all the harder. Anyway, it's almost 20 years later and I'm still an RN. I've worked med-surg, OB, public health, school nursing, and now I'm in home health. Wouldn't trade my career for anything! Cindy

As far as public health issues, you could address the new immunization table that was just issued for Jan. 2006. Go to http://www.cdc.gov and search immunizations. As a side issue, the supposed connection between autism and the MMR vaccine is being discussed again. Another issue is confidentiality of reportable infectious diseases. When I was filling in for a friend in a local city health dept., part of my duties involved contacting people with one or more of these diseases and offer assistance, referrals, educational material, etc. One patient hadn't been told yet by her doctor and I ended up having to be the one to break the news to her. Just some stray thoughts - hope they help!

I've been an RN for almost 20 years, but have been a home health RN for about 2 months. I had to get both knee replaced and surg:nurse::nurse:ery was done in Nov. 2005. My surgeon will release me for "light duty" in about 3 weeks, but my employer doesn't want me back until I can pass the fitness test and be back up to full speed. Has anyone here had knee replacement surgery and returned to home nursing? Any tips would be great. Thanks, Cindy

I am in a similar situation. I'm an RN who just how both knees replaced in Nov. 2005 due to arthritis. My doc. won't let me go back to even light duty for another 3 weeks at least! I want to get back as a full-time home health nurse, but I'm not so sure that will work. I understand the depression. Hang in there and do what you can! It helps me to give myself time to relax and just take a step back from everything. After I've cleared my mind of worries, I can focus on positive solutions. Prayer also helps me alot! Good luck with whatever you can find and with managing your arthritis.

When I worked in OB and we had an especially demanding or obnoxious patient, I would put "PITA" on my worksheet next to her orders. It was a way to remind me to watch extra closely to everything I said and did with her and her baby. I'd heard in nursing school that the letters "WNL" meant either "within normal limits" or "we never looked". One of my old friends from OB once wrote "CMV" next to a patient's baby and I freaked thinking it meant cytomegalovirus, when she really mean cool mist vaporizer for the mom's cold! Finally, if you ever hear that a patient is on Vermox and you don't remember what that med treats, think (in a thick German accent) Vermox is for the vorms!" (ringworm!):chuckle

I last worked OB in 1996, so my info may be dated, but I used alot of the same guidelines to decide when/if to do VE that have already been talked about here. I was big on Friedmann curves. When I started to suspect that her labor progress was slow, she was high-risk, or my nursing intuition said to start one, I did. The docs appreciated it because they had info in a summarized form that helped with making clinical decisions and the couples could also get a "picture" of what was happening. Just putting in my 2-cents worth! Cindy

Lots of good info here! I have worked at 2 local health depts. and some of the dutes were immunizations (kids and adults), infectious disease tracking/education, clinics (well child, cardiac, plastics, vision, ear, satellite immunization, etc.), community education, BP screenings, lead kids, and more. Flu shots are the main focus now. Now I'm a home health nurse and all my experience (med-surg, OB, community education, public health, school nursing) has come in handy at different times. Lots of nursing principles go between specialties. Good luck!