PickyRN

So since I'm a med-surg nurse, I should try to get my CMSRN this year. Might that help my chances for higher starting rank?

Ok, so I'm getting my BSN next July (2012) and I will be joining the Navy at that point. Here's my question: When I join, I will have a BS, a BSN, and a masters degree in theology. I will have 7 years of RN experience. Will I be at the same rank (Ensign) as the brand new nurse who just passed their boards and hasn't worked a day as a nurse? Is there a chance I could get commissioned as a LTJG instead? Does anybody know what the criteria are for starting at a higher rank?

Studies have shown that night shift workers should not turn the lights down, because this stimulates the body to think that it is night time, and messes with your circadian rhythm. Keep the lights on, and your body won't know it's supposed to be sleeping. :-)

I bet you shop at the upscale places too. Well, for those of us who can't afford $100 shoes and the walk-in-closet where we can store them.... I wear my work clothes to work. I wear my church clothes to church. If I am going to some function (party, over to a friend's house, etc) I wear casual dress pants and a polo. If I am on "my time", I wear Whatever I Want! I am not what you would call "fashionable," and I hate even the word "fashion" because it implies exclusion: "Eeew! Look at that person, they aren't dressed correctly!" As far as shoes go, I wear my dress shoes to church. I wear my boots when I go hunting. For the balance of my time, I wear the proscribed "running shoes". GASP! That man is not wearing the appropriate foot attire! Well they are my feet, and I challenge anyone: where do you get the right to tell me what kind of shoes I should wear? (pant, pant). Ok. Rant over.

Ok, let me start by saying that I started in this field as a non-licensed nurses' aide. Then I became a CNA. Then I became an LPN. Then I became an RN. BSN looms. So I have experience at every level of nursing (except for senior management). 1. As a CNA, I saw nurses who made comments like, "oh, you're just an aide." Like a CNA is worth less as a human being than a nurse. I also knew nurses who valued my opinion and showed a real spirit of teamwork. I loved working with those nurses. 2. As a LPN, I saw RN's that were snooty towards me because I was "just an LPN", and others that were indifferent ("we're all nurses"). But I ALSO saw CNA's and medication aides who seemed to resent my license. They were rude and disrespectful, not because of who I was or what I was asking them to do, but because I was in charge of them. There was one woman who had been a medication aide at this nursing home for years. I started working there, and she felt like she didn't have to listen to me because I was new (or whatever). 3. As an RN, I have worked with LPN's who didn't have any problem, and LPN's who were very "bristly" about the whole thing. Especially if you refer to LPN's in any way as "not as good as" or "less than" an RN. When I make comments like that, I am usually referring to staffing numbers (on our floor, an RN can have 3-5 patients by themselves, an LPN and RN team can have 6-7) or policies and procedures (there are certain things that LPN's are not allowed to do that RN's are). Do I think LPN's are not as smart as RN's? no. Do I think they are not as gifted, committed, kind, knowledgable, etc? No. But I think we need to recognize that there is a reason for the distinction. RN's have more education, are responsible not only for themselves but for their entire team, and they are "in charge" of LPN's by virtue of the way the system is set up (LPN's by definition legally must be "supervised" by an RN). On the one hand, RN's should not be cocky and oppressive with their position. On the other hand, LPN's should not act bitter and all "victim-y" (is that a word?), taking offense at every imagined slight. As another poster already said, "Can't we all just get along?"

I have worked nights for two years now (straight out of RN school). One thing that I have found to be helpful is lumping shifts together. By this I mean that it is not good (for me) to work one night, then have a night off, then work two, etc. The only way you can do that is if you STAY on the night schedule. So (until recently) I worked every Thursday, Friday, and Saturday nights. I went to church straight from work on Sunday AM, then went home and took a 4hour nap. Then I would get up, and I would be up until bedtime Sunday, when I would be tired again. That is how I convert to a "day" schedule. To switch to the night schedule, I stay up late the night before my first shift. I go to bed around 3AM, and sleep in until noon. That way, I have enough sleep, and I am halfway to the "night" schedule. It's definitely easier to do in steps this way.

1. Yes, we do. Day shift charge nurses don't take patients on my medical unit. Night shift nurses, however, do. Now ask me how the dayshift charge nurse job is different.... the only difference is that they take off orders on the charts. I would gladly give up my patient load on my charge nights to take off orders. 2. See #1. Charge nurses on my unit either (nights) have their own patient, or (days) help out with the other teams patients (in theory...depends on the nurse). We have to do the quality checks on the accucheck machines, assign new patient beds and track admissions and discharges, deal with staffing, handle conflicts, listen to the other nurses complain about everything under the sun, do charge paperwork that tracks how many patients and staff we had (census, etc). Many other things.

This was probably written by somebody who hasn't worked in a clinical setting for years, if ever. It is impractical to have each patient wash their hands with soap and water before you check their blood sugar. Most of my patients aren't ambulatory.

Lotte, have you ever worked in LTC? some of these pt's need only a few pills, some need more. When you are passing pills during meals, you have all of your people in one place, and giving one person their meds takes about 1 minute. You can do the entire room of forty to fifty people in about an hour. As a nurse at a nursing home, I regularly passed meds to 50 people. As a med-surg nurse at a major metro hospital, my load is less, because the acuity is greater. If all I had to do was pass meds (not vitals, assessment, etc), I could pass meds for my whole floor of forty patients in an hour or so.

I am an ADN RN. I have a 2 year degree, that qualified me to take boards and become a Registered Nurse. My sister-in-law is a BSN. She received an education that qualified her to take boards and become a Registered Nurse. She received more education than I did, but not clinically. What is my point? If a BSN grad is "better" than an ADN grad, then they should state that you have to have a BSN to take boards. Obviously this is not the case, so what's all the fuss? An RN is an RN, no matter what degree they have to get there. Everybody knows that most of your education happens AFTER you graduate anyway. Saying that you are upset because you make the same $$ as someone with less education is like sitting on a plane and being upset because the guy sitting next to you paid less for his seat. It's not his fault, and the airline shouldn't give you a refund, you agreed to pay for the ticket before you got on the plane.

There is a young nurse that works on my unit who is about five feet tall and 90 lbs or so. When she started, we tried very hard to not comment on her size, but we got to talking about it one day, and nobody wanted to ask her how old she was. I finally said I would. Just then she walked by the nurse's station, and I said, "Can I ask you a personal question?" She said, "Twenty-four," and smiled at me.

I considered joining the military as a nurse, but there are four obstacles: 1. my family (wife doesn't want me to join), 2. my weight (I would need to drop about sixty pounds), 3. my health (I have psoriasis, and a hx of retinal detachment...both of which would require waivers), and 4. my lack of a BSN (I have my associates). So even if I wanted to join, it would be a few years before I could. If I did go in, I would join the Navy Nurse Corps. Why Navy? My paternal grandfather was a PT boat sailor in WWII. My maternal grandfather was a Navy Seabee in the South Pacific during WWII. My dad and four out of my five uncles (both sides) served in the Navy during Vietnam. My sister and brother are currently active duty Navy on two different aircraft carriers. If my family heard that I was even CONSIDERING a non-Navy branch, I would be disowned. ;-)

Right Medication. Right Dose. Right Time. Right Route. Right Patient.Those are the original five. I found a website that said the next two are "right reason" and "right documentation", but I also found "right to refuse" as well as "right to be educated." I think that we could continue to add "rights" ad nauseum.

Nursing is my second career. I was a pastor first, but found that it didn't pay enough to support my family AND pay off my 7 years of student loans. So my mom (30yr RN) suggested I become a nurse. I bit the bullet and went back to school (aargh!). Did my head feel like it would explode? Not really. Yeah, you worry about stuff like med errors, but you soon realize that they happen to everybody, and you try your hardest to not make one. Also, with anything that might kill somebody (insulin, heparin, etc), you double check if you're not sure. If you are told to do something stat, do it. If it's really stat, they will expect you to do it right away, and if you stand there and look like you don't know your first name, they will get somebody else to do it. Just remember, inaction can be just as harmful as the wrong action. If you learn your book smarts, clinical skills, and common sense, you will do just fine.

You know, there comes a time when you just need to put the shovel down and stop digging.