tenexe

Is someone actually doing a nursing care plan. I thought those were made up like lunch breaks and safe patient ratios.

We don't make the money that we should because we allow ourselves to be underpaid, undervalued and in many cases abused. Sorry but thats a fact. Unfortunately Unions are not the answer either.

To begin with you will not get compensated adequately for the skills that you inevitably bring to the table. You will have to compete with others in a market that is not as favorable to nurses as they try to make it sound. In addition you will most likely work in an environment where you will be expected to metaphorically pour 16 oz of water into a shot glass without spilling anything. Good luck.

I knew someone would respond with the fibromyalgia. Sorry but still not buying it. I have aches and pains every day myself. I'll bet if I went to enough doctors someone would tell me that I have fibromyalgia. I have seen people with very minor injuries carry on crying and screaming. I know they are exaggerating their pain. Drug seekers also don't just seek drugs for the high. They frequently seek the drugs and dramatize the pain for the secondary gain of attention. In addition I can also point out that I have yet to meet a man diagnosed with fibromyalgia. Come to think of it most of the patients that present in the ED, around 75% are women with some type of unaccountable pain with no objective findings. Sorry but its the fact but you can all flame me about it. half of the people in the ED I work in now refer to the ED as the womens clinic. And having traveled for over 2 years I've never seen an exception to this anywhere. I'm not saying that these people don't have pain. But remember pain is subjective. I can say that the pain I have every day is a 1/10 and someone else can say the same level of pain is 8/10. Regardless I can tell you the pain I have is barely worth tylenol. Just because someone describes the same level of pain as 8/10 doesn't mean they should be medicated with anything other than tylenol. I'm also sorry to disagree with you but nothing should be taken at face value. Objective data should always be part of any assessment.

looking at your own medical records is not a hippa violation. It may violate hospital policy but it is absolutely not a hippa violation. You must also realize that very few hospitals understand the hippa guidelines themselves.

good luck, pay sucks, conditions are probably some of the worse in the country. The nurses down there tolerate it. Cost of living is higher than you would expect also. Didn't used to be but it is now but the hospitals will always site that to justify the lower salary.

Sjoe hit the nail on the head. I also wanted to return to florida from philly after finishing nursing school. What I found is the cost of living is comparable and in some areas more expensive in florida and the salary and work conditions are horrendous. (I did a travel assignement at the great cleveland clinic in weston) What a dump. Anyway the nurses in florida get pain low wages and work under horrible conditions because they allow it. If all the nurses walked off the job what do you think they would do. if all the nurses banded together they could force the florida legislation to pass a mandatory staffing ratio similar to cali. Anyway you only get the repect and work conditions that you allow. Physicians are still making high six figures and CEO's are still making millions in salary and bonuses. Nurses aren't treated with respect and professionalism because they don't demand it. And demanding respect isn't telling a doctor off or setting limits. Demanding respect is saying If I'm working with critically ill patients and responsible for their lives I want to make 40+ an hour. I want no more than 1-2-3 patient load depending on the acuity (i work in ed). And I want ancillary staff. If we demanded this we would get it, but only if we banded together. Unfortunately too many nurses function like the short end of a dysfunctional relationship and buy into the ******** of We can't walk out because who would take care of the patients, or Your supposed to be nursing because your a caring person. The patient's, fellow nurses, hospitals, and the field as a whole would benefit more from organized, professional, well compensated and non overburdened nurses. i'm not sure when the rest of the nurses in florida are going to wake up, but i'll be waiting.

To begin with only the complaint of pain is subjective. There are however very objective signs of pain that can be observed. If your telling me your pain is 8/10 (being 10 is the worse pain you've ever had in your life) and your sitting calmly reading a magazine, text messaging, laughing...etc. Well you either have no prior experience with pain other than a splinter, you are exaggerating or you are lying. END OF STORY. By the way I work in the Emergency room and I would say the exaggeration of pain is the rule not the exception. In addition, providing narcotics and controlled substances to those that are seeking them for other than appropriate means is not a harmless process. People that have addiction and substance abuse issues are DIRECTLY HARMED by allowing them to successfully manipulate for these medications. (First rule is do no harm...remember) If you think that a lawsuit is able to be won by nonsense like improper pain management (I'd like to actually see the circumstances around that one). wait until you see the lawsuit by the substance abuser that goes home and dies of an overdose of controlled substances that they were given by an ED Physician to manage their "pain". Yup especially when they have a documented history of substance abuse and are known to the hospital. This happened at the hospital I just left. A 21 year old male died following an overdose of medications that he was provided in the ED for a complaint of "dental pain". Well guess what. That hospital, physician and every nurse involved in that case is being sued by the family, and they will and should win. Providing that patient with those medications was unethical. But Physicians and nurses go right down that road because they are forced to by hospital administrators bullied by regulatory agencies that no longer survey and evaluate but dictate to the cries of political correctness. I certainly believe that true pain should be addressed but what other area of medicine do we treat people based on purely subjective information. When a patient comes in and complains of chest pain we evaluate the pain parameters and than take into account the OBJECTIVE data such as EKG results, diaphoresis, etc prior to calling the cath lab don't we. Pain is no different. If the patient is lying there reading a magazine, lying on a stretcher, legs crossed in front, no guarding, full range of motion in all extremities, relaxed facial expression, non-pressured speech, no psychomotor agitation, no diaphoresis, no increase in pulse or blood pressure, (lets see how many more objective signs can I name). Well you get the point. This is frequently the patient telling me they are having 9/10 abdominal pain, and usually for many days. Sorry I'm not buying it! Tylenol. If we are going to just medicate a patient based on their subjective comlaint then just put a dispenser in the ED lobby and stop wasting everyones time. i will continue to appropriately assess both my patient's objective signs and certainly document them as such. As for some of the other comments the Drug companies are horrible and the Physicians are complicit to give people whatever they ask for. Then you have made up things like fibromyalgia. Give me a break. Everyone can send their flaming messages towards me but I've yet to see someone with that diagnosis that isn't on a dozen psychiatric medications. Not stating that this is the case with everyone, but in the 5 years I've worked in the ED I've yet to see the exception.

I have traveled for over 2 years and have worked 2 full time jobs. We are paid a fraction of what we should be paid. In addition we are frequently not valued by the hospitals that we work for, Sorry but Its a fact. Working in the ER, assignment of 5-6 patients, no ancillary support, and then I have a patient with a strange diagnosis and go to look it up on google and find out the nurses are no longer allowed internet access. So the only option for me to access information is to ask one of the doctors. But i hate to bother them when they're busy shopping on Ebay or checking the latest sports scores. Sorry but it happens because WE ALLOW IT. One more year till my car is paid off and bye bye nursing.

First of all it is always better for people to manage their lifestyles in a healthy manner rather than to rely on chemicals. Unfortunately that is not supported in our society. We encourage chemical dependency. Secondly I never said marijuana should be legalized because alcohol is, I merely made a comparison of the detriments that each bring to the table. (I hope I spelled detriment correctly). Making cigarettes and alcohol illegal would no more make people deal with their "issues". Thats why having drugs illegal prevents drug addicts in our society. yeah that works great. What is scary though is that you would want the government to continue to make decisions for us and to tell us what we can and can't do. Boy is that a slippery slope! "There is no good reason to legalize marijuana" I take you have extensive experience and have researched the topic completely to make such a strong black and white stand.

Wow.... what a huge amount of misinformation out there! To start with my credentials: I worked with mental health clients for over 15 years including substance abusers so I have a great deal of training and experience with this issue. For starters people who socially use marijuana are no more impaired when they stop using that people who drink. Any of you gone to work after staying up late drinking? well you were most likely more impaired than someone who smoked a joint. Secondly it has been conclusively proven that marijuana does not kill brain cells, (alcohol does), nor does it have any long term impact on any part of the memory. Second hand smoke is extremely unlikely to make you test positive on a drug test even if you were in the room with the person smoking. Even in nursing school one of the questions asked was "is marijuana a gateway drug" well my psychiatric nursing text, my professor and my own professional experience all agreed that this was a fallacy as well. Marijuana or THC has much less impact on the body than alcohol. So if you all want to jump on the bandwagon about "reefer madness" then you need to study some history and realize that the only reason that marijuana was made illegal was because of hurst publishing which had a stake in a new material coming out called polyester. Well hemp was also being harvested at this time and another person involved in making money off polyester happened to be the attorney general. Well Hurst owned all the newspapers and started the misinformation campaign to get hemp and all of its byproducts made illegal. So brush up on your history, brush up on your facts. the fact that marijuana is illegal and alcohol is not is one of the largest hypocritical standards in this country. Just a sidenote but i don't use marijuana but I do know plenty of people who do that hold full time jobs and function as normally as anyone else I know. As far as the other little items, marijuana is also not addictive, like cigarettes and alcohol which both are legal. As far as saying everyone who smokes marijuana has issues. Do you know everyone who smokes marijuana. Actually I've come to realize that everyone has issues. As far as your relative walking down the street naked, I doubt it was just marijuana he was using, as a matter of fact i would guarantee it. Someone who would do that clearly has other things going on or was abusing another substance. Sorry, managed a psychiatric assessment center and that story wouldn't be bought by any mental health professional at my facility. Its not that i advocate the use of marijuana, I advocate intelligent informed opinions rather than urban legends and misinformation. I also advocate personal freedom and the lack of government intrusion into our personal lives. So my final question would be, someone who smokes a little weed at 9:pm for insomnia who is sleeping by 11 and sleeps well through the night, and someone who is up all night unable to sleep and only gets one hour sleep. Who would you rather have at your bedside. these issues are complicated and not solved by one liners like "everyone who smokes weed has issues".

I felt really overwealmed at first also. In time as I've begun to get more information and understand it there are some good opportunities out there but its not a easy way to make money without understanding all the details and knowing how to negotiate the waters.

A lot of these are scams that work out for the benefit of the agency more so than for you. As a traveler you are only entitled to this benefit if you have a permanent tax home. If you do then read on. There are 2 ways that they will do this. one is that they will only tax part of your income and the other is that they will give you an extra allowance on a daily basis that is tax free. The government sets a varying rate on how much you can deduct at the end of the year depending on the cost of living in the area where you are living. Many agencies only add this extra money to the days that you work and not your days off. The government allows the deduction for every day that you are away from your tax home. So if you are working 3 days out of 7 you are missing 4 days that you could deduct at the end of the year. hope you follow. The other thing that they will do is offer to only tax part of your income. for exampl example they tell you they will only tax a percentage of the hourly rate which we will say is 30.o0 hour. Say they only tax 15 dollars of that 30. According to the government you are only making 15 dollars an hour. Now its true that you may increase your takehome pay at that moment but consider that if you work overtime at time and a half you will only make time and a half over a 15.00 hour salary not 30. because of the lower salary the agency doesnt' pay as much into social security, disability, etc. but you have to realize that your long term social security benefit will be affected since social security at retirement is based on earnings. the other thing to consider is that if you get injured on the job your disability payment which is usually a percentage of your salary will be based on that 15.00 hour. the verdict is also not out with the irs as to whether this is even a legal way to get paid and could make you more of a red flag for the IRS. You can still claim all these deductions and because the per diem deductible may well exceed your standard deduction you will find that all your other deductions that you are able to claim will have more value. sorry this is so long and i hope it makes sense. I would strongly recommend a tax advisor. One agency that I have spoken to and who will be doing my taxes next year is http://kobaly.com/ kobaly. I called and spoke with them they were extremely helpful and friendly. they also specialize in travelers so they will be able to do the best for you as far as maximizing your deductions. and no I don't work for them I just called them last week with some of the same questions that you have as I am preparing to do my first travel assignment. Very nice people, and very helpful.

Your right they probably didn't feel the need for a lecture, just as most doctors don't lecture patients as to why they don't need antibiotics for a viral infection but prescribe them anyway because its easier. No harm there either.

i guess it is silly when most research indicates that most of these horrible stories you hear have nothing to do with spider bites at all, let alone the recluse. silly, like when we almost killed wolves to extinction because we thought they were dangerous to man. you can call anything a monsoon, there is nothing anyone can do about the weather. when you get involved wih mislabeling wildlife based on urban legends and unsubstantiated stories, it only spreads fear and ignorance. below is list of the most common causes of suspected spider bites. feel free to access the link yourself and read up on the actual research regarding this topic including how difficult it is to get bitten by any recluse spider. this includes articles from people that have lived in houses infested by them in a state where they actually are found. http://spiders.ucr.edu/ conditions that have been misdiagnosed as brown recluse spider bites as reported in the medical literature bacterial staphylococcus infection streptococcus infection gonococcal arthritis dermatitis cutaneous anthrax reaction to drugs warfarin poisoning viral infected herpes simplex chronic herpes simplex varicella zoster (shingles) arthropod-induced lyme disease rocky mountain spotted fever ornithodoros coriaceus bite (soft tick) insect bites (flea, mite, biting fly) fungal sporotrichosis keratin cell mediated response to fungus topical poison ivy/poison oak chemical burn lymphoproliferative disorders lymphoma lymphomatoid papulosis underlying disease states diabetic ulcer vascular disorders focal vasculitis purpura fulminans thromboembolic phenomena polyarteritis nodosa misc./multiple causative agents pyoderma gangrenosum pressure ulcers stevens-johnson syndrome erythema multiforme erythema nodosum toxic epidermal necrolysis (lyell's syndrome) one of the more pertinent causes listed here is that the expression of lyme disease can give the classic "bull's-eye" patterning characteristic of brown recluse bite. misdiagnosis in this case can be rather disconcerting because lyme disease can be treated and cured with common antibiotics. if diagnosed as "brown recluse bite" instead, it will obviously be treated as such and then the lyme disease can progress into more serious symptoms of heart and central nervous system disorders.rick vetter, m.s., staff research associate, studies the systematics, distribution, and public health impact of arachnids in southern california (in collaboration with p. kirk visscher.)