Calm and collected

What a ridiculous article obviously NOT written by a nurse! I don't understand if the purpose of the article was to entice people to enter nursing or to encourage nurses that they have got it made-LOL. What the heck is a "shift nurse" anyway?

I find this disturbing. I worked LTAC for a few years and I get the problems associated with multiple room changes. Honestly, I can't blame the residents getting upset at having to move. As I am sure you know, we are to consider the SNF their home and their room their personal residence. Moving is hard at any age but these residents must find it very hard, especially if there I no perceived benefit for them. Your thought that the residents are to blame for negatively impacting that particular resident's care make no sense. You chose to start this very complicated process so you actually are to be "blamed" ( I don't like that word but you used it yourself) You have not failed her. She is getting care in a better staffed unit. Your rapport with this resident is a whole other issue you need to examine.

Just wow! I usually love your posts but this seems to blame procreation for unfair health coverage rather than the horrible system. Why nurses get despicable healthcare coverage is beyond my understanding. So is your post.

I think it is a huge disservice to the nursing profession to allow anyone to enter advanced nursing programs without significant experience as a general nurse. I worked with wonderful NPs while working in hospice and they all had YEARS of experience as RN's. I do remember one NP who jumped from nursing school to NP Program and she was unable to perform as an independent practitioner and we RN's had to guide her. Granted that was an anecdotal case but bottom line: Experience matters! Just my opinion based on my experiences.

I worked hospice for 13 years. I loved most of it but the on call wears on you. You can work a full day, start your on call at 5 and it is possible to be called out all night. As I got older, I found working 16 hours straight was too exhausting. It is impossible to predict when a crisis will happen in hospice.

So, so long ago I watched Dr. Kildare and also my next door neighbor was an RN and was always called upon when kids, pets, you name it, got hurt. I admired how calm she was no matter what. However, when I went to college, I chose psychology as a major with plans to get an advanced degree and practice. As luck ( or fate) would have it, I applied for a part time job in the kitchen of a locked facility for patients with psychiatric illness who needed care in an institution. This was the early 70's and I was in my junior year of college. There were no jobs available in the kitchen but I was offered a job a a nurse's aide. ( no certification then) I said " sure, why not?" and got $1.70/ hour to start. I LOOOVED it- my favorite job ever! I saw all the psychiatric disorders my heart could desire. This was before all the regulations on meds, restraints, etc so kinda like the wild west. I so admired the RN's and LVN's who managed these patients. I was hooked! I graduated with a BA in psychology and promptly enrolled in a trade school for LVN. I left nursing for awhile to have/ raise 2 children and returned to community college in the 90's for my RN. Always could find a job no matter where we moved and made decent money. Ended my career working hospice for 13 years. I always tell people I got into nursing because there were no kitchen jobs!!

Your heartbreakingly beautifully written narrative touched me. It shows a nurse who, despite seeing the constant illness and often death, still holds on to compassion. I thankfully retired just before the pandemic hit but I am proud of colleagues like you. Take care of yourself as much as you possibly can.

I followed a similar course as you CNA-LVN-RN. I took a break while my kids were little ( after working as LVN for 3 years) I went back to get my RN at 36 and that worked just fine. I worked another 20 years as an RN. So being 27, you have lots of time. I would say to follow your heart, take the position that lets you balance your career with parenting and go to school later when they are older. I never regretted it.

Back in my days as a charge nurse in LTC/ Medicare rehab unit, we were always pushing Ensure, milkshakes, etc on the poor little patients who just didn't want them. I always thought that if they put Ensure in beer bottle lookalike containers, some of those patients would think it was happy hour and drink up!! Sadly, just a fantasy that never came to be.

As an LVN who enrolled in an RN bridge program in California, that would never happen. Not sure about Texas but highly unlikely and unsafe!

I am about to do the same. Received my LVN in 1977 and RN in 1991. Practiced until 2016 and then quit work but kept my license active. I know I need to go inactive but I also feel sad about leaving a career I loved. I feel your loss.

Thanks to all for your comments and condolences. I have been busy with plans to lay my WW2 vet dad to rest with military honors. I now realize he was in a gray area when rapid was called. The nurse who callled was in her late 20's I would guess. I took him home that day and the steroids did give him a "little bump" so he was able to easily tolerate the 25 minute ride home. I was just seeking input from this great resource we enjoy here. As a recently retired hospice RN Case manager, I often would provide 02 in the home in response to family concerns, to give the family " something to do" when they would call the office in a panic as their loved one had a frightening ( to them) change in respiratory status ( found this could often prevent 911 calls instead of calls to hospice) or per patient request. Some were COPD pts who alrady were on home 02 sometimes for years. Again, thanks immensely for all the helpful comments.

Thanks everyone for your comments.

Okay- I have a question for my very highly educated fellow nurses. I took my 98 year old father to the ER 10 days ago for respiratory distress. He was previously ambulatory, able to walk with a rolling walker, alert and oriented x4. He had severe wheezing and experiencing respiratory distress. He was recently diagnosed by cardiologist with CHF and pleural effusion He was admitted for PNA and tx with abt. I brought his DPOAHC with me that clearly stated his wishes for DNR but comfort care okay. As a recently retired hospice RN, I would not have even taken him to ER except that he was experiencing severe resp distress I could not manage at home with SVN treatments. I wasnt able to get home 02 delivered from Apria even though NP ordered it for documented CHF and wheezing on minimal exertion. This was over 2 weeks of trying. He was admitted, WBC 3.5, blood and sputum cultures negative. He had a DNR bracelet on and orders were clear for comfort care, I actually met with hospice evening before to set up care and take him home in next day or so, Before I arrived at his room the next morning, they called a rapid response as he was wheezing and in distress. Basically they gave him albuterol SVN tx and steroid IV. I walked in as they were stabilizing him. Bottom line is I took him home on hospice care with MS and ativan and 02 in place and he died after 3 days very comfortably. I think he had COPD even though he quit smoking in the 1960's but he had been having some mild wheezing easily managed by inhalers before moving in with me a few months ago. It had progressively worsened over the past few months. My question? Why did they call a rapid response on a clearly documented DNR patient? I am not blaming anyone and no real harm done but I really am asking if this is what happens. Please don't take this wrong- really just want to know what is expected.

One of my favorites- during my stint in SNF as RN charge had a medical records clerk write : masculine degeneration every.single.time when coding diagnoses ( days of paper charts and books as reference) instead of macular. Got mad at me when I tried to correct her so just laughed.