delmar

I work in a hospital-based SNF as a Nurse Case Manager. Our MDS Coordinators (as are the RN Case Managers) are all on the Nursing Salary Scale =$52.00 hour. Now, before you all gasp in dis-belief, I live & work in of the world's most expensive places, San Francisco & I believe, that the State of California has the highest tax rates in the US....so it's all relative. In any case, those of you making in the $20/hr range, I'd suggest doing a local salary survey - remember you are bringing in $$$ revenue for your facilities!:biggringi

Hi RN Echo The situation you describe is one that is routinely played out on a daily basis, in hospitals around the nation, turnover, burnout, etc... The reaons for the Nursing Shortage are multi-factorial, but w/the avarage age of an RN in the US being 47, coupled with inflexible shifts/hours, we all know the shortage will worsen. Nursing at the bedside is back-breaking manual labor, taking both a physical & emotional toll. I now work a M-F 9-5 day job as a Nurse Case Manager in a large urban Medical Center. Am I still a real Nurse? You betcha I am! Another job I had in our organization was as a Home Health & Hospice VNA Nurse - loved every minute of it! Soooo, the morale of the story is, you have options. At least you Nurse Manager is supportive??? I wonder, though how long she'll last. Please remember, take care of yourself!

I've worked @ UCSF twice- great learning environment & if you are under 25 w/lots of stamina - the 12 hour shifts are great+ plan on working lots of nite shifts- everyone rotates to nites, no matter how much seniority- unless you work in a clinic! Check out California Pacific Medical Center www.cpmc.org great place to work, with 3 (soon to be 4) campus' Experienced RN's make $50+ per hour w/ great benefits per Diem's make well over $65/hour Best Wishes PS San Francisco is quite small - lots of great neighborhoods, including Noe Valley, Marina, Castro, South of Market, Pacific Heights - something for everyone!:balloons:

Having previously worked Risk Management, I can tell you, this case is a tough one. First of all, you facility should contest the findings of the state surveyor AND the fine. Hard to guess, but would this frail, elderly lady w/ mult med probs have survived the Heimlich?

Any words of wisdom from experienced NP's and/or student NP's? I've been an RN for 16 years, and as age 50 fast approaches, I'm trying to figure out what I want to do when I grow up! The NP role has always interested me & I would also love to teach... Also, as I need to work full-time(or at least .8 FTE) while in school, the campus-based programs here in the San Francisco Bay Area offer only "traditional" programs where one has to work only very part-time.(and starve:o ) Many of the distance, web-based programs such as Frontier, or SUNY@ Stony Brook seem quite appealing..I'm interested in either Adult or Family NP. Thanks very much & I'm very grateful for your feedback!:balloons:

I suggest reading: "An Uniquiet Mind" by Dr Kay Jamison, Phd(Psychology) She suffers from Bipolar disorder, & has achieved a prestigious career as a Professor @ Johns Hopkins Univ - a great read. I Had a colleague/friend w/Bipolar - he's doing quite well now, but had some "rough patches" in the past....

Also, Check out Ball State Univeristy School of Nursing(in Indiana) State University NY (SUNY) @ Stony Brook & INdiana State University College of Nursing in Terre Haute. There are others such as Felician College in NJ & College of St Scholastica in MN. I've been researching this for some time- they all look great, but Frontier seems suberb!

Dear Multi-Purpose The situation you describe is the sort that gets my B/P up in the 240/160 range! This is illustrative of one the MANY reasons we have a shortage of nurses: a hierachical, punitive, rigid, convent/military style system(designed by nurses, of course!) Here you are, a talented clinician, who wishes to earn some extra $$$, keep your clinical skills current & most of all, take care of patients! Instead, you are penalized, & face termination for taking care of YOURSELF (God forbid!) My advise: Say adios to that PRN job & the "Dragon Lady":angryfire who runs the Staffing Office @ the Hospital & offer your skills (on YOUR terms) the hospital down the road - remember, we are in the midst of a nursing shortage which is here to stay & you my dear, are in the proverbial Driver's Seat! Best Wishes! (My B/P is back down to 120/80 now:) :balloons:

Good Day, I'm curious as to how many of our RN colleagues with non-nursing bachelor's degrees have found "barriers" to continuing their education at the Masters level ? For example, I have found that the vast majority of schools do not consider RN's with non-nursing Bachelor's degrees for admission to their MSN programs. The few that actually do consider such candidates for admission, do so I'm told, based on the "philosophy" of the faculty (such as UCSF which has a well-known "MPEN" program for non-nurses with a bachelors in any field BUT nursing. I believe that other well known schools such as Yale, Case Western & University of Washington (Seattle) also consider RN's with non-nursing Bachelor's without "jumping thru too many hoops"! I have also found some schools that have a so-called RN-MSN "bridge" program, which in general requires 16-24 credit hours @ the BSN level. (As if we need to cross any more "bridges" on our educational journey!) With the shortage of qualified nursing faculty, it is quite surprising that more MSN programs don't consider RN's with non-nursing BA/BS degress for admission. Of course, we are sometimes a profession slow to embrace change! The irony in all of this, is that my application to an MEd, MBA, MPH or even a JD program would be highly regarded, whereas it would be considered with "less" favor to a MSN program!

Hello Thank you very much for bringing up an issue vital to our profession - that many of us have or struggle w/a mental illness. I have previously been tx'd for depression. Most of my friends are RNs, & every one of them has had a hx of depression and/or anxiety. Other friends/colleagues have been in recovery for ETOH. Again, thank you for you courage.

Your comments truly reflect the fact that you are "not even a nurse yet" Have you done your Public/Community Health rotation school yet (in the inner city of Detroit, CHicago, Harlem NY, Oakland or LA ?) I seriously doubt it. I've said it before & I'll say it again, there is NOTHING "Critical" about Critical Care Nursing; ALL Nursing and Caring IS Critical though! Health Promotion (ie Diabetic Teaching) is just as "critical" as monitoring the patient in acute renal failure on dialysis in CHF, on the vent for resp failure due to pneumonia, and adjusting his insulin drip. Perhaps if the patient had a Nurse advocate in a Public/Community Health setting in the first place, he would not have ended up in your very 'critical' of "critical" care units. Of course, all of this would take a bit of "critical" thinking skills for you to comprehend !

"Coldly analytical and detail oriented" One also hopes that the "excellent nurse" does not forget that there is a real patient hooked-up to the monitor and drips, whilst you are filling in your Flow sheets. Also, when dealing with end-of-life care issues, one hopes that the "excellent" nurse realizes that there are family members of the dying patient who have spiritual and psycho-social needs...

"Both units require excellent nurses" Interesting concept. One would hope that all clinical settings require "excellent nurses". In fact, one would hope that ANY setting which requires the skill-set of an RN, ie Case Management, Psych/Mental Health, Long-Term Care, Public Health, Hospice, Home Health Care, Nursing Education, Nursing Administration, Forensic Nursing, School Nursing (K-College), Ambulatory Care, Oncology (including Radiation Oncology) HIV/AIDS.., Occupational Health. I'm sure of missed some other "specialties", but having worked in most of the ones mentioned, I consider myself an "excellent" nurse. Forgot to mention, I do have trauma ICU/"Critical Care experience, and there is nothing "Critical" about it, except in certain circles, elitism !

To Kathryn All I can say, is please hurry up, get back to school & get your RN !(or, at the very least, a degree in creative writing or journalism) A beautifully written post, which aptly describes the many reasons why I am no longer a Nurse Manager! Having been one, makes me appreciate the thankless job my boss has; and, she is truly one of the Best in the Nursing Profession!