romie

What exactly was you charge? Were you charged as an adult? what are the nursing rules in your state? Can you petition for either an expungment, sealing of the record or a pardon by the governor? Depending on your state clemendy may not me out of reach because I know in IL the ever forgiving Gov. grants over %60 of pardon requests. Good luck.

I used to use Allnurse.com as a touch stone for what nursing is, But some days I cannot believe some of the nasty crappy things that RNs say or feel about their patients. It makes me really sad. If you feel so entitled as an RN spend a couple more years in school, become an MD and then pass judgement. My patients love me because I care about them, not because I care how they are paying their bill.

Maybe in your suburb it's acceptable to be a discriminating RN, but in my home town of Chicago, you take care of people regardless of their ability to pay

I was getting report on a patient and the nurse mentioned that the patient (according to their suspicions) was homeless. My response was, "How is this relevant?" I actually don't give a ****** about how the medical bills are paid for . That is why I became a nurse instead of a physician. People ask me all of the time " why do you spend all of those years in school and you are ONLY a nurse and not a doctor? (I have over 10 years of higher education under my belt and I'm only an RN and proud of it). My response has been " I care about taking care of people and unfortunately being a physician these days is more about being a figure head and less about caring for people, so I am very happy being an RN." So I could give a s***** about how the bills are being paid, I am doing my job taking care of people in need. Let the nasty dirty money people do their job after I'm done bringing your mother back to life.

I was one of those unfortunate nurses who went to a liberal school which believed that basic health was a human right and that our practice as nurses should not at all be affected by how much insurance one or one doesn't have. Believe me, I have protested to the administration when we discharged patients home who could barely walk or even answer a phone to their homes yet let those patients with fancy insurance languish for days while we waited on them hand and foot because their insurance paid for it and they were perfectly capable of taking care of themselves and did not need nursing care. Healthcare is a right, not a gift. Those nurses who think otherwise are lucky to have their jobs.

Thank you so much. Conscise and to the point.

To simplify it. I'm at a staff meeting and there are 10 of us and we are there to discuss the care of our patients. It is custom or acceptable for the ten of us to breast feed during the meeting. However, Jenna, is a new staff member and either--refuses to breast feed, doesn't have any breast due to a mastectomy, prefers to use formula, prefers to breast feed in private or just for whatever reason does not engage in the group breast feeding. Now I like Jenna both as a person and as a nurse. She is a friend, is smart and witty and has helped me out on numerous occasions. If Jenna felt uncomfortable during the group breast feeding sessions, would I, as a friend and someone who cares about Jenna, participate? No. I wouldn't in solidarity to Jenna for whatever reason that she cannot or chooses not to participate, I will do what she is doing because I care about her as a coworker and as a friend.

The prayer in a work setting issue is a bit like breast feeding in public (but not quite). Both are normal healthy human activities. Both ideally are conducted in a setting in which everyone involved helps facilitates the process and no one feels victimized. Both have "the right" to be conducted in public (well, I wish this world would get a little bit more tolerant of nursing mothers and the babies that need their milk. We are mammals after all! We are classified as such because we nurse). In my own spiritual practices as an agnostic yogi, I prefer to do my full blown out expressions of spirituality in a setting that is conducive. I would be horrified if I went to a staff meeting and the other staff members had to do sun salutations or pranayama against their will. It demeans my own personal practice as a yogi and turns it into a spectacle instead of the special experience it is. However, I have been known from time to time, do a few mudras (hand yoga/ special hand signs) or silently chant to myself before a big test or a dreaded meeting. Actually, during a meeting, I can practice prana (breath control) discretely without anyone being aware. Its too bad that the OP's coworkers are not more sensitive to other people's spiritual practices and don't make their own spiritual practices more special by not including them in a meeting ( what I mean by that is that a work meeting is a relatively mundane time, not exactly the time to get a marriage proposal or announce the birth of your child, very unromantic, usually under fluorescent lighting and in uncomfortable chairs). A simple moment of silence will suffice. If they insist on a group prayer for whatever reason (my own spirituality is special by itself and does not need numbers, but I will say that a roomful of people breathing in unison is cool, but not something I need at work). Nursing moms should absolutely have the freedom to nourish their infants anywhere and anyway they please, just as any one of any faith should have the same freedom for themselves, but with that freedom comes responsibility and the need for tolerance. I wish I could nurse and if I could, I would probably only want to nurse in a zen like space so it would be a fantastic baby mommy mind melding experience, but I understand that infants have needs that are unscheduled and sometimes people feel the need to talk to God/Godess/Vishnu/ Yesu at the last minute. (Actually, the semantics of many of our phrases for last minute/ unprepared have a prayer element in them, if you think about it) Should nursing moms be confined to unsanitary and uncomfortable bathrooms and back alleys to perform nature's miracle--absolutely not. Should a nursing mom who is at home but has a few close friends over have to hide her baby's needs--certainly not, she should stay put in her comfy chair. I would hope though that she thinks ahead and assesses each situation but I wouldn't mind if it just so happens that she has to do it while I'm around. A nursing mom should use her time with her infant not to make a political/ social statement, but to nourish physically, mentally, emotionally and spiritually both herself and her infant. If life happens and it happens to be in the middle of a parking lot, we'll just have to deal with it, but most nursing moms would rather be elsewhere when the need arises. Should prayer groups be hidden or confined, absolutely not, but they should position themselves in a way that demonstrates that they think ahead and assess each situation. If it is absolutely necessary, then go ahead, but if it is not, then I would hope that they would respect their god by not creating any casualties or collateral damage through their practices. Again, if they absolutely have to pray in a group with non participants in a room and it cant wait until a more appropriate time, then let it be a moment of silence, reflection, coffee break, bathroom break or something. Just as I have a last minute need to meditate (which I can do discretely, but I'm not ashamed to do publicly and if anyone asks I use the opportunity not to evangelize but to educate--I was discovered by a classmate doing a handstand before a test in a far off area of my school and I explained that the asana (sanskrit for pose) helps improve circulation to the brain. If I worked for an organization that 99 out of 100 people where yogis and we made a point of engaging in activities that made that one person feel alienated, I would feel so bad and personally not engage in my practices while that person was around just to support them. It would defeat the whole purpose of my spirituality if I made that person feel bad and alienated them. If I was one of 99 nursing moms sand we had a staff meeting and 99 out of 100 of us mothers nursed our babies during the staff meeting while one mother felt bad because she either did not have any babies to nurse or could not nurse, I would feel bad for her and out of respect for her take my nursing activities outside of the meeting because I would not want to make a coworker I cared about feel bad in anyway.

I know as a former agency nurse that this is controversial because real good agency nurses are far and few. To be an actual traveler or agency nurse you have to be quick on your feet like nobody's business. Your patient is about to code and you can't get a PIXIS code so you have to be really creative or gracious. I don't think this new practice is desireable because it leaves new grads with uncertainty and discontinuity in their preceptorship, which is essential to nursing practice, but it is a sad reality and a way that some hospitals are saving money. When I was hired as a resource RN, the hospital said to me: We do not hire people for full time positions. We hire people through our resource nurse program and after your probationary period you can apply for a full time position. Unlike my first nursing job where I my benefits and PTO kicked on starting on day one. Very very sad. but that is where the money is.

A lot of hosptials are using the BS line about the economy and the shortage of nurses to justify not hiring (don't get me started). Instead of applying for traditional full time positions new grads should be applying for resource or agency nursing positions. It's a new fad among some hospitals because then they can hire new grads without having to pay for benefits to see if they work out or not. Plus they don't have to guarantee hours if they don't like you.

Wow! I am completely awstruck by the positions and rationales that are taken by many of this forum. I have to keep checking my URL/ HTTP web bar to make sure that I am, in fact, on the allnurses.com forum. In my nursing school we were taught that healthcare was not a privilege but a matter of social justice. People have a RIGHT to healthcare. While I am acting as an RN and providing healthcare I don't give a rats a.. who is paying the bill, but that it is my duty not only as a licensed healthcare professional to provide that person with expert healthcare, but it is also my duty as an ethical human being to help them. In nursing school we spent a whole semester (wow, one semester, which included weekly journal type papers and one research paper) on ethics. I'm probably a little biased because my nursing school is one of the primary sponsors and advocates of Emergency USA, which is a little like Doctors without Borders but has a nursing focus and we had regular speakers from the program. Emergency USA builds and sustains healthcare clinics in war torn regions and the latest press release from Emergency USA was a letter urging NATO to stop their barricade and open a humanitarian corridor to let injured civilians from the recent Helmand, Afghanistan bombing through to receive the free healthcare they need from Emergency USA nurses and physicians. And I'm not some whimsical new grad idealist. I have worked two jobs as an RN at the same time. The first job paid my bills, the second job I made enough to just cover the medical benefits for myself and my spouse. I paid over 800 a month for health insurance and I'm still stuck with the bills and getting reported by collection agencies because I refuse to act like a bank and provide a temporary loan to the insurance company until they can get their act together to figure out who is suppose to pay what. Obviously this free market thing isn't working. We are going to pay for it collectively whether we like it or not. Wouldn't it be more cost effective to pay for prevention and encouraging healthy behaviors. Our government doesn't think so. Our government won't pay a specially certified diabetes educator nurse 100 a week to counsel and monitor someone but will gladly pay 50,000 or more to amputate their leg and the ensuing aftercare. The integrity of any culture or society is based on how well the weakest members are cared for. Do we want our society to be remembered for the Desperate Housewives of Atlanta, Dances with the Bizarres, Flee or for the quality of care and respect that your premature infant or elderly aunt received in their most desperate times of need? I really need to avoid this topic because it really burns my soup.

Instead of getting caught up in peripheral issues, we should be ripping apart the cover letter instead. That cover letter better shine shine shine! When I was completing nursing school I applied for a Graduate Nurse Internship type program at a very prestigious hospital. Half of my cohort of 38 applied and we all had degrees in outside fields, some of us even had PhDs in biology and were lawyers. Anyway, only 1 person in my entire cohort was offered a position in this program so I keep asking myself: who are they looking for--the holy reincarnation of Clara or Florence? Point is, your cover letter is only only the beginning. The worst is yet to come. Read Brenner's theory on novice to expert and put some of her stuff in your letter and interview. That may help. Have faith though because getting into these special new grad internship type programs are way harder than getting a regular nursing job, so don't be discouraged.

I'm going to completely confuse and contradict myself here: Definitely consider the words and phrases used in the description of the position and in the description of the program. One resume, cover letter advice resource I read once suggested highlighting these key words and phrases and incorporating them into resume and cover letter because these days many organizations use computer programs to assist them in sorting through applications. Imagine the organization is using a google type search program and you want to make sure that your letter and resume are on the top page of results. A very basic example is this: if the source uses the word hypertension, don't use the phrase high blood pressure, but hypertension instead. That being said, how can you avoid the trap of being disingenuous? I don't have the answer but I think it goes back to our writing 101 lessons on paraphrasing. Its of utmost importance however, that your cover letter reflects your personal style and shows the person reading it a little bit about yourself as a unique individual. You certainly seem accomplished and ambitious but everyone else is also going to have as many equally good accomplishments. The difference is that you are you and people like to hire people that they like.

I agree completely with Patti RN that any cover letter, in fact any letter that you will ever write, should be your own words. In my own critique I offer suggestions and give then give a specific example to illustrate and clarify that suggestion. I trust woahmelly and any college educated individual to know that an example or illustration should not be utilized verbatim. That is basic plagiarism. Any "How To" book, seminars and classes I have ever taken have used specific examples to enhance understanding of a point. Most resume books will have sample resumes--they are not intended to be copied verbatim. Disclaimer: The following examples are illustrations intended to clarify and promote understanding of concepts. Any document that is submitted by the applicant is to be their own work. Any advice or specific examples, whether obtained from this forum, any other internet source, book or other source should be assessed by the individual applicant and utilized at their own discretion. This disclaimer applies to any application, resume, cover letter, interview or other document submitted by the applicant that is intended to be their own work.

Great advice everyone. If I may, here are some additional pointers: The first paragraph needs a lot of help. It should in four sentences or less state the exact title of the position you are applying for (which you only sort of did), state who you are (which you didn't) and serve as an introduction to all of the fabulous skills, knowledge and accomplishments that you detail further in your letter. A possible rewrite would be: Greetings! I am applying for Graduate Nurse Intern position with the XXX Medical Center New Graduate Program (find out the exact name of the program and the exact title you will have during the new graduate program). I am a nursing student at xxxx college/school of nursing and will be eligible to sit for the NCLEX this spring of 2012. (The last sentence should say something very general about your skills/ knowledge/ competencies that are aligned with the mission statement and/or "job description" of what they are seeking in a good candidate). Give a date that you will be eligible for the NCLEX as this will determine which cohort you will be considered for--the manager needs to know if you are going to sit for the NCLEX this month or this year even. If you have your ATT and have already scheduled your date, either give that date or the period. "I will be taking the NCLEX at the begining of June 2012." Look carefully at the "job description". Are they seeking a candidate with excellent oral and written communication skills? If so, state that and give a brief clinical example of your excellent oral and written communication. This is a great way to sneak in your involvement in the community too. "I recently served as a presenter for the xxxx Red Cross chapter where I am a member of the Disaster Action Team." Are they looking for a good team player or a good leader? State that you are and then give a brief example. It's challenging to keep it short and concise but stating testifying that your have superior group member interpersonal skills as evidenced by a specific example through your medical reserve corp participation is much more interesting than simply stating that you are a member of the medical reserve corp. Kills two birds with one stone and tells a story that HR person reviewing hundreds of applications would be refreshed to read.

The situation described by the OP is not an uncommon one and I am a bit surprised to see so much criticism of him/her plight. Yes one should completely own up and take responsibility for their actions, regardless of the circumstances behind the conviction. It's unfortunate but the main reason why people with criminal backgrounds are having such a hard time getting jobs is because of insurance/ risk management issues, not because they are necessarily bad people. After an incident in my region where a well known fast food franchise was sued after an employee killed a customer and had a prior record, the regions freight rail company laid off hundreds of their employees who had criminal backgrounds, even though these had been employees who had been with them for years, in some cases 10 years or more, but the train company was afraid of lawsuits. It is a fact that more than 1 in 5 adults in the US have some sort of documented criminal history. The reality is the biggest difference between those with criminal records and those without is that those without haven't been caught. Everyone at some point in their lives have committed some crime, no matter how big or small. Driving to another county for a shopping trip to pay lower taxes? It's technically tax evasion. For every person with a DUI how many hundreds of people have driven without incidence and but would have been out of range for alcohol in their blood? Fortunately there are some organizations out there that help people get jobs who have criminal backgrounds. Some are state run others are private NFPs like the Safer Foundation in Chicago whose mission it is to prevent recidivism and make society SAFER for everyone by getting people back to work. Please check out those organizations for the good ones will help you with job coaching, record expungement, even link you with financial assistance until you are working. DirtyHippieGirl made a comment that the OP might be hiding something but I beg to differ. It is cruel to make that assumption because there are so many factors involved that are complete unknowns. First of all, many hiring managers don't know their own state laws and HR and Risk Managers may be completely different pages. Secondly, each state classifies crimes differently, each SBON has their own criteria and guidelines for how they assess applicants with criminal histories. Add up all this confusion and it is no wonder that there can be such a gap in knowledge. I urge the OP to look into organizations that help people with criminal backgrounds get work-- you don't have to have a felony in most cases to get this help. They will at least link you with companies that already know your background and are not using that as the primary consideration ( These companies either can afford the insurance that it takes to hire people with criminal histories or get federal and state incentives to hire people in this situation). Finally, consider nursing work that isn't bedside, like case management, resource utilization, research, nursing infomatics. It's essential to stay hopeful and not give up. Somebody out there will give you a chance and wont have defective hiring and screening processes.

I think the nursing answer would be: If a patient presented with Chest Pain, I would respond appropriate and implement the necessary interventions. I don't care if they are faking it or not, I'd rather not take the risk and it is not my place to judge. If a patient presented with depression and stated that life was unbearable and overwhelming, I would respond appropriately and implement the necessary interventions. Again, I'm not going to take a risk and judge otherwise. There is nothing like a patient suicide to make you rethink your ability and effectiveness as a nurse. It's worse than a patient falling on your watch, I presume.

RN 58186, your response completely resonates with me. I have been struggling with my own depression for years. The onset was about 2001 and I started taking meds in 2002. You appreciate how it terribly cyclical it is, even with the best intervention. I've enjoyed my years of remissions and have been devastated by it's unexpected recurrence. Its more than just feeling bad for a couple of days or weeks. Actually, some people with depression don't even feel sad or bad at all, they just lack energy and drive that they used to have. The fact of the matter is that the World Health Organization, which concerns itself largely with helping poor indigent people, is very concerned about depression, which some people may claim is a wealthy person's disease. Just like patients who are s/p CABG off or on pump, using mammillary vs. saphenous grafts, every person dealing with depression is completely different. It's a MEDICAL condition. In some cases it can be as lethal than any s/p CABG can be and I've worked my share on ICU's and telemetry to know what I'm talking about. There is a big difference between people like your friend on disability and people with debilitating depression. Real depression is like an invisible cage that traps you inside. If I had a choice between chronic depression and chronic paraplegia I would choose paraplegia. Being stuck in a mental cage is far worse than being stuck in a physical cage.

Your last paragraph was concise in a way I can only dream of. I was born in 78 and stayed outside in the summers playing in the yard or the lake or the woods until it was dark. Too bad our last generation of parents have only raised kids who only want to be pop stars.

and now for the long response: I thank Jdoug (the OP) and the respondents on this intriguing post. I have a lot of ideas churning in my brain about the whole depression thing (thanks to 10+ years of liberals arts education) so I'm speaking from not only a clinical perspective, but a socio-cultural-what-the-f-is-the human-condition perspective. Jdoug's friend should probably, because I am assuming that she lives in the United States and we are a very competitive country-seek some professional advice that will not be found on this forum. No offense to any of my fellow nurses but what we say here ain't going to reimburse her insurance company like a few strokes of a psychiatrist pen will. Also, I couldn't sleep knowing that the new child is being taken care of in that type of environment, while it's okay right now, could become bad very quickly. There is the whole East/ West perspective on depression. Fact is that I'm assuming most forum members are participants of the western society and therefor have to appreciate depression from the Western perspective. According to the WHO, by 2020, depression will be the number one cause of disability. It's cost to society is not measurable. And depression happens to be the number one lethal type of mental illness. Few people kill themselves due to schizophrenia or dissoaciative fugue. Depression causes more deaths than any other mental illness. Jdoug obviously knows that depression is a real and deadly affliction. On the other hand, can I tell you how sick I am watching ads on TV for medications that are designed solely for the purpose of growing out your eyelashes and eyebrows? Ever heard of mascara? Gosh, even I have used mascara a few times in my life. You also get the case of people who are not really clinically depressed who are just really competitive types who will get a fluoextine prescription just for the extra edge on the competition. That issue I haven't even begun to get my head around. From a liberal arts perspective I'm reminded of novels and movies like Blade Runner and Johnny Mnemonic where people have debilitated from too much information. We are given entirely too many options and have too much information and are overloaded by choices, pressure to succeed. My parents were considered successful if my father got a job straight out of highschool and kept it, bought a house, a car and got a pension. Today, you have to have a masters degree ( I have one, but little good it does) and you will change jobs 100 times and there will be no pension and you wont be considered successful unless your child gets accepted into the most exclusive Montessori School, you win a Pulitizer or are deemed better looking than Paris Hilton by the latest reality TV show or You Tube channel. So I would say that it is really tough these days. I cannot imagine being a child in this day in age when I spent my summers swimming in the lake all day and lollygagging with my best friends on my bike instead of taking Sullivan courses in order to ace not my SAT, but my PSAT! I think we have too much artifact in our lives that are causing real medical and psychological problems. Remember that stress is a real cause of heart disease. I'm under 35 and grew up with a rotary telephone, can operate a computer running on BASIC and know how to use a can opener that isn't attached to the underside of a cabinet. This is not the way that life is supposed to be and I don't have any answers. Again, I would suggest a lunch date and strong shoulder to cry on. From there, who knows. (steps off the soap box)

Thanks Jdoug and all of the poster on this intriguing thread. I had prepared a very long and winded response which I immediately deleted and opted for the following: Sounds like the first and foremost thing she needs is continued friendship and emotional support that only people like Jdoug can provide. As far as meds are concerned--hell maybe she needs ECT or TCM therapy or new cocaregiver. There is even stem cell replacement therapy in the works for depression. Does she need this or just regular lunch dates with a listening ear?

Hello colleagues, I'm interested in leaving the bedside and going into pharmocovigilance nursing with companies like Baxter and Abbot. I've never done this kind of work before, but I believe that I have the skills to excel in the area. Are there any nurses here who have worked in pharmocovigilance (butchered spelling) and have any advice? I imagine that it would be a lot like utilization management and case management for insurance companies. Any advice on putting together a resume for jobs, interview prep, what to expect, or even opportunities to shadow a nurse currently working in the field in the Midwest would be greatly appreciated. I have over three years of hospital experience in telemetry, some management experience and have a masters degree with research experience in an outside field. Any advice or pointers would be greatly appreciated.

Thanks a lot GrnTea and thanks to PeepnBiscuits for posting a really interesting and challenging question. You seem to be very dedicated to your practice and your patients must love you for the expert care you provide.

While I was in nursing school we were trained under the idea of social justice and that access to healthcare is a universal human right. Now as an experienced RN who has worked with both the well off patients and patients from very low socioeconomic situations I think I understand the issue better. Turning philosphy into policy and practice is an entirely another issue, but one that should be informed of this universal truth. The worth of any society is not based on how fabulous the wealthy and priviledged are, but on how well that society takes care of its most vulnerable members. Ideally our society should be perceived through the lens of how good our schools are, how healthy and happy our children are, how well we take care of our elders, how well we empower disabled individuals to reach their fullest potential and not on the consumeristic Real Housewives of Atlanta/ BH/ NYC and how much our CEOs are getting paid. Take education for example. Our founding forefathers believed that in order for a democracy (pseudo democracy/ republic) to work, each member of the democracy has to have a minimum education in order to understand the issues and be informed voters. Here in lies "free" education for our children in the US. (The quality issues and ensuing debate could take up warehouse full of servers). Even from a capitolistic free market perspective it makes sense that healthcare is a social justice issue and should be a right and not a privelege. More and more employers are recognizing that by investing in preventative healthcare for their employees and offering discounts for health improvement behaviors, they see improved productivity, reduced absenteeism, and greater loyalty. I disagree with the notion that because something "costs" something that it is a priveledge. The logic is faulty because everything "costs" something. The US legal system is very costly but everyone has a right to due process. Who pays for public defenders? Who pays the judges? Who builds the court houses? Who pays the law enforcement officers and the lawmakers? It costs a lot of money to prosecute an individual, even to write up a parking ticket, but you have a right to appeal that parking ticket and you have a right to an attorney in criminal cases. As far as our "free"education system, you home owners in some school districts know precisely who is footing the bill, even if you don't have any children. Safe drinking water costs a lot of money, but it is a right. If your child developed cancer because she drank contaminated water, in the US you would have the right to engage in litigation to preserve your child's right to safe drinking water. Sure it costs money and all of us pay for the drinking water through our rent, our taxes, our water bills, but if someone needed drinking water and was on the brink of dehydration failure to provide drinking water would probably land you in jail even if that person did not have the ability to pay. Just to complicate the issue. Medicare is a program designed to provide healthcare coverage for older adults. If there was a 80 year old man who was worth over 10 million dollars, should he be denied MEDICARE because he CAN afford to pay? Shouldn't we just bill him at the market rate and expect him to pay for his CABG and extensive rehab in a SNF out of pocket. Or does he have a right to Medicare? This is a wonderful topic and I thank the OP for presenting it. I especially appreciate the input from the NHS nurses. Just as an aside, would you alter the quality of your care for your patients based on their ability to pay and your perception of their right to healthcare?

Thanks for the advice. This was a great question! I completely spaced on the labetalol as another drug option and will certainly keep my eyes open for clonidine.