ColetteFL

Hi there, I'm a new DON of an ALF in Florida. 125 beds, currently 98 residents, staff of 30. Staff are all aides and med techs, I'm the only nurse. Corporate demands are significant, way above State requirements, but that's ok because I know everything will be covered when State comes in. Still, it becomes frustraiting that there is so much reporting. I've got a corporate nurse that requires notification of almost everything; sometimes it's a pain, but once again, I know it protects me in the long run. And the corporate regional team over-all are very supportive. It does become crazy, what with residents, families, staff, MD's, HH nurses, vendors, and other staff members all coming at you at once. I've had to do a lot of behavior modification! And sometimes I just have to close my door and put up a sign: "The nurse is in session; please do no disturb". My staff is great, but there are a lot of call-offs. Marketing Director expects me to drop everything and go run do an assessment (they are on commission). I have a Memory Care Unit (Alzheimers) with a Director but she is an aide, not a nurse. MY ED is fabulous; she has a very positive attitude and everything is "fixable". Plus she is willling to help me out when the load gets too heavy. Oh, and I'm on-call 24/7! Sometimes I get a lot of calls, sometimes not. Currently no SO and kids are grown and gone, so calls at 2 am only bug me, not someone else! Blessings to all in this line of work! We carry a heavy load!:monkeydance:

Wow! Thank you Eileen! I had given up on getting a response to this post - I knew my message was long and deep, so I wasn't surprised when no one wanted to take it on... ...and your idea is absolutely awesome! I had actually thought about starting a "caretaker" business, but it did not occur to me to target the End of Life demographic. Great idea! I'll start doing some market research and see what is being offered in my area. It'll be easy for me, because I already market and network for my current position... I gather from your title that you are a Career and/or Life Coach - thank soooo much for taking the time for such a thoughtful and well-written answer - you're awesome! :bowingpur Gratefully, Colette :loveya:

Tiffany, You are on my prayer list, with special thoughts: I raised a chronically ill child as a single mom, so I can relate. When things look down, try to feel His loving arms around you... Blessed be.

HH is the future of health care. As we baby boomers age, there will not be enough beds in LTC and hospitals, and you will see more borderline "acute" care done in the home. Think about it: a post-surgical pt is sent home, but then develops a infection with MRSA (picked up during the hospital stay). The pt goes back into the hospital, and the pt is put on IV tx and daily dressing changes. Once the wound is well approximated, the pt is sent home, with HH. HH will monitor the IV Vanco as well as the wound. Now there is a bed free in the hospital for someone who HAS to be in the hospital, the pt doesn't have to go to a LTC facility, and the pt gets to go home, to finsh the healing process in a comforting environment. That's just one example of a HH pt. I work as a nurse liasion for a HH, after 2 years on a Med/Surg floor. The only thing I miss about the hospital is the ability to practice my clinical skills. HH is the wave of the future :yeah: Good luck!!! Colette

Hi, I need some creative feedback from all your smart people! I became an LPN at 52, after being downsized from my corporate job. (I became an LPN because I was able to get right into LPN classes, but there were 2-3 years waiting lists for RN. Also, I raised a chronically ill son who was a long-term resident at Shriner's Hospital, and I had had a lot of exposure to Hospice, hence the decision to become a nurse). I am now 56. I have 2 years of great Med-Surg, tele, and surgical hospital experience and am currently working as a Nurse Liaison for a home health company (a combination of intake/assessment and marketing - good money). I'm thinking of going back to school and getting either the RN, a BSN, or maybe even Masters. My primary care MD thinks I should go to med school, but that doesn't appeal. I do *not* have a BA, so I would be starting from scratch (as it were). Before nursing, I was a corporate administrator and before that I was a stockbroker (!), so I've got a lot of varied experience. I've got the smarts for college and the kids are gone, but I would have to finance education with loans, which doesn't appeal to me. I love end-of-life nursing, spiritual and general comfort and support, but hospice LPN's aren't paid well. I've even thought about becoming a chaplain! - but that's another low paid position. Another idea that appeals to me is using the experience that I have to travel around the world, as a medical volunteer/employee, but everyone wants RN's (as far as I can tell). Anybody know how to find international travelers who might need an LPN companion? I'm wondering if the decision to go into debt for school is really cost-effective at my age, and if anyone has any creative ideas that I might not think of...? thanks for reading, sorry it's so long. So many good people on this site! Thanks in advance, Colette.

How funny to see my old post resurrected! However, the answer is a resounding No, not all states accept Excelsior. Here is the link to the site that explains all that: http://www.istudysmart.com/content.asp?cid=70 I think that nursing boards are concerned about the lack of clinical experience with an Excelsior degree, so they want to see that you have "X" number of hours as an RN in your home state before you can get endorsed in the new state. Hope I said that right Still haven't decided about Excelsior! ... ended up being offered a job in the next county, and I've moved there - nurse liaison for a home health agency; great salary. But I'm thinking now about a BSN or MSN... my oldest son has moved to Colorado, and Excelsior is restricted there. In the meantime I'm gonna CLEP pre-reqs and see where life takes me. never a dull moment!

In addition to underpaid's comments, I would add the following: if you don't want to offer skilled nursing, it is a much easier venture. People need companions and care-givers, and (in Florida anyway), you don't need to be licensed to do that. You *can* oversee caregivers as an LPN. Also, Medicare is changing the rules of payment to HH agencies in January (called PPS), and many agencies will go under or have to cut back; it's going to be difficult for a lot of people/agencies. Good luck on your venture, whatever you decide to do!:):):)

In any profession, there are snobby people and people who do not play well with others. To say that everyone should follow the same path is being short-sighted. "Nursing", as a profession, is much broader now than 20 or more years ago. It's really more of a generic term than a specific job description. Not everyone wants to wipe bottoms just like not everyone enjoys paperwork or 12 hour shifts or starting IV's or whatever. There are so many choices in nursing today, and that is a wonderful thing. But don't assume that everyone should follow the same path, or that everyone should suffer and "pay their dues" just because that's how it "used to be". Aides and nurses and doctors and administrators all have different levels of education and experience. Ideally they are all members of the same team, with the patient at the head of the team. Realistically, there will always be people who look down on others or who build themselves up by treatng others badly. Let them spin their wheels! They are creating their own karma! Be responsible for yourself and your attitude toward others. Help to create peace in the environment, and become part of the solution. Just a thought :monkeydance: :monkeydance:

Hello all. Thanks in advance for reading. I'm an LPN, almost 2 years experience on a Med-Surg floor in a hopsital where LPN's are trained & utilized as much as the RN's. Great OJT. The situation I'm facing is this: I want to start back to school next year for the RN, but the question is: Excelsior or brick and mortar? I'm getting very close to making a decision, and I want bounce my thoughts off of others to make sure that I'm thinking straight. Here are the contingency factors: 1. the local cc nursing program is in disarray; not a good time to enroll 2. There is a local private college, very expensive, I'd graduate with large loan to pay back 3. There are other cc's in the next two counties, but I'd have to move, change jobs, etc. Not sure if I can even afford to move.... 3. My mother lives in Virginia, age 85 but my son lives here in FL, not with me, but he's chronically ill and needs me from time to time (also has my granddaughter! :-). I'd like to stay flexible/be able to travel even while I'm in school, so I've been considering Excelsior HOWEVER 4. I am very concerned about the limitations states are putting on Excelsior grads; what if I want to move? what if I want to do travel nursing after graduating (oldest son lives in CO)? 5. ALSO: would like to get this (school) over with asap! A friend of mine just passed the CPNE with Excelsior and only 2 out of 8 passed; they were the two with hospital experience, so I intend to continue at a hospital. Also, I DO need almost all pre-req's. Can you even do pre-req's with Excelsior??? Any thoughts/ideas/suggestions/feedback? I'm older (54), smart, graduated at the top of my class, self-disciplined, blah blah blah. What do you other, more experienced people think? Thanks for reading! This forum is fantastic because of the fantastic people!

Hi, I saw that noone had replied to your question, so I thought I would respond, however you may not like the answer! Most agencies, travel or otherwise, will not take a new grad. They want 1 or 2 years experience as a staff nurse in a hospital. And even if there was an agency that was desperate enought to take you, you should turn it down in your own best interest. You have too much to learn, and you need a good orientation. A travel nurse is expected to be able to "do it all". School can only teach you so much. The rest is learned on the job, and the learning never stops. Give yourself a break, find a good staff postion for a year and just consider it a continuation of school - only now you're getting paid!

Your first job - whether it's LTC or a hospital @ $12.50 - will not be the job that you have for the rest of your life. Relax, be flexible, and soak up all the experience you can, wherever you can. It will look good on your resume, you will gain experience no matter where you work, and you will find yourself an "LPN II" before yoou know it. Keep smiling; it's all good. :wink2: :wink2:

I'm an LPN on a Med-Surg floor. We don't assess acuity, but there is always an effort for continuity of care. Also, LPN's do ALL the same stuff that an RN does; we only have to have an RN there to sign off for certain stuff, like hanging blood. In my hospital the LPN's are respected, and just as capable as the RN's; in some cases, more so. Having said all that, there are still cases of favoritism, or charge nurses giving themselves easy assignments, or not taking an admission even when they have fewer patients with easier acuity. (If our census is high, charge nurses don't take patients, but when it's low, they do). I've learned just to take what's given to me, and do the best I can. And I get back-up for all major (and some minor) decisions, and I chart everything. My advice to you is: find a place where people get along, mostly. One year on a resume looks good, you won't look like a "job hopper" if you've stayed a year. There is something to be said about quality of life! No need to be miserable where you work! Good luck!