patricelynne

I, too, am in home health care/hospice and after 3 decades in hospital, it is heavenly to be able to schedule my own hours! I can second the idea that you really need a few years of med-surg experience to be able to do this kind of nursing. One can become certified in case mgmt. as well. If you ever work for an insurance co. as a case mgr. you'll be much more marketable to that co. if you do have your certificate in case mgmnt. The pay scale at that level is much higher than in hospital or even in routine home health care. I have also heard of nurses who work on sets of movies being made to deal w/ the accidents and they make incredible salaries, for nurses. They have a fair bit of ER experience and are union members, as are all the people working in filmmaking. There are a few websites dealing w/ space nursing/medicine. NASA has needs for care in aerospace medicine and it's a new subspecialty at this point. In some ways it's a spinoff from medevac nursing---just higher-tech. A good friend of mine worked for Holland American Cruise Lines at sea and had LOTS of ER and some L&D under her belt. Hope these ideas inspire you! Good question to throw into the mix!

Hello there!---What a situation for someone so new to this role in life! I have a few thoughts that might be of use. For one, what you have done is throw yourself "into the fire" much as many new grads did enteriing the military right out of training, and serving in Viet Nam, in my time. "Home Before Morning" by Linda Van Devanter, RN illustrates some of what I'm talking about. They, as you sound like, were altruistic with huge hearts; but it's overwhelmingly easy to get one's heart broken in nursing. In order to help others we MUST take care of ourselves. By that I mean look at the short term and long term goals. Long term it sounds as if oncology/hospice work is your choice. If it is not, but the only place you could start, you have a dilemma on your hands. Assuming it IS your true calling, honestly, I can't fathom why you were not steered by HR or Nursing Admin. to spend at least 6 to 12 mos. getting your proverbial feet wet on a routine med/surg type floor. The point is to learn to prioritize, think and analyze issues through quickly and---essentially---learn how to run a floor as charge nurse/air traffic controller. It's paramount to get an "internship" phase under your belt. It teaches you to see the big picture and roll with the punches. When you really have some quality time behind you, only then can you pick and choose which subspecialty you think you want, i.e.: L&D or ICU, or heme-onc. and all the attending issues such as the death and dying, long-term planning for extended care, medico-legal issues etc. It feels to me as if you jumped out of an airplane with a parachute on but no briefing. You're trying to figure out how to find the ripcord, gauge when to pull it, aim for a safe landing place, and wondering how to land, and actually DO this thing! Consider a nurse internship program. They have them at Johns Hopkins Hospital, and they should have one at VCU or U.Va. A year spent this way pairs you with a nurse/mentor for a year in the area you work out with the program--for YOUR best interest. You are coached and evaluated and you get the counseling as you need it right when you need it. I'm serious here. All I have read indicates you could adjust to all nursing requires in a much less painful way, with less odds of a flash burnout. Any of us who have been nursing since the 70's have burned out at least once. When that occurs you must figure out why you would want to go back in, what you want for your own growth, should you even stay? Is it mentally healthy for you to do this any longer? You change as you mature personally. Perhaps your needs evolve, too. One of the greatest things about having chosen nursing, for me, has been trying different subspecialties and starting all over again in a new venue of care. Presently, I am in home health care/hospice and case managing. Never would have believed I'd ever do that 37 years ago! You can go forward here, but get yourself some waterwings if you're going to swim in the deep end. Start off with an internship program and you'll NEVER regret it. You'll be hired and paid as the nurse you are. You'll just have a great deal more help making the adjustment to all the hats you wear as a RN. If you are transferring in dealing w/ grandmother's death, working personal issues out, etc. your mentor will teach you how to recognize what you are doing and guide you 'til you are ready to go it alone. Grieving is a beautiful thing, not meant to be gotten over with fast, and swept away. It polishes our souls and lends credibility to what we say and know what to do. Allow that, and get help with it if needed. I say it's beautiful because it allows us to transition from the loss to going on and growing through the loss. My husband passed in March. I do know what I talk of. I wish you blessings in being your own best nurse, for yourself.

:welcome:Hi Guys!---Re: funny drug names, when I was a student nurse in the 70's, we had a lot of really rundown patients from the rougher side of Baltimore. Kinda' the type who look "ridden hard and hung up wet"---most had beaucoup problems wrong w/ them and inevitably the interns would say: " Just give her a dose of Digicorticovitamycin-TB!"---It cured everything.

:eek:Re TVCCRN's statement about not removing saline locs 'til they're practically in the vehicle, when my honey & I were newly-married and he was in his internship in NY, I was nursing at a hospital across town. A 20-ish yr. old dying of liver Ca. was to be sent to the larger facility where John was practicing for a CAT, by ambulance. She'd been "weaned" off of steroids in the preceeding days and there was an order to remove the IV. No way! I made a heploc out of it, for luck, and sent her out in a claustrophobic ambulance in midday traffic jams in a snowstorm. Sure enough she coded in the scanner. John, in the ER that month, ran to help, and ---perhaps this was a blessing for her---she never knew what hit her and passed on. Being a teaching hospital, they hit her with everything and everyone they had. Had she no access there wouldn't have been one forthcoming. One of the anesthesiologists had had to find this one; her vessels were so scarred. Can you imagine what the jerk who ordered the IV to be d/c'd must have been not thinking with??? And they call some of them doctors....... "First, do no harm."-----Hippocrates-----

In my senior year in training we had 3 mos. of team leading and mine was on Osler 4, a public ward with primarily indigent, physically-challenged patients from Baltimore's ghetto. The first room on the ward held 4 and was called the Rose Room The sickest, most likely to crash were in there and on monitors, the old green Emerson ventillators, w/ chest tubes bubbling away, on O2, sneaking ciggs if at all possible. Found a jar of Kosher pickles between the thighs of one on NAS. Another time an intern discovered a bottle of Four Roses in bed with a man w/ a bronchopleural fistula joining his pancreas and his left lung. Had to really watch 'em! One eve shift a classmate and I were dealing w/ a 300+ sized granny---the kind who was on "CorticodigovitamycinTB"---and she coded while giving birth to major constipation results on a bedpan. The timid little lady opposite her saw all of us attempting to "save" the first lady and it scared her so much that she coded, too! Down the hall, an elderly man said to the nursing aide: "Something is wrong with my equipment." and stroked immediately following that. (Turns out he knew something about enginering and made a metaphor.) A new admit was delivered to the floor from ER on a stretcher and was waiting outside the Rose Room for transfer to a bed. He figured out what was going on and got off the stretcher, stating "I got de trombonepleabitis but I ain't stayin' here! They'll kill me here!!" Boy did he shoot out to the elevator fast! Never dull is it boys and girls?

Hi there: first born in Catholic family with a father who was a "dry drunk" depressive w/ ETOH personality. After he retired he began Zoloft and noone could believe the diff. Mom was a nurse; her father was alcoholic and mother was orphaned at age 13---very hypervigilant. Her mother was a nurse, too but no ETOH in the picture. She had a mother who never recovered from an infant's death and was certifiable as well as brilliant. Grandmother used to tell her girls she never knew a well mother. Sad.

Hi Guys!---My experience in over 30 years has been that the more rarefied the specialty-nursing one is doing, the tougher they come. NICU, CCU, ER for example, vs. regular med-surg wards, general peds---you get the picture. Floating to general units it seems the nurses are so grateful for some help they act like human beings--generally; and I've worked all over the country. The new guy on the block in the more critical care areas is at their mercy. I think that's for a number of reasons. They'll accept you when you "proove" yourself, but they won't loose any sleep over who is going to teach you. If you don't adopt the attitude towards patients, i.e. in ER I ran into this frequently, you quickly become outcast. One ER in NY state I worked nights in was so prejudiced toward blacks, native American indians [sadly nearly always inebriated,] and anyone on Medicaid, that it was so toxic to me I began running 5 hr. long episodes of bigeminy and tri. That did it. Life's too short to spend it with people who don't value others. There ARE other jobs/places to nurse. I tried a number of kinds of nursing I never dreamed I'd have done to find something compatible with my soul. Believe me when I say that there are fantastic people to work with in our profession. That said, there are the same volume of great ones and stinkers in many other lines of work. One of my sisters, a special ed teacher burned out in the public school system in under a year. No one would tell her the diagnoses of her sp. ed students and she wasn't allowed to see their records! Schizophrenia, bipolar, FAS, etc. After she left they hired two teachers to take her place. Now she tutors one-to-one out of her home and her sanity If you are a spiritually-oriented person, read "The Secret" by R. Byrne. It'll change everything about your life for the better. You'll learn how to pray for "thine enemies" and how to keep your perspective. There's a DVD if reading isn't how you want to approach this. I've studied Florence Nightengale's life and she was up against this problem, too! Being English, dealing w/ Irish Catholic nuns who thought they kknew it all and didn't care for her approaches to patient care---and Flo trained at Kaiserswoth Hospital in Germany under the Deaconesses. not in Great Britain so THAT made her suspect to them. Shehad a number of volunteers who truely had no idea what they were in for in the Crimea. When all became clear, however, there was dissention among the ranks. She was a hell of an administrator and teacher; God love her. So, as I've said before, some things never change; guess that's human nature!

Several: A 400+ lb male who wouldn't bathe with gangrenous testes...that ER probably still smells like clostridium Welchi. A baby with a pulse less than 20 bpm due to getting 2cc instead of .02cc Digoxin. Yes, the pharmacy HAD labled it improperly and mother was beside herself. A man who shot off his privates when the gun in his belt went off...permanent damage. A 20-something who was on PCP and jumped off a 10 story bldg. after pulling his eyes out. A woman who was frequently abused by the boyfriend who came in after he'd shoved chopsticks into both ears as far as he could. And I'm just getting started! There's a reason after 30+ years I'm in case management nursing.

I graduated from the last hospital-based three year class at Johns Hopkins Hospital in Baltimore. [Now they have BSN and beyond programs there.]Graduating out of our "blues" into our whites was still a big deal for many of us in the 70s. I loved our graduate cap and was one of two who still wore them in the 90s at Providence. People commented on it AND on the fact that I wore my school pin, above my name badge. Even wearing scrubs I wore my pin. I noted when we were in Norway once, touring the hospital a friend practiced in that all the nurses wore white scrubs, and had their school pins on. Another scrub color meant one was an aide, or housekeeping. The hospital provided the scrubs, laundered and ironed them so no wrinkles. Looked about as good as you're going to get in this day and age of scrubs. The white, to my way of seeing things made the nurses more recognizeable and honored the training and experience. I can pass on the cap now, but I like my white scrubs and pin. Took a lot of work to earn them! I don't mind caring for them as I can get stains out better and iron them. Call me old-fashioned, but I agree w/ the nurse who pointed out the unis that police and firefighters wear---the recognizability factor. I guess I see a way to compromise so people can have their scrubs and whites at the same time!

Hi Guys---Back in the 70s when I worked in the Johns Hopkins Pediatric ER we had MANY volumes of ridiculous/audacious calls on the poison control phone as well as regular phone. Being a teaching institution, pediatric interns rotated through monthly. Some of these docs were not very street smart, having had their heads in textbooks for a long time. One of my favorite calls that I witnessed went as follows: Caller-Hey, doc, our baby ate my girlfriend's diaphragm: what we gonna do? Intern-What do you MEAN the infant ATE your diaphragm?!?! Caller-He's 2 years and has teeth and he ate the diaphragm; now what're we gonna do? Intern-Well, you'll have to watch his stool and check for it to come out the other end. Check through it and it should show up in a day or two. Caller-Yeah, but what 're we gonna DO, doc? Intern-I tell you, he'll pass the thing. If he doesn't, bring him in and we'll x-ray him to locate it. Caller-Yeah, doc, but what're WE gonna DO???.......... Never dull!-----Patrice in Alaska

Hi There---this idea may be of help; see what you can find at these websites: http://www.mygovernmentgrants.com, http://www.nextstudent.com, http://www.findtuition.com, http://www.freegovmoney.net, http://www.usagovernmentgrants.org. There IS free money out there and you can go after it. The social worker at any hospital can assist you with applying for welfare if you decide to go that way. Laurie Blum's website is quite useful, too. She's written books on free monies for just about anything you could imagine---even rent, utilities etc. Don't give up if you really love this profession. No matter how the world goes, politics etc., we will always need you if you're a nurse. You can't beat marketability like that w/ a stick! Talk to any college grad who can't get hired because he/she doesn't know how to DO anything society needs. And as Joseph Campbell wrote "Follow your bliss!"

Hi There---If you haven't heard of this do look into the programs out there fornursing internships. Medical Colleges of VA, Johns Hopkins, LOTS of teaching institutions offer them for a year. They pair you w/ a preceptor RN and you plan out your learning experiences together. You progress at your own rate and there is much flexibility as far as assignments, trying work on other floors to see what you think without committing to them long-term. Any search engine can list them for you to look at and you can probably find one in your area. Assuming you do well you will have a position after you finish the internship. You are paid while you do this as you arehired by the facility teaching you. It speaks well for you on resume and can save your sanity and your altruism in the end. Don't allow joy robbers to ruin your calling. I found in some of the NICUs an ERs I worked in there was this clicque-like mentality and freezing the new guy out. Kind of like marking one's territory. You are better off leaving those places because they won't change. It's abusive and immature and noone needs it. Let me know if you try out the internship idea. You can't lose if you do it and the transition to "the real world" of nursing will be much less painful

Hi There---Society as a whole in this country has been changing in "appearance" since the end of the 1960s. The focus on being free to do and look any way one wanted, braless or not, impacted so many aspects of life which hasn't returned to the more formal level it used to inhabit. I remember the days in the '50s and '60s when one dressed up to take a plane trip, go to church, doctor's appointments, etc. Re. the last one, the day my mother entered her OB-Gyn's office in a housedress, hair not up to par, no makeup on, was the day he took her request seriously and said "Pat, it's time for Premarin." Mom always looked dressed to the nines if going anywhere; that's as it used to be once upon a time. Hats and gloves are rare enough to be remarkable in many cities today. What a sad shame. There is no excuse for sloppiness in a formal meeting, and job interviews are just that. Some of this is a reflection of how many were raised with or without standards to aim for. Sure doesn't speak well for a sense of pride in oneself or a lady's confidence level!

I once nursed in a private psych hospital in NY; among others we received all the alcoholic and/or suicidal priests and nuns in that archdiocese---talk about sad. Damned if you do and damned if you don't! Anyway, I agree 100% with your observations. We were taught that the brain is the biggest chemical factory in the body. It shouldn't seem so outlandish that some of the time things don't always work as planned. Every other organ in the body has a huge list of diagnoses that might go wrong; why would anyone think the brain should/would be exempt from any number of equally dire problems? It is incredible to be the witness of active hallucinations, and the analogy of behavior during hypoglycemia was right on the money! Did anyone see Oprah's special on this subject, including attention to AY's tragedy? Check out her website on this. One woman's spouse was a surgeon and he never figured it out. Now his wife is dead and he's raising a daughter. I am amazed at the general lack of compassion among the majority I've read here. Believe me, I am not "a bleeding heart liberal." I worked in the prison system and in four ERs. I have seen involutional melancholia and catatonia twice in 12 years working all areas of maternity. Amazing how fast those two came around enough to speak, stop soiling themselves, ask about their babies, realize that they needed a shower and a meal--- after an IM of progesterone-in-oil. Also remarkable how painful PMS mental sx's reverse after progesterone suppositories are utilized. My point is that comprehending the biology behind hormone fluctuations and mental distress is just getting going. Study these subjects a bit more deeply before judging someone's neurochemical reactions to life.

Hi There---All the "travellers" I've worked with in the past at Prov were pretty-much pleasantly surprised at how wonderful it is up here. MANY have stayed, married here etc., and that's after nursing all over the United States., ARH is union, Prov is not, although the union tried and nearly made it during the last decade. There's a sense of sisterhood/brotherhood that sets in living and working in "the Greatland." I'm from Maryland originally and I do miss my eastern siblings, but I doubt I could stand to move away from here. It'll either capture your heart and "follow" you as you compare everything to Alaska---or it won't. Hope you love it as much as we do. Get a 4-wheel drive and come with an open mind.-----Best---an Alaska nurse