osiris7

A staffing service here in San Diego is offering $50/hr. I'm guessing that's because they haven't had much luck either getting or keeping nurses. I've never worked in corrections before, but I am interested in it, esp. at those pay rates. Some of the thought of it is a little off-putting, but maybe I'll check it out. :idea:I am a male nurse, by the way.

i'm hearin' ya. i also hate the driving. in addition to the on-the-job driving, i also make a 40-minute drive to and from work (i commute). thankfully it's mostly a reverse commute (against traffic), but it's a lot of driving and i don't like it. driving kind of weirds me out with anxiety anyway, and i often stay in the slow lanes. yes, even us guys get anxious :i i find it's important to remember that you can't make everyone happy and you also can't solve every problem, esp. ones that were there for years before you showed up. also remember that while "the buck stops here" with the cm, you're also part of a team. if you can push second visits off on per diem or an lvn, do it. having a home health aide in the home is also helpful, and getting the msw and/or chaplain involved is also a good thing. you can't do this alone. if you have more than 13 or 14 patients, it's too many. talk to your supervisor and express your concerns. you might be surprised how much they might be willing to work with you. you're just one person, not super-nurse.

Yeah, uniforms are important in the world. Up until not that long ago, nurses wore the cap, which few do anymore. I'm a man, and there's a definite blind spot for men in nursing. People always ask "So you're going to med school?" When I tell them I'm a nurse. Maybe I should wear a nurse's cap! Hehehehe. I can wear a labcoat and everyone DEFINITELY assumes I'm a doctor. Works well for picking up drug rep freebies. By the way, I'm a nurse who doesn't wear scrubs and doesn't work in a hospital. I am a hospice homecare case manager and just dress in casual dress clothes. Once upon a time there was a drive to make the bachelor's degree the entry degree for nursing, to make it more like a true "profession" for which the bachelor's was always assumed to be the entry level degree. That didn't work. Nursing has had this problem with not knowing if it was a white collar job or a blue collar job. Engineering had this problem for a long while also. And so it goes on.

Condoms are probably fine, because they involve MALE control of fertility, which is really what it's all about. As someone once said, "If men could have babies, abortion would be a sacrament". Women in control of their fertility is a threat to the patricarchy. --Kal angie wrote: >>>>What I don't get is that while they don't feel right about selling BC pills, it's still OK to sell prophylactics in the store? After all, using them could interfere with causing a viable fetus as a result of sex.

so where can I find these recommendations? >>>>>Medicare doesn't regulate caseloads, they just make "recommendations" Lyn

While I thoroughly object to the idea of oversedation without cause, I must say that Haldol is often used for terminal agitation. The research clearly indicates that thorazine and haldol are preferred meds over benzodiazepines for terminal agitation. She may have been closer to death already than anyone realized.

Dedadron is amazingly good stuff, in my opinion. It 1. Helps with neuropathic pain 2. stimulates appetite 3. increases overall energy levels 4. decreases inflammation 5. decreases nausea --we even use it in a custom-compounded anti-nausea suppository along with reglan and benadryl. Works great! I've just seen some amazingly immediate, positive effects on people. We use it frequently at our organization. It does not have quite the same mineralcorticoid effects as does prednisonse (moon face, etc.). While emotional lability is certainly possible, you'll know pretty quickly if this is present. The other negative effects are usually over the long term, and most of our patients are looking at the long term.

I am a hopeful agnostic. I have received such gratitude from family members for caring for their loved one, that I know that the person lives on in their hearts, and that the living have the knowledge that they provided the best for their family member. That is worth it all to me. I think that you can't discount how being working in hospice brings up feelings about our own mortality, in one way or another. There is some degree of projection that is inevitable. When I have just seen someone die after years of frailty, and I see the photos of that same man as a healthy, happy young man, that is not an easy thing. I would urge you to explore your own inner beliefs about what you value, what you feel is more important or than your own existence, or what might transcend it. Don't confuse religion with spirituality, they aren't necessarily one and the same. I guess, for myself, I just don't feel that there is any particular reason that I should live on forever, but even if some part of me does, I don't think I can do much more than live a life that makes sense, and spread some love along the way. I usually just feel that when I look at younger people, it will be their world eventually, and they will hopefully care for it as I have tried to. Kal in San Diego

I think a lot of people just have a problem with the word itself: Morphine. It brings up a lot of preconceived ideas. I am agnostic, but if I'm with someone who believes in God, I often say that it is a natural substance that was put on earth to help us. I usually say that they can try a small amount and it will work quickly, but it will also leave the body within a few hours. I reinforce the idea that at the doses they will be using, it will not hurry death along, it will just make it so that the person can be comfortable.

I seem to be averaging around 14 patients right now. Of course, our entire agency has over 600 patients on service at the moment. :balloons:

I work for a non-profit, and I can tell you---I've heard stories from patients as to why they left the for-profit agencies. They were told they couldn't continue chemo or radiation ("call us when you're done with that") , they felt pressured to have a DNR, they didn't have a dedicated hospice inpatient facillity. These are just some of the things I've heard. You are absolutely correct in terms of billing and funding---we work exactly the same way, except that actually the non-profits have a sort of built-in advantage because they often receive a lot of charity and benefactor money. I think that this fact alone often allows them to be more lenient: They often have deeper pockets.

Kevin wrote: >>>>>The short version is that in my life, I have already had to (and still must) >>>deal with two government run healthcare systems. One in the military, and >>>the other the VA. Any time government employees get involved in health >>>care, the system motto seems to become "we don't care, because we don't >>>have to." Given what I have seen, I don't want our government anywhere >>>near most of my health care issues. I worked in the VA system, and I don't recall anyone saying or acting as though they 'didn't care because they didn't have to'. We worked hard to provide the best care under difficult circumstances and under difficult budget restraints. Can you imagine a system where caring for working military and veterans was a priority, rather than afterthought, somewhere far down the list past whatever new, overpriced, unneeded weapons system they wanted? The House of Representatives recently voted on the 2004 budget which will cut funding for veteran's health care and benefit programs by nearly $25 billion over the next ten years. We're quick to support a war, but slow to support those who fight them. Does that seem right to you?

All interesting points on healthcare. I don't like that we have a system where: 1. We can't buy pharmaceuticals from whoever or wherever we want. Isn't that the American way? The claim that 'the safety can't be assured' is just plain bogus, and they know it. Canada has certified pharmacies that sell drugs that are often made here in the U.S. 2. We have a system where WE pay a for a great deal of the research that goes into developing pharmaceuticals, but then pay exorbitant amounts for them. 3. The pharmaceutical companies claim that they spend so much of their high profits on research, an untrue assertion. They actually spend more on advertising than they do on research, usually. 4. Some people cannot find insurance, even if they want to pay for it out of their own pocket. That's just wrong. 5. An individual wanting to pay for his own health care--cash--will be billed FAR more than the hospital will bill an insurance company for the exact same procedure or hospital stay. 6. Where we take what is truly socialised education for granted, but are terrified of the idea of socialised medicine. 7. People use the emergency room as a doctor's office because their employer won't let them buy into a health insurance plan. 8. Companies like Wal-Mart make money hand over fist while their poorly-paid and uninsured or underinsured employees use emergency rooms at taxpayer expense. 9. Our country becomes less competitive because companies would rather locate in a country where the government pays for health insurance (e.g., Canada). Automakers have already discovered this. 10. We pay far more, as a percentage of our GNP, for healthcare than any other country on the planet, and that percentage has kept rising. some stats: At current rate of increase, number of years before more than half of all Americans are either uninsured or seriously underinsured 20 Number of other fully industrialized countries that do not guarantee minimum healthcare to every single citizen 0 Annual per capita income in Shanghai $350 Annual per capita income in New York City $20,500 Money spent on medical care in Shanghai annually $38 per person Money spent on medical care in New York City annually $3,000 per person Number of infants born in Shanghai who die before their first birthday 10.9 per 1,000 births Number of infants born in New York City who die before their first birthday 13.3 per 1,000 births Life expectancy at birth in Shanghai 75.5 years Life expectancy at birth in New York City for people of color 70 years Life expectancy at birth in New York City for whites 73 years Percentage of U.S. GNP spent on healthcare in 1935 3 percent Percentage of U.S. GNP spent on healthcare in 1965 6 percent Percentage of U.S. GNP spent on healthcare in 1995 14 percent At current rate of growth, number of years before U.S. healthcare costs would exceed nation's entire GNP 75 Percentage by which per capita U.S. healthcare expenditures exceed those of Canada 40 percent Percentage by which per capita U.S. healthcare expenditures exceed those of Germany 90 percent Percentage by which per capita U.S. healthcare expenditures exceed those of Japan 100 percent Primary reason U.S. automobiles are more expensive than Japanese cars considered to be of comparable quality Higher employee healthcare costs Year the average Fortune 500 company's healthcare costs are expected to equal 60 percent of after-tax profits 2000 Average amount of time U.S. patients are allowed to speak before being interrupted by their doctors 18 seconds Percentage of U.S. patients who, once interrupted, go on to finish their statement or question 2 percent Widely held belief among Americans The U.S. has the best healthcare system in the world U.S. rank among world nations in per capita expenditure on medical care 1st U.S. rank among world nations in malpractice suits 1st U.S. rank among world nations in infant mortality 25th

The address for Fitchburg State University in Massachusetts is: http://www.fsc.edu/catalog/Grad/nursing.html They also offer a certificate in forensic case work. Kal

Hi, I'm an RN with six years of experience, primarily in ICU and telemetry. I am interested in becoming certified in hyperbaric nursing. Any information would be appreciated. TNx! ------------------ wherever you go, there you are.