aaa rn

The State I reside in has many counties and each has its own definition of what role the PHN will play in their community--Some have nurses working in many aspects of community nursing (several already mentioned) and others have specialized programs--Homeless, TB, Maternal-Child, CPS-Fostercare, Adult Services, CD, Clinics, etc. PHN work can be rewarding--but just like any work sites, there are downsides--for example, gov't work operates at a slower rate, the wage tends to be a little less than the hospital setting, harder to get rid of bad supervisors, creativity can be stiffled b/c it is tax payer based, higher education is often not reimbursed, nor higher wages for advanced certs, programs are at the whim of public opinion, Having said this, the role is worth all of the above. Often, the public is greatful for your help.

Having worked the psych setting for a couple of years, my advise is for any worker or student to be aware of your surroundings at all times--know your codes, know who is your back up, know your exits etc. I would say about 75 % of the time, the units were well secured and potential problems averted--However, the other 25 % could be a ride. Most nursing sites / jobs encounter mental health issues--sometimes even among your peers--this rotation should be a great learning experience.

I took AP I and Micro at the same time, by the same teacher. The teacher tried to dissuade me from taking the two courses. I did not relent, I just considered myself forewarned. My persistance payed off--I got an A in both courses. The key to my success was the use of a tape recorder (now called a digital recorder)--So, my advice is for you to go to an electronic store and ask the sales person for a reliable, long recording, user-friendly device. You will not regret the investment. Good luck and don't forget to breath!!!

The last two posts indicate one nurse is residing in Sonoma County (I know this lovely county well) and the other from Solano County. My remark was actually a compulation of info garnered from either direct conversation with existing PHNs from No. Cal or by recent job listings citing PHN openings. The counties include: Marin (very recent listing in the paper) County; Yolo County--in fact a friend of mine recently went on a job interview and they are interested in hiring her. Sacramento County--frequent openings in several programs--I've even seen listings in Nurseweek (it's been awhile though), Placer County--I've met PHNs at conferences over the last few years and they have indicated recent hirings. My advise to you is to call the various programs (not Human Resources--too bureaucratic) and ask the Nurse of the Day if they can give the name and number of a nurse supervisor that can actually give you real info such as 1) are there openings, 2) what programs does the county offer, 3) other than a PHN cert, are there other requirements? Let me know if I can be of further assistance--PHN work is great. I'm not sure why more BSN prepared nurses don't make more of an effort to try this type of nursing--the personal rewards are quite satisfying.

I've done two reports recently--both found in all aspects of nursing, 1) Access to health care--who gets care, who doesn't (distributive justice); 2) Domestic Violence, many mandated reports are not assessing for this problem, many hospitals have inadequate protocols to address this issue when a postitive finding occurs, the community is woefully underfunded to assist at the macro-level. On both reports, I recvd very high grades--lots of info on both of these topics. Good luck. ae

Hi Grannypatches...WoW, I can't believe how archiac some nursing programs are. I've worked two sites that expected narrative charting. One employer expected us nurses to use DAIR charting, The other, SOAIP charting--both have similarities. D = DATA. What did you hear and what do you know to be true (empirical evidence garnered thru the five senses and known facts). A = ASSESSMENT. So, as a nurse, what did you think of the above data? I = INTERVENTION. So, what did you do about the situation? R = RESPONSE. How did your patient respond to your intervention? S = SUBJECTIVE: what did the patient say? O = OBJECTIVE: What are the known facts and what is the empirical info? A= ASSESSMENT: See Above I = INTERVENTION; See Above P= Plan: What is the next step? Using the two templates, for expample, the narrative would read something like this: Mary Smith c/o HA. States she has tried to relax but the headache is getting worse. Mary Smith grimaces as she talks. MAR with PRN Tylenol Q 6 hrs- HA. Mary Smith has had a HA x 2hrs, could benefit from prn Tylenol. Provide pt with 500 mg Tylenol. Response: Effective or Plan: F/u with Tylenol results in half hour, contact attending if no relief. Granted, this scenario is simplistic, but I hope it helps. Good luck.

Hi Grannypatches...Wow, I can't believe how archiac some nursing programs are. I've worked two sites that expected narrative charting. One employer expected us nurses to use DAIR charting, The other, SOAIP charting--both have similarities. D = DATA. What did you hear and what do you know to be true (empirical evidence garnered thru the five senses and known facts). A = ASSESSMENT. So, as a nurse, what did you think of the above data? I = INTERVENTION. So, what did you do about the situation? R = RESPONSE. How did your patient respond to your intervention? S = SUBJECTIVE: what did the patient say? O = OBJECTIVE: What are the known facts and what is the empirical info? A= ASSESSMENT: See Above I = INTERVENTION; See Above P= Plan: What is the next step? Using the two templates, for example, the narrative would read something like this: Mary Smith c/o HA. States she has tried to relax but the headache is getting worse. Mary Smith grimaces as she talks. MAR with PRN Tylenol Q 6 hrs- HA. Mary Smith has had a HA x 2hrs, could benefit from prn Tylenol. Provide pt with 500 mg Tylenol. Response: Effective or Plan: F/u with Tylenol results in half hour, contact attending if no relief. Granted, this scenario is simplistic, but I hope it helps. Good luck.

Under nursing news, there is a post that is very similar to your post/ It starts out with the bi-line that a female pt died, ignored ... you might be very interested in this discussion--mirrors many of your thoughts.

One.of our best nurses has bilat hearing impairment. She has learned to read lips and is quick to remind those around her that she needs certain considerations to communicate such as face to face talks etc...she also has a special steth. This particular nurse is very caring and sensitive to those with disabilities. Don't let your hearing loss keep you from being the good nurse you are destined to be.

Hi Jenner I too graduated from a nursing program and went straight into Psych nursing. I really enjoyed my two years working a PICU department. Your perceptions of how this classification is perceived by other nurses is dead on right. Often the psych nurse is de-valued and under paid. So, not only is the patient marginalized by society but so are the healthcare professionals that dare to render care. I remember my first week as a Public Health Nurse (following my psych experience), another nurse was having a medical crisis and she wanted another new hire (with 5 years med surg) to assess her rather than me (b/c I was just a psych nurse)...well as it turned out, when all was said and done, my assessment skills turned out to be better than the other new hire. Why, b/c in the psych setting, we nurses are reliant on our nursing judgement--away from the technologies found in an acute care setting. Most people (nurses included) don't realize that the mentally ill come to MH settings with a host of medical issues--HTN, hepatitis, Diabetes, AIDS, pregnancy, communicable diseases like TB, dual diagnosis where chem dep is just as bad as their suicidal ideation--and the list goes on, much like an ER department. I once had a unit of twenty patients, three were DNR b/c they were actively dying. Bottom line, hold your head high and know that your skills (psychmotor, communication, caring, meds) honed in the mental health milieu are just as valuable as any hospital nurse. The other tasks such as IV lines, feeding pumps and the like can be learned with a couple of in-services and return demonstrations. In today's market where there is a nursing shortage, go into job interviews with a list of skills, types of clients that you have rendered care to, and let the free market do its job--mainly, treat you as the valued RN that you are. Good luck.

Hey BodyElectric, I work as a PHN (many years) in No. Calif. And there are many reasons why I have stayed--some listed by your post. Our county is male friendly and have had several male PHNs over the years. Some of the males promote out of field into management positions, some have left for advanced degrees/positions in non-acute nursing jobs, and one that I can recall, left relunctantly b/c of personal reasons. My advise is to follow your passion. If the area that you reside in doesn't have a male track record--then be a trail blazer and show the nay-sayers that men belong in every aspect of nursing--even maternal/child programs if that is your leaning. Remember, the women's movement of the 70's was not exclusive to females but to also males in female dominated fields such as nursing, flight attendant and primary education to name a few. A side benefit to males in a predominate female role (in my opinion) is that males tend to raise the pay bar at the bargaining table during wage negotiations. So, I for one, welcome your XY gene pool into our overly estrogenized PHN field. PS I've been told by other county PHNs (from other counties in No. Cal) that acute care experience is no longer a requirement--only a recommendation. Best to you in your nursing endeavors.

I'm so sorry you did not pass--what a disappointment! Can you recall any specific areas that you felt deficient in? Perhaps you can re-review those areas. I remember when I studied for this test--I was less than confident with cardiac and ortho--so I studied especially hard in those systems. I also bought small books that gave quick, key info--designed for the test taker--I found those very helpful. I also agree with the post that suggest studying with a group or a trusted, serious nursing student. Best of luck to you on test #2.

1-5 Agree 6,7,8 strongly agree 9 -- agree, however, much more needs to be done to attract qualified RN educators 10--strongly agree. Good luck with you thesis

Hi Mcknis In my humble opinion, one can never be over qualified because of education. And, if you ever come across a prospective employer that says you have too much education and not enough experience for general nursing (such as bedside), my advise is to high tail it out of there. From my readings regarding our nursing shortage (world wide), employers should be more than willing to help get you up to speed with entry level skills. Additionally, hospital nursing is not the only show in town. There is also community nursing--local ie schools, county ie PHN, state nursing ie Dept of health services and there are federal jobs. Also lest I forget to mention private sector jobs such as Occupational health, blood bank, teaching, etc My only other advise (not requested by you) is that you wait just a couple of years between your BSN and your MSN--as a student and as an experienced nurse, I see a difference in the student nurses that have waited and those that have fast tracked themselves (critical thinking, creative thinking, demeanor, and enjoyment of the advance learning experience). Welcome to the adventures of nursing--keep your goals high and enjoy the journey--You have many options. aaa rn :welcome:

Hi Mcknis In my humble opinion, one can never be over qualified because of education. And, if you ever come across a prospective employer that says you have too much education and not enough experience for general nursing (such as bedside), my advise is to high tail it out of there. From my readings regarding our nursing shortage (world wide), employers should be more than willing to help get you up to speed with entry level skills. Additionally, hospital nursing is not the only show in town. There is also community nursing--local ie schools, county ie PHN, state nursing ie Dept of health services and there are federal jobs. Also lest I forget to mention private sector jobs such as Occupational health, blood bank, teaching, etc My only other advise (not requested by you) is that you wait just a couple of years between your BSN and your MSN--as a student and as an experienced nurse, I see a difference in the student nurses that have waited and those that have fast tracked themselves (critical thinking, creative thinking, demeanor, and enjoyment of the advance learning experience). Welcome to the adventures of nursing--keep your goals high and enjoy the journey--You have many options. aaa rn