nurseratchett29

I am a LPN in a "start-up" hospice in Mass. I share a caseload with a RN. We have about 20 patients. She does the initial assessments and the biweekly CNA medicare supervisions. Although according to regs I cannot sign careplans or do the initial assessment, I am able to do a lot of other things that are time consuming...For instance, often times, family members are unavailable to sign the hospice consent during business hours or are in an area that my partner is not going to be in on a particular day. I am able to do the signon, review the chart, set up our med list etc. and that takes a lot of pressure off her. We share the visits so that there is always a fresh viewpoint coming. We have a pretty large territory between us so sharing the caseload frees up mileage and makes it easier to do the unscheduled visits that always come up. It balances out also because I am incharge of the CNAs.Although I cannot do Medicare sups. I am basically their direct supervisor who they report to and am in charge of follow up with their cares to make sure facilities and families are happy. I also co ordinate their schedules and track the CNA medicare sups to make sure we are in compliance. It makes for a good fit because we work so well together. I love my job!!!!!

I have worked on this issue for years with a certain organization who shall remain nameless. We have come along way but there is more work to do. White People still do not get it. Racial stereotypes are demeaning and need to stop. White people do not understand what the big deal is---they don't even blink an eye at the "Fighting Whites" (U of Northern Colorado) because they don't get it--it is just another perpetuation of the centuries long struggle against racism. I wonder if they will ever understand. b

Very Odd==When I worked up at the Brigham a few years ago, most of the nurses I oriented with were new grads and last fall when I oriented with UMASS in Worcester over half were new grads. Don't give up--many hospitals have new grad/preceptor programs and I believe that both UMASS and the Brigham had them. Try some of the job search sites they may help. b

good luck!!!!!!!!!!!!!!!!don't forget to remember how valuable you are and make sure they know that!!!!!! b:gandalf:

I just accepted a job for $14,000/yr MORE that my current salary!!!!!!!!!! I was solicited out of the blue by a Fortune 100 company who saw an old resume on Monster.com. The interview went very well and I received a phone call with the offer 3 hours later. I was in shock and had to ask her to repeat the figure because I thought I was hearing things. I have been working a second job to supplement my income for the past 2 years so I can buy a house and still spend money in the style that I have become accustomed. Don't get me wrong, I was not destitute before this offer--but this salary offer is more that my full time and parttime job salaries combined!!!!!! They actually offered me even more than I had requested!!($5000/yr more). The moral here is this--Do not be afraid to ask for a higher starting wage if you have the experience to back it up--if you market yourself well, you can make a VERY decent living as an LPN (depending on your local market of course). WE are still very important members of the nursing community especially with the shortage. :gandalf:

I live in New England and just discovered those suede clogs with the rubber soles that everyone else has been wearing for a couple of years. They feel like sneakers but are somewhat waterproof and don't look bad with pants. I got a "generic" pair at that store that begins with Wal (do not want to violate the rules here!!!) for about $12 and they are great!!!!!! Lightly insulated and great!!!!! b

I ordered a stethoscope from them and had the same problem---Contact your credit card company IMMEDIATELY and file a claim. I took me over a month but I did get my money back. They are horrible--no one answers the phone, and when they do, they are rude. They make empty promises and never follow through--I will never do business with them again--but please, CONTACT YOUR CREDIT CARD AND FILE A CLAIM.

Just wanted to share----Had a hairy moment the other noc. Have worked for 6 years in peds homecare and have had my share of emergencies but this was new to me but I guess it happens: Was changing trach the other noc on my wonderful 7yr old patient. He uses a Shiley 4.5 PDC. We always schedule this procedure when myself and his Mom are present to decrease his anxiety and make the procedure smoother. We usually work together with one of us removing the old trach and the other inserting the new one. I removed the old one and when Mom tried to insert the new one it would not go in. We are both very experienced in this and my little guy is used to it so it usually goes well but this time, it would not go in. We ended up having to temporarily insert a 4.0 non cuffed just to keep the stoma patent and called EMS. He has recently had a growth spurt and needs to have a stoma dilation because of his growth. It was a little hairy but all turned out well--Just wanted to share with others that this can happen after a growth spurt and that a seeminly routine procedure can always go south in a heartbeat. It reminded me of the importance of having backup plans and a back up trach tube of a smaller size to keep airway patient in case of emergency. It may sound redundant, but sometimes we are not mindful about these things when things are going great with our patients..

I work in an endocrinology practice currently but also do Pediatric homecare and skilled visits--Here in Massachusetts, LPNs are used for many different areas--most specialized areas require experience--if you want to branch out, start out in LTC that has a sub-acute floor or rehab. This will give you more clinical experience on paper that other areas want to see. Get as much experience with skills certification as you can and dont turn down opportunities for training in specialized areas (IV cert, ACLS cert, etc.) It may take some time to pay your dues but it will pay off--the only problem is that eventually, you will be at the glass ceiling and unable to move any further because of license limitations--this is where I am now. I am working on my degree so I can advance after 10 yrs as an LPN> Good luck

Before you buy anything from these "College Network" type companies, check with the Colleges directly first. You will find that the preparation costs are much less if you buy study materials directly from the college you are considering.First of all, College Network tried to sell me a course I didnt' need for my degree.It was in the same category that I was lacking in (humanities) but when I went to Excelsior's website, I found that one particular humanity course was required and it was not the one they were trying to sell me. In addition, they suggested taking Microbiology first--good advice but nothing I couldn't have figured out by myself--the price for their microbiology preparation was $415. I ended up gettting the preparation from I Study Smart for about $320. After I bought the materials from them, I found that if I had registered with Excelsior directly and got the materials from their bookstore, it would have been under $250. Indiana State University does have a good program but it is only for LPN to BSN if what College Network told me is true.Good luck in whateever you decide b

I am doing this right now.Taking my first class. Been an LPN for 10 years and am totally capped out on salary and am at the glass ceiling.The only way for me to advance is to get RN.MY advice is as follows: 1.Homestudy takes a LOT of self discipline.You will succeed if you are able to spend a lot of your free time in selfguided study.If you are not able to do this, a traditional program may be better for you. 2. Check out the college and university web sites before buying anything from companies like the College Network or I Study Smart.You can often get the same thing from the college directly and it is much less expensive (My microbiology class cost me $320 with one of those companies but Excelsior College only charges about $250 for almost the same preparation.In addition, when I am through, the exam fee will be $215. 3. The costs of this type of degree are higher than that of a local community college. There are enrollment fees (almost $900 with Excelsior) in addition to student activity fees graduation fees etc. In addition, the clinical fee is about $1500 at Excelsior.You would also have to pay for transportation to Albany and lodging because it is a 2 day clinical testing program. Often times your employer will only pay for "tuition reimbursement" and since this type of degree is often selfguided, you are often on your own for costs.4. If you are planning to continue to go through to RN, my advice is to do it as soon as possible--life steps in very easily and you very easily put it off and procrastinate until one day you wake up and 10 years have gone by. I hope I have given you some insight. beth

Hi everybody!!!!!!!!!!!!!!!!!!!!!I'm back!!!!!!!!!!!!!!!!!!!!!!It's been crazy lately and haven't had time to pee. Doctors are more VALUED but we are much more VALUABLE. It's a status issue. They do get paid a lot more (for the most part) but I do know of one particular system that moonlighting attendings get only $17 an hour (not a typo). They also have a VERY high overhead. Most are paying off loans that we cannot even fathom. New PCP's starting out are at the mercy of patients who book appointments and don't show or late cancel. Our newest doc in our practice sometimes only sees 4 patients all day because he's still building his practice but gets stuck with everyone else's sick patients. The specialists make much more money and have much more prestige but again, there is another 2 years of training to be able to be certified. ==Gomer--although your analysis of the ration of M/F MD's /Nurses is correct in general, it does not take into consideration the different areas of specialty. Most Primary Care Physicians (in the Boston area anyway) are now WOMEN. The men are opting for the specialties and also (in our area anyway) it is very difficult to get people to book with male primary care docs. In certain areas of nursing, there are more MALES than females. I have been in ICU's staffed only by men. I see 4-6 patients during the course of my day personally for nurse appointments. This is in addition to processing 30-40 prescriptions a day, managing the flow of patients for 3 doctors, handling all triage calls, and doing all followup lab correspondence. I often spend 1/2 hour with each patient booked in to see me but get paid by the hour while the doc's bill insurance for the nurse/doc. visit. They have to order everything I do so are ultimately responsible for my actions and accordingly, they get paid for it. Whatever I do for the patients that THEY see, gets added to THEIR visit's encounter form and they are able to bill for treatments that I do. Doesn't seem fair, but that's the way it is.

I drive about 40 miles each way. Depending on the time I go in, it takes me from 50 minutes to up to 1 1/2 hours. Going home is a different story==Takes me from 1 hour 15 minutes to 2 hours depending on the time I leave. THE MASS PIKE IS HELL!!!!!!!!!!!!!

I AM NOT OLD. I AM NOT OLD. I AM NOT OLD. I AM NOT OLD. I AM NOT OLD.I AM NOT OLD. I AM NOT OLD. I AM NOT OLD. I AM NOT OLD. I will convince myself of this@!!!!!!!!! 17 Out of 25, My god, I'm ancient!!!!!!!!Even the ones that I never personally saw I have heard of.

I have worked in both types of places. The thing is that our names, titles, addresses and disciplinary record are public record (at least in MA). I see no reason to have to show your last name on your badge if anyone can get it if they really want it. Let them do the research. I have done psych and substance abuse and do not want it to be that easy for someone to just show up at my house. If they have to go through the state, at least there might be some kind of record that they requested the info.

Interesting thread. I have some definate opinions. I, too, am from Mass. and work in a primary care practice. The medical assistants (most of whom are CNA's or PCA's) are legally allowed to give injections here after just being signed off by the nurse manager. They also have the responsibility of calling in prescriptions for the docs. They'll say "Call in Cipro 250mg BID x 5 days" and the MA's just do it. They have absolutely no concept of interventions, contraindications, lab values etc. I think this is very dangerous and have expressed my opinion to be told "The physician is taking responsibility, you don't have to worry" But of course, I worry about my license. And injections!!! A high school drop out with 9 months of general classes at a "health care institute" does not constitute a competant professional. I am very well paid, and sometimes I feel like they are giving these MA;s more responsibility so they can cut my position. I know that in RI when I was a new grad, they had CMT's (certified medication technicians) who did general meds and nebs and that type of thing. We had to give narcs, injections, and Iv's and it did save a lot of time for us. I was fortunate, I had two nursing students as my CMT's because ultimately, I was responsible for every med they gave. Scary, isn't it.

As I mentioned earlier, I have several tattoos and totally agree that if someone came in to interview with me for a job that tattoos and piercings would have to be concealed. I have a pretty crazy personal life but once I walk into my office, I become a professional and a (hopefully) respected member of a practice. My appearance is often the first impression that new patients get of our practice. And, let's face it, many people still have a preconceived notion of the type of person who gets tattooed and pierced. DON'T MISUNDERSTAND, I DON'T AGREE WITH THIS NOTION, but it exists. People also have a preconceived notion of what a nurse should look like and although it has loosened up a little, we are still expected to maintain a professional image. OH MY GOD, DID I JUST SAY THAT? WHEN DID I GROW UP AND GET OLD?

In many states, it is illegal to get a tattoo, even with parental permission until after the age of 18. I have 5 (so far) and will continue to add to the canvas that is my body. One draw back is that many hospitals/bloodbanks do not allow you to donate if you have been tattooed within the last year. I am in favor of waiting for adolescents because it costs thousands of dollars to remove them if you change your mind. I elected to get them in viewable as well as unviewable areas even though I have to wear a lab coat when I wear short sleeves at work. This was my choice and I don't regret it. My professional life is my professional life and my personal life is another matter. About piercing--for an adolescent to have a piercing done is more risky because of the infection potential. I have seen so many kids with infected ears from earrings that the thought of belly piercing on this group makes me cringe. I totally agree with Macair--taking her and making her watch someone else getting pierced may be a great deterrant.

Boy, I stay away for a couple of weeks and all kinds of stuff gets posted. What's this from RNCM about how we should be ashamed? I take my work very seriously and love what I do. My patients frequently thank me and for the most part are very nice. Of course, I get my share of pains in the ass but that comes with the territory. The point is that although my job is to take care of my patients, they are not the ones who pay me or who I have to answer to day in and day out. It would be nice to be shown some appreciation and gratitute from those who sign my paycheck instead of only being adressed when they feel there is a problem. Everyone needs to feel appreciated and that;s what nurse's week is supposed to be all about. Recognizing the hard work we do to try to improve people's lives. It is true that I didn't go into nursing to be recognized, however, a kind gesture (and one that doesn't include the old single finger salute) would be nice. It is cheaper to provide job satisfaction than it is to recruit and train new hires constantly. Just a thought.

Well, I waited a whole week. Still Nothing! I shouldn't be surprised. I did casually mention to one of the docs in my practice that the hospital hadn't given us anything and she gave me a pound of coffee. I guess that's good considering she usually treats me like her personal servant rather than her nurse. I was very impressed with the fact the during secretaries week, the girls in the office all got gifts from the hospital and the practice manager gave them mugs with candy in them and also gave the same mugs to us during secretaries week. I guess i;ve graduated to secretrary this year. Pretty soon they'll be paying me like one if I don't watch out. Any way, I thought that maybe, just maybe, this year would be different. I guess I was wrong again. They say the ultimate defination of insanity is doing the same thing over and over and expecting a different result. I feel like Linus sitting in the Pumpkin Patch all night waiting for the Great Pumpkin to appear. Oh, well, some things just never change. I can't wait until boss'es week so I can give the practice manager her invisible gift. Boy is it great to be appreciated!!!

Since one of my hobbies is knife throwing, the surgeon would be in a hell of a lot of trouble if he/she even thought about throwing something at me. Another surgeon would be needed to extract the thrown instrument from their forehead!!!!

I can't wait till I see how this new hospital shows it's appreciation.They had a icecream social at the busiest time of the day today for the whole staff and the secretaries got towels for secretaries day a couple of weeks ago so I HOLD MY BREATH WITH INCREASING ANTICIPATION WAITING TO SEE WHAT THE INCREDIBLE WEALTH OF USELESS JUNK AND FREE FOOD THAT I DON'T HAVE TIME TO EAT WILL BE. If they wanted to show appreciation, they could give us flex time once in a while or offer some "stay signed" bonuses. They offer all kinds of sign on bonues but what about giving us a bonus for appreciating the fact that we show up every day?

How about a luncheon that's held in an agency office during the noon hour when only the office staff can participate. All the field staff are at their client's homes or at school with their patients and can't leave. Or how about $10 off CPR recert (WHAT A PERK!!)Or how about a nice highligter? WOW!!! I COULDN'T HAVE LIVED WITHOUT THAT ONE!!! And it was nice to be able to provide free advertising to the agency whenever I used it!