tropicalfish

Quoted from Post #3. Most of the stuff I see in nursing is developmentally around the 13-14 yr old stage and very dangerous. I agree absolutely!! The level of functioning of nursing unit can vary widely, however, I likewise see, that nursing units function at "juvenile" levels---cliques, bullying, racisim, etc---much less the juvenile behavior of others, including certain MDs and VP levels and above. I don't have a full idea on the cause/s of all of this, however, a short list includes: --who has the power in the system and who doesn't---which makes people to feel inferior---with resulting behaviors increasing on "both" sides of the power --all of this has gotten worse as finances have gotten worse and management (whether in healthcare or business likely this applies---but more so in healthcare) and management thinks they can "slide by" with further abuses---very easily --nursing school (and I have been nursing faculty in the past) focuses solely on the patients, with only a tiny fraction being given (in some programs only) on the nurse's personal development; AND similarly, woefully inadequate information (if any) is provided and discussed about healthcare economics, financing in healthcare, payer sources, how to work with professionals in other disciplines, how to communicate with those who have the power, OR HOW to get nursing power. To me, this is just a set up for failure. Times have changed, but women's place in society--meaning hospital "society" has not appreciably changed. Why Not?? We all need to think about this and decide what we can do about it---both in individual practice and a group. One of the Major failings I see--over the span of years--is that nurses keep waiting (including academia and nursing professional organizations--especially the ANA) for somebody else to come to save them. That's not going to happen. There are "Haves" and "Have Nots". the "Haves" (of any kind or circumstance) are not interested in helping out the "have nots" (yes, we can think of some exceptions---but I'm talking about the overall way things work in healthcare)----they are too comfortable with what they have.

Hi, One of my nurse friends and I were discussing this topic. We likewise have opinions about the differences in cultures between healthcare and business. Both of us have been nurse for over 35 years. My friend has two adult children working in the business world---a young man and a young women. They are both professionally educated. They have both stated, independently of one another, that the racism, sexism, and bullying that is openly tolerated in hospitals is Not tolerated in the business world. If one of these problems come up it is severely dealt with---it is Not tolerated and it does not even come into the environment as much as it does in healthcare.

Thank you So Much BirdieGirl31, The information you provided is extremely useful. I will definitely benefit by your comments.

Hello sir1, Staff, I am glad to see this thread. I hope it grows greatly and fast!! When I saw it I immediately checked it out-----for help for myself. I hope to learn more from others in the future. Thank you for starting this thread!!!

Also, Wound Care is a FABULOUS choice for a business!!! I wish I were interested in that. But if we were located near one another I would love to do a joint venture with you. But back to wound care------ Have you thought about doing "Consulting" work with hospitals and clinics??? You get paid a "salary" by the facility. I have met someone doing exactly that!!! (You can still do your own private patients at another site---and have them pay you cash.) Also, remember the need for Liability Insurance. And, have you incorporated yet???? It is Essential. You get great "write offs" on your personal income taxes. Have your clients--whether private patients or consulting facilities pay your business. I have had a dream of helping nurses start businesses. I believe it is a way to either supplement your income or become TOTALLY FREE of institutional healthcare---which is my goal.

Addendum to previous note: third party reimbursement is not all that it's cracked up to be. The paper work is Immense. You would need an account service to do it for you, which is why some MDs are even refusing to take Medicare and Medicaid (though will take some private insurance because the patient can simply send the bill to the insurance company to be paid-----but what I've also seen is that the patients must PAY the doctor while waiting for the insurance to pay the doctor.

Hello, I noticed someone writing about third part reimbursement. I think that the RN needs to be an Advanced Practice Nurse, but I'm not sure. I worked as an APN with an MD in solo practice. The Accountant worked with me and I saw that both Clinical Nurse Specialists and Nurse Practitioners can be reimbursed for their services by Medicare, private insurance---but that this is through an MD practice only. (My MD did not take Medicaid, so I don't know about that. She was not making enough money to take Medicaid patients----it would not sustain a start up solo MD practice's expenses.) I also think that CNS and NP could get third party reimbursement (Medicare, private insurance) when they have their own business, but pay an MD to be their sponsor. (I agree that this is totally unacceptable, but MDs lobby and spend money to make themselves have all the advantages, much less nursings' history as a Female dominated line of work. I believe this problem will go away as nursing education advances, but especially when nurses UNITE. We are the largest single healthcare provider in the US and if we stick together we could shut the whole problem down.) But back to business....... I worked for 2 national healthcare insurance companies and at the time no one other than MDs and chiropractors (but very limited amounts of money) could receive third party reimbursement. Others were fighting to have this happen for them. These included acupuncturists (helped by the fact that some anesthesiologist's obtain accupncture training) and they sometimes did get paid, but on an episodic basis. I did meet once a few years ago at a nursing conference an RN who was doing battle with insurance companies--I don't know what happened with that. But it will take more than one RN. When I worked in case management in national insurance---the nurses trying to get approved for reimbursement were openly laughed at by both the MDs and Senior Management. I started a company in holistic care and I do private pay---meaning---get out your wallet or your check book or your cashier's check or your credit card and Pay Me. Also, I do not bill for services-----you need an accountant to help you then and I know I cannot afford that now. Once I make enough money to support my self I will start more substantial amounts of charity/pro bono/free or hugely discounted work. My feeling is private pay is a better option at this point in history. Otherwise, you need to look more deeply into how to get insurance to pay------this is a BIG endeavor.

Hello Research Nurses, I very much want to become a Research Nurse. I have a BS (in nursing) and many years of experience, especially in ICU. However, I want to make a major change and Research Nursing is very attractive to me. How do I find companies to work for? What qualifications would be especially helpful for me to have? What areas would be better areas of research for me to apply for? (I am a generalist at heart, so I would be interested not only in med0surg types of studies, but lab work, treatments, obgyn, women's health ,etc, drug trials, device trials, etc) When I go for an interview what are they going to want to hear?? (I put in my resume yesterday at a tertiary hospital with RN level research positions open in cardiology, geriatrics, and another posting that just said "research". I applied for all 3. I have looked on LinkedIn for companies---but it has been overwhelming to try to figure out: what is the job title I should apply for??? which companies are more likely to hire and train a newbie??? and what would I actually be doing as an RN (even tho they posted the job description) Any comments you can provide would be of great use to me!! (Maybe I should have made a separate post for each question I have) Thank you in advance for any help you can provide.

Holistic Nurses are often interested in practicing Alternative Modalities. Holistic Nurses often take training in Alternative modalities. This is also what I have done. Holistic Nurses often have an Entrepreneurial Spirit. And so do I. My life's work as a Nurse and Advanced Practice Nurse is to support the development of Nursing. The world is changing and Nursing is poised on the brink of expanding it's practice and it's importance in the whole health care arena!!!! One of the biggest ways will be in Holism and modalities, methods, of self-healing and self-responsiblity for one's own health care. I want to help people to help themselves!! Nursing, as its basis, is the helping/the support of people in their own healing. Florence Nightingale said, we are to put the patient into the best possible place for them to heal themselves (see her book, "Notes on Nursing". I was educated in Nursing in the late 70's and early 80's. There is nothing new about caring for the whole person---it is what nursing is. We are unique in all of the health care professions.

Any nurse can be a Holistic Nurse. You do not need to have a Masters Degree in order to be a Holistic Nurse. Holistic Nursing is the manner in which you practice Nursing. A Holistic Nurse uses the concepts of holism, the recognition of human beings being Bio-Psycho-Social-Spiritual Beings. Any nurse can study holistic nursing and put it into practice. There is a wonderful Home Study Course of Study that is available, and developed by, the American Holistic Nurses Association. I have taken this home study course and earned 65 CNE. You get 9 months to complete it. I easily completed it while working full time, starting my business (which any nurse can do too), and caring for my family, and doing volunteer work, among other activities. (I am a Network Leader with the American Holistic Nurses Association in the Chicago Metro area.)

To find local meetings of the American Holistic Nursing Association: GO TO http://www.ahna.org My Network is called: Chicago Holistic Nurses in Action We would love to see anyone in the Chicago Metro area to attend our meetings. There are local meetings across the country. Find one that you can attend. They are great for learning more about Holistic Nursing, Networking with other Holistic Nurses, as well as, other Practitioners.

i have been training in a variety of alternative and holistic modalities. as an independent practitioner i have an office space that includes space to present classes. i have space for 1:1 appointments with clients also. a good place to look for space is to rent from a holistically minded massage therapist. then as the business grows you can set up your own primary office if you want to. my main interest is ultimately to teach to the public, as well as, for nurses. the climate in the nation (and the world) is exactly right for the progression of nurses as independent practitioners. (i also still work as a bedside nurse. i focus on the whole person and the whole family and use my interpersonal skills, my compassion, my knowledge base to assist families with decision-making, care planning, etc----that nurses have always done.) when i attended a recent american holistic nurses association annual conference i spoke with a nurse researcher about her research results toward her phd. (the ahna conference always includes opportunities to see the research results of nurse researchers and to speak with them!!) she looked into all the usa states and found that all nurse practice acts state that rns can independently practice holistic modalities. look at your own state's nurse practice act and call your state to discuss the nurse practice act if you want to!!!! i currently practice in several body modalities (hatha yoga and tai chi for health), several energy modalities (non-touch energy healing modalities), aromatherapy/essential oils, bach flower essences, as well as some additional modalities----i am interested in many options. i am credentialed in all of these modalities. i have completed the home study course in holistic nursing offered by the american holistic nurses association and i am on my way to being board certified as a holistic nurse. the sky is the limit for rns!!!! we just need to think in a way that is different from the way we have in the past. the world is changing. healthcare is changing. the time is ripe for rns to bring forth the heart of nursing---which is the recognition of, the practice of, caring for the whole person and the whole family and the whole community. to be a nurse has always been to care for the whole person---the bio/psycho/social/spiritual being. for further information on holistic nursing go to: http://www.ahna.org

i am the network leader for the chicago holistic nurses in action local chapter. i’ve noticed many questions about holistic nursing education, availability of jobs in holistic nursing, availability of holistic nursing education, and requests for information about holistic nursing books while reading this thread. the american holistic nurses association at www.ahna.org is the place to go for all of this information and more!!

Fewer employer groups will make for lack of increase in pay and benefits. It will also decrease the choices that RNs have for jobs. It will also lend itself easily to black balling. (being unable to being hired because all employers will know your background). RNs need to seriously look at NNOC.org the National Nurses Organizing Committee for information on how to develop ourselves and our profession whether there is universal health care socialized medicine or one payer.

In Illinois the CNS is an APN. I took the AACN exam for Clinical Specialist in Adult Health. Then applied for an APN license with the state of Illinois. The application asks for minimal information (I already have an RN license in Illinois.). Once you have the APN license you can obtain the Controlled Substance license. An MD must sign a form indicating collaborative practice. I did not have to send in a copy of the collaborative agreement, but it must be on file in the MD's office. When I applied for my APN license I sent everything in at once: the application for APN license, the application for Controlled Substance license, and the MD form indicating collaborative agreement and which controlled substance classifications are included in the collaborative agreement. In Illinois the APN license is covered under the same practice for Clinical Specialist, Nurse Practitioner, Certified Nurse Midwife, and Certified Nurse Anesthetist. The application process was very simple. I filled out the forms, wrote 2 checks (one for the APN license and one for the controlled substance license), and had the MD fill out the appropriate form and sent everything together per FedEx ground delivery. I don't know whether there are programs that support prescriptive ability or not. My application was never questioned and the application gives no indication of any exceptions or special programs needed.

I remember so many of these things! and I have been laughing and thoroughly enjoying these posts. I graduated in 1976. I remember: using a combination of vaseline and sugar on decubes; we used a wooden tongue blade to mix it and apply it on the decube glass bottles and tubing for chest tube suction and drainage; clamping the chest tube in order to take the patient out of ICU to go to a test the MDs refusing to write DNR orders and the RNs refusing to follow DNR orders being in trouble with the Head Nurse if the nurse told the patient he/she had cancer the discovery of Toxic Shock Syndrome the discovery of Legionnaire's disease and everyone's fear of it taking care of AIDS patients and not wearing gloves I don't remember what we did with used needles before the stage in which we chopped off the needle and dropped it into a soft red plastic box hanging on the wall; the needles could poke through the plastic!!!! doing urine specific gravity in ICU with a glass tube and a weighted glass that the nurse dropped into the glass tube after putting urine in the tube (I forgot the name of it) I was in the first generation in my metropolitan area to Not be required to wear dress uniforms; I was allowed to wear white pant suits, but I had to wear white nurse shoes, no gym shoes allowed I remember when the nurse had to get the surgical consents and the MDs signed it some time at another location right before surgery when the woman signed a surgical conset for radical mastectomy and did not know beforehand whether she would wake up without a breast because a frozen section biopsy was done at the start of surgery and if it indicated cancer she got the mastectomy, but if it did not, she only had a biopsy done!!!!!!! when sometimes a woman couldn't have a hysterectomy unless her husband signed the consent and sometimes she refused surgery because she didn't want her husband to find out because some men refused to consider her a woman after that when patients stayed in the ICU even after being DNR, because there was no place to send the patient for hospice when cholecystectomy patients stayed on the med-surg floor for 3 weeks when only one or two patients out of 10 had IVPB antibiotics when there were no more than 4 RNs and 2 CNAs on 3-11 shift for 64 patients (I took care of 10 patients on a med-surg floor as a new grad); the "older" RNs protected me as much as they could; they took 12 or more patients if we didn't have 4 RNs on the floor

I've just read through more of the posts. I noticed that CNS is not an APN in all states!!!!! I'm in Illinois and as someone previously noted in Illinois the CNSs, NPs, CRNAs, Nurse Midwives are all APNs with the same license. I also have prescriptive ability (an additional license which required the signature of the MD I'm working with). She was interested in either a Physician's Assistant or an APN. Since I can have prescriptive ability in Illinois, including Controlled Substances she was able to choose me to work with her. I feel very bad that this is not the case in all states. The public really needs to know what nurses do and what APNs do and can do in the future. And I agree with the post that states she tells the patients that she is a CNS. I have a similar situation. Everyone assumes I'm an NP.

I'm starting as an APN in Pain Management in January. I'll be working with an MD who's in solo practice. This is new for her. She had been in a group Anesthesiology practice, but then went for Family Practice training and has now set up a solo practice in pain management. She is planning on Pain Managment consultations, Palliative Care, and Hospice. I will be working in her office and seeing all of her patients in the hospital. I will also see the Hospice patients in the inpatient hospice unit (which she set up). She said she is training me to do everything that she does except, of course, the epidurals. She is so excited about teaching me and working together!!!! I will see patients independently in the office. I will make rounds on all inpatients independently. She is training me and we will be working together side by side for about 3 months or however long it takes to know her habits. We are also both HIGHLY interested in holistic care. This is my special area and she has little experience or knowledge about it. She wants to learn from me and have me initiate holistic care for the office as well as apply it independently with our patients. I am also setting up an independent business in holistic care. I am starting with a website with resources for the public and I plan on teaching the public and eventually nurses. My first class will be in January 2007. I am teaching the public about Bach Flower Essences (which the MD I'm starting to work with wants to know about and help her use in the office. She doesn't know anything about it except that she's sees it as a promising treatment, but wants to work with someone who knows how to diagnose and prescribe it.) (I'm certified at a basic level at this point, but plan to continue my education in this area.) I'm also a Reiki Practitioner. I have also studied many other areas of holistic care, as well as Metaphysics. She has recently gotten priviledges at 2 area hospitals and is starting to receive referrels. She didn't know how long it would take to start and estimated it would take longer than this. She needs me to start over 2 months sooner than her original estimate. We are going to do some remarkable things together. I graduated almost 30 years ago from an MS program in the CNS track. There was no NP program at that time. Nurses continue to shoot themselves in the foot about education. Other healthcare professionals don't care which degree you have. They want to know what you are interested in and what do you want to do. I just had a thought--I should put this in the NP Forum also. I am: APN-BC, Adult Health