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Nurse Beth MSN

Writer

Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger (nursecode.com), author (Your Last Nursing

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Content by Nurse Beth

  1. Nurse Beth

    Nurse Charged With Homicide

    Radonda Vaught, a 35 year old nurse who worked at the University of Vanderbilt University Medical Center, has been indicted on charges of reckless homicide. Read Nurse Gives Lethal Dose of Vecuronium Radonda is the nurse who mistakenly gave Vecuronium (a paralytic) to a patient instead of Versed. The patient died.
  2. Nurse Beth

    Nurses Call the Governor of Tennessee

    The state of TN is prosecuting nurse Radonda Vaught for reckless homicide. You can contact the Governor or DA to let him know what you think about this choice. Governor Bill Lee 1st Floor, State Capitol Nashville, TN 37243 (615) 741-2001 email: bill.lee@state.tn.us District Attorney Glenn Funk
  3. Nurse Beth

    Loan Forgiveness for NPs

    Dear Nurse Beth, I saw you on AllNurses and you seemed so supportive, so I thought I'd reach out. I wanted to see if you knew anything about HRSA for PMHNPs. I was hoping to connect with someone who had received a scholarship or loan forgiveness via a HRSA program (NHSC or Nurse Corps). If this person was a PMHNP, that would be ideal! Dear Reaching Out, Thank you for the kind words! There's opportunity in Medically Underserved Areas (MUA). MUAs meet certain criteria: Ratio of primary medical care physicians per 1,000 population Infant mortality rate Percentage of the population with incomes below the poverty level Percentage of the population age 65 or over People living in designated MUAs suffer from lack of access to preventative care, and many have worsening chronic conditions. In some clinics and critical access hospitals, NPs are offered loan reimbursement as a recruiting strategy. There are also Health Professional Shortage Areas (HPSA) HPSAs are so designated when the HHS Secretary determines a provider shortage A geographic area, population group or health care facility can be designated as an HPSA. Here are the eligibility requirements: Be a licensed registered nurse (nurse practitioners and other advanced practice nurses are encouraged to apply) or nurse faculty Have completed your training (diploma, associate, baccalaureate or graduate) an accredited educational program Be employed full time (at least 32 hours per week) at a critical shortage facility Be a U.S. citizen (born or naturalized) or National and Lawful Permanent Resident Have graduated from an accredited school of nursing located in a U.S. State Also check out Nurse Corps and National Health Service Corps. National Health Service Corps (NHSC) clinicians must serve at approved HPSA sites. Millions of dollars are awarded to expand primary health coverage. Funding preference is based on the facility you work and and your financial need. HPSAs with a score of 14 or higher signify greater need. It can be very rewarding to serve in a MUA and there is funding to help you do it. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  4. Nurse Beth

    Am I Blacklisted?

    Dear Nurse Beth, How can I tell if I've been blacklisted? Dear Blacklisted, Employers and recruiters would never openly admit to having blacklists as willful and malicious job obstruction is illegal. While there is no official, universal "blacklist", blacklists do exist and there are ways to unofficially give a poor reference. One sign of being blacklisted is to suddenly have a job offer withdrawn late in the process. Another is if your job search is unusually difficult in a good market. Reasons recruiters and employers blacklist employees or potential employees are for bad behavior; excessive absenteeism; failure to show for an interview, insubordination and incompetence. The policy in many companies is that HR can only answer yes or no when asked if a previous employee is eligible for rehire, without explanation. This protects the company from liability. Likewise, many employers will only divulge start dates, end dates, and titles. In reality, a manager contacted as a reference can easily give a disparaging reference without really saying anything, by lack of enthusiasm or strategic inflection. It's not professional, but a manager could say"Oh, Sean? ........ya........he was ......ummm....fine" if they wanted to communicate that the employee was a poor performer. Or they could simply say "No comment", which has the same effect. If you think a reference you are providing is giving negative feedback, do not use that reference. If you believe a previous employer is blacklisting you, you can reach out and ask for a 1:1 conversation. Ask what went wrong and how you could have been a better employee. There are other reasons for job rejections. Employers may check your credit history and will check your social media postings. Make sure your resume is pristine and your interview skills are honed as they may also be the culprits. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  5. Nurse Beth

    RN Since 2014 Needs First Job

    Dear Nurse Beth, I became RN last 2014 and due to some personal issues and financial issues here in our country i'll not be able to continue my nursing career or look for a nursing job, I decided to work in a different industry and it's completely different field. Now i quit my job and will start to look for a hospital because i want to pursue my dreams. Would you think there's still some hospital who will accept someone like me ? Thank you so much. Dear 2014 RN, You will not be eligible for most new grad residencies even though you have no experience, because they are offered to RNs who graduated no more than a year ago. Take a nursing refresher course to update your skills. The course instructors and other students may be able to provide some hiring leads. Consider working in subacute to get started. After a year or so, your chances of getting hired in acute will be much better. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  6. Nurse Beth

    Bitter and Out of Options

    Dear Nurse Beth, Any advice for a new grad RN who can't seem to find a job? I live in a big metroplex so I'm aware that can contribute to the problem. I currently work as a PCT for a community hospital that is part of one of the largest hospital systems in my area and I've told my manager about my current status but I feel like I'm being pigeon-holed at this point. I would have loved to stay at my current hospital as an RN but it seems that despite the "job openings" that they post, they rather stay short staffed and save money instead of hiring a new nurse. I know I'm being bitter but I feel like I'm out of options. Dear Bitter, Congrats on getting your license! You are disappointed because your home hospital did not hire you, and that's understandable. But it's time to turn the bitterness into focused energy and get a job. You are in a very narrow window of time as a new grad. You have new grad status for about 1 year after graduation and it's important that you land a job during that time frame. This is the time you are eligible for new grad residencies, which provides the most support for transition to practice. You may need to cast a broader net and relocate. There are definitely new grad friendly hospitals, although you may have to move out of the big city to find them. Later on, once you gain 2-3 years experience, you will be marketable anywhere. Check in with your classmates and find out where they are applying. There are FaceBook groups for new grads in certain areas, like California, Your resume and cover letter must be pristine, and your interview skills on point. I wrote the book below for new grads just like yourself, to walk them through every aspect of the hiring process, and gain needed skills. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  7. Nurse Beth

    Do I Need my BSN to Travel?

    Dear Nurse Beth, I am considering to go back to school to get a BSN. I would like to travel and I am wondering if a BSN is more attractive to employers. I have been in the Dialysis section of Nursing for about two years now. Dear Wants to Travel, It is important to get your BSN and I hope you will. You will have a lot more career options with a BSN. As far as traveling, it's not required to have your BSN. Agencies do not require it, although it's possible a hospital may prefer or even require their Travelers to have a BSN. When a hospital hires Travelers, it's because they are in need and what is important is experience. Travelers are expected to hit the ground running. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  8. PET scans are typically performed in the outpatient setting and not inpatient. They are not emergent. This was a full body inpatient PET scan which might be said is inappropriate resource utilization. If it had been done in the outpatient setting, it's unlikely that Versed would have been administered. Essentially a patient died because a dangerous medication that was never ordered was given. The patient, a 75 yr old female, was admitted to neuro ICU on 12/24/2017 with intraparenchymal hematoma of the brain, headache, homonymous hemianopia (loss of visual field bilaterally), atrial fib, and hypertension. She was alert and oriented and doing well, about to be transferred to SDU. While the patient was waiting for her scan, she asked for medication to prevent claustrophobia. The provider ordered 2 mg of Versed, and the pt's nurse was asked to come down and administer it. At the time, the pt's nurse was covering a lunch break for another nurse and asked the "help all nurse" to go down and give the Versed so the procedure would not be delayed or rescheduled. The "help all nurse" performs different tasks, but there was no job description for a "help all nurse". It is not clear if the "help all nurse" was an ICU nurse, or a nurse floated from elsewhere, such as Med Surg. Clearly, the "help all nurse" was not trained in conscious sedation, and was seemingly unfamiliar with both Versed and Vecuronium. The "help all nurse" searched for Versed under the pt's profile in the Pyxis but it did not come up. So she chose override and typed in "VE". The first drug to come up was Vecuronium, which she selected. She then proceeded to reconstitute the drug, not recognizing that Versed does not need to be reconstituted, and not taking heed of the red cap on the vial or the words "paralytic agent". Next, she administered 2 mg of the Vecuronium IVP and left the patient. Vecuronium and Versed Vecuronium is a neuromuscular blocking agent that causes paralysis and death if patients are not monitored. Basically, the patient will be paralyzed, conscious and unable to draw a breath. All sensation will be experienced- panic, pain, fear, but the patient is unable to cry out. It's truly the stuff of nightmares. Versed is often given for procedural sedation but is not a paralytic. Versed can affect respirations, and patients must be closely monitored for hypoventilation. Timeline Here is a timeline of events, where the time was documented. The doctor ordered Versed 2 mg IV at 1447 on 12/26/2017. The Pharmacy reviewed the order at 1449. Vecuronium 10 mg was withdrawn from the Pyxis at 1459 using override. Vecuronium administered but not documented. Patient left alone, unmonitored. Rapid response was called at 1529. Return of spontaneous circulation (ROSC) was restored after 2 rounds of ACLS Patient was intubated and returned to neuro ICU Patient displayed myoclonic jerks with posturing in ICU Anoxic brain injury is documented Extubation was performed at 1257 on 12/27/2017 Death was pronounced at 1307 due to pulselessness The Findings The Department of Health and Human Services Centers for Medicare and Medicaid (CMS) did not investigate the event until October, 2018 as the death was not reported to them at the time. According to CMS standards, patients have a right to receive care in a safe setting and hospitals have a responsibility to mitigate potentially fatal mistakes. CMS ruled that Vanderbilt failed to provide safe care and protect patients. Vanderbilt was placed in serious and immediate jeopardy by CMS. Since that ruling, the CMS has accepted Vanderbilt's plan of action. What Went Wrong No documentation of the Vecuronium being administered Patient was not monitored Autopsy was not conducted as should have been for an unusual death such as one caused by a medication error Death certificate said the cause of death was a cerebral bleed, not a medication error. Contributing Factors Pyxis override functionality - a necessary function, but contributed to the error Failure of the hospital to ensure that only nurses trained in conscious sedation can administer Versed Failure of hospital policy to address the manner and frequency of monitoring Concern about convenience over safety- pressure to not reschedule a test rather than taking the time to safely prepare the patient Staffing- Covering another nurse's patients results in an unsafe workload Blaming The simplest thing is to blame the nurse for 100% of the error. Her failure to follow basic medication safety steps is not defensible. But stopping there prevents us from learning how it happened and preventing future mistakes. We need to learn more about the science of mistakes. We all make them. Something in our brains allows us to see what we expect to see and not always what is there, as in running a red light. Or not registering red caps and cautionary labels on a high-alert medication. The "help all nurse" was distracted in that she had an orientee with her, and immediately after giving the medication, went to the ED to perform a swallow screen test. She was performing a series of tasks. The patient's nurse did not delegate appropriately as she did not confirm the "help all nurses " knowledge and skills. Tasks should be delegated to the right person, and this was not the right nurse to administer Versed. Maybe nurses are not all interchangeable as administrations sometimes like to think. Vanderbilt did not clearly define role expectations, or patient monitoring in conscious sedation. What do you think were the causes, and would have prevented this from occurring? Related post When Nurses Make Fatal Mistakes Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  9. Nurse Beth

    Nurse Charged With Homicide

    it reminds me of the story about Kim Hiatt, too. She was the nurse at Seattle Children's who committed suicide. Her story is here in the article When Nurses Make Fatal Errors
  10. Nurse Beth

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Right but why was she put in the position of a help all nurse if she was so inexperienced?
  11. Nurse Beth

    Nurse Charged With Homicide

    Red or white?
  12. Nurse Beth

    Nurse Charged With Homicide

    Perhaps she wasn't fully trained to be a "help all" nurse. She wasn't familiar with Versed, so clearly a lack of experience. Meaning...why did Vanderbilt put her in this position? Shame.
  13. Dear Nurse Beth, NYS - I own a Permanent Makeup & Medical Service salon. My services range from PMU to Microneedling. In NYS can LPNs offer juvaderm/botox/restylane injections? Dear Wants to Offer Juvaderm/Botox/Restylane Injections, I'm assuming you are not running your current business as an LPN, as that would be out of scope for LPN practice. You don't say what "medical services" you provide, but under New York State law, LPNs practice under the supervision of an RN or a licensed provider. There is no situation under which an LPN can "hang out their shingle". You definitely cannot inject juvaderm/botox/restylane as an LPN operating independently. Please do not even consider this, as you will put your license at risk.For one thing, you most likely cannot even purchase reputable fillers on your own. They are purchased under a provider's license. That is why cosmetic nurses (RNs) who own a spa align with a state approved medical provider to perform services. If you are interested in cosmetics, consider working as an employee under a physician in an office. There you will receive on the job training or complete training courses provided by vendors. As far as your current business, please read your NY LPN scope of practice and check with your insurance provider and business attorney to make sure you are not endangering your license by performing microneedling. In other words, even if you are not providing services as an LPN, what would happen if a disgruntled client discovered you are an LPN and reported you to the Board? Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  14. Dear Nurse Beth, I failed RN program twice at same school, both times in clinical rotation. First time was in 1991, Advanced Med-Surg, then after picking myself up and having to wait another year until that class rolled around, I attempted it again, passing all the required skill check offs again, repeating the associated academic class although I had a high B grade with GPA of 3.8 prior to the failure. I was successful without any issues at all, in fact my instructor was impressed with my skills and ability to apply theory to clinical setting. I then progressed to the next quarter, Psych Nursing which I excelled at both clinically and academically. Then proceeded with Maternal Nursing, I had high B academically and was seemingly doing good in clinical, no needs improvement in any area, but then at clinical review, I was told I was being failed. Honestly it was so long ago and I was in such a state of shock, I can't even remember the specifics, it was after a vaginal delivery without complications and the patient was in the wheelchair, alert and talking, voicing no complaints. I asked if she wanted to get back into bed and she declined. It was at end of clinical training day and I was to get changed and meet professor and classmates for post clinical review. The clinical instructor and other staff had left the room and I was the only one with the patient. I stayed in room with her until a nurse or CNA came into the room, then explained that I needed to go. It was my understanding that the nurse or CNA, I can't recall, was ok with my leaving. I was not assisting with the birth only an observer, however, I did give a brief report of patient's status and left. The next day, I went to clinical rotation and was told I had been failed because I left the patient unattended which was a safety issue. I appealed the decision and although one of my previous clinical instructors said she would vote in my favor, she sided with the other 5 instructors on the panel. As you can imagine, I was sick to my stomach. I bawled my eyes out for hours, depressed for days & weeks. All that money gone, all those classes wasted. I had 5 children at the time, so I just did my best to put it behind me. In 1996, I decided to apply to LPN school and was successful. It was 15 month program but I only had to do 12 months. It was on quarter system. I made all A 's in academics and 3 A's and 1 B in clinical. I have been an LPN since 1997 but I have a hunger to be an RN. I have had to work full time so going back to school wasn't a possibility, but now that my kids are grown and I can work part time, I have been craving going back. I'm 62 though so I don't know if I have what it takes. I know I am smart but with nursing school clinical grading being pass/fail, it freaks me out. Maybe I am just not cut out to be an R.N. I don't even know if I can get accepted since I failed out of nursing school twice. Are all R.N. program clinicals pass/fail? I understand how critical it is for students to be able to apply theory to clinical situations but the pass/fail is so black & white. As an LPN, I did the same job as my R.N. coworkers except hang blood, and do admission assessments so why was my LPN clinicals graded and not pass/fail? Does Board of Nursing determine this or the school? I am thinking that things might be better now, as there are simulators that students get to work with prior to clinical rotation that can help build my confidence in clinical rotation. Do you think that I would be able to work as an R.N. due to my age which would be around 65 when I graduated. Am I just chasing a pipe dream. My goal isn't to stay in clinical nursing. I did UR for 8 years in managed care and want to purse case management or advice nurse but every job I see requires an R.N., even the same job I did for 8 years at UHC, which I got laid off from in 2013. Thanks for reading. Sorry so long. Dear Should I Try Again, So to follow...in: 1991 you failed the RN program, reason not given 1992 you failed again in the same program for leaving a patient unattended, although according to you, the patient was attended 1997 you earned your LPN with no problem As to whether you are eligible for an RN program, you may be. You failed over 2 decades ago, and have successfully practiced as an LPN for over 20 years. Each school has its own admission criteria, and you will have to talk with Admissions in the school you plan to apply to. However, you could be asked about failing, and the explanation you provide (no fault on your part) may work against you. Most undergraduate nursing programs are pass/fail in clinicals, and while it's understandable that memory still affects you, you are a different person this time around after over 20 years of clinical experience. Your age is a challenge because while schools cannot discriminate, it's hard to prove age discrimination. After graduation, you would need to work bedside for at least 2 years as an RN before you would be eligible for most non-clinical roles, such as case management. You will be facing competition from younger applicants. It's not impossible if you have extraordinary drive and passion to be an RN. Otherwise it's important to come to peace with your regrets and put it behind you. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  15. Download allnurses Magazine Since nursing education and training began 150 years ago, it has undergone many changes. Nursing education has evolved from hospital-based apprenticeships to college and university-based programs. Along the way, there has been much debate about the best way to prepare nurses. Hospital setting or academic setting? ADN or BSN? Today multiple educational pathways for entry into nursing exist. Nurses can receive their education and training in nursing education programs at the diploma, ADN, baccalaureate or even master’s level. NCLEX One thing that is agreed upon is that, regardless of educational preparation, all eligible graduates take the same licensing exam, called the National Council Licensure Examination (NCLEX). Prior to the NCLEX, nurses took the State Board Test Pool Examination. The National Council of State Boards of Nursing (NCSBN) renamed the test to the NCLEX in 1982. The first version was a paper and pencil-proctored test. Candidates had to wait months to take it, as it was only offered twice a year. Nurses from that time recall traveling to huge testing centers where they would hear “Pencils down. Booklets closed” and test for two days. Under the direction of the NCSBN, the exam has since evolved to computerized adaptive testing. Diploma Programs In the year 1873 three nursing educational programs—the New York Training School at Bellevue Hospital, the Connecticut Training School at the State Hospital (later renamed New Haven Hospital) and the Boston Training School at Massachusetts General Hospital—began operations. It’s generally acknowledged that organized, professional nurse education in the United States began with these 3 programs. Diploma programs all, they were called “Nightingale” programs because they were based on Florence Nightingale’s teachings. Aspiring nurses trained in hospitals under an apprentice-like system. Graduates of diploma programs recall being trained to stand up and offer their chair whenever a doctor came into the nurse’s station. Labor was exchanged for training, room, and board. Student nurses provided the patient care, sometimes supervised, sometimes not. Hospital servitude was the first priority and education was secondary. In time, it was realized that the needs of the hospital trumped the needs of the nursing students. In other words, if patient care was needed on a surgical unit, the student nurses would forfeit their planned Peds training to provide care where it was needed, on the surgical unit. Likewise, classes were canceled if nurses were needed on the floors. Diploma programs still exist but are far less common than ADN or BSN programs. BSN Programs After WWII some forward-thinking leaders began to promote moving nursing education from hospitals and into universities. Nurse leaders argued for an educated workforce that would adhere to practice standards. Hospitals opposed the change, fearing the loss of free labor. At the same time, patient care was becoming more complex. Intensive care units became more common in hospitals, requiring greater nursing expertise. Nurses now needed a theoretical base to their practice. However, the four-year nursing programs were not able to turn out enough nurses to meet the nation’s demand. ADN Programs and Role Differentiation Meanwhile, as an economic fix, community college programs began offering ADN programs in the 1950s, which seemed a happy compromise and became a popular track. ADN programs supplied large numbers of nurses, relieving the nursing shortage. Students without access to four-year educations could still earn a nursing degree. It was originally thought that ADN nurses would be “technical” nurses working under the supervision of BSN or “professional” nurses but hospitals never differentiated practice based on educational preparation. As a result, Diploma, ADN, and BSN prepared nurses all have the same role and responsibilities in clinical practice. The RN license, and not educational preparation, drives the practice role of the RN. BSN vs. ADN Entry Level Degree In 1964 the American Nurses Association stated that nurses should all be prepared at the baccalaureate level. This began a deep and bitter divide within the profession between ADN and BSN prepared nurses that continues to this day. In 1982, the National League in Nursing (NLN) supported the BSN as the minimum educational level for entry-level nurses. With much debate, many other organizations adopted the same position over the next 3 decades. However, in the 1990s, concerns over a nursing shortage pushed the argument to the background. In 2010, the Institute for Medicine (IOM) issued a statement that 80% of all nurses should hold a BSN by 2020. New York and New Jersey followed with a “BSN in 10” law requiring nurses to obtain their BSN within 10 years of licensure, but to date, there is still not a national, standard educational entry level. In most recent years, employers themselves have begun to require BSN prepared nurses, taking the debate out of the hands of nurses and nursing organizations and into the marketplace. Magnet hospitals employ a higher percentage of BSN nurses. Advanced Practice Today there are a number of masters level programs including clinical nurse specialists, nurse practitioners, midwives, anesthetists, clinical nurse leaders (CNL). In addition, there are doctoral programs that prepare nurses to influence healthcare policy and assume advanced leadership roles. Accreditation Established in 1893 and called the American Society of Superintendents of Training Schools for Nurses until 1912, the National League for Nursing Education was one of the first professional nursing organizations. The purpose of the National League for Nursing Education was to establish and maintain a universal standard of training for nursing, released as the first Standard Curriculum for Schools of Nursing in 1917. Accreditation is a voluntary, self-regulatory process. The Accreditation Commissions for Education in Nursing (ACEN) accredits diploma, associates, bachelors, and master’s nursing education programs. The Commission on Collegiate Nursing Education (CCNE) accredits only bachelor and master’s level nursing education programs In 1952 the National League for Nursing Education and the Association for Collegiate Schools of Nursing joined together to become what is now known as the National League for Nursing (NLN). Accreditation of nursing schools was the purpose of the newly formed NLN. Challenges The primary problem with nursing education now is the gap between school and practice. Nursing students lack sufficient clinical experience to function independently. Residency programs help to close the gap, but residency programs are not mandated or regulated. One hospital might orient its new grads for 4 weeks, another for 16 weeks. Residency programs follow a quasi-medical model where new grads are supervised and supported for a period of time before practicing independently. Career advancement requires a BSN or higher degree. Universities and colleges must work together for a seamless transition to academically higher education. Mobility programs facilitate articulation and transition from one nursing degree to a higher nursing degree, in which ADN prepared nurses return to school and obtain their BSN or masters degrees. Fortunately, many online programs provide easy access for the adult learner. The Future It’s interesting to see where the next 150 or even just 50 years will take us. Will educational preparation drive practice differentiation? Will nursing adopt a formalized and standard residency status for new graduates? What is known is that healthcare is changing rapidly and nursing operates in a contextual environment of society, regulations, and reimbursement. Nurses will be an important part of the change and assume new roles in managing and providing our nation’s care. Education must prepare nurses who can practice effectively and lead effectively.
  16. Agree with Been there, done that. Being tired is one thing, hardly being able to get yourself up is another. Take care.
  17. Nurse Beth

    I want to be a Writer! Any tips?

    Have you thought about writing for allnurses? At the bottom of the page is a link that says We Need Writers! It's great exposure with a huge audience
  18. Nurse Beth

    Wants to Quit RN to be an MA

    Dear Nurse Beth, I recently quit my first med/surg nursing job. I was there less than a year. I'm 45 and this was a second career. Although I gained invaluable experience, the stress was all-consuming. It was spilling over into my personal life; affecting my marriage and my parenting. I hated it. Some examples of the environment: I was responsible for 5 patients, or so I was told. It was upwards of 7-8 usually. I was not only asked a handful of times to perform duties outside my experience (ex. pulling chest tubes when I had zero experience with them), but the charge nurse had the nerve to tell me to delegate a med pass to a PCT. Her reasoning? "The patient likes her a lot and is more likely to take the meds from her." I refused. This put me at odds with her because I didn't take her suggestion, as she said "she knew best." The acuity of the patients was very high although it wasn't an ICU. As orientation neared completion, I asked for additional time, as I wasn't comfortable with the high acuity and being so inexperienced. They refused. So, I quit. Here is my question: Can an RN apply for or even work as a Medical Assistant? I want to work in healthcare; however, I do not want to work with such high acuity patients or even work in a hospital setting. Part of me just wants to do basic nursing skills with patients and that's it. I realize I may sound crazy with this question, as I worked very hard for my license. But, it's the truth. I don't want to step foot in a hospital again. I'd love to work in a clinic; however, I only see postings for MA's. I'd even work for an MA's salary. I don't care. The money doesn't matter. Any advice? Thank you. Dear Quit, You've had only one working experience as a nurse and it was a very short experience in an unsupportive environment. You don't say how long your orientation was but let's say it was 8-12 weeks. That's not long enough to evaluate if nursing is for you. Pulling chest tubes is a medical function, but even if you were only assisting the doctor, you need guidance and supervision the first time. An assignment of 7-8 high acuity patients is not reasonable. Don't paint all of nursing with the same brush because of this experience. You owe it to yourself to give it another chance. Consider that this wasn't you, it was the facility, and look for a job with better working conditions. Technically, you could work as an MA although employers may be reluctant to hire someone as overly qualified as you, and it would be hard to make a nursing comeback if you change your mind. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  19. Nurse Beth

    Over using sympathy card

    That's a good question, but like DaveyDoo, I haven't seen it in nursing. I've seen the opposite, such as the ICU nurse who lost her twin teenage boys in an accident. She took time off from work, and the first time I saw her afterwards, we rode up in the elevator together. I was amazed at her peace and composure. And courage. But ALL of us suffer losses, because life happens to everyone. Divorce, heartbreak, wayward children, illness, sick parents...and we show up at work through it all. I compartmentalize at those times, and usually focusing on work and patients helped me get through the shift.
  20. Nurse Beth

    Diverted Drugs for Dad

    Dear Nurse Beth, I'm currently an LPN going RN. In 2017 I was caught diverting narcs which I was taking to my sick dad at home. I didn't say that though but I said I took them for my self. My nursing license got suspended for 12 months and now I have it back. They made me go through rehabilitation like a real addict would finished everything they wanted me to. Prior to that incident, I had a final clinical to graduate as an RN/BSN. Because I was so overwhelmed with all the issues of rehab no job I withdrew from the clinical. My question is I really wanted to be a nurse practitioner, should I re- register for the clinical and continue with school? In my state which is MN I'm disqualified from working in nursing homes, daycares..and all facilities licensed by department of health services., where should I apply for a job? Will I be disqualified too when I go for my clinicals in Atlanta? Dear Diverted for Dad, You completed your requirements but now have a stipulation on your license. If you are restricted from practicing in all facilities licensed by the DHS, your options are limited. Private duty nursing may be an alternative. First things first. I would prioritize your three goals of working as an LPN, returning to school, and becoming an NP. Your first priority is to work as an LPN, which realistically may require an unrestricted license. Moving forward, you need an unrestricted license to pursue your RN. It's pretty much a safe bet you would not be able to do clinicals with your restrictions. The school would not want the liability or monitoring requirements. To explore your rights and options, see an attorney specializing in representing nurses in Minnesota. Things may have turned out differently if you had an attorney when you were initially charged. It's always recommended to have an attorney when dealing with the Board of Nursing (BON). As Lorie Brown, our own allnurses nurse attorney columist always says, the BON protects the public, not you, whereas a skilled defense attorney can walk you through the next steps and help you make informed decisions. Check out the Nurses in Recovery forum for support from your fellow nurses. You are not alone. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  21. Nurse Beth

    New nurse struggling

    The best thing is to find a solution in house. Try speaking to your supervisor as suggested. The very last resort is quitting- be sure and don't quit your job unless you have another one lined up. So sorry you've had this experience, you should have been offered a home unit from the beginning.
  22. Agree with all the other posters. I'm an educator, not in clinicals, but in acute care. If I had a new hire show up a half hour late for Orientation the first day, I would definitely have concerns. It's up to you to change her first impression of you and show her how reliable and conscientious you really are.
  23. Nurse Beth

    Hard of Hearing, Where Can I Work?

    Dear Nurse Beth, I am a hard of hearing nursing student. I am actually working as an LPN in a nursing home. Going back to school for my RN. I would like some advice on which setting I can practice. Dear Hard of Hearing, Congrats on going back to school! When you apply for a job, you are not obligated to tell your employer that you wear hearing aids or have a hearing loss unless you are requesting an accommodation. Pre-employment, an employer may not ask about any physical impairments. You can apply to any setting you prefer, and practice nursing in any setting as long as you can perform the job. You will need to be able to hear breath sounds and heart sounds in a clinical position. Since you are working as an LPN, you may already have an amplified stethoscope. Organizations You are not alone-there are many organizations that support nurses with hearing loss and other disabilities. The Association of Medical Professionals with Hearing Losses (amphl.org/) advocates for all healthcare professionals with hearing loss. Know your rights. On the Exceptional Nurse website, read about a hard of hearing LPN attending a RN nursing program who successfully sued the college for discrimination when they attempted to block her education. The National Organization of Nurses with Disabilities and the Society of Nurses with Disabilities both provide resources. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  24. Nurse Beth

    Nurse accused of impregnating women in vegetative state

    Are patients' doctors in LTC required to do a physical exam from time to time?
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