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Hi There, I work at a VA Facility. In the application they want to know if you served for veterans preference. That does not mean you get a job. They rank all the applicants in a point system. Pretty much you get 5 extra points if you are a vet. Whoever has the most points gets hired. Being a Vet does not mean you get the job. It means out of a ranking system the person who was hired was ranking more than 5 points in the lead above you to get the job. I don't think they ignore the preference, but in the end, the best person gets the job. Being a vet is no guarantee.

Discuss the Situation, What you did about it, What was the Outcome. Another way to put it... Highlight what you have done, why you did it, what was the impact? For example. For a Nurse I Level I to work towards Nurse I Level II, this is under the Professional Practice Category. "Nurse Betty identified a Hospice patient declining condition made it difficult for the patient to swallow oral pills. She notified the provider and pharmacy of situation and recommended discontinuation of any unnecessary medications and to change the necessary medications to liquid form in which the patient had demonstrated he could swallow. The medications were changed to liquid form by the provider as a result, resulting in improved patient compliance with meds." This is an Example of a Nurse I Level II to Nurse II Statement for Practice: Betty the Bomb Nurse applies the nursing process to improve care, and manages complex care. Ms. Betty showed this in evaluation of a general surgery patient s/p abdominal surgery with long post op course, initially post operatively the patient was on Telemetry, but after several days MDs discontinued monitoring as pt had no events (history of MI); an EKG was obtained before d/c of telemetry which was normal sinus rhythm -- this was performed on day shift. Working a PM shift Nurse Betty was providing care to the patient, and had worked with the patient previously the past few days and determined something was ‘off’, but she couldn’t put her finger on it which warranted continued observations/assessment. Nurse Betty's through assessment and intuition determined the patient had a new onset of atrial fibrillation. Patient was started on cardiac meds, and converted back to normal sinus rhythm within 24 hours of Nurse Betty's assessment. Nurse Betty's assessment and subsequent interventions resulted in prompt treatment of atrial fibrillation, and resulted in patient not having to be anti-coagulated for the rest of his life. Think of all the examples where if you were not working your not sure if the same thing would have occurred. Think of the times when your on the phone and really advocating, or having difficult conversations with the disciplinary team. Think about the ah ha! moments where your like thinking about why you are a value or asset to the VA, that is what they are looking for! I agree with the other posters, Your facility should have information about this process and examples. The examples above are for just one example for one dimension. Ask for your next highest "Nursing Pathway" that has concrete examples of what they are looking for. Best wishes. Your first year you can get up to two step increases so I would spend a lot of time on it!!! You likely won't get to be a Nurse II until year 3. Nurse II is someone who is beyond the unit and focused on things hospital wide beyond the unit or service. Starting out Year 1 your just focused on your assigned patients, year 2 your more in your unit and on committee's etc. Not many people can meet criteria for Nurse II that early. Focus on getting a performance increase based on doing ABOVE your current pay. Hope this helps. Best wishes

Hi, I am sorry dear that I can't ease your mind. I'm a Veteran and I work for the VA as well. Job opportunity sounds great. However not sure if it sounds like a good fit giving all you have going on. If you are having a baby I think you will not like the commute. Jobs are not everything. Why not find a job closer to home. Life is to short to be commuting all the time. The VA is great, It is great you want to invest in the system. I think the commute will be hard on you, and don't recommend commuting for families. You will be adjusting to a lot, the baby and him not being active duty anymore. Too stressful. Money sounds great, position sounds great. But how will your marriage be? How will time with husband and baby be with that long commute? things to consider. Also important to Note if you have been an If you are a New RN with no experience you do not qualify for Nurse I Level II. Your past experience is not RN experience so it does not count. If you are ACLS certified, and have high GPA make sure to include that as it may make a difference in your pay (I received step increases with this). Also for cost of living try to use this calculator to determine what the exact difference is for cost of living. Cost of Living Calculator: Compare the Cost of Living in Two Cities - CNNMoney Good luck. Talk with your husband about it and what happens when baby is born, what are you doing for daycare etc? What does your day look like with baby + commute. all things to consider. Best of luck in your choice. Congratulations on your graduation, and Congrats to your husband's ETS, and soon Honorable Discharge!

I have recently been accepted into a DNP program and start this fall. I chose the Adult Gerontological CNS track. They made us choose Primary vs Acute and I chose Primary, (Although the consensus model states a CNS should be trained from acute to primary care). However, everything I read on CNS is worrysome. They have the consensus model which includes CNS as advanced practice, but is not even accepted in all states. I feel like if I become a CNS I would be able to validate my role, but it would require me to teach everyone what my scope of practice is. Also I will be limited to moving or working within the country because the CNS role is not advanced practice is as many states as the NP. I am likely going to change my track to NP role, and likely do something that also involves (CNS) type scope such as education, research, mentoring etc. Either way I plan to certify as an Advanced Practice Certified Wound Ostomy Continence Nurse as my specialty, and I could do that as a CNS or an NP. I want to do short term missions and volunteer work, I feel like if I become a CNS I will sell myself short. My employer is in HIGH support of the CNL role and has committed to have one on each unit by 2015! This is blurred with the CNS role. I think because there are more NP's I may just have to join the crowd instead of waving a banner of acceptance for the CNS. I just have to email my advisor to confirm I want to switch to NP track. I still have not fully made up my mind but I am thinking NP will be the way to go, and I can still do all the things that I want to do as a CNS. as an NP if that makes sense.

Usually when you have an episode of an illness it will not exempt you. They would require a letter from the physician stating that it was an isolated event because of vitamin deficiency, and you would not need to receive any follow ups EVER. But it sounds like they don't know the cause. I would not lie about it either. You can try to apply and see. You never know until you apply and they say no.

All you can do is your best. You are only human. If it were to happen, bleed out your site, and report it right away to get proper tests done. You can't have an absolute mindset. I WILL NEVER do that. You don't know what the future holds, all you can do is your best.

Yes Policy regardless if central or peripheral. NEW LINE = NEW TUBING/MEDS. This should be under your policy, I think it would be bad practice to spike the old bag with new tubing? You need entirely new set up. However, if the patient's blood pressure was 80/40 and they are symptomatic, you need to think about life saving measures first. Think of the time it takes to get new medication IV bags from pharmacy and get everything set up, you may just have a code blue on your hands. If my patient was symptomatic and crumping i'd hook up the "contaminated" lines, after the situation normalized, I would switch over to new meds and new tubing to be in compliance with the policy. Benefits of giving the med with the 3 hours line with symptomatic low blood pressure, versus - withholding meds just to get new tubing. We have to critically think. Of course when situation normalizes, hang new tubing. If you don't have a policy really you should speak with your policy and procedure committee.

Sabbath is all about taking a day of rest. A great book to read is Sabbath by Wayne Muller. Gives perspective about the act of Sabbath, not necessarily the date it occurs. God wants us to live at peace with others. I would spend time in prayer about your Sabbath. It's about glorifying God and finding rest. If you can do that on Monday instead of Friday, go for it. It's about the act, and where your heart is. Strongly consider spending time praying on observing Sabbath on your days off, rather than suing a company who won't hire you because you won't work a specific day of the week. Sabbath should be in your heart, not on the day of the week. I think your in a Catch 22 and I think your employment options are very limited. Try to work for some type of faith based clinic or something who can honor your request, as a hospital 24/7 operation will not work well for your schedule needs. I would spend time in prayer regarding your Sabbath, rather than suing each and every company that does not extend you the job offer. You have demands that aren't with the 'times', regardless if it's based on your religion or not. And if you won a lawsuit or not. Just because you CAN sue someone and win, does not mean that you SHOULD sue someone. What would GOD do? I think he would work work work work work work work, and take a day for rest. You can do that. Modern day work weeks are not those of biblical times. Please reconsider and do some inner searching and prayer. You can still honor God and work Weekends.

I went to the review at the 2011 Conference, the all day review. I thought it was helpful, but if I had to pay for it on my own I would not have completed it. GOOD NEWS!! I found the link for the order form for the book. Contact the number on the order sheet for more info: I would HIGHLY RECOMMEND THIS Book for STUDY!!!! Also buy the practice tests at castle worldwide when you are done studying. The manual is 65 dollars but well worth it!!! http://www.surgery.emory.edu/wocnec/pdfs/order.form.pdf go to the website above to find the pdf order form for the emory manual thanks.,

Hi Marilyn, I would not take it right after your course, give yourself a few weeks after you get back home to review everything. The best resource was the CWOCN certification review book. I believe I got it from Emory, I printed off a PDF form and mailed it in with the money.- I just tried to find the link online, without result, but since you are going there for your wound program, look into buying their CWOCN Certification Review book while you are there, there is also a practice test in the back of that review book if I do recall. That Was awesome, and whatever stuff I did not know out of that book, I went through the other books to read. There also are test questions in the back of the chapters in the texts required for your wound and ostomy classes. Become a member of the WOCN if you are not, then you have access to the member library which has a catalog of all the old journals, which all usually contain a CE with test type questions for review. - those were really helpful. Castle worldwide sells practice tests for 30 bucks a pop. That was so helpful and well worth the investment to see where you are at. Review all your practice tests for certification, and expand on all the answer, why this one is right, why this one is not the answer. Especially when comparing the different types of abdominal surgeries and diversions. Most of all, just start with the TESTING PLAN that is outlined in the application booklet when you apply for your exam. THAT IS WHAT IS ON THE TEST. Don't read about stuff thats not on the testing plan. I would recommend to go through the testing plan and then utilize all your resources to learn or relearn the info, then at the end of review of the testing plan take the practice tests. Don't start with any practice tests first because you will feel like you have no idea what they are talking about. Best wishes, and congrats, on working toward the GOLD STANDARD for certification!

Fair Observation with evidence listed! No judgement needed; the evidence already sealed the deal. You are only judging that they are seeking drugs; thats fine - clearly it is what they are coming to the doctor for. No one can judge if they are in pain or not. Only they know.

Just because the patient is in the hospital does not mean that because they don't feel like doing something doesn't mean nursing staff should be their slave and do it all for them. It's all about knowing your boundaries. Just because I can do xyz; does not mean I will do xyz for you! I have no problem telling a patient NO I won't be able to do that; who is being rude to me "commanding" me to do things for them; that they can do for themselves. They can get mad at me; I'm not a mean nurse --- I am promoting self care; it's called tough love!; they are manipulative and I won't for the sake of 'compassion' be trampled on and do things just because they don't want to when they are ABLE. I also have no problem doing cares for a patient who is being rude and swearing at me that really is UNable to complete self care. Or a patient who is feeling ill that really can't do something. I gladly do whatever request they may have; or whatever order they bark at me. If you are UNable by all means that's what i'm here for! But i'm not your slave. For example the person who is completely independent at home and goes to the bathroom on their own, brings their own hand to their mouth when eating, can put lotion on their own legs, can wash their own groin...and suddenly believes they are on vacation from performing self care and demand that you complete xyz task when they are only admitted for like a venous stasis ulcer or something. I believe in tough love and stretching people; questioning what is different about the hospital than at home? why do I need to do this for you? We want you to be independent here, and will help facilitate that. Your perceiving that I don't want to help you at all; I want to help you to help yourself! I usually have a rule; I do for others what they CAN NOT do for themselves. I don't contribute to your laziness by doing everything for you - and continuing this co-dependency. I can be the nurse that you don't like or request not to return; but I know what my job is; and it's not being your mother; and your not an infant! (so that is what I think in my head about those patients) No your arms work; you can put the water to your mouth to drink your pills. No you are here for cellulitis of the leg --- how does that translate that I will wash your groin when you are fully continent with no neurological problem preventing you to do so? and when you do it for yourself at home? You hold your urinal and set it there; this is where i will measure it; leave it there and I will flush it down the toilet after I get your output. I refuse to do for others what they can do for themselves. Maybe I am a witch. I won't let those lazy patients turn me into their slave. And I will pull the "it's not in my job description to be your mother card". Patients can be a jerk to me and I will still give them compassionate care and do tasks that are relevant to their hospitalization even if they were cussing me out while I did it. However feel free to cuss and kick me out of your room because I won't wash your genitals when your hands work or refuse to put the water to your mouth when you are fully able. Another analogy is a mother, college student and laundry. 1. College student comes home for break and is at library all day studying focusing on their upcoming finals. Mom does laundry while student is gone; to help college student be more successful for finals. 2. College student comes home for break twiddling their thumbs and watching TV all day bumming around then to top it off gets aggressive towards mom starts ; "I do my laundry all the time at school - I need you to do it for me; and your going to do it!" Mom says excuse me but you are fully able to do your laundry honey - you can wash it during commercials etc. is there enough soap for you? Want me to help sort it for you? Student says to mom; "screw you; you never want to help me do anything; just get out of here i'll wash my own damn laundry then!" 3. College student comes home for break twiddling their thumbs and watching TV all day bumming around then to top it off gets aggressive towards mom starts ; "I do my laundry all the time at school - I need you to do it for me; and your going to do it!" Mom says would you like it ironed too, can i fold it for you too. Oh you need a soda, i'll bring it right to you, oh you want the remote and it's only 1 inch from your hand....here i'll pass it to you. Oh! let me give you a bath tonight; just because your home! 4. College student comes home for break and is at library all day, when he comes home to spend time with family he watches TV and washes his laundry in between commercials. Mom helps student while he is home, cooking meals, allowing him a place to stay, accommodating to the needs of the student. What type of mother are you?? I'm 1. 2. and 4. Who else agrees in tough love?

Liz! Don't worry about feeling like a ditz. It's about patient safety and their care. The best advice I ever heard from a preceptor was. All that matters at the end of the day is that your patient's are happy. If you forgot something, or didn't document something, or looked like a fool for a little bit. All that matters is that the patient was satisfied with your care, and that you did your best. All that matters is the patient at the end of the day, not your ego, or if you feel like a Ditz. It goes away after a while then you 'get it' and are not novice RN anymore. When you feel bad say you yourself "I did my best, and my patients were happy with the care they received, I am not a ditz and I'm always learning, I will improve my practice!"

Using Springhouse Review. And the AMSN practice test to see where i'm at. Any recommendations on this exam? Thank you!!

Hi Nursevaldez2: If you have all your nursing pre-req's just go on and get your BSN. Unless you have small children, or have some reason why you have to do a little bit, then go on. If you go LPN to ADN to BSN it will take f o r e v e r. Get your BSN NOW you won't regret it!