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llg PhD, RN

Nursing Professional Development
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llg has 42 years experience as a PhD, RN and specializes in Nursing Professional Development.

llg's Latest Activity

  1. llg

    Holding ATT for not attending ATI review

    Like the previous poster, I would look to work out a compromise if I were you -- maybe another review course that would fit your needs better. But if they list the course as a requirement anywhere, they can enforce that requirement.
  2. I would have pressed charges from the beginning. If you company tries to hurt you because you press charges ... you would almost certainly have a case against. Talk to a lawyer about the relevant labor law ... then press charges unless the lawyer advises you not to.
  3. llg

    Considering changing careers

    My advice is to be very careful in your choice of schools. I don't know the schools in New York ... but do your research before making any commitments. You are exactly the type of student who is sometimes victimized by the worst schools out there -- a single mother without much money, who may be looking for the easiest, fastest, cheapest way to become an RN. Such schools will take your money and provide you with a sub-standard education. You will have bad experiences in school and get your nursing career off to a bad start, ending up with a degree from a school that is not respected -- if you graduate at all. Do your homework and find a school with a good reputation for providing its students with a positive experience and a strong nursing foundation. If you are going to do it, do it right and get a good education that will be worth the time, energy and money that you will be investing. Good luck to you, whatever you decide.
  4. llg

    Unfair Tests?

    I am the product of a "concept-based curriculum" from back in the 1970's. It's been around for a long time and has stood the test of time. Patients (and real-life situations) don't present themselves exactly the way it may have been described in a textbook. Real life can be messy -- and it's the nurse's job to use her understanding of the concepts underlying the presentation to figure out what is going on and what he/she should do. We need to be able to act to unique situations that may, on the surface look very different from anything we have seen or rehearsed before. The student's focus should be on striving to understand the basic concepts underlying situations -- and not on memorizing facts from a lesson -- because the long-term goal is not to be able to recall facts, but to assess a situation and use our understanding of general principles and concepts to act wisely to new and unique patients/situations. If you really understand something well, you can recognize it in a new, unique situation, analyze it, and arrive at an appropriate response. That's a level of learning that is much higher than merely memorizing some facts and/or protocols.
  5. llg

    Graduating MSN Education....now what?

    From your post, it sounds like you have been away from clinical practice for a few years. That fact may make it difficult for you to get a job doing any kind of clinical teaching for a school -- what types of clinicals would you be qualified to teach? What was your MSN in and what types of experiences did you get while in school? What type of job did that degree prepare you for? It sounds like you know the basic facts -- the pros and cons to the various types of nursing education jobs. You just have to start looking at the specific jobs in your area and decide which ones appeal to you the most. No job is perfect. Which set of pros and cons makes the most sense for you?
  6. llg

    Should I accept Johns Hopkins Offer?

    How much money will you lose if you say "yes" to Hopkins and then change your mind if you get into Chapel Hill? If it is not all that much money, I'd give that option serious consideration. If might be worth a few hundred dollars to "hold" your place at Hopkins while you wait for UNC. Of course, if it will cost you thousands (which is probably not the case), then you need to make a firm decision now -- and decide how much risk you are willing to take.
  7. llg

    You should never ask a nurse this question.

    I feel that it is a perfectly reasonable question to ask a nurse. Particularly some nurses about whom there are some factors that would lead people to think that the nurse might have wanted to be a physician at some point in his/her life. For me, it was the fact that my father was a physician and that fact that I was a good student. I had the ability and resources to choose either path. I think it was/is perfectly reasonable for people to ask me why I chose the path I did -- why I rejected the career path and yes, lifestyle and culture, in which I was raised.
  8. llg

    While we were arguing; we disappeared

    The hospital I work for now has something like that. Big, clear single word job titles right under the name tag. "RN" "RT" "Doctor" etc.
  9. I'll give you a little help here. What Sour Lemon is asking you to think through is that we can't possibly give you a good answer to your question because you did not give us enough information. What did you do badly during your first interview? What types of questions did they ask that you were not able to give a good answer for? Did they give you clinical scenarios and ask you to describe what you would do in that situation? Were there other types of questions that stumped you? Can you give us some examples of the kinds of questions you struggled with? etc. Without having that information, we can't really give you suggestions for improvement.
  10. For the most part, yes, almost all of the activities you listed above would be part of the physician's orders in an American hospital. A few things, like routine hygiene measures, turning the patient, basic comfort measures, etc. could be done without orders. However, within those order sets, the nurse has some leeway as to how things are done. The nurse is also expected to use judgement to continually monitor the patients and to make adjustments as appropriate, notifying the physician and discussing it as a team if the nurse feels a actual change in the order is needed. Much of the motivation for that system is not for increased safety (though having both the physician and the nurse working together to formulate the plan of care might increase the safety.) Much of the reasoning is purely political, the physicians want control of what happens to the patient. The system is also designed with the finances in mind. The physician's order is what authorizes the nurse/hospital to provide the service and get paid by the "3rd party payer" (insurance company, government program, etc.). Whoever is paying the bill doesn't want hospitals to provide extra services that add to the cost. Physicians (or sometimes, Physician Assistants or Nurse Practitioners) have become the "gate-keepers," deciding which treatments are going to be performed and paid for. The payers police the physicians and hospitals to keep the costs down.
  11. llg

    Seniority and preferential scheduling

    I think this post goes a bit too far -- taking a legitimate point and emphasizing it too much. Long-term employees may not always be stellar ones, but they have been serving "well enough" for a long period of time. They are the core group of the department whose long-term work has contributed greatly to the success of the unit. Most nurses are average (by definition). We can't all be super-stars. Yes, the stars deserve some rewards -- but so do the average nurses who work competently and carry the load of the department over many years. You shouldn't have to "go the extra mile" to earn a few benefits. Doing a good job over a long period of time should also earn you some rewards. If those "average, mediocre" nurses all left ... it wouldn't be "all the better." It would be a horrible crisis. Yes, there are some bad nurses out there who need counseling, training, stimulation to improve, etc. But a long term nurse who has served adequately for years deserves to be treated with respect and helped to improve if necessary so that he/she can continue to work with dignity.
  12. llg

    Ridiculous class schedule, please help

    There is something I am not understanding here. Do all students in your program have to take that same course load? If not, why are you being scheduled that way? Are you not taking the standard curriculum for some reason? Are you already "off track?" If most other students do take that same load, then why should you have more problems with it than they have? Talk to some upperclassmen and find out exactly how difficult those classes really are -- how many hours of work they require per week, etc. It may not be as much as you think. Any given class can be made more difficult or easier, depending on how it is taught. Find out how hard/time consuming they really are at YOUR school before assuming they are as hard as they are at some other school. (Decades ago, at my school, some of the classes you mention were easy ones that involved 2 hours of class per week with 2 hours of lab -- and not much homework. The harder classes were the ones in which you had to read a book per week and write a paper every 2 weeks --not the little science labs courses.) Find out the specifics of each class by talking to upperclassmen before you decide. The posters here probably went to different schools.
  13. I agree with JKL33. Learning to work in a stressful environment without stressing yourself and burning out is a process that often takes a while -- and considerable change in the way you see yourself and your work. I agree that much of the "take better care of yourself" advice out there is often too superficial to handle the deeper issues that can be involved. Be prepared to have this take a while. What other specialties interest you? Did any appeal to you as you went through your student rotations? Have you seen any type of job out there that you might like?
  14. I always used, "Sorry, I have other plans." What those other plans might have been were none of their business. I think you are lucky if they are asking you well in advance as you describe them asking if you have any days available in November. That wouldn't bother me so much because I could then pick a shift to volunteer to "do my part," and then be able to say, "No, I've already scheduled myself extra for the month" whenever they asked again. I used to tell my Manager that I would pick up a little occasionally if I knew well in advance and could pick my shift ... but that I would never pick up extra time at the last minute. Also, do not answer your phone when the caller ID says it is them. Let it go to voice mail and then respond only when you are good and ready to talk to them.
  15. You sound like you are starting to experience a bad case of "burn out." It's great that you can recognize that something is wrong and that you are looking for ways to improve your life. So ... start by patting yourself on the back for that. I think the next step in your "recovery" will be the hardest. In order to move forward and improve the quality of you life, you will need to make some changes. Most people fight making those changes because they cling to the idea that the way they do things now is the right way. They have made the choices they have made in the past because they were the right decisions to make -- and doing anything different now would not be a good choice. But doing things differently (or making changes) is the only way to improve things. Does that make sense? If you really want to stay in the ED because you like the nature of the work and the team you work with ... then you will have to find ways to take better care of yourself so that you can better cope with the stresses of the job. How many hours per week do you work? Can you cut back a little? Have you been using your scheduled off time and vacation time regularly ... and using that time to do things that nourish your psyche and soul? Have you been able to leave work behind when you walk out the ED door? You will probably need to separate yourself from the ED a bit in order to keep working there long-term -- or it will "eat you" over the years. Or are you really looking to leave the ED and find another specialty to work in? Do you think you can stay in the ED and thrive there long-term -- or do you think that finding another specialty is what you really want to do? Remember -- all specialties have their own set of unique skills. You won't "lose your skills" when you leave the ED. Your ED skills will weaken a little, but you will gain a whole new set of skills in a new specialty. You will become more well-rounded as a nurse as your focus broadens.
  16. llg

    PhD nurses educating DNP students

    I can agree with this. Nobody who doesn't examine patients regularly should be teaching "physical assessment" or similar content in the curriculum. The qualifications and recent experience of faculty members should match what they teach. I am 100% in agreement with that principle. But as I said in my previous post, the DNP is a young degree ... and nursing is still a relatively young academic discipline. Nursing is also a practice science, which gives it a different set of issues from the pure lab sciences. It's going to take quite a while for the discipline of nursing to mature to the point of having some of the standardization that you seek. A lot of the most qualified faculty members to teach DNP students may be nurses with PhD's who have maintained a practice focus rather than become pure academicians. Also, even the more mature disciplines have a lot of variation at the doctoral level. That is the nature of the doctoral level education. It is more specific and focused on the specific interests of the faculty than the more generic, entry-level curricula of Associate's and Bachelor's programs. All of this is just more reason for each student to carefully research a variety of schools before choosing one for the doctoral-level education. I think that need for research is true at all levels -- but it gets increasingly true at the higher levels. You need to choose a school that matches your needs and philosophy. All schools will never be alike -- and shouldn't be.