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Thank you! I appreciate your response. That is very helpful.

Hi, Is anyone here an instructor for an online education program? Is there a clinical aspect to your program that you oversee? If so, how does that work with your license if you are teaching students in other states. Thanks! eflr

I am just completing my certification form Duke Integrative Medicine. I believe the Duke program was one of the first coaching programs. They teach a "pure coaching" model. It's a wonderful program based in mindfulness. Health coaching focuses on self-sustaining behavior modification. It is different from the education we do as a nurse. It also is different than psychotherapy. It focuses on the present moving forward, not exploring past issues. It is a completely different set of skills. However, providing education and resources can be incorporated into this role, but not the focus. As someone mentioned previously, it is client/patient driven. The goal is to support them to make the lifestyle changes they want to make and sustain them for the long term. It is a process over time, not a quick fix to a goal. AHNCC is another great resource as they have recently developed a nurse coach certification. I believe one of the main organizations of the training is inursecoach.com. I think they were greatly involved in creating the certification. We, as nurses, know it is greatly needed. However it is still a challenge because most people don't know what coaching is. So I tend to do a lot of educating about what coaching is. I am also still reviewing liability issues. As nurses, we are held to our highest license, there are also legal issues that are unclear surrounding nutrition advice.

Hi, Does anyone have any experience with a nutrition education program for RN's. The only credible ones that I come across are for NPs or for becoming an RD at the BS/MS level. I am working towards certification for Integrative Health Coaching through Duke, so I'd like to find some additional education for nutrition. Thanks! eflr

I am a med-tele nurse experiencing hospice because my dad is there. I've staying there most the time. It has been very confusing to me so I'd like to know more about what hospice is meant to be. I don't feel my father's pain/restlessness has been managed very well. Over the weekend, he was seen by the weekend doc. When we met we had told her he was finally in a good place and had the best night the previous night due to change in his meds the day before. That evening, he ate and conversed with family. I spent the night. The nurse had given him po pain medicine at midnite and I heard him gurgling shortly after. So I went to check on him and he was so sedated he couldn't even focus on me. His respirations were decreased. I went to get the nurse. She explained to me that this was his"disease process." I told her no, I'm sorry, I think he's overly sedated. She continued to explain the "disease process" until I finally said please come to the room to assess. He continued to be sedated throught the night, so I got charge nurse (who apparently was notified earlier by nurse, but did not bother to come to room). She said it appeared he got to much, it just needs to wear off. He was so sedated, I couldn't get him to stay awake enough to urinate, so I was concerned how that would happen. My mom was distressed. Finally in am, I was able to get a little more response after calling pt advocate. But even MD argued it's his disease process. (Turns out she majorly increased pain meds earlier that day, even after we had told her he had the best night the previous night.) Foley inserted and eventually he woke up, but very aggitated. I requested MD be called for plan. MD, not so receptive, d/c'd all scheduled meds and only made available PRN. He's been consious, slightly loopy, ever since, but eating. We met with the regular doc that had seen him during the week and got him back on plan. It was such an agonizing, frustrating experience. I feel they have an attitude of he's in hospice, so there's an underlying excuse of "he's dying." But I feel he should dye in his own course, not because of negligence. Is it wrong to think that these circumstances should be corrected? It was also very frustrating because during the night, other than nurse/ charge nurse, there were no other resources for help. Any thoughts would be appreciated.

Thank you this was great insight. I agree I need to work awhile before going for the MSN, but was trying to plan to see if the BSN was really necessary. I think your right when you say having the BSN will open more doors to graduate studies - at least that's consistent with what I've seen from schools. There are some programs that you don't need it, but seems like most want you to have it. Thanks!!!

Thank you - I will look into those schools!

Thank you to all - I appreciate all the resources!!

Hi, I'm a new nurse and wanted to see if anyone knew of a link to a good site regarding pain meds. I'm looking for something like a chart that shows mildest - strongest, and a brief summery of what each may be used for/comparison between each of the different kinds. Being a new nurse, I'm really struggling with making decisions with regards to pain and understanding why one med may be more desirable than another. Any feedback would be greatly appreciated. Thanks!! eflr

Try Northeast Ga Health system or Gwinnett medical center.

Hi, I'm looking into the RN to BSN programs in south florida. I just graduated from a school in Ga with an ASN and have a BS in a field outside healthcare. I may move to Fl to be with family so I'm looking into schools there. I'm trying to decide if it makes more sense to get the BSN or just get the MSN. But I'd like to learn more about any schools that offer the RN-BSN and how difficult it is to get in, if there are online programs, and experience others have had. I have a 3.8 GPA. Ultimately I'm very interested in nutrition, preventative and holistic medicine. Thanks - I appreciate any thoughts!! eflr

I'm a new nurse that graduated from an ADN program. I'm nearing the end of my orientation on a med-tele floor and don't feel like I'm ready to be on my own. I started the orientation in mid-August, it has included class time as well as having a preceptor on the floor. I haven't felt good about the preceptors that I've had, but I've been trying to make the best of it. When I was in school I had a great clinical instructor (a nurse that worked on a cardiac unit and back in school for her NP). She taught me the way my brain works - methodical, systematic, organized. So I was hoping to have similar qualities in a preceptor. The first preceptor I had for 2 weeks was extremely disorganized, so I talked with my manager. She assigned me to 2 other nurses, because of the scheduling and the other choices, that was the best she could do. One had great time management, the other good patient care. But being older nurses, they take so much for granted that they really don't "train." I've asked questions, but feel like I've had to pick a lot up by osmosis and I only know so much to ask questions about. Even when I've asked questions, I receive a response like "just do this." But for me I need some substance - why am I doing this and how does it relate to the patient in front of me. So I worked with them for several weeks until the classes were over. Then I got switched to night shift and started over with yet another preceptor and learning a totally new routine. She showed me the tasks for night shift, but has pretty much let me go on my own and is available for questions. I'm concerned because I feel like I've learned the "tasks" and the routines of the shifts, but I don't feel like I've received any insight into how to approach patient care - what to look for and what to consider with the many different types of patients that we deal with. How to take all that stuff I learned in school and apply it to the patient sitting in front of me. Insight from a clinical perspective. For example, here is a patient with pneumonia, these are generally their issues..., you need to look out for.... and check.... I've also had a conversation with my clinical instructor, the one I mentioned that I like, and she agreed I may not have had the best orientation experience which makes it more difficult. So because I fear for my patient's safety and loosing my license, I'm very stressed about being on my own. I know some of this is normal, but I don't feel like I have what I need. So I'm trying to consider my options. It was said to me I have 6 more shifts and then that is all they can do for me. I don't feel that it is a matter of time, but of the content I've received. So I don't know if I should look to be moved to another unit or look for a different job in another hospital where I might get better training. I'd appreciate any insight. Thanks!

Hi, I've just recently graduated with a ASN degree, passed my boards and have a previous bachelors degree in a non-healthcare related field. Does it make sense for me to pursue a BSN degree since I already have a BS? or go straight to the MSN degree? Will I be lost in an MSN program without a BSN? I'm enrolled in a BSN program and started to take the classes, but now I'm rethinking that path and think it's best for me to go straight to MSN after I get some experience. I will need to start planning for it and take some core classes I'm lacking. I think I'm primarily interested in becomeing an educator (not at a college), as opposed to becoming a NP. One fear I have is loosing my BSN place and then having requirements for the ASN-MSN program change (if they change to require a BSN) and then I will have to start all over anyway. Thanks I'd appreciate any thoughts you may have on your experience or how an MSN is perceived without a BSN. eflr

Hi, I've just recently graduated with a ASN degree, passed my boards and have a previous bachelors degree in a non-healthcare related field. Does it make sense for me to pursue a BSN degree since I already have a BS? or go straight to the MSN degree? I'm enrolled in a BSN program and started to take the classes, but now I'm rethinking that path and think it's best for me to go straight to MSN after I get some experience. Will I be lost in an MSN program without a BSN? I will need to start planning for it and take some core classes I'm lacking. I think I'm primarily interested in becomeing an educator (not at a college), as opposed to becoming a NP. One fear I have is loosing my BSN place and then having requirements for the ASN-MSN program change (if they change to require a BSN) and then I will have to start all over anyway. Thanks I'd appreciate any thoughts! eflr

Hi, I will be graduating from an associate degree program in May and I'm trying to get some sort of feel out there as to what the job situation is. I've heard from many different sources that some of the hospitals have hiring freezes - especially for new grads. Is this true? I would love to hear from anyone as to what they are seeing in terms of hiring in the hospitals that they work. Also, I've already started applying to hospitals, but many say that there won't be new grad positions up until April - which seems to be so late for May grads. Is it best to go through HR or to somehow go to the departments that you want to work directly? It is such a frustrating and confusing process because HR is like a brick wall - they are never very responsive and they discourage you from following up throughout the process. Any advice would be appreciated. Thank you!! eflr