coco3299

I love my job and made a natural transition into management from a staff nurse to lower level management (supervisor) to finally manager. The reason why I am going to be leaving (aside from the fact I have a new degree I want to put to use) is that we have spent the last 4 years talking about the same thing and circling the drain with the same issues! It is almost nauseated to sit at mandatory meetings where voices are not heard and the agenda of investors and shareholders is priority but if the just listened to 'the people' they would realize even greater potential of not only money but employee and customer satisfaction. We have taken on a mentality that everyone is expendable and work good people until they quit and spend time and money finding new people instead of just preventing that from happening. My job has been really supportive and I have done things I always wanted to do (get better at being a leader and managing and organizing processes) but beyond that there is little room for opinions on how to make real change work. I've seen so many people come and go I am tired of picking up the slack, training people, answering to why something impossible didn't happen. Companies need to learn the difference between lifting their 'lid' and being delusional.

I'm here looking for corporate owned places that may be in ga other than American laser but you should try there on their site go to ABOUT and search careers they have some states hiring, not mine though.

So the long story short is I have an obese pt who continues to insist she was told in home lymphedema therapy is available for her. I am home health nurse and we only do compression for wounds and then pt is offered long term option such as compression socks they can manage alone but we dont do long term swelling management only heal wounds. So my question is 1. Does Lymphedema ever go away? What is long term goal for pt with lymphedema? 2. Is home health used in such situations, again she is morbidly obese and I think this is her main problem rather than lymphedema. 3. How could this pt even have ABI? 4. I am not even sure her large legs could be compressed if her ABI was satisfactory. 5. She has no caregiver and 5. Cannot go to outpatient clinic but primary MD is frustrated with her and MD has offered to write orders if home health can assist. I have discussed with CWOC over phone but went back to order joint visit but over phone she stated this would be unlikely for pt and Lymphedema is usually managed by clinic where pt is seen often not home health where the pt only sees MD sometimes once a year. Pt even states clinic did indeed tell her this about being able to ambulate to clinic often but again she says they told her home health can do this but offered her no company names which lead me to believe she is fibbing and refusing to accept responsibility for her obesity.

Hey guys, thanks for any help in advance... I am a home health nurse and while I was in orientation I was seeing a patient who is very pleasant and concerned about the wound. It has gotten to a certain point, like 4x2.5 and undermining and stopped healing. THe patient is only 80 lbs. Iodoform has been used with mesalt for quite some time. It was SLOWLY closing last I saw her but I had to change areas because her regular nurse was back off leave. SHe was none too pleased to have that nurse back and I am finding this nurse may not be as into such patients as this one (and one other wound pt) as she should. Recently at team meeting she said the wound was in DECLINE again. Ugh. What can be done for this lady to see what the problem is, she lives a sedentary lifestyle but will stay off the sacrum if requested, she says she doesnt know and does not know why this year old wound is not healing. When a wound is anemic, what does that mean exactly and how can you know for sure? Does silver nitrate have usually good results? When is mesalt used? How long should one dressing be used?

The Messiah? Be lucky you have a job. Getting paid peanuts in your scenario would take years, in the meantime be happy you have a CAREER that is lasting. Stop trying to find any excuse to get to the end result in your mind that was made up before an action even took place... just searching for a reason to down talk. Take a look around, the reason nursing became this big boom everywhere you look is because Medicare became this free for all and places where hiring nurses to keep up with the need. Now that Medicare has been sucked dry the hospitals are turning patients away and telling them to follow up with PCP where they used to admit them for any and everything. And calling off nurses for low census and there is an overflow of new grads who were told how great the profession could be long term and now the door is being closed in their face. So say what you will about THE MESSIAH but I am sure you will be taking those patients you get because of the reform. If you dont like it then go somewhere else. And while I'm on my soap box if you have an opposition to mandated insurance, then fine! sign a waiver saying you won't come to the ER if you have an emergency and tell your patients the same. If you dont want car insurance then you dont drive a care. We cannot afford to keep taking cases and not getting paid.

Is it online or ground? Didnt mention online which leads me to believe it is ground. Not sure why when every other school has online classes and they were on the forefront of this....

Ummm I don't get where these questions are from and what you need done...

Well that sux. Im so afraid of this. At least you have credentials that can def. get you another job. Some people are losing jobs they got by luck years ago and with a layoff they are realizing they were too secure with no real educational backing. You will def find something else soon. Where do you live if you don't mind me asking.

Well I am bumping this thread because I want feedback from others- who else had state limits on preceptors? What if you were mainly online? I had no idea there were contracts with BON regarding preceptors- I wonder what that entails.

I am confused by this too because some programs take nurses from all over the US online, but my online program is saying that students can only go so far for preceoptors because of BON contracts??? So how do other schools have students nationwide? I am moving two states away and don't know how this is going to work...

Theoretically I know NPs can make the difference. I have been treated by an NP and request that my preemie son see an NP at his peds office- she is great. My main concern has come my first semester at NP school which is online and basically I am being given random assignments and taught NOTHING! To boot, I contacted a friend in CNS track at a VERY REPUTABLE school where they offer online as well and she said the same thing. She was just as bothered by it as I was. She said she is over it and ready to graduate. Again, I know NP's can do the job, I have witnessed that, its just that with the demand for convenience it seems that online professors forget to actually TEACH. The irony is that the criticism that comes from attending the UOP was much greater than my current school and the Univ of Phoenix actually TAUGHT me and interacted with students daily! I am afraid for my profession if our schools don't realize they may be lacking right now. I have been sitting here a week trying to decided if I want to write someone of authority on this matter. I mean, I want to take care of patients for crying out loud! I want to be confident that I can perform the duties of my job when it's all said and done.

So you liked UOP too? What type of MSN do you currently have? I am sitting here considering transferring from this school. While their BSN program seems to be more organized, perhaps they are not in tune with the needs of the online learner. I need to make sure I am going to be ready to treat patients when I leave this school and right now I am not convinced they are helping me move toward this goal. I wish more people would respond because I really need to know what other's have experienced in doing online NP coursework.

Students usually take classes to bring GPA up. Go to a GPA calculator and see how many classes you would have to take to bring it up. The other option is 'conditional acceptance' where you have like a year to bring GPA up.

I heard LSU is tough too. Being from Alabama I have always heard and sensed personally that attitude described earlier by USA which was my turnoff. I knew if they were so crazy with their demands during admission then they would definitely continue and get worse as the classes got tougher. I like a smaller program that treats me individually.

Thanks, I was hoping to get some more feedback!

I do not have the time nor the energy to argue the 'what if' all day. We stated our positions, moving on. I did not read past your first line when I saw the thesis you had written. Point is when the program comes along I will take it. Then you can protest at Washington if you want to. Good Luck to you!

If you read the concept of the initial poster the topic was a bridge from MD to NP. Thanks!

I'm sure it was 'doubtful' that nurses would ever have prescriptive authority but they now do. Chaos and conflict brings about change. Primary doctors are running low and the number of insured will greatly increase with the passage of the healthcare bill. This is why part of that bill was to greatly increase the number of primary practitioners available to the public, per the government. This will indeed anger many doctors who feel they had to 'work harder' but from that anger will come those doctors who want to be known as initiators and innovators and find a way to create that program to shut those whining doctors up. They will say 'if you want them to be doctors, then lets make a program'. DUUUUH. Only logical thinking such as the original poster would lead one to see that the closer nurses are to MD's that bridge programs would pop up, just like bridges from Bachelors to BSN or LPN to MSN! And in previous years that quote was just a cute saying, but with the flood of NP in the market I can say personally that nurses do indeed make better doctors. Nurses take on a wholistic approach and treat their patients more humbly rather than getting their MD credentials and being pompous throwing info at patients and walking out leaving the Nurses and Patients to decipher what he said. Personally I have seen two adult NPs that were top notch and made me feel totally comfortable as a patient and very recently my preemie son was at Peds NP who did a complete body asessment on him and found a deformity on his spine... a gluteal crease or something... that even his neonatologist didnt find in 8 weeks in the NICU. Specialty doctors can be very knowledgeable and the bridge will be basic at first, no doubt, like Family Practice, but not far from happening. You sound a bit sarcastic and cynical and I do not know your credentials but if you want to turn your nose up at the possibilities that lie ahead I feel sorry for you. Healthcare is dynamic and will NEVER stay the same. You can either get with it or be without it. This board is for nurses interested in empowering one another and I am totally tickled that you woke up on the wrong side of the bed! Hope you have a better day :)

So I know many NP programs offer distant learning now and I have decided to start one myself. I went to University of Phoenix for an MBA years ago and I just wanted to know if anyone could answer any part of this question. 1. In your online studies did you feel you were prepared to take ANCC test? Why or why not? 2. How much feedback did instructors give you online? At UOP we had constant personal feedback in the forums that was always directed to the concepts of the course. My first weeks at this school make me a bit uneasy. We are basically doing assignments that dont really relate to (for example) patho. I am expecting the instructor to move at a fast pace and reference the readings, but she just keeps giving us random case studies that dont have a real right or wrong answer or relate to the outline concepts. Is this normal? 3. Where can I find school ANCC pass/fail rate. The BON has undergrad stats but not grad stats. 4. How is ANCC compared to NCLEX. Am I phrasing this right, or does NCLEX do NP as well?

With what part don't you agree before I rant on everthing in that quote...

I told my friend last year that these programs would be sprouting up in no time. Its the only natural progression that can come from NP's and esp since nurses make the best doctors. It sounds like you want to be involved in the dirty work of getting it started, I myself want to finish NP work there and when I look up again these programs will be everywhere and I will take advantage. Good luck and Godspeed as Im sure others are working diligently at this.

This is the second of my top two areas to work in. I notice, though, that most free clinics are ran by local medical schools. If you live where there is a medical school then chances are they have cornered that market. I am not sure how, perhaps they use part of their grant money to run it, perhaps they get reimbursed by state for collecting data for the state. You could look into getting reimbursed from the state.

Keep in mind that with the passage of the Affordable Care Act earlier this year nurse practitioners are considered a cornerstone to being able to give care to so many Americans that will be insured in coming years. It may seem slow now but hang in there everybody and their stepmother will want to be a NP when its all said and done. Not to mention the bill calling for states to restructure their laws regarding NP independence. If not now you will eventually be able to start your own practice and hire yourself.

It sounds like it might just be you being nosy and this may be none of your business, but in any even if you are THAT nosy you can request a public document of that person sent to you for around twenty bucks. Call the board.

LOL no one is going to say what is the wrong/right thing they would have done which is to ask once and not make a big deal. When it was obv there was nothing to be done as far as getting it then give other 2300 meds and wait an hour to see if pt noticed and chart as given. Then make not to fax pharm for next admin. If coworker asks tell them you had overlooked it. Obv this place has no pyxis by how country it sounds. I have worked at places like this before and they will def contribute to you facing state board. I had manager call me when I was working agency and ask if I gave all the dilantins because there were extra. smh. 'look at the charting' I said. Then another nurse lied about giving something and she called me to ask about a conversation we had. I was like 'if it aint documented it aint done and vice versa' so 'I dont remember look at the charting' all the while making a mental note not to answer the phone for them again after I clock out. And I didnt! Only thing is when OTHER NURSES (lol) do things like falsely documenting they have to always check and double check and cover their own a$$ which is why it is not advisable. From a legal standpoint I wouldnt give a jack sh*! about charting it wasnt there if it wasnt. And if the hospital wanted to make something of it I would call every state organization I could, but that confidence comes from experience and they are basically playing on your inexperience. Trust me, you will be the fall person if the fit ever hits the shan. Trust that. But reporting them you have to be prepared to pack your stuff, but then there is whistleblower protection. Its a tough titty kid but you gotta make up your mind. Thats how nurses get caught in pickles, damned if you do, damned if you dont. But what everyone else has said is illegal too, not charting the truth. As another said you could always 'borrow back' I didnt know borrowing and replacing later was illegal. As long as you follow the 5 rights of administration.... I feel for you, good luck.