Kat Mandu

During a phone conversation with a friend who’s also in his 60s, I mentioned how I now used a magnifying mirror when applying my makeup. His response was, “My God, why would you care at our age?” Well, I care. Because I’m not dead yet! And because I’m still very much alive, taking care of myself, which includes wearing makeup, though not as heavily as in my youth (I’ve found as I age, “less is more”) gives me a better body self-image. When I feel I’m the best version of myself I’m more positive about life and it lifts my spirits, even if I’m home alone all day. Being in your 60s and beyond is never an excuse for devaluing yourself! I’m not advocating any medical cosmetic procedures (I’ve had none) but if this is what it takes to feel better about yourself and the face you present to the world, then go for it if you’re physically sound enough to withstand the procedure. The fact is, we’re all aging, even the young-ish people we see on the internet. The aging process typically begins in the 40s and 50s, but can covertly begin as early as the mid-30s and continue more brazenly after that. Even if your muscles are toned, repetitive expressions will etch lines in your skin. (Remember how your mom said if you keep making that face it’d get stuck that way? Well, she had something there!) Psychological Benefits of Caring for Your Aging Self In my nursing career, which has encompassed hospice, geriatric, home care, oncology, psychiatric, and wound care, I’ve had the opportunity to observe the changes that take place among the mentally depressed, the older, sicker patients I’ve had. It was astonishing how even a dying woman would perk up when given a “make-over”, usually by her daughter or friend (or a 2-bit shave and a haircut for men). Psychiatric patients responded by becoming less depressed, more optimistic, and social. Many rated themselves more highly on many psychological assessments. It is worth noting that many nursing homes, hospices (yes, hospices!), psychiatric facilities, and oncology programs have small salons stationed within their units for women who wish to have their hair styled and/or makeup applied (usually by volunteers who come in once a week). One study found that those who look older than their chronological age died earlier and were less physically healthy. (Kligman AM, Graham JA. The psychology of appearance in the elderly. Clin Geriatr Med. 1989 Feb;5(1):213-22. PMID: 2645998.) It was concluded that “cosmetics can help the elderly attain some of the benefits enjoyed by the physically attractive.” An investigative article by the BBC stated, “Most people felt about eight years younger than their actual chronological age. But some felt they had aged – and the consequences were serious. Feeling between 8 and 13 years older than your actual age resulted in an 18-25% greater risk of death over the study periods, and greater disease burden – even when you control for other demographic factors such as education, race or marital status.” I’m not saying we need to try to try to give the illusion of turning back the clock such as Cher, Jane Fonda, Dolly Parton and John Travolta have and who all admit to repeated plastic surgeries. Their faces, after all, are their fortunes. And that, after all, is Hollywood. What I am suggesting is that we still care for our skin, our bodies and appearance to become the best version of our present selves that we possibly can. Celebrate Our Bodies We need to celebrate our bodies and faces regardless of where we are in life. Was a time when I had this image in my head of my being forever 24. Then I’d pass by a mirror and think, “Who the hell is that old bag?" Then the self-examination, self-deprecation would begin. Ruby Woo and Me Until one day, the light bulb went off and I realized no matter how my face and body had aged, it was like my 25 year old Ford pickup truck (which no one seems to understand why I still drive it!). It’s older, true. Dents and dings, more than 150,000 miles, faded paint, shocks going out, manual transmission, dome light doesn’t work. But that little truck is mechanically sound, turns over in sub-zero-temperatures when other, newer, bells and whistles cars have dead batteries. A few years ago, a brand new Lincoln turned into me at an intersection. The Lincoln had to be towed away on a flatbed truck while I drove off in my little truck, head lights still working and with the mechanical parts still intact. I call her Ruby Woo (after the Mac lipstick) and she’s reliable, takes me where I want to go and is very low maintenance, her appearance be damned. I’m like Ruby Woo. After all I’ve put my body through, it’s always come through for me after 60+ years! All the traumas, physical and mental, passage of time, physical punishments (like being on my feet for 12-18 hours a day, lifting heavy loads, going on 4 hours of sleep at times, broken bones), serious illnesses and accidents, I am still here. Maybe a little slower and some aches and pains, but still reliable and continue to function to a degree that surprises even me. I realized how remarkable and awesome my body is for all I’ve put it through! My Epiphany So instead of denigrating my body and its appearance to myself, I realized, with gratitude, the debt I owed it to treat it well, and yes, that includes using cosmetics just as I’d use touch-up paint and body work on Ruby Woo. You don’t stop caring for something because it’s old. So instead of denigrating my body and its appearance to myself, I realized, with gratitude, the debt I owed it to treat it well, and yes, that includes using cosmetics just as I’d use touch-up paint and body work on Ruby Woo. You don’t stop caring for something because it’s old. It’s Only Too Late If You Don’t Start Now** I’d suggest you begin watching on Youtube other women close in age to you that are still having a love affair with life and have a positive take on living your best life after 60. My favorite is Polished After 60. I’m sure you can find others. Start putting on your lipstick. Comb your hair. Get it styled (in my case, I’ve learned how to cut my own; not as difficult as you might think with the plethora of Youtube tutorials). Experiment with some makeup (wasn’t that one of the most fun things to do as a girl?) Take your vitamins. Try to maintain the social relationships you already have and whenever possible, develop some new, even if the person is younger than yourself. Always remember You are awesome and your body, which includes your face, are a miracle. Treat it well! From my blog: https://nursingouttakes.com/blog *Bette Davis quote **Author Barbara Sher

I see lots of posts revolving around dogs. I guess you can tell by my handle I'm a cat person! How many here love their kitties? I always had dogs - big ones...Collies, Rottweilers, Chows, Labs, mixed breeds. After my last dog died (15 years old) I decided it wouldn't be fair to a dog to have me as a guardian. I walked my dogs 1 mile every day, rain or shine, fed them the best food and lavished them with attention. But then work got busier and I was spending more time away from home and I had no one who wanted to share in their care. I've always had cats aside from dogs and truly they make excellent companions. Their aloofness is sometimes funny, but they are very affectionate, and intelligent and you'd be surprised at the schemes they come up with. I call one of my females "the Evil Genius". They each have their own personality. You can bond with a cat just as much as a dog. I still miss my puppies and wish I could have another, but now am dealing with growing older, less energy, and less room for a dog to take a good run. This picture is of Macey Runner, who belonged to one of my hospice patients. She was the constant companion and emotional support cat for 15 years to my SO who died 2.5 years ago. Macey only lived another 6 months after his death. I like to imagine George and Macey romping together through a beautiful rose-laden field (his favorite flower), fully healed and enjoying each other's company as they did in life.

As others have remarked, the world of employment is your oyster when it comes to nursing. Think about what you love or are good at doing. Do you love computers? There are many avenues in healthcare IT, such as writing or evaluating charting software, troubleshooting glitches that impede nurses from documenting care. Human resources - (would be such a novelty in my part of the world to have an HR manager that was actually a nurse!?) Recruitment and retention of nurses also Spring to mind. Pharmaceutical sales, if you like sales and meeting people. Insurance companies hire all the time for their compliance depts and as case managers. Fitness instructor, life coach, run your own nursing agency, records review, Lamaze instructor, instruct new hires how to use facility documentation software. If you're good at writing, approach pharmaceutical companies about writing their brochures. You could also proofread, edit medical and scientific papers. Advertising - get into a facility's PR dept. There are so many channels open to you as a nurse, I hope you investigate them all before you toss your hard-earned degree aside!

A friend was once in a similar situation. She used this service a few times called Allison & Taylor Inc. https://www.allisontaylor.com/ Their site says: "Find out precisely what a past employer will say about you, giving yourself employment guidance and peace of mind. We make actual phone calls to your former bosses & HR. Conducted discreetly, our reference check process gives your reference's word-for-word commentary, viewable in your private, secure online account. Over 53% of those called do NOT HONOR POLICY." ------- It costs about $79 but sounds worth it to me not to be blindsided by a vengeful manager. She said she had a fast turnaround time and a very complete report as to what was said. I am not affiliated in any way with this company. Just a thought. I wish you the best!

I thought it was barbaric (there was no anesthetic) and asked the obstetrician (Yes, obstetrician. They, and pediatricians can perform circumcisions on infants) if he didn't think it painful, esp. since the poor little guy screamed his head off. He used Gomco and said newborns didn't experience pain the same way as older children. My job was to give the infant drops of sweetened water to "distract" him (which I'm sure it didn't.) I noticed a few male nursing students who were observing, crossing their legs! I coped with it by moving on to a different department in the hospital. Before I had ever witnessed a circumcision, some 20 years before when I gave birth to my son, I had reservations about it. As it happened, the day he was born, he was the only male in the nursery. Every time I heard a baby scream bloody murder, I'd ask the staff, "Was that my baby?" (thinking that the circumcision was in progress.) Fast forward to today...I've had a few conversations with my now adult son and told him if I'd known what I know now about how brutal circumcision was, I'd have never allowed it. His response was always appreciation for my having had it done as he wouldn't have wanted to look different than his dad or peers at school. As an aside, the circumcision cost $80. :-0 While working in hospice, I saw a lot of older men with nasty complications d/t being uncircumcised. If the foreskin had been pulled up around or just under the glans, it would be a veritable nightmare if the pt had any type of lower body edema. Then it would be impossible to pull the foreskin back and urine would fill the pouch, inflating it further. If the foreskin was retracted to just under the glans and edema occurred, it would literally strangle the head and again, impossible to pull down. My dad was from the "old country" where circumcision was not routinely performed. He decided at the age of 48 to have it done. He was in a LOT of pain afterward and he did have the benefit of anesthesia pre and post-op. I can't help but think that an infant would feel the same level of pain.

I thought it was barbaric (there was no anesthetic) and asked the obstetrician (Yes, obstetrician. They, and pediatricians can perform circumcisions on infants) if he didn't think it painful, esp. since the poor little guy screamed his head off. He said newborns didn't experience pain the same way as older children. My job was to give the infant drops of sweetened water to "distract" him (which I'm sure it didn't.) I noticed a few male nursing students who were observing, crossing their legs! Before I had ever witnessed a circumcision, some 20 years before when I gave birth to my son, I had reservations about it. As it happened, the day he was born, he was the only male in the nursery. Every time I heard a baby scream bloody murder, I'd ask the staff, "Was that my baby?" (thinking that the circumcision was in progress.) Fast forward to today...I've had a few conversations with my now adult son and told him if I'd known what I know now about how brutal circumcision was, I'd have never allowed it. His response was always appreciation for having had it done as he wouldn't have wanted to look different than his dad or peers at school. As an aside, the circumcision cost $80. :-0 While working in hospice, I saw a lot of older men with nasty complications d/t being uncircumcised. If the foreskin had been pulled up around or just under the glans, it would be a veritable nightmare if the pt had any type of lower body edema. Then it would be impossible to pull the foreskin back and urine would fill the pouch, inflating it further. If the foreskin was retracted to just under the glans and edema occurred, it would literally strangle the head and again, impossible to pull down. My dad was from the "old country" where circumcision was not routinely performed. He decided at the age of 48 to have it done. He was in a LOT of pain afterward and he did have the benefit of anesthesia pre and post-op. I can't help but think that an infant would feel the same level of pain.

Inspirational! Thanks so much for writing such an interesting piece!

If the news would stop covering Trump's insane antics, it might lessen his impact on his followers. He's playing the media like a fiddle, as usual. The bell has rung, fight's over. Let's everyone turn towards supporting our new president and rebuilding our country. Shame on the news for covering his craziness. Hopefully, our government has a plan in place to prevent any more violence.

Congratulations on your interest in one of the most rewarding [for some of us] areas of nursing! It differs from hospital nursing as you usually have frequent and extended interactions with the patient's family. You'll find yourself being nurse, counselor, mother, friend, psych nurse, and educator, usually all during the same shift. You'll serve all types of patients with a myriad of conditions and see things you would never see in a hospital setting. You need to be able to separate your work life from your personal life (as it's not uncommon to become attached to certain patients when you've cared for them for a long time). A sense of humor is a must (for me, anyway), as if you can't laugh at some things (not at the patient), all you'd do is cry. Hospice nursing can be very emotionally and physically draining and you must learn to take extra special care of yourself. That being said, first decide if you want to work at an inpatient hospice where you have lots of support or home care hospice where you still have support but not as close by. With HC you have to shoot from the hip more often and nurses whom I've known in HC have found this to be most attractive as no one is hanging over your shoulder micro managing. Some hospices provide a car and some don't. Those that don't usually reimburse you for gas and mileage. If you choose this route, be sure the reimbursement is enough to cover more frequent oil changes, wear and tear on your vehicle, and eventually enough to replace your entire vehicle because you'll be putting a ton of miles on it. Depending on the terrain, a 4-wheel drive, while not absolutely necessary, is a good choice. Your experience should make you marketable right now. Does oncology experience help? Yes, somewhat, but not essential. Remember, you're not there to cure anyone, but to make what remains of their life more tolerable. Understanding a patient's disease process can be learned on a case-by-case basis so you'll know what to expect and what to watch out for. For instance, any type of cancer can spread to the bones of the spine, which may lead to spinal cord compression which is a true emergency. But some of this should be covered in your orientation, along with educational materials your employer should provide, in-service sessions and you can always study on your own. The interesting thing about hospice nursing is every time you think you've seen it all, you'll see something new! Other areas of nursing besides oncology that are helpful (as not all patients have cancer) are LTC, sub-acute care, psych, wound care, med-surg, pulmonary, home care, to name a few. Certification is great after you have hospice and palliative nursing practice of 500 hours in the most recent 12 months or 1,000 hours in the most recent 24 months prior to applying for the examination. But it’s not necessary to obtain a job in hospice. It actually only increased my pay scale by $1/hr back around 2007. Since I worked at least 2000 hours a year, it was like a $2000/year raise before taxes. A potential employer might allow you to shadow one of their nurses. The only way you’ll know is to call every hospice near you, ask for the DON and find out. Worst that can happen is they’ll say no. You could try volunteering at a hospice, which can be really time-consuming, given the orientation and extra hours you’ll be away from home. But this would give you an inside look at what goes on in a hospice. I wouldn’t volunteer as a nurse (don’t know if that’s possible anyway) but just as an extra set of hands. At an inpatient hospice you might pass water, distribute floral arrangements, read to and visit lonely patients. You’d get to cover more territory, see more things than a nurse assigned certain patients. I understand many hospices are going to the 3 day 12 shifts. You can always be contingent and let them know when you’re available. One final piece of advice…when you find a hospice that wants to hire you, make sure YOU interview THEM and do a bit of research online about employee satisfaction. Back in the day, when hospice was a grass roots, nurse run proposition, most of us felt we had a calling, a ministry, if you will. But all that’s changed in the last 10-12 years, IMHO. The profession is going more towards palliative care, rather than the bulk being end-of-life. Many of the diseases….breast and lung cancer, for instance….certain kinds are not immediate death sentences and just require pain and symptom control. Hospitals and LTC, realizing what a cash cow end-of-life care was, began opening their own “mini” hospices, taking business away from small hospice organizations. The smaller hospices started advertising in order to capture an audience not quite at death’s door, so you have more active and complicated patients. At the same time, like the other facilities, they’ve cut back on staff but expect you to function at the same pace. You can also expect to deal with the same stuff you’d experience in a hospital. Incompetent administration, back biting colleagues, dictator style lower management (who might have even less experience than you!), favoritism, unrealistic patient loads, etc. Not saying they’re all like this, but some red flags to watch out for. Remember, it is a business. When taking a poll among my nurse friends in other specialties, I found the pay scale was lower and the benefits shoddier in hospice. This may just be my part of the country, however, several years ago, I took a break from hospice to work in drug rehab and was stunned when my starting pay was a full $7 an hour more! But as I said, might just be where I am. A blogger once did an interview with me which is pretty dated, actually, the website appears abandoned, but in it, I described what a typical hospice position is like. You may find it useful. https://www.careerocean.com/hospice-nurse-career-guide Good luck with your noble pursuit. If you have more questions, you can always message me and I’ll do my best to answer if I can.

You definitely need to know the concentration before deciding on the mL as numerous posters have said..... I learned a lot from my old Curren book also. One thing that stuck with me is the question when calculating a dose, "Is that reasonable?" Most drugs are measured in whole mLs, however, there are some exceptions, such as narcotics and insulin that are measured in TENTHS of a mL. Above is a 1mL syringe to give you an idea of the difference between a 3mL and 1mL syringe (which is what you'd have to use if the correct dose figured out to be truly 0.15mL). It is divided up into tenths. 0.15mL would be right about where the red line is drawn. I probably wouldn't mention it to your instructor, either. Some can get quite surly if you point out their mistake. One I had gave everyone the wrong information then marked the answers (which the students got factually right) wrong on the test. It took some hair pulling to get that changed! Sounds like you need to bone up on dosage calculations yourself and learn decimal place values. Good luck. And remember, there are no stupid questions.....

Read today in USA Today that "The State Department said it was working with Chinese officials to identify alternative routes for US citizens to depart Wuhan over land." "Those provided seats on the plan will face health screenings before boarding. The flight will refuel in Anchorage, Alasjam and the state's Health Department said anyone who appears ill won't be allowed on the plane. Passengers will then be screened "numerous times" during the flight and again in Alaska before continuing on to California," the department said in a statement. Wonder how many nurses will be involved in the screenings? Ironic, really. Back in the day of early commercial airplane flights, the first flight attendants were all registered nurses. This requirement disappeared when many nurses left to enlist during WWII https://www.thevintagenews.com/2016/09/11/first-flight-attendants-registered-nurses-requirement-disappeared-many-nurses-left-enlist-wwii/

Diazepam is Valium. Lorazepam is Ativan. Both of the benzodiazepine family and both list their uses in part to seizure and anxiety disorders.

I agree with almost everyone here regarding why nursing school is so hard. There's so many hurdles to jump ---- beginning with the pre-reqs. Some of it has to do with the pre-reqs, such as algebra and chemistry. Those two alone keep more otherwise good potential nurses out of the programs. I realize those two subjects in some way are helpful in nearly any line of work, but during most types of nursing, the courses I took (and realize these can vary from school to school) were way too much - information overload. I've never found the need for algebra or a deep knowledge of chemistry in my practice. The chemistry we need to know was covered in the nursing classes (eg. respiratory vs metabolic alkolosis/acidosis.) The drug math we use, even the dimensional analysis method, doesn't come close to any of the algebra I had to learn. Drug math was covered in nursing classes each semester and as someone mentioned, we had to pass with a near 100% score and only got 2 shots at it. Some of it has to do with draconian instructors who haven't been seen in or practiced in a clinical setting in 30 years. Some will mark points off an otherwise meticulously researched paper for a few spelling errors. Some have the old-school mentality of separating the wheat from the chaff. That's one reason why so many students drop out during the first semester. Tests or grades can't fall below 80% in most schools. That's a "B" in most other majors! As some mentioned, the critical thinking (new buzz phrase for logic and reasoning) is tough. Answers are not spoon-fed as they are in other types of professions. I do disagree that memorization is not required. Many things need to be committed to memory --- conversions, lab norms, symptom lists; there are sites devoted to mnemonic devices to help students remember many things related to nursing, pathology, etc. Also the time invested...clinicals are not just something you show up at a few times a week. The night before each clinical, you drag your butt to the hospital and research the patient(s) you're to care for more thoroughly than any practicing nurse ever has the time to do (wish we did!) Then comes the clinical, the care plan, etc., you may even find yourself writing a process paper on one of those patients. Then there are research projects, studying alone or with a group...all very time consuming. I usually tell aspiring nursing students to prepare to have no life for the next few years. Is it worth it? Yes. Definitely! I also tell them, "Nursing is the toughest job you'll ever love!" A very rewarding profession whatever your specialty. Guiomar Thoughts become things - choose the good ones! Mike Dooley

I would recommend that anyone taking the 50 question assessment test wait until a week or two before the actual exam. Any earliier and you run the risk of discouraging yourself if you score too low on it.The self-assessmemt test cost 535 when I took it. Unfortunatly, while you can go back and study your qestions and answers, there's no second chance to download a new self-assessment test with different questions. Wait until you're pretty sure you're prepared for the test. About the week before the actual test I took the assessment exam and its results were something like "Well above average. Well above the 20th percertile and likely to passl" This did wonders for my confidence and told me I'd studied much of the right information. Gpod luck with the exam Hope this helps. G. Goransson, RN, CHPN Author of: "How I Passed the CHPN the Fisrt Time http://www.chpnexam.com

Hi ~ I've written a short book on my experience and strategies passing the CHPN exam this year. I'd like three or four career hospice RN's to read and review my morificecript before I offer it to the general hospice nursing population for sale. This ebook will probably retail for $29.95 when offered publicly. It will be provided free of charge to 3-4 qualified respondents, to whom the book will be provided free of charge. My only requirements are that you are a currently licensed RN working in a hospice setting or, that you are preparing for a soon-to-be given CHPN test, or have passed the CHPN already. Also, you would agree to both a confidentiality agreement and use of your name, review or comments in advertising, and that no comments regarding this ebook are pubished on a public forum, such as Allnurses, without prior permission from the author (me). I would appreciate also, your critique and input on the ebook contents and price. Please contact me @ [email protected] if interested. G. Goransson, RN, CHPN http://www.kittyboxers.com