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JNJ

JNJ

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JNJ's Latest Activity

  1. Just FYI, many of the larger international health and welfare agencies that operate in developing countries ('third world' is no longer PC) do not accept gifts of out of date medications. However, smaller clinics and individuals may accept expired OTC medications and I have given recently out of date Tylenol etc to an underfunded orphanage in Tijuana, knowing that it would be safe and potent for some years to come.
  2. JNJ

    On Line Masters Program?

    You might want to check out the states in which you want to practice - also if you want to work in education. Some Boards of Registered Nursing e.g. California, can be very sticky about MS versus MSN. I know this to my cost - took me five years and dozens of letters/references etc. etc from my DON etc before CA would approve me as a full instructor. The BRN classified me as an Assistant Instructor for those years although I had years of full instructor experience, a degree in Education, and had published many times in educational journals. I even headed the Curriculum Committee in the school of nursing. When the BRN finally changed their minds about the appropriateness of my degree, I felt like sueing them for lost earnings over the previous five years - the school used my expertise and I had enjoyed the work, but the school paid me as an Assistant Instructor. This also meant I was not eligible to apply for the ADON (and thus, later, the DON position when it became open). This isn't a personal diatribe about the unfairness of life (!) as I found ways to do what I wanted to do, but I did want to really spell out the possible implications of not having that MSN.
  3. JNJ

    On Line Masters Program?

    California State University at Dominguez Hills has been offering Master's degrees by distance learning techniques for many years. I spent five years part time getting mine and the cost was only $6,000 total. They now do a Master's in Nursing online with various specialty branches. Dr. John Bear publishes an extremely useful book called something like, "Non-traditional degrees." This covers bachelors up to doctorates in non-traditional settings and helps keep you on the appropriate paths regarding degree mills and other such pitfalls which can become a time bomb waiting to go off in the resume. This book is not easily found; sometimes there is a small, rather suspicious advertisement for it in some of the nursing magazines. But it is an incredible resource and has guided me safely thru many educational issues. Dr. Bear acts as an education expert for the Federal Govt. and I do believe he is absolutely bona fide.
  4. JNJ

    picc lines & peds

    I've been maintaining a home care PICC for two years, two ports in a 25 lb child. We flush pre and post with 3-5 cc NS. Daily 3cc of 100u/ml heparin to each port. This protocol came from the (BMT transplant) unit in the mid-west that first placed the PICC. I did a comprehensive literature search for this sort of question a few months ago and came up with no definite guidelines. There was a thread around the subject though. Try a search or contact the manufacturer of the PICC. Consider the weight and fluid status of the child too.
  5. JNJ

    Need advice about an idea I have

    In the UK a midwife visits the newly discharged mother and baby for up to ten days - even making two visits a day if s/he feels it is warranted. Usually when the infant is 10-12 days old (but up to one month old if the midwife feels she needs to stay involved) the Health Visitor takes over the care, visiting prn, identifying health care needs and finding ways to meet them, not necessarily doing all the 'work' her/himself. There is such a variety of need for both mother and infant. In years of health visiting, I found it a very fulfilling job, with every day a little different. The job description is very, very wide, but certainly there is a huge need for the mother and baby part of it in the USA. (Obviously the HV met the mothers prior to delivery.) RHVs in the UK run their own immunization clinics (with an MD on the premises) and well baby clinics and follow thru right up to pre school visit. They have powers of referral and are trained to do basic tests on hearing and vision which pick up problems earlier than I see done in the USA. RHV requires RN with at least part of the midwifery course and varied RN experience. It's one year in HV college (sociology, social policy, psych., epidemiology, statistics, HV theory and practice, primary care issues, child abuse, public health etc) with fieldwork practice then about six months in supervised practice. The job can be very different depending on geography e.g. inner city, retirement area, immigrant area etc. I'm sure an enterprising OB RN could develop a practice for herself in this sort of work in the USA.
  6. Renerian: I'm sorry the professionals you talk with have had difficulty finding work in Ohio. Perhaps they are simply nursing professionals and lack the skills and knowledge to successfully become independent. Indie nursing takes marketing and moxie and tenacity and humor and thinking out of the box and research savvy and . . . get the point. You may want to direct them to the National Assoc. of Ind. Nurses independentrn.com where access to the forum requires membership, but oh how we share the above qualities and most of us are/are getting there with a little support from our friends. Power to us all. JNJ
  7. Rachel: In many states, the Medicaid program uses the term "independent nurse provider" (INP) to designate a nurse who is self-employed. I am an INP for Medi-Cal in CA. INP means that I provide nursing care independent of employee status with a healthcare organization. I obtain an order signed by my patients' physician(s) which legitimizes the administration of medications, treatments, and other procedures by an RN. I practice nursing within the CA Nurse Practice Act by maintaining MD orders on my activities. I think the terminology "independent" may have come from the IRS which uses the term "independent contractor" (IC) along with their rules and regs. for self-employed people of any profession. The National Association of Independent Nurses (NAIN) at independentrn.com defines "independent" as self-employed. I hope this clarifies the independent RN situation for you.
  8. JNJ

    Out Of BEDSIDE nursing

    Have you considered being an independent RN? There are many, many ways to achieve this. Most of what we dislike about bedside nursing is not actually the nursing care, but the politics, people, budget issues, schedulers, managers, etc etc. I fought burn out for 30+ years by changing my specialty every few years. It's a little scary and some of it was forced upon me by changes in my husband's work, but mostly it worked out. Education (I have been a qualified nurse educator since 1984) is not an easier option. The stresses and budget issues can be more overwhelming than bedside nursing, pay is not usually up to what one can earn in a high acuity clinical area, promotion structure has it's own problems (think drive to publish, get the Ph.D, tenure track etc) and taking ten raw students to an acute clinical site is a very specific sort of nightmare (and no educator of any caliber teaches what they do not practice!) Currently I work as an Independent Nurse Provider (INP) for Medi-Cal. My motivation is the control over my own life. I work about 3/4 time, still do something considered valuable to society, maintain clinical skills and am thanked for my work every day. I spend about half a day per month on paperwork related to being an IC. Check out independentrn.com although you cannot access the supportive, intelligent, practically useful forum without membership.
  9. JNJ

    Out Of BEDSIDE nursing

    Have you considered being an independent RN? There are many, many ways to achieve this. Most of what we dislike about bedside nursing is not actually the nursing care, but the politics, people, budget issues, schedulers, managers, etc etc. I fought burn out for 30+ years by changing my specialty every few years. It's a little scary and some of it was forced upon me by changes in my husband's work, but mostly it worked out. Education (I have been a qualified nurse educator since 1984) is not an easier option. The stresses and budget issues can be more overwhelming than bedside nursing, pay is not usually up to what one can earn in a high acuity clinical area, promotion structure has it's own problems (think drive to publish, get the Ph.D, tenure track etc) and taking ten raw students to an acute clinical site is a very specific sort of nightmare (and no educator of any caliber teaches what they do not practice!) Currently I work as an Independent Nurse Provider (INP) for Medi-Cal. My motivation is the control over my own life. I work about 3/4 time, still do something considered valuable to society, maintain clinical skills and am thanked for my work every day. I spend about half a day per month on paperwork related to being an IC. Check out independentrn.com although you cannot access the supportive, intelligent, practically useful forum without membership.
  10. JNJ

    I have failed as an HH nurse

    Nursebailey: Please do not give up - the nursing world is so very much in need of independent nurses. This cycle will change and you will be back in business again. Read the reply you have already had carefully - it was full of great ideas. Get a basic business card printed with something simple after your name such as "Amanda Bailey Licensed Practical Nurse (LVN) - experienced in the care of your loved ones at home. Call for free in-home consultation. References available" HIPAA does not mean you cannot advertise. And please do not complain about a mother being paid to look after her sick child. We do not make ourselves more or better by standing on someone else. This mother must be entitled to these care $. By all means fight for what you want/need, but not by putting someone else down. I practice in a similar line of work to yourself. I mainly work with Medi-Cal patients at home. Have you tried contacting a senior supervisor type person at your State's Medicaid offices. They may be able to help you by giving your name to a patient needing more/different nurses. Also, as you have peds. experience, have you tried to get into that huge informal network of mothers of sick children that exists throughout the USA? Have you asked the mother of the child you still have 8 hours with about networking for you? Have you asked the Regional Center for help finding a client - they are always contacting me saying they have more clients than nurses in SoCal. Just keep on keeping on and please take heart and do not give up. This too shall pass and you will regain your former position, and with a little wisdom gained too. Good Luck.
  11. JNJ

    I have failed as an HH nurse

    Nursebailey: Please do not give up - the nursing world is so very much in need of independent nurses. This cycle will change and you will be back in business again. Read the reply you have already had carefully - it was full of great ideas. Get a basic business card printed with something simple after your name such as "Amanda Bailey Licensed Practical Nurse (LVN) - experienced in the care of your loved ones at home. Call for free in-home consultation. References available" HIPAA does not mean you cannot advertise. And please do not complain about a mother being paid to look after her sick child. We do not make ourselves more or better by standing on someone else. This mother must be entitled to these care $. By all means fight for what you want/need, but not by putting someone else down. I practice in a similar line of work to yourself. I mainly work with Medi-Cal patients at home. Have you tried contacting a senior supervisor type person at your State's Medicaid offices. They may be able to help you by giving your name to a patient needing more/different nurses. Also, as you have peds. experience, have you tried to get into that huge informal network of mothers of sick children that exists throughout the USA? Have you asked the mother of the child you still have 8 hours with about networking for you? Have you asked the Regional Center for help finding a client - they are always contacting me saying they have more clients than nurses in SoCal. Just keep on keeping on and please take heart and do not give up. This too shall pass and you will regain your former position, and with a little wisdom gained too. Good Luck.
  12. JNJ

    Funding a doctorate degree

    A long shot, but depends on how desperate you might be to try anything. In San Diego several hospitals were so concerned about the nursing shortage that they grouped together and came up with enough to fund more nursing educator positions (I suspect there is some quid pro quo regarding getting first look at the new grads for hire). Any chance you could approach hurting facilities in your area - especially if your dissertation focuses on something dear to their hearts . . . Good Luck.
  13. JNJ

    making your own scrubs- patterns?

    I always sew in an extra pocket with zip top to stop everything falling out during the (occasional!) bathroom break.
  14. As someone else has posted, the answer to your question depends on the school you are in. If the RN program follows a certain pattern, there may be a point at which you have completed the equivalent of the LVN training, but the school has to be willing to subbmit the paperwork for you to the LVN board in order for you to be allowed to take the NCLEX-PN (CAT). One other point, the thinking process taught for RN and LVN is different. You may need to make some special preparation to get yourself in the mind-set for LVN testing. Not sure what the advantages are for you - most RN programs are very busy without this added distraction.
  15. JNJ

    preceptors for employees

    It's part of the description of being a professional - we teach and train our own.
  16. JNJ

    "Shift goes to the lowest bidder..."

    Just to offer a little comparison - airline steward 'bid' for their shifts a month in advance - not in $ terms, but in terms of what routes and class of passenger they prefer to work. If the hospital starts the bidding at about what an agency nurse gets paid (but not what the agency gets paid) I don't see the problem. One smart HR person, I believe, and goodness knows we could do with a few of those people thinking outside the box. As with most things, the market (and the nurses) will decide if this system works or not.