Tom123

With just a year of experience you hit the nail on the head. Keep up the good work. I hope you continue with your education.

I believe that a BSN graduate will gain more, and contribute more to his/her graduate program if he/she has about 5 years of experience. My reasoning is based on the fact that the clinical experience we had while in our BSN program did not give us a true picture of what clinical experience is all about. I also think that having the 5 years of experience will allow the graduate student to assertain what he/she wants to concentrate in at the graduate level. I had 10 years of experience between my BSN and MSN, and I had 18 more years of experience between my MSN and PhD. I must admit that I am glad that I did have the experience. I do not believe that anyone needs as much as I had, but experience really counts. You need to get your hands dirty. Learn what the basic RN is doing. You will never understand it, unless you have experienced it. Good Luck. :wink2:

Thank you for telling us your story. It really shows how important it is to have malpractice insurance. God Bless and Keep you.

That may be true. Depending on the state where you practice, your employer may have the right to collect any damages attributed to you, in a lawsuit. I know that is true in Florida.

I have malpractice insurance, and fortunately I have never had to use it. However, I do know of nurses who have used their insurance to defend them in court. Malpractice insurance does not defend you against the Board of Nursing. That is an Administrative Hearing. Malpractice insurance defends you when you are sued for malpractice -- negligence, wrongful medication that caused damage to a pratient, etc. These are defended in a Court of Law. However, you can be called to the BON for an administrative hearing on the same issures. Your malpractice insurance does not help you there. Keep your insurance. I remember a nursing student who stated "it is silly having that insurance, you are never going to be sued." She is the only nurse out of my graduating class that was sued within the first 5 years, and she had NO insurance. She lost everything, including her licenses to practice. YOU NEED MALPRACTICE INSURANCE. The hospital or facility says it will defend you. Who are the lawyers working for whe the hospital is sued or the nursing home, etc, and you are named in the law suit? The hospital is defended. You are out there on a limb, and the limb is ready to break. That attorney is only going to defend the hospital. They will let you sink or swim on your on. Hope this helps.

Nursing Educators do have a speciality. It is called Nursing Professional Development. I am certified in the field. A BSN is required to siit for the examination, plus other basic requirements must be met. If you pass the examination, offered by the ANCC, you become certified in Nursing Professional Development for a period of 5 years. The examination covers the following areas. Principles of Practice Educator Role Leader Role Consultant, Facilitator, and Change Agent Roles Researcher Role After 5 years you are required to renew your certification. In order to renew you must: Option A: Professional Development plus Practice Hours > Hold a current, active RN license in a state or territory of the United States or the professional, legally-recognized equivalent in another country; > Hold a current ANCC certification; > Complete the professional development requirements for your certification specialty which are: For this specialty only, professional development Category 1 equals 37.5 contact hours. If you double this category, then submit 75 contact hours. > Professional Development Categories 3 (presentations) and 4 (publications/research) cannot be doubled. Category 3 Presentations Present five different topics related to your certification specialty. Presentations that are a requirement of your employment are disqualified from this category. If you double this category, then you must present 10 different topics related to your certification specialty. These specialties may not double Category 3: Adult Health Clinical Nurse Specialist, Gerontological Nurse Practitioner, Gerontological Clinical Nurse Specialist, Nursing Professional Development. Audit: If your certification record is selected for audit, you will be required to submit supporting documents such as a copy of the presentation outline, abstract, letter accepting your abstract, or a letter inviting you to speak, and evidence that you actually presented the topic e.g. thank you letter on official letterhead. Category 4 Publication or Research Publication: Publish an article in a peer reviewed journal or a book chapter or develop education materials (such as a CD or web-based materials. Articles that are not yet published may not be used.) If you double this category, then you must have published two different articles in peer reviewed journals or developed two different education materials. Research: Serve as the primary investigator in an IRB-approved research project related to your certification specialty and completed during your five year certification period, or complete a master's thesis or doctoral dissertation in your certification specialty. You can double this category by competing two IRB-approved research projects as the principleinvestigator. You can also double this category by completing one publication and one research project. Nursing Professional Development may not double Category 4. Audit: If your record is selected for an audit, you will be required to submit supporting documents to include either a copy of the table of contents and a copy of the entire article or chapter journal name with the date and your name or the copy of the IRB approval letter or IRB letter of exemption and a one-page abstract, no more than 250 words, describing the research study and findings, and the period the research was conducted. Category > Practice Hour Requirement: Completed 2,000 hours of practice in which your primary responsibilities included teaching, managing, or consulting in continuing education and/or staff development. > Complete a minimum of 1,000 practice hours in your certification role and specialty; > Pay the renewal fee. Option B: Professional Development plus Testing if you do not have practice hours in your certification specialty. This option only applies to those certifications in which an exam is available. > Hold a current, active RN license in a state or territory of the United States or the professional, legally-recognized equivalent in another country; > Hold a current ANCC certification; > Complete the professional development requirements for your specific certification, as identified above. > Pay the renewal fee; > Pass the exam I am the author of the Ethics and Legal section in the Core Curriculum Text, 3rd ed. In my opinion, certification in Nursing Professional Development definitely qualifies as an Advanced Nursing Practioner. I definitely support placing this as the 5th Advance Nursing Practice Level speciality.

GoTo, What do you mean that this is on your license? I have never seen an application for a nursing position asking if I have a mental condition. The only thing you are required to report to a prospective employer is if you are on probation from the BON. It is non of their business. I thought I understood what you were going through, but I am now confused.

Hi Goto, I understand you are in a "Right to Work State," so am I. In Florida there have been cases like yours brought into court on a Wrongful Termination Lawsuit, and the employee won. I am sure your attorney has asked for and received everything from your previous hospital. They need grounds to terminate, even in a right to work state. Your co-worker who was told that if she became involved she would face disclipinary action -- THAT IS INTEMIDATION, and it is ILLEGAL. She can also bring a lawsuit, but she has to understand that they will probably find some MINOR thing in order to terminate her. Your situation does SUCK, but I still think there is a legal way to get back at the hospital for firing you. Ask your attorney what the actual laws are regarding wrongful termination. I bet there is some law that you can hang this hospital out to dry. This really makes me mad. I have been a nursing executive in a right to work state, and our policies required that evidence of policy violations be documented, and that the following steps be taken. 1. Verbal counciling 2. written warning (if for the same offense -- if for a different offense, you have to start over with #1). 3. 2nd written warning with supension up to three days, and documentation that employee has been notified that another infraction will result in termination. 4. Termination. I continue to hold you in my prayers. I wish there was more that I could do, because it is unfair to you. Please check out the Federal Laws regarding wrongful termination also. They apply in a right to work state. God Bless, Tom

RandeeN, I am sorry to hear about your burnout, but from what you describe, I can definitely understand. I am confussed. Is your nurse manager requiring you to have a note from your physician to return to work? I thnk the answer to that is yes. Also, who is refusing to let you see the available positions in the hospital? If it is your NM, then make an appointment with the Vice President. She cannot refuse to let you see what is available. That is illegal. I gather that you have been at this hospital for several years. You have probably gained a reputation as a good or excellent nurse. If that is the case, USE IT. Take your last few evaluations and see the VP. Having been in the VP position, I would much rather see one of my best nurses, go to another unit -- with less stress that loose him/her. As you have undoubtly heared the old saying, "Nurses eat their young." Well, regretfully, in many cases, Nurses try to eat other experienced nurses as well. The Best to You, and please keep me informed.

I am currently in the process of gathering research for a Nursing Book I wish to write. As you can see from my bio, I have been in nursing for over 40 years, and have seen drastic changes in nursing care, nursing judgment, and just how nurses feel about delivering patient care. I would appreciate every nurse's input on how you feel nursing has changed, or "Where Has Nursing Gone?" Thank you for your assistance in this project.

I am very sorry to hear that you are going through all of this. I know you do not have any drug/alcohol issues. Did you ever tell a fellow nurse, etc., that you were seeing a psychiatrist? If so, that is where the complaint stems from. I must ask, did you sign the consent agreement? You need to appear in front of the Board of Nursing and explain to them what has been happening in your life, etc. This will let the Board know that you are tired, because of everything you have to do, including work. Also, and please do not take this the wrong way, if your state has an IPN (impaired nurse program) seek them out. They will be able to assist you. I am from Florida, and the IPN program in this state is very helpful, not only for nurses with drug/alcohol problems, but also for nurses who are facing a trememdous amount of stress. This allows the Board to know what is going on with you, but also protects your license. As far as I am concerned, your supervisor acted too hastily. He/she should have come up to your unit, and spoken to you in private, to assertain what was going on. She could then have asked you if you would be willing to submit to a drug/acohol test. It is probably mandatory in that hospital. You may also have a case in wrongful terminiation. They forced you to resign or be terminated. They used pressure, without any evidence of wrong doing. Ask your attorney about that possibility. Please keep me informed of what is going on. I have dealt with several cases involving the BON. You and your family are in my prayers. God Bless

All IVs are gtts/min. I know we use a pump and schedule it to go over X number of minutes, hours, etc. But, when you boil it down iit all comes up as gtts/min. I know you are asking about other drugs, but are you having a problem with calculating gtts/min?

THANK YOU CUBBY777 This behavior must stop. I have been in nursing for 44 years. In the ancient days, we had to stand up and give our seat to the doctor, when he (very few female doctors) came to the nurses' station and was going to write his progress notes, orders, etc. Doctors got away with yelling at the nurses. Then I reentered the U.S. Navy as a Nurse as a Nurse Corps Officer, and rose in rank to LT, and Lcdr (Lieutenent Commander). I then out ranked the doctors. So when one started this type of behavior, I disciplined the doctor. I would not stand for the behavior. After leaving the Navy, and returning to civilian practice, I continued NOT to tolerate the behavior. In some hospitals I was supported, and in others, I was not supported. When I climbed the ladder and became a Nurse Administrator, I definitely would not tolerate the behavior. My nurses knew I would back them. Now, if the nurse was getting ready to do something that could be harmful to the patient, yelling might be in order. Otherwise, it is not. If a doctor has a problem with a nurse, he/she should go to the Nurse Manager and let them know. The Nurse Manager investigates the complaint to see if it is valid. If so, the nurse is counseled. If not, the doctor is informed that the nurse used proper nursing judgment, and the complaint was invalid. Nurses, seek out the Nurse Administrator. Have your Nurse Manager invite him/her to the next staff meeting to discuss this problem. I really think that in today's environment, the Nurse Administrator/Executive will support the nurses. Again, Cubby, thanks for your response. I agree completely. Tom

I must ask the question -- Was an experienced RN available for consultation -- or how about the Nursing Supervisor? I agree whole heartedly, NO physician has the right to yell at a nurse. It is actual hospital policy to call a physician for medication reconcilation, on admission, then the young nurse had no choice. But due to the hour, maybe some critical thinking is needed. My experience has been that ALL medications are cancelled upon admission. Therefore, new orders must be written. I know I have only been in the business for 44 years, but what physician is responsible for writing the admission orders? Is there a hospitalist in the house? There has to be some other course of action that could have been taken. I would love for the young nurse to copy the policy for all of us to see. That would clarify most of the questions everyone has, and also let us know the diagnosis, why was the patient admitted? Answers can be given more appropriately if all of the facts are on the table.

I would not have called the physician at that time, based only on the need to know the dosage of a med, that was not taken. I think you probably had orders for other antibiotics, IV probably. It is like calling the doctor at 1 AM for a sleeping pill or a laxative. Don't do it. But about yelling doctors. This physician would have yelled if he were the admitting physician, and the patient was in a crisis. I handle this a couple of ways. 1. I hang up the phone and page the doctor again. I then tell him/her how sorry I am for having been cut off. If he starts yelling again, I just make comment that I am quoting him in the nursing notes. If he does not wish to address these issues, I will contact my supervisor, and have him/her handle the situation. In these cases, I have usually called to Chief of the Service. If that does not help, I call the Chief of Staff. That usually gets results. I do this as the supervisor. 2. If the physician gives me a minute to speak, I try to explain the necessity of why I had to call him/her. I even let them know that it is hospital policy. I am bound by hospital policy. If he/she continues not to listen, I return to option #1, and work my way up the chain of command. Hopefully you have a very supportive Nurse Manager, and a supportive Nurse Executive. That always helps.