Sehille4774

Meh. Its not so much about clinging to false illusions "Its going to be ok (regarding the economy)" To me, I choose to have an optimistic attitude becasue of a couple reasons: 1. Noone KNOWS the future...it could end up all ok..so much of what you hear is speculation or best guesses. 2. So what if we are heading into a "great depression" type of scenario..not much that you or I can do to about it...being scared and miserable about the possible financial collapse is not going to change anything...so why not enjoy the good while you can? 3. Understand that if inflation goes crazy and even a loaf of bread costs 4000$ overnight...no amount of preparation is going to save you..what ever you managed to get in your bank account isnt going to go very far..but it happened before and people got through it..so will we. Ehh. Sorry to single you out. So tired of the pervasive "Doom and Gloom" pessimistic attitude in this country....I believe that makes it worse. Sure..we need to get our act together but thats a whooole other topic..as is this post..opps. :)

Sorry Nisteber. I forgot that in these forums you have to carefully screen every thing you say. My bad. It's been awhile since I logged on here. Gee I wonder why. I wasn't complaining about my choice. In fact...the total cost of my education was closer to 120K, so with all the scholarships I got, I came out pretty good. I want to go on for a masters degree..so no..my planning was perfectly fine for what my goals are. But thanks for the input. I'll think of you and cry a little in a couple of years when I am working as a NP. ------------------------------------------------------------------------------------------------ My point in saying what I said in my original post is that their are alot of other expenses that people do not consider. Around the time I graduated...it was standard for many institutions to have significant tuition reimbursement programs--10 to 20k or more. And I took that into account when I decided to go to the school that I went to. And within 6 months or so of my graduation, many of those programs vanished. I was also expecting to go work somewhere that had a 10-15k sign on bonus..those vanished too.

Absolutly Commuter. It is a topic of fascination for the public. I also hear "I wish I was getting paid big bucks like you to take care of people". Alot of Jealousy out their if you make any kind of decent salary but 50K lets say, is not the same 50k as it would have been 5-6 years ago. I just feel like...ok. Well, why hate on me? Go to nursing school then if thats what you want to do. People forget the things that WE Give up to earn that salary...things such as family time and holidays that MONEY cannot replace.. And it is not worth it half the time to me. How about the personal risk we take exposing our selves to dangerious pathogens all the time..quantify the dollar amount for that! What about the toll the stress and the job takes on many nurses minds and bodies? Salary..as i have come to learn is no substitute for good health. Someone actually asked me the other day..."What dollar value would make it worth it to you to work more for us"..and I thought to myself ....you know...I am not sure that their is ANY dollar amount that would make me want to work more then the huge amount of hours I already work and give up any more free time. That is not to say that I regret the extra hours I work above 40...I certainly do it becasue I WANT to..and I do Like picking up the extra salary. But Many times that I work extra hours it is not so much that I want to but it is desparetly needed for someone to go in. When you consider the 5 years I gave up in college...potential income earning years that I could hardly work very much with school...that is probablly 70k in income I lost...then add the 50k just in student loans I have and I havent even come close to breaking even yet. So no. I feel zero guilt accepting my salary. I dont think you could get alot of people to do this job if they were not well paid. Great topic. Thanks for posting!

So lets say that John Doe wants to hire me and pay me out of his pocket to be his child's nurse. We agree to certain terms and rates. I am now my own boss...I do report the income to the IRS at the end of the year. I have my own liability insurance. What documentation should I be doing? Anyone with experience with this...what documentation do you do? Should I be writing a daily shift note? Do you write up some kind of contract to have the family sign?..

Amen....This sums up this entire debate. If I had a choice between having a jury perceive me as a sloppy nurse cause some coffee spilled on one of my notes..or being perceived as obstructing justice for altering legal evidence...I'm gonna pick the lesser of the two evils and take my chances rather then commit a CRIME. Yes, it is illegal to Tamper with evidence..so you dont under any circumstances want to do anything to give the impression that you did that... First off, they can do forensic testing to determine when your note was written..so if you rewrote it 3 months later...and did not include the old copies..they can tell it was a rewrite. Well what happened to the originals? A jury may think you are trying to hide something. Both facts I recently read in a documentation CEU that I took. I am here tonight because my office was pushing us to do rewrites for coffee stains..so i was wondering what this community has to say about that. I guess if it happens during your shift and you start your note over right away, it would not be too bad.

Yeah..well. Not everyone has to be the same as you redhead. How bout live and let live? If i feel most comfortable conducting myself in a professional manner and ENJOY making a difference...why should I feel bullied into conforming your attitudes and behavior or else Get crucified for being too Niiiice?

Yup! Well every extra moment of studying pays off tho $$. I was hoping to be someone clinically that was good enough to be able to frequently have an impact and I have gotten my wish. I rather enjoy the art of 'practicing nursing" versus just going through the motions...I believe you're only as good as the knowledge you managed to master...and their was a heck of alot of that. Many can memorize facts and figures...not sure everyone graduates able to apply what they have studied to the various situations we encounter. That sets those who can critically think apart from the rest of the pack. I used to email professors over breaks and summers for reading lists and what chapters we were starting with ect to get a head start. i often didnt get to as much time as i wanted to read..and often felt like it wasnt enough. I used to read my texts while sitting on public transportation back and forth to work and home and school until i got my car finally about 1.5 years in. I used to sit on my lunch breaks at work reading reading reading...if i got my CNA assignment done early and had a few extra minutes I was ...yes, you guessed it READING! WHAT a journey that was. I thought it was a Living He L L at the time!..hehe...especially when your in the midst of that and dont even know if it will work out for you in the end!...when you havent had a free day to just RELAX and do nothing for months..when you see 7 dollars in your bank account to eat for a week because instead of taking an extra shift at work you stayed home and studied so you could keep your grades where they needed to be. Sometimes I couldnt even get all the money together for my texts until midsemester..that was really something trying to keep up those times! I guess I am in a nostalgic mood tonight :)

Shoot. Well i think most new grads would be willing to suck it up for a year and make 35k or so if it meant they would get hired where they want right away. Just who is going to replace the baby boomers?

I've Been taking care of a cognitively normal (or above normal) medically fragile child for about 2+ years, since she was an infant. She has had SO many surgeries and issues during her first years..yet this kid is really tough!...Almost always silly, pleasant, curious with the world around her..no matter what. Before she hit 1.5-2 years she figured out how most of her equipment works by herself...down to connecting the end of the tf bag into the GT extension, opening the clamp and pressing start on the pump to make it work, for instance. Its actually incredibly inspiring how much some of these children deal with SO much yet cope and move on, and dont even know it!...makes you scratch your head at some of the trivial things we adults whine about! :) Well recently this patient was just about to attend her first day of normal-child preschool. I care for her on nights, so 430 AM rolls around and she wakes up for our routine round of morning nebulizers, coffalator and suction..and she says "I'm going on the schoolbus today" And I say to her "Wow Really! You'll like it, school is LOTS of fun!" And she says "Do you want to go too??" Awwww. Sooo cute! And I'm thinking "Naaa Been there, done that Sarah's going home to bed!" ;0)

Yeah..personally...I HATE being watched too...It's distracting when i'm trying to focus on what I am doing...not put on a show. Ironically...I have found the cure for that is to LET them watch..show them the good care you do and that you have nothing to hide and amazingly, after a bit they stop feeling like they need to watch you like a hawk. Course..I work in Peds...I'm so used to having to give a lengthy rationale to be allowed to even give a Tylenol LOL!!!...just how it is ...its never gonna change so I decided to accept it and move on. I actually Enjoy finding ways to integrate the families into the medical process...And I get alot of thank you's for it.

Isn't 24/7 visiting hours kinda considered the latest and greatest new trend: IE "Family Centered Care". I have no problems with this as long as the family member arent too disruptive and the pt can still get rest. Ive personally had family members that were critical that wanted us there 24/7.. Specifically my middle aged dad who had VRSA sepsis and osteomylitis, on heavy pain meds for 6 months in the hospital, did better waking up and seeing a familiar face..he often didnt know what was going on..and being an independent person all his life, he took comfort having the perception that someone else was there to watch out for him. Now more then one or 2 people after visiting hours is unnecessary. Gosh...I just think it helps to throw the families a bone sometimes. A little bit of kindness goes a long way..and if you rush them out of the room with every procedure..they end up feeling suspicious that something not right is going on...Have confidence that if you are providing quality care then it shouldnt matter who sees what you do...in fact you can explain what you doing and sometimes it lessens the fear for them..with the pt's permission of course.

You know I appreciated other POV's about this topic...but as an overweight person..obviously I both notice and hate the discrimination...and the only place I ever experienced it was in the medical field, especially nursing school. I feel the problem is that we psych ourselves out...(with all the media and ect) to the point that it seems soooo impossible to lose weight, ect...When in reality it takes some work..but it is certainly not impossible..and that is the attitude we should be approaching it with. However...people who haven't been there don't realize that once you get to a certain point with your weight, esp. if you have ANY kind if musculoskeletal injury, which then do not heal well, Like me, it can be really painful to exercise, even if you have the energy, and the will power. I hurt myself with anything too vigorous, am constantly having to wrap ankles and knees just so I can get through my walks...so it is a loooooong slow process for me (I currently hike about 15-20 miles per week even though I weight 330). It is extremely hard to lose weight just by eating low cal..Last time I tried just that I lost so much muscle mass that I had a hard time supporting my own weight anymore and had no energy. So I have come to terms with the fact that the only way I can lose weight is a little at a time...And I think that when you are talking about maintaining a low cal diet over a period of maybe years for some people..many people are going to have a hard time doing that. But lucky for me, I am a nurse, and I have the knowledge and tools I need, and willpower. Imagine!...Its actually my DREAM not to be thin, or cute, but just Healthy and In Shape and be able to do all the things I want to do with ease. Most of my weight was gained prior to becoming a nurse. I did not gain my weight overnight...just 10 or so pounds per year..but over 10 or more years, that added up. I have always been active but i just like to eat, didnt understand calorie intake vs energy burned too well.or realize even though I wasnt eating huge amounts..what I did eat, apparently had alot of calories. But If you met me on the street...trust me, you would think I don't try.....that I just sit home and eat all day, and that I dont care..you would never see that I spend many hours per week trying to get my weight down...I guess their is my biggest gripe...its hard enough to put that kind of work into making a major life change to start, but then to get the negative attitudes you get...it does not make it any easier. How about someone noticing the positive changes I am making once in awhile? People just make assumptions about you...that you are lazy or stupid or slow..without even knowing you..(AKA the Hiring problem) I "pull my weight" on the job, LOL, believe me..because I do not want those labels. I do every bit of the physical work as well as anyone else on the job. I resent that this is AMERICA...I thought that we decided that we are not going to discriminate in this country...all these other groups have protections...but not me? Not in the workplace? Its embarrassing so most overweight people do not want to fight this fight. Thats why it is acceptable....We need to be more vocal. I am sorry for what some will feel is Too Much Information in this post but believe me when I say I already feel grossed out and stupid enough about this and I take full responsibility........I did this to myself..but I just thought maybe it would be helpful to share my perspective in an honest way.

That's a really bad practice! Wow. That sucks. As I see it...you do not have alot of choices besides go get another job, go along with it, or do things your own way but at the expense of taking some flack. Obviously alot of the people are complacent at that facility or else you would not have a whole staff going along with it....and, on that note, obviously administration is aware if everyone is doing it...(Kinda hard to do anything about it if the management staff is going along with the sloppy practice) I have no prob. standing up for where patient safety is concerned.....but if it is a battle that I definitely have no chance of winning then I am not going to throw myself in the line of fire...for what? I think if it was me....(and I have been this person quite a bit) I would do it the right way...make it kinda clear that it is my right to practice in a safe way..and defend with rationales if necessary, but otherwise kinda leave the other nurses to do what they want and I do what i want...but just be really polite about it..dont give them a hard time unless you feel it will actually get you somewhere towards improving the practice of the facility. Continue to participate in the group dynamic in a positive way. If you dont make a huge deal about things...it has been my experience that in this situation you can kinda slip under the radar without having to get a whole new job. Being THAT nurse can come with consequences tho, in varying degrees. It can make u a target for ridicule and if admin is one of those types that tries to find a way to get rid anyone who does not do what everyone else is doing...then maybe u would be better off getting another job. You could try to go directly to admin about it and run it by them to see where they stand on it.."Hey, just so you know I do not want to pour meds that will be given by another nurse because of x y and z. And I will pour my own meds..(maybe find a nicer way to phrase it haha)....And if administration supports your right to give the meds the safe way..then problem solved, you don't have to worry about what everyone thinks of you becasue you have been told by your boss that you are allowed to do it the right way. It helps to be organized and have clear objective arguments when u go into a meeting like that. Good luck!!

CapeCod: Get the MD signature tatted on your chest too, ROFL.

It could work if it was done in a universal way....meaning, the Govt or some agency would create a specific symbol and location for the Tattoo....and then do the necessary PR work so that all need to know medical personal would know what to look for and where to look. Actually sounds like a GREAT and time saving idea. You obviously could Never just look for someone's DNR tattoo that they got on their own and assume that just because you see that it is intended to communicate that they do not want to be resusitated. DNR could be a loved ones initials.

amen. that was my key strategy in nursing school.

ME too lol. If we were already proficient at all these skills...then obviously we wouldn't pay the money to go to nursing school to learn them. I wouldnt worry. Keep working on it..youll get better..their is always room for improvement

You may face discrimination...likely will...But nothing you can really do about it ..just accept and move on. People are how they are...cant change everyone..nor do you have time as a nurse. I am discriminated against at times for a different reason..by peers, uppers, DR, patients, But, once they see home much I do give a crap about getting good outcomes..and that I am a hard worker and good nurse...that stops pretty quick. Well worth it anyway..Being a nurse rocks. Males in nursing are highly sought after..they add alot to the profession. I think nursing would be better if it was more evenly distributed between males and females. The reverse is true...their are some men that will be so...relieved if you are around because they are very embarrassed getting certain procedures from females (like caths). Employers like male nurses. I kinda chalk it up to human nature and move on from what i cant control. Worry about whether or not you Like nursing...as in providing medical care to patients and helping people...If you think you will Love that...then everything else kinda works itself out. I take alot of crap at times that I would NEVER tolerate in other fields...but I would do it a billion times over to get to be one of the lucky few..that love their job.!

I see your point...about adrenalin I think the issue here is that she was fired for refusing to something that was not in her scope of practice.

I think only you can answer that...But if you have to ask this question at all..that should tell you something. Playing some video games is not the problem..its can you stop when you need to. I flunked out one semester because I was spending too much time playing FFXI...which to be fun is a very time consuming game. By that point I had already invested much time in the game...and I had alot of online friends that I enjoyed questing with. But once I flunked out that last semester..(also my dad Almost died in the same time period from complications of heart surgery) I decided that I am not a person that can stop when I need to...so I quit entirely and didnt have any further problems. Course I found many other distractions...but Lol. Once you get into nursing classes...its exciting and I was more interested in making it through to become an RN then my distractions. I believe senior semester I read the entire Twilight Series (About 2000 pages?) in a month or 2 but still got a 3.75..my highest to date :) By that point I really knew my stuff. Passed first time in 76.

NrsLucky.... Don't necessarily second guess yourself too much either based on internet advise. We weren't there..so I feel it is impossible to really say with any good certainty whether or not your actions were the right ones or not...due to lack of complete information. If her spo2 was 98% with no s/s of sob or mi or poor perfusion. I don't know that 02 would be my first thought in a situation where you had to act quickly...nor would I have taken the extra time taken to find and hook up the EKG machine...(you can tell with a quick listen if her HR is regular or not) (Perhaps after she was stabilized) Afterall, who is watching the patient while all that is going on. What if she arrested? I might be inclined to call 911 though (even if it got me in trouble) Again...you only have so much time in a major emergency. You have to carefully prioritize what you do with that limited time. If the patient made it through then I guess you all did ok. Wasn't their anyone else but you and the Dr who could have started that Atropine in the office...thats who I would have called in. Are you even trained in how to start IV access? Proficient at it? I KNOW that personally since I never do those, I doubt I could have gotten access. I assume the ammonia packets are those things you have people who fainted sniff to wake up? Dont know alot about those. Dont spend too much time dwelling on this....learn what you can from it and move on! JMHO :)

She is an LPN. Sounds like you have legitimate grounds for legal action if you so choose. Some lawyers will evaluate your case and if they think you have a case they will take it with no money up front... Why do this? I mean you are obviously going to be fine...And lawsuits are not good for anyone really... I suggest it because it is not right that our employers push us to do things that are not in our scope or are unsafe..and if we say no...all to often we face the real threat of retribution! Its good for us all as nurses when someone fights back against these practices...to set the standard that We will NOT be treated this way! I hope you do look into it..and thank you if you do!

Meh. Well thanks for the info all. They just got approved for some state paid respite hours. So that solves that issue.

Ok...thanks both valid points For one thing...they have an agreement to recieve 16 hours from the agency...they would still recieve those 16 hours from the agency. These would be extra above those 16. Also..I thought that some people hire nurses on their own, free of an agency, and just pay them out of pocket?.. Grrr. Its frustrating....you cant leave this kid with anyone but a nurse...but I know their must be some way to help them with this that doesnt put me at risk. But yes..one of my main concerns was getting in trouble at my job. Maybe I should just call the agency and they can just arrange it through them but at a reduced rate and the parents pay the agency directly. I would have done it for them at like $10/hour.

Hey all.... I was looking for info or tips anyone might have for me. I have been taking care of a client for about 8 months...I guess I am basically the primary nurse on the case, via an agency. I carry my own liability insurance.... The parents would like to be able to go out once in awhile in the evenings for a few hours...and have asked if me and one other nurse could cover those hours on the side, and they will pay me out of pocket. I'm not really worried about this....I know the patient well, all the emergency proceedures, ect. I am wondering if their are any other steps I can or should take before saying yes..... I would much rather find a more legitimate way to go about this then go under the table... For instance...do I write a note? lol. And where would I even put it? Yea I really have no idea what legal issues are involved here if any....which is why i am asking on this forum. Thanks!