Lannister

Yep...!!!! We have all worked places where the one male nurse that works there gets ALL the "quarter-tonners," dangerously mentally ill or simply "difficult" patients day after day after day... Lannister

You did the right thing. You had an order and followed it. I usually treat under 60... To add... as a nurse... I was taught to treat both short & long (Juice for short and a sandwich/cheese/milk/crackers etc for long) Lannister

Men do suffer "burnout"... but it has been my experience that it is rare in the "Assertive" male. Probably because the "Assertive" ones tend to "fix-problems not blame"... take action versus react and if improvements aren't forthcoming in a reasonable period of time... seek employment elsewhere (facility or specialty or profession). They usually don't play "victim" well and therefore take responsibility for their dissatisfaction. When my vehicle leaves the parking lot... I'm looking out the front windshield... NOT in the rear-view mirror... When I got tired of being overworked, underpaid/valued, and arguing about "mandatory overtime"... I didn't blame anyone else, nor did I just "suck it up." I did some research, completed some more prereqs, and returned to school. For 3.5 yrs, I worked nights and weekends only, went to school in the mornings and did what I could for my child when I could (yes as a single parent) So yeah... I think some of us do suffer burn-out but I think we are more likely to take action to alleviate our "burn-out" versus simply react to the "burn-out." Just thoughts based upon MY experiences... Lannister

Stay away from CraigsList and Adult Friend Finders. Or atleast don't post a Picture of your Face on there... Lannister

1.) DO NOT record him... unless you want a federal WIRETAPPING charge. Some people are just vindictive... Don't stoop to their level... but DO protect yourself. DOCUMENT, DOCUMENT, DOCUMENT...!!! Lannister

Just a couple comments/observations. 1.) Degrees/Credentials: The 3 other NPs that I work with daily are Bachelor's Prepared NPs. Like PA's, the NP role was "competency based." Meaning, until recently (~ 1999-2000) fully licensed and practicing NPs held ASN's, BSN's, MSN's. The deal was that pretty much ANY RN (ASN/BSN/MSN) could apply to, be accepted at, and complete a NP program and if they passed the NP boards, could be fully licensed to function as a NP. So there are A LOT of experienced NPs out there without Masters degrees. These NPs are going to be found among the ones who have been practicing greater than 15 yrs. So the whole issue about what degree the current NPs hold versus what degree PA's hold is disingenuous at best. 2.) Salary/Compensation: The Average compensation package for ALL PAs & NPs is generally greater that $70k/yr, includes Disability Insurance, paid health care for the provider (family members sometimes extra), Malpractice Insurance paid, Licensing and Credentialing fees paid, around $1500-$2000 plus 5 paid days in CME/yr and other perks (professional fees, books/journals, lab coats, parking, meals, equipment, etc.) This often includes office space, and ancillary staff. There is NO comparison of this to the compensation and working conditions of RNs/LPNs. 3.) Licensing: While it is true that APNs have fought for and secured independence in many states, many/most the overwhelming majority of ARNPs/APN DO NOT work independently. In most cases it would be foolish to do so for a myriad of legal/ethical/professional/$$$ reasons. As a matter of fact, MOST graduates of APN programs NEVER work as APNs (do some research). While it is true that PA-Cs need to be affiliated with a Physician to practice, it is a often repeated myth that all PA-Cs need to be "supervised" or that they work "under a physician's license." PA-Cs have their own license, their own NPI numbers and their own DEA numbers. In many states, PA-Cs require "sponsors" not necessarily "supervisors." In many/most states, "Supervision/Sponsorship" is NOT as it implies for licensed and currently Certified PA-Cs. In most cases, "supervision" for the Licensed and Currently NCCPA Certified PA-C merely means that the physician ONLY needs to be in electronic communication (phone, fax, email) with the practicing PA... and NOT/rarely/never at the same site as the "experienced" practicing PA-C. So in these cases, PA-C "supervision" is the same as the NP "collaboration" requirement in many states. As a matter of fact, there are hundreds of instances where PAs (and NPs in states that require "collaboration" agreements) have purchased buildings, set up clinics and paid Physicians as consultant/employees for "supervision"/sponsorship. This is all perfectly legal and the going rate around here seems to be about $1000/mo for the Physician-employee to answer their cell phone on the rare occasion the PA or NP practice owner calls. 4.) As a former CCRN, I can state that it is absolutely untrue that the average RN has anywhere close to the general health care knowledge of the average new-grad PA or NP. Its just NOT TRUE regardless of how bad many here want it to be so. Claiming that this is true, is the equivalent of the EMT-"para-gods" that show up with crappy attitudes, to facilities across the nation daily, claiming that they have the same or more training & knowledge than the Nurses. When in reality we KNOW that a EMT-B can be completed in 14 days and a EMT-P can be completed in 6 months. 5.) There is NO difference in the roles of a clinically practicing PA or NP or Physician in a Primary Care setting. As a Matter of fact, if no one wore a name tag, the casual observer would be hard pressed to point out who was who and what credential they held. See... what many don't understand is that PA's/NP's and Physicians all "practice medicine." The NPs like to label what is being done for the patient as the practice of "advanced nursing" for political reasons, but its basically the "practice of medicine." This is why if a patient presents to a PA/NP/Physician with anything from Azotemia-to-Zoster the treatment/plan of care will essentially be the same because the legal and ethical "Standard of Care" is the same. 6.) There ARE organization dedicated to the elimination of the unnecessary contentiousness between NPs & PAs. "Clinician 1" is but one organization with this as one of its goals. Also... it has been my experience that the NPs and PAs out here "in the trenches" actually practicing together aren't the ones with the bitterness and spite. The vitriol is usually spewed b the "wanna-bes"... Just some initial thoughts after reading this thread... YMMV Lannister, EMT-B/I/P--> LPN--> RN, FNP, PA-C

Sort of correct... ARNPs and PA-Cs are often in the "call scheduale"... My SP is always available to me by phone... but I may be the one "on call." (Usually q 3rd weekend)

Can we have a current update on the status of this...??? Thanks

Of course that's clear now... :up: but your initial post: Lead me (us?) to believe that YOU are making the decision... which would be YOU... "practicing medicine without a license"...!!!

I live in a small community (~80k people)... I see my patients in the grocery store often. On several occassions... these patients have pulled up their shirts or pulled down their trousers in the middle of isle 6 in the store to show me their concerns. I try to stop them and tell them to see me in the clinic. (they don't want to pay the Co-pay) I know a nurse who "went next door to help a neighbor" ... and then got named in a suit later... NOT for me...!!!!!!!!!!!!!!!!!!!!! Go see your doctor...

:):)Yes... Lots of facilities and Hospitals require a drug test before they allow you to do clinicals (as a Student) or work there (as a Employee). These places test all potiental hires... so it would be a "slap in the face" to the employees NOT to test students doing clinicals there. If you don't do drugs (or can stop long enough to pass the test... 30-45 days for WEED) it shouldn't be a problem...:nuke:

Nope... As I understand the OP... She (the LPN) IS NOT even calling/communicating with the "legitimately licensed personnel"... This LPN can/will just scream patient orders off the top of her head (without consulting a properly trained and licensed RN/APN/PA/MD/DO) while walking down the hall... (am I correct...??) As a former LPN...and current APN... I KNOW s/he is not adequately trained to do so... It sounds like this LPN is "practicing medicine" without a license... It IS your duty to report this to the BON and seek clarification. If one of these patients have a poor outcome... YOU WILL be held liable... simply because YOU followed the "orders" of a person YOU knew was NOT authorized to "Practice Medicine." NO ONE will protect your license as well as you will...

Not put my thumb on the side port of a G-tube before I try to flush it... YUCKY...:barf01:

That's cool... but Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!! There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!

Background: 20 years working in healthcare as a CNA (LTC & Hospital), EMT-B/I/P (yes I took all three of them individually in the military and worked "the bus" and the ED/CCU as a Tech in civilian healthcare), LPN (LTC), RN (Med-Surg/CCRN/EDRN), NPP (FNP/PA-C in ED/IM/Cards/Remote Med). I teach ACLS to the local EMT students and work in Cardiology and Internal Medicine and the ED Per Diem. I has gotten so bad that I started keeping a copy of my licenses in the nursing station. The last time this happened (about a year ago)... I called local department to speak to the director personally (He is a drinking buddy of mine) to ENSURE that the medic was disciplined or fired!!! Personal EGOS have NO PLACE in patient care...!!!!

:lol2::lol2:...:bowingpur

I only tell people who ask... I don't hang steths and other crap from my rearview mirror... and as a APN... I don't have to wear "uniforms" other than business attire ("GQ" jackets/shirt/tie/slacks). I am not particularly worried about becoming a "victim" because like many of the nurses (male and Female) here... I have a CCW (concealed carry weapons permit, I carry daily, and WILL shoot the $hit out of anyone standing between me and home...!!! On first glance... I look like a well dressed Detective). My wife doesn't even ask for my medical (FNP/PA-C) opinion anymore for her and the kids (unless there is blood involved)... because she KNOWS... I will simply refer her and them (the kids/in-laws/neighbors) to their respective PCPs... (treating family and friends is "bad juju"). When she did (10 years ago) my standard response was always... "Make a appointment with your/their PCP...:w00t:

I've been drug tested a LOT...!!!! Randomly tested for 8 years in the military... and Pre-employment tested for various EMT, Nursing and FNP/PA jobs over the last 20 years. In the military (I was a medic, so one of my responsibilities was to administer the UA) there were people who I knew were snorting/smoking cocaine (because I witnessed it) who passed EVERY pee test... but the "occassional" pot smokers were doomed!!! Most places I have worked (Post Military)... do Pre-employment testing. After that... they only test "for Cause." If you do something dumb and/or get injured on the job... then I think you should be tested... otherwise... What you do on YOUR OWN TIME... should be YOUR business... and NOT subject to the perview of those that only pay you for 8-12 hours of your time and expertise. (If you come to work "high"... you SHOULD suffer the wrath...!!!) A problem I see is... Even if the nursing unit is trying to find out who stole the vicodin/oxy/fentanyl patch... A unit wide urinalysis drug screen will likely, only illuminate the pot smokers... which will likely lead to them (the nursing unit/admin) having to discipline/sanction/trash several very good patient centered nurses. The simple fact is... a recreational cocaine/crack, narcotic or ecstasy user can use on friday... and be "good to go" for a urine test on monday. The Alcoholic (with 4 DUIs) is safe... but the occasional pot smoker will be in jeopardy for weeks. These occasional pot smokers may have NEVER been "high" on the job, but they are in danger of losing their career... simply because during a "random" 8 hr shift... a narcotic thief diverted some oxy... then the unit decides to do a unit wide UA and because THC is detectable for 30-45 days (longer if they are testing your hair) from that day... while you were on "vacation" (your time) "chillin"... in Jamaica... you took a few puffs ... A tragedy... Just some thoughts and experiences... Lannister btw... I'm currently studying for a Drug and Alcohol Counselor test so this has been something I have had to think about and deal with...

Which was my only point. A currently licensed ACNP, FNP sitting on the stand claiming that they didn't act because they were only hired as a RN (not APN) on that med-surg moonlighting job won't cut it legally.

Yes... but... You may still be held to the "practice standard" of your education versus your position... Just a thought...