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DidiRN

ICU, step down, dialysis

Content by DidiRN

  1. DidiRN

    Public Health Nursing

    Public health nurses are licensed Registered Nurses. Most have a bachelor's degree in nursing. Some may continue with graduate studies focusing on a masters of public health or other relevant graduate degrees. Education in public policy, epidemiology and health administration can be helpful if the nurse wishes to continue their education. Work Environment Public health nurses primarily work for government health departments and community health centers. Nonprofit organizations can also employ public health nurses. An office environment is primarily where these nurses will work. Many times they will also go out into the community. They may work alone or with other public health nurses or on a multidisciplinary teams/committees. Skills / Qualities Public health nurses must be knowledgeable of population health and diseases. They must be comfortable speaking to small and large groups since many times they hold educational seminars in communities. They must be culturally sensitive if they live in areas of diversity; Bilingual is a plus in these areas as well. Extensive travel is possible in certain positions. Good communication skills imperative since these nurse collaborate with other disciplines and public health nurses. Knowledge of pediatric health including immunizations and specific local health concerns are important as well. Another important area is knowledge of public policy and the local political arena. Duties / Responsibilities Public health nurses focus on population health. They will be involved in reviewing data on areas such as the incidence of infectious diseases, chronic health conditions, mental health, smoking and drug use rates, and general community health trends. From that data, they can develop plans to improve public health. Many public health nurses need to become involved in the political arena in order to push for laws for community health. They occasionally may need to assist in monitoring environmental issues such as local landfills that may become a threat. Other Duties Access to care. Coordinating care with low income individuals and families and the uninsured. Responsible for education of other public health personnel. Training of new public health nurses The development of community education programs in order to improve population health. Assist with child health clinics including vaccinations Domestic violence services Preventative health campaigns that focus on community trends Working with local schools to improve pediatric health Case finding and monitoring persons with communicable diseases Public health nurses can also work for global health. Global health focuses on the health of the worldwide population. Nurses in this area may travel to foreign countries in order to hold health clinics or meet with others to develop plans to improve health. Advocacy plays a big part in global health. Job Outlook Demand varies per region. There is a demand for this specialty particularly in low income and/or undeserved communities. Some areas may not have shortages in this field of nursing. Salary According to the Robert Wood Johnson Enumeration and Characterization of the Public Health Nursing Workforce survey conducted in 2012, Public Health/Community Health Nurse salary ranged from $45,089 to $73,852. Resources American Public Health Association Association of Public Health Nursing Explore Health Careers/Public Health Nursing Robert Wood Johnson Foundation Public Health Nursing Global Health
  2. DidiRN

    What is a Nurse Practitioner?

    Nurse Practitioners (NP) are registered nurses (RN) with graduate level degrees and are considered advanced practice nurses. They are able to provide health care services to patients in a variety of different settings. Some responsibilities include: assessing, diagnosing, and managing acute and chronic conditions. They are also responsible for prescribing medications as needed as well as health promotion and disease management. Salary Salaries vary quite a bit from state and specialty. NPs who specialize in acute care or work with surgeons can usually command a higher salary than ones who work in a family practice office. The mean salary according to the Bureau of Labor Statistics in May 2012 is $91,450/year. It is important for new NPs to understand the negotiating process during the interview and hiring process. Not only is salary negotiable but benefits, loans repayments, vacations and bonuses can be negotiated as well. Knowing how much revenue you bring to the practice can help serve as a point of reference if this is possible to discover this ahead of time. Many websites can give tips on how to negotiate as well as local salary information. Educational Requirements The minimum educational requirements for an NP is a masters in science of nursing. Some programs require some RN experience while others do not. Some colleges offer a route for individuals without a nursing degree; they are generally known as direct entry programs. These types of programs usually require a bachelor's degree in another field as a prerequisite for admission. The American Association of Colleges of Nursing (AACN) recommends (not requires) a minimum of a doctor of nursing practice (DNP) by 2015. However many colleges and universities are moving forward with the DNP requirement and no longer offer the MSN approach. These typically take three to four years to complete, while the MSN requires 2 years of study for individuals who already are RNs. There are different types of specializations for the NP which include: family nurse practitioner, adult geriatric nurse practitioner, acute care nurse practitioner, pediatric nurse practitioner, psychiatric-mental health nurse practitioner, neonatal nurse practitioner and women's health nurse practitioner. A few programs offer dual degrees such as Vanderbilt University's dual Family Nurse Practitioner/Adult Gerontological Nursing with an Emergency Care focus or Case Western Reserve's Adult-Gerontology Acute Care NP with a focus on Flight Nursing, Cardiovascular Nursing and Oncology/Palliative Care NP focus. Certification is required in order for NPs to practice is most states. The American Academy of Nurse Practitioner (AANP) is one organization that offers a certification exam. The American Nurses Credentialing Center (ANCC), which is affiliated with the American Nurses Association, also offers a certification exam. There are only small differences between the two. For example, the ANCC allows NPs to earn CEU's by precepting NP students. The AANP exam can actually be taken prior to graduation. Most NP positions require one certification or the other; a few organizations may prefer to hire NPs with a specific certification. It is imperative that each NP know and understand the requirements of their practicing state. Almost all states require certification from either AANP or ANCC before a license is issued. Prescriptive authority are requirements that must be met in order to legally prescribe medications. To prescribe controlled substances, NPs must apply for a DEA (Drug Enforcement Agency) number. This number is also used to track the number of controlled substances the NP may write as well as for identification purposes by the DEA. Most states require a NP to have a current collaboration agreement with a physician. These are written agreements in which the physician agrees to oversee a NP's practice. The requirements of these agreements vary from state to state. Some may only require physician agreement in order to prescribe medications only while others may require it for the NP to a diagnose and treat. Some may require the agreement to include written treatment protocols, periodic physician review of the NPs charts, patient referral and consultation, or resolutions of disagreements between the NP and the physician. States where this agreement is not required are considered independent practice states. Work Environment NP's work in many areas within health care organizations such as hospitals, mental health facilities, community health centers, physician offices, long term care, urgent care, and hospice. New areas are opening up such as telehealth and home health. In independent practice states, NP's can even open their own clinics and treat patients. Duties / Responsibilities Diagnosis and manage patient all types of health conditions Detailed physical examinations (history and physicals) Orders diagnostic and/or laboratory tests and interprets results Orders treatments and monitors effectiveness Collaborates with other members of the health care team Performs procedures dependent on area of specialization Patient and family education and counseling on health conditions Projected Vacancies The Bureau of Labor Statistics (BLS) does not differentiate between projected vacancies for nurse practitioners and registered nurses. Many do foresee an explosion of opportunities in many areas of the US due to the current health care climate and shortage of primary health care providers. There may be areas that have few opportunities while others areas may have a high demand. Understanding the Practice Doctorate in Nursing [video=youtube_share;k1ULRWGVeog] Resources The American Association of Nurse Practitioners Medline Plus article on NPs National Association for Pediatric Nurse Practitioners FAQ About Psychiatric Mental Health Nurses from the American Psychiatric Nurses Assoc. ANCC Certifications AANP APRN Prescribing Law - State by State (MEDSCAPE 2018) Bureau of Labor Statistics NP Occupational Employment and Wages (5/2012)
  3. DidiRN

    positive advice about Walden University NP program

    Closed for staff review
  4. DidiRN

    Hyperhydrosis

    Hello, I am sorry you are going through this, but we cannot provide medical advice per our Terms of Service. Please check with your health care provider regarding your symptoms. :) Thread closed.
  5. Several posts have been removed for being off topic/against TOS. Thread reopened. Please be respectful and stay on topic :)
  6. DidiRN

    Wcccd 2014 fall nursing hopefuls

    MODERATOR NOTE: Please do not post names/initials per our Terms of Service. Thanks :)
  7. DidiRN

    NJCU ABSN 2014!

    MODERATOR NOTE: Please do not post personal names including initals and email addresses per our Terms of Service. Many posts have been edited to remove them. Thanks :)
  8. DidiRN

    did i fluid overload her to death??

    Duplicate threads merged per Terms of Service.
  9. DidiRN

    my back

    ICULinda is correct. Thread closed.
  10. DidiRN

    New Grad Jobs In Philadelphia and Surrounding Area

    Moved to PA Nursing forum for best response.
  11. DidiRN

    Opinions? Father in hospice...

    Per our Terms of Service, we cannot offer advice. Thread closed.
  12. DidiRN

    Is Med Surg Pre-cursor for Critical Care Success?

    Closed for staff review
  13. DidiRN

    Flight Nursing

    Flight nurses require a Registered Nurse license with several years of experience in critical care and/or emergency nursing. Some RNs may already be required to have or plan on obtaining paramedic certification/license. Certifications in BLS, ACLS, NRP (Neonatal Resuscitation Program), TNCC (Trauma Nursing Core Course) and PALS (Pediatric Advanced Cardiac Life Support) are usually required. Other certifications that may be mandatory are Basic Trauma Life Support, Pre Trauma Life Support, and Transport Professional Advanced Trauma Course, CCRN and/or CEN. Certified Flight Registered Nurse (CFRN) often required within one year of hire. Hazardous material training is beneficial due to the occasional landing sites near accidents or large scale spills of hazardous materials. Work Environment Flight nurses work outdoors when arriving at an accident scene or a scene of a disaster. Exposure to inclement weather may be possible, although many flights have criteria to not operate in certain types of weather. Flight nurses work close to moving mechanical parts which and must be aware of potential flight turbulence. They will also be traveling to inpatient facilities for inter-hospital transfers that may require rapid transport. There are challenges while working inflight that include cramped surroundings and loud noise from the aircraft. Noise is such a problem that many employers require intermittent hearing tests and all flight crew are required or strongly encouraged to wear hearing protection. Skills / Qualities The ability to quickly adapt to different working environments is important. Nurses must be skilled in many different areas such as managing IV medications, ventilation management, advanced life support and cardiac monitoring. Understanding of pre hospital and emergency care on top of critical care is vital. Quick life and death decisions are frequent, so nurses must be comfortable in the management of the critically ill. Excellent interpersonal and communication skills and the ability to work in high pressure, rapidly changing situations is highly valued. Some employers may even have height and weight restrictions. Duties / Responsibilities Flight nursing has numerous responsibilities which include: Rapid and thorough assessment/triage of patients with conditions such as trauma, cardiac, respiratory and other critical illnesses. Management of pediatric clients The ability to work closely with other flight nurses, flight paramedics, advanced practice nurses/physicians Airway and ventilator management Initiation and management of intravenous medication, fluids, and blood products Maintaining patient safety before, during and after flight May be required to participate in community and outreach and other educational events May be required to participate in preflight liftoff checks and/or assist other flight personnel. Initiation of emergency care in the absence of a physician Management of patients during aircraft problems such as rapid decompression, wheels-up landings, and other aircraft emergencies Job Outlook Flight nurses typically experience a low rate of turnover so openings are not as abundant. Employers include private companies, hospital systems, or are members of the military. Salary Salaries are typically higher than average for flight nurses due to the extensive required experience. Some websites have quoted an average salary of $55,000 per year to up to $96,000 per year. Resources Air and Surface Transport Nurses Association Association of Air Medical Services Medevac Foundation International
  14. DidiRN

    Need advice from fellow LVNs...

    Moved to Texas Nursing for best response
  15. DidiRN

    Canadian Lpn to Rn program

    Moved to Canada Nursing Programs forum for best response.
  16. DidiRN

    Has anyone attended UTI in Perth Amboy, NJ

    MODERATOR NOTE: folks, please don't use names here per our Terms of Service. Thanks! :)
  17. DidiRN

    Private Duty Nursing

    Both registered nurses and licensed practical nurses work in private duty nursing. Both require an active license. It is also important to be certified in basic life support. Work Environment/Salary Most of the private duty jobs are in the home of the patient. Some patients and families may hire a private duty nurse to work at the bedside while they or their family member are in the hospital. Some pediatric private duty nurses may assist them in getting ready for school or appointments. Some are employed by school districts to care for these patients during school hours. Private duty nurses typically work for an agency, but some can work as a private contractor. Agencies are advantageous in that they can find cases for the nurse to work on, thus eliminating the need for advertising and other obligations such as taxes and insurance. Some patients and families may request that their nurse travel with them to vacation spots although that is not common. The pay in private duty nursing is typically lower than other fields of nursing. Skills / Qualities An experienced private duty nurse will be knowledgeable in many different areas such as ventilator and tracheostomy care, oxygen therapy, wound care and many others. For pediatric clients, nurses should be knowledgeable of the stages of development and proper psychosocial care of age group they are caring for. Familiarity with long term pediatric chronic health conditions such as traumatic brain injury, cerebral palsy, genetic disorders, and prematurity is important as well. Because they are very independent, the private duty nurse should feel comfortable working alone without any direct supervision. Even if employed through an agency, the nurse still needs to know what to do in case of an emergency, or for any situations where it is not possible for another nurse to be there quickly. Interpersonal skills are vital; having an empathetic, professional and friendly personality without crossing personal boundaries is important. Duties / Responsibilities Nurses caring for clients are responsible for: Assessment of the patient Frequent documentation on the patient's condition Communication and education with patient and their family Monitoring equipment such as ventilators, infusion pumps, etc. Calls to physicians as needed Medication administration Nebulized therapy and maintenance of oxygen therapy Dressing changes Vital sign monitoring Managing patient supplies Safety monitoring Assisting with activities of daily living Job Outlook There has been growth in the pediatric area of private duty nursing. This age group are surviving longer with the advances in technology now but are more medically complex, thus accounting for the job growth. There are still opportunities for adult private duty care though but may not be as abundant as pediatric cases. Resources Private Duty Homecare Association National Association for Homecare and Hospice Home Care Association of America
  18. DidiRN

    Flight Nursing

    Education Requirements Flight nurses require a registered nurse with several years of experience in critical care and/or emergency nursing. Some RNs may already be required to have or plan on obtaining paramedic certification. BLS, ACLS, NRP (Neonatal Resuscitation Program), TNCC (Trauma Nursing Core Course) and PALS (Pediatric Advanced Cardiac Life Support) are usually required as well. Hazardous material training is beneficial due to the occasional landing sites near accidents or large scale spills of hazardous materials. Work Environment Flight nurses work outdoors when arriving at an accident scene or a scene of a disaster. They will also be traveling to inpatient facilities for interhospital transfers that may require rapid transport. There are challenges while working inflight that include cramped surroundings and loud noise from the aircraft. Noise is such a problem that many employers require intermittent hearing tests and all flight crew are required or strongly encouraged to wear hearing protection. Skills / Qualities The ability to quickly adapt to different working environments is important. Nurses must be skilled in many different areas such as managing IV medications, ventilation management, advanced life support and cardiac monitoring. Understanding of pre hospital and emergency care on top of critical care is vital. Quick life and death decisions are frequent, so nurses must be comfortable in the management of the critically ill. Excellent interpersonal and communication skills and the ability to work in high pressure, rapidly changing situations is highly valued. Some employers may even have height and weight restrictions. Duties / Responsibilities Flight nursing has numerous responsibilities which include: - Rapid and thorough assessment/triage of patients with conditions such as trauma, cardiac, respiratory and other critical illnesses. - Management of pediatric clients - The ability to work closely with other flight nurses, flight paramedics, advanced practice nurses/physicians - Airway and ventilator management - Initiation and management of intravenous medication, fluids, and blood products - Maintaining patient safety before, during and after flight - May be required to participate in community and outreach and other educational events - May be required to participate in preflight liftoff checks and/or assist other flight personnel. - Initiation of emergency care in the absence of a physician - Management of patients during aircraft problems such as rapid decompression, wheels-up landings, and other aircraft emergencies Job Outlook Flight nurses typically experience a low rate of turnover so openings are not as abundant. Employers include private companies, hospital systems, or are members of the military. Salary Salaries are typically higher than average for flight nurses due to the extensive required experience. Some websites have quoted an average salary of $55,000 per year to up to $96,000 per year. Resources Air and Surface Transport Nurses Association http://www.astna.org/ Flight Nursing from Discover Nursing http://www.discovernursing.com/specialty/flighttransport-nurse#.UpqaVMRDvng Association of Air Medical Services http://www.aams.org/ Medevac Foundation International http://www.medevacfoundation.org/
  19. DidiRN

    Infusion Nursing

    Work Environment In the hospital setting, infusion nurses may be part of an IV team that places IVs for the floor staff or they may only assist with difficult access. They can also be a part of a PICC (peripherally inserted central catheters) and midline access team. Hospital infusion nurses can also train new graduate nurses in intravenous therapy. Outpatient clinics employ infusion nurses where patients may come in for intermittent infusion of medications such as antibiotics, cardiac medications, blood products, or chemotherapy. These nurses may need to be proficient in telemetry monitoring depending on the type of medication being infused. The focus on reducing health care expenditures has created opportunities for infusion nurses to practice in the home. Some home health companies incorporate infusion nursing as part of their organization. But many companies focus exclusively on home infusion. Nurses infuse similar medications at home that they do in outpatient centers. Infusion nurses are exposed more frequently to potential blood borne pathogens than many other nurse specialty areas. Many patients also have drug resistant infections that require frequent infusions in an outpatient setting. Infusion nurses must be very cognizant of infection control precautions. Opportunities or Projected Vacancy Rates The Nurses Infusion Society predicts positive growth, especially with the increasing number of medications and biologic agents that require IV administration. Opportunities are growing for infusions to be administered in the home setting. Skills / Qualities Most infusion nurse positions require some basic nursing experience, and may care for patients across the lifespan. Registered nurses are primarily infusion specialists.They must be highly skilled at performing venipuncture. Certain jobs may require extensive experience in midline and PICC catheter placement. Knowledge of different IV medications, fluids and blood products is required. Infusion nurses must be competent in working with a variety of different vascular access devices associated with infusions. Duties / Responsibilities The infusion nurse needs to do an assessment of the patient before, during and after the start of the therapy. Ensuring the supplies are available as well as the medication to be infused is a responsibility of the nurse. Infusion nurses may also be responsible for drawing labs from central lines and monitoring these results. Open lines of communication with the patient, physician, radiology and pharmacy is important as well. Another important aspect of infusion nursing is patient and staff education. Patients need education on the medication, side effects, and what to observe for after the treatment is complete. Infusion nurses are responsible for orientation of not only new infusion nurses but training of new graduates on IV therapy and insertion. Salary Salaries can widely vary from different regions. Most infusion nurses are paid hourly. Discover Nursing reports that the average salary of an IV therapy nurse between $44,000 and $57,000 a year for 2013. Resources Infusion Nurses Society offers information regarding policies and procedures, conferences and general info. Infusion Nursing from Discover Nursing The Association for Vascular Access deals with types of vascular accesses, which type to use on individual patients and quite a bit of general info.
  20. DidiRN

    Public Health Nursing

    Education Requirements Most public health nurses have a bachelor's degree in nursing. Some may continue with graduate studies focusing on a masters of public health or other relevant graduate degrees. Education in public policy, epidemiology and health administration can be helpful if the nurse wishes to continue their education. Work Environment Public health nurses primarily work for government health departments and community health centers. Nonprofit organizations can also employ public health nurses. An office environment is primarily where these nurses will work. Many times they will also go out into the community. They may work alone or with other public health nurses or on a multidisciplinary teams/committees. Skills / Qualities Public health nurses must be knowledgeable of population health and diseases. They must be comfortable speaking to small and large groups since many times they hold educational seminars in communities. They must be culturally sensitive if they live in areas of diversity; bilingual is a plus in these areas as well. Extensive travel is possible in certain positions. Good communication skills imperative since these nurse collaborate with other disciplines and public health nurses. Knowledge of pediatrics health including immunizations and specific local health concerns are important as well. Another important area is knowledge of public policy and the local political arena. Duties / Responsibilities Public health nurses focus on population health. They will be involved in reviewing data on areas such as the incidence of infectious diseases, chronic health conditions, mental health, smoking and drug use rates, and general community health trends. From that data, they can develop plans to improve public health. Many public health nurses need to become involved in the political arena in order to push for laws for community health. They occasionally may need to assist in monitoring environmental issues such as local landfills that may become a threat. Other duties of public health nurses include: - Access to care. Coordinating care with low income individuals and families and the uninsured. - Responsible for education of other public health personnel. - Training of new public health nurses - The development of community education programs in order to improve population health. - Assist with child health clinics including vaccinations. - domestic violence services - Preventative health campaigns that focus on community trends - Working with local schools to improve pediatric health - Job Outlook Demand varies per region. There is a demand for this specialty particularly in low income and/or underserved communities. Some areas may not have shortages in this field of nursing. Salary According to Discover Nursing, the average salary for public health nurses range from $44,000 per year to $55,000 per year. Resources American Public Health Association http://www.apha.org/membergroups/sections/aphasections/phn/ Discover Nursing/Public Health Nursing http://www.discovernursing.com/specialty/public-health-nurse#.Uppk_MRDvng Association of Public Health Nursing http://www.astdn.org/index.php?option=com_content&view=featured&Itemid=470 Explore Health Careers/Public Health Nursing http://explorehealthcareers.org/en/Career/149/Public_Health_Nurse#Tab=Overview
  21. DidiRN

    Home Health Nursing

    Home health is an area of nursing that is primarily focused on caring for patients in their home. Nurses in this area make intermittent visits to the patient's home and sometimes in assisted living facilities seeing individuals there. The focus is to keep the patient in their home safely for as long as possible. Most visits are short term only and others are long term. Nurses may encounter patients from all across the lifespan and for all different kinds of health conditions. Educational Requirements Both LPNs and RNs can work in home health. Some employers may require RNs to have a BSN but this can vary widely. Opportunities/Projected Vacancies Home health is expected to rise in the number of job opportunities. Organizations that hire home health nurses can be affiliated with hospitals and private non-profit or for profit companies. Some individuals are able to work as an independent provider and receive reimbursement directly for their services. Work Environments Nurses work exclusively in the patients' homes, with occasional visits a home office. These home visits usually take anywhere from 30-45 minutes to a few hours if a nurse is opening a new case. Nurses may face unsanitary conditions in home: exposure to cigarette smoke or parasites such as lice, scabies and bed bugs. Pets can be present as well. Driving is an integral part of this field and the nurse must be comfortable traveling. Skills/Qualities Many home health agencies prefer or even require experience in home health nursing due to the meticulous documentation that is required for Medicaid and Medicare reimbursement. This documentation can be challenging to learn. Some may even be responsible for knowing how to properly utilize ICD-9 coding. Another reason for requiring experience is that the home health nurse has minimal supervision out in the field and decisions must be made independently. However some organizations are willing to train nurses new to the field. Good communication and organization skills are imperative. Nurses organize their day by the number of visits he or she needs to make plus making time for the extensive charting required and drive time between different homes. They are also expected to communicate not only with patients and families but with physicians and other health care professionals. This may include social services organizations, insurance companies, respiratory and other medical equipment companies. Duties/Responsibilities Visits comprise of assessments and evaluation of physical and mental conditions, assessment of safety in their home, and perform treatments or lab draws. Many of these visits may be patients who were recently discharged from the hospital or long term care facilities. Visits can also be done for medication administration and supervision of home health assistants who provide personal care. Teaching is an integral part in these visits. Nurses are responsible for educating not only the patient but their caregivers as well. Home health nurses are usually more cognizant of reimbursement issues. Medicare visits are in general more particular in their requirements for reimbursement and patients are admitted short term for the most part. Forms such as the 485 are the "plan of care" that contain basic patient information along with medications and physician orders. This form is also important for reimbursement. Nurses must understand reimbursement for visits in order to properly plan their care before the patient must be discharged. Close communication and collaboration with other care managers from government and private insurance companies is important. Many times these care managers can approve more visits if the patient needs further care. Some Medicaid visits are much more long term but still requires knowledge of requirements for the patient to remain in the program. Nurses may also visit patients for vital sign monitoring, wound care, monitoring drains, and intravenous therapy to name a few. Telehealth is another aspect of home health that involves remote biometric monitoring but not all organizations utilize this technology. This is a device that plugs into a phone line or data can be transmitted wirelessly. This is then sent to a database in the home office for nurses can evaluate. Blood pressure, pulse oximetry, pulse and weights are the most common factors. Salary Salaries can be paid per visit, per hour or even salaried. The amount of salaries vary widely. Some areas may pay nurses more than working in an acute care environment while others may pay considerably less. Mileage is paid but some agencies may not offer this option. Resources The American Association for Homecare The National Association for Homecare and Hospice
  22. DidiRN

    good morning

    Moved to Nursing Student Assistance forum
  23. DidiRN

    Good nurse gone

    Threads merged
  24. DidiRN

    simmons online fnp

    MODERATOR NOTE: Several posts have been edited to remove personal names which is against our Terms of Service. Thanks :)
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