Guest27531

CP1983, Thank you for your response. I, too, am certified and I found the course very interesting. I was wondering, in particular, about the usefulness of the instrument and how those who need one done find staff who are certified.

I think you will do fine in school. It won't take you long to get back in the hang of studying, particularly since you are so motivated. But you need to prepare yourself emotionally for a very difficult profession. You will not be coddled and you will need to be strong within yourself. So, if you really want to be a nurse, stop thinking about whether or not you can do it. Classes will be easy. Then the hard part begins. I did it as a single parent so I know it can be done. I wish you the best!

You may be "clueless" now but if they really need you and you want to go the "administration" route this may be a doorway. Medicaid/Medicare regulations are learnable and so is budgeting. If you are not in a big city and it is a small nursing home it may work for you.

It sounds like a very difficult transition! Here are my thoughts (for what they are worth): 1. How much does the nursing home need you? Are you located in an area where they are having problems finding people to even apply for the job? 2. How big (or small) is the nursing home? 3. If you have no budgeting experience is the nursing home able to wait until you learn how to make budgeting decisions? 4. Will you be able to do the resource calculations to decide whether to accept a new resident? 5. Are you prepared to live a professional life where you must be more concerned about regulations (state and federal) than most nurses need to be? 6. Are you prepared to have a 24/7 job responsibility? I wish you the best of luck and hope you get replys from current or former nursing home DONs to give you some advice based on actual experience with that function!

I haven't posted on AllNurses for a very long time but I did not know where else to turn to ask for New York State-specific information. (The PRI is only used in NY). I would love to hear from case managers, nursing home nurses, home care nurses and anyone else who would like to talk to me realistically about the PRI. In particular, I am interested in the following: 1. Since it is so out-of-date is it still useful to you? 2. Do you have trouble finding certified PRI nurses to do the assessment for you? 3. How do you find someone to do the assessment for you? 4. Do you use paper or do you have the assessment in a computer? Thank you to anyone who has anything at all to say about this topic.

The usefulness of Nursing Theory in nursing practice is like Philosophy in life...most people don't realize they are living their lives (i.e. Practicing) by it but they are. The more we realize there is the possibility to actually know the reason we are doing something (or not doing something) the better our life (practice). I'm glad you are enjoying it...it should be interesting!!

Congratulations!! thank you so much for returning to tell what happened. I don't look on this site much but I had this one tagged so when you posted it popped up. Just keep on going...you are getting to your goal and you will find a job you like. Some are dreadful but nursing, itself, is wonderful. I feel blessed to have been able to have a wonderful career in nursing. I have has many jobs and seen many changes in health care but the changes keep on coming. Currently, my hospital is going through a hostile take-over and I'm seeing that those who can be flexible and can go with the flow are surviving and even thriving. Those who try to hold in to old ways are having melt downs... Your experiences and opportunities will be different than mine but if you can see it all as an adventure and think if all the physical activities as exercise (I wear a pedometer to remind myself) you will thrive. Congratulations!!

I used to work for VNS (1.5 years full time and 10 additional years contract). I loved it and decided that I would return to work for them Per Diem when I retired. So, 1.5 years ago, I retired from full time employment (too young for real retirement, however). I applied to work for VNS and received no response. I went to a job fair and asked them about it. The recruiter was very nice, looked at her list and indicated that the position I wanted was not available. She also apologized that they cannot get back to those who are not chosen because there are simply too many applications and showed me a pile of resumes nearly 6 inches thick and the job fair had only been open for 1 hour. I watched the Web site weekly and have applied two additional times and heard nothing. I understand that they have many applications for each position but it is still difficult not to hear anything. So, I understand your concern. I advise you to keep your resume posted through their Web site and keep applying for the position you want whenever it appears, however, I do believe that you would not be a desirable candidate for Per Diem or Part Time (at least if I were the recruiter) as you do not have the home care experience that would be desired for Per Diem or Part Time. I highly recommend applying for a Full Time position with them, working for a year and then change your status to Per Diem or Part Time. It may be the only way to get your foot in the door with them. I wish you the best of luck!

I'm certain that many people will give you tips that will help you get organized. My days of caring for the whole family are past, so I will address a couple of other aspects that will also give you additional energy and the ability to cope with the enormous responsibilities you face: 1. Talk to your husband about sharing some of the household responsibilities. Ask him what he can do to contribute to the functioning of the household and care of the children. Once you see how he responds, you can take it from there. Hopefully, he is supportive of you returning to work and will find at least a few ways he can help. 2. Have a set schedule for everything. Once you start "living" the schedule, it will take increasingly less energy to get through the tasks of daily living. 3. Don't forget to laugh. Make it a point to laugh! That is, purposely find things to laugh about. There is a very important physiological reason that Laughter Yoga is catching on. Laughter will boost your immune system and keep your energies flowing. 4. This is the most important: At the beginning of each new activity, take a minute to "ground and center" yourself. There are multiple techniques for doing this but the simplest, quickest and most practical way for nurses is to physically stop, take a few deep breaths, feel your feet on the floor and open your listening. This is one of the basic techiques of Holistic Nursing and can be used in ALL nursing (and home) situations. It takes less than one minute and it will change your world!

You are in a difficult position. You say you were "almost graduated" when you were dismissed. That seems like a real problem to me. Although I do wonder what class you failed, it is hard to imagine failing any class and still being allowed to graduate, so I cannot fault your school. In your interview, you need to be completely honest about your short-comings and not blame the school at all but apart from that I can't say I have any words of wisdom. I do wonder whether you should consider another career as testing will continue throughout your nursing career. Some people just don't test well and it is better to change careers now than to be dismissed from full-time employment which will follow you for life.

These days it seems to take weeks between each step! In my experience, the best move is to end the call with an inquiry about the next step and when you should expect to hear from someone. It has been several months now...so, how long did it take before you heard from someone? or did you have to call them first?

Although Beth Israel and St. Luke's-Roosevelt Hospital are both part of Continuum Health Partners, the nurses are covered under separate contracts. St. Luke's-Roosevelt Hospital are NYSNA while BI nurses are not NYSNA. Not actually certain but think BI nurses may be 1199. Salary would be "comparable" but not exactly the same.

getting a bsn is essential these days if you expect to work in the hospital. don't even think about not completing your program if you intend to have a career as a nurse. now, getting to another point you raise - "was told my high confidence level comes across as being unteachable". you absolutely need to work on that. a "high confidence level" is usually not a good thing for a new nurse (or a nurse in a new specialty) so you need to look at what your problem is here. if you take your bsn education seriously, it will help you overcome your arrogance. i believe i am qualified to speak on this matter as i had a similar "high confidence level" after graduating from an old-fashioned diploma school at st. vincent's hospital school of nursing. it was 3 full years of nursing (including summers) and when i graduated i had experience in almost everything and could comfortably be in charge of any unit in the hospital. i did a bsn degree "because it was the right thing to do" but i planned on writing articles about how much more i learned in my diploma program. i was wrong. the education is on a different level and i did learn a lot in my bsn program. i hope you will, too.

Absolutely right! You do not need a doctor's order to do an EKG for chest pain and, as described previously, one would wonder about an RN who did not do one stat but this is a good example for you to use to talk to your Nurse Manager about how "standing" orders vs "verbal" orders vs "prudent action" are handled at your institution. Excellent new nurse question.

I think you are on the right track and I advise you to continue doing everything you can to get into hospital nursing. Your salary may or may not be higher right away but I'm certain that it would pay off in the long run. You mentioned that you are pregnant so be really careful about your health insurance. If you are covered by your husband then it won't be a problem but if you are covered by your employer you should stay where you are for now. Also consider whether you have maternity leave where you are now as it is common for those benefits not to kick in until you have passed a 3-month probation. I wish you the best of luck!

I retired from one major hospital and started working (in the same unit) Per Diem through an agency (that's a long story, don't ask). Recently, I became Per Diem through the hospital (which I should have done the moment I retired) and I make significantly more as I am eligible for the in-hospital experience differential that I didn't even know existed. So, experienced nurses with "external" experience may make significantly less than nurses who have been working full-time at the hospital. It is becoming harder and harder to learn pay rates as it differs so much from hospital to hospital and depends on union/non-union, educational differentials, experience differentials, shift differentials, etc. Even rates paid by agencies are not altogether clear. I was registered with two agencies and the rate of pay was in question at one time or another at both agencies.

It doesn't sound at all silly. Your description brings back memories of my basic training and the times that I experienced similar situations. Don't be concerned that you have a character flaw...in fact, what is currently a disadvantage will, likely, turn out to be an advantage when you have more experience. One of my instructors in my first year told me that I was too "stand-offish" for nursing. She said she had noticed that I didn't really like to get too close to my patients, that I seemed to hold back. It was probably true and perhaps I needed to hear it at the time but I have had letters from patients over the years indicating that they felt closeness and care from me...so, sometimes it's physical and sometimes it's not. Also, you still have to learn some important interviewing techniques (often during your psych rotations) that will help you say the right things, even when you don't feel like you know what to say. The techniques seem somewhat awkward and forced at first but they work. One of my most difficult assignments was when we were studying Death & Dying and I was assigned to a young mother (about my age). She had advanced bone cancer and they hadn't been able to get her out of the stage of denial. It was very important for the sake of her two children that she help her husband figure out a plan for the children after her death. I went to see her the evening before my clinical with her to do my assessment and I was terrified! I had no idea what to say to her and I was certainly in no position to give her advice. Because our studies were centered around Death & Dying, we had been given certain interviewing techniques to help us talk to the patients. This lovely young woman was nearly catatonic and would not speak to me nor look at me. She remained lying down on her side and looking out the window. I first went around to the side of the bed where I could face her but was quickly scared off when she didn't respond. I started to leave the room but something brought me back (probably the fact that I didn't have enough information for my Care Plan!). I turned around at the door and came back and stood behind her. I spoke to her gently and told her that I had read her chart and that I was very sorry to read her diagnosis and to read that she was in a great deal of pain. I told her that I would return in the morning to give her a bed bath and to wash her hair and that I would try to be very gentle. Then, I remarked that it must be difficult for her and her husband to figure out what would happen in the future. I asked if they had decided how he would manage the household without her. She didn't respond and I quietly left the room, feeling quite a failure. The next morning the instructor took me aside and said that after my visit she began to cry and was able to move to the next stage of grief (bargaining). This allowed the staff to be able to work with her and the father of the children so they could start making realistic plans for their future. It changed everything for them. My instructor was very clear that it was something I said that allowed her to make the break-through. I'll never forget it. I'll also never forget her. Also, not everyone is meant for all types of nursing. For my part, I had a hard time during my pediatric rotations. I liked the learning part but the clinicals were difficult because I was already a mother and all I wanted to do was "mother" the children. That is very different from being their nurse. Even with all my nursing experience, I would still not feel comfortable in pediatrics. So, you will find the type of nursing that works for both you and your patients. In the meantime, just take the clinicals as they come and do the best with what you are being taught. It sounds like you have good insight and are being thoughtful in your work. That makes a great nurse!

Holistic nursing is a nursing specialty for which an RN may obtain certification. An individual wishing to become a Holistic Nurse must first become an RN. Once an RN you would take additional courses (mine was 1 year) to learn the specialty after which you may be eligible to sit for the certification exam. There are three certifications - one for RNs with a diploma or Associate Degree, one for RNs with a BSN, and one for advanced practice (Nurse Practitioners or Clinical Nurse Specialists) nurses.

VNSNY is a wonderful company to work for and your manager is always just a phone call away to help you handle any unusual circumstances. The Internship program for new grads is new since I worked there but I would trust them completely.

As I read through the posts I am reminded that "home health" is a very broad term and there are, indeed, very different types of jobs within that catch-all phrase. I originally read the post and assumed (mistakenly I think) that the reference was to a skilled visiting nurse, the job that I had. Obviously, that is not the only job in home health. I'm sure there are many home health jobs that would be appropriate for a new graduate, particularly if there is proper back-up or if it is a one patient shift job. It may also depend on the referral and intake process that would screen out some of the more difficult cases that I had to deal with. I am in NYC, in Manhattan, and the Visiting Nurse Service will send a visiting nurse into a home to do an assessment without any real screening (when necessary and only as a service to the community). There are other referrals that have been pre-screened prior to discharge so there is more information and, of course, there are the better known cases that just need continued skilled nursing. I cringe whenever I think of a new grad having to face some of the things I faced because it took all my clinical skills, my critical-thinking skills, and emotional strength to do a good job. Here are things I faced that I would not think a new grad could handle easily: 1. An apartment so filled with items collected over the years that there was no real pathway to reach the patient (think Grey Gardens) who was hidden in a back corner of a filthy dirty apartment filled with roaches and goodness knows what else. Hadn't seen a doctor for "many years" and had serious medical issues, including gross skin lesions. 2. An apartment that had an unlocked door with no caregiver present for a bedbound, incontinent patient, no linens on the bed, no food in the cupboards, and three underage (less than 7 years old) underfed children. 3. A patient who needed the nasogastric tube reinserted. In the hospital I assisted with this but it was not the function of the RN so I had never inserted one. 4. A male patient who needed the foley catheter reinserted. Again, in the hospital it was not the function of an RN to insert a foley catheter in a male patient so I had never done one. 5. A patient who had severe CHF, was fluid overloaded and had run out of Lasix and the doctor couldn't be reached. 6. A patient who was in severe respiratory distress who didn't want his doctor called but his wife did. 7. A newly discharged patient (came home the night before) who had a new colostomy she wouldn't look at. She was anxious to the point of shortness of breath and she couldn't stop crying. She had only a couple of supplies that had been given to her at discharge and it was a type of colostomy bag with stoma ring that I had never seen before and it appeared to be missing critical parts. The current bag had come off so feces was all over the patient and her clothes, still she would not look. The primary reason Medicare would allow a skilled home visit was to teach her to do colostomy care. I had never faced these things before but my background allowed me to address each situation with a clear head and to find a solution to the problem within the space of a normal home visit. I just don't think a new grad would be able to do that. For career purposes and purposes of continued learning and well-rounded nursing practice, I still don't recommend it for the new nurse. Nevertheless, I do agree that there are jobs in home health that a new grad could handle and with jobs scarce it is just normal that "you gotta do what you gotta do."

Whoever said that? I worked as a Visiting Nurse with VNSNY and it is not for a new grad! Although home care agencies may hire new grads I do not recommend it. Before I worked for the VNS I worked in the OR, the Open Heart Recovery, ICU, CCU and Labor & Delivery units I still found it to be challenging - both clinically and administratively. You must be prepared for anything clinically and you must be clear-minded enough to be able to write a comprehensive care plan and order the correct supplies and equipment for the diagnosis. It requires extensive clinical knowledge, good planning skills, good management skills, and good people skills. IMHO it is not for a beginner.

Congratulations!!!! You will find there are ups and downs along the way but, 30 years into my career, I still feel the way you just described.

I'm so sorry to hear you are not satisfied with your education. I was never an LPN but what you describe does not sound right. What school do you go to? Perhaps if your post is directed as other students who go to your same school you can find out if there are others in the same situation. From your description, I would advise changing schools when you move to the RN level.

I was 7 years old. I couldn't read or write but I learned "Hospital" so I could write it on a blackboard and put it at the entrance to my bedroom where I had my dolls lined up for shots. I was always very kind because I didn't want the shot to hurt. History: My baby sister had allergies and we used to spend alot of time at the Navy infirmary getting allergy shots for her. I clearly remember sitting in the corner and watching the "health care provider" jab her arm again and again as she screamed. No one talked to her and no one seemed to be kind. As I sat there, a Navy nurse walked by, just outside the door and I wanted to call out to her to come in. I just had the feeling she would know what to do; she would be kind. I wanted to be her so I could help. When I was in high school, I volunteered in a children's hospital in Wash, DC When I was between high school and college I worked as a nurse's aide in a nursing home in California full time. On each occasion, it was the nurses who gained my respect and, although I am saddened by our health care system, I am proud to be a nurse. I would say to you that when the calling is there, it won't let you down. Follow your heart.

You are making the right decision. When you do start working, you can use the tuition benefit (assuming there is one) toward grad school. By the way, do your friends know they will be required to pay taxes on that tuition benefit? I completed my education the long way, starting with a 3-year diploma program. It was fantastic and I was confident of my skills and could have been in charge of a unit when I finished but it took forever to finally reach graduate school. When I finished a Masters and wanted to go on for a Doctorate I was toast...just couldn't justify that many more years in school...so I stopped after receiving a Masters from Columbia University. If you start with the BSN you will be at least three years ahead of where I was...