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CCU, L&D, Home Care, Research, Holistic
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NYLady has 30 years experience and specializes in CCU, L&D, Home Care, Research, Holistic.

NYLady's Latest Activity

  1. 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!
  2. 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.
  3. 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!
  4. NYLady

    PRI Assessments

    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 Since it is so out-of-date is it still useful to you? 2.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.
  5. 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!!
  6. NYLady

    Name the hospital and its Starting Salary!!!

    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!
  7. NYLady

    When did you decide nursing was for you?

    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.
  8. 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.
  9. NYLady

    When did you decide nursing was for you?

    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.
  10. 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...
  11. NYLady

    New Nurse needs help interpreting labs, please

    Your example of BUN caught my attention because certain patients with CHF who are being appropriately treated aggressively for fluid overload will be expected to have an elevated BUN and and pushing fluids is not the correct action. You should tread carefully on action you plan to take because of your "interpretations". In a LTC facility, you will likely have very slow turnover of patients so you should concentrate on getting to know the individuals and speak to the doctor for each abnormal that you think should be treated. It may irritate the doctors at first but don't hesitate to tell them that once you come to know each patient, you will not be calling as frequently. Focus on the critical labs first, such as potassium. If that is too high or too low it can cause lethal arrhythmias. This is one of the only labs I can think of that would cause me to take independent action (if allowed) and I would send a follow-up lab to see if it is real or whether a very high potassium is related to sitting around on the counter all day. A rising creatinine is also an indication that physician evaluation is required. Most abnormal labs do not require independent nursing intervention but certain abnormal labs or trends should be mentioned to the health care provider responsible to diagnose and treat the patient.
  12. No, they are not the same thing. A physical exam is just what it says it is - an examination of the physical body. It may be a "complete" physical exam and include looking in the eyes (retinal exam), ears, throat, feeling the lymph nodes, auscultation of the lungs, abdomen, heart, palpation of the liver, looking at the skin, hair and nails, palpation of the prostate, etc or it may be a modified physical exams to assess a particular aspect of the body such as examination of a wound to assess wound healing, auscultation of the heart and lungs to determine whether there are abnormal sounds. The key is that it is an examination of the physical body. A health assessment includes health history including symptoms (both physical and psychological). It has a much broader scope as an assessment tool. In practice it may include a complete physical exam, a modified physical exam, or no physical exam.
  13. NYLady

    New Grad RN CAN'T FIND WORK!! What should I do?

    You could get a job as a CNA after graduation to help you have income but it won't count as RN experience. Also, it is unlikely any reputable hospital will hire you as a CNA after you graduate because they know you are planning to stay only a few months. So, not really a good plan. I don't know the rules regarding time frame from graduation to NCLX (you could contact them regarding that issue) but I caution you not to wait any longer than necessary as you will begin to forget material and your chances of doing well on the exam go down the longer you wait. Where are you located? For most places, the best plan is to know all possible RN jobs and just keep applying until you get one. By the way, this seems to be good advice for experienced RNs also. I applied three times to the Visiting Nurse Service for a Per Diem job (a place I once worked full-time for 1.5 years) and it took them 1.5 years to finally call me back. They just don't have many openings for the number of people applying, so we need to keep trying.
  14. NYLady

    I like learning about diseases but hate nursing

    To the OP - You have written a very thoughtful description that shows good observational skills and excellent personal insight. Many people are not fortunate enough to have this combination at at early age or ever, for some people. You have your whole life ahead of you, so take a deep breath and relax. You need to use your critical thinking skills to plan ahead. First, you need to finish your degree so you need to decide if you want to be "done" in a few months and have a degree in nursing or change specialties right now and put in more time. There are pros and cons to both, so you need to make a list and consider carefully. If you choose to stay with nursing and pass the Boards, you will need to get a job you don't like for at least a year to have the experience under your belt. But, once that is done, you will have unlimited choices in nursing, including entrepreneurship. There are nursing jobs (like home care) that give you the freedom to enjoy good weather more than if you had an "inside" job. From what you describe, I suggest staying away from any longterm jobs where you would be indoors all the time or focusing on the patient's illness or something specific like sales all the time (no hospitals, no nursing homes, no private duty, no school nursing, no pharmacy, no pharmacy or device reps) as it sounds like you have some wanderlust and need to stay somewhat unfettered. Once you get your experience, you can explore Travel Nursing (which has short-term contracts) or simple Per Diem work or just have your nursing as a foundation which will always be beneficial. Just be sure to keep in mind that probably any other profession you choose will also have the requirement to "put in your time" before you can be independent. Secondly, (once you decide whether you are going to get that BSN), you need to really put the puzzle pieces together to figure out what career you would like. It sounds like you might be well suited to a job where you make appointments with clients (like Physical Therapists or Social Workers) so you can schedule your time effectively. Depending on your personal interests and geographical location, you may also consider Alternative Care therapies. In California and the Southwest, these are more prevalent, however they do exist all around the country. In that specialty, you could establish your own business with clients and either create your own schedule (to have that all-important freedom) or shift to focus on a flourishing business (if the wanderlust subsides). Once you imagine your "perfect" job, you can uncover the steps to reach that goal - probably requiring a Masters (or certification) in a Specialty that will meet your needs. I have personal mixed feelings about your situation. I'm a little jealous that you are young and thoughtful and can set it up any way you want. I wish (in a way) I could have a do-over. I started a little late and followed a slow and winding road and now I'm a little too old to start something completely new. However, I'm very happy because in small ways I did follow my heart and did have a wonderful career with more freedom than many nurses had (in my 21 year research job) and, honestly, I don't want to relive some of the hardships nursing students and new nurses face, so I'm satisfied to leave it to those of you who are just starting out. I am now working Per Diem and have discovered (to my great surprise) that my best job is with the hospital I worked in for over 27 years so I'm grateful that I did "put in my time" but there are other ways of handling a career and your have the option to create a world for yourself. I do recommend you finish what your started including graduation, NCLEX, and 1 year of in-hospital nursing experience. I wish you all the success in the world.
  15. :lol2::lol2:
  16. Nursing theory is important to nursing practice in the same way Philosophy is important to living. We all know that in life not everyone studies Philosophy but, whether they know it or not, everyone lives by a philosophy. Studying a little philosophy can help us know more about how we live and, sometimes, to live better. Studying a little nursing theory can help us know more about our practice and, sometimes, to practice better.

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