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jjjoy LPN

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Content by jjjoy

  1. jjjoy

    oh so now we PAY to do residency to get a job?!?! seriously?

    Wow... you took the words right out of my mouth... again... as I, too, am drawn back again and again to this topic. I agree with much of what you wrote. And even if we keep rehashing the same things, I do appreciate hearing you and other posters (hi to you other regulars!) on such topics because most everyone else I interact with will fall asleep if I dare to venture into the exciting topic of nursing school curricula!
  2. jjjoy

    Masters Degree to RN? San Antonio

    Since income seems to be an issue, be sure to thoroughly check out the local job market and general prevailing wages. You may have heard about some nurses pulling down over $100K/year but that doesn't mean that your wife can get, or would want, that kind of job. While most nurses make a good, solid wage and don't have to live paycheck to paycheck, most don't come anywhere near to $120K... even working overtime, nights and weekends. The majority of nursing jobs out there offer a structured wage ladder that eventually caps out. Nursing administrator salaries are likely more open-ended, but then you are most definitely moving into "rat race" territory and away from actual nursing practice - politics, budget fights, committee meetings, etc. If administration is the direction your wife wants to head, she might also consider just start working towards to getting into that directly. There is coursework in health care administration and hospitals have departments of marketing, accounting, finance, etc. But I imagine that your wife is more likely looking for something completely different. Some people like the idea of going straight on to become a nurse practitioner where there is more *potential* for higher salaries as well as avoiding the grind of understaffed, non-stop 12-hour shift work. In some areas, freshly-minted direct-entry NPs are snapped right up, but in other areas many end up right back at a bedside RN job due difficulty landing an NP job. NP pay & demand vary quite widely. A lot of people aim for CRNA, which is known for high wages most places. However, that generally requires experience working in an ICU first as well as getting into one of the highly competitive programs and being in school another couple of years. Finally, if one makes it that far, the job is working with anesthetized patients - very little of the kind of patient interaction that many people go into nursing for in the first place. Also note that clinical practice generally doesn't allow for dedicated lunch hours or running out for an errand in the afternoon. You may have to work on holidays or be called back to the hospital during your kid's baseball game. You may be busy non-stop for 12-straight hours, literally on your feet, putting out one 'fire' after another. You go home, try to rest and start again 12 hours later. Of course, in few jobs besides nursing can one work full-time by just going in 3 days a week. And with shift work, when you're off, you're off. Like anything, there are pros and cons and variation by employer and job. These are just things that office workers or others may not have considered prior to making a change to nursing.
  3. jjjoy

    Any other new grads considering a PhD?

    I hear ya, but it doesn't seem to be the standard mindset of nurses... which makes sense since nursing is a practice. The ultimate goal of most any nursing research is to improve nursing practice (generally measured by improved outcomes). There always should be a lot more practitioners than academics in that kind of field.
  4. jjjoy

    to take a refresher course or not?

    As another noted, there isn't a standard curriculum for refresher courses, so you'd have to find out what the course you are looking at entails. In general, the class probably isn't necessary and I'd bet you can get a job without one. Where I am, there's no expectation or requirement that re-entry nurses will have taken one. But in today's hiring world, in some places, even with experience, it can take months to land a job and the class might be a useful activity while continuing to apply for jobs. And just accept the loss of class fees if you end up dropping out due to landing a paying job. But check out the actual program to see if it might have anything to offer you. If it doesn't, then forget it. The refresher course I took through a community college was just a once a week evening lecture and otherwise self-directed study at a low cost with an optional clinical experience. Very workable with a full-time job or full-time job search. Another one offered by a private college was an almost full-time four month program and cost A LOT, though it did offer a good chance of being hired on at their affiliated hospital. In the class I did take, most had been out of nursing longer - much longer - than just 2 yrs. It included about 50 hr of mostly pointless lecture (rehash of med-surg nursing text) and required something like 20 hours of self-directed skills lab. (This school's lab was amazing, open at all hours for drop-ins, well-stocked with modern supplies and staffed with a currently working RN who could answer real-world, latest practice questions - nothing like my alma mater's skills lab!) As I hadn't worked bedside after graduation, I mainly took the class for the hospital clinical opportunity. It was just being paired up with another nurse for several shifts but for me it really helped to feel a lot more confident in interviews. Still, that experience wouldn't be useful to many re-entry nurses and most classmates didn't participate.
  5. jjjoy

    Jobs you can get with a BSN but no RN license

    What did you learn besides license-required professional nursing care? You learned disease processes, medications, diagnostic tests, life span health & psychsoc issues. You learned about mental illness, public health, preventative care, health education and more. You have experience interacting with people in times of crisis, vulnerability, anxiety, etc. You spent time in different health care facilities, directly interacting with health care personnel. Even without a license or professional clinical practice, this kind of knowledge and experience is valuable and in demand in various areas. Having a bachelor's degree in addition that specific background can definitely help open doors to certain jobs. Since nursing is related to most any aspect of health and well-being, you can look for health-related jobs that require/prefer a bachelor's degree in a "related field." I suggest checking local hospital job boards, health department job boards (county, state), academic medical centers, & universities. Also, explore the listings at any major employers in your area as they might have a department involved in something health-related that you weren't aware of, such a niche medical supply manufacturing branch or an internal employee health department. Do some exploratory job listing searches on-line using key words like "medical" "health" "entry-level" "bachelor's required" etc. From what you find, start identifying other key words & phrases that might help find other "hidden" job listings... words & phrases such as clinical research coordinator, health information managment, reimbursement, and more. Other areas/businesses/key words to check out insurance companies, medical suppliers, manufacturers, health information technology, quality improvement, publishing, professional associations, coding, abstracting, community health and more. One thing is to not let yourself get too distracted by all the RN job listings you may come across in your searches and end up spending too much time thinking "if only". Finally, even if there aren't any open job listings that you are currently qualified for, you can still give a company/department manager/etc a call and ask more about a certain job, their line of business, recommendations for getting into their field, etc just for information. It could be a fruitless effort, but it's also possible that you'd learn more about other related possibilities and directions to explore! Best wishes to you!
  6. jjjoy

    Sutter Health New Grad program unpaid.

    And in that case, don't newbies also have to suck it up when they get short-changed by employers who don't provide the kind of training and support that they may need? Or perhaps they just have to suck it up that they'll need to uproot to another locale and/or be unemployed for 6 more months in order to (hopefully) be accepted into a well-reputed new grad program? What options are there out there for newbies who really do need more than the standard amount of training and orientation traditionally provided to new grads? Is it just tough luck that their nursing program didn't ensure specific preparedness to handle an acute care floor nursing job with just 8-12 weeks of orientation? How much training is part of 'just suck it up' labor costs? What level of training is needed? Is the employer able to provide consistent quality training at that level? How much supervision is required? Does supervision require paying an additional FTE for several months? How much room for judgement errors/time delays/incomplete tasks is there for the new employee who isn't yet "up to speed"? It's a very different picture between a retail entry-level new hire and an entry-level new hire in acute care bedside nursing.
  7. jjjoy

    Cath Lab nurses!! Intro plz!

    I work closely with the cath lab collecting and submitting ACC data, managing the lab's documentation and database computer systems, & reviewing charges among other things. I do have an RN license, but my work doesn't involve any direct patient care. I hope to learn what other labs are doing since the cath lab is a unique dept that others in the facility don't understand and can't offer help with (such as with component coding). Our lab covers cardiac, peripheral and neuro angios/interventions as well as special procedures, pacers & EP studies as needed. I'm amazed at how much the lab staff need to be familiar with and are constantly learning (new equipment, techniques) especially since they are now all cross-training for every type of case. I'm also amazed at how many other tasks fall the the clinical staff... CPT coding (to charge correctly), inventory maintenance (ordering, receiving, stocking supplies), QI data collection, and more.
  8. jjjoy

    Getting Conflicting Counsel

    The way most programs work these days, you don't *have* to take time out working as a full-time RN between BSN & MSN. And going straight through avoids the risk of starting to work, getting side-tracked by life, and never making it back to school. However, there are also convincning reasons to take the extra time. For one, in these tough times, it may not be easy to get a part-time RN position as a new grad to work at while starting the MSN program. And if you can get such a job, you still might prefer to be able to focus 100% on learning the ropes as an RN the first year or two instead of splitting your efforts between learning to function in an RN role and being in school for advanced practice. Finally, your own personal learning style and motivations make a difference as well. While some do just fine going straight through, others may feel a lot more confidence and focus if they've put in more time as a RN, which could add to the likelihood of their success a new advanced practice nurse. Some just want to practice as FNPs in primary care and others want to experience a wider spectrum of the nursing profession to be well-rounded. Basically, don't forget to factor in your own strengths and weaknesses and motivations as you consider your options.
  9. jjjoy

    Am I crazy because I love med surg???

    I'd think that more nurses would like it, or at least not hate it, if they had adequate time and resources and colleageal support to provide the kind of care that they feel proud of. As others have noted, in too many places, prioritization becomes not a practice of 'A B or C *first*?' but becomes a *regular* practice of 'A & B not C *or* B & C not A?' And when the nurses are then blamed for not getting to C or A or whatever, it makes for an unpleasant work experience. But with a supportive environment, I can certainly why med-surg would be appealing to some!
  10. I agree with the above. I do want to comment, though, that the "first year of work is the real last year of school" message often isn't given to nursing students until just prior to graduation and often isn't given at all to pre-nursing students. Instead, what most aspiring nurses hear is "You can always count on a job in nursing" and "once you have your license, you're good as gold." So it can come as a bit of shock to find out as graduation approaches that straight out of school and/or without recent experience you may not be as marketable as you expected to be or have the kind of choices that were described as available to anyone with a license.
  11. jjjoy

    Sutter Health New Grad program unpaid.

    In regard to volunteering... most volunteer work that an inexperienced new grad would be allowed to do wouldn't improve the new grad's marketability as an acute care hospital nurse.
  12. jjjoy

    Sutter Health New Grad program unpaid.

    "Raking in the profit"? I don't think there's that much money to be made by offering unpaid internships so long as they adhere to the policy of not counting interns in the staffing numbers. There will be the same number of paid nurses, the same number of paid assistants, the same number of patients and the same amount of reimbursement - so no extra income there. And to provide an internship program, even if it's unpaid, isn't free to a hospital. The nurses have to take extra time away from their regular responsibilities to work with the interns, and dedicate paid staff time to making sure that the program is running smoothly and continues to be benefitial to both hospital AND the interns. Where the hospital hopes to save money is by increasing the retention of paid new grads and by keeping down the length of time any given paid new grad will need to be on orientation.
  13. While I can understand exasperation with newbies who act as if they know more than their experienced colleagues, I think sometimes they are misperceived. If a newbie says "I was taught XYZ but I'm seeing ABC here. Why is that?" They aren't necessarily saying "I know better than you and you're wrong!" They are probably saying that they thought they knew something, this observation doesn't seem to match, and they sincerely want to learn how it fits together. After all, isn't it a GOOD thing if the newbie is questioning the use of Lopressor that she's unfamiliar with than to just blindly accept that it must be right since her preceptor seems okay about it? Sure, the newbie can go look it up later, but meanwhile, are they supposed to administer a medication for a purpose they don't understand? As was noted before, good nurses aren't necessarily good at teaching/training new nurses. But the newbie has no idea how to judge if their preceptor's questions of their competency are valid or if the newbie is right where they should be on the learning curve.
  14. FlyingEagleRN - congrats on the job and thanks for sharing your experience as a new grad! It sounds to me like you are saying that wanting to work on a med-surg unit in a hospital as a new grad was a 'dream job' and perhaps going after that was hubris on your part. I wouldn't agree with that. But I would agree that many nursing programs these days leave graduates underprepared to succeed in today's entry-level hospital jobs while hospitals aren't willing to pay for bridging the widening gap. Still, for today's new grads, where landing any job at all can be tough, I suppose any hospital job is a dream job.
  15. jjjoy

    What exactlly is "Charge Nurse"?

    Maybe they do bring such issues to the other charge nurses but if it is resolved then there's no reason for you to be aware of it. Or perhaps they always come to you simply because you are the most helpful/knowledgeable/etc charge nurse that they have on any shift and you get things done. If that's the case, they're not going to let you know that they're asking more of you than others.
  16. jjjoy

    What exactlly is "Charge Nurse"?

    Whether a nurse is assigned 4 patients in acute care or 30 patients in LTC, that nurse is responsible for CNAs, family questions, carrying out orders, dealing with crises etc - so that alone doesn't seem to merit the job title "charge nurse". But I imagine the title in LTC might be more of a regulations or policy issue. There might be policy that dictates that there *must* be a "charge nurse" on-site for each unit at all times. If there's only one nurse for an entire "unit" (med cart), then it could be easier to simply designate each of them as a charge nurse. If day shift nurses are paid as "nurse" and night shift nurses as "charge nurse" (even if pay is the same) then the facility should have clear policy somewhere on their books defining the two different designations. However, in practice, there may be little to no difference and so people brush such questions aside as bothersome and irrelevant.
  17. Honestly, if you worked busy shifts, I think server experience could be considered a positive thing. It involves dealing with non-stop competing demands in an ever-changing environment. It involves being on your feet and thinking on your feet for hours on end. It involves interacting professionally with people of all types and often getting the brunt of customer disatisfaction even if there's nothing you can do about it. All those skills can benefit a nurse. You might want to consider adding a few descriptions of your server work... not to explain what the job is, we all know that, but what transferable skills and experience that job provided you with... such as handling up to 6 tables of 6 during dinner rush (multi-tasking) or showing new servers the ropes (training) or ensuring that all items are up to standard before serving them (quality control). That last one sounds kind of dumb, but being conscious that server responsibility isn't just mindlessly delivering food to a table suggests that you recognize that nursing isn't just mindlessly following orders. Your inspiring past volunteer/community service shows a long-time interest & motivation in working to meet people's needs and certainly should be included, but they were several years ago and short-term experiences. Perhaps that's why I don't think you should just brush over your more recent work experience. Regardless of what you do with your resume, have confidence that your previous experience is worthwhile and not something to try to brush under the rug as irrelevant or trivial.
  18. Which job? That is a VERY personal decision. In many cases, a newbie can't go wrong by starting in acute care. It allows the newbie to actually practice and make real much of what they covered in school. And it doesn't pigeon hole the newbie either since acute care experience tends to be valued across the various nursing specialties. Even if you ended up leaving in less than 3 months, the experience would be incredibly valuable to understanding your own preferences, strengths and weaknesses and perhaps give you better direction in planning your next move. However, one must also factor in their own personality, goals, motivations, strengths and weaknesses. The valuable inpatient acute care experience won't be worth much if you end up so burned out that you give up on nursing altogether. And if you are successful & motivated in the clinic job, you may be able to build upon that perhaps through networking, specialization, and lateral moves. Also, if you 've got pressing financial obligations or feel that another stab at acute care right now could seriously risk your mental and physical health, the clinic job might be a better bet for the near future to stay on keel.
  19. jjjoy

    Doctoral degree to become an NP???

    And I also hope that APNs also see PAs as doing a bit more than "following rules promulagated" by physician supervisors! Anyway, back to NP education... Nursing theories, holistic care, health promotion, patient education, non-medical intervention, etc should already have been covered in one's BSN program. In fact, all prior nursing training made a point that nurses need to AVOID diagnosing medical conditions and prescribing medical treatments. Shouldn't NP training then be about preparing the students to EXPAND their practice to include those activies, as opposed to deepening understanding of nursing theories or priniciples of health promotion or of research statistics? NP programs should still make sure students are up-to-date in these areas, but not experts. On the other hand, an NP student probably hasn't had any formal training in following patients as part of the medical team, diagnosing medical conditions, prescribing medical treatments, etc. That means more pathophys, more pharmacology, and more hands-on clinical practice to build competencies in those skills required to expand their nursing practice to include NP practice. While some NP students come into the program already knowing their field backwards and forwards (eg can already outperform their physician colleagues and just need the official stamp to prove it), many must have a curriculum that assumes no prior experience in that area.
  20. jjjoy

    Are "real" nurses as mean as my future instructors?

    Who is saying that treating students respectfully means letting them do as they please? This as about those instructors who actually do behave unprofessionally with their students. I can't deny that there are immature students out there whose behavior is egregious. There are also some immature instructors out there as well. Thank goodness many aren't! I understand questioning the validity of unprofessional instructor behavior claims from students who don't want to do homework, who don't want to prepare for clinical, who don't want to give up showing off their belly, etc. Sometimes, though mature, motivated students claim to have witnessed unprofessional instructor behavior, and in those cases, there may some truth in it.
  21. jjjoy

    LVN first then RN or am i wasting my time

    In general, I don't see getting one's LPNs first as a hindrance. It might be a great way to go for you especially with the long wait lists. However, there are specifics that might making getting an LPN first a more or less appealing option depending upon your own situation, preferences, etc and depending upon the LPN job market and nursing school options in your area. Some questions to consider... What is the job market like for LPNs in your area? What is a realistic wage to expect as an inexperienced new LPN grad (sometimes wage potential is overestimated)? How do you feel about the types of nursing jobs available to LPNs in your areas? (eg in some areas hospitals don't use LPNs and nursing homes are the primary employer of LPNs). Don't just look at wage averages & job descriptions listed on-line or in a school brochure. Look at local job listings and call and ask at health care facilities in your area. What is a realistic time frame to earning one's RN if you start in the ROP LPN program? What local LPN-RN programs exist? How accessible/affordable are they? Can any of the coursework from the LPN program be credited towards another degree or would you have to start from scratch or re-take RN pre-reqs? I hope you find a path that works for you!!!
  22. jjjoy

    Office nurses ARE real nurses!!

    It's no mystery why to many people's minds RN = acute care nurse. Many people know that there are different levels of nurses and thus may reasonably, though incorrectly, assume that the "highest" level of nursing licensure is for the "highest" (most unstable pts) level of nursing care. Some non-acute care nurses may get similar questioning of their capabilities as an early childhood or home ec teacher. Within nursing, many nursing programs over the years were specifically created to train up hospital nurses. And RN clinical rotations still are predominantly in acute care settings. It can seem like a waste to some to go through all that rigor related to acute care nursing, and then choose a path that doesn't build upon that. And to others, the only reason to take a nursing job with less pay is because they can't keep a job with higher pay d/t lack of skills and competence. I'm not excusing dismissive attitudes, just looking at the basis of some of the assumptions underlying that kind of attitude.
  23. jjjoy

    is "beating around the bush" common in nursing?

    Just to clarify, I wasn't saying that I personally thought that newbies should be on a crusade to educate their more experienced peers. I was saying that that was what several instructors seemed to be encouraging us to do. I did have two clinical instructors that were much better at a facilitating a really worthwhile wrap-up that addressed real-world concerns and not just textbook-perfect expectations. I appreciated them at the time, and appreciated them even more after finishing school.
  24. jjjoy

    is "beating around the bush" common in nursing?

    I certainly agree that one won't win points by accusing experienced colleagues of being sloppy or the like. And some folks just are plain obnoxious & inappropriately critical no matter what. On the other hand, sometimes nursing educators (depending on who's teaching) set up this common conflict. Some instructors never explore why some questionable actions might actually be okay. Instructors may even have none-too-subtley given the impression that only lazy, sloppy, unsafe nurses would ever stray from following protocol - that compromise is NEVER okay. At least that's the impression I got from many CI's. From the commonality of students and newbies questioning experienced nurses, it would seem that many nursing students get this impression as well. The overmedication of psych patients is a great example. I know we had it pounded into our heads that overmedication of patients was a rampant problem out there, and that we as the new vanguard armed with the latest information had a great responsibility to protect our patients from overmedication even if it meant upsetting the status quo. Any good nurse worth their salt would be grateful to learn from any source, even an inexperienced newbie. And that we would be irresponsible if we didn't question and share our information.
  25. jjjoy

    is "beating around the bush" common in nursing?

    When we asked instructors about the many questionable practices we saw as students, we were simply told that 1) we use the experience to clairfy what kind of nurse we didn't want to be and 2) not be concerned with anyone's practice but our own. As students, we might be accused of not being fit for nursing if we pushed a med a few seconds too quickly, even while watching nurses push the same med much, much quicker over and over again. How confusing is that?! School *explicitly* taught that this or that was the ONLY RIGHT way to do something, no ifs ands or buts, that there was never *any* justification for variation. What if you can't find time to do x? Then you need to make time! What if the proper supplies aren't available? Then you need to get those supplies! Shouldn't nursing students be warned that their practice will not always be by-the-book and that that by itself doesn't make them a bad nurse? That, in fact, nurses have to find ways to accept they will be giving imperfect nursing care? Shouldn't they be given some guidance on how to evaluate shortcuts that they see others making and/or that they might be considering for themselves? Guidance on not just how to prioritize "what first", but also on dealing with the practical issue that items lower on the prioritization list might keep getting pushed down the list as more high priority issues continually arise throughout a shift?