Crystal2dish

Ryansofie - I will add that I see the opportunities and possibilities opening up for nurses like ourselves. We need to redefine ourselves as nurses apart from what the MacDonaldization of nursing has become, i.e. a corporate crank out of entry level highly skilled human mechanics or disconnected PhD's. I have been discouraged from working as a nurse because of the growing conflicts and dehumanization of "healthcare". I know that I need to redefine myself for others not as an employee but as a consultant or "gun-for-hire". I see the niche opportunities and know that I have to polish up my outside persona with college credits, possibly a graduate degree or maybe two. For example, how long do you think that the fleecing of hospice patients (among other things, of course, but money is corporate speak) in an assisted living situation would continue if you added legal advocate to your resume? Bulldog nurse with legal teeth! I will leave the PhD in nursing for others. I refuse to stay quiet or quietly disappear because I don't "fit" into the current picture of the time. I am tired of being spoken to as though I were a simpleton because of the work I chose to do and I am tired of being paid a fraction of what I know I am worth. I am also increasingly aware of increased discrimination from "energetic" employers who are blinded by my gray hairs and apparent career stagnation from logging so many years in one field. It makes me wonder how far this division between young and old will go - to the point where we are prodded much like cattle into the proper channels for aging and dying "humanely"? Who will advocate for us then? A recent annual visit to my physician has further steeled my determination to be a force for change. At first it was the exam room that brought me to attention: I was brought into the room before it was ready for me as the paper on the exam table was obviously used and there were not one but TWO tubes of KY jelly left uncapped on the countertop by the sink. As I stood in the room frozen in surprise, the trainee CMA proceeded to pull down a fresh sheet of exam table paper and tell me to "hop on up". She told me to hold my arm up as she took a BP without supporting the arm. This was one visit I remained fully dressed and washed my hands immediately afterwards. I realize I could have said something instead of letting my jaw catch the breeze and swing, but I realized the fledgling CMA was doing what she had been taught and for me to do anything or say anything would have sent her from the room in tears. Who is teaching these CMA's? Scary stuff. I am learning to see these problems as opportunities for change. I don't rely on the existing system any longer to take care of my health and have become an active DIYer. Life is short. Too short. However long I have left to live this life, I want it to be sweet. Hope this rant helped... :typing

If dementia is involved, there is a different process to deal with the resident's behavior than if the resident is lucid. Examples of dealing with the dementia may include positioning the resident so he may not see out the door (but still have a view out the window) or approaching him with a partner. The resident may have some very real fears that will not dissipate with a confrontational discussion. If the resident is lucid, then the SW and NM may discuss the appropriateness of his targeting male caregivers and disturbing other residents by yelling out. Whatever route is chosen to deal with the resident, it will need to be a team effort with proper protocols followed and documented. Residents are considered to be vulnerable adults and as such have specific rights. Then I must comment on your statement " I need this resident to know who is in charge..." as a possible reveal as to why he may be targeting you. You are an employee. You may be in charge of some things, but perhaps you have not yet grasped the limitations of your dominance. The resident cannot up and leave. He has to live there. Perhaps it is not the resident who needs an attitude adjustment? Rudeness is a somewhat subjective description of behavior. Perhaps the resident knows more than he is given credit for and is expressing his fear (?) of you the only way he can. So definitely involve others, to include the nurse manager and social worker, in working to improve this situation for everyone.

My advice is to find a place for your grandfather to live. Preferably somewhere close enough for your grandmother and you to be able to visit often, if not daily. Think of your decision not as "putting them away", but placing them in an environment where they will have the caring and the support to maximize their lives as they change. It is a transition for this stage in their lives and yours. All of you will have the opportunity to just enjoy each other. It has been my experience as a nurse that people with dementia become comfortable with routine and familiar things. I worked in a unit that had been designed specifically for the wanderings and behaviors of dementia to allow maximum freedom and safety within the structure of the unit. Staff was handpicked, trained, and educated on the natures of dementia. Activities are planned for the residents daily and personalized for them while participating within a group setting. Not all nursing home/memory care units are the stuff of nightmares. The best ones encourage and support continuing family relationships and participation, including meals together. Caring for a loved one with dementia is a noble task at best. The reality often results in caregiver burnout, among other things. What is your support system like? Another point that may come up is the legal one. The familial responsibility for caregiving may be clear among the family members, but if it hasn't legally been clarified, there could likely be issues down the road when you will least be able to deal with them. Especially if money or real property is present. I understand your position as I, too, have been in a similar position. On a personal level I learned the hard way that one person cannot do it all for another person. Sometimes stepping back and letting go while letting others step in to share in the caring can be a more loving act for both yourself and those who love the person with dementia. Sometimes as caregivers, we forget we need TLC, too. So good luck with your decision! :icon_hug:

My two cents; Books to read - (food for thought) Gary Zukav - The Tao of Physics Barbra Ann Brennan - Hands of Light and Light Emerging Beck Walters - The Sacred Lawrence Blair - Rhythms of Vision Ina Mae Gaskin - Spiritual Midwifery Fritjoe Capra - The Web of Life These books are alternate reading to explain commonalities in a different light, so to speak. Best way is to find material that clicks and build from there. Life is short. Follow your bliss.

my guess would be so they can grow her they way they want her. or maybe because she was cute and smiled and giggled... plus maybe because gn's work for less until they become rn's. anyone? :typing

I have lived with both dogs and cats, often at the same time. I have come to the conclusion that cats take things seriously because they often live twice as long as dogs. :typing

Always safety first. Proper body mechanics. Protect yourself by refusing to participate in unsafe situations. If you or the resident become injured, it is not helpful or positive to say the least. The resident's behavior is inappropriate and the expectation that he be assisted to the commode anytime he asks is unrealistic at best. Unless, of course, he is the only resident in the LTC facility. The standard for toileting is every 2 hours, which would allow for a max of four times/shift. Behavioral issues aside, does the resident have regular bowel movements? What does his stool look like? Does he use the urinal? Does he produce regular urine in adequate amounts? Is there pain or discomfort with elimination? If all physical systems are clear and functional, maybe caregivers could be restricted to males only. You do not have to regularly tolerate sexually inappropriate behaviors from anyone, including residents. The ideal scenario would be a team effort and nursing care plan to realistically revise the residents care plan. If your immediate supervisor is helpless to make changes, continue up the ladder of responsibility until you start to be heard. State the facts: Record dates, times, pertinent comments, actions, staff involved, etc. Do not include OMG statements or speculations. Don't fluff the pillow as the facts alone are enough meat on this bone to evoke change. Coordinate same efforts with your coworkers (writing/documenting just the base facts) and put forth a concerned, respectful but coordinated front to your superiors. Don't be alarmist, but work pro actively. If change doesn't happen and you all continue to be ignored, perhaps you may consider changing employers. Good luck!

number one reason to change is because you know you love peds. everything else is either a bonus or an incidental. period. office versus hospital: regular, predictable hours with weekends and holidays off. regular breaks. a desk. patients usually are not as ill as ones in the hospital. your own computer. vacations. your own phone line. more time and energy for home & husband. able to make more plans and carry them through. you start to realize you can have a real life... bored? you will always be as busy and interested as you need to be. maybe you will be the one nurse who has the energy, vision, enthusiasm (because you love peds), and interests to pro actively bring changes or new ways of organizing or doing to the office setting. for a start. you can be a role model. a mentor. a safe pair of arms. the nurse patients ask for when they need an injection because it doesn't hurt as much. the list is long. and if you try the office setting and it really, truly does not work out for you, the worst case scenario would be a new set of experiences in peds and new personal/professional references to add to your resume. how could you possibly go wrong? you love peds! :dncgbby:

i think that your staffing ratio is on par with the average ltc night shift - in my humbling experience. that means it is consistently busy enough to keep everyone awake and if a change in resident status occurs, the roof won't collapse. so to speak. i have also learned that numbers of bodies can mean so many different things. as in how responsible and reliable and professional (to name a few)are the people you work with? how well do you all work together as a team? is your work about following up on some more than others or tracking one or more members of your team to make sure everyone is in the same game? quality vs quantity makes all the difference in the world. so does youth and vitality. and really great coffee... :zzzzz

Here's my two bits: you will almost always get less than you ask for, so the rule of thumb in negotiations is to ask for more than you will settle for. It will help to check with the state employment agency or other local authority to determine the pay range for your area. More experience usually will get more pay, but not always. Another tried and truism is that it is the nature of people to lower their asking price to make the sale, but the quirk in the nature is that people also place more value on the same object if listed at a higher price. You are your best asset, so don't sell yourself short! Good luck! :)

Like the posting but must let you know your links are not direct.

NYG -You are fortunate in so many ways that you don't really grasp at this point. But I must ask the burning question to you of how is it that you can experience such intense and moving emotions in an environment that made you very miserable, then believe keeping your emotions to yourself will be possible in your next patient care position? Surely if psych is seems to be "it" for you, you have the ability and insight to at least recognize that the emotions and body are inseparable in healthy people. Now that you have said your goodbyes to the horrors of Med Surg, you feel relieved and elated and can eat again. Have you clarified for yourself what it was about the work in Med Surg that made your body respond as it did? Was it the sights, the sounds, the smells, the contacts? People are people and in Psych, still waters may hide some very deep drop offs. They may also vomit, defecate, swear a blue streak, and other foul and other unpleasantries. The scary ones may feel no emotion at all. Like the sociopathic personality. And if you spend some time there, you will eventually meet the person who will challenge your core emotional fear and shake the inner ground you stand upon. Hide your emotions? Bury them deep? Only at work? In psych? Listen. What would you say to the suicidal teen who is on your unit and her history includes regular sexual activity with family members since birth, the inability to physically conceive a child, and isolation from normal socialization processes outside of the home environment? Keep a stiff upper lip? Life is what you make it? Go forth and start anew? The privileges unique to nursing include the opportunity to appropriately and respectfully connect with others on an emotional level. To tell you that I have physically felt the room fill with the light of joy and happiness at the moment a patient dies, despite the visual of the family crumpled and weeping at their loss is to share with you that I am connected emotionally to myself and able to empathize with everyone else in that room. When the family members hug me and cry on my shoulder, I know that it is okay to let my tears, my emotion, my sadness, show. I don't feel ashamed nor do I ball up in the corner and wail like a toddler. I have found my emotional balance while retaining the professional integrity of a nurse. I have experienced situations where my gut connection, my emotions, were not in sync with what appeared to be happening. If I ignored my feelings and went along with what I was told to do or what everyone else was doing, eventually I would reach an "Aha" moment and recognize what my feelings, my emotions had picked up on long before my head was in agreement. Like feeling the dagger vision of a bitter old nurse raising up the fine hairs on the backside of my neck... Professional nursing can be compared to a lifelong apprenticeship as there's always something new to be learned. You are a well educated nurse at the beginning of her chosen career. Emotions are part of this game. They are part of the hands on of health care. Emotions can keep us connected to ourselves and others. As you evolve in your nursing career, you will no doubt encounter other nurses that will try to manipulate you through your emotions. You will have situations where you absolutely must be alone in a private room with the door locked behind you before you can express a strong emotion safely. The odds of turning into an embittered old nurse will be less if you learn to accept, understand, and trust your emotions. Keep them private if needed, but don't deny them healthy expression. They are a part of being human. They help you understand yourself. Think about it. :icon_hug:

An addendum for the thread... every LTC I have worked has the narcs in the same blister card as the regular med drawer. Many times the cards are so tightly packed into the drawers that pills will break through the foil backing and either be found rolling around on the bottom of the drawer, stuck somewhere among the cards, or magically disappear. It is another reason why I check the back of the card when counting narcs. If I can see that the backing has been cut/slit or otherwise corrupted, I will call a supervisor to co-initial and either confirm that the tablet in the blister is correct or someone's substitute tablet. It may be a pain for the nurse I am counting with, but I have learned narc count is not something to flash through just so everyone can go home. So more advice for nurses working in LTC's that use med card blister packs in drawers, it pays to be careful when pulling them and returning them to their assigned order. Your careful efforts will be less lost or missing pills. This is critical with narcs and things like coumadin, antibiotics, and qod meds. Plus your cart will be neater for the next nurse who follows you.

Just a thought, but having had the experience of single parenthood and having friends with same lifestyle, I will recommend that you search for job that best fits your needs for regular, possibly flex hours, great wages, and is close to family friendly amenities. If you take a job because it is close to family but is a job that you disdain, you are shorting yourself and your child-ren of a happy parent. The best case scenarios for professional single parents that I knew were always made possible by relocating for a promising position. The job interview can include questions from you regarding family issues, childcare, schools, etc.. You will bring your job home with you whether you intend to or not, something to think about when deciding to accept a position that is not what you really want. Single parenting is hard enough, why not accept a job that gives something back, enriches your life, and makes you smile?

My two cents; I have worked in LTC and in clinics as LPN for years. Many, many years.... My experiences with the missing narcotics were always in the LTC facilities. The agency nurses were never responsible for the missing narcs; it was always an employee of the facility. One offender removed liquid MS from 10 ml bottles and replaced the quantity with tap water - as he shot up in the bathrooms. It takes a long time to nail narcotic thieves in the LTC system, so in this case pts were dying and nurses were unknowingly administering tap water for pain. Another instance of narcotic theft was in a very large LTC (several stories in a large metro area) and the shift supervisor (of the entire building) possessed the keys to all the narc drawers for all the med carts. She regularly took one to two tabs from the blister cards as she had opportunity, and would occasionally take the whole card (30 to 60 tabs per card). Yes, two nurses counted at the end of each shift and the nurse ending their shift immediately became suspect. The sheer volume of med carts in the building, however, created many suspects. Eventually the thieves were "caught". The MS nurse was brought to the office of the DON and confronted by the eyewitness that saw him taking the bottle of MS into the bathroom and found his used syringe in the wastebasket. The supervisor who was helping herself to narcotics was observed under suspicious circumstances by myself and only by by writing up a detailed report of what I had witnessed and giving to the DON, was this supervisor finally confronted and questioned. Under no circumstances were police involved. Both employees were terminated on the spot and escorted out of the building by in house security. No reports were ever filed with the Board of Nursing. And so these nurses were free to continue working as addicted nurses elsewhere. And I must add that the agency nurses I have worked with have always been some of the best nurses I have ever worked with. And that's my two cents.

Being a new nurse can be very scary. One transitions from the safety of guided classroom lessons and months of theory into the chaos of real life. You suddenly realize that what you do or say or forget to do or say could result in the death (worst case scenario) of a patient. That said, it does not necessarily mean you were not meant to be a nurse. Analogize this transition with that of becoming a parent. Being in nursing school is similar to nine months of dreaming and idealizing baby and parenthood. The birth itself is an individual experience that is what it is despite the preparation. But no matter the pain of the birth, it is the people around you, assisting the birth process every minute of the way, that ease you and baby into the next stage of your lives together. Parenting begins and you will always have discovery moments along the way that you never knew could be as awesome or as tiring or as (blank) as it is at that moment. You grow as a human being. You grow as a parent. Your infant grows toward adulthood. Your family grows into a community. And so on... Before you throw out the baby with the bathwater...sorry, couldn't help myself ... why did you decide to become a nurse? What were your life experiences that made you decide nursing would be your path to help people? What specifically had your past experiences been that made you see yourself doing something other than what you are doing now? That said, it is important that you discuss your concerns with your supervisor. You stated the people you work with are great, so hopefully you can find someone to discuss this with and find other options. Right now you are like Dorothy in the land of Oz wearing the ruby slippers. 1. You are the envy of many with your BSN. 2. You live in New York. 3. (Guessing) You are young with lots of room to grow! Yes, there are many other options to pursue as an RN. I also know that only you can determine what will work for you and be compatible with your true interests and dreams. Other people are not mind readers and cannot give you answers until you know what direction you want to pursue. Don't panic. Don't dread the day. Try to listen through the fears. Nursing homes are hard work, too. Less supplies, less staff, more on you. Tons of paperwork, less computer friendly than hospitals. Perhaps you could do some research online and interview nurses who are doing work in a field that holds interest for you. Try to define specifically what you like and don't like about nursing, focus on the like part, and go for what you want. "Everyone sez" only holds water when everyone has a paddle on the same boat. Only you hold the key to knowing what skills you want to use and grow and that, NewYorkGirl, is called power. :dncgbby:

My thoughts on this are as follows: 1. If it isn't in writing, then it wasn't stated or agreed upon. Clarity in a contract is everything. 2. If you are an agency nurse, you decide the where and when of working conditions and how much compensation you will accept for your services. Then you transcribe these parameters into ink and paper, keeping a copy of everything for yourself. 3. Don't be wishy washy about what you want, keeping your fingers crossed behind your back and hoping they will grant your wish. No. Take control. Decide and clarify in your own mind what you want and only then can that be written down and communicated to the agency. Understand? An agency nurse is their own best agent/advocate. Ultimately, you and your license stand alone in the tangled legal forest. Best way to do this is to be proactive, organized, and communicate clearly and specifically. 4. Let each agency know exactly what days and hours and etc. they can have you for each week/month. Make sure you know that you can get from point A to point B at stated locations in time. Your words need to be backed up in writing. So don't write it unless you can meet or exceed the expectations. The individual details between you and each agency are confidential. I experienced a backstabbing sneaky cutthroat competition between two agencies I worked for at one time. Fortunately, I was able to discern the underhanded agency from the more ethical one and stuck to my guns. It was a tricky scenario and created a bit of chaos in the workplace as the lowlife agency tried to undermine my credibility with the boss by suddenly pulling me off the floor to work elsewhere. Another plus for careful wording in contracts and understanding the fine print. It is helpful to understand some rules of business and law to protect yourself, but it can be done. Never give up the control as it will ultimately be your reputation and license on the line. Sounds bothersome. But it is easier to do than you think as it is just a flip in the mindset between being a drone worker and an independent agent. No offense intended re: drone workers. It is stated as such because the majority of employees, whether nurses or steelworkers, find it easier to have someone else manage the scheduling and assignments. Then the worker can focus only on what the worker skills do and so on... When I work as an agency nurse, I carry my office in a bag. I have a cell phone, a calender, a book of contacts, etc. I have my little toothbrush, breath mints, deodorant, snacks & lunch, plus enough money for whatever. All organized and condensed into one bag. I always state that I will accept the assignment only with such perks as free parking in close proximity to the workplace, etc. I show up early, introduce myself to everyone, put away my stuff into a secure locker or drawer, and am ready to work. Prior to entering the zone of agency nursing, I shared similar concerns to yours. I have since learned that the above only makes employers want you more and on a permanent basis. It also makes your life richer and gives you more freedom and control. There is something freeing about knowing you can walk out anytime if the workplace is just not throwing off good juju. You no longer have to play head games or whine about how awful it is at work and how unbearable your days have become. You become an independent "plug-n-play" professional entity. And how you play it is entirely within your control. And that's just my experienced opinion...:dncgbby:

how long does it take for a new nurse to feel comfortable working in ltc? the average length of time is about six months to one year. by the time you have reached that marker, you will either love it or hate it and be ready to leave. if you love it, you have fallen in love with the residents you care for and understand that the ltc is not the next best thing to a funeral home, as so many "outsiders" do. there is life, love, laughter, friendship sharing, drama, and a richness of life up close that a nurse anywhere else wouldn't have the opportunity to experience to the extent you do. some residents have families that you will almost become a part of, while other residents need you to look after them as though you were their family because there is no one else but you. you will learn the gentle art of patience, listening, and the rhythms of your floor well enough to "sense" when something isn't right. then you will use your nursing to validate or investigate. it can be a privilege and an honor to work as a nurse in ltc. the downside is the paperwork, the shifting politics, the high staff turnover, and the general lack of supplies and equipment. sometimes the food is so nasty that you wouldn't feed it to your dog, the staff toilets have seen better times, the housekeeping doesn't, and there is a smell that pervades everything and never goes away. there is always work to be done, pills to be passed, narcotics to be tracked, residents who turn critical during your shift, and the bad apples who see ltc's as easy pickings for their narcotic fix. the best advice i can and have given to newbie nurses to ltc is to trust themselves. take the time to give the correct med to the correct patient at the correct time. practice good nursing and don't get sloppy and careless just to get to break on time. there are "tricks of the trade" to maximize your time while minimizing risk for error. these will come in time. you will spend time off work looking things up like policies, meds, disease processes, etc. the bad eggs are good and slick at throwing curveballs your way to try and create confusion. but stick to your guns and be the nurse you want to be. your patients are the ones who will be depending on you. keep them safe above all else. secondary tip would be that there are a wide variety of ltc facilities out there. you may need to work at more than one to find the ltc that is right for you. all of them are hard work and lots of it. but if you are a nurse for all the right reasons and have some ethics and smarts, you can only grow as a nurse. good luck!

Josh, If your dream is to be a physician, then everything else is a distraction. What that means is if being a physician is your dream, your soul reason for being on this planet, then do not let the incidentals of money and other things distract you or sidetrack you from that goal. Hold that thought. As for the academic requirements to grow you from point A to point B, you will need to do your research. Thinking and dreaming are inspiring, but laying the bricks to create the path means you will have to do the work to get you there. Examples include what is your current GPA? Are you taking lots of science courses, especially biology, chemistry, and advanced math? What type of physician would you like to be? Do you like to work directly with people? Do you prefer the thinking part of science and would you be more inclined to pursue research? Do you spend some time each day taking care of yourself physically (exercise, good nutrition, cleanliness, and sleep), mentally, socially, and spiritually? Do you have balance in your life? Are you well organized? Have you interviewed any physicians who are doing the type of work you would like to someday be doing? How did they get from point A to point B? Have you sent for admission information from the college or colleges you would like to attend? Have you discussed your plans with an admission counselor? Have you discussed your plans with a financial aid counselor? My point in asking yourself these questions and more is to set you off in a direction that will help you find answers that matter and more. A person can certainly enter the healthcare arena as a nurse and move on to become a doctor. It is your dream, after all. You are the spark that will make it happen. But it would be helpful, I think, to know yourself if you really want to be an MD or a nurse, as they both help people, but in different ways. What are your strengths? Ambitions? Do you have the personality to run the ship and land safely with all present and accounted for or - given the leadership opportunity, would your ship run aground and everyone on board is on their own? Money will come to you if that is what is needed for your goal. Believe in yourself and know and visualize yourself in your goal and the money will come. You will have to connect with people and organizations to facilitate this, but the money will be there if you are pursuing what is in your heart. And that is the bottom line. Good luck and keep believing!:dancgrp:

LPN vs MA? In my experiences as an LPN working with MA's, I noted that the MA's had killer office skills - typing, phone, filing... They also could not administer narcotic or steroid injections. Otherwise, they pretty much did everything I did. However, I had one experience after being hired for a conservative, Catholic organization that scared the bejeezuz out of me for a long time. I had been hired (after some of the most extended, thorough, and complete screening processes of my entire life that included everything but an anal probe) to work as a MA with 2 other ancient & wise LPN's and one nervously hyper MA with major control issues. I lasted exactly one week before being "let go" like a bag of garbage out the alley door. Why? I can only guess. The organization changed the job description completely after I was kicked out the door. I checked. I believe I was "let go" because I tend to think and act with the autonomy of a Real Nurse and years of this behavior have made it impossible for me to choke down and swallow the expectations that my primary job responsibility was to Smile and make the patients feel comfortable in that special way Disney has trademarked. The MA in this position had a beautiful smile and the ear of our floor manager. The MA was also sloppy, scattered, and didn't mingle well with her co-workers. By some unspoken default, I was passed on to be "oriented" to the unit by her. :uhoh21: I shadowed this MA as she processed and roomed pts and was horrified to find that she blew off every non-routine concern they had (ex: one pt was depressed and asked for information on health care directives, a standard packet we usually give to anyone who requests this). Nor did the MA extend herself past the basic routines. Ever. She never passed on any of the pt concerns to the MD nor did she ever remind the pt to talk to the MD about the concern. But she did smile and she did act like a cover model for Medical Assistant magazine (if there is such a thing!). And management loved her. And she resented me for jumping in to do the (nurse)things she wasn't doing. The point being is that there are "good" MA's and MA's that could disappear forever and never be missed. I have known some excellent MA's go on to become excellent RN's. I would advise any nurse considering transitioning from shift work into the realm of medical office/clinic work to give some thought to their own strengths and what their future career goals are. Can you handle the diversity and challenges of a culturally diverse large city clinic or would the slower pace of a small yet culturally predictable GP clinic be for you? How do you feel about handling paperwork and working with computers? Are you able to create and maintain harmony with your team, no matter the disparity in personalities? Is there a union present? I have noted a big difference in morale between union and non union staff. If you live in a larger community, a suggestion would be to register with more than one agency and accept only assignments with clinics. That would then allow you to taste the offerings out there and the employer also gets to test you as a potential employee. Plus, agencies in bigger cities tend to be competitive and you are usually paid top dollar. And you can be hired for a company you have grown to love just by working there and doing your best without so much as a job interview! :grpwlcm:

We had this cute, quiet little old lady in the nursing home who had a very gravely, deeper voice, wild steel gray hair that had a mind of its own, and she always wore a dark sweater several sizes too large for her tiny frame. She rarely talked to strangers or others and when she sat in the smoking lounge of days gone by, she would either be slowly smoking cigarettes with the elegance of a movie star, turning pages over in an outdated magazine, or observing others while appearing to "chew" her tongue like gum. She was a real character. During one of the many night shifts I worked there, I shared the work with one of the veteran nurses of the home. She was one of the few people that our mystery patient would talk to. That night I was given the honor of being welcomed to the small group of people the patient would talk to. The veteran nurse told me that the patient was a member of the NRA. I asked the patient what the NRA was, thinking it was interesting to have a patient that had had interest and experiences with guns (!). The patient stopped chewing her tongue, looked me straight in the eyes and said "Nice Round Ass".

I chose nursing as a career because I was given limited choices between being a secretary, a stewardess, a nun, a teacher, or a nurse. I hated typing, I was too tall to be a stewardess (airline attendant nowadays), enjoyed having a sex life, and the thought of teaching children at my young, wild age was too boring. Nurses could get a job anywhere at anytime and earn enough to support themselves and remain single. So I chose nursing. Two plus decades later, I am changing my career to something that is not nursing. So many changes. Uniforms have gone from starched white dresses, support hose, and carefully pinned caps to fluorescent leopard prints and running shoes or Crocs. I receive less respect for what I do than do the greeters in a fast food restaurant. My bladder is shot, I have major varicose vein issues, and chronic back pain. I have decided that I will no longer sacrifice my time and my health to fatten the wallets of those who run the systems. No longer will I subject myself to the rigors of mandatory/obligatory overtime, searching for edible food in vending machines, or risking my life driving to work in storms. Meh. Enough. The young nurses on the floor seem to be as casual in their nursing as the uniforms they wear. They don't bother to measure for TEDs or select the proper BP cuff; whatever is available is what they use. It is disheartening and scary for me to have to participate as a patient in the new and changing healthcare system. Some of the nurses can barely speak English. Recently, I visited the ER for nonstop vomiting due to headache. I just wanted some medication to stop the vomiting and check my BP. Simple. I knew what was wrong with me. But the doctor refused to listen to me, an old battle axe nurse, and proceeded to exam me with his bare hands. I then developed a staph infection on/in my face. A necrotic, inflamed flesh eating ugly time of infection. I recognized this early and was given abx treatment. No one admitted that poor handwashing by a doctor could have possibly occurred in their ER. Every time I look in the mirror now, I have deep facial scars that remind me that the healing is no longer in healthcare and it is time to change course.