All Content by BaRNs
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Why it is better to be a Nurse than a Physician.
I feel enlightened.
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change of state!
First step is checking with the new states board of nursing to be sure that it has reciprocity with your current state with which you hold licensure. I believe you have to attend a class on child abuse identification to hold NY licensure. But I am sure they will give you temprorary licensure for a certain period until that is complete. And a large facility would more than likely offer those types of courses. http://www.op.nysed.gov/nursing.htm is the site for New York Office of Professions, or you could contact a hospital or facilty there with which you are interested in applying to and ask them if New York offers license resiprocity for New Mexico. Typically this isn't an issue since the advent of modern NCLEX testing and the NCSBN. https://www.ncsbn.org/index.htm will have information on reciprocity and every states board of nursing contact/directory information. Hope all this helps :)
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So...where else do you work?
women's clinics (if you don't mind being very focused in only one aspect of your profession) outpatient centers (narrow focus on your particular specialties provided at your clinic) SNFs (must master multi-tasking and supervision) Drs offices (for the nurse that wants a steady 9-5er) cancer treatment centers (must have a ginormous heart) school nursing (if you don't mind being overworked!) inmate nursing (not for the squeemish or easily rattled) plastic surgery offices (pt intake nurse positions as well as PACU style and Anesthesia {advanced degree required of course} positions available here) Nurse educators (with substantial experience down the road in your career, God knows we need more, but you have to be willing to get a masters and take a large paycut for it...seems odd, but it's true. Why do you think we have such a bad shortage of them...?) Shipboard nursing (cruise industry has a minimum of one and often 3+ aboard many of the larger/newer cruise lines vesels, LOADS of fun) Travel nursing (not the hospital kind, but the abroad kind to developing or even 3rd world countries, can be very rewarding in both personal fulfillment and financially) There are many many many others, but I have known at least one nurse that has done each of the above. The best part about being a nurse is with a few years experience in an acute care setting you can get any of these jobs with little effort (with the exception of shipboard nurse as these jobs are coveted). If you want to market yourself as an RN you will need to get that 'hospital' type nursing under your belt for a couple years minimum. Most travel nursing agencies won;t accept your application until you have a year minimum acute care experience. Lots of times if you travel in the US you are going to facilities where nurses are on strike and you have to be willing to cross picket lines to go to work and suffer the snears of fellow nurses. They all have advantages and disadvantages and all of them have pts that can benefit from your care. :) Congrats on choosing nursing. Keep up the studying.
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Skin cancer nursing diagnosis
I think you are talking about prevention? As in primary prevention (such as vaccinations) and secondary such as treatment of disease and tertiary as in limiting disease spread and minimizing it's effects (chronic or incureable). If this is the case then relating it to skin cancer would go something like this: Primary: Sun screen Secondary: Appropriate medical regimen Tertiary: Paliative surgery, such as removal of a spinal compression tumor to alleviate back pain in where the cancer will not be cured, but the symptom of back pain can be relieved... Altered body image is a good one for NDx. I used that one a lot Can't go much further into this as you should really be able to find the answers to these on your own and I think I have said too much already. I am a sucker for nursing students, though, since my first preceptor last year. Buen suerte amigo (good luck)
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Nurses with tattoos?
see above statement. Here is one of our CURRENT intolerant policy makers. People took offense at female doctors and for that matter women that worked at all. They told them to be careful as they could be PORTRAYED badly. The old generations in this country have a nasty historical record of intolerance, but the good part is...these meatsacks we inhabit don't last too long, so change is inevitable. Rock that nurse tattoo and trust me, it will break more ice than it will set fires. You wear scrub pants to work anyway.
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Why it is better to be a Nurse than a Physician.
Wondering what your take on this is. IMO: Nurses get to treat the person, while physicians are relegated to treating some disgusting disease or condition. We get to spend our time helping the person reach their peak abilities and goals while physicians focus on battling some process. ...oh, and my malpractice insurance is wicked low in comparison! So why is it better to be a nurse?
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LPN starting RN school spring '09
I have had many LPN friends do this over the years and MOST of them say how hard it was to take time off and jump right back in. My tips would be to find out which med-surg, mother-baby, and other primary texts they will be assigning and buy them NOW. Refresh everything you learned during your LPN especially since you haven't been working. You will have forgotten much of your education in 3 years without daily practice. Anyone would. Heck I can't remember how to divide fractions sometimes...brainspasms I guess, but you lose it after a while is my point. They will not be giving you special considerations as those types of programs are very fast paced. You need to get on it before it's too late or you will regret wasting these next 4 months. Mark my words. They will jump right in with things like Interventions for Patients with Cardiac Complications and expect you to know everything about the A&P and basic health alterations of the cardiac system already, so that's why I recommend getting your assigned texts early. You should also go back through your old text books and refresh. If you highlighted yours like a Christmas tree like I did it should be no problem to do a 3-4 week self-refresher course. ************When you study try to focus on the Nursing process ADPIE!! Assessment, diagnosis, planning, intervention, evaluation, and study each unit in those 5 chunks...most nursing texts are layed out like this anyway.************ I don't joke when I say they will jump in like you've been doing it all your life. They have very little time and a LOT of lesson plan to fit in that small period. You will be very busy. Kudos to your hubby for being man enough to help you do this while he works. Men rock! :) Best wishes to you. No matter how hard school is. Your first 6 months on the job will be harder! haha. But it is SO worth it. The most rewarding job you can have!
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Nursing Supervisor escorted two druggie nurses off hospital grounds last month
There was actually a large pooling of information on this topic done by encyclopedia.com in the late 90's. They gathered from over 5,000 sources and our instructors used it in our classroom when we studied this issue in school. If I remember right it said things like psychiatric nurses were more likely to report there own drug use because they were more likely to view the ensuing treatment as acceptable and beneficial. It showed that there were higher incidences of abuse among ER/CC specialties than on medical units, but stated it was more likely related to the personality type of the people that sought those specialties. I have seen a few nurses fired (from different units) for diverting and I could see it coming a couple times and a couple I had no idea. One was actually a case where an RN was diverting opiates for her aging cat...no joke. You can't tell.
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thoughts on only Paralytic while intubated....
Holy #&*$^%! Valium or versed at the VERY LEAST! Paralytics with nothing else on board tugs the fringes of incompetence on that physicians part. I would bring that event up with your charge AND dept/unit manager. That will make for excellent staff meeting dialogue to prevent that from occuring again. I have seen docs do some crazy things during intubation in the OR and ICU over the last several years, and have seen almost this exact incident happen before. You need to get in this MD's face and advocate immediately, if he fails to respond you get your charge nurse involved and call his attending or his medical director ASAP! He will be Johnny-on-the-spot with versed at a minimum after that. I can't imagine a medical condition that would allow for a paralytic and contraindicate some type of sedative. I seriously doubt this MD had a specific, justifiable reason for not scripting you some kind....
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Safe Staffing Saves Lives - ANA has started a campaign for us
We have 'nurse legislative day' in washington state in late winter at our state capitol and many of us attend to put a face on with those requests. Most states have similar things on the books. Your state representatives should set aside time to meet with you upon your request. It is their job and obligation to meet with you. If they seem hard to reach, then I recommend not re-electing them. As a pt advocate in our current health care system we should ALL, without exception, be invloved in this way. Way to go ANA, but representatives are smart people, they know a form letter when they see one. Put a face with it and it means a whole lot more. If you can't manage one day a year to do this for yourself, your license integrity, and most importantly your patients, you need to loosen up your schedule. It is your responsibilty.
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needlestick :(
I haven't had one in almost 6 years. Is that unusual? I think my fear keeps me on my toes. Accidents are called accidents for a reason though. I hope all turns out well for you. I know two nurses and an MA that have been stuck with used syringes from HIV or Hep C pts. None of them contracted the disease though. We are a remarkably resilient species of animal. Our immune system is second to the cockroach and some other insects and the best in the mammal kingdom. Once you get past the first negative screening you will breathe easier, but I am sure you will have this in the back of your mind a while. Unavoidable, I know. I have to agree with another comment, though, that said she would stop breastfeeding regardless of the pediatricians recommendations. Although I am a man and can't possibly share your level of concern, it just seems the prudent thing to do. You may wish to seek a second opinion on that issue.
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New RN looking for a job!! I am desperate!!
CubanGirl, That feeling that you forget everything you learned in nursing school over the summer while you job hunt is totally normal. Almost every one of us fealt that. Our web discussion board was filled with those sentiments after we passed our boards. I went right into an OR residency after I took 3 months off to do some backpacking with several friends I hadn't gotten to spend much time with while I was studying like a mad scientist for 4 years. I was scared out of my mind the first month and my RA totally knew it. My job hunt took me about 2 months when I buckled down and did it. There are plenty of nursing jobs out there though. If you are desperate for ANY job you can pretty much walk in and be hired at nearly any SNF, as they typically have turnover rates >30%. If you are after a residency program they usually start them at specific times throughout the year. Some do them yearly, some do them monthly, depending on the size of facility and educational infrastructure they have set up. My tips for gaining rapid employment are: 1: Practice your answers to commonly asked interview questions. 2: Don't be afraid to call a dept. manager 3-4 times regarding your application status. They like follow-up as it shows you have a desire to work there. Refrain from calling the human resources personnel as they have very little to do with hiring outside of putting your application in the right hands. Find out the dept. manager's name and number and call them. If HR won't give it to you, be resourceful and find it yourself via a hospital directory or physically going down there and putting a resume in their hands. Internet applications are fine, but they lack a personal touch and you are yet another faceless name in a large stack. 3: Find out 2-3 things in your facilities mission statement that you like and find some way to let them know those things are important to you. Whether it is in your resume or during an interview. 4: If you are after the 'good' spots, be patient. Wish you lots of luck and congartulations on passing! Don't trade all that stress you got rid of by passing for new stress from not getting a job! lol
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Nurses with tattoos?
I have tattoos from the Navy prior to nursing (12 to be exact, and large). Does your hospital have a bad hair or mustache on women policy? I find those offensive! :) Little Devil's advocate for you. My tattoos are excellent ice-breakers and my biggest fans are little old ladies. Being a young guy helps too in that dept. I'm sure.. I wear long sleave layering shirts under my scrubs though as I am socially competent enough to realize that they COULD offend someone. In another 20 years when my generation, with all our tattoos, writes the hospital policy and changes things to suit our needs mine will be giant masses of indistinguishable ink anyway... "What is that grandpa?" "Well it used to be a sexy naked lady." "Well it looks like Jaba the Hut now." Seriously though. These kinds of 'appearance' policies are generationally implemented. When our generation (I am 29 end of August) get into those policy-making positions we will view tattoos with much more familiar and tolerant eyes. So far each generation of the last 100 years has become more tolerant than the last of others personal choices and lifestyles. I am not saying hope for speedy deaths of the intolerant elderly, but lets face it...our children's generation will have things that shock us like our tattoos shock our current silver-hairs.
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Smoking on Campus
I used to get upset about that fact that smokers got those 3-4 extra 10 minute breaks to go get their fix. Then I realized that if they don't go out and do that they have a tendancy to be foul SOBs and unpleasant to work with. I prefer not to smell the stink of smoker clothes anyway, so the longer they are away the better (we only have 2 out of about 40 staff RNs on both shifts so we are lucky). Eeeek, was that too mean? Seriously, IMO these folks need tough love, incentive, and constant reminder to quit. Most of them make a conscious effort to take their extra breaks at downtimes or when they have 'caught up' so I don't tend to get too upset. Our hospital makes them walk a LONG way though as it is banned from the campus/parking lot/and even your personal car if you are on the property. I love that policy and thank God every day that I live in a democracy! Die smoker Die!!! jk We have pretty muched shoved these cancer spawns into the deepest darkest holes of our society as we can, especially on the west coast where it is illegal to smoke indoors ANYWHERE including bars. Work is about the only place they can go have a smoke break anymore, can't say I blame 'em. Besides these folks are dwindling in vast numbers. With all the anti-smoking advertising now-a-days I see way fewer smokers than I did say 10-15 years ago. Only a few wrinkly, stinky, yellow-stained hold-outs left.
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RN vs. LPN clinical rotations
I don't know that any nursing program sets out to 'weed out' students. The more students they have pass, the better they look as instructors, and a program as a whole, the school makes more money with more successful students and they get to keep their accreditation another year! :) An RN program (ADN or certification programs alike) at the community college level will be another year on top of your LPN program and many do ladder formats where you take your LPN exam after the first year then your RN boards after your second. While I don't know the specifics of your clinical shortcomings and why you were failed I would just say this: Stay positive, decide if it is appropriate for you, decide if YOU can buckle down and meet the requirements the program sets for you. The school should only be passing those who meet their minimum standards, as is the practice with virtually every educational program. So don't expect it to be easy. While that LPN year may be a shock to the senses if you have never been in higher education before, I can assure you that the RN theory and clinicals will demand much MUCH more from you, and if they didn't then LPNs would be delegating to RNs, you get my meaning? :) Take a deep breath, set aside 1.5-2 hours of every day M-F to study theory and another 30-45 minutes on clinical prep (depending on how you structure clinicals @ your school) and finish any major projects or research papers (ugh, glad that's over) and lastly prepare to have no life. As far as clinicals go, your instructors will only expect more out of you as time goes, as they should. Neither you nor I want a less than competent nurse/physician/pharmacist caring for us. Do whatever needs to be done in school and play the game to win. When you pass and hit the floor, most of the things you learn go out the window anyway. If it is something you really have a passion for then keep trying and I wish you the best.
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What nursing school did everyone attend?
U DUB! Univ of Washington. BSN. Going to go the cheap route for my MSN though, aka online courses. I can't see paying that tuition again for education and leadership courses.
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Titrating Medication
Well you will most likely have to learn a lot about medication administration well beyond just titration. I mean as a hospice LPN you will have a lot of autonomy and only a phone to reach someone for questions most of the time. Hospice nurses are very knowledgable as they have no one right next them like us floor/unit nurses :) . You will have to learn multiple pumps from multiple manufacturers, manual titration and much much more. If you passed your LPN you will be fine. You might do good to take a 100 level math course from your local community college for ~400 dollars, to help you refresh your fractions, multiplication, division, and rounding abilties. I know it sounds silly, but I used to be awesome at all things mathematical. I am only 28 and 6 years out of school, but those abilities fade fast. 'You don't use it, you lose it,' kind of thing...totally true with math. A 4-6 hundred dollar investment would make you more confident in your abilities and put your license in a lot less jeopardy! Good Luck. I admire Hospice nurses a LOT! No way could I do that. I did my residency in OR and we had a saying that "the best pt is an unconscious one." Gotta love that dark nurse humor!
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Pregnant and Nursing.....
I congratulate any woman that can handle all those hormones and deal with a cranky manager, demanding famliy members, and etoh withdrawals! I pack this Y chromosome around so my input is nullified! The "Stay hydrated" tip is clutch! We don't drink enough water in our recirculated facilities as a profession on the whole. Drink lots of fluids and know your limits. Back when I was a CNA I watched my favorite nurse carry a full term on her feet at 41 years old! She worked to 39.5 weeks!!!!! Some of my guy friends call into work for hangovers...so I applaud all you ladies that do this and work at the same time. ESPECIALLY on your feet on the floor. Kudos.
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Is a bad feeling good reason to see a doctor?
When you get spammed with all the diseases and conditions that afflict people as a nursing student does it is easy to become a hypochondriac. And we probably all do to a certain extent. You know your body like no one else. So there is no better judge of when you need to seek help from a HCP. During my first year in OR after my residency, I had what I found out later was a panic attack. I just felt 'wierd,' I was sweaty, my heart was racing a lot over a 3-4 day period, I couldn't get to sleep (at all one of the nights) very easily. I am of the persuasion that I refuse to put toxins in my body. I consider toxins to be pretty much all medications from ASA to MS04. So I know that a doctor is going to want to prescribe me something to take. I prefer my naturopaths approach. She tells me that when I feel 'off' to get lots of rest and other simplistic approached to my health and well-being maintenance, and if I see improvement it was probably something inconsequential to begin with. We have an innate abilty to heal ourselves. I once had food poisoning when I was 19 from some bad ground beef (hey I was a broke college student, so what if it was a week old in the fridge). I had 103.7 temp and had diarrhea, vomiting, and proFUSE sweating for 2 solid days. I didn't go see the doctor and I was fine. He probably would have been able to successfully limit the amount of suffering I endured, but I was convinced I wasn't going to hospital until my temp was 104+. You know better than anyone what you need.
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Best Paying Hospitals in South Florida???
This is easy. Fortune magazine ranked them :) Baptist Health of south Florida is by far one of the best companies a nurse could expect to work for ANYWHERE in the united states, let alone Flroida. Why? They had the highest % of nurses making over 100k/ year and only 13% nurse annual turnover as opposed to a national average of 20%. That must mean they provide sufficient reason to remain employed there! Check them out. I have a cousin who worked for them at West Kendall Baptist in Miami for 11 years until she moved out of state. She was an important factor in my choosing nursing as a profession.
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Is the pay really that bad??
Lets end the discussion on fiscal responsibilty as that was not the topic posted. Lets try to get back to the authors intent. Which, correct me if I am wrong, is wanting to know why he has heard nurses complain about not getting paid enough. If I had to pick one reason to punctuate all the others it would be STRESS. Many, if not most, of the nursing jobs out there (especially long term care and med-surg) are incredibly stressful and often border on unsafe for patients which in turn is dangerous for the integrity of your license as a health care provider. Parents not teaching you how to manage your money is meant for another website and forum all-together.
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Is the pay really that bad??
When you take into account the shortage of nurses and understand that pay is based on supply and demand, as I am sure you do working in banking you will see that nurses are drastically underpaid. If we weren't underpaid you wouldn't see a mass exodus of new nurses from the profession due to burnout every year. Ask any med-surg nurse if they make enough money! Did you go to school for your 'banking' job? Did you go through a residency/internship for your specialty in banking? Do you have people's physical (not financial ) lives in your hands on a daily basis in banking? Work in the field in a medically under-served region for 6 months and if you tell me you make enough money you'll shut me up forever. However, I know that when you get your first bad staffing night and have a pt code (have cardio-respiratory failure/heart attack/stroke) on you during that shift, you will change your mind. It is all about what we have to put up with. We have many issues in our field ATM: Not enough schools Not enough teachers/instructors Not enough men interested in nursing Not enough nurse:pt ratio legislation Too many people with licenses that burnout and never return Too many old nurses of the baby-boomer generation that are retiring in mass exodus fashion and requiring long term care from fewer younger nurses. You factor all that in, among many other things in our current health care system, and you have a MAJOR crisis. No, we don't make enough. You may find the occasional specialty nurse that is fit perfectly into their job, but ask some med-surg or LTC nurses (which make up a vastly disproportionate number of nurses to specialties) and my guess is they don't.
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Credit checks for employment
I want to be sure that everyone knows this is a complete UNtruth. Like I said in a previous post your credit 'score' is only 3 characters of information on your consumer report. The information your facilty is using is to match up your resume with residential and employment history which are all on your consumer report (aka credit report). I should also add that when you get a standard credit check from say a car dealership, they are limited to the information they need and that you signed consent to give them, aka credit score. That is why they are typically much much shorter than your full consumer report which is what your company is using.
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Credit checks for employment
The practice of denying a NURSE a position based on credit score is illegal. The use of the information MUST pertain to the job applied for. http://www.ftc.gov/os/statutes/031224fcra.pdf This is the adobe reader full version of the FCRA which you should use in conjunction with your states employment law website to gain a better understanding. Here is the beginning of the section defining legal usages. " 604. Permissible purposes of consumer reports [15 U.S.C. 1681b] (a) In general. Subject to subsection ©, any consumer reporting agency may furnish a consumer report under the following circumstances and no other: (1) In response to the order of a court having jurisdiction to issue such an order, or a subpoena issued in connection with proceedings before a Federal grand jury. (2) In accordance with the written instructions of the consumer to whom it relates. (3) To a person which it has reason to believe (A) intends to use the information in connection with a credit transaction involving the consumer on whom the information is to be furnished and involving the extension of credit to, or review or collection of an account of, the consumer; or (B) intends to use the information for employment purposes; or © intends to use the information in connection with the underwriting of insurance involving the consumer; or (D) intends to use the information in connection with a determination of the consumer's eligibility for a license or other benefit granted by a governmental instrumentality required by law to consider an applicant's financial responsibility or status" You also need to understand what type of information is on your 'credit' report. Your credit score is the most insignificant bit of information about YOU that can be obtained from this document. Your places of residence, aliases, and work history are far more valuable to anyone not applying for a CPA, accounting, or money handling position. While an employer is nearly guaranteed to account for credit score on hiring practices of Chief Financial Officers for corporations we ARE on a nursing website, so lets not get too finicky about this. You have NOTHING to worry about. :) Almost everyone's credit score is total garbage fresh out of school. I am in the process of researching Texas employment laws and will get back to you soon as I can. Navigating these sites is tedious. My own states is bad enough and after 7 years I am only now somewhat familiar with it. So give me some time for a new state! :)
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Missing narcs returned to med cart...sorry long
This should be immediately reported to your state board of nursing! Immediately. I cannot express enough the urgency here. Your license is actively on the line...The statute of limitations for prosecution for something like this is well over 12months. Give them a call on their hotline NOW! The longer you wait the worse this will be for all parties involved. This is completely unacceptable behavior by any HCP. Appaled!