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I am a new employee working for a health program that specializes in helping long term care clients return to their communites, either through assisted living, independant living, in their own homes, etc. I hope no one minds me asking about this on a forum for long term care patient's. I promise i'm not trying to steal LTC patients away (I love the nrusing home community--- just trying to provide options for those who want to go to other settings.... and can safely do so), but I wanted some suggestions from people who work everyday with patient who require nursing home level of care. I am the programs first and only nurse to date. I was hired on with the specific purpose of managing a case load of medically complex clients. The program has never offered this service before and will only take patient's by referral. I have been asked to choose what criteria qualifies a patient as medically complex, and hence will be choosing what patients will be in my caseload. The population I serve must already qualify for nursing home level of care, so a great majority already have multiple medical complications. Does anyone have suggestions on what type of situations would qualify a patient with nursing home level of care to be "exceptionally" medically complex? Initially I intend to take any patients who are referred to the program, but I would like to provide some general examples to my providers as examples of what a patient they refer might look like? Any suggestions on criteria or examples of an "exceptionally medically complex" nursing home patient would be appreciated

I am a new employee working for a health program that specializes in helping long term care clients return to their communites, either through assisted living, independant livings, or in their own homes. I am the programs first and only nurse to date. I was hired on with the specific purpose of managing a case load of medically complex clients. The program has never offered this service before and will only take patient's by referral. I have been asked to choose what criteria qualifies a patient as medically complex, and hence will be choosing what patients will be in my caseload. The population I serve must qualify for nursing home level of care, so a great majority already have multiple medical complications. Does anyone have suggestions on what type of situations would qualify a patient with nursing home level of care to be "exceptionally" medically complex? Initially I intend to take any patients who are referred to the program, but I would like to provide some general examples to my providers as examples of what a patient they refer might look like? Any suggestions on criteria or examples of an "exceptionally medically complex" nursing home patient would be appreciated

I am a new employee working for a health program that specializes in helping long term care clients return to their communites, either through assisted living, independant livings, or in their own homes. I am the programs first and only nurse to date. I was hired on with the specific purpose of managing a case load of medically complex clients. The program has never offered this service before and will only take patient's by referral. I have been asked to choose what criteria qualifies a patient as medically complex, and hence will be choosing what patients will be in my caseload. The population I serve must qualify for nursing home level of care, so a great majority already have multiple medical complications. Does anyone have suggestions on what type of situations would qualify a patient with nursing home level of care to be "exceptionally" medically complex? Initially I intend to take any patients who are referred to the program, but I would like to provide some general examples to my providers as examples of what a patient they refer might look like? Any suggestions on criteria or examples of an "exceptionally medically complex" nursing home patient would be appreciated.

I am doing some work determining hospice coverage and I've run into a situation that I am unsure of. Hospice is not one of my specialties and I could use some input. So here is a brief situation: A patient is placed on hospice for end stage cardiac disease. He has to receive hospice care in a long term care facility because he also has COPD and requires a ventilator. Can the COPD be considered seperate from the admitting diagnosis or would you consider these related conditions. Does the ventilator count as palliative care or is it an agressive treatment? Just not sure how to approach this situation. What do the experts in hospice nursing think?

I was told all through nursing school that every good nurse should have atleast one year of medical surgical nursing under their belt before starting into a specialty. The issue I run into now is that because the jobs are slim and almost every new grad is trying for the medsurg jobs it is actually a lot easier to obtain a position in a specialty field then medsurg right now. This was certainly the case for me as I have been hired on as an ER Nurse and a Psychiatric nurse. Now however as I look through job postings online most of them have a simple yes/no question for "Do you have medical surgical experience?" or just have a scale for how many years of medsurg experience you have. There is no space for a narrative answer. I am not currently searching for a new employer, but I am curious how this will effect me in the future and just wanted opinions on whether you would answer yes or no to whether ER nursing counts as medical or surgical nursing.

Try as I might, I have been unable to secure a position working on a medical surgical unit. I do however have experience working as a nurse in the Emergency Department. When filling out applications that ask whether you have medical surgical experience does ER nursing count for anything?

On top of being a Registered Nurse I am also a Registered Polysomnographic Technologist. I worked in a sleep lab for four years during which time I performed sleep studies and scored sleep studies. I can tell you from my experience working in the sleep lab that a portable sleep study is far less accurate than a full polysomnography. The advantage of having your sleep study performed in a laboratory is that you will have someone available to replace any sensors that come off during the night. I can not tell you how many portable sleep studies I have seen come back without any usable information.

First of all $21.80 and hour if working full time is more than $40,000 per year not less than $30,000.00 and it is certainly possible to purchase a home, food, and clothing. My family of five managed to do so on far less than that prior to my graduation from Nursing school. You might not be able to live in a dream home or wear designer clothing, but if your capable of budgeting it is a completely livable wage. Second, the wages in Utah do reflect the market comparible wages. If you refer to the Unites States Bureau of Labor Statistics you will see that Utahs wages are on the low end, but the wages are comparible to several other states including; Idaho, Florida, Georgia, North and South Carolina, etc. In fact there are states listed as having lower wages on average. Utah on average happens to have lower wages then other states in most fields. It is not Utah Specific. Engineer's in Utah (gosh I hope engineering is not considered women's work) tend to make $10,000 to $20,000 less per year then in other states as well.

I have lived in Utah my entire life and I am responding to your post. I do not believe in any way shape or form that Utahns accept lower nursing salaries because it is "women's work." A statement like that is based on stereotypes and cultural ignorance. Women in Utah are not held back professionally any more than they are in other states. Likewise, for most nurses in Utah their job is NOT "just a part time job or a second income". Seriously??? Nursing is not a flight of fancy for anyone who enters the profession. To the best of my knowledge the wages are lower here because the largest chain of hospitals in Utah (IHC) is a not-for-profit organization. The other hospitals and healthcare agencies do base wages on marketplace comparibiliy which.. yes are going to hit up on the IHC salaries since they are the largest health care employer in Utah. As for why we accept these lower salaries... Honestly I have felt no need to compare wages against the wages in other states, so on that variable you may be correct. I don't have any intention to move just for a higher salary. Frankly, I think paying an inexperienced employee who requires large amounts of additional training more than $21.00 an hour would be ludacris from a business stand point. The money I make as a new nurse here is sufficient for my families needs and I am doing work I love. The job market in Utah is tight right now. Its difficult to get on with any of the large hospitals even if you worked for them while going through school, but its still possible to obtain employment as a new grad at the apparently very low going rate. I was able to obtain a job within a month of receiving my license last August.

I am not a military mom and I am not a single mom at this juncture either, but I do work full tima, raise 3 children ages 10, 7, and 4, and go to school full time. I am no longer single, but I was a single mom to these children for a time. My answer to you is...... A mother manages as best she can. It wasnt that long ago that I was posting to allnurses in a panic because school/family complications had required me to drop out of my nursing program. It was a horrid time for me. I felt I had to choose between my family and my future. I've been very blessed since then and everything is back on track, but I learned a lot along my way. 1. As a single mom, a good child care provider is your best friend. Do not feel guilty for having a child in daycare or after school programs. Most children enjoy the opportunity to interact with other children their age, and lets face it Mom's in nursing school have no time for setting up play dates. Nor are mommy's any fun when cramming for exams. And I am sorry, but the old "I don't want other people raising my children" addage does not fly. I never met a child who could not differentiate mommy from another caregiver. By selecting the best caregiver you can you are indeed making a parenting decision. Parenting does not stop jsut because they are not at home. 2. As a single mom you probably have a reduced income. This sounds horrible but may work to your advantage. There are many programs out there to help single mothers. You may qualify for a suppliment to help pay for the afore mentioned child care. Many schools have organizations for single mothers and/or free child care services through the school itself. Your reduced income may also help you to qualify for more grants as well. Always take advantage of a grant since this does not add the debt of school loans. 3. Do set aside special "no school time" with your children. I know its hard for us nursing students to put down our books, but do it. Your children are the priority, not school, and they sometimes need reminders of that. 4. Try not to wallow in your single situation when it comes to school. I love my new husband to death, but I had an easier time of nursing school before I remarried. Sometimes a spouse can complicate the nursing school experience because not only do you have to take care of the needs of your children, but the needs of your spouse as well. Spouse's are funny little creatures... THEY WILL FEEL NEGLECTED while you are in nursing school. 5. Keep a calendar. Keep it updated with everything and check it frequently. Not just your school assignments, but your children's school calendar and activities. If you have a school/childcare conflict you'll want ample time to find a back up sitter or to rearrange your clinical schedule if allowed to do so. Nothing worse than having your kids on spring break during finals week and not having a sitter arranged for. At one point I actually had all my days mapped out in 15 minute increments to make sure I didnt miss any assignments, clinicals, classes, parent teacher conferences, or SLEEP 6. Do not short change yourself on sleep. I recently had a professor state that if you get 4 hours of sleep a night while in nursing school you should feel lucky. I call Bullcrap. If you dont get enough sleep, you wont retain the information you study. If you dont get enough sleep your more likely to slip up at clinicals, or maybe even sleep through your alarm and miss clinicals. If you dont get enough sleep you will be more emotional, more cranky with your kids, less able to cope... Period. Get enough sleep. Your kids deserve a happy mommy when you actually have time to be home with them. 7. DOnt be ashamed to ask for help. As a nurse you'll be helping people constantly. You wont feel burdened. If your lucky enough to have family nearby, ask for help when you need it. They know your trying to improve your life and your children's life. They know its temporary. 8. When all else fails..... go to Mcdonald's.... seriously. Take the kidlets to dinner somewhere with a playland. They'll feel like they are getting special mommy time, but you can get some extra study time in while they are playing their little hearts out! So yeah... Hope atleast some of that helps.

I am sorry but unless this was a military hospital you were jipped. I did not have anywhere near the experience you had (as far as sleep deprivation) I chose to breastfeed all three of my sons, but I still opted to have them go to the nursery at night. Both hospitals were I delivered my three children have a policy which allows you to have the babies sleep in the nursery and be brought to you when they appear hungry so that you can nurse them. Rooming in is supposed to be an offering not an enforcement..... that is unless they dropped the cost of care for you

Okay so I am still a student and nowhere near ready to go for my N-Clex, but I agree with everyone else here as well. Do not give up. I do however think it is a great idea for you to move from retail to healthcare while you are preparing for your next go at the N-Clex. In my state as soon as you have passed your first semester of nursing school you are eligible to test for a CNA. You still have to pass the tests for CNA, but you do not have to take a CNA course. CNA's dont make a lot, it might even be a pay cut, but sometimes working in healthcare and seeing some of the concepts you've elarned in real life scenarios makes it easier to retain and apply those concepts on tests..

Hi there. I am a nursing student in Utah rather then a practicing nurse, but I can give you some reassurances in regards to moving to Utah as a new graduate nurse. There are several large healthcare employers in Utah that offer New graduate opportunities. Intermountain Healthcare for instances offers New Graduate Opportunities very frequently at a reasonable rate of pay. (Certainly enough to meet the cost of living here in Utah) Hiring opportunities are by no means sporifice even with the worsening economy.

Goodness gracious! I hope I didnt offend anyone. I am absolutely pleased with the kind words of advice and encouragement. Everyone is so great. Even when the advice doesnt fit my situation. I am entirely grateful. Thanks to everyone.

This question was posed quite some time ago so I don't know if anyone is still following this thread, but I thought I would give a little bit of input. I am a nursing student who currently works as a polysomnographic technician in a sleep lab. Sleep Technician's as we are commonly called are not nurses nor are we respiratory therapists. We are part of a seperate allied health field. Having said that there is still some opportunities for nurses in sleep medicine. If you are already a nurse it is easier for you to become a board registered polysomnographic technologist. This would normally require atleast 18 months experience performing sleep studies, but as a licensed nurse you would be able to take your board exams after just 6 months performing sleep studies. Secondly our lab does employ some Nurse Practitioners with sleep medicine as a specialty. These dear ladies often make rounds within the hospital to detect sleep disorders in individuals there for other medical issues. You would be surprised how many heart attacks could have been avoided if apnea was recognized and treated earlier or how many psych patient's can be freed from depression by treating similar sleep disorders.