BSN_after_40

I was working the day shift on Christmas Eve when a very dangerous blizzard began that morning. The roads leading to our small town hospital were closing and most of the pm staff were calling in due to dangerous driving conditions. Well, of course I had plans to be with my family that evening but reluctantly agreed to stay and work the pm shift. My daughter was only 3 years old and my fiance was going to surprise her that night with a Santa costume. We planned to set up a scene where she "catches" him putting gifts under the tree. I called and told him that I would be home very late and hopefully we could still pull this off. Meanwhile, neither the weather or a holiday can stop sick people from being admitted to our floor. Right around 4pm, a young boy about 4 or 5 was admitted with a rare disease I fail now to recall but something he had eaten made him very ill and had been vomiting and unable to eat for a few days. By the time he was admitted, he was very dehydrated and limp. The parents were exhausted and of course very worried. When we were admitting him, he weakly looked over at his parents and said "how is Santa going to find me here?" His mother was unable to think of anything to say and started crying. The mentioning of Santa reminded me of what I was possibly going to miss out on. I then thought to myself, how selfish I was, my baby was home safe and healthy. These parents are spending Christmas in a hospital room with a very ill little boy to worry about. That's when I had a great idea. I asked the parents if they could step out into the hallway for a minute. I told them how sorry I was about their son, and how I might be able to produce a "Santa" if they would like. They both happily agreed and mentioned that they just happened to have brought his presents with in case he was admitted to the hospital. We decided to find the best one and have my Santa bring it into the room that evening. I called home and talked to my fiance. I mentioned the situation and realized I never even asked him, I just knew he would do it. He was more than happy to do it. We arranged with our family to take our daughter for a couple hours while he did this. Remember too, there was a horrible blizzard going on outside. As the evening came, the little boy had numerous emesis and was so weak he could barely open his eyes. Around 9pm, in strolled Santa. He really hammed it up and even brought candy for all the nurses and staff working that night. The little boy's parents were thrilled to see him and the mom gave him a hug, then the present. We all stood outside the door when Santa walked into the little boy's room and loudly said "Ho Ho Ho!" The little boy woke up and said "Santa! Is that really you?" He then sat up and gave Santa a big hug. Let me tell you, there was not a dry eye in the place when we saw that touching moment! Santa gave him the gift and sat with him for long time just talking and telling him that he will be fine, Santa just knows these things. Santa came out and the parents where very thankful for his help. The rest of the night the little boy perked up and played with his new toy and had to tell everyone Santa came to see him, and that he was going to get better fast! For years after this, especially around Christmas, the nurses still asked me what it is like to be married to Santa.

I agree with EmergencyNrs. Get your RN. I made an $8.00 increase in pay going from an LPN to an RN. Well worth the extra year at a community college!

Working in rural areas has its challenges, especially when working in a long term care facility in the middle of nowhere. I was a new RN grad and full of enthusiasm, even though I was in my late thirties. As I scanned the local job listings and word of mouth jobs, I came across an ad for a Unit Manager in a small nursing home 30 miles away from my home. I thought well, it couldn't hurt to apply even though my only experience was 14 years as an LPN at that point. I made the call and was surprised to find out it that the DON was a person I had worked with years ago, she hired me on the spot! I hadn't even taken my board exam yet. Talk about pressure! Well, I started out fine and oriented with a great BSN who taught me a lot. It was a busy little place with a memory care unit that was always full with a waiting list a lot of the time. The facility was known for taking the "tough" patients that other facilities would not take. Somehow, they did well and the staff worked well in that area. The general area was a different story. One of my jobs was to make out assignments for the aides, 2 to a group. Sounds pretty straight forward right? At least I thought so. I was not told of the "rules" when I made out schedules for a week. It turned out that 2 aides only worked one wing together because separately, they were the meanest pair of women you could meet! They did good patient care though. So when I tried to put them on separate wings, you would have thought that the world ended. The tough part was they didn't just bring this to my attention; they screamed and hollered like children! I calmly adjusted the schedule and told them to relax, the world was not over. Lots of grumbling went on about that for a day or two. Next, I found out that the PM schedule was not "expectable" either by the aides' standards because I had put a female aide and a male aide together that had slept together before and now they can't work together because he will ignore her all shift. What? I have to know who slept with whom before making out the schedule. Are you serious? This type of bologna went on and on because it was allowed. But it gets worse. Some of the PM shifts I was working in my office and noticed that several of the teenage aides took many breaks, sometimes to the point where they were outside more than working with the patients. It turns out that there were a lot of "herbal" breaks going on. I couldn't believe it; even one of the LPN's on the med carts would join them from time to time. I was blown away. I complained, I confronted, and I wrote people up, nothing changed. The administrator would get close to the young caregivers and they would talk her into letting them get away with it. The DON was completely disconnected and couldn't confront anyone. I was so frustrated! The last straw came when one of our patients that was completely unable to move or speak was found on the floor with a large gash in his head. Luckily, I was on that evening and heard his feeding pump beeping. I found him on the floor beside his bed; tubing pulled to the limit, drenched in sweat, probably moments away from a heart attack, in a large pool of blood. I found out that they had just done rounds and it was obvious he had been repositioned so poorly that he fell out of bed. Thank God that feeding pump went off or he would have been found dead. I reprimanded these aides after I gathered all the information, wrote them up and gave them a 1 day suspension; I wanted to impose a more severe suspension but the administration said no. The capper was when the union rep chewed me out for "embarrassing" them in front of the other staff, and I had no proof of their negligence. I am usually a pretty calm person, but I "freaked" out on this person, reminding her of the potential liability of the facility to give good competent care to all residents and how I was tired of the behaviors that were tolerated there. Are you kidding me? 1 day off for almost causing a man to lose his life because they were too busy rushing to go on break or take the time to make sure he was safe? Good lord! I resigned. I know that the facility has improved greatly since then, and state has watched them very carefully. I feel I learned a lot in my nursing career from that experience, and will never allow myself to get in a position such as that again. It is no wonder that there is a nursing shortage; I had an ulcer from working there not to mention anxiety like I have never felt before. I even started smoking after quitting for 16 years. Talk about getting thrown into the fire!

Thanks for all the supportive responses. How sad is it that situations like this exist everywhere. In many other cultures, elderly citizens are honered and respected for all thier wisdom, why would our society treat them so disrespectfully? I enjoy nursing, it is a part of me, and something I have passed onto my daughters. I know that there is a nursing shortage but we shouldn't tolerate abuse. I hope we all don't find ourselves on the other end of this treatment when we are in our "Golden Years." Good luck to all of you.

What is this program? I have not heard of it before.

I agree with the others that posted the DON can't prove anything and to not be too worried. If she does tell other potential employers about that situation without a shred of proof it would be considered slander. Get out of there as soon as you can. It sounds like a sinking ship!

In LTC settings now a days, it is all too common. It is so hard to find good help and when we do have a good worker, no matter if they are a nurse or CNA, we burn them out by having them cover for those that call in all the time. I have seen so many great workers end up with back injuries or so run down they get sick. Mean while, trying to cover those that tend to call in on weekends, holidays, night shifts, or when ever the worst possible time to replace them gets old pretty fast! My favorite excuse for a morning call in was a woman who couldn't find her bra! I thought I was being punked at first but she was serious! I told her that was not an excuse and I expected her to come in, bra or no bra! She came with a bra on and didn't speak to me for a couple days. Hold your ground with this CNA. I can almost guarantee it won't be the last time you have to deal with this type of behavior. I am sure the calling in frequently will catch up with her and she will pay the piper. Good luck in the future.

This is a long story but I think it could give some encouragement to those of you just starting out in nursing school or thinking about going back for a higher degree. Every journey has to start somewhere, here is how mine began. Oh, how I can remember the days of being a scared-to-death practical nursing student. I began the program in the fall of 1990, green as grass! I didn't even know what I wanted to do with my career, but I knew I wanted to be making enough money to independently support myself and my baby girl. So, I went into the local technical college and took a test to see where my interests were in regards to a program major. Well, needless to say, nursing was at the top. I never realized it until later that it was probably my grandmother that inspired my interests the most with her nurturing ways; she was a certified nursing assistant in the hospital, working mostly with peds. She could have been "grandfathered" into an LPN position back then in the early '70s but refused; she was a hands-on caregiver and felt that the more skilled area of nursing was just not her. She was the baby rocker, the storyteller, and the best cuddlier in the world. Anyway, I was 21 and looking for a career but I had no idea how much it would become part of my identity. Nursing encompasses such a vast sea of possibilities, each one of us never knows what shore we will land on. Clueless and scared to death was the state I lived in for about the first 6 months of school. There were some pretty strict rules to follow back then, and you NEVER questioned them! The nursing program was pretty much a fixed course to follow, not like today when you can pick and choose what course you want to take. So, we stuck to the path paved out for us. I can recall one of the instructors that taught most of the clinicals. She was an old Army nurse, so you know where I am going with this! She was a frightening woman, to say the least, and she was not afraid to call you out in front of a patient and make you feel like the biggest idiot alive! I personally had several run-ins with her during clinicals, and spent a lot of time crying! One clinical day in the hospital, I was writing down how much urine I had just emptied from a catheter onto an I&O sheet at the end of a patient's bed. He was a new TURP and very kind to the little blonde nursing student that was trying to seem knowledgeable. She walked in as I was writing this information down. I had never written on one of these sheets before and had written it in on the wrong time. Well, she blew a cog! Yelling at me saying how stupid I was that I couldn't even read a simple I&O sheet right there, in front of my patient. I was mortified! I apologized and fixed my mistake quietly, trying not to cry. He felt really bad for me but was afraid to say anything to her, as I said, she was scary! At times I felt like she enjoyed being mean and condescending to us newbies. Halfway through our skills class, which she taught too, we had a mid-term evaluation with her. Many of my classmates were failing this class, and it was one of those classes that if you failed, you had to wait until the next fall to take it again, lots of pressure. When it was my turn, I wasn't too nervous because I knew I was maintaining a low "B" by my calculations and had not failed any tests at that point. I walked in and sat down, she opened her grade book and smugly said, "It looks like you are failing. So, what are you going to do about this?" I was dumbfounded! I just stared at her in disbelief, trying to make sense of the information. How could I be failing when I was doing better than most of my classmates? She seemed almost happy, and talked to me about retaking the class next fall (did I mention it was only November?) and not to plan on taking any other core nursing classes until then. I just nodded and left her office. My classmates looked at me like I had just exited the principle's office with a suspension for misbehaving! I gathered my things, headed out of the school and picked up my daughter. All I wanted to do cry! I brought my daughter to my mother's house and she agreed to keep her for the night after I told her that I was failing school and just wanted to be alone to process what had happened. So I drove promptly to the nearest liquor store and bought a case of beer! I sat at home and cried and drank and cried. My boyfriend was 7 hours away at his college. I called him crying about the whole situation, all he could do was to tell me that it will be ok, I know it will be ok! The next morning, I had a class with you-know-who teaching from 8 am to 10 am. I think back now, I don't even know why I went to class, I was in shock I think. I checked my student mailbox and there was a note from her that read, " I didn't add your last test score to your grade. You are at a "B-" right now." Oh my God! What? I was floored! But, nowhere on the note was an apology, an explanation, just those two lines! Although I was grateful for not failing out of nursing school, I had also spent a night in hell trying to contemplate my muddled future as a student! Let me tell you that I gave her the evil eye all morning as she lectured! How could she be so mean? School went by pretty fast after that, and before you knew it, it was graduation. I was very happy it was over and sad about it too, you get pretty close to your classmates; they become your extended family. Back then taking the board exam was much different than it is today. There were only a couple places in the whole state that offered the NCLEX and only twice a year. So we signed up and planned our 5-hour drive to take the dreaded exam! Talk of computerized testing was a few years off; it was all paper tests that were separated into a 4 hour morning session and after an hour lunch, another 4-hour afternoon session. The examiners walked up and down the rows watching for any possibility of catching a cheater. It was too much for one of the guys a table down from me and he vomited his breakfast up all over the floor. After he left, no one came to clean it up! So along with the "Nazi Patrol" watching our every move, we had to smell vomit for two hours before lunch break! What a nightmare! I had to wait 6 weeks to find out if I passed, and thank God I did! My fellow nurses told me that they send out the results in an envelope. If the envelope was large, it meant I failed and it would contain papers to reapply. If the envelope was small, it was your license and you passed. Well, a medium sized envelope came 6 weeks later and I had to have my friend open it because I was too scared! Over the next nine years, I worked in a small hospital on the medical-surgical unit. I loved it there! I thrived on the fact that you never knew what we might have to deal with, and the crabby patients only stay a short time! I also was floated to Geriatrics, Out-Patient Surgery (recovery), OB and Mental Health when our census was low. After a couple of years, I got to know every nurse in that building and lots of good experience to boot. I was asked several times why I hadn't gone back for my RN yet. I told them it was because of being a single mom but I actually I was scared of failing. A lot of the LPN's on my floor went into the program only to quit or fail. These were co-workers that I found very knowledgeable and competent, so I was too scared to follow in their footsteps. As time went by, I realized that most of them didn't put much effort into their studies and partied a lot. So, I started out with a few classes and went into the RN Program, 11 years after becoming an LPN! Again, the fear crept in and held me in its gripe. I thought "what the hell am I doing here?" I was in my late thirties by then with a husband and 3 kids. But with a lot of encouragement from friends and family, I stuck it out. It was the hardest 9 months of my life! I warned my family I would be married to my school work for the whole time. My wonderful hubby, the same guy that said "it will be ok" repeated that statement many times that year. Graduation day was a dream! I made it! I was a GN and scheduling my test to become an RN! Oh boy! The memories of that exam came back to me. I knew it would be much better this time around because of computerized testing and finding out quicker, but I still was shaking in my boots! The testing site was 2 hours away from our house. I decided to drive there the night before and stay in a hotel alone so I could study uninterrupted. I told few people outside of my family and boss that I was taking the test, just in case I failed it! To add more pressure, I landed my first RN position in a nursing home as a unit manager, even before I took my test! Yes, just heap on the pressure, please! After the fingerprinting and emptying the pockets I was at my computer trying to remember how to read. After what seemed like days and millions of confusing questions, the computer shut off at 75 questions. What? What just happened? Oh my God, I must have done so bad I failed! I composed myself and left the testing site only to sob on my way to my car and called my hubby. He was so sweet and reassuring! "Who cares if you failed, you can take it again, right?" At the time, those words didn't mean much. I was sure I failed and cried a lot over the next two days. I told my boss about it and her optimistic that I must have passed. The other 2 RN's I worked with had their computers shut off at 120 and 200-something for the exam. So I waited the 48 hours, miserable as could be! Oh my God! I passed! I had to read that computer screen many times to make sure it wasn't a mistake! I did it! Holy crap I did it! I called my hubby at work, crying for joy this time! He knew right away I passed just by my blubbering! He is such a great guy! I couldn't have done it without him. All the dinners he had to make, all the holidays I missed, all that was for a goal, and I succeeded! After that, my income increased greatly. My husband had been working for a package delivery company for several years and was miserable. Although he made good money, he hated the time away from his family, the hundreds of miles driving every week, and the crappy winter roads. I told him he could find another job now if he wanted, he definitely earned it! He found another job in a small factory in our little town. Even though I was the breadwinner now, he couldn't be happier! He took a 50% pay cut at first, but within 2 years he was almost back at his original wages minus the many hours of overtime he used to make. His happiness was worth its weight in gold to us; Christmas time used to be his busiest month at work and by December 25th, he was always shot and crabby. Now, he is his old self and a holiday bonus to boot from his new company! The first RN job I worked was at this small nursing home in a rural area. I loved my boss and licensed staff to pieces, but the aides were another story! Because of all the state cuts and management issues, we had no benefits what so ever! No insurance, no 401K, nothing. So needless to say, attracting desirable staff was a challenge. It was a job I loved even though I ran my butt off every time I worked and usually had 100 hours or more on every two-week paycheck. During the last weeks of school, there were reps from universities in the surrounding areas trying to recruit us into the BSN programs they offered, I thought to myself why would I do this for 2 more years? But it stuck in my head. After I successfully completed the RN Program, I felt like maybe I could go a little further. I spoke to several other nurses that had taken the 4-year track and others that went back after completing an ADN Program as I did. I must admit, I had the "school bug!" I researched and found my best option was a BSN Program with most of its classes online and 2 days a month on campus. The university was an hour and a half away from my home so going only every other Tuesday didn't sound too bad. I spoke with my husband who frankly wasn't too keen about going through the process again, especially a full 2 years. But, he was supportive because he was just that great. A friend of mine had completed this program about 5-7 years before and highly recommended it to me. She said it is nothing like the intense curriculum one experiences in an ADN Program. So I signed up. What a crazy time this was for me to go back to school. I worked full time for a year before I would start that fall. I had my oldest starting high school, my youngest starting kindergarten, and we had recently found out that our son had Asperger's Autism. Just writing this down makes me wonder what the hell I was thinking! All this on top of working like crazy at my job. Things started out really well. It was refreshing to see that everyone in my class was at least in their mid-twenties, with the majority in the same age group I was. I felt very comfortable for the first time in nursing school. Meanwhile, my oldest daughter starting growing her "teenager horns." She was always a willful kid, but now it seemed she thrived on the fact that mom was gone a lot and she started getting into trouble. She was sneaking out at night, lying most of the time, fighting with my husband constantly. I learned a new term in this period of my life; triangulation. She would ask me if she could do something and if I said no, she would go to my husband with the same request. It got pretty ugly at times, lots of verbal outbursts, groundings, and fights between me and my husband because of the games she was playing. She managed to remain on the honor roll at her high school through all this and was also confirmed at our church. This went on for my entire junior year. I was so glad when there were school breaks! When her 16th birthday rolled around, we bought her a car for her good grades. Also, I helped her to challenge the CNA test and she got herself a well paying the first job. I managed to get her hired at my place of employment thinking I could keep on eye on her. It sounds good but when I would go out of town or away for a weekend, she would have a party at our house and call in "sick" all weekend. It spiraled out of control when we reluctantly agreed to let her enroll in a post-secondary program at a college 30 miles away from us. I kept hoping she would straighten up but it just got worse. For those of you that have never had any experience with a post-secondary program let me tell you, be informed of your rights! We found out that the college had no obligation to contact us when she skipped, was failing, or got into trouble. For God's sake, she was 16!!! When we tried to pull her out, she pulled a suicide stunt at one of her friend's houses. They called me and told me was passed out and had taken "something." I rushed over and nurse mode took over. When she wouldn't wake up, slapped her and told her to "wake up" and "what did you take?" The other girl's parents were shocked by my response to the scene. I tried to tell them standing there watching was doing nothing for her and we needed to call 911. She was not acting as she had overdosed, and her pupils were not dilated, this was all an act for this family to see. I know right away it was a stunt but I had to be sure and send her into the ER. They pumped her stomach and received a lab report back on her blood. The doctor, someone I had worked with for several years took me aside and confirmed my suspicions, the so-called overdose on Tylenol that she had claimed was another lie. Her levels barely read a normal dose taken for a headache. How humiliating it was to be back at the hospital I had worked at for so many years with a suicidal daughter that wouldn't talk to me or my husband. You think this bad, it gets a lot worse! That evening, a county social worker shows up in her hospital room. She asks us if it was ok for her to talk to her. We said yes, please help us. Little did we know that that was the worse possible thing that could have happened. Because our daughter was a suicide risk, she spent 72 hours in the psych ward. They examined her and felt that she may have a borderline personality disorder. But, the counselor felt she more of a willful teenager than anything, trying to get her own way at any cost. She saw firsthand the manipulation, and the lying. We hoped for the best. They released her but the county was starting to take over. They placed her in a group home for juvenile delinquents immediately after releasing her from the hospital. We were reluctant but agreed to it. We started in-home counseling, marriage counseling, and my husband looked into anger management classes too. I cried all the time, I was forgetful at work and my coworkers were starting to notice. I really thought about quitting school, it would have been so easy but something inside me said stick it out, this will pass. By now I was in my senior year and only had to be on campus 1 day every 3 weeks. I didn't go that month, I couldn't do it. The next month I drove there crying all the way, stopped in a restaurant and turned around and drove home. My classmates thought I had quit. Our daughter showed the staff at the group home her manipulative ways, lied and got in trouble there as well. Meanwhile, the social worker met with us and assured us she would be home soon. The one thing I haven't mentioned so far is that my husband is not her biological father. She has always known this but has always called him Dad. The social worker looked up her biological father and his criminal record which was full of DWI's and domestic abuse for decades. At this point, he had not seen her or tried to make any sort of contact in over 6 years. Before that time, he had some visits with her until I learned he was using drugs around her. By law, social services had to contact him. He had been in contact with me through over the last 6 years. He had me in court at least every 3 months trying to get out of paying support and medical bills. When he heard she was in the group home, he and his wife drove down and started their con on her. He figured if he could persuade her to move in with them, I would have to pay him for child support. At the time, I made three times as much as he did and he knew it. We continued our counseling, meetings with social services, court appearances, and anything that would help us. Our daughter played the martyr to a tee; she told social services outrageous stories of abuse that didn't even make sense. After being in the group home for a month and a half, she could leave but she didn't want to go home because we refused to allow her to return to the post-secondary college. So, instead of social services insisting that this girl go home and listen to her parents, they set her up in a foster home that had no rules and basically let her stay out as late as she wanted, skip school, and have her boyfriend come over whenever he pleased! Meanwhile, we looked like the most horrible people because we had rules, insisted on returning her to the local high school, pointed out that her father was a really bad idea for possible placement. My husband finished anger management and his counselor said he saw no anger in him, just frustration and sorrow. We went to court several times and the social worker just kept putting things off saying she wasn't ready or the minor doesn't want to go home. We did everything the court asked ahead of schedule, even the judge started looking at this case as strange; we were good people caught in a willful teenager's game. My husband and I do not even have a parking ticket on our records! That time in my life I actually felt like I wanted to end it all, but can you believe it I did finish school? I ended up with a "C" in one class but otherwise graduated with honors. But before this, to make a long story short, I used reverse psychology on her; her father had convinced her to move in and she did spend a month and half there. He was on his best behavior but I knew it couldn't last. I told my husband to back off and let her see how good she really has it here. We started going on trips and trying to have fun without her as our main focus. It was hard considering 1/3 of my wages were being garnished at this point. Soon she was coming home on visits, starting to come around. Then the day before the court was actually going to give custody to her biological father, she confessed to me and her evil social worker that he had been using drugs around her again. Her father freaked and threatened to actually kill the social worker. After all those horrible months, it was over. She moved home and it was nice, but we had our struggles. She went back to high school and graduated, barely. We let her move out a month before her 18th birthday. Our younger children suffered too, all that energy spent on one child really hurt our other two emotionally. We kept up with the in-home counseling for another year and a half. This story does have a happy ending. I was called by my local community college to teach an evening skills class for the LPN program. The director of both the RN and LPN programs were nurses I had worked with as an LPN. They knew I had just finished my BSN and were interested in me filling in some spots at the college, I was thrilled! I know that all of the experiences we have in our lives attribute to who we are as people, and professionals. The last thing I would ever want to be is that horrible Army Nurse I had to endure in my LPN clinical. I feel that being an instructor is a great responsibility and not taken lightly. I find that the students will recall things I said in demonstration better than I do and how easy it would be to lead them astray. I also feel that I learn and grow as I teach. I am only an adjunct instructor right now, but I have interviewed for a full-time position just this week. I feel like I am at the beginning of my next journey as a nurse, my next adventure. I can't wait! As for my daughter, she is 20 now and doing great. We have our great relationship back and talk 2-3 times a day. She has said many times how sorry she is for what we went through but we all came out whole on the other side, thank God. As for that social worker, 6 months after this was over the state was there doing an audit and happened to pull our case. A state official called me and personally apologized for how badly this case was handled. She said she had to call me to verify the facts because a 10-year-old could tell who was running the show and we were persecuted because of it. We endured thousands of dollars in lawyer's fees, counseling, child support, and just plain hell. The sad fact is though she is still a social worker at the same office, with the same job, and lives only 3 blocks from our house. Good luck to all of you entering the nursing profession. If you can dream, you can do it!

Dear Patricia1101, I understand your situation all too well. When a nursing student has to put the things they learn from books and instruction into actual hands on activities, it is only normal to feel overwhelmed. It is when you are going to have the responsibility as the nurse that you start to feel the full weight of every decision you make. Be sure to ask for help from your instructor or even other staff nurses. I know as a student you will tend to feel like you are a hinderence to staff but they would rather you ask for help than to do something wrong on your own. Hang in there my dear! Your conscience is a good indicator that you care and you will be a good nurse and care giver. Those that do things just to get them done in the clinical setting without a care are the ones we instructors worry about. Always remember; no question is stupid, when in doubt, ask! Let us know how things go and good luck in your future!

It is sad that the situations we are put in as nurses are getting worse and worse everyday. I too worked in a LTC facility that was constantly under fire with the state and even the feds. I recall pulling into the parking lot in the mornings and instantly having a headache and a stomach worrying about what I had to deal with that day, what I forgot to address the day before, and how long I would be there trying to fix things. It is no wonder there is a shortage of nurses. We are working with bare bones staff, budjet cuts, and underfunded facilities that the state thinks can pull money out of the air to fix things that they are cutting! Reimbursement has dropped again, and everything else has increased. I can remember working 3 years without a raise! How many professions would allow that? I did quit that job and it was the best decision I have made in a long time! Best of luck to you in your future!!

I would also suggest you take the job and try it out. Any experience is good, even if it is a hellish situation. My first RN job was a Unit Manager straight out of school. I must say that it was a dream come true but I had to run my butt off. Being young is to your advantage as far as sleep deprivation and ability to run, but don't let it come between you and the staff. One of the worst mistakes I made was to make close friends with those I supervised. They took advantage of it and made it hard to delagate tasks or disipline. For example I caught one of my friends (an LPN) stealing pain meds. It was hard to blow the whistle on her but I had no choice. Best of luck to you my dear. You are entering the dog eat dog world of nursing. Let us know how this turns out for you. I think we should start a post for the husbands of us nurses. They really feel the stress of our crazy schedules, working long hours, and weekends or holidays we have to work. I know I would not be where I am without my supportive hubby!

One assignment will never leave my mind; it was quite a horrible experience! They called and offered me a job working at 3 pm until 11 pm, for three evenings in a row. They assured me it was an "easy" assignment taking care of a ninety-something-year-old woman in her home while her husband recovered from a hip replacement. They told me she was very sweet but had a short-term memory problem. She could not be left alone as she had very progressed Alzheimer's. She and her husband were married for about a thousand years and had no children so he was very concerned about her safety. I agreed to the assignment. It went from Sunday to Tuesday evening. I had to find a teenage babysitter because of the hours, I was never a fan of that but it was all that was available. I arrived at her home at 3 pm and relieved the nurse that had been there during the day. I should have known something was up when she practically ran out the door when I got there, giving me a brief overview of her care, meds, and routine. I introduced myself to the little old lady, who was sweet and quiet. We sat down and talked for a few minutes, and then she looked at me strangely and asked who I was again. This was only the beginning of the "memory issue." Throughout the evening, she walked around the house calling for her husband "Allen." I had to redirect her many, many times by telling her he was in the hospital getting better. Her memory of who I lasted for 5 to 10 minutes at the most. She was even frightened by my presence several times if she would leave the room then come back in and see me, the stranger in her home! This went on and on. I fixed supper with her by my side as much as possible, and as long as I kept her busy talking to me, I didn't frighten her as often. We ate supper, had her meds, and watched TV until it was her scheduled bedtime of 9 pm. I recall counting the minutes until I could leave; reorienting someone that often is exhausting! I got her ready for bed and tucked her in. I thought finally I could relax a little. After about 10 minutes, I could hear her moving around in bed, start crying, and then calling out "Allen" again. I came in to help which of course scared her but managed to settle her down again to sleep. This happened several times. After a few more times, I thought I would just let her fall asleep and not come in and scare her. Well, I heard her getting out of bed and moving things so I went in to help her. That's when I saw it, she had decided to load a handgun and place it near her because she was afraid to be alone and Allen wasn't home. I froze in my tracks! It was sitting on her bedside table, with two boxes of bullets! Of course, she saw me and got scared but luckily she was on the other side of the room from the gun. I told her who I was and talked her into using the bathroom before getting back into bed. While she was in the bathroom, I frantically hid the gun and bullets in the kitchen, shaking like a leaf the whole time! I helped her back into bed and tucked her in, by then she was pretty tired and finally fell asleep. Meanwhile, the whole situation sank into me. If I would have made any noise in the living room, she could have easily come out and shot me dead! Or just coming into her bedroom to help her, she could have blown me away! It was so hard not to cry thinking about it! I watched the clock and finally, 11 pm rolled around. "I made it!" I thought. Then it was 11:10, and 11:15 pm. Where was the night nurse? At 11:20 pm I called the agency. They told me that the night nurse had called in and they couldn't find a replacement. By then I felt like I was in the twilight zone! They told me I could go ahead and leave if I wanted to. I said "What? And leave her here all night alone, I can't do that!" Obviously, they didn't care if I lost my license, but I sure did! I was basically stuck! Called my sitter who was angry I was already late and couldn't sit for me all night. Just then, around midnight, someone was knocking at the door. It was the neighbor; she said she was notified by the agency that I couldn't stay the night so she could relieve me. I nearly cried! I told her about the gun in her room. She said, "Oh yeah, Allen has them all over the house; she probably has another one on the table by now!" After that statement, I promptly thanked her and left in a hurry. Did I mention this was in Montana? Well, it scared me pretty bad and I told the agency they could stick the next two nights where the sun doesn't shine!

There are so many different perceptions to the question of should I go for the 4 year BSN or be happy with the 2 year ADN. There are advantages to earning a 4 year but one should have a goal and a clear understanding of why they desire that advanced degree. When I worked at a hospital, there was only a .25 cent difference in pay for two more years of school. But, if your goal is to teach or be a Public Health Nurse, the additional 2 years can be worth it. I went back a year after taking an ADN program and board exam. I now work as a Public Health Nurse and part time LPN instructor, both of which require the BSN level of nursing. Many more doors open up to the higher degree. I loved the BSN program, much less stress than the ADN program. I guess I did mostly for myself and don't regret any of it.

Your story and the replies from other nurses who cared for terminally ill people really compell me. I had an experience when I was 12 years old I will never forget. My grandmother was dying in the hospital of bone cancer. She was such a huge part of my life and I was closer to her than anyone else, even my parents. I was holding her hand and telling her what I had done in school that day when she passed. I felt her hand go limp and I looked at her, with a peaceful smile on her face. She had been in so much pain. Anyway, I looked at my parents who were crying and some how, felt myself come out of my body and saw them from the ceiling. I can't explain it, but I clearly saw myself, my parents, and my grandmother for a few seconds from above the room. I felt no sorrow, just peace. I quietly said "I will go tell everyone she is gone (in the waiting room)." I was able to walk to the door then I felt like I crashed down into my body and starting to sob. I know it sounds crazy but it did happen to me. I can't figure out how but I feel like her spirit clung to me for a brief couple of seconds before she went to heaven. That night, I had a very clear dream. I walked down this dark tunnel holding her hand. When we got to the end, there was a bright light. She stopped and looked at me and said "I have to go now, But I will be watching over you." And then she walked into the light and I woke up. I have never had any kind of experience like this before or since.

Good advice "WorkingTheStreets." I have had people ask me to be a reference for them and it is always an area where I hate to go. I have found that you never know who the person on the phone is, and if your intent was misleading you could be slapped with a slander suit. I only give references to DONs I know personally and trust. If not, I will verify dates of employment ONLY! I have had to politely hang up on a couple of employers that wouldn't stop trying to get info out of me! It is a tough world all around out there, be careful what you do and say when it comes to employers.

I agree with the other posts about the coworker not only dishing up meds, but signing them out as given! As a former unit manager, I would have chewed some behind on that! You sound like you have big plans and going for the higher degree is always a struggle with juggling job and family. If you have your BSN, maybe public health would be a good start for you. A Maternal Child PHN could be the way to go. I have worked in long term care and know of the short cuts, short staffing, and frustration. I have been a PHN for almost 3 years now and it is great! Look into it! Best of luck to you finding your nitch!

Your story is so moving. I have a few friends who have lost children to SIDS and I can't imagine the pain you must feel. Best of luck to you in your future nursing career. I am sure your compassion will make you a wonderful nurse. God Bless you and your family.

Bravo! I especially like your comments about the twenty year olds! I work part time in LTC and boy they think I must be blind when they are sitting feeding residents with one hand and texting with the other! I don't understand it! When I was a CNA years ago, you had respect for the residents and facility! But yes, let's be glad we are working:yeah:

Over a few months, we had a rash of cancer patients on our ward. The time period was somewhere in the early 1990s. We had many end-stage patients, most were elderly. But there was one young woman I will never forget. She was in her early 30's. She was married with three small children. She had colorectal cancer. From my recollection, we had admitted her a few times over the previous year as she was receiving chemo and needed IV fluids to rehydrate her from the side effects. Our medical surgical floor had a variety of acute cases, but back then, we served many end-stage patients that probably would have been sent home on hospice or a nursing home today. So it was always interesting and sad at times too. A lot of time was spent on talking with families, explaining end stages choices, and comfort care practices. The young woman, who I will call Brenda, was told that her cancer was not responding to chemo, and to make her final arrangements and decisions. We tried our best to give her family the privacy and time they needed to do this without a bunch of us nurses lurking about while trying to remain supportive. How awful I felt every time I came into her room, trying to make small talk to a woman not much older than I was, knowing she was dying. She was, of course, sad and very quiet. She offered little conversation and limited what she said to simple requests for pain meds or another blanket. Her husband must have been about the same age. He looked pretty tired and washed out. He too was not open to many conversations. Our social worker tried to talk him into incorporating hospice services but he refused, I am sure it was mostly shock and disbelief of the whole situation. The children were confused why Mommy couldn't come home. The oldest was maybe 8 or 9; he knew something was terribly wrong. I would guess the other two children about 5 and 3, with the youngest being a little boy. The younger two children would be trying to play while visiting, only to have everyone else in the room very unresponsive to any happiness or laughter. Many times we would offer them an ice cream treat to try to lighten the mood in the room, soon they got to know which nurse to approach for a treat when they came. Then, the husband started coming up alone. I couldn't help but hear them discussing talking to the children about how serious the situation was, and how they needed to do this soon. Brenda was receiving heavy doses of Morphine to control the pain, and her abdomen was filling with fluid. She was also told the cancer had spread to her liver. As any nurse with some experience caring for end-stage cancer patients can tell you, there is a distinct odor a patient will omit when they are terminal. Even if they are clean and continent, the odor is present. We began to sense this odor in Brenda's room. We knew she was drawing nearer to death. A couple of days later, in the evening, the three children came in with their father to see Brenda. Of course, ice cream was given out to 2 smiling faces, and one not so happy. Seeing their mother so weak and frail was wearing on the oldest, it was very apparent. He tried to hide his tears when we would enter the room. I knew the primary bag was running low, and soon I heard the IV beeping as it was almost empty. When I came in to hang a new one, I really wish it could have waited a few minutes more. I did knock, but unfortunately, I came in during the midst of the big speech Brenda was making to her children. She said, "I am really sick and I am not coming home again guys, I am sorry." The news was too much for the oldest, he knew that she was very ill, but no one had voiced it to him yet. Hearing those words sent him out of the room to the waiting room crying and again trying to shield it from anyone in the hospital ward. The two younger children began to ask innocently "why?" Brenda continued to talk very softly about how she was not going to get better, and God wanted her to come to heaven to be with him. She had such grace to her voice, she knew it could be the last conversation with them and repeated how much she loved them several times. It was a conversation no mother would ever choose to have to make, but she did it very well. I was starting to cry myself as I spiked the bag and tried to punch in the numbers through blurry, tear-filled eyes. Trying to stay focused and professional was very hard; I wanted to be invisible at that moment so I wouldn't take any attention from the situation or my reaction to overhearing that intimate conversation. It was only a few minutes in the room, but it felt like hours. After I left the room, I went down the hallway, ignoring my co-assigned who was trying to tell me she was going on break. I brushed past her and went into the bathroom and cried. I couldn't tell you how long I was in there, but soon my co-assigned came and knocked on the door to ask if I was alright. She had no idea what I had just witnessed. I said, "just give me a few minutes and I will be out." I have gotten used to caring for patients during their last days, cleaning them up and preparing them for the funeral home; it can become too routine. For the case with Brenda, I took it in pretty deeply. Seeing the faces of the ones she was leaving behind, wondering how they were going to handle being without her really haunted me, it still does to some degree today. As nurses, we are expected to care for our clients, regardless of anything. It makes us professional when we can handle anything with a straight face from bones sticking out of the skin to an abused child. But we are not robots; certain things sink into our thick skin, and remain there forever, like a scar. Brenda really sunk into my skin. I guess it was because I too was a young mother at the time. My kids are my whole world, and the thought of leaving them behind at such a tender age would have been too much for me to even imagine, or want to imagine. Brenda went downhill fast after that evening. She lingered for a few more days but was unresponsive. It was so hard to face her family in the room, waiting for her to pass. We kept her clean and comfortable. They knew when we came in every couple of hours to step out without even having to ask them. She was 32 years old when she finally passed. Her husband was alone with her when she took her last breath. He did eventually allow the hospital social worker to help with finding resources to help him and the children adjust to life without her. I wonder about him and the children from time to time.

I have been trying to make a decision for over a year now and I thought I would post this to other nurses that may have been in my shoes. I have been working for almost 3 years in a Public Health setting, or a desk job which is very quiet and easy going. My clients are over 65 and I case manage thier Elderly Waiver Programs. I like my job, The hours are great (no weekends, holidays, or evenings), and I love my boss to death, she is great! The problem is that I feel so unchallenged and held back. I worked in LTC for the first 2 1/2 years after I got my RN and then this job fell into my lap half way through my schooling to become a BSN. Another thing I like about my job is that it is very flexible and has allowed me to teach part time as well. What I really want is the hospital experience. I am looking into going for my master's degree in the next few years and let's face it, I am getting rusty sitting behind a desk! I know I need the acute care experience. So any advice out there? I worked as an LPN in a hospital for many years and maybe I miss that challenge. Going part time is not a good option because the insurance is outrageous and they only want a full time employee. Help!!!

You have to protect your license and not get caught up in a potential malpractice suit. You as the nurse are the last line of defense for the patient/resident when it comes to giving ANY medications. Have you gone to the unit manager? DON? Believe me, if this woman dies of an overdose at your facility, I doubt the MD will back you up. If this woman constantly wants pain meds, document exactly what she says, rate the pain, and what she was doing prior to the complaint. Then, start with a psych consult. Does she have a guardian? If none of this helps, I would talk to the MD. Call him constantly about your concerns and document his responses. Good luck to you!

caliotter3, I'm sure that there are many nurses in the same situation you are in. The hospital I used to work at permanently laid off almost all of it's senior staff to cut costs and then turned around and hired all new grads, at significantly less pay at part time status, but scheduled full time as a skeleton crew. As with most health care facilities today, they look at the money, not the care. I hate how I feel about this job, it is the job I always wanted. It works so well with my family time. I think I will check into the per deim idea, and put the teaching aside for a year. Thanks to all that have posted. Caliotter3, hang in there, I hope you find a great job. As the baby boomers continue to age, nurses will continue to be in demand. Take care.

I hope I don't come off sounding ungrateful for my present job, because I did my time in the trenches of double shifts, holidays, night shifts, short staffing, all that. I remember VERY vividly those days. I worked very hard to get to where I am today. I guess some of us are just not cut out to sit behind a desk 40 hours a week. I have been doing this for almost 3 years now thinking I would adjust. I apppreciate all your comments and input.

That is a really interesting way to make a living. As others have posted, it would be interesting to talk with you about this and setting up something like this myself. I live in a rural area and I know there is nothing like this around. Please email me when you have a chance, I know you are busy!

Reading your story was like reliving the exact same experience I had taking the RN boards! I was sure I failed when that screen went black after 75 questions! I remember going through the security fighting to hold it together until I could get myself into my car and cry my eyes out, which I did. I called my hubby and could barely get the words out that I was sure I must have failed! A few days later, I checked the sight and found I had passed! What a relief and again crying but this time for joy! When I took my LPN board exam back in 1992, it was all on paper, and you had to wait until you were notified my mail about 6 to 9 weeks later! I was told if it was a big envelope, you had failed and it was paperwork to reschedule the exam, which was only given in Minnesota twice a year. If it was a small envelope, you passed and it was your license. Well, it was a medium sized envelope and I had my husband open it, I passed and was very very happy! But back then, most of the questions were pretty common sense and I felt sure I had passed. With the RN boards, it was way different. Congrads to you for passing. It is a great accomplishment no matter what age you are!