ILoveRatties

Bpd = borderline personality disorderNOT bipolar.

Maybe I should contact the person at the DOH to whom the daughter spoke?

Suanna, too bad you are wrong. The suspension was without pay and there was no investigation, just falling over themselves choosing a disciplinary approach to me. No questions asked, period. The suspicious thing is, is this woman had already talked to my manager while her mother was still alive, my manager spoke to me, and all was well. The woman had snapped on a couple of nurses, and kicked other nurses off her mothers' care. We all knew we were dealing with someone not of sound mind. It wasn't till a week or so after her mother's death that she called the DOH. And insisted on speaking with someone 'high up'. So, I get suspended without pay for 2 days, and every move I make is being watched, families and patients questioned after I care for them, every little bit of documentation being reviewed, pretty much hell. I was the one who tried, gently, to point out to the woman that her requests were inconsistent and not in her mother's best interest. Me 'pushing back' in the face of her furious demands infuriated her more and made me the focus of her craziness. I took care of her mother for eight hours, only. But her diatribe to the DOH painted me to be cruel and dangerous. My place of employment is treating me as though I am very likely cruel and dangerous and that they are doing me a favor not to fire me. My policy with BPD or NPD people is to avoid them at all costs, because they either use people or abuse them, and leave chaos and confusion in their wake. Unfortunately, I had already started advocating for the patient before it became clear that the daughter's agenda was all about the daughter. I am contemplating contacting the 'normal' daughter and asking for her support. The one who apologized for her sister and thanked me for trying to help their mother. Unfortunately, the families of BPD/NPD people also have learned not to 'cross' them and try like crazy for peace at any price. I don't know who I'm more angry with: the crazy, hateful daughter or my employer for totally caving to the DOH. It's like they are all of a sudden looking for a reason to fire me. Work has changed like night and day.

I took care of a pt who had a daughter who truely was borderline personality disorder. DeLing w/ her was crazy, as those familiar w/ bpd know. The pt was end-stage and the daughter's vehement; furious demands were contrary to the patient's best interests. Anyway, I advocated for the pt and her needs. The daughter was furious. I only cared for the pt once, as the daughter asked that I not care for her mother. The pt's other daughter was very apologetic about her sisters behavior, and begged that her mother not suffer, which I totally agreed with. One day later, the MDs forced the issue and the family made her comfort measures only. She died peacefully shortly thereafter. The crazy daughter saw me as the family wad leaving the hospital and yelled awful things at me. Well, it turns put that she called the DOH, and the hospital is frantic to satisfy the DOH, and I was suspended for 2 days via a phone call from my boss. I was not obnoxious at all, just tried to sort out the truely wrong demands of this woman. The other sister was completely fine with me and appreciated my efforts to help this family understand end-of-life options. I've been through it personally more than once, and have always been thanked by families whom I have helped through that experience. I am angry that I am the hospital's sacrificial lamb to satisfy the DOH complaint. What, if amything, should I do?

This just in, boys and girls: AGH is going to team up with Highmark and Cleveland Clinic, and all patients with Highmark insurance will HAVE to go to AGH. That is going to cut patient admissions to UPMC facilities by 25%--ooh, cut on the chin to the Evil Empire. This is NOT a rumor. The free flow of money at the UPMC hospitals has come to a very screeching halt. Too bad, since I work at one of them.....

I'm sorry for your situation.

Even with West Penn downsizing dramatically and so many of those nurses flooding the job market, UPMC is hiring nurses all the time. Passavant just underwent a huge hiring period. McKeesport has lots of positions listed. UPMC East will be hiring to staff an entire new hospital. UPMC is plowing money into Mercy, Passavant, UPMC East, Childrens.

Both Hershey and Geisinger have outstanding reputations, all the more amazing in that they are well outside the areas of the 2 huge cities in PA, those being Pittsburgh and Philly. Country living, tertiary facilities.

It's been 2 years since I withdrew. For those in the same shoes, you can't let it ruin your life. It took a while to recover from what I truely believe was PTSD, and I could have stressed out over the debt. I'm past that now. You will not become homeless as long as you can work as a nurse. True, because of the debt, I will not be leaving my kids much of an inheritance, nor can I pay for expensive colleges. I regret that alot. But it's water under the bridge. Can't be undone. You just have to come to some kind of peace with it all. Your life is NOT OVER, you will be happy again, you will adjust to having a huge student loan debt, you will work full time until you drop, lol. But every day I go to work happy to be doing something I enjoy and am very good at. I appreciate the collaboration and respect given and received. I have never for one second missed the OR nor doing what CRNAs do. They can have it. Money isn't everything. Each to his own. It's vital to let everyone know that choosing a professional direction because of the $$ is a bad idea. At least it was in my case. I never thought of what CRNAs do as the pinnacle of nursing. I always just saw it as another specialty. I thought I would learn how to do it, then do it until I retired. But with all the BS SRNAs are put through, I think that it helps alot if you want to be a CRNA more than anything else in the whole world and if you really hate bedside nursing. Neither of those applied to me. Plus, I already had an APN role I enjoyed. I thought I needed the big bucks. I'm living without them.....

The question being asked is not about schools that do not require the GRE at all, but those that waive if for people who have already taken it. two thoughts 1. just why should one be required to retake the GRE if you have successfully completed an MSN program. 2. why make it a matter of deciding where you go?? Unless everything else is equal, just study for the thing if you are required to take it and pass it again.

I'm going to stand by my "pretty clueless" assessment. In no other Advanced Practice role education would this subject even come up, let alone having been condoned for decades. When I envision APNs, I think of mature people with true self-respect and a love of nursing. I think of nurses who respect other nurses and who delight in mentoring younger nurses. There are a whole lot of forces at play in the OR in ACT practices. It's a hard place to be an APN. CRNAs give a great anesthetic, with all that entails. They do things that other nurses are not allowed and are not able to do. They know alot about their specific area of practice. This is just the beginning of Advanced Practice in nursing. I saw VERY FEW CRNAs who ever showed one iota of being anything other than good administrators of anesthesia and survivors in the OR culture. What a practitioner thinks of him/herself is very evident in how he/she treats students. I think I can safely say that there is no other APN role with this reputation of treating students horribly AS A PART OF THE CULTURE.

It's been a while since I posted to this thread. I agree with the person who said that hazing is condoned and perpetuated because of political reasons. That hits the nail on the head. It has everything to do with the need CRNAs have to be seen as being as good as MDAs. An extremely insecure group, in that regard. I think the only place any self-respecting CRNA would work would be either in private practice or in the military. I was surprised at how little self-respect CRNAs in ACT practice had. And really shocked by how much they kow-tow to MDs, both surgeons and MDAs. They are obsessed with 'looking good' to MDs. And I was never around so many nurses who hated nursing. And who totally dissed non-CRNA nurses. And those people with no true sense of their role except as it was valued by MDs tell each other all the time that they are the 'cream of the crop' as far as nursing goes. I consider them pretty clueless as far as advanced practice nursing goes. ILoveRatties, RN, MSN

I think the OP significantly overstates the patient assessment and intervention done by OR circulators. I spent a year as a SRNA and, believe me, it is the CRNAs who have that major role. The surgeons do the surgery, the CRNA takes care of the patient, the scrub techs hand off instruments and supplies to the surgeons, and the circulators do something else. I think they take care of the environment--assuring that everything goes smoothly. The OR is like an alien world, and the OR RN assures safe passage for the patient. They are keeping track of the big picture. They have to know everything about the big picture that can go wrong, how to prevent it and what to do if the **** hits the fan. The CRNA monitors all the vital signs, gives meds, intubate, oxygenate, etc., etc. including induction, maitenance and emergence from anesthesia. The OR RN doesn't write a vital sign down nor track any of that during the surgery. They assure proper and functioning equipment, supplies, assist with positioning at the beginning and throughout the case. You can say 'go-fer' but that's insulting and incorrect. The OR RN is not sterile and not doing the second-by-second monitoring of the pts condition, so is free to be able to move around the room and leave the room to get things, etc. I wouldn't like to have a non-RN keeping track of the big picture during my surgery. All I know is that everyone in the room was aware when there was a newbie or an incompetent circulator running the room. It affected everyone else. All the roles are necessary in the OR. It is sort of like being a coordinator. Assuring that things run smoothly. The CRNA, scrub, and surgeon are very very focused on their own thing during surgery--the OR RN is free from that, but does what no one else can do--pay attention to the big picture. What they do is important. The best OR RNs might look like they are doing nothing, but that is because they have it all under control. For sure, it is a unique specialty in nursing. The OR nurse doesn't need to do much of the hands-on patient things. Someone else is doing them. No one develops much rapport with the pt--the contact is too short-term. The pt is usually asleep and if not, the CRNA is at the pts head doing the talking, touching, reassuring etc. No, it is not like bedside nursing--that kind of nursing is for the bedside. The OR calls for caring for the patient in another way--but it is just as much nursing.

Gilli, I sent you a PM. Please read it before you decide.

There seems to be a real hiring slow-down in Pittsburgh. The stock market slump affects hospitals capitol improvements but the decrease in Medicare reimbursements affects the daily operating budgets of the same hospitals. This seems to be a time to take any nursing job one can get, and be happy about it......There will be little picking and choosing on the part of the job-hunter--its now a sellers market. I have not been working for 1.5 years, going to fulltime grad school then dropped out, I have 30 yrs experience, and I'm having trouble getting back in. AGH is mostly just hiring casual staff. Except there are like 6 positions posted in the coronary step-down unit. I've worked CTICU forever.....but will probably be spending most of a year doing floor nursing....if I'm lucky.... NOT a great time to be a graduating student nurse.....I feel for you guys. Hopefully my man Obama will get this economy turned around.