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MsLoriRN

MsLoriRN BSN, RN

Med-Surg; ER; ICU/CCU/SHU; PAR
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MsLoriRN has 25 years experience as a BSN, RN and specializes in Med-Surg; ER; ICU/CCU/SHU; PAR.

MsLoriRN's Latest Activity

  1. MsLoriRN

    A Question to Nurses and Nursing Students.. HELP ME!

    Yes, you will get used to it. We all do, and we all have stories about our early reactions to "goo" in nursing. There will always be something that is tough to take, but you'll get through it with enough exposure to it. As for the responses that included things like, "some specialties don't get exposed to blood/guts/whatever, so go into those specialties," I would just have to remind all future nurses that to get to those specialties, you have to go through nursing school. And then you usually have to get experience on the floors of the hospital as an RN. So you'll have to deal with it before you can get out of it! Be sure you know why you want to be a nurse...be sure you know it's what you want...then you'll find your "how" to deal with the rough spots. Best of luck! MsLoriRN:nurse:
  2. MsLoriRN

    What is it REALLY like for new grads right now?

    Hi, Jamie! Just to encourage you, what you are seeing is, indeed, job cycling related to the extreme recession. Nursing has been through this before...I was caught in it as a new grad back in the early/mid-80's! It is complicated by the retirement of baby-boomers, both from bedside nursing and especially from positions in academia (teachers). It's the latter that causes the difficulty getting into nursing schools at this time. It's partly the former that is causing hospitals to request experienced RN's, because it takes a year of working in REAL nursing (school clinical rotations will NOT give you this) for a new grad nurse to become self-sufficient as a bedside nurse. That coupled with an influx of experienced nurses coming out of "retirement" due to spouses out of work allows the hospitals to pick and choose. So it's a complicated time, but if you REALLY want to be a nurse, you'll get there! Just make good and sure it's what you want to do. You think you're miserable behind a desk? Go into nursing for any reason other than that you really want to be a nurse...you'll know misery there, too...maybe worse! Good luck! MsLoriRN:nurse:
  3. I've heard from hundreds of them. Among the most oft-asked questions I receive is this one: "I think I would like nursing, but I'm worried about my back...will I be able to take it physically?" In response to a question posted on this forum, I composed the majority of what I've decided to share in this article, in hopes that it may help more than just a few. I recently read a Washington Post article about proposals in some circles to provide nurses with mechanical devices to assist with patient lifting, transferring, turning...the things that typically cause strain on the back and neck of a nurse. Arguments against such devices ranged from cost issues to general resistance from nurses because of concerns about patient dignity. While these things are argued and debated, nurses will, on a daily basis, be required to lift, transfer, and turn their patients. Discussion and debate are good...but they do not do the work of the nurse, and won't likely be implemented for some time to come. So, in the meantime, allow me to share my experiences and what I've learned, in hopes that it might help a fellow nurse with an aching back, or prevent a student nurse from receiving an unnecessary injury, or help someone considering nursing as a career who is concerned about the potential for injury, to hear one nurse's experience and ideas. Of course, I wouldn't be a proper, modern nurse if I didn't insert a disclaimer here...this is only my personal experience...I cannot guarantee anyone an injury-free nursing career, nor healing of an existing injury. You need to take care of your own back, and, if you're already hurt, see your own health-care practitioner for treatment and advice before you try any of my tips! Glad that's out of the way! Personally, I have many years of nursing under my belt and have done so with a "tender back" for a number of them. My very worst years with back pain were, oddly enough, when I was a student nurse! I believe it was because I didn't feel comfortable, as a student, asking the other nurses to help me, and so I would do too much on my own...things that the staff RN's probably would not have done on their own. I would often walk back to campus bent over--literally--with each step sending pain shooting through my lower back, and then spend the next 12 hours on my heating pad! If you wonder whether or not I was worried about becoming a nurse, I was. But I wasn't about to ask my nursing school instructors if I could "skip clinical because my back hurt." I figured that was a good way to be shown the door. So I just gritted my teeth and kept going. I picked up bits and pieces about body mechanics, but either not enough, or I didn't apply them correctly. Sometimes you just can't, when things get really hectic. I finished nursing school, received my BSN, moved to my fiance's location, and found my first job at a major metropolitan teaching hospital. It was there that the "recovery" began. What I learned, starting from that point and continuing over the years, allowed my back to not only heal from it's early insults, but to strengthen and stay healthy. Again, I can't promise the reader anything...but if it worked for me, it may just help you, too. Here is my advice: #1. Learn the body mechanics, learn them well, and take the lessons seriously. As a professional RN (as opposed to a student nurse), the first "orientation class" my hiring hospital sent me to was one on body mechanics, taught by the P.T. department. If you've been through PT, you probably know that those folks are able to "move mountains." That is to say, they can work with folks who require major assistance...because they understand the concept of "leverage." Granted, their equipment can be sophisticated, but it isn't always. They just know how to do it. If you could somehow connect with a physical therapist for just 1/2 an hour of body mechanics training, you'll be off to a great start. But it is just a start. #2. Do not hesitate to ask an RN (or a fellow student nurse) to help you with a lift, or a boost up in the bed (which you will do non-stop as a hospital nurse!). It's those little things that we "think" we can do on our own that injure the back over time. Yes, it takes time to get a helper to join you. Your patient will have to wait an extra minute for a boost, and they may not like it. But you will need to keep in mind that to them, it's just one boost. But for you, it could be the 100th boost you've given that month. If you do them improperly, you WILL end up with a bad back. Done properly with the correct amount of people, you should be able to do everything safely. That said, we, as a nation, are growing heavier and heavier. Morbidly obese patients are common, and they are less able than anyone else to reposition themselves in a hospital bed. This does put the nurse at a greater risk for injury. But what of the nurses themselves? Are we in much better shape than many of our patients? It's time to consider our own bodies, and what we can do to try and prevent a back injury. #3. This one is for ALL nurses, of all ages: did you know that weak stomach muscles are a common cause of lower back pain and injury? Most all of our muscles have "opposing" muscles...just as your biceps oppose your triceps. When one contracts, the other relaxes, and vice-versa. With the lower back, your abdominal muscles are the "opposers," so to speak. We have to work to keep our abdominals in shape. A muscle that is in shape, or "toned," looks the way it does because it is always in a slight state of contraction. That's why, with weightlifting, the muscles seem to "stand out," and contracting them on purpose enhances that. (Think the "6-pack abs" picture.) Do you use your abs in such a way that they're toned, every day? Most of us don't. But we DO use our backs in such a way that they're somewhat toned, in our everyday bending and lifting, and nurses use their backs a lot. In the end, our back muscles are more toned...so they contract slightly, which shortens them; this causes the arch in our lower back to become more pronounced. If our abdominal muscles were as strong as our back muscles, they would be in a state of equal contraction, and would, thus, shorten and "pull" the spine back into more natural and healthy alignment. But most of us have strong backs and weak stomachs (no nursing pun intended). Our weaker abdominal muscles are not compensating for the contracted back muscles. I learned that If I did "crunches" (situps), my stomach muscles would become toned, and would "pull" the back muscles into a better balance. Without the balance, the lower back arches too much, and the vertebrae begin to compress the intervertebral discs. Over the years, you can suffer herniated discs and other lower back problems. My advice? You've got it...do those crunches! You do NOT need to join a gym...do them in your living room. You don't need to do 100 of them...start with 8. Your abdominals will ache! That means you're using them. Look for video instruction online (like this one, HERE) if you're new to crunches to be sure you're doing them correctly; if you do them wrong, you can do more harm than good! And if you already have a back injury, check with your health care practitioner before you begin exercising. I hope this will be of help to you as you go about your work as nurses. Hopefully, someone will come up with a mechanical/technological solution to this age-old problem we face...until then, do your crunches, and help your fellow nurses with their transfers, so they'll help you with yours. Take care of yourself, as well as your patients!
  4. MsLoriRN

    Nursing and Back Problems

    Hi, I have many years of nursing under my belt, and have done so with a "tender back" for a number of them. My very worst years with back pain were when I was a student nurse, oddly enough! I believe it was because I didn't feel comfortable asking, as a student, the other nurses to help me, and so I would do too much on my own...things that the RN's would not have done on their own. I would often walk back to campus bent over like an old lady, and spend the next 12 hours on my heating pad! What I learned, over the years, are things that you likely had to learn post-op. So you may be way ahead of the game. But here you go: 1. Learn the body mechanics, learn them well, and take the lessons seriously. As a professional RN (as opposed to a student nurse), the first "orientation class" my hiring hospital sent me to was one on body mechanics, taught by the P.T. department. If you've been through PT, you probably know that those folks are able to "move mountains"...that is to say, they can lift/assist/walk with folks who are almost "dead weight"...because they know how to do it. If you could somehow connect with a physical therapist (how about you contact your orthopedic surgeon who did your back surgery?) for just 1/2 an hour of body mechanics training, you're good. 2. Do not hesitate to ask an RN (or a fellow SN) to help you with a lift, or a boost up in the bed (which you will do non-stop as a hospital nurse!). It's those little things that we "think" we can do on our own that injure the back over time. Done properly with the correct amount of people, you should be able to do everything safely. 3. This is for ALL future nurses, not just those with rods in their spines: did you know that weak stomach muscles are one of the most common causes of lower back pain and injury? Most all of our muscles have "opposing" muscles...like your biceps is "opposed" by your triceps. When one contracts, the other relaxes, and vice-versa. With the lower back, your abdominal muscles are the "opposers," so to speak. We have to work to keep our abdominals in shape. A muscle that is in shape, or "toned," looks the way it does because it is always in a slight state of contraction. That's why, with weightlifting, the muscles seem to "stand out," and contracting them on purpose enhances that. (Think the "6-pack abs" picture.) Do you use your abs in such a way that they're toned, every day? Most of us don't. But we DO use our backs in such a way that they're somewhat toned, in our everyday bending and lifting, and nurses use their backs alot. In the end, our back muscles are more toned...so they contract slightly, which shortens them...while our stomach muscles are NOT compensating for the shortened back muscle. If we did "crunches" (situps), our stomach muscles would also be toned...contracted...shortened...and that would "pull" the back muscle into balance. Without the balance, the lower back muscle contracts/shortens, the back "arches" slightly, and the vertebrae press harder on the intervertebral discs. Over the years, you can get herniated discs and other lower back problems. The solution? You got it...do those crunches! You do NOT need to join a gym...do them in your living room. Look online if you're new to crunches to be sure you're doing them correctly; if you do them wrong, you'll do more harm than good! I hope this helps some...and I wish you all the best as you consider the profession of nursing! Email me if you have other questions. MsLoriRN PS: There are plenty of options outside of bedside care for nurses...I write about them...but you DO have to get experience FIRST, so please do count on having to work in a hospital at the bedside for at LEAST one year. It is not likely that you can work in labor/delivery/nursery right out of sschool...too many nurses want in there!
  5. MsLoriRN

    Some Help Please

    Well, it's difficult for any of us to say what you should or should not do, but here goes... First, finish your bachelor's degree. You're probably planning to do that anyway, so that one was easy! Second, it sounds like you have young children at home. Anything you can do to be at home with those kids is the best thing you can do. If you absolutely must work, and you can get a job with the summers off and can afford to take that time off, then you have a couple of serious questions to ask yourself (this is my specialty...asking future nurses to ask themselves questions to see if they really want to be nurses!): 1. What is it that you think will be so much better about nursing than teaching? Nursing is a wonderful profession, yes, but you will have many challenges to the altruistic image of the "angel of mercy" just as you will find in the wonderful profession of teaching. In nursing, it'll be long hours on your feet, rotating shifts that will be exhausting, heavy patient loads, dealing with clients (patients and their families) who are "not at their best," etc. Don't get me wrong...there's a lot that's great about nursing. But you have to have a strong "why" in terms of why you really want to be a nurse if you're going to be able to figure out the "how" when the going gets tough and discouraging, and it will. 2. It sounds as though you've only worked one teaching-related job and have spoken to one friend in the public school system--is that correct?--so you may be making a "snap judgement" about your future in the profession. My friend, I do not know of any profession where you won't find things that are a disappointment, that are not "ideal," that are not filled with disillusioned people. Do a Google search on "I hate nursing," and you'll find over a million results! But try a search on "I love teaching," and you'll read fantastic things! Why not focus your career efforts on being a better teacher than the ones who are only concerned about their salaries? Be the one who makes a difference in the lives of her kids (in the classroom...and at home, too!)...read the stories and writings of those who've won the "Teacher of the Year" award, and aim high! If you went into nursing, I would tell you the same thing. The young nurse who "bails out" because work is hard, people are not nice, another nurse was mean to her...either bailed out too soon, and could have had an incredible professional life ahead of her if she'd taken that tough time and used it to make herself stronger and better and kinder to the next generation of nurses who came behind her--OR she perhaps was not ready for the realities of nursing to begin with, or wasn't compatible with the rigors of the profession. This isn't a "pass" to people in our profession who for no acceptable reason make life hard for other nurses...consider them losers with a capital "L." What it is is a call to those in the profession who care about the profession to be bold and be public about making it better from the inside, in any little or large way that they can. 3. Here's the last question, and in my personal opinion, it's probably the most important...will this be the best choice you can make for you children? When you had them, you obviously were concerned about that...and that was good! I would dwell on this question for a long time. You can go back to school later in life...but you only get one shot to raise your kids well. I don't think this made your day any easier...but I am all about people working within a framework of reality about the good and the bad about nursing. I receive a lot of inquiries about becoming a nurse from people who are looking at it only because they know there is a demand, and the news said it was a "stable career." That's a bad reason to go into nursing, if it's the driving force! For you, you sound like someone who really wants to make a difference for others...and that's awesome! But I don't know that you'll be any less disappointed in the harsh realities about nursing than you are right now with a couple of experiences with teachers. I would probably advise you to finish your degree, and go to work for a while...give it 3 to 5 years, and do your level best to be the awesome teacher that you desire others to be. If it's not a match for you, then look into a new career if you feel you must. I do wish you all the best, and encourage you to continue working hard to change the lives of those around you for the good! MsLori, RN
  6. MsLoriRN

    Help with deciding becoming a nurse or occupational therapist!

    Hello, You may want to check around to see how the OT profession is looking in this economy. For the vast majority of potential nursing students that I talk to, I do NOT recommend that you choose nursing because of perceived salary or security benefits! (They are not quite what the media portrays!) But from your post, I have a sense that you've already begun to look at the things that I like to see a future nurse consider. I would advise you to consider if your short term goals require a BSN, or if an Asoociate's degree would work just as nicely for you. The BSN may end up costing you more than it would be worth, given what you seem to be indicating your interests and your "driving force" in all of this may be! I wish you all the best as you pursue your interest in nursing; email me if you had other Q's. MsLori RN, BSN
  7. MsLoriRN

    Advice for prospective nurse...

    Hello, To answer your questions, most days I've loved being a nurse and some I wished I was doing anything else...doesn't that sound like every other career you could pick from? As for whether or not I recommend it, that depends entirely on you. I speak to a lot of prospective nurses. I've written books for them, I counsel them...some I know would make fantastic nurses, and will love their nursing careers. Others I know would likely end up joining the ranks of those who say, "I hate nursing" and walk away from their careers frustrated and hurt. To get you started, I would tell you that the best thing you can do is not necessarily to ask nurses if they like being nurses...but start asking yourself, why are you thinking about becoming a nurse? What is it that draws you to this profession? What is it about yourself that has lead you to think nursing would be a good "fit" for you? Are your expectations about the profession realistic? (Note: if you're looking at a weekly TV show and getting ideas, dump them.) What do you know about being a nurse? Nursing isn't easy...academically, emotionally, work-environment...yet it is rewarding for those who have the "why" of their being a nurse figured out in order to give them the "how" of getting through the parts of the job/profession that can be gut-wrenchingly difficult. If I've given you more questions than answers here, that's good...for it is where you need to begin! I wish you all the best as you consider our profession for your future! Ms.Lori, RN BSN
  8. Hello, I have a few thoughts for you: Have you thought much beyond getting out of nursing school and getting a job in the hospital? Is there some specific reason that you are planning to get your BSN? If you do not have a specific goal in mind in the short term that requires the BSN, I wouldn't do it in your situation (working mom, unable to handle the debt-load that the BSN will lay on you). Get your Associates degree. You will take the same NCLEX exam, and, when you pass it, you will get the same RN license, and you will be paid pretty much the same salary as the RN who has a Bachelor's degree...but you will NOT have the crushing debt to repay. Does your life require you to remain in the LA area, or in California, for that matter? And I do mean require, like as in your husband has a good career there and you simply cannot go somewhere else...not, "I love it here, my friends are here, my kids' friends are here, they love their school," etc. You are looking at one of the most difficult places in the country to get a job as a new grad nurse. If you are required to stay there, then I'd suggest you do your research on some of the other ways you can achieve your goal of becoming an RN while working smartly to set yourself up for hopefully an easier time finding employment; where in health care are people being hired right now where you are? Where is the need? If you want more ideas, email me. Do not listen to the new grad nurses posting how hard it is to find jobs unless they have taken a mature, measured, smart approach to their nursing goals. (I have read so many posts from new grads and/or student nurses who went into nursing school thinking they could breeze through it, graduate, start work in the ICU or the ER, work for a year, then go on to become an N.P. or a C.N.A.; I've responded to these misguided and misinformed students more than once...and I do really mean misguided--someone along the way had to have told these poor folks that they could actually do it. Anyway, if these are the posts you are reading and they are causing you to despair, don't.) There are jobs out there, but you need to be realistic about a few things, including the purpose of your first job, and the location. If you expect to graduate from nursing school and get a job in Labor and Delivery in LA, you will probably be disappointed. Watch your debt. Watch your debt. Watch your debt. Yes, school costs...just do it smart and do it according to your personal needs and why you're going into nursing. If you load yourself with more debt than your family can handle, you do more harm than the degree will do you good. There are plenty of ways to smartly add the Bachelor's degree. Some nursing careers require the degree, most don't. I wish you the best as you pursue your nursing career! Lori R.N., B.S.N.
  9. MsLoriRN

    Stem Cells May Reverse Type 1 Diabetes

    You know, my wonderful 15 y.o. son has dealt with this lousy disease since the tender age of 3. :crying2: I know it intimately, and it is a real beast. If you haven't lived with it 24/7, you DON'T GET IT. I promise you that. You don't get it anymore than I get what it's like to battle cancer. My Mom has battled it. My Dad is battling it now. I have 2 good friends who are battling it. I empathize with them. But do I really get it? Do I really understand it? No. As a nurse who taught newly dx'd diabetics in the hospital, I thought I knew about "D." Even after 10 years, I now realize that all I understood were the mechanics. I didn't know crap about D. And I respectfully submit, that unless it lives in your body, your kids, your home, you don't either. For those with type 2 diabetes, you don't get type 1, either. Even if you take insulin shots, YOU DON'T GET IT EITHER. Type 1 diabetes is it's own special nightmare. That's the "preamble" to my response to the article about reversing diabetes with stem cells. Here's my response directly to the article: As the article clearly states, "THIS IS NOT A CURE." This is good for someone who has had type 1 (used to be termed "Juvenile") diabetes for many years and is suffering severe complications of the disease. They, and ONLY they, will benefit from having normal blood glucose values returen for a period of a year or two. They, and ONLY they, may benefit from being exposed to toxic levels of damaging radiation and losing their immune system and Lord only knows what else in the long-term, in order to save them from what would otherwise be their imminent kidney failure, limb-loss, stroke or blindness. Like most of the other procedures that have "cured" type 1's of their diabetes, the "cure" has been worse than the disease itself, and is, therefore, not acceptable to the vast majority of dear ones who live with this disease every day. The research team from NW and Brazil are aware of this, and clearly state it in the article. They also state, correctly, that it is a step...a door that has opened, that they hope will lead to another step, another open door. As do my son and I. Will I excitedly show him the article? I don't think so. There are several procedures out there that have led to insulin-independence for a time, but at a great cost and risk to other areas of health and life, and are thus also unacceptable to the majority of type 1 sufferers. There are only 2 places that we give our "D" research dollars to. The Diabetes Research Institute in Miami, and the Children With Diabetes Foundation. I don't give $ to ADA or JDRF. I won't post why here, as I'm sure it would be deleted. I do hope the staff here won't delete my suggestion that anyone of you who may have a child with diabetes and need a place where you can go for love and support visit childrenwithdiabetes[dot]com, and go to the parents' support message boards. They were my LIFELINE for those early years, and often still are! The conferences they put on...which the best of the best researches attend, sponsor, and speak at...are awesome and life-giving to the KIDS, who get a chance to see hundreds and hundreds of other kids who are just like them. If you're a nurse with a heart for kids suffering with diabetes, may I encourage you to consider becoming a CDE? Don't do it just for the money if you don't have the heart...we don't need ANY heartless CDE's. Don't do it just so you can work in an office/daytime clinic environment (rather than rotating shifts!) if you aren't sensitive to the emotional ordeal that this desease is...we don't need ANY insensitive CDE's. But if you have a positive attitude, are a team-player, and want to do a great work with your RN career, there's a shortage of CDE's out there and WE WANT YOU!!! There's my .02 worth. I'll climb down off my soapbox now. Lori RN
  10. I've been writing to a number of new grads/prospective nursing students this week, so I'm going to repeat some of this verbatim just to save my sore typing fingers!!! If you've read parts of this in other areas, that's why. I hope it may be helpful, just the same. Nursing school admissions are tight. The job market, in some places, can be tight, too. (More on this in a moment.) It is disheartening, I realize. But you all have to realize that this isn't completely new. Nursing, as a profession, has been here, to a degree, before. Nurses were being laid off, allied professions were being cut...this was over 2 decades ago now. For current and immediate-future students, you're caught in the middle of a really wierd situation right now. Trust me...there IS a nursing shortage! And it IS going to get worse. No one has yet touched on the core issue of retiring baby-boomers yet...nurses and patients...and that's where the real crisis is going to come in. We're just on the edge of that cliff, leaning...leaning...leaning out and flailing our arms, about to fall off. Y'all don't seem to be getting this! And I can understand why. You get out of school, you have loans to pay off, you want a job. Period. That is coming through loud and clear! What's not coming through is looking, less-emotionally, at the bigger picture, and the long-term reality. The problem seems to be that, like every other business around, hospitals are having to make the same gut-wrenching budget cuts as everyone else. I wrote about this in my book, because it's really hitting so many areas of nursing right now...students, faculty, schools, hospitals...everyone is affected by the current economic situation. Hospitals, whether they're short on nurses or not at the moment, are dealing with a cash-crisis. A brand new nurse, fresh out of school--no matter how many "A's" you got in nursing school, no matter how many articles you've written above and beyond, no matter how many volunteer/student-work/extra-credit hours you've logged--a brand new nurse will take close to a full year to mentor and precept into an independent RN. They will spend tens of thousands of dollars on you, above and beyond the salary they pay you, just to get you to the place where you actually "earn" that salary. Don't be offended...the hospital typically knows that you are a great investment!!! These just aren't typical-times right now. I know you may not believe that right now, but most of the skills of nursing are learned after you get out of school! In school, you are learning the "science" of nursing, the "theory" of nursing. Upon graduation, you will learn how to apply that science and theory in the real world of nursing. Your clinical rotations were not the real world. Nursing requires judgement skills; judgement skills are the result of experience backed by the theory and science you learned in school. It just takes time. OK, so...what can you do? First, recognize that you DO have options: 1. Realize that your first job is just that...it's your first job. Few new grads, whether they're nurses, lawyers, engineers, or architects, land their dream job right out of school. When you say that there are "no jobs anywhere" in your area, is it really NO jobs? Or have you limited yourself in any way by not considering jobs in, shall we call them, "less than desirable specialties?" . I really disliked my first year of nursing! But you know what? It was only my first year. Once it was over, I was the "experienced RN" that hospitals were crying out for! I named all my future positions, where and when I wanted them. But that first year, in what amounted to a "glorified nursing home" was not what I had EVER imagined for myself. So...have you really looked everywhere??? 2. I have read more than one nursing student posting how upset they were that there were "NO JOBS" out there, only to then read that he/she is a senior in nursing school who wants to go on to become a nurse anesthetist, and to get into that program he/she has to have at least a year of ER or ICU experience...and "NO ONE WILL HIRE ME." Mmm, mmm. Now I climb up on my soap box! To such students, may I tell you in the kindest way that if any hospital DOES hire you into their ER or ICU as a new grad, they are setting themselves...and very possibly you..up for a possible lawsuit because of the consequences your lack of experience and immature professional judgements may cause someone? I worked 10 years of my career in critical care...ALL areas of critical care...and new grads simply do not have the knowledge, skill, or judgement abilities to work in these areas. Period. Want to become a Nurse Anesthetist? Then graduate nursing school, take whatever job you need to to get working as a nurse, so you can actually begin to function as a "real" nurse (not just a student nurse!) at the bedside, fulltime. Learn. Learn, learn, all you can in that first job. Be the BEST new nurse you can be. Get the BEST peer reviews. Get the BEST reviews from your Unit Manager. Be the nurse the patients and their families write letters to the hospital directors about (good letters, of course)! Then, at the end of that year, go apply for a job in the ER. Go get a spot in the ICU. Believe me, when you're in there, you'll be starting all over again with the learning curve! But when you're in, you're in...now, what you did that first year in that first position? Do it again. At the end of that year, go apply for that slot in the Nurse Anesthetist program. Smile...you'll have earned it, because you worked for it. Well worth it! Few new graduates, whether they are nurses, engineers, lawyers, or architects land their "dream job" fresh out of college. Most new grads expect to start, oh, somewhere near the bottom, and work their way up, gaining experience, wisdom, leadership skills along the way that will be used in their futures. In nursing, we are fortunate...the bottom isn't that far from the top. It doesn't typically take more than a year of doing what you'd rather not be doing in order to shoot straight to where you do want to be. So just get started. 2. Let's say you really have looked at every hospital, every nursing home, every assisted living center in your area, and there are NO jobs. You have a decision to make. I tell my kids this all the time: you can either choose where you want to live, and then work at whatever you like best that is available there, or you can choose what you want to do, and then go wherever you have to go where you can do what you love. It's just that simple. If you wait long enough and are willing to do what it takes at first (probably not too long, but be ready for a year or so), with a career in nursing, you'll probably be able to have BOTH. Jobs ARE out there. Go where they are, get your feet wet and become the experienced, independent RN everyone's looking for! Do what it takes! It's WORTH IT!!!
  11. Hi, It's got to be disheartening, with all the great stuff you clearly have on your resume! You're caught in the middle of a really wierd situation right now. Trust me...there IS a nursing shortage! And it IS going to get worse. The problem seems to be that, like every other business around, hospitals are having to make the same gut-wrenching budget cuts as everyone else. because it's really hitting so many areas of nursing right now...students, faculty, schools, hospitals...everyone is affected by the current economic situation. Hospitals, whether they're short on nurses or not at the moment, are dealing with a cash-crisis. A brand new nurse, fresh out of school--no matter how many articles you've written above and beyond, no matter how many volunteer/student-work/extra-credit hours you've logged--a brand new nurse will take close to a full year to mentor and precept into an independent RN. They will spend tens of thousands of dollars on you, above and beyond the salary they pay you, just to get you to the place where you actually "earn" that salary. Don't be offended...the hospital typically knows that you are a great investment!!! These just aren't typical-times. I know you may not believe that right now, but most of the skills of nursing are learned after you get out of school! In school, you are learning the "science" of nursing, the "theory" of nursing. Upon graduation, you will learn how to apply that science and theory in the real world of nursing. Your clinical rotations were not the real world. Nursing requires judgement skills; judgement skills are the result of experience backed by the theory and science you learned in school. It just takes time. OK, so...what can you do? First, recognize that you DO have options: 1. Realize that your first job is just that...it's your first job. Few new grads, whether they're nurses, lawyers, engineers, or architects, land their dream job right out of school. When you say that there are "no jobs anywhere" in your area, is it really NO jobs? Or have you limited yourself in any way by not considering jobs in, shall we call them, "less than desirable specialties?" I really disliked my first year of nursing! But you know what? It was only my first year. Once it was over, I was the "experienced RN" that hospitals were crying out for! I named all my future positions, where and when I wanted them. But that first year, in what amounted to a "glorified nursing home" was not what I had EVER imagined for myself. So...have you really looked everywhere??? 2. Let's say you really have looked at every hospital, every nursing home, every assisted living center in your area, and there are NO jobs. You have a decision to make. I tell my kids this all the time: you can either choose where you want to live, and then work at whatever you like best that is available there, or you can choose what you want to do, and then go wherever you have to go where you can do what you love. It's just that simple. If you wait long enough and are willing to do what it takes at first (probably not too long, but be ready for a year or so), with a career in nursing, you'll probably be able to have BOTH. Jobs ARE out there. Go where they are, get your feet wet and become the experienced, independent RN everyone's looking for! Do what it takes! It's WORTH IT!!! Best of luck to you, Lori RN
  12. MsLoriRN

    RRT or LPN need advice to decide

    Hi Melissa, I hear your confusion and frustration!!! I hope I can help out...you've got a TON of responsibility, and not much time to meet it. So here's a hug, :icon_hug: , take a deep breath, and let's talk! OK, so the RRT job looks enticing to you, and I can understand why. Will it all be in trauma? Nope. RT's do lots of work in the ICU, but it's not trauma. Many folks are on ventilators, and the RT does checks on those, but the nurse at the bedside does most of the hour-by-hour management. FYI, early in my RN career, the hospital laid of RT's to save $$$ and required the RN's to become certified in giving chest PT (it's a technique RT's traditionally did to loosen the gunk clinging to patients' airways, say if they had pneumonia--that's REALLY simplified, but it'll have to do here) so we could do it in the RT's absence. I don't know what's happening in the minds of the hospital bean-counters right now, but it's just something to think about. The situation with nursing, hospitals, and the national economy is very complicated right now. But it's not completely new. People in situations like yours are, honestly, the BEST and just about ONLY reason I ever recommend going for the LPN. Honestly, I don't often recommend that people go the BSN-route right off the bat, for a number of reasons. For you, I think you would be able to achieve your goals by starting off with the LPN, and then doing a "Bridge to RN" program while you are working and earning money as an LPN, so you can support yourself and your child(ren). Again, grab the mini-course to get more info about this, but in the meantime, be sure to check with your LPN school if they are "connected" with a Bridge to RN program where your course credits can transfer. All that said, if the Respiratory Therapy career sounds more like what you truly want to do, then go for it! But if nursing is what's in your heart, then do everything you can to get there, by whatever route you are able. It'll be worth it! I wish you all the very best, and I hope I've been able to help a little! Lori RN
  13. MsLoriRN

    New Grads and getting hired

    Hi, and first off, congratulations on being as far down the road to "RN" as you are! The hiring of new grads being slow right now isn't a brand new phenomenon. Nursing has been going in cycles such as this one for decades...just so you know. It gets better. It gets worse. It gets better again. Take heart, you'll find a job! I always advise new grads to take the long view of things, and to realize that your first job is just that...it's your first job. It's not your last one! Kind of like buying your first house...you don't buy the dream home right out of college. You have to work your way up to it. Get your foot in the door, get that first year of experience that they're all clamoring for. Once it's done, wherever it's done, you'll be the experienced RN that gets hired on the spot! As for whom to send the resume to, typically your initial contact at the hospital is the nurse recruiter, so you would address all written communications to him/her. Be sure to include in your cover letter that in case you haven't heard back from them within one week (or two, your choice), you will, as a courtesy, call to follow up on your resume submission/interview. Again, this is with HR and/or the Nurse Recruiter at this stage. Once you've been invited to interview on a specific unit, you will then meet and interview with the Unit Manager/Head Nurse, and from that point on it will be up to him/her to hire you or not, so any follow-up from that point on would be with him/her. Same procedure, you send a follow-up letter, and state that in case you haven't heard back from them within a week or two, you'll place a courtesy follow-up call. This encourages them to get back to you with their decision, one way or the other. There is nothing worse than being kept hanging! So you have to keep the ball in your court here. I hope this helps, and I wish you all the best of luck! Stay with it...it'll happen! Lori, RN
  14. Hi, and an early "welcome to nursing!" to you! I LOVE IT that you asked this question about math and nursing!:yeah:I've had several high-school students who love math tell me that they were surprised at how much math there is involved in the profession, and just recently, too, so your post wasn't surprising to me at all. "Nurses do a lot of math on the job. Your basic math skills--addition, subtraction, multiplication, and division--will be used multiple times each day. If you tend to make lots of "little mistakes" in math, you know, like absent- mindedly saying that 8X7=54 instead of 56...that's NOT acceptable in a nurse. So if you tend to be haphazard with your math, you'll need to change that trait! Medication dosing errors kill people. There's no room for error here. In addition to basic math skills, you'll also need to be proficient in basic algebra. Many medication dosages are written as "give this-many-milligrams per kilogram of body weight." This means that you have to weigh the patient, then plug that amount into the equation to figure out how much to give. Let's say the dose is written as 10 mg. per kg. body weight. You weigh the patient and find that he weighs 60 kg. So the dose is 10mg/kg X 60kg=600mg. Simple, basic algebraic equation. Things can get more complicated from there, as more variables get added. Perhaps the medication order is written for a particular concentration of medicine (obviously liquid formulations), and the pharmacy sends a different concentration. You will need to calculate the dose based on the patient's weight, then re-calculate it for the changed concentration. We can complicate this even further--let's make this a drug that needs to be "titrated" (change the amount) to achieve a particular blood pressure, urine output, laboratory value, etc. Math, math, math! If you don't love math, that doesn't mean you shouldn't go into nursing. It's not the core of what nursing is all about. But it is important that what math you are required to perform, you are good at and accurate." I hope this has been somewhat helpful...most of all, I'd stress to all of you that while, YES, you DO need to focus A LOT on academics during your student years, keep in mind that a huge part of being a nurse will come from your hearts. Anyone can learn math (well, okay, ALMOST anyone!)...I'm not downplaying its importance, obviously. But not everyone can be a nurse...even if they're a math genius. You have to want it, or it can eat you alive. This is a profession that'll grip your heart. If you are right for it, you are qualified for it, AND you really want it, you'll be able to make it happen. Is it easy? No. Is it worth it? Again, if you really want it, YOU BET!!! Go for it, give it all you've got...it's way worth it! Best of luck to you!
  15. MsLoriRN

    Should I Become a Nurse?

    Hi again, Sure, I'd be happy to respond :) (Gives me another chance to play with these smilies...) It helps to have a little background in the history of ICU nursing, and why it was "created." Actually, it started with CCU's (coronary care units). I'll keep this VERY brief, you can search around and read more if you like; in a small nutshell, what was happening was cardiac patients were not surviving their heart attacks because doctors simply couldn't be with them 24 hours a day. So they got the idea to provide specialized and advanced training to select RN's, and teach them to basically be the doctors' "eyes, ears, and sixth sense" on a 24 hour a day basis. These nurses learned to read EKG's, auscultate (listen to) heart tones and distinguish the sounds they were hearing and what was normal, what was abnormal, and what it meant when related to the EKG and other clinical presentations, and so on. They trained the nurses how to respond to certain emergency situations and gave them "permission" (via standing orders from the physicians) to implement emergency treatments based on the clinical judgements that they made at the bedside. When they did all of this, heart attack victims began to survive the event, and CCU's were "born." Here's the KEY THING you should take away from this in response to your question about the new grad in the ICU environment: Much of what the ICU nurse does is based on judgement calls. It takes t-i-m-e and experience... and plenty of it...to develop that kind of judgement. I worked with a number of nursing students in the ICU. Most were in their final year of nursing school, and were selected to rotate in the ICU because they had demonstrated particular skill in their other clinical rotations. And even so, most of them were overwhelmed to terrified! These patients are very, very sick. The technology takes time to master, interpreting the data you get from the technology takes even longer to master, and you have to know what you are doing so you don't kill someone! I firmly believe that if a hospital hires a nurse fresh out of nursing school into their ICU, they are in a severe staffing crisis, and they are setting themselves and probably the new nurse up for a potential lawsuit, and will likely see that new nurse burned out, and possibly even leaving the profession before he or she ever should have. All that said, I love critical care nursing, and I recommend it highly to anyone who feels drawn to it! But not until you've had at least a year of med-surg experience. Even with that, you'll still be overwhelmed when you start! But that's what preceptors are for! :wink2: Finally, remember that there are a number of critical care "specialties" that you can go into. The critical care units at smaller hospitals will often have everyone in one or two units, but larger hospitals will have them divided up into neurological, surgical, surgical heart, medical, coronary, pediatric, and neonatal ICU's. Also, within the critical care specialties you have things like the ER, PAR (post-anesthesia recovery...you might be interested in that!), cardiac catheterization lab, and even more, depending on the facility and what they offer. So you see, there is a kind of "stair step" that you take into the specialties, AFTER you've gained experience and have refined your clinical judgement skills. As a new grad, you won't be anywhere close. (jmho...) Hope this has helped, and good luck to you!
  16. MsLoriRN

    Should I Become a Nurse?

    Hi, Ryan... GREAT questions you're asking! You are wise to consider all these things before you commit the time, effort, and $$$$$ to nursing school. As for things like catheterizing patients, it goes right along with sticking needles into people, starting IV's, and the like. You will be terrified the first time you do it, but each time after that gets a little easier, and soon enough, you're not phased by it at all. Then, there will be weird things that will "get to you." Every nurse has his/her own particular "goo-phobia," as I call it. I can take a lot of gunk, but sweaty patients make my skin crawl. (weird, I know!) I've talked to lots of future nurses about the "blood and guts" factor in nursing, and how you handle it. As for getting a job in ICU right out of school, it's not likely. I worked most of my career in all areas of critical care, and I wouldn't have wanted that job right out of school. You would not be "safe," nor prepared for the amount of clinical judgement calls the ICU nurse needs to make. So it will take you some time to get where you believe, at this point, you want to end up. For CRNA school, you may want to visit this page: http://www.allnursingschools.com/faqs/crna.php Generally, you need one year of acute care experience, a BSN, and your RN license, but these may vary by school. My advice to you is to consider the profession carefully, from many angles (as you seem to be starting already), and, should you decide to become a nurse, to take your time getting ready to get the CRNA. Anesthesia is one of those areas where you are at a high risk of being sued...it's just the nature of the profession, I'm afraid, in our litigacious society. Don't be afraid of going into it, it's a great opportunity for a nurse...just make sure you're ready, you know what you're doing (that's where getting the needed experience comes in), and you really love it! Then you'll do great! :wink2: Good luck to you! Lori