lmd32

We have a foreign doctor in our nursing program. She speaks excellent English and is very knowledgable, especially in patho. She tried to pass the boards for 10 years but had trouble getting a residency because she had just finished med school in the Phillipines and had not practiced independently. She has had a few issues but they are more cultural than nurse-doctor stuff. I think she'll make a fine NP. I do resent that bit about "swallowing their pride" though. We also have at least 3 people in my program who chose not to go to medical school and prefer nursing.

Do you want to just work with DD folks? If so, I'd try the state agency employment web sites. You could also look for private DD service agencies and see what they know. Another resource might be the ARC or even Special Olympics. I am currently a psychologist in a state institution for DD adults. We have lots of nurses, both RN's and LPN's. One of our docs told me that you can certify as a DD nurse. I have contemplated specializing as a nurse practitioner for the developmentally disabled when I finish school.

A major factor in going back to nursing school is the opportunity to work something other than days. Swings are my least favorite with a family although I didn't mind it when it was just my SO and me. Night shifts are probably my favorite. I work a flexible job while in school and I often show up at 2am and surprise the night crew. I even did night clinicals in LPN school.

I guess it depends on how rural you want and how far you're willing to drive. I have a friend who lives in Roslyn and commutes to Bellevue every day. It probably takes him about an hour each way but he's always liked to drive. I know several nurses who commute over the mountains from Cle Elum to Seattle. Also crazy I think. Let's see, it's Seattle you're looking at? Would you accept a ferry commute from Bainbridge or Vashon? It's a little longer (I think the ferry alone from Bainbridge is about 30 minutes) but I never minded that commute since you got to sit and look out the window and not drive. What's always worked for me is to get a map and a compass and draw a circle around where I wanted to work at the outer limits of my commute. Then drive around inside that circle (or look on the web if you can't come and look) and see what you like.

I have to disagree with what seems to be the consensus here. I'm not going to argue the merits of Kroger's vs. Wallmart vs. mom-and-pop. But, to get back to the original question, should employees pay for part of their health insurance... I have worked for the state of Washington for the last 12 years. When I was hired, the state paid 100% of my health insurance, my family's health insurance, and my dental. This was a HUGE benefit. About 10 years ago, we got a small raise and at the same time began to pay about a little less than the amount of the raise for our health insurance. We didn't strike but I sure wanted to and did my best to convince others. It was a "foot in the door" phenomenon. Every year, the percentage of my health insurance I pay has gone up and my wages have not kept pace. I know that most employers require employees to pay for part of their health insurance but if you luck into a place that's paying 100%, fight to keep it. I would take a pay cut to get back my employer paid health insurance.

4th career, huh? That may put you one up on me. One nice thing about nursing is that there is plenty of variety. While nurses do get bored or burned out (just read the posts), they can often change to another type of nursing rather than a whole phase shift. I like the "incredibly easy" series (and their siblings "ridiculously simple"). Some of them seem to start too simple for me but others I really need the basics. I particularly enjoyed patho made incredibly easy. I also like their NCLEX review books, mainly because they're organized by subject. Check out the student nursing section. The "teach a student something a day" thread is very helpful in figuring out the basics of nursing school. Good luck to you!

I have a vegan daughter and one who used to be a vegetarian but now has added fish. (we call her a fishaterian). So, we are having: Fruit salad (my specialty, via Granny) Vegetable antipasto (currently marinating) Shrimp kebabs (for the fishaterian, she's making them) Tofu kebabs (for the vegan) Turkey and gravy (for the rest of us) Stuffing (in the bird and vegan in a casserole) Mashed potatoes and vegan gravy (made by the vegan girl) Some kind of yams (ditto) Cranberry sauce (apparently the other daughter's specialty, involves craisins and mandarin oranges, sounds good) broccoli with lemon pepper sauce rhubarb pie and vegan pumpkin pie (made 'em last night) sparkling cider for the kids and mimosas for the grownups I used to do 2 dinners one on Tday and a vegan one the day after but we have less people this year. I am thankful (among other things) that I ditched the dysfunctional husband and his dysfunctional family. Talked to him last night, their not having Thanksgiving because his brother's in jail for DUI. So, what about the kids? I invited them all to my house but they wanted to stay at his mom's and mope. Just as well, we'll have a better time without them.

I worked on an acute care, mainly voluntary, inpatient psych unit in a community hospital. We had no policy about searching and rarely did. Along with occasionally being aware that there were illegal drugs and alcohol on the unit, I remember walking past a patient's room one day and being aware that there was quite a breeze coming in. The man had used the toolbelt he brought with him to remove the whole window from the frame because he was feeling overheated. We were on the 5th floor and there was a 6x6 foot hole in the wall. Scary!

I tried to call Washington State Protection and Advocacy Service but got stuck in voicemail. So, I sent them an email. It said: I am a student nurse, currently doing a mental health rotation at Western State Hospital. I am appalled by the procedure used to implement med overrides. I understand that, in Washington state, the right of a patient to refuse psychoactive medication can be overridden on the strength of an evaluation by 2 MD's. However, the method used to administer these medications is barbaric and abusive. On the ward where I worked last Wednesday, I observed a woman overpowered by a group of MHTs, placed in 5 point restraints, and an NG tube shoved up her nose against her will. The placement of the NG was not successful, and considerable bleeding resulted. The nurse then inserted the tube in the other nostril which was successful, but the patient pulled the NG tube out before medications could be given. IM Ativan was then given and the patient took the oral medications 30 minutes later after she was calm. On this ward, 5 point restraints and an NG tube is the standard order for administering refused medications. I question why there is not a protocol with a hierarchy of less restrictive and intrusive interventions and why, specifically, IM medications are not used. If I can be of any help to you in investigating this procedure, please contact me. Also contact me and advise me if there is some state agency I should report this too. I have not heard back from them. I checked with some of the other students and, apparently, most patients are cooperative with the procedure if it is presented to them as inevitable. I just happened to see a particularly bad example. I still think it's needlessly intrusive. I also question the wisdom of exposing student nurses to this type of mental "health" environment. I can assure you, no one in my class wants to work as a psychiatric nurse. And I know that inpatient, long term, chronic state hospital patients are not the only psychiatric patients in the world. I don't feel my instructor is supportive. As I have mentioned before, she has been very defensive of the staff and I feel I am getting a reputation as a trouble maker. I do need to pass clinicals. Maureen- what's a code 8?

One last one for the night. Y'all are dredging up memories. I once worked with an RN whose first language was not English. She was a very good nurse but sometimes forgot the words and had to be creative. We had a patient come in with a penile laceration. She couldn't remember the correct word and drew a picture instead.

Okay, this isn't exactly a blooper because I know what they meant but I laugh every time I see it. Our case managers often chart "patient evacuates spontaneously" meaning that they know how to find the door if a fire alarm goes off. But to a nurse...

We've been having quite a few transcription errors come through. Can't remember them all but "rule out lime disease and berry berry" stands out. The patient apparently had an overdose of fruit salad.

I'm going to try to make this relatively brief so as not to bore folks. Michael, you are welcome to pm me if you want more info. The Deparment of Developmental Disabilities in my state (Washington) serves mentally retarded children and adults. Their IQs range from 70 on down. Most were born with their disability, although some suffered accidents or illnesses that impaired cognition. As long as it occurs between birth and age 18, it's technically DD. As you probably know, birth defects cluster so a lot of these folks have seizure disorders, physical problems, and mental illnesses as well. Nationally, there is a trend to de-institutionalize the mentally retarded (and the mentally ill). I believe that Oregon, among other states, has completely closed their state institutions. Washington is moving more slowly. I work for a large state institution. As the trend toward community placement has grown, we have moved out a lot of people. We're pushing the envelope now and we are moving out a lot of people who we would not have thought were ready for community living. People with intractable seizures, multiple medical problems, significant mental illness and behavioral problems. To our surprise and delight, some of them have done very well. The folks we are left with now are the ones we truly believe the community is not ready for. So, in my state institution, you would find people with serious problems, either medical or behavioral (in addition to their MR). We have 4 full time medical providers (3 MDs and a PA), a psychiatrist, and several PharmD's. We have physical and occupational therapists and aides, speech pathologists, psychologists, and social workers. The nurses where I work see a variety of medical problems, both acute and chronic, as well as behavioral issues and mental illnesses. Most common chronic medical problems are seizure disorders, endocrine disorders (including diabetes), and lately, as our population is aging, dementias. We serve only adults. Our youngest is 19, he still goes to public school. Our oldest is in her 90's. In a community setting (group home or tenant support), you would have generally more tractable folks. A lot of them would be more functional and just need some help with more complex skills such as money management. Since there is more community support and acceptance now than there was 70 years ago when my place was built, children with DD are cared for in the community, either in their own homes or therapeutic foster homes. There are a few residential treatment facilities for children with mental illness. And that's my story.

IMHO, unlicensed personel do the real work on the psych ward. They're the ones out there interacting with the patients, implementing behavior management strategies, and often, running groups, providing recreation, supervising work or school, you name it. What you do varies a lot from setting to setting. In short term (

my heart is still crying out... i'm not for nursing... i want to bail out... but i love my parents and i don't want to disappoint them... i know that they just want what's best for me... oh, amy, i'm so sorry. it's awful to put a lot of time and effort into a field, only to realize it's not for you. all i can say is that nursing is an incredibly diverse profession and there is probably an area you will love even if you haven't found it in school. don't worry about being "selfish", we all are and would be crazy if we weren't. think about what you said in that presentation and look around and see if there's an area of nursing that fits your wants and needs. best of luck to you.