NurseDiane

If this "manager" was so concerned about you going into the separate break room, why didn't she go in the room when you were there to see what you were doing? "Managers" love to exert their "power" any way they know how. Since there is obviously nothing wrong with your clinical performance, this is what the "manager" decided to make up. Nurses, in general, think nurses that don't share every personal detail of their life with everybody are "suspicious" or hiding something. You go into the alternate break room for the peace and quiet. In the regular break room, that's where everyone spills the details about their marriage, children, families, friends, and gossip about others. There is nothing wrong with staying out of the "gossip station". "Because no one else does it" is totally irrelevant----you are not doing anything wrong. Not spilling the details about your personal life has no effect on your clinical performance. If that "manager" wants to act like a b*tch, let her. Keep doing what you're doing. Don't quit because of one stupid remark that bears no relevance to your performance.

This is not the end of the world, but I would strongly advise that you retain an attorney for any board hearing, any board questioning and any document signing. The BON's goal is to scare you into signing a consent order before speaking to an attorney. The Florida BON is ruthless and the IPN is nothing more than a giant profit-driven organization that makes a crap ton of money from board-ordered "evaluation" by unqualified practitioners that are not addiction specialists. Forcing you into an IPN contract before an adequate investigation is done should be illegal. A thorough investigation will show that this was a documentation error, and not an issue of diversion or addiction. By telling you that they will turn you over to the DOH, it's nothing but a threat. Who cares if you get turned over to the DOH? At least the DOH will conduct an investigation before any hearings regarding your nursing license are conducted. The BON knows that the vast majority of nurses panic at the thought of any disciplinary action because they do not understand the process, and often just "submit" to whatever the BON wants them to do. DON'T DO THAT. So what if they turn you over to the DOH? At least then an investigation will be done. The BON cannot justify forcing you into an IPN contract when there is no evidence of diversion or drug use. They just don't want to have to spend any money on handling something like this properly. If you consent to an IPN contract, you all be their b!tch for the next 5 years. Do not agree to enter IPN before a complete investigation is done on this incident. The penalty for a documentation error is far less than the penalty for entering IPN. Tell the BON that you are respectfully declining their offer because you do not have a drug problem, you did not divert any narcotics, your drug screen was totally negative and they have nothing to support the necessity for you to be in a monitoring program. Threatening nurses to consent to a 5 year monitoring contract with IPN is a bottom-feeder behavior. Let them do some work for their salary. The Florida BON tries to throw every nurse into IPN no matter what the offense is or if it involves drugs or it doesn't. IPN is a profit-driven monster. Remember that consenting to join IPN doesn't automatically assure that something won't be slapped onto your license if somebody at IPN or BON feels that you haven't done enough to "participate" in the program. The BON can unilaterally extend your contract for no reason. They have total control over you. It is not the end of the world if you get a mark against your license for a documentation error, but you can be guaranteed that you will never work as a nurse again if you get a mark against your license for a drug-related offense. You will not lose your license for a documentation error. This is exactly the reason why you need an attorney. One thing you definitely do not want to do is be questioned by the BON or DOH without an attorney present, or without being prepped by an attorney before the questioning. As soon as the BON & DOH know you have an attorney, their demeanor will change because they know they can't threaten you anymore. Talk to a lawyer. Be honest. Try to get all the documentation you can, including the results of your drug test for the attorney. An attorney can request all of the documents that the BON has in its possession---if you requested those records, your request would be refused. You have to consent to entering into an IPN contract---the BON cannot order you into it. That's why they throw ultimatums in your face--the less time a nurse has to think about it, the more likely it is that they'll agree to it. The BON or DOH cannot take any action against your license without a full investigation and hearing. The BON wants to make "turning you into the DOH" sound really scary, but it's not. An attorney can negotiate with the DOH much better than you can. There is no way a documentation error should turn into a drug offense without an investigation. You will likely not get out of this scot-free, but agreeing to enter into a 5 year IPN contract is ridiculous. You will probably have to take some type of course on proper documentation, and maybe get a strike against your license, but that's it. Maybe a small fine, too. Fight for your license. Don't let the BON scare you into something that is totally unnecessary and which will cost you tens of thousands of dollars over the course of 5 years. Use that money to retain an attorney.

It depends on where you live & what you need an attorney for.

Get a job while you're in nursing school to help pay expenses & stop relying on the school loans to fund your lifestyle. Bad decisions put you in the financial mess you're in now. Loans have to be paid back. Start living frugally, start paying the loans back NOW, before they start building up interest. If you're moving back in with your parents, there is no reason why you can't pay $2,000/month working one nursing job. At this point, don't worry about working 2 full time jobs---worry about getting one job & doing that job well. Don't get your heart set on working in a pediatric ER from the get-go. You need experience before you go to a setting like that. Your idea of a "sustainable lifestyle" will have to change---you will have to drive a used car instead of a new car, make do with an older cell phone instead of getting a new one every other year, & curb your spending habits. The only way to not accumulate $200,000 in school loans is to start working to pay your living expenses NOW so you don't depend on loans to fund your "lifestyle". I think $200K is WAY TOO MUCH for a nursing degree. I can't see how transferring back in state would be more expensive than what you're doing now. It might even be worthwhile to take a break from school, or drop to part-time, work for a while to make some money that you can put toward school instead of taking out all that money on loans. Don't worry about what's going to happen AFTER you have over $200k in loans---start being proactive NOW in order to reduce the amount of loan money you need.

While doing a GYN case in the OR while I was a student nurse anesthetist, I was trying to give the patient a bolus of propofol in the IV, but I didn't realize the stopcock was turned the wrong way. So I pushed the plunger on the 60cc syringe as hard as I could, and it popped out of the line, spraying the surgeon's head with propofol!!! That was pretty embarrassing.

I don't have a nightmare interview to report, but I wanted to comment on interviews for clinical nursing positions. Places treat interviews for staff nurses like they are interviewing for C-level positions, which is absurd. When I was hired for my first RN job out of college, it was at a major NYC medical center---I was hired over the phone, after a phone interview!! How interviews for staff nursing positions have turned into some ridiculous affair, I don't know. If a nurse has just graduated & passed the board exam, then they are going to need a longer orientation period than a seasoned nurse that's been doing it for a couple of decades. The most important thing is whether the nurse interviewing for the job is going to be reliable, professional & pull their weight. Their "personal interests" don't matter. I think a good answer to the question of "Why do you want to work here" is "Because I need a job to pay my bills". That's as good an answer as any, because it's the truth. Putting someone on the spot with ridiculous questions, "panel" interviews & multiple interviews with different people is ridiculous.

"Hematuria" is not a diagnosis. It is a symptom. Blood in urine is a symptom of whatever condition is causing blood in the urine. Your DON needs to go back to clinical practice for a couple of years to learn what correct clinical practice is. It sounds to me like the DON didn't want any notation of hematuria or blood in the urine in the patient's medical record, because that would raise eyebrows with the state if it was not addressed promptly (or at all). (I am assuming this occurred in a LTC facility.). Did you ask the DON what you should write instead of hematuria? Most LTC facilities don't want to address any medical issues because they don't want to lose money. If a patient had blood in their urine, the LTC facility would have to collect a urine specimen to be sent out to a lab, get the results back and possibly send the patient out to a urologist or to the emergency room to get a diagnosis & treatment, which could possibly affect their profits.

You're right---the BON is not your friend & they attempt to get nurses to implicate ate themselves instead of having adequate evidence to prove their case. I believe it is a violation of an individual's right to due process, even though dealing with the BON is technically "administrative", to be accused of something without a shred of evidence to support the allegations. This is why BON's need an independent, unbiased & neutral organization to govern their operations instead of being "self governing". However, the BON's must change the way they handle nurses with substance abuse issues. Instead of treating their illness as a character flaw & intentional act for which they punish those nurses, not only by mandating them into a "contract" that they must comply with whether they can afford it or not, but by not humiliating & shaming them by publication of their "offenses" on a website for the entire world to see. There is no reason why a nurse's family, neighbors & friends should have access to humiliating & intimidating information that has nothing to do with them at all. I find that to be the most offensive thing of all. Your story made me smile---I like hearing about nurses that have successfully battled the BON, and won. BON's base things largely upon the fear of the nurses they are pursuing and not the actual facts of the matter.

Whether they still worked at the facility at the time the complaint was filed makes a difference. If they did not work at the facility at the time they submitted the complaint to the BON, the facility has no responsibility over them as far as "vicarious liability" and you can sue them individually. If they still worked there at the time the complaint was submitted to the BON, the facility could have vicarious liability in a lawsuit since the manager was an employee of the facility. DO NOT MEET WITH THE BON ALONE. Make sure your attorney is with you, or someone as your representative. Record the meeting in its entirety. Do not sign anything, do not admit to anything, do not agree to a "plea" or consent agreement. If what was filed is 100% false, fight it with all you've got. Do not just "talk"---demand to see whatever documents the BON has in their possession. If they threaten you in any way, such as saying if you don't submit to a consent agreement you will have to face a hearing with the BON, make sure you record that statement or have them sign something stating the same thing. If they still want you to submit to a consent agreement, decline the offer & tell them you want to proceed to a hearing. At the hearing, the manager that submitted the complaint has to show up to testify. If they don't, the complaint that they submitted can't be accepted as legally sworn information & the BON have nothing to prosecute. The person that submits the complaint has to testify to the BON---without a witness to substantiate the statements in the complaint, whatever is in the complaint cannot be taken as fact. If your lawyer is with you, let him/her do the talking & don't say anything. The BON wants you to implicate yourself & admit to just a teeny little thing that might be fact in the complaint so that they can proceed with a disciplinary action. If the BON was dropping the charges, they wouldn't want to meet with you---their investigation would have shown that what was in the complaint was false. They are trying to push you into a corner & get you to trip up & admit to something in the complaint. "I don't recall", "I'd have to see the records" and "I can't answer the question as asked" are great answers to questions. Good luck.

If what was stated in the complaint is absolutely, 100% untrue, you can sue the hospital/facility and name the manager individually in the lawsuit for defamation, slander & libel---what she wrote (and likely stated) to the BON has affected your livelihood, and this is the key point in slander/libel/defamation lawsuits. The hospital would likely deny any liability & throw the nurse under the bus, distancing itself from her actions as much as possible. This is much different than a medical malpractice lawsuit, where a facility's insurance would cover a staff member. A facility's malpractice insurance wouldn't cover a nurse manager's actions as far as defamation, slander & libel--she'd have to hire her own attorney, pay her own legal fees & deal with the consequences of her actions. Even if she had her own malpractice insurance, it wouldn't cover something like this. "Reporters" are not protected by law when they submit a complaint to a licensing board containing untrue claims that defame someone & negatively affect their livelihood, even if they are that person's supervisor/manager. At the very least, you should sue for lost wages, potential lost wages, emotional distress, legal fees/costs and punitive damages for the manager's egregious actions that hurt your career/livelihood. At the very least, she will probably lose her job. And make sure that you notify the media about this---the public needs to be made aware that nurses are being reported by their peers/supervisors/managers with false information, resulting in the nurses losing their jobs, having to pay attorneys to fight the allegations & unnecessary emotional distress. I would also report this manager to the BON for submitting a complaint that included totally false claims & allegations, as honesty & integrity are a requirement of being a licensed nurse. I would be interested to know what that manager put in the complaint about you, and whether the complaint was made before or after you left your job. People that file false complaints, whether they are strangers, superiors, another nurse, your neighbor or ex-spouse, can be sued for making false statements that negatively affect your livelihood, especially to an administrative board. As far as potential employers finding out about an investigation, as far as I understand, pending investigations/actions with the BON cannot be revealed or published. Only when there is action/discipline against a nurse's license can it be made public.

How would it be more expensive to transfer to a community college at home for two more years? If you live at home, that saves you a crap ton of money. "Time consuming"? Do you know what time consuming is? Time consuming is working 7 days a week to pay off school loans. The school you're going to isn't the only nursing school in the country. I cannot see how pre-reqs wouldn't transfer to another college. I don't know what "they don't transfer well" means. They either transfer or they don't. Pre reqs are pre reqs, no matter where you take them. Anatomy & physiology is the same no matter where you take it. Pharmacology is the same no matter where you take it. Statistics is the same no matter where you take it. Inorganic & organic chemistry is the same no matter where you take it. I don't want sound mean, but it seems to me that you would rather just stay in the situation you're in than put in the time & effort to figure this out. If you have to forego a semester to move back home, get your credits transferred to another college, find a job, then that's what you have to do. $200,000 is one HELL OF A LOT OF MONEY. And that is without interest. You can buy a home with that kind of money. If you are saddled with that kind of debt right out of school, you can forget about buying a new car, or a place to live, or living anywhere else but a studio apartment on the bad side of town for 10 or so years. And nurses are having hard times finding jobs these days. You shouldn't count on being able to even get 2 full time jobs. There isn't any nursing degree worth $200k. You already have close to $100k in debt. If you put your nose to the grindstone, do what you have to do---which means getting a job, learning to live frugally, taking as little loan money as possible, living with your family---you can get away without having to take any student loans. You can't do anything about the past, but you can control your future.

Why can't you get a job now? You can certainly work at least a part time job while going to school. $200K for a nursing degree is ridiculous. Get a job, and transfer to a school that is cheaper. Try to get into a school near your family so you don't have to pay for room & board. There are tons of ways to lower college costs--the problem is that many college students don't want to make sacrifices to do it.

And here is a perfect example of absolute & total waste of health care dollars. If you're laying there eating a bag of Cheetos, your belly pain can't be too bad. No million dollar workup--in fact, it should be immediate discharge with a referral to a clinic. Why are health care costs so astronomical? Because the "You have the right to be seen & treated regardless of your ability to pay." There needs to be some sort of judgment call permitted by triage personnel because on an average day, an ED is full of non-emergencies. There is a large percentage of people without any health insurance at all that use ED's as a primary care clinic for themselves & their children & never pay the bills. Those costs are dumped onto everybody else, via higher taxes & higher costs for private health insurance. This B.S. has to stop. People have to start taking some responsibility for their own health & the system has to stop "rewarding" people for their bad choices. You're obese because you eat McDonald's every day? We've got a cure for you--bariatric surgery!!! You're a diabetic because you weigh 400 lbs. & eat a cheesecake every day? No problem---there are tons of different medications for diabetes out there!! You can keep eating that cheesecake because we can control your blood sugar with medications!!! How about rewarding those who do eat a healthy diet, stay active & take care of themselves? Those rewards can come in the form of lower insurance premiums, co-pays & deductibles. People that take care of themselves are being punished for the bad choices of others, and it is not fair. Why should my insurance premium, as someone that does not go to the doctor hardly at all, be the same as someone that goes to a doctor every other week for some health problem due to their sh***y lifestyle? Take some responsibility for yourself, for God's sake.

Good luck with the "face time" part, and I am not saying that to be snarky or sarcastic. Insurance companies & medical practices have created a "system" where it is difficult to provide the type of care that patients deserve. Your job is different than mine--I don't spend much "face time" with patients, but the "system" has forced everyone to cut corners in an effort to increase volume in order to increase reimbursements. I cannot do my job--just like you--without every other member of the O.R. team working in sync to make sure the patient is SAFE, over & above everything else. But, if I was asked what some of the other staff does on a daily basis, I honestly couldn't tell you. So, if I was asked to do a peer review of them, I wouldn't know what to say about their actual work performance. I could say that they are friendly in the locker room or that I have no interaction with them whatsoever. I know what you mean by "equal" in a team setting. Things couldn't run ANYWHERE without everyone doings their jobs to meet a common goal. My point was that if different job titles were told to do peer reviews, I don't know how that would be possible since a part of peer review, as far as I know it to be, is critiquing their work performance. While I believe it would be possible for an RN to do a peer review for an aide, I honestly cannot see how an aide could possibly do a peer review for an RN since they really don't know whether the RN is practicing safely or not. That was the point I was trying to make. I just find it strange that an aide would be expected to do a peer review for an RN, that's all. To be honest, the whole thing makes me laugh because of how the entire healthcare industry has turned into nothing more than a profit-driven business. Do you honestly think that peer reviews make any difference to a facility or how it functions? The most important thing is safe, quality patient care. Maybe nurses should be asked to do peer reviews of nursing management & administration. Now that would be interesting...................

I'm curious about a scrub tech being permitted to be a "laser operator". You don't mean that a scrub tech can actually "use" the laser, do you? I am curious because I know in some states, only MD's can use lasers for dermatology/cosmetic purposes, and in other states nurses and even "technicians" can do dermal laser procedures. There are lots of "spas" that perform laser hair removal & the person operating the laser does not have any professional license--they just took a course for a couple of days to learn how to turn on & push the laser around so the spa can charge a couple hundred dollars per procedure. I have to assume in a general O.R., you must mean nurses & ST's can turn the laser on, input settings, etc. for the surgeon to actually use. Usually---and I say usually because sometimes facilities will skate on thin ice for financial purposes---the state sets forth who can do what when it comes to clinical practice.

In this day and age of extreme short staffing, I find it hard to believe that there is no other way to witness waste than to take another nurse away from their own job tasks to watch a nurse waste narcs. Electronic dispensing machines have been around for decades. EMR's have been around for many years. Electronic med carts have been around for many years. It's difficult for me to believe that there is no way to electronically monitor a nurse wasting a medication. Video camera surveillance in a med room could provide an "eye" to witness waste.

You do? Really? I feel that a cover letter is a waste of time, paper & ink because no matter what is in the letter, it is the application & resume that really makes the decision. Plus, HR Googles every nurse before inviting them for an interview. So, you can write a fabulous cover letter, have a resume that would knock socks off, but if you post anything that is not politically correct on social media, you go in the garbage can. I actually think that there should be a law preventing employers from looking potential employees up on the internet. In some states, employers cannot ask questions about criminal convictions. But in the states that allow it, even though employers are theoretically not supposed to discriminate against those with a criminal history unless it is a direct conflict of the job, they still do. I also don't think nurses with actions against their licenses should have to answer that question on an application, especially if it is more than 10 years old. That question, without a doubt, is discriminatory right out of the gate. A job application should be a basic document where a potential hire writes down demographic info---education, experience, licensing, certifications. It should not be a place where a nurse has to tell a potential employer about being in a 5 year monitoring program for a DWI that occurred 16 years ago. A 16 year old DWI wouldn't even appear on a criminal background check---why should it be relevant just because the board of nursing decided to punish a nurse for something that occurred 16 years ago to justify their paychecks? Why should a history of petit larceny that occurred 15 years ago, when the nurse was 18 years old, long before they were even licensed, be relevant just because the BON decided to slap that nurse with a disciplinary action against their license just because they wanted to flex their power? This is why I think a cover letter is a waste. Decisions are never made because of a cover letter. A nurse applying for a job needs a job. Maybe they have experience, maybe they don't. The way nurses are being hired these days is ridiculous. I was hired for my first job out of college, at a major NYC tertiary/teaching hospital, over the phone right after I was interviewed on the phone as a senior in the month of March. I was told what date I would start, when I had to go to health services for my physical & what documents I had to send them. Staff nurses are not C-level positions at Fortune 500 companies--interviewing them like they are is ridiculous. I have actually been asked questions at interviews that are illegal to ask--about my "family" (disguised to find out if I had kids), my husband, questions relating to financial status (to see if I planned to retire out of the place), if I exercised or went to a gym (trying to see if I had any physical disabilities), where I lived (to see if I would be able to get there on short notice, i.e. to cover sick calls). The interviewers have all kinds of questions that don't directly say anything to violate the laws, and it makes me laugh when they think I don't see through their act.

Working as a team is much different than comparing the practices of various healthcare workers. Just like a nurse can't perform surgery, an MA can't manage a patient on a ventilator or flush a PICC line. To say that everyone's practice is equal is not realistic. Everybody's actual job is essential to keep the place functioning as a whole. I believe human beings are equal, but job responsibilities are not. Since you have a master's in nursing & are a certified nurse midwife, I am surprised you don't know how to take someone's blood pressure or turn over an exam room. In order to function as a team & keep the flow moving, sometimes people have to do tasks that they don't ordinarily do, that may be "beneath them", no matter their skill set. As a midwife, you can provide pre-natal care & deliver a baby (I think), but you can't perform a c-section. Professional practice is governed by state licensing authorities. I totally appreciate a team working together to keep the process moving, but to imply that front desk employees are equal to clinical providers is not accurate, I don't think. You actually make a great statement when you say that "people have different skill sets"---if you do not know the skill set of your peer, how can you possibly write a "peer review" for them? As a CRNA, how could I possibly write a peer review for you as a CNM? I don't know what you do (well, I do, kind of--but don't know if you are doing it well or poorly) nor do I know what the goals are. And you couldn't write a peer review for me---you know I give pregnant women spinal & epidural anesthesia, but you have no idea what I do in the O.R. because you aren't there. So, even as 2 post-graduate prepared nurses, we wouldn't be able to peer review each other. Working together is important. When a cog is absent from the wheel, it greatly impairs function.

What I find ridiculous is that a BSN, even though they try to say that it is "focused" on nursing, is no different than other majors that have to take all the basic stuff any BS major has to take. Everybody takes 101 level courses---English, math, chemistry, etc. They all take stupid basic electives (mine were East Asian music, oceanography 1 & 2 [which I LOVED!!], astronomy, Greek mythology & some other stupid ones) and the "meat" of the major doesn't come until junior year. Sure, for nursing you have to take anatomy & physiology, statistics, microbiology, pharmacology as pre reqs---but you take those in both ADN and BSN degrees. Nursing students at 4 year college don't take any specialized nursing courses or step into a hospital until their junior year. If you completed pre-reqs for BSN, you can probably have them transferred & do an accelerated BSN program. The only courses you are going to need are the nursing ones--I assume you have already taken anatomy & physiology, chemistry, microbiology, pharmacology, psychology. If you have all of the pre-reqs, transfer them over so all you have to do is the nursing stuff. You can probably be done in less than 2 years.

If an RN is equal to an aide, I'd ask the MA's to do nursing tasks & when they go to the manager to report that they're being told to perform nursing tasks & the manager comes stomping over to you to ask why you are telling an aide to do a nursing task, I'd say "Well, didn't you say that RN's and MA's are the same? If we are the same, then we can do the same stuff. So, that's why I am asking the aide to flush this patient's PICC line."

Well, it is true! It's NMFB (not my f****** problem) that the hospital doesn't have a 24 hour pharmacist. I am not going to practice beyond my scope of nursing because the hospital is too cheap to employ someone that can, legally, mix meds. If something happened because a nurse mixed up a medication that another nurse administered, and a patient was injured, you can bet the the hospital would NEVER stand up for the nurse & tell the state that it is their policy for nursing supervisors to mix up medications that other nurses administer. The hospital would throw the nurse under the bus to protect itself, fire the nurse for not following P&P & then fight the nurse's claim for unemployment. When the hospital & nurse got sued, the hospital would try to get out of the lawsuit by saying the nurse didn't follow facility P&P so they have nothing to do with it. Unless you can find somewhere in the hospital P&P manual where it states nursing supervisors are to act as pharmacists on evening/night shifts, mixing up medications that other nurses administer, I would stop doing it. (And if the hospital P&P manual says something like that, take a photo of it & send it to the state Department of Health.) No matter who or what it is---a rural hospital, long term care facility, home care, etc.---these places expect nurses to take on tasks that are beyond their realm of practice. They'll try to convince the nurse that it's okay because the facility allows it, etc., but the bottom line is that the state draws up what nurses are allowed to do. Don't do it. If the facility tries to threaten you with your job, just let them know you'll be contacting the state to let them know you were fired for refusing to act beyond the realm of nursing practice. There is no place worth putting your nursing license at risk for. Trust me on that one.

Ugh---I feel for you, I really do. I have a friend that left nursing when she gave to birth to her 2nd child (she has 4 children total) and now that they are in college, she wants to get back into nursing. She was an ICU nurse when she left, she is a hard worker, extremely reliable & an excellent nurse. She took a review course, renewed BCS, ACLS. But she doesn't have a BSN, which is a major hurdle for her. When she worked as a nurse 20 years ago, it didn't matter. Now, it does. She doesn't want to enroll to get a BSN if she won't be able to get a job anyway. She sent tons of applications & didn't even get one call. I feel that hospitals are making bad business decisions when it comes to not hiring experienced nurses that took a leave of absence for whatever reason. The human body hasn't changed for quite some time, some medications have changed (which is no big deal) and treatment of some diseases have changed. That stuff is not difficult to adapt to. Everybody has cell phones & computers these days, so learning EMR's is no big deal either. I actually feel that this could be considered a form of discrimination. I know several physician's that took time off to stay at home with their kids & had no problem returning to practice. Why is nursing different? Not hiring an experienced nurse just because they took a leave of absence--no matter what the reason is--is discriminatory practice. As far as your resume---I would put an separate additional area for "Continuing Education" to show that you did take a refresher course. I am on the fence about explaining the 10 year leave in a cover letter. If anything, I would probably put something on the resume that explains the 10 year absence in semi-specifics. You don't say what your disability was, but if it was anything mental health related, explain it in a vague, non-specific manner. You can elaborate in a face-to-face interview. I'm not sure that I would put anything specific about any disability in writing--you don't know where those documents go. The truth is, life happens. People leave their jobs for all kinds of reasons & should not be discriminated against when trying to get back into their careers. I personally think cover letters are the equivalent of toilet paper---I don't even know if anybody reads them, because it's all just "I want a job. I'm so get at what I do. I'll be an asset to your company. Blah blah blah". They go right to the resume. On your resume, I would include something about the 10 year absence, whether you say you took an LOA for family reasons (which many nurses do). I would somehow focus on the fact that you worked for the same place your entire career, (maybe mention this in your cover letter, because it will speak for itself on your resume) you were let go because your initial leave lasted longer than you thought it would but the same organization hired you back----that says a lot. The bottom line is that you had a 10 year absence---it doesn't really matter what for. To expect women to continue working a full time nursing job with young children without taking any time off is not reasonable, nor is it reality. You could put something in the cover letter like "After a 10 year leave of absence from nursing for family and personal reasons, I am eager to return into the nursing field to utilize & build upon the experience & skills I attained during the X number of years I worked at XYZ Medical Center. Although it has been 10 years since I worked as an RN, I have not forgotten the important skills of prioritizing, being organized, patient safety and providing quality patient care. Blah blah blah." Deflect from the 10 year absence & make yourself attractive to an employer. I think it is absurd that hospitals think nurses who have taken time off cannot return because they're like new grads, which they're not. The problem is that in today's healthcare environment, places want nurses that can hit the ground running because they don't want to spend the money to train them.

NO, NO and NO!! That is too much debt to take on at this stage of the game. If you are bored as a CM, remember that when you work in the OR you have NO interaction with patients at all. It is very boring, very stressful & dealing with the personalities of surgeons is a whole issue all to itself. All you do is pass instruments as the scrub & do paperwork as the circulator. Bored is not necessarily a bad thing. Most nurses complain about being overworked, underpaid, & the unsafe environment of various facilities that purposely run with extremely short nursing staff to save money. Many nurses would kill to have a desk job where they were "bored". Remember, at 59 years of age, the risk of getting hurt is much higher now than it was 10 years ago. Not having a BSN is definitely an obstacle, but I don't know if it is worth it to get it at your age, if you only intend to work another 9 years. Another obstacle in getting a job is your age. It shouldn't be, but it is. My advice would be to suck it up & continue with your boring job until you retire. Nursing is not the career it used to be (I am saying this as a nurse with 30+ years of experience) and if you are lucky enough to have a job where you can sit, not have nursing management micromanaging you and just do what you have to do, I say take advantage of it. The chances of getting a hospital job even if you are enrolled in a BSN program are low. Don't risk losing the job you have now. Maybe to give you the excitement you seek, you can take up skydiving or scuba diving with sharks or some other "exciting" hobby. "Excitement" in a nursing job isn't what you want, not at this stage of your life. Trust me on that.

No, No, No. Mixing meds so that the ER nurses can administer them is practicing beyond the realm of your license since mixing meds is the job of a pharmacist. I know all about this because once, many moons ago, as the off-shift house supervisor, I was told to mix up a bag of chemo that the pharmacist had forgotten to mix up before he left for the night. I refused to do it. I called the pharmacist at home & told him that he had to come in to mix up the bag of chemo because I wasn't doing it. Because he lived about an hour away, he tried to convince me that I could do it---he'd talk me through it, blah blah blah. I still refused. I know he was pissed off when he came in, but that was something he should have done before he left & he didn't----not my problem. It is not your problem that the hospital is too cheap to hire a 24 hour in-house pharmacist. An RN mixing meds on the unit that they are going to administer themselves is much different than an RN mixing medications that are going to be administered by another nurse. That is against practice laws, and you should let administration know this. If they give you a hard time---or even go as far as terminating you over your refusal to mix medications---just let them know you will file a report with the state Department of Health, Joint Commission and the EEOC for making you perform tasks outside the realm of nursing practice.

Well then, what is the "policy" as far as insulin titration? Unless the practice can produce proof of a policy that you were not following, I can't see how they can throw you under the bus. Plus, the doctor wasn't following "the policy" either. If they are going to throw you under the bus, they're going to have to throw the doctor under the bus too. If they can, and do, produce a "policy", make sure you see a date on it. If the QI person identified an area of concern, the process should have been a manager speaking to you about it so you could change it. Plus, the doctor also needed to be notified of this so they could change how they were practicing. If you didn't know you were doing anything wrong, you certainly aren't going to do it a different way. Also---who was the person that taught you to do it this way?