auroranae

Sorry no one else has answered your query. I am an LPN in the Baltimore area. I have 27 years of experience and have worked in every venue from MD offices to Alzheimer's Units to Community Nursing to Private duty pediatrics. There are a lot of opportunities out there in this area. Harbor Hospital and GBMC do hire LPNs. Johns Hopkins hires them for the Community Physicians offices - they are all over the Baltimore area. There are several home health care companies that hire new grad LPN's and just about any LTC facility will give you a chance. Salary... well that varies. Expect 15-18.00 an hour to start unless you are working nights or evenings or weekends. Some facilities pay higher rates but you have really look for them. I hope this helps. I am currently a pediatric nurse working with a home health care agency. I work nights with 1 child who has serious health issues and must be monitored 24/7. I make 20.00/hr and have been for about 10 years because the type of patients that I work with are model waiver ( medical assistance covers health care because they have capped out their private insurance) and all the state will pay is 20.00/hr--- I have found this pay is the same in every state I have looked into relocating to because the model waiver program is uniform across all states. Again... I hope some of this helps. If you really feel a pull to the health care profession once you get your foot in the door you will be able to see what it is that you like best and then you can specialize in that area. Good Luck.

It may be years before you hear those words spoken again, if ever. But the time in between is made totally worth while by the rare occasion you hear the words "Thank You". In 26 years I can count the times I have heard it on 2 hands with fingers left over... but that does not make me any less compassionate or caring to all of my patients. I think of the smiles or light touches on my hand as unspoken thank yous and that is enough to keep me going... most of the time.

In many cases those who are suffering with Fibromyalgia also have other illnesses that may or may not have been accuratley diagnosed... often rheumatoid arthritis, lupus, scleraderma and any other number of autoimmune illnesses and syndromes go hand in hand with each other and unfortunately they are not always a black and white right or wrong diagnosis and treatment. Sometimes it is the most frustrating thing on earth to feel awful and not even be able to understand it yourself, let explain it to others. Never place judgement on our co-workers or patients, you can never really know how they really feel. Some people can live with pain and illness and no one knows, while others cannot manage the most minimal of tasks ... everyone has different tolerances and different ways of coping.

Hello all! I am an LPN ( nearly 24 years now) and have had the TCN modules sitting in boxes- yes they sent all of them to me at one time which was overwhelming to say the least- in my living room for 2 years. I started the psych module when I first got it, but became very ill... was ill off and on for several years before being diagnosed with Lupus, then started a round of 'let's see what meds will help and what won't.' I have been in 'remission' for about 6 months with some minor flares and am ready to buckle down and get these modules out of the way. My goal was to start them in June of 2006 when I had to quit my full time Home Health visiting nurse job because of the Lupus and take 2 years to complete all 12 modules needed before I can move to phase II however... 18 months later and I am just getting around to opening the boxes again. I have had a hard time getting someone from TCN to contact me reguarding my study materials. I paid alot for them and each module says in the front to call to make sure it is the most up to date version of that module before beginning. Well my liason is no longer working -- she left to have kids--- and no one else has returned my calls or answered my emails. I have gotten more information from all of you on this list... Thanks so much! So... now I just need to find the energy to get the studying done and get those darn tests scheduled and taken care of... Thanks for the help... ~dawn the OLD LPN in Maryland

I have been working for a pediatric home agency doing private duty for chronically,terminally ill children since 1993. I have also spent the last 4 years working for a company doing home health visits 3 days a week. I love both positions for very different reasons, but also for the same reasons. I love working with the kids even though they have some very unusual and often very rare syndromes. It keeps me on my toes and up to date with new meds and treatments. I do alot of trach and GT patients with these cases. I also enjoy doing the home visits. On a really busy day I would put in 10 or 12 hours and see 7-9 patients. Not too bad, except that most of the time is spent in the car in traffic travelling from case to case. I would travel 100-150 miles a day most days. But the patients were varied and interesting. I would see new diabetics and cardiac patients to do diet and med teaching, new moms and babies for newborn checks and breast feeding teaching, wound care on just about every type of wound or surgery imaginable and alot of IV starts, maintenance and trouble shooting. I took care of patients with MS, cancer, chronic fatigue.... you name it. It is a great way to keep up on the latest techniques, meds and syndromes that are out there. The down side is also my favorite part about both jobs- working on my own and being accountable for my work. It can be very stressful when you are in a home care situation and things are not going the way you want them to. You have to make decisions about the immediate care needed, contact the MD, arrange for supplies, therapies, and so much more. And you have to make sure you follow all state and company protocols, maintain the HIPPA privacy act, give quality care and be cost effective for the insurance companies so you do not use all the home care visits that they allow before the patient is well enough to not require the home visits. With the private duty cases many of them are on public health programs and not of the highest educational level or in the nicest neighborhoods because so much of what they had was used to care for their child until they were eligible for assistance. I have had cases where the parents had to divorce and live separately with one of them quitting their job so they could qualify for assitance-- not because they wanted to divorce or live separately! It was the only way they could get the health care needed for their child. It is a difficult type of nursing care to provide and not the kind of thing that everyone can handle. But you not know unless you try it, and the rewards in the people you meet and relationships you have with them is rewarding in itself. Just my thoughts...

I was 15 when I started nursing school. I went to a vocational school while in high school. It was a 3 year program where we went to high school half a day then to the vactional school where we took the community college classes. It was a very difficult and demanding course load and we lost nearly half of our 20 class mates during the 3 year program. I graduated at the age of 18 nearly 23 years ago. I have had a wide variety of nursing jobs along the way and thank my instructors for using the RN curriculum and standards for I was more prepared and able to handle more than any employers expected making me a better nurse. Unfortunately the Class of 2006 was the last PN class in our state from vocational school. They have closed down the program after over 30 years. Have no idea where the new nurses are expected to come from now...

I am having a mild flare up that has been getting worse over the past few days. I was doing really well and only taking naproxen every now and again. I tried Soma which did help a little, but I had an allergic reaction to it and can not take it anymore. So I have gone back to the naproxen and now am worried about the long term side effects from it. I had a virus infect my heart last year and my heart muscle is still weak so any possible heart problems from any of the meds that give any degree of relief causes great concern. I have never used narcotics for my pain. Not that the pain is not bad enough to warrant them, I just am not able to function and take care of my home and family while taking them. My luck I would be zonked on the sofa and the boys would catch the house on fire. I can see me being so out of it the house goes up in flames while I lay there looking at the pretty fire. I am extremely sensitive to narcotics so they just are not an option. Does this mean my pain is less or that I am not really suffering with fibro? No- it just means that I grin and bear it and try to keep going. I have found out that alot of others are like me. As long as they are moving they are fine. It is when they stop moving that the pain hits hardest and life becomes unbearable. Which comes first-- the depression or the pain? Does it really matter? One begets the other in a vicious cycle until everything is connected to everything else. Have pain can't sleep can't concentrate can't keep up at work can't keep up at home have pain ... breaking the cycle is the key... but no one seems to have the key that fits everyone. Certainly not the one that breaks my cycle. Treating the symptoms of the problem don't fix the underlying cause so.... depression or pain first is the not the question. The question is how do we stop both and thereby stop fibro flare ups and give quality of life back to people like me who are busy, active and intelligent human beings that can be reduced to a lump on a couch if the pain is bad enough?

[the co. has the nerve to claim it cares about the pts wellbeing, Yeah right and I'm blue w/ pink spots too] Hey can you send a picture of yourself? I have never seen a blue person with pink spots, and I have been a nurse for 20 years! I am lucky that this is what happened the summer I graduated from nursing school. I applied for about a dozen jobs and was hopeful that I would be able to choose the one I wanted to take from the job offers. Well... silly me. Back in the mid-80's is when the "time management/cost-effective" people came thru and audited and then bought out 3 of the hosptials and walk-in care centers in our area- along with several nursing homes and clinics. Their biggest "cost-saving" move was to get rid of all the LPN's since we are apparently not really nurses. They gave the bulk of the LPN duties to CNA's and PCT's ( a new position they created from cna's with a crash course in nursing practice without the theory). Needless to say within 5 years 1 hopsital had closed it's doors, another had been taken over by a large Medical University and taken under it's wing and rebuilt. The others have since been bought yet a gain by a company with the same cut-costs policies. I was lucky to have not gotten a job and then fired. I had to work as a medical office receptionist as their weekend and evening nurse when the regular one needed time off. I had to work doing insurance claims and billing and even the collections for the office just to keep a foot in the door in case a nursing job came up. BUt I learned alot and have been able to use that experience to help me with all of the jobs I have held since then. Try to look at the positive, and deal with the negative when you have to. It may be a good thing in disguise!

I am in LPN in Maryland who is an hourly employee. I am paid 18.50 an hour plus $.25 a mile. The hourly rate applies to all time that is associated with patient care- follow up calls to other disciplines, md calls, coordination of care with other agencies, paperwork time etc. Alot of the admin work I do at home but that time is still calculated into my patient care hourly time on my time sheet. I understand there are other home health agencies who have an entirely different pay rate. A friend in another county with another company gets 35.00 per visit and $.25 a mile. She does not get an hourly salary so any work done at home is not compensated for. I do not know what the RN rate is ...

Tom- The problem you have is that you cannot look at a lab result and say "AH HA!" there it is! WEll, with FM you can do that in a sense... but it sounds more like "AH Ha, that's not it either!". The tender points are a criteria but not the only dx tool. There are a battery of lab tests that are done and based on the ruling out of all other possible problems, FM dx is given. If it is not Rheumatic Fever and it is not Rheumatiod arthritis and it is not Sarcoidosis and it is not Lupus --- all of which have nearly EVERY SINGLE SYMPTOM AS FM-- then the we know it is FM. There are studies and diagnostic tools in the works. I go to Hopkins Rheumatology for my FM and they are really advancing in understanding, but it takes time. I was at Hopkins in 1982 for a lecture about AIDS. I still have the notes from that lecture. THEY ARE ALL WRONG according to the standards of today. But, we know that AIDS was and still is a real illness. The tests they did then were worthless in detecting it, they suggested an Autoimmune disorder similar to LUPUS or RA... and that is how they first approached the disease. As they learned more everything about how to diagnose and treat and even how the disease was transmitted was re-thought and relearned and retaught to the public. It just takes time to fnd what they need to know, doesn't mean the test isn't there...they just do not know enough about the illness yet to do the right series of tests. The same is true of HELLP Syndrome in pregnant women. There is a large number of women with this, but I wonder how many on this list have ever heard of it? It kills mothers and their babies every year in the US... it is one of the leading causes of infant mortality and premature birth. And there is still no positive test for it... If there is no test than it does not exist?

On the path to the FM dx I was told I had rheumatic fever. That scared my Mom nearly to death. My labs show that I probably had it at some time without knowing it since my last complete blood work up several years ago. Gee, nice of some patient to have shared with me. But, FM being so unknown, no one seems concerned by the pain and drastic decrease in my mental ability or the pericarditis of unknown origin. I have a high tolerance to pain ( I gave birth to 5 of my 6 children naturally and they were 9 and 10 pounds) and only sought help after 3 days of pain so bad I cried with every movement I made. The chest pain I have ignored since last August when diagnosed -only because my DON called 911 when I did not look too well and my blood pressure was 210/180. I was refusing to go all the way to the ED. I was told the heart was healthy and the pain and pressure and fluid would "go away" and not to worry about the abnormal stress test. I failed with flying colors! Me- a very active mother of 6 who walks and does yoga and plays soccer with the kids, and baseball and rides bikes... and now to be told I am inactive unless I am going to a paying job because "being at home" is not active. Try getting 4 kids ( 3 under the age of 9) out the door to school, taking kids to baseball, dance, church, work and other extra-curricular activities 6 days a week inactive. Oh and then I cook and clean and do laundry and light housework as my body allows...may take me a week, but I will get the floors vacuumed and mopped and the rooms dusted! Again... I get the looks and rolled eyes... like this is a life that someone would choose to have. I would prefer my old life, the one where I could work 30 hours a week, take care of my children, pay all of the bills and feel very satisfied with the job I was doing. Now I am made to feel guilty for not being able to continue my normal life. It is sometimes worse to deal with than the pain and chest pain& SOB. A modicum of sincerity from medical staff would go a long way toward helping me cope with the changes in my lifestyle that I cannot control when I go to a DR appointments.

I am a nurse who was recently diagnosed with Fibromyalgia. I have done alot of research on this and in many ways it is a catch all term. There are some lab tests that may suggest you have it, but the only way to confirm diagnosis is based upon the "pain points" the patient has. There are a total of 18 pain points that are associated with Fibromyalgia and a patient must have pain in at least 11 of these points on a consistent basis. Most patients do not have pain in all places at once, but rather a few places that are always painful such as knees, ankles, wrists, etc and then random transient pain to the other pain points such as neck, shoulders, hips, feet, calves etc. There is also another group of symptoms that go with fibro... severe fatigue and weakness, memory loss- short term and often described as a "foggy" feeling or "forgetting what I am about to say", as well as insomnia. Because of this CFS is also thought to be part of the fibromyalgia family of illnesses. Please note that the ONLY treatment for fibromyalgia is palliative. This means that the symptoms are treated since the cause is not yet understood. The palliative treatment is to treat the insomnia and increase physical activity. By increasing the amount of "good sleep" or REM sleep, which many fibro patients never cycle to before waking, and thereby increasing the amount of serotonin secreted by the brain, you can, in many cases, improve the patients pain tolerance. Serotonin is a natural pain reducer or anesthetic so the patient may experience pain, but it will be less severe and less debilitating and therefore, more tolerable. THe only way to increase serotonin secretion at this time is with drugs that are commonly prescribed for depression. Amitryptilline is the drug of choice, but patients with other health issues may be given paxil as a substitute. There has been some correlation between depression and Fibro, but it has been found that it is a result of severe insomnia causing a reduced secretion of serotonin. Once that has been treated the depression symptoms are gone. But, the anti-depressant tx will continue to prevent insomnia from returning. These are not psych patients, they are neuro and rheumatic patients. Many have multiple disciplines affected by the fibro. More than 70% of patients with fibromyalgia also have GI probs- namely IBS, but less than half of patients with a primary diagnosis of IBS have fibromyalgia. A large number of patients with fibro are later found to have Lupus. Many Lupus patients have fibro as secondary diagnosis. You can have fibro without Lupus, but some studies suggest that if you have Lupus, you will have or develop Fibro at least to some degree. The most affected population for Fibromyalgia is women, the same basic group as those for Lupus and Rheumatic problems. Because of this, it is thought that these 3 illnesses are closely related which makes it harder to pinpoint the cause of any one of them. Oh- and Fibromyalgia is considered a SYNDROME- which means it is a group of symptoms that alone may be a minor problem- ie: pulled muscle, sprain, digestive disorder, but when found together are something with a totally different cause and do not necessarily respond to treatment as separate problems. For example- treating IBS with traditional meds will in all liklihood not be as effective, if at all, in a patient with Fibro. The reason is not yet understood, but perhaps will soon be. The reason for the sudden onset of this diagnosis is simple... it was only recently in medicine that woman's complaints have been really looked at and studied. PID is a recent dx as is Pelvic Congestion Syndrome. Does not mean they haven't been there, just means that doctors are actually listening to women's complaints and in so doing are starting to note patterns that were previously not seen. 40 years ago cancer was considered a catch all term for patients with various illnesses that a doctor could not diagnose or that did not respond to treatment. There were many doctors who did not "believe" in cancer. Because of this many people died who could have been treated successfully. Looking back it seems silly that doctors thought it a made up illness. I wonder if the same will be said of these "catch all" neuro and rheumatic illnesses and syndromes that we are seeing more of these days. When treating a patient - with any illness- it is important to remember that you can NEVER know what they are going thru unless you too have gone thru it. Therefore, you can NEVER judge a patient. No matter how nuts they may seem, one day it may be you that is being looked at that way. BTW- I was diagnosed with Fibro but am having symptoms that have affected my heart as well. I have been to see a rheumatologist who gave me the fibro dx but dismissed Lupus even though I exhibit many of the symptoms and have a familial tendency. Her official report read" Patients with fibromyalgia are typically overwieght and inactive...Returning to work is recommended to prevent inactivity which will only exaccerbate the pain and symptoms of fibromyalgia". Even a learned person who nearly exclusively sees patients with fibro is not above stereotyping and in so doing may actually be causing more harm than good. According to her report I should be working my nursing job-- I am a visitng nurse and drive 100-150 miles a day seeing patients for 12-14 hours a day. I am currently unable to walk up a flight of stairs carrying a laundry basket or vacuum AND mop my floor in the same day with becoming short of breath, so fatigued that I cannot think or function, or experiencing such pain in my body that to move is nearly impossible. Add to that the still unknown heart problem- Pericarditis of unknown origin- again not a symptom of fibro at all... well, taking care of my 6 children and trying to lead as normal a life at home is hard enough, but to be told that unless I am going to a paying job I am inactive is very frustrating and very predjudiced thinking. I am sorry this is so long, but as nurses we must remember that to judge someone can prevent us from providing the care they need. I am on the other side of that judgement now and it is not a nice place to be. My pain and symptoms are very real, as is my fear that I may not be able to return to work, go to my son's baseball games, see my daughter's dance recital, keep my other daughter in college, because I am in pain and many times unable to walk or drive, or remember what I was doing or saying, or take care of my family the way a mother is supposed to. And because people tend to disregard my illness because it is "a catch all term".

Gradutated nursing school in 1984- I went to a vocational school while in high school and we were actually taught the curriculum for the AD RN program at the local community college, but being just out of high school the most we could test for was LPN. Our instructors taught us everything they knew and I am grateful. While working nights in a nursing home there was frequently no RN in house to do things an RN was 'supposed' to do, and then there were often times an RN in the house had no idea what to do.( not saying anything against RN's-- have worked with good and bad RN's, LPN's and CNA's over the past 20 years.) Gloves were never available, we did baths, tube fdgs, iv's, wound care, laundry, snacks, took orders, checked orders, performed cpr and called 911, prepared the patient for transport and then walked them to the ambulance to make sure they got there ok... we never had enough time, enough supplies, enough staff and always had too much to do, too many patients and too many complaints coming our way... but we all survived and I can honestly say that some things have gotten better... but then some things have not. I now have all the gloves I could ever want, support staff available if I need them, computers to make my charting easier and a generation of MD's that are more receptive to the ideas and observations of nurses... I also now have too many things to do and not enough time to do them, computers to make life easier and charting more uniform, 101 new generation drugs to have to learn everything about in case a patient has a reaction to one... and a computer that is supposed to make my life easier... I am a home care nurse and the best thing that I still have that I had in any job back in the 80's is time to spend with my patients so that I can build a rapport and really get to know them as people and not just as illnesses.