anichols

sorry, have seen one too many cases of facial mrsa from pimple-popping to even *consider* playing with someone's zits, no matter where on the body they are....(besides, the gunk in them wierds me out anyways!)

had one just the other day...a guy c/o a "lump" and worried he had "hysterical cancer"....when he started talking about his scrotum i figured out he meant "testicular". odd part was, he could pronounce "testicles" just fine--but it was *still* "hysterical cancer" he worried about!

i've worked locked alzheimer's and psych. they are in no way the same, excepting the acting out. and this seems to be what the lady posting seems to be missing. the degree and friends she cites as her reasoning are the same as many others have...who have different opinions. perhaps she needs experience, or perhaps just a reminder that certainly she herself has had cases where the textbooks did not cover the scenarios she may have seen and she has had to adapt the theory to the case. that too, she will hopefully recall, is taught along with the theories. perhaps if someone had not used the label "lying", thus making her feel she needs to be defensive at being labeled as amongst those who are dishonest? perhaps if another more politically correct term were used? on her behalf, she is most likely coming across as argumentative not because she is actually so but because it is her way of trying to explain her viewpoints and respond to others who have not yet found the "magic words" needed to give her a clear grasp of the picture...she is (hopefully) trying to work it out by re-iterating the areas she is stuck on until she can have the resolution needed. much like an alzheimer's patient, come to think of it. as for reminding someone of a death and making them re-live it for therapuetic reasons in this given instance?...specifically against the do no harm, as it causes medical issues (ie--hr, b/p, et cetera). also, they may have dealt with it just fine before--before they "became" a newly-wed again, or before they went back to being 40 again. re-opening it to make it fresh, when they honestly for organic reasons cannot recall--not just blocking or disassociating--it, to be hashed through, forgotten, and then reminded again and again and again. sorry. unending grief cycle is in no way therapuetic. it is simply cruel.

i like having to be mentally on my toes and ready at all times. yeah, i can do a tube or iv or run a code...so can any nurse (some do it better though!). but i get the chance to make a difference by picking up on the subtle nuances, not just going "oh, look--the dressing needs changed again and here's your antibiotic".... psych nusres don't just treat symptoms and wounds or see the person as a medical diagnosis (ie--diabetic, oncology, what-have-you)--we try to heal the whole person!

schiz adults...always fascinating, rarely dull. borderlines suck me dry, depressions bring me down, youth units make me give up on humanity (mostly from their life stories).

i want brownie points!!!...got myself two borderline disorder pts who are threatening to write me up for not sending them to er last night for "chest pains" (right after overhearing them discuss how "they always have to send us out of we say that because it could be serious and you'll get some kick-@$$ meds, man...i got morphine one time"). both w/ perfectly gorgeous and stable vitals (despite repeated checks--"the dynamap is broken, take it again"...okay, fine, but my fingers and ears aren't and you're still stable!), changing descriptions of pain and locations...oh, and lest i forget..."i have a history of heart problems (but no dx and got a couple of ecg's right here they've taken since some other nurse who didn't want to keep playing with them keeps sending them out...oh, look! normal, every last one of them!). and my favorite of the night: "i need to go to the hospital i'm sick!" (yes, you are...that's why you are here. and this is a hospital. or maybe it's 'cause i'm a psych nurse that i somehow didn't get trained in assessments or vitals or ever work a "real" hospital like every other nurse out there?) like ya'll er nurses to much to give you the hassle of my attention-hungry drug seekers....so do i get my brownie points now? now, what was that bit about people who go to er all think they really are having an emergency and nurses are bad for not understanding that?.... oh--both survived the night just fine, just as healthy in the morning, and were pissed i put them on extra checks overnight for medical reasons just in case "because that may affect our pass privilages if the treatment team finds out...you won't chart it, right?".....:angryfire

to the OP: others have pretty well covered the doctor angle you asked about but...and this is just from my viewpoint...my husband was going to go from engineering to nursing. after some soul-searching, he is now going for his paramedic instead. deciding factors: engineers are accustomed to working independently. nursing is constant interaction. engineers are accustomed to doing their own problem-solving. nurses problem solve, but then have to get an okay from doctors on most things. prints are straight-forward and easy to analyze. a scared, confused, or malingering patient is far from that. engineers, as a lot, tend to be very logical-minded. nurses need to be, too. but the patient is usually more emotional-minded and will sometimes not be able to see things logically. that was the main factor for my husband--constantly dealing with emotionally needy people when he is unable to understand that mindset. paramedic also deals with all of the same problems as nursing, but is more task-oriented in the manner he is used to, and with quicker results like he is accustomed to (treat, transport, done as opposed to weeks or months before the patient is well). and, well, honestly...he's more suited to butt-kissing for shorts stretches to get a task done than he is do do it all day with doctors, family members, and sometimes the patients themselves to boot. think if any of these qualities apply to you--they may not. but, as my husband has said, in the end he'll have the same degree as i do, make about the same, and get to be "doing somthing" (no flames! not my words!) rather than spending half his time playing kiss-up or trying to be a nurse when others see you more as their personal maid for their stay....

now see, i'd been told to watch the earlobes for imminent death--they "turn under" (back towards the scalp). i think it's the same rationale as the nose--dehydration. and i've seen it many a-time. i'll have to keep an eye out for those nose, too, from now on....

transitional (lpn to rn) or traditional? transitional at columbus is a breeze so far, mostly internet, don't know about the traditional program.

if you can handle the responsibility of planning your own schedule and stay aware that there will be "dry" periods, then i say go agency. but as i've been agency-only for a while now, i'm prejudiced! some can't handle not having a set schedule and either don't schedule themselves enough or wig out when a week goes with no work (of course, if you wait another week you can probably get overtime!). cna's with my agencies (register for more than one...betters your chance for hours) make 5-10$ more than staff. you will have the option of not going back to places you don't like--and you *will* get sent to some real h*@#-holes--, and may even get to be a "routine" agency at somewhere you like and go almost nowhere else if you so choose. you may have to drive a fair distance if you're not near a big city. i use indy agencies although i live in s. indiana...and they have assignments for me ranging from next to cincinnati to north of indy (my preferred driving limits), so there's a lot of facilities to choose from if you are willing to drive. i now work exclusively at a place in indy although it's 1 1/2 hours away, just because i like it there so much...and 3 shifts at agency pay makes up for 40 hour's worth of staff pay, so i have more free time! if you agree to a shift, you must show. but you do not have to agree to any shifts...if you want a week or so off, just say so and voila! but it does take budgeting (summer hours are always handy--everyone else wants to go on vacation--but hours dry up around christmas when staff wants overtime to pay for presents) and self-discipline. you'll be expected to go into a strange place and be able to keep up as if you've always worked there, and every place has someone who *hates* agency because of the pay difference...and will let you know their opinion! i use medical staffing network (msn), atc, and acessible staffing.

when i went through lpn school 1/2 the class wanted to work at riley...and were told that : a) LPNs don't get hired there and b) all nurses want peds/ob so chances of getting a job there are slim, especially with it being "the" children's hospital. i know 2 lpns who promptly got hired there. so if l&d is your thing, go for it!

think this is gonna be a soap-box rant...sorry! i agree with the holism including spiritual beliefs. however, i personally would feel mighty peeved if anyone began to tell me about any form of religion (excepting a chaplain, from whom i would expect it) as i would take it as a sign the other person is assuming i have no spiritual beliefs of my own or not enough brain cells to think of such things myself (as in i am quite capable of developing my own relationship with whatever god i choose and don't need another to tell me how to do it, especially as an adult has had quite a few years to think on such matters! and darn few in america have never heard of jesus so there's no point in yet another lesson). i am aware others may disagree--i just wanted to point out it's not best to assume anything about the patient. yes, people with depression can make decisions contrary to what they would normally make. but i think sometimes the depression dx is used to cover up the fact that *others* are not happy with that person's choices. for example, my father is in the terminal stages of leukemia. he says he's ready to die. is he depressed? of course! is his decision to give up due to depression? no--it's due to a long life of not much but hardships and constant struggle of one form or another and being in pain and plain old being tired of fighting everything all the time.... antidepressants may help, but life will still be a battle for him. why should he have to keep it up if he doesn't want to? and lord help the nurse who tells him he has to do it because it's god's plan...that was tried and after telling her to go to (ahem) "hades", he pointed out that he thinks 70 years of toughing it out to make god happy was enough and it's high time he (dad) had a chance to have his happiness/plans considered and that god can keep him alive another 50 years if he so chooses, with or without dad's help! since our family is entirely in the medical field, we now have him at home doing our own hospice care...for some reason he's "over" other nurses! the upshot of this post is that i think the patient's wishes, if not obviously a temporary abberation, should be respected...religion and death included--because very few take those matters lightly, especially concerning themselves.

not allergic to tomatoes...but allergic to the plants themselves. nasty case of hives. dad always thought i'd gotten into poison ivy (not allergic) when i was supposed to be staking up the tomato plants, so took forever for him to accept i really was allergic to those dang plants. thought i was allergic to my husband, but it turned out to be a detergent he'd used. and green soap...especially irish spring--will get me in hives even through the wrapper (i am *so* glad i found that out with the wrapped bar in my hand before i washed my whole body with it!)

MR group homes, weekend doubles and all the study time I needed during LPN school. But agency nursing has been a life saver ever since (especially now I'm back in school)...pick where and when i want to work...sure there are bad facilities but some are complete cakewalks and you can study (think 3rd shift occupational clinic)! And I only need to work 2 days a week to make what I earned working full-time in LTC! Agencies hire CNA's, too, if you are one....

have to share my favorite madatory meeting story...once worked weekend doubles at a ltf and was in school full-time during week. d.o.n. knew this and was willing to leave paperwork for me to complete. then came the new administrator. since i had it worked out with the d.o.n, i didn't go to the mandatory meetings during classes. but no paperwork was ever left--new admin didn't do that, be there or be written up. these meetings included such highlights as watching a fast-food training video about giving the cusomer an extra pickle to improve satisfaction and we were all told to give 'em the pickle--it was even posted in every hallway. he also enjoyed reading the list of who he'd fired that week and reminding us our state doesn't need a reason to fire. oh yeah, and his trip to the zoo with his kids or how he bossed around the workers at a drive-thru burger joint because his order wasn't right and made them *deliver* a new one. these lasted roughly 1-2 hours apeice. plus regular inservices and i ended up dropping out of school because i could never make class and missed tests...one week we had 4 mandatory meetings/inservices, all one time only and during dayshift! the place i work now leaves minutes and knows i'll have a problem making meetings. it's my responsibility to learn new info but i love them for trying to accomadate me!