ProBeeRN

I moved from home care to a wound /ostomy nurse position in acute care (after obtaining my wound care cert). I was asked about my lack of hospital experience and I sold myself by talking about the acuity / variety of patients I handled in home care (many inpatient managers are not aware of the acuity in today's home care patients), and played up my autonomy, decision making, and critical thinking skills. In my opinion the nursing skills that you don't encounter in home care (for example, IV push meds, complex drips, inserting NGs) are pretty easily picked up if you have a strong base in assessment and critical thinking - which home care does provide. You may want to ease your way in through a skilled nursing facility or subacute rehab associated with the Healthcare system that you want to get into. After 6 months you can usually bid on an internal acute care facility and have some inside connections. Good luck and keep applying. NYC is a very difficult market. Move upstate if you can relocate!

I left the company last year, some years they would take a couple new grads, some years they did not. I was basically on my own after 4 months, on probation for 6, but linked with a designated mentor for the remainder of the year. It was a great program. I got really lucky, like all of us as new grads, I didn't know what I didn't know then.

I'll bite. I'm no historian but I did go straight into home health as a new grad. The large HH company near me was piloting a new grad program- it required a BSN, several interviews, a successful summer internship, and a full year of orientation. Not many home health companies are able or willing to devote that much to a new graduate, and in home health any less than that is disservice to the patients. Going to acute care after HH is difficult too. HH is not always respected by nurse managers in acute care (wrongly imo). So be prepared to possibly spend time "working yourself back up" to acute care through sub acute rehab or similar if you ever want to leave HH.

I agree with karen4164 about pouching the peg. Is the tube stabilized? Sometimes if the tube is stabilized properly the tract will shrink and stop the leakage. Try a commercial stabilizer, Hollister has one.

I wear a lab coat as a wound care RN (as per my boss's request) . It helps staff and patients distinguish me from a floor nurse - at my facility we are considered part of the education department.

The wound should have been debrided first. A VAC won't do much on a 100% slough wound bed. If regular granufoam is used then Santyl can be used underneath if there is some (less than 25%) necrotic tissue present. Santyl cannot be used with silver products. If the patient is not a candidate for surgical debridement you can suggest a 7 day trial with Dakins to see if it cleans it up a bit.

I have a husband, I have small kids, I have a dog. I'm busy right now with a bunch of home improvement projects. I'd like to make more time for fitness and running. I like to cook and I like to travel. I enjoy my job but it doesn't fulfill me...my job isn't my life. My life is very full right now. I find many friends my age (early 30s) feel the same way regardless of their fields.

When I worked 7-3 I had my son enrolled at a daycare that opened at 6. Some of them offer before/after school care as well.

I like to color my hair a deep purple and I'm working on a half sleeve, but I recently started a new job and before I interviewed I colored my hair to a dark brown and currently I make sure my tattoos are covered while working (which isn't difficult since I wear a lab coat in my current setting). First impressions are everything! My current job entails a lot of one on one patient teaching and I'm not doing the nurse-patient relationship any favors if the little old lady in the bed is intimidated by her nurse at first sight, or feels like I am not professional/competent.

It took me a while to learn to "just say no". I still have problems with it sometimes. Screen your calls from work, if it's important, they will leave a voicemail and you can call them back. Or get a cheap prepaid minutes phone to use for work calls only and turn it off while you're sleeping. Much easier to avoid them that way :-)

After reading the first 20 posts or so- Guilt is not an effective motivator. However, I find that sometimes a good dose of fear (aka a reality check) is not necessarily a bad thing. For example- the noncompliant diabetic that just had a toe amp-I've not no problem pointing out that once the doc runs out of toes, he's going to start working his way up the foot to the leg. Of course this is coupled with lots of disease process teaching and positive reinforcement for good health behaviors. I've had some discussions about weight with obese patients. I'm honest about repercussions- and then we talk about ways to manage their weight. But I don't try to guilt them into anything. You can't guilt change. For the record, I'm a size 10-12, so I'm no skinny chickie either.

He took Kaplan/ used the q-bank prior to the first time and then continued to use the q-bank through the second time. The key to him passing was slowing down and reading the question- he was rushing through and not figuring out what the question was actually asking. For what it's worth I took Kaplan before I took NCLEX and found it incredibly helpful

The market is tight... my advice is to try and at least keep a toehold in the field- you have an active license and no sense letting it go to waste- and if benefits aren't an issue you might have an easier time not looking for full time? Can you continue with the peds HH and substitute school nursing? Look into per diem hospital work? How about intermittant peds visits? If you leave the field entirely to be a SAHM you're going to have a lot harder time getting any job with a huge gap in your resume. I mean, even 1 shift every week or two is enough to keep up an employment history. At least until you figure out what that "something else" is. Good luck!

We're in Western New York- Buffalo area

"People come on this board and ask "should I quit" when they've got a no-win situation going at some crappy job it took a year to get" It was such a hard decision for him. He felt like a failure, and like he was letting me down...and after that experience we're nervous about any offer --- "what if..." you know? This unit is very small with 12 patients- he may be the only RN but there will be experienced LPNs working with him. I keep telling him- worst case scenario- it's 12, not 40!

FINALLY! After almost 2 years, my hubby (a 2009 BSN grad) has been offered a nursing position! It's been a loooong road... May 2009- graduated BSN August 2009- failed NCLEX with 265 questions October 2009- got married!- yeah, we like to cram all of life's big events together, makes it more exciting January 1 2010- passed NCLEX with 75 questions January-May 2010- submitted a bunch of applications to all major hospitals, not even a callback May 2010- offered a RN night position at a rehab/LTC June-August 2010- worked fulltime nights with 40 patients and no orientation. Had panic attacks. Eventually quit after 8 weeks August 2010 to December 2010- a bunch more applications filled out. Resume looks even worse due to only 8 weeks at rehab. One interview at another rehab. No offer. January 2011- 2 interviews! 1 rejection letter, and 1 job offer! Offer accepted as of yesterday!!!!! Of course this position is almost an hour drive away. Per diem weekends, nights and evenings. 8 hour shifts. Locked psych unit (hey, he's over 6 feet and 250 pounds-- i wonder why they chose to take a chance on him... ) But it's a NURSING JOB!!!! And they are even giving him an orientation. Praying that this one works out for him! I'm so nervous that they will call and say "oops, we changed our mind, we actually don't want to hire you". Do hospitals ever do that? LOL If not, our plan B is to move to California, live on the beach, and sell necklaces.

Call Adult Protective Services. They may remove the pt from the home. However, they may just tell the family "the heat needs to be on"-- if the home does have heat available--and if the family complies than that will be it. What about a space heater and keeping the pt window closed? At least that would be something. As far as the roach infestation- I've seen many a pt in a roach or bed bug home- from what I've (personally) encountered, that is not necessarily considered an abuse or neglect situation. But definitely call APS and they should at the very least get a caseworker involved in there that can assist with overall environmental management.

I dont have much info on Bhutanese patients persay, but in homecare I run into this type of situation all the time- keep in mind that you can't set the same goals for each patient, and each patient needs to be approached differently in terms of disease teaching/ management/ etc based on culture/educational level/history. In general, I'd say keep your phrasing short and simple, avoid long winded explanations, and watch your medical terminology. Sometimes I get a lot farther by saying "Do you check your sugar?"- while holding up my finger and pantomiming- than saying "Do you have a glucometer in the home?"

I usually see 6-7 as a case manager, and get paid hourly. Some nurses see 9-12 in a day- but not in 8 hours, depending on travel time, it's more like 10-12 hour shifts with that many. Get a complex wound vac patient and it's an hour visit, easy, with vitals, teaching, assessment...Them patients can be dang time consuming!

LOL took me about a year and a half

Unfortunately I'm home health with 8 hour shifts. I'm calmed down a bit now though and I'm going to try and attach some days to a weekend to make a 4 or 5 day stretch. The only problem is I won't know I'm approved until my boss makes the schedule about 2 weeks in advance- getting the "vacation week" is the only way to "guarantee" your PTO. We can request it any time, because all our sickdays-vacation-personal days are lumped, but it always depends on staffing if we get approved. And to have to buy airfare 2 weeks before we want to go somewhere (we want to do Disneyworld)- hella $$$

Ours is all union contract, its a certain number of people that can have a given week, and 100 percent seniority. Technically someone can take 2 or 3 weeks in one 4 month "block" before anyone else gets anything

From someone with a school aged child- what's your plan during the summers or extended school vacations? The advantage to finding childcare for 12 hour shifts is that it's less days to coordinate. In the summer that's 4 days a week to sleep in and make pancakes for your kid, instead of trying to work out a 5 day work week. I went through nursing school a single mom (but with a very good support network) so I get where you're coming from.

I've been at my current job almost 3 years. And not once, NOT ONCE in those 3 years have I been able to take a week of PTO during a time when my kid is on a school vacation. Not a Christmas break, not a spring break, not President's week, not a single week in the last 2 weeks of June, July, or August. Every year I accumulate 50 bazillion hours of PTO that I NEVER GET THE CHANCE TO USE!! And I just got the call that they are handling vacation requests for February-May and I did not get any of the weeks that I requested. I JUST WANT BE ABLE TO TAKE A VACATION WITH MY FAMILY! Now I would understanding if I was a new hire. Or been there a year. Or two years even. And it's not like people aren't leaving- we've hired a TON of new people AND had some retirements this year. WHAT DOES IT TAKE?! Last year I had to move my honeymoon because they couldn't "guarantee me time off" the week after my wedding. SOOOOOO FRUSTRATED!

Check out payscale.com and search Buffalo. And according to yahoo.com its the second best city to move to right now. My hubby is from NYC so we when we compare the two Buffalo comes up much lower in terms of housing, taxes, etc. Not sure how we'd compare to say, the Midwest.