rnmaven

You don't need a special pump to backprime. If the secondary tubing is connected at the upper Y-site on the primary line, you just lower the secondary IV bag and the primary solution will backprime up the seconday line and flush it out. Like I said in my prior post.......just let it run into the empty bag, give a squeeze to the drip chamber and now the line is backprimed with neutral solution and ready for your next IVPB med. I haven't heard of any studies supporting going to a 96 hour set change for in-hospital care. 72 hrs is the max I know of. The P&P's that say to change the secondary tubing every 24 hours I believe are based on the fact that unless you backprime, you are breaking the system multiple times. I would ask to see the evidenced based study that supports all of this. Bet they can't even supply one for you.

I don't know the exact numbers, but diploma schools do still exist in the US. My almamater, Muhlenberg Hospital School of Nursing is still alive and well. Back in 1974 they had the vision to collaborate with an associate degree program and at least give you some credits to apply towards your BSN. The program has evolved and certainly meets the needs of the community it serves. Times have changed and there aren't as many HS graduates moving into the dorms and spending 3 (full) years "training". I believe that as parents' educational levels have increased over the years, more and more parents encourage their children to go straight to a BSN route for their education. I believe that most diploma schools that have survived have found their niche in serving the adult learner who needs a bridge into nursing. Either they are changing careers, or perhaps and LPN who wants to become an RN but can't afford the full time commitment or dollars a university setting involves. Additionally, not ALL students of nursing aspire to "beyond the bedside." Certainly, when I graduated HS, I thought that I wanted to be a nurse and nursing to me was a career caring for patients in a hospital setting. Diploma schools have not gone by the wayside entirely......the strongest ones will most likely continue to survive.

I agree that in order to enter a NP school the RN should have a good solid foundation in experience at the bedside. That experience is invaluable in creating a foundation upon which an advanced practice is built. You will be a better autonomous clinician and more secure in your individual decision making abilities. Re: the doctorate degree. I agree that this should be the way to go. Look at Physical Therapy........also now a DPT for practice. If the profession's goal is autonomy and direct access then the clinical doctorate is the way to go. I'm all for advancing the profession and I believe that life experience (clinical) combined with education is the way to go! I've practiced at the bedside (in varying degrees) for 28 years. Just finished my MSN and am considering taking post masters courses for Geriatric NP. I would have no problem if someone encouraged me to also have a Doctorate. The more education I cram into my brain, the less room there is for Alzheimers to develop!:wink2:

Dear Nascar Nurse, Please print out all of these responses and make an appointment with your DON to discuss. Healthcare facilities seem to have bought into the notion that they should operate like a hotel or Disney World in order to be successful. If our patients want customer service, I tell them they should check into a hotel. If they want care from an intelligent professional then they have come to the right place. Good luck and stand firm to your beliefs......you are on the right track. The others have derailed and are lost.

West of Newark is nice: Milburn, Summit. South of Newark try Cranford, Kenilworth, Clark, Westfield. You can also find some nice new condos in the Bayonne and Jersey City area if you are looking for a closer to NYC city lifestyle. Go on NJ.com and look in the classifieds for rentals and homes to buy. Good luck. You could also look North of Newark in the Belleville, Nutley, Montclair areas.

I've been working for an agency on a full time basis for almost 4 years now. It has been fairly consistent work. I've been cancelled on occasion but for the most part, I get all the work I want and need. Recently there seems to be more pressure to take 13 week contracts because the NJ Hospital Association has made all agencies bidding on full time hospital work to take less money in return for these guaranteed 13 weeks of work. I'm just curious, why would a full time agency person want to tie themselves up on a contract that pays less per hour? It seems to me, that if I wanted that kind of "guarantee" I'd go work for a hospital! Also, apparently, if you take one of these contracts the hospital will tell you when to work and that will include things like weekends, holidays, etc!:angryfire It just doesn't seem to be the way to go, but the agency I use is stressing that there is less and less per diem work available and that if we want work in the long run, we'll need to take these contracts. What are your thoughts on this? Thanks!

Try this site: and search thru the links......I'm sure that they have something about the plans for BSN in NYS. http://www.op.nysed.gov/nursing.htm (You're going to have to copy/paste this link because I don't know how to transfer links over.....sorry.) Anyway, I really don't see the big deal about just continuing on after a AD. Financially it works well because you get to work as an RN and just chip away at whatever BSN requirements you need to have that requirement. Russell Sage College in Troy NY offers programs where you could continue on and with just a little more effort you could finish up withh a MSN and be done with it. Good luck!

I was trying to search this site to look for the news item that was posted awhile back re: the BSN requirement in NYS but couldn't find it right now. Anyway, it is true that the state of NY is going to go BSN as the minimum requirement for sitting for your license. Those with AD or Diplomas will be grandfathered in and those completing current programs will have 10 years to get a BSN. REALLY........this is not a big issue. If you are using the AD or Diploma route to obtain your RN that just means you'll have to continue your journey to more education. In today's nursing education structure this is not such a big deal! There are plenty of online programs and there are also BSN to MSN programs offered. Take it from someone who took the VERY long route........I was a 3 year Diploma grad that also came with an AAS degree via the community college. (1977) THEN, because there weren't any online programs and very few BSN programs that would accept me as a transfer student........I spent the next 6 years finishing up a BSN. NOW......I see grads from my same diploma school going to a local state school and getting the BSN to MSN degree in less than 3 years. It's a good way to go if you don't want alot of school loans, or you're older, etc. I just spent the past 4 years doing a MSN program just because I still have another 17 years or so to work and need to keep current with degree requirements. That's the nature of being a professional. Nobody said it would be easy......you have to become a lifetime learner or you will just become outdated! Good luck!

So here is a monumental FIRST step towards safe staffing laws in NJ and no responses? I am surprised but also not surprised to see that basically no one has responded to this post! That is the problem I see in the state of NJ. I see the CA nurses association sueing Gov. AHNOLD and I see the posting from the MA nurses association re: the farce of Magnet status.........but nothing from NJ. I have been mentioning this bill at the hospital I work at and virtually no one has heard of it or comments on it's importance! Nurses in NJ need to be much stronger politically and make this issue known to the public. When patients tell me......oh, it seems short here tonight......I tell them about the bill and I tell them how important it is to have safe staffing. When I complain about being unable to care for 8 or 9 med/surg patients I'm told......do the best you can. Well, guess what, I can't be the BEST when I'm taking care of that many patients.....and I can't take care of 3 ICU patients either........yet I see this kind of staffing (and worse) in ALOT of NJ hospitals! That is because NJ nurses are weak and have accepted this unacceptable staffing as the norm! WAKE UP NJ NURSES!!!!!!!!!

You should definitely finish up your LPN to RN goal but DON'T move to NJ! Even though the pay rates quoted seem great, it all gets eaten up by the cost of living here! For example: Current pricing on new construction in my town $725,000 for a 4 BR home on virtually NO property.......taxes on that home would be well over $15,000 per year......car insurance......$3600/yr for my car and my son's car.....both 5 years old......I have friends paying well over $11,000 for their cars with one son driving. It just never ends! The money sounds good......like you can say......I make well over 6 figures working at the bedside......nobody believes that! But believe me, I can't wait to leave this state! Hope to finish school this year (MSN) and move upstate NY and teach.......I don't care what they pay! In the end.......it's never the money that keeps you in a job. You have to really enjoy what you are doing! Good luck!

Night shift is tough......sometimes when you're really busy it's a breeze but since we NEVER get OFFICIAL breaks it's hard to keep going though those 12-13 hours and be totally awake. Believe it or not, we DO try to let the patients get some sleep so for me, that means charting between 1 and 3 AM and as soon as I chart.......BOOM, it's time to fight off the nodding off! I feel that this wouldn't be half a problem if we could just leave the floor for 1/2 hour, put our feet up and relax. But with the shortage of nurses, you can't leave the floor and burden your comrades with your patients......it just doesn't work. So, we make coffee and eat......two things bad for the body. It's a tough shift.

You might want to check back with RWJUH re: hiring. They have had to use alot of agency again lately so maybe they need more nurses.

I'm very surprised to hear that someone in South Jersey is making $40/hr. Around Monmouth County which certainly has a high cost of living, I think the nurses are tops $27/hr and that's with a night differential. $40 sounds more like a PerDiem rate. Some of the central NJ hospitals (Rahway) are offering $40 for per diem rate and if you work a third shift (they guarantee you two) you go to time and 1/2 of that rate ($60). Agency work ranges from $48 to $55 per hour right now. I work agency. But as more per diem people have signed on to the $40 deal, I'm finding myself cancelled more than usual unless the census is thru the roof and they are "holding" patients everywhere.

I guess you could look up styles of charting formats as one approach to this assignment. Like at one hospital we use D (Data), A (Activity) R (Response) as the headings for each narrative written. Regarding Nursing Research......most of the schools are pushing the APA format. You could do a search under Google....for APA writing and find information about using that style of writing in nursing research. Good luck!

Hey, love this commentary......it goes along with my post on Nurses Wearing white...only this one (matching the bedspreads) is much more entertaining! The real issue on this topic (mandated changes in uniforms) is that nursing leadership and hospital administration are very accustomed to an autocratic leadership style. That's the bottom line. And unfortunately, nurses at the bedside have SO many issues to fight about that they can't unite enough to combat these kinds of issues. The truth is that these kinds of seemingly petty issues eat away at you, affect productivity, job satisfaction, self-esteem, etc. I agree that nobody is telling hospital administrators, doctors or other so called "professionals" what to wear. Our work is very difficult and we should be comfortable in what we wear. I think it is degrading to be asked to match a decor like some kind of cocktail waitress or something along that line.:angryfire In any case.......these kinds of decisions should be made in a collaborative framework with input from the end users. (the nurses in the OB unit). I have seen petitions ignored from administrators. You must speak with the CEO directly......make an appointment and go together......speak with one voice......practice your approach. Good luck!

Hey, love this commentary......it goes along with my post on Nurses Wearing white...only this one (matching the bedspreads) is much more entertaining! The real issue on this topic (mandated changes in uniforms) is that nursing leadership and hospital administration are very accustomed to an autocratic leadership style. That's the bottom line. And unfortunately, nurses at the bedside have SO many issues to fight about that they can't unite enough to combat these kinds of issues. The truth is that these kinds of seemingly petty issues eat away at you, affect productivity, job satisfaction, self-esteem, etc. I agree that nobody is telling hospital administrators, doctors or other so called "professionals" what to wear. Our work is very difficult and we should be comfortable in what we wear. I think it is degrading to be asked to match a decor like some kind of cocktail waitress or something along that line.:angryfire In any case.......these kinds of decisions should be made in a collaborative framework with input from the end users. (the nurses in the OB unit). I have seen petitions ignored from administrators. You must speak with the CEO directly......make an appointment and go together......speak with one voice......practice your approach. Good luck!

We still don't know what a "breast man is!" Come on! We're dying to know! And re: that website on male breast feeding..........YIKES! I guess this is interesting info for gay male couples adopting! So we can all do that bonding thing! Wish my hubby would've done the 2AM feedings! :chuckle

We still don't know what a "breast man is!" Come on! We're dying to know! And re: that website on male breast feeding..........YIKES! I guess this is interesting info for gay male couples adopting! So we can all do that bonding thing! Wish my hubby would've done the 2AM feedings! :chuckle

I have this argument with nurses all the time. In fact when I go on my rounds I find patients receiving multiple IVPB antibiotics with all three or four IVPB's and tubings dangling in the breeze. I throw them all out and back flush the last one connected with the primary solution, squeezing a little extra into the empty bag to make sure that the solution now in the tubing is just the neutral, primary solution. Then, I hang the new IVPB med. I used to sell IV systems with Abbott Labs and sold also IV pumps for them. Their pumps (the Plum line) have a backpriming feature that not only allows you to clear air in line alarms but also allows you to backprime in between incompatible IVPB meds. It is a perfectly acceptable procedure......the problem is that most depts of nursing education have not incorporated it as an official P&P. Backpriming allows you to use that IVPB tubing for the same 3 days as the primary tubing. It maintains a closed system (less breaks in the system then you would have if you had to change the IVPB tubing with each antibiotic.) and is more cost-effective. The only time I use a separate tubing is say for Prevacid which requires an in-line filter on the distal end of the IVPB tubing. I give that med and dispose of the whole tubing and filter. When you find multiple IVPB tubings dangling in the breeze (oh, and usually not capped off in a sterile manner either.....did you notice?) tell that nurse or show that nurse the backpriming technique. Better yet, tell nursing ed to make it an official P&P.

I did receive your reply and agree that most of this movement is an attempt to improve the professional image of nursing. I agree that there are many ways that nurses can improve their professional image. I do not wear Sponge Bob Scrubs but I do prefer the printed tops that have hearts on them because my background is in CCU/CTICU and I always tend to buy alot of heart motif fabrics. The issue I have with this latest "decree" from the hospital revolves around the process for decision making within the nursing profession. Nursing has historically been the victim of mandates, rules, take it or leave it administrators. That is the problem. If the decision to wear white was an outcome of a panel of nurses working in collaboration with administration then the acceptance of this decision would have been different. That is not the case and continues to be the reason why many nurses leave the hospital setting and move into other areas of the profession or leave the profession altogether. In this situation, administration basically ignored a petition signed by over 150 nurses. This lack of understanding is just a symptom of the autocratic style of leadership that exists within our profession. Of course if I choose to continue to work at this hospital I will have to wear white. I believe that any other color would also have allowed for a professional image. At another hospital I go to the dress code is Navy scrubs with white tops or actually any combination of Navy/white. However, at that hospital, different departments wear different colors. One morning I heard a visitor waiting for the elevator say.......you would think this place would have a dress code......everyone is wearing different colors! So, as was mentioned by another post, even though WE know what color is for what department.....the public doesn't know our secret codes! It will be interesting to see how this goes. I guess I'll be buying lots of Oxyclean for my laundry!

Good one! I had a disagreement with a confused elderly gentleman the other night who said to me......"with that sarcastic attitude of yours now I know WHY they KEEP you on nights!" I said.......well, you'll be surprised to know that they don't KEEP me on nights.......I CHOOSE to work nights!As always.....the usual generalizations/stereotypes. And of course that's why administration feels that they need to TELL nurses what to wear and mandate a color that is not realistic to wear given the less than glamorous work that we do at the bedside.........but I KNOW.......what work? Don't the patients sleep all night?

From the contract I saw lying around a nursing office, my agency basicly bills double what they pay me. I was actually surprised because for some reason I thought maybe they'd get 20-30% more......but the nurses are in great demand here in NJ so the agency seems to be able to bill at that rate. So basicly, when I'm getting between $48-$50/hr the agency is billing between $96+ per hour. And if I get OT they bill the time and a half too. I don't know if independent contracting would work in NJ but I think in a more rural area it might work. I asked around in upstate NY and they don't have agencies......so I might try independent contracting there if I move. Good luck!

As usual........somebody always picks on the nightshift. Who said we don't care what we look like? I spend a great deal of time making sure my uniforms are taken care of and are crisp and ironed when I arrive to work.......how I look at the end of 14 hours of hell is another matter.

PLEASE!!!!! Let me know who I should write to and also I would love to testify! Thanks!

WOW! I am overwhelmed by the 50 replies that have been posted on this thread! I appreciated the variety of opinions on this topic and thank everyone who posted for their honesty and insights! When I posted this thread, I was looking for some ideas to include in a letter to administration regarding this "decision". You guys really gave me some thoughts that need to be included! My major objection to the color white is the short lifespan of this color scrub or uniform. I too am a magnet for ink, blood, vomit, dust at the desk, etc. The underwear issue is another objection I have. Supposedly the "committee" who decided on white at this hospital actually mentioned monitoring nurses for thongs...........so you SEE.........there is a sexual nurse fetish aspect to this decision. From an organizational standpoint I am REALLY against this decision because it is the usual administration imposed dictatorship. No collaboration, no discussion with nurses in the trenches.......just take it or leave it. I am seriously considering working at a hospital where they don't require us to wear white. I work for an agency and the agency sent us the "dresscode" rules and expect us to comply. The staff at this hospital have been given two free whites from the uniform company that will be supplying all the other uniforms. I haven't seen the free whites but I'm sure they are quite ugly. I currently own about 5 nice sets of colorful scrubs. I feel that they reflect my individuality and NO I don't own Sponge Bob Scrubs. I have never had a patient say they didn't know I was the nurse. I have had to correct them when they call their NA (If we have one even working with us) their nurse. So I agree that if you take everyone else out of scrubs you'll know who your nurse is. I wouldn't even mind having all nurses in a uniform color like Navy or whatever. As long as it is actually a decision made by a panel that includes nurses working at the bedside. That's all I ask. Some respect for the nurses who are out there doing their job and trying to project a professional image despite the fact that they have to mop floors because housekeeping doesn't answer their pages, draw blood because some CFO downsized or eliminated phlebotomists, do EKGs for the same reason, empty garbage, empty linen bags that are overflowing, take dinner trays out of the patient rooms because the dietary people never return after dropping them off........you get the picture. No wonder the public doesn't know we are the nurse! When I wore white and a cap, I had about 4 nursing assistants working the med surg floor and 2 working in ICU's. They were wonderful people and worked very hard. Our housekeepers knew us and we knew them. They kept our units sparkling. When people said to me.......how can you be a nurse? I can't stand bedpans! I just laughed........because I RARELY handed out a bedpan or cleaned up after it's use. Now........I don't have to tell you. By the end of a shift I am splattered with some kind of body fluid. When I get home in the morning I strip in the laundry room and the uniforms are washed almost immediately. Even with the colorful prints we all know the germs that are residing there! So thanks again for your input........I'm sure the "battle" will be lost because the ER started a petition and it was ignored. Just as most outcries from nursing are ignored.......our major problem in the profession.