nekozuki

A prime example of how racism plays out at my job: I'm biracial, but with my light skin and dye job, I am perceived as a white woman. I am treated differently at my job in subtle ways -- I am seen as more approachable and less aggressive. I am the first one to whom OT is offered, more likely to be given cash incentives, and when I cop an attitude, I am never called aggressive or accused of having an attitude problem. I'm perceived as "easier to deal with" and reap the benefits. All of administration, the board of directors, everyone in upper management are white, despite the majority of the nursing staff being black employees who've been with the company for 20-30 years. We promote from within. No one has put in the work to train up, empower and elevate a woman of color. Friends promote friends, and when the people at the top are white, it becomes a self-perpetuating thing. Management/owners are not overtly racist. They believe equality is important. But they do not have self-awareness of how their bias plays out. If black women disagree, they are labeled aggressive. When they talk with their close circle of friends during report, the cadence/speech changes to reflect who they are versus the professional code-switch they must use in front of patients/coworkers to sound "white" and thus, "appropriate." They are then called clique-ish for this, when really they are finding solidarity with one another. They are more regularly reprimanded and cited for behaviors that the rest of us exhibit, because there is a spotlight on "ghetto" attitude. The worse thing is black women are called aggressive, but when there are patients whose families are obnoxious/troublesome, management says "hey, let's put them with [black nurse] because she'll keep them in line and scare them into acting right! They'll get intimidated and leave us alone!" Racism is constantly labeling black women as aggressive to deny them professional respect, accolades and rewards, then weaponizing them in order to do your dirty work. It's not fair, it's not right, and this is why we need to work harder to educate ourselves and elevate people of color to positions of leadership.

We received the email last week! On Tuesday, six weeks exactly from the due date.

Nothing yet! Myself and two coworkers also applied, none of us have gotten anything.

CNA duties *are* nursing duties. There is no separation between the two. For the sake of efficiency, nursing tasks that are safe for a layman to do can be delegated under supervision, but there is ZERO distinction. It's always weird to me when nurses think that wiping butts is beneath them or can hardly change a diaper. How do you do skin head to toe skin assessments without being able to roll, move, undress, and ambulate a patient? All my patients are total care and too fragile to be handled by anyone but a nurse, so we don't use CNAs here. Our ratio is never more than 1:3, so that helps. But it's always hard to precept/orient new hires who came from places with a lot of CNA support, because I know they're going to struggle. It's not easy giving a bedbath and putting a diaper on a 150lb PVS patient who neurostorms every time you touch them, while keeping the ventilator tubing, central line, JT/GT, subrapubic catheter and multiple monitors/wires from screeching. The joke in our facility is "How do you tell the difference between an LPN and a BSN?" "If the diaper is on sideways, the nurse has a BSN."** **I love you, BSN nurses, don't come at me with the fury of a thousand suns

Throw a small group of people together in an extremely stressful, high-pressure and competitive situation, and this sort of thing can happen. Benign quirks and personality differences get blown out of proportion, little annoyances become intolerable, and people find reasons to pick at one another. By the end of nursing school, our class was down to only 8 people and separated into two cliques that loathed one another. Three days after graduation literally everything was forgotten and no one cared. As time passes, none of this stuff will seem important anymore. Take this as a lesson. Ask yourself what parts of your personality might come ass as abrasive or off-putting. Be grateful for the learning experience and ability to work on how you interact/engage with others before entering the workforce. You'll be fine.

If you want to avoid hoop-jumping and want easy exams to pass, just go to one of those 50,000 dollar for-profit degree mills that do clinical rotations in some terrible LTC one violation away from being shut down. Standards protect us. Standards ensure that you have a basic foundation and can meet minimum criteria. Ten years with an LPN license doesn't guarantee that you can pass the RN Nclex. That being said, it seems so cruel to be one point away and be told to re-take everything. What a nightmare.

Honestly, pretty much every field sucks. Retail sucks. Hospitality sucks. Some of my friends are engineers, and sometimes it sucks. Education sucks. In just about every job, you have to get up at the same time every day and do things you might not want to, or not be able to pay your bills. Work is a microcosm of society, in that a bunch of people trying to make their rent plod through their day, and have typical interpersonal conflict and deal with environmental stressors. It's not a nursing thing. It's a human thing. Take comfort in the fact that it's awful everywhere

Honestly, q4h albuterol is normal in our facilities (different medical daycares and groups homes with patients of various ages and conditions, some ventilator dependent, some that are highly functional and eat/breathe on their own). For a few of my patients with significant reflux/vomiting, they were kept on that regiment for years. Pulmonology wanted it that way due to chronic issues + potential aspiration/overlap issues from reflux + being fragile while around other kids. Possibly excessive, but definitely not unheard of. Bless school nurses. You all are such a catch-all for everything under the sun.

I'm a queer nurse that must provide care to homophobes and people that think that simply existing in a queer body is bringing about the apocalypse (and tell me to my face). But that doesn't really matter. Nursing isn't about me being a champion of my personal values. It is about fulfilling the duties and obligations my job requires of me, and that's that. So I do my job. If you can't, find a job that constructs itself around your social/religious narratives.

I applied for the fall 2018 LPN to RN/accelerated track as well! 4.0 pre-reqs, 3.96 overall GPA, 91 on the TEAS, so I'm not worried about getting in, more worried I missed something on the application or that east campus never passed it along.

Income-wise, I'm considered upper middle class for my region, but I also have no student loan debt, no children, and I keep my credit card balance at a few hundred bucks. But I also have to work 60 hours a week, constantly negotiate for higher pay through agencies, and field multiple calls a day. I work per diem in an area with a severe nursing shortage (and a relatively low cost of living), so some of my friends break 100k. But it's hustle, juggling agencies, inconsistent, and sometimes not worth it.

I work in a series of pediatric group homes with six patients staffed by two nurses. Most of the kids are on hospice or PVS, nearly all of them wards of the state with little parental involvement. It's a pretty sad atmosphere where you're just caring for kids the state is waiting to die so they can upgrade abuse charges against the parents for murder. They try to make it as relaxed and low-stress as possible, and honestly, the *only* dress code rule is pretty much to be clean. Crazy tats and funky hair are totally acceptable. People come in with pajamas on, bizarre footwear, street clothes, last week during the cold snap I relieved a nurse wearing a tank top, sweatpants, and full lace-up Ugg boots. My company isn't perfect, but I appreciate that they roll with the punches in terms of redefining what "professional" means. The times are changing, and tats/hairdye/piercings will no longer be the ruler by which we measure professionalism.

Underwear color. We were forced to wear all-white scrubs with white underwear to prevent colors/patterns on our butts from showing through. Then, a new clinical instructor later docked us all points for not wearing nude-colored underwear, because the visible panty-lines of our mandatory white underwear was too "deliberately provocative" for the hospital setting...y'know, when we were just following the program rules

Thank you so much, SnowyJ. There are so many children whose abuse and exploitation could have and should have been detected, reported, and stopped at the school level, and I'm so grateful you're refusing to play a role in that brand of neglect/inattentiveness.

Any updates on HamsterWatch 2016?

Pediasure, pediasure, pediasure! It's a great supplement. Also, I have a patient on the spectrum (also showing signs of anxiety/OCD although doc says she is too young for a formal diagnosis on those particular fronts) who hates pediasure and many textures/flavors to the point of forcing themselves to vomit afterward (and also has violent episodes when anyone tries to open her mouth), so I blend up yogurt, fruit-flavored babyfood, oatmeal powder and whole milk. Other times I will blend up whole-wheat pasta, chicken or beef, vegetable baby food, and spaghetti sauce to create something tastes like spaghetti sauce but goes down like tomato soup. Often I'll add a bit of oil or melted butter to add additional calories and fat (as well as sneak in liquid vitamins). I don't permit her to eat sweets/sugar/too much white stuff, because that can cause unhealthy food addiction and worsen her behavior (since when has sugaring a kid up ever helped their ADHD, aspergers or other conditions?). We also worked extensively with PT, OT, and speech to stimulate, exercise, and reduce sensitivity orally. Sometimes it was rubbing textured objects over the gums to help acclimate to new sensations, other times it was just stretching the jaw muscles. Our ultimate goal was to acclimate her to new textures/sensations without attaching food to it to prevent oral aversion and future feeding problems. As time moves on, we have been able to slowly introduce new flavors by pureeing them into her usual meals without adding strange or new textures. Success has slow and incremental, but consistent. Of course, all this is done ONLY in conjunction with a GI/nutritionist, and I perform these functions as a private duty nurse, not as a school nurse (I needed orders to give her pureed food). You perform a different role, so it may not be helpful to you. But if I were in your shoes, I would be referring Mom out to someone with the training and expertise to help her make informed decisions. Let her know you are willing to help her abide by the treatment of a GI/nutritionist/dietician/OT/ST, but it is her responsibility to do so. Some hospitals have "feeding clinics" where kids with difficulty eating can attend daily over the course of weeks or months to help them transition to new food, so you might be able to point Mom in that direction, especially since your patient is pretty high-functioning. None of this may be helpful to you, OP, but I thought I'd share my experiences and the remedies nonetheless! Good luck to you, and I'm so happy to see a school nurse so invested in the welfare of her patient when she doesn't have to be.

I feel you, OP. Those peds nights shifts are so hard, especially when equipment gives off that dreamy lullaby of white noise. Even if nothing can be proven and the agency takes your word for it (and the family doesn't pursue it), a complaint about you sleeping would still stick in the minds of staffing/management, and possibly diminish your credibility in the future. Quite a few nurses have fallen asleep at my job, but they only get reassigned to another case from what I've seen. What frightens me most is that many parents accept it as a reality or encourage it just to ensure they keep shift coverage ("I don't mind if you sleep," or "here's a pull-out sofa, it's yours if you agree to stay on with our daughter").

You have two choices: 1. Quit and try to find a less toxic work environment 2. Take a step back, re-evaluate yourself, and figure out how you can develop and improve your interpersonal relationship skills to function in a work environment that sometimes seems hostile. While option one might seem like an easy fix, your outcome is dependent upon others (and you may never find a place that is friendly). The second option gives you the control, as well as the opportunity to grow as both a colleague and a person. Even if you ultimately decide the leave your job anyhow, these skills have universal applicability. You worked so hard to get through nursing school and to where you are today. Don't sell yourself short. You can adapt and survive in a fast-paced, high-stress industry if you develop the assertiveness, confidence, conflict resolution*. *Unless you feel like your license is genuinely being threatened. In that case, get the hell out of there!

Can an LPN be an independent provider in the state of New York? I thought they had to go through an agency due to initial assessment, RN oversight, etc.

42 bucks an hour? Wow. I have nothing to contribute in terms of advice. I would simply like to know if you want to adopt an LPN.

When I quit or request to be taken off a case, I'm not shedding any tears over my agency being inconvenienced, but I do feel a tremendous amount of guilt for (some) patients. Sure, there are the wacky new assignments you never accept again (Mom running around the house naked talking to ghosts, one family decides to turn off the AC in July, maybe a case feels like a big fat lawsuit waiting to happen, etc), but what about the ones you've had for awhile? If I'm leaving a case because it's gotten stale or because I feel like I'm being involuntarily sucked into the family dynamics, I usually never tell the family. The agency is informed well beforehand, but I feel like the family would take it as betrayal if they knew I was voluntarily leaving, and possibly retaliate in some way. So, I smile big, wave, and never come back. I'm torn because I'm having elective surgery (weight loss surgery) and will be out for six weeks. I'm agonizing over how to break the news to my patient's family, and whether I should say anything at all (or simply lie about it being some other surgery). I've been the only nurse staffing their case for almost two years, and given their rural location and complexity of the patient, I know they will have a hard time replacing me. I *have* to do this for myself, my health, and my future, but that doesn't help the crushing sense of guilt I feel for abandoning” my patient (whom I adore like my own niece). The family has received a series of devastating blows in terms of the patient's health over these past few weeks, and I figured I'd drag my butt to the AN forums to commiserate. What is your MO for quitting a case? Do you tell the family, or do you high-tail it out of there without a word? Do you ever feel guilty for moving on? Anyone have any stories?

5-6 days a week if I agree to it, but only because I work in PDN.

I don't post much, but I have spent four years lurking. I know if Thecommuter or Ruby Vee have already posted, I probably don't need to; anything after that is a subpar rehashing. Lots of smart nurses here!

They may be shorter, but LPN programs have 2-3 times the required clinical hours of an RN/BSN program (at least in my state). Less time in the classroom, more time studying on your own and working the hospital floor. But we are also subacute. You take a random person, give them half the clinical hours of an LPN program, then put them on a critical care unit? Well, that's another issue entirely.

Wow. We get annuals, but it's not invasive like that! A doctor just ensured that we have full range of motion, can bend/squat, basic neuro checks, listens to lungs, palpates abdomen, checks vision, etc, stuff we need to be able to perform our jobs. Height/weight/VS are charted, but that isn't on the physical itself, it's just for the office records. No questions about meds, weight gain/loss, gyno stuff, etc. Most of the nurses in my company are semi-retired and over 50, and the physicals haven't caused anyone to lose their job. But since we work independently in PDN, it's just a very basic way of ensuring we're able to do our jobs.