NrsLucky

I am not sure if this will be very helpful in answering your question but I personally know a Physician Assistant who works part time at a local hospital in California as a Respiratory Therapist and also in a Cardiology office. I know of an NP who works as a Paramedic too, although NP's and LVN's work in the same field unlike the latter I listed. You can also try calling the BRN to get an accurate answer. goodluck, NrsLucky

HI OCNRN63, Thank you for your insight. i absolutely am not proud of my response. I listed my response knowing that I would sound pretentious and rude, because I felt it was relevant. I literally just reached my limit at the time I blurted them out due to my professors acting like a bunch of mean girl high school students. I have never witnessed something like this truly since I was in high school. I am half Filipino, my dad is filipino and my mother is english/british. I do not however really speak tagalog. There is a back story which I did not list because it would have made my initial post even longer. This incident(s) which prompted the aggression from my instructors is why I am so exasperated and frustrated with their lack of professionalism and objectiveness. I have not liked a great deal of people in my working career but never purposefully went out of my way like they are. Essentially what occurred which resulted in this was an initial complaint I made to the Dean regarding an instructor's inappropriate conduct with a classmate of mine as well as several comments and questions he directed towards me. Since students here are brought up to be really passive and not speak out against their superiors, my classmates never spoke out despite them complaining behind clothes door. This student in particular was a 16 year old male who was very shy. During a lecture this professor who is also male would inappropriately stroke him whilst talking and make comments about how he smelled to make the class laugh etc. I complained to the dean about that to no avail because of course all of the nursing department likes him and none of my classmates wanted to speak out for fear of retaliation including the student who verbally told me that he disliked the teacher and was uncomfortable. Another incident eventually transpired where this professor directed questions towards me in front of the class regarding my sexual orientation and if I had a boyfriend here etc etc. Please note I am male. I walked out of the class and complained to the nursing department and dean but was literally disregarded the entire time. nothing was done by them, but a professor of mine who knew i had a legit complaint forwarded my case to the HR department head since the dean had officially "closed" this case despite nothing being done. The HR head after hearing my story investigated everything and sided with me which resulted in his termination. Now the nursing department in its entirety dislikes me. There was this big spectacle made by this professor when he was leaving and apparently he was crying and blatantly blaming me to the students who liked him as well to the teachers. I never asked him to be fired in the first place I simply wanted him to be reprimanded and told he was wrong but the dean refused to have a documented complaint in his file so they all tried to simply not do anything about it. This caused me to continue to escalate it because I know I was right and she was being deceitful. Now despite the fact that I have always been well like everywhere I went I am hated for no reason aside from the fact that I said something when someone was abusing his authority. I have tried to apologize to everyone and explain my actions as to why I didn't let it go. I brought snacks for the nursing dept. etc. The majority of the students do not want to associate with me because they are scared what the professors will do if they speak with me. I am beside myself because of this type of behavior. It seems so surreal to me. The comments these teachers have made that my friends translate and tell me are literally on the verge of harassment. I have already complained to the dean who does nothing and even made a statement "Have you learned anything from this Mr. Lucky? Are you proud of your actions?". I have already taken additional action and issued a complaint to CHED. Just pending action now. The thing is my family simply wants me to let it go and move on when this year finishes and go to a different school. But this school which is a very small rather new school, is so unprofessional and literally corrupt that I don't want any other student to have to go through that. Because had I laughed it off, and allowed this teacher to continue to disregard professor-student-conduct, I would still be liked.

:) roser13 your attempt was appreciated

The Title pretty much sums it up...I am an LPN/LVN who was pressured by family into pursuing a BSN degree abroad in the Philippines. I will have been here a full Year in May. I have finally reached my point today...lost a grip on my professionalism as my sanity waned a bit...and made two comments which although feels really good to say has now made my relationship here with my "superiors" more strained... The Statements: "nursing doesn't have a gender, race, or ethnicity. So wipe the drool dangling from your mouth doll." which I told to my proctor that always degrades and harasses me after she made an extremely ignorant comment. AND "Your ego is really slowing down my genius. check that **** at the door please. I came here to work." to My proctor after he pulled me aside from my duties in order to quiz me for 15 minutes on several different topics which we are not even covering yet along with his colleagues just to simply find something I didn't know. The final incident which caused me to act so irrationally was due to me being unfairly graded which has continued throughout my entire enrollment at this school. I have received 95% or higher on every single written nursing exam, however only 80%-88% on practical demonstrations of skills. It should be noted that it is so easy to forget that these professors are in fact professors because of their behavior...they act like high school students...Due to the Philippines not recognizing LPN/LVN's, none of my nursing subjects transferred. Because I have an Associate of Science degree however which I obtained through my local Community College, several of my science subjects were credited such as A&P, Microbiology, Health Edu, Chemistry, Pharm, English etc. Which shortened my time. In addition to my A.S degree which was earned separate from my LPN/LVN program, I also completed 7 months of a Paramedic program but withdrew upon acceptance into my LPN/LVN program, as well as a Medical Assisting program during High school through ROP.The reason why I state my educational background is to emphasize that although I have much to learn, which is why I came here in the first place, I am not incompetent. I also have experience in several different areas of nursing, and because of the length of time I spent in a Paramedic program I have additional assessment skills acquired through this training. The teachers here have really showed resentment towards me because of this and thus made it a point to exercise their superiority over me daily. I am disregarded routinely and can never seem to win. If I raise my hand and answer a question the teachers roll their eyes, if I don't know something they make it a point to state and emphasize it to the entire class. Because I have worked in a Hospital, I have a familiarity with U.S nursing practices, and therefore am accustomed to standards of care which to be honest is severely lacking here. I state this routinely as I refuse to jeopardize my integrity when providing nursing care and I stand up for myself whenever necessary, always ensuring to remain objective however and explain my rationale. This causes the teachers to state things like "you are not a nurse here", "you are not in the U.S", "this is the Philippines", "This is how we do things here", and today I received "if you think you deserve a grade above a 90% based on your demonstration than you should already be a nurse." and "not even god could change the grade i gave you because I am your professor and decide what grade you deserve."I am a confident nurse, but I am not cocky whatsoever. For this professor to give me an 82% however which is the same grade she has issued others who have not even taken health assessment yet is absolutely absurd and demonstrates her bias. We were suppose to simply demonstrate how to administer oxygen via nasal cannula, mask, tent mask etc. and articulate the importance and procedures of oxygen therapy. This is extremely basic. During my demonstration, since I have actually worked as a nurse I simply conveyed what I would normally do, ensuring I covered all the key points but also going in depth instead of simply stating like most students who do not yet possess these skills "I would listen to lung sounds". etc. I stated I would check the patients MAR before entering the room to identify if their was an order, look for the DX of the patient including history and existing conditions such as COPD etc., RX such as respiratory depressants, if labs were drawn and available such as ABG's/HGB etc, diagnostic tests such as PFT etc, baseline vitals and assessment, etc etc etc. I even gave here the normal lab values for ABG's! such as PH 7.35-7.45, Pa02 80-100mm Hg, PaCO2 34-45 Hg, HC03 etc. I talked her through an entire respiratory assessment, auscultating lungs, listening for rhonchi, rales, etc. checking mucous membranes and skin during assessment to identify signs of cyanosis and to rule out hypercarbia, hypoxemia. Retrieving vitals P, R, BP, O2 Sat, etc. administering the oxygen, all the way down to how I would document and then return in 15-30 minutes to recheck the patient. She than said "perfect" very sarcastically before handing me my eval paper which stated 82%. I asked her why I received that and she literally said that no one in my batch deserved higher than an 88% because that is the highest she will ever give one of us since we still have much experience and things to learn and we don't deserve a perfect score. I attempted to explain my case but was rebuffed by everyone including the dean being told absurdly rude irrelevant things such as "Lpn's are not real nurses Mr. Lucky(intentionally long pause on her part)...at least here in the Philippines. "My family is pressuring me to remain here and complete my education. Not only do I not want to because of how negative, unprofessional, and biased the nurses are here, but also because I can identify how severely lacking the education is as well as how the overall practice of nurses in the hospitals are. I don't want a subpar education...I want to be the best nurse I can be...my family I feel is just looking at the cost effectiveness of things. Words of wisdom of any kind would be appreciated...even if its not encouraging...as long as I can grow from it...I welcome it. #HELP

okay...so i made a very drastic decision that i am slowly realizing perhaps was not the best decision for me. with much reluctance i resigned from all three of the nursing positions which i held including my most recent which i have only had for two months as a center manager in order to pursue a bsn degree in the philippines. this decsion was made in haste and was not at all thought out on my part in regards to just how severe and impactful this decision was going to be on my life. i made this decision with much pressure from my family who i now feel coerced me in making perhaps one of the worst decisions i have ever made. so a little background on me...i am only a vocational nurse with a an associate of science degree...and yes i am half filipino...however i have never been to this country before and i am not fluent in tagalog nor any other language spoken here aside from english. my family has harassed me for almost three years now to go the philippines to complete my educational goals for various reasons. they despise the fact for some reason that i am only an lvn while they are all rn's who received their degrees from the philippines. they also stress to me the drastic difference in cost in education as well as the lack of a waiting list. well my half-sister and brother along with my cousin were going to the philippines to earn their degree and my family would not leave me alone. they wanted me to go as well because the school which i am now enrolled would credit all of my subjects and this would shorten my time to three years for a bsn. they told me that if i went they would cover my tuition, books, uniforms, etc. me, my siblings, and my cousins would stay in one of their vacation homes and would have an allowance every month of 800 dollars each which i found was equivelant to roughly 34,000 pesos which is the currency here. we all would attend the same school and have a driver. initially i said no which prompted my family to tell me that if i didn't go now they would not pay for me to go to a university in the u.s when i was ready and only pay if i went to the philippines. other things were said and i eventually decided to go. now that i am here and school has started i find it very difficult. not only do i not fit in but i cannot even blend in because i have a really light complexion and green eyes which i inherited from my mother who is european. i do not speak the language well enough which causes laughing from classmates and others here when i speak. everything is so different here and the poverty is so sad that it breaks my heart to see it. i feel home sick and i miss my friends and job. i don't know if i should just pack up and fly back home and try and salvage my life or if i should just stop complaining, suck it up, and finish my degree here. also, i am immensely worried that employers will be critical of me since i earned a degree in the philippines. i know my family says that they wont, but being a manager, i have clearly witnessed other managers pass on rn's who had foreign degress in favor of rn's who were u.s trained based on the assumption that philippine nurses tend to have a subpar education. i am seeking advice from wise nurses who can try their best to place themselves in my shoes and give me honest feedback on what themselves would do whether it is to stay or go home. i know if i go home now my family will be out money and be upset...but i can always pay them back...but if i stay i just don't see how i can stand 3 years here... your feedback would be appreciated more than you know... sincerely, nrslucky

"Can you make me better?""It hurts Nurse Lucky...right here...make it stop please.""Why am I sick?""I wish I could be like those other kids...""Can you hold my hand...my feet are cold...and the room is moving again.""Nurse Lucky...why am I bleeding there?"&"I'm getting better nurse lucky...I was able to eat all my food this time like you asked.""nurse lucky it's been a whole day and I have only hurt once today...and it wasn't even that bad.""Mom says that soon I'll be able to go home and you can come visit me!" (even though this isn't true "/)"I just needed to share these words with other nurses... How does one cope with questions like that?..I am having a hard time taking care of one of my patients...she causes me so much strife by speaking words so innocently bold and truthful...she is only 10 and my heart literally hurts for her...Has anyone ever been in a Situation like this?

My advice to you would be to remain at this job for a minimum of a year. Employers prefer applicants who have shown longevity at a place of employment and have a work history that shows you have not simply "jumped" from one job to the next. Remaining with an employer for a minimum of a year is also the courteous thing to do. When you leave a location you want to retain good references and not "burn bridges". Leaving after only a few months does not leave a good tast in the employers mouth in regards to your character. I understand that this may not be the most exciting evnironment nor the ideal place of employment for you, however it is a job where you are employed as a NURSE. Regardless of the fact that it does not require you to work in the full capacity that you know you are capable of, you are in a nursing position per your job title at your establishment. Most importantly though, it is experience that an unemployed new grad(trust me there are many), pray about daily. Also, I think before you make any drastic decisions in terms of employment which could affect your career, you should really think over what a typical day in an LTC/SNF facility entails. I gladly left the first opporunity that became available to me and personally never want to go back to that type of environment. I preferred working at the Urgent Care I worked at much more than I ever did in an LTC/SNF. The patient to nurse ratios in these facilities in my opinion are ludicrous and dangerously set. At the LTC I previously worked at I had only 2 CNA's to help me provide patient care with a patinet load of 35. You have assessments, med pass, treatments, charting etc. All of these tasks need to be done efficiently and accurately. It gets difficult at times to not make any mistakes when you have so many patients to take care of. I understand however that each individual has their preference in work environment and you may be comfortable in that type of fast pace role. I just think you should really contemplate your options and situation. Good luck in your decision and your career. Respectfully, NrsLucky

Okay so I want to start off stating that I am an LVN. I do not touch PICC lines. I have a question for RN's who know their scope of practice regarding them. So I have been picking up shifts in a Sub Acute SNF lately in order to work with a good friend of mine who wanted me there to help him. I generally have always avoided SNF's because of the high volume patient load and the small number of staff I had to assist me in providing exemplary patient care. My friend is an RN who has his BSN but went to school in the Philippines. This is his first job in this type of setting. He previously worked for about 5 months in a Doctors office and also in Home Health. This particular SNF that we work at promised him adequate orientation and training however only gave him 2 days of it before releasing him on the floor alone. I anticipated this would happen which is why I requested to have my status changed to per diem awhile ago. In order to help compensate for this facilities lack of orientation and training I requested to be put on shift with him and was granted this since I have a great report with the managers and the staff. I was "secretly" "orienting" him as best I could and for the most part did a great job since in this type of setting I can function in a higher capacity compared to when I am working on Med/Surg. Things were going great until one evening when I was not there he had a situation in which a patient was bleeding steadily from a PICC line insertion and who was under his care. He phoned the MD who informed him to remove the PICC line and apply a pressure dressing. If this did not stop the bleeding than he informed him to transfer the patient out. My friend dc'd the PICC line as directed and attempted to apply pressure. The bleeding continued and the patient was transferred out. The Charge returned from I am assuming break and my friend gave a report of what occurred. (The Charge does not like my friend or any foreign nurses for that matter, I know this because she told me this when I worked there full time.) She of course immediately pointed out that my friend was not PICC certified and should not have touched the line. This is where my heart dropped because I had no idea he wasn't certified. I feel so horrible because I didn't tell him that he needed certification for this. He was oblivious to this fact as well. His take on this is that although he feels very bad he had no idea that he could not touch these lines because in the Philippines you do not need a certification and he used to start them and dc them all the time. He also is upset because he feels he was never oriented appropriately or given all the rules as he should have been. He wasn't even given an employee handbook or told where he could find the policies of this location. I'm not going to get into what actions were taken against him, but he was reprimanded. He is asking me for help but I do not know what to say. So I want to know if he was horribly wrong in this situation and if so were severe disciplanary actions indeed necessary? The Charge Nurse has been relentless in taking action against him. ALSO: This was just a basic summary. The MAR was checked etc. before he dc'd the line and there were other steps taken as well... Your opinions would be greatly appeciated... Respectfully, NrsLucky

update: okay...so due to my previous circumstances i was advised not to discuss this in a public forum, however that has since changed as of this morning. i wanted to update everyone who was kind enough to give their advice and encouragement. although i would have liked to go deep into detail and inform everyone who has asked about the events following my post...i am going to instead refrain from doing so in favor of a brief summary. this decision is based off of some of the responses this thread has received from nurses regarding lvns/lpns in general. the tone of this thread has taken on more of a negative one and has since shifted in the direction of lvns/lpns do not belong____etc. im sure everyone has their own opinion regarding this issue however it was never really my intention for this discussion to go in that direction. i simply sought advice from wise nurses pertaining to my situation and actions so that i may grow in my profession. to prevent this discussion from becoming any more negative i will post a quick description of what has since transpired. legal advice was sought...however as of this morning my case was "dropped". i am taking this as a sign and do not have the energy to continue on any further in seeking any legal action. it was too hard to even secure a legal advisor who was willing to even entertain my case because i would be "taking on a dr.". this morning i was basically dropped "for my own good" since i didn't look up to the challenge of pursing further action that could potentially "blacklist" me and "drag out". everyday has been a battle with this md. i am not a confrontational person. it has been emphasized to me throughout these last several days that i have more to lose than gain based off that i would be going up against an md and his practice. his license indeed trumps mine is what i was told...which means his word is law in the medical field. no one is going to take the word of a "1/2 nurse over that of an md." i finally concede. i am going to take the "apology" i was given and the reassurance by everyone involved including the md that i "did an excellent job given the circumstances and followed all of the the facilities protocol to the t." therefore i should actually have "been commended for thinking so clearly in such a tough circumstance and knowing my scope of practice." i was seething inside when i was being told this btw. everything has been so confusing i feel like it has all been one huge mind game. i also declined the urgent care position offered by the pa and decided to focus on my work with the hospital i am employed with instead. although...because i was told "don't be ridiculous. we are going to put this behind us. which means you will keep your job. if you want to reduce your hours than i will permit that...however it is more conducive for both of us for you to remain working here." by the md i am scheduled to work in clinic 1 day a week. when i fervently disagreed to this i was pulled aside by the fnp who has helped me throughout this entire process and told to "just say yes. you can't win with this guy. it will benefit you in the end. trust me...i wouldn't direct you to anything that would harm your career." so this is my present circumstance at the moment...and to be honest...even though i am relieved this is ending...i kind of wish that i would have just walked instead of attempting to take action before being knocked down. like some of my fellow nurses on my med/surg floor said..."you were set up to fail. you wouldn't have won anyway...no matter how right you were...but at least you were brave enough to try." with that being said...thank you to everyone who gave me advice and reassurance...throughout this process it has been very comforting and encouraging. respectfully, nrsluckey :thankya:

:thankya:

I will take everyone's advice. I'll contact an attorney tomorrow. Im just concerned about the damage this may cause to the relationships I have with a lot of people. Thanks for everyones advice...n please say a prayer and cross your fingers for me...I think I'm going to need it if I'm going to try and go against one of the powers that be... Sincerely, NrsLucky

Your message is completely full of wisdom and well recieved. Thank you so much. I did not even think in that mindset at the time this transpired. I think just from being in this office/clinic setting I was used to these protocols that the RN told me to follow and I simply forgot how to critically think as I was trained to do. Thinking back now I can't believe I would not have administered 02 ASAP or connected her to a cardiac monitor to see exactly what her heart was doing. This seems like Emergency 101 when I think about it. I think my half thought out rationale was that she didn't really display signs of poor perfusion nor did she have a any documented signs of an altered mental status, chest pain, shortness of breath, hypotension, or other signs of shock during her intake. Her pulse was 50 and 02 98% per pulse ox btw. I will definitely make sure that I am more equipped to act appropriately the next time I am faced with a situation like this. Again thank you for your advice. Respectfully, NrseLucky

I am unsure of what to do now. I was called by my friend the NP from my prior job who told me that the Dr. wanted to talk with me. I kindly declined because I do not like confrontation. The Dr. snatched the phone from the NP's hand and told me that he wanted to speak with me and that there were things that needed to be worked out. He said that "things were said that weren't necessarily meant" and that he expected me to be in his office tomorrow in the AM. He assured me that there would be no yelling but that this would be a "pleasant" meeting. I did not know what to say...so I said okay. He passed the phone back to the NP who told me she would call me later. I later found out by calling my friend who is an MA there that she informed the Office Manager as well as the NP that the Dr. shoved me off of my heels onto my butt and into the exam light. She said that she was asked by the NP because all of the MA's who witnessed it were talking about it as the clinic "Gossip". She said that my friend the NP pulled the Dr. inside her office along with the Office Manager and they had a "heated debate". That so far is all I know but she did say that she think based off of the small bits of conversation she was able to hear through the room that he plans on "apologizing" and offering my job back. I don't know if I should show up or if I should just decline. He said before he ended the call "Don't disappoint me or make me come to you.". This worries me...immensely.

Thanks for your feedback. I am going to do my best to move on and learn from this experience. I really tried to talk to the Dr. He just didn't want to hear in anyway that his actions were wrong. I worked there a decent amount of time and for him to just terminate me that fast because of his ego shocks me. I do not want to subject myself to his name calling again so I will simply walk away as you suggested with my head held high. If he ever wants to reach out and apologize great, but I am not going to seek him out first. I do not like being called an "ignorant piece of work" or anything like that. Thanks agian, NrsLucky

Hi Altra, I appreciate your response. This was another reason why I actually posted this as I stated in my main post that I know I am not the most experienced nurse in situations like this and I felt there was potentially more I could have done. The reason why IV access was not initiated at first was because I need an order by the Provider in order to begin that. The patient was a 21Yo F with a C/O of nausea. She denied chest pain, headaches, sob, arm pain, etc. Denied a past medical hx or family hx as well. At least that was the data collected by the MA. The provider had not even seen the patient yet. Generally though phenergan is normally what is ordered for this CC. Glucose was 78. I checked her glucose while the Dr. was assessing the patient. Her pulse was steady although low. Her BP was low too, however for her height and weight did not seem fatally out of normal limits. The Dr. has stated prior that he should be brought to a patient before EMS is called if he is on site. Perhaps I should have set up the EKG. I opted not to until the Dr. entered because I wasn't sure if the Dr. would have wanted that immediately; I do understand that this of course would have eventually been needed. Again that is something I will probably do if this happens again. Again I appreciate your feedback. Respectfully, NrsLucky