rach_nc_03

\\Sweet! That means 30's are the new 20's! I feel more energetic already!

I hated it. Pettiness, vindictive students and teachers (threats of violence from a fellow student).....the LYING! Being treated like an idiot by nurses in clinicals. Being chastised for standing up for my values and principles (hm, I thought nurses were supposed to be willing to stand up and demand good patient care?). A 75% reduction in income- and I'm talking about my starting salary as a staff RN. Screwing up my back and hip permanently, to the point where I'll probably never work at the bedside again (which is fine with me). Exposure to some of the most appalling treatment by employers, worse than I ever expected (and I worked in a fortune 100 corporation for several years, so I saw all sorts of things). Being shunned for being smart and a hard worker. Having people at my rural school act like I was a snot because I'm articulate (oops, should've dumbed myself down, I guess). All in all, a miserable experience- but it gave me a way to work as a research nurse, which I love more than any job I've ever had. Well, except for being a jazz singer on a cruise ship (that was a sweet gig!) It was worth it. And my husband was deployed overseas through most of my time in school, so I was too busy to agonize much over his absence.

Good question. Is the process for qualifying for a student visa to go to school in Canada any different from the process for getting a visa for going to school in the states? My own experience was much like the others here who graduated in the last 5-10 years. I had a choice between: 1. accelerated BSN program with 3-year mandatory hospital commitment; tuition paid up-front (upwards of $20K). I understand they later changed the tuition policy, but if I had $20K in my pocket, I'd be using it to pay my living expenses while in school! 2. normal BSN program at a handful of local universities- all had extensive waitlists (1-2 years), and none would accept any of my gen ed courses from 15 years ago. Would've taken me almost 4 years to finish, to the tune of $9k. 3. CC programs that had a variety of admissions processes (waitlists, lottery, testing, GPA requirements). I chose a school over 1 hour away because it was the only one that admitted based on testing and GPA alone. I had a 4.0 in my pre-reqs and a perfect score on my admission test (wasn't the NET, but one of the other ones). Closer schools had 2+ years waiting lists. My school accepted 16 out of 350+ applicants. I know of no one in my program who came in with an entrance test score below 85%, and a GPA of at least 3.75. Oh, and the state paid for my tuition because I'd been laid off from the tech sector; they would pay for any degree or cert. program no more than 2 years long, if you took a job in the state in a high-demand field (like nursing, obviously.)

:barf01::barf01::barf01::barf01::barf01:

Amen. Read my recent post about having hip surgery, a failed epidural, and NOT getting any pain meds for several hours post-op. And how my surgeon almost put me in a coma at hour 36 because nothing could touch my pain by then. The biggest problems we seem to have with being judgmental are pain, obesity, and alcohol/drug abuse. (and yes, I've had those same thoughts.) In a perfect world, we'd all see something of ourselves in our patients. If only!! Where's Ghandi when you need him? :wink2:

as for the protocol for having a same-sex staff member in the room during skin assessments- I've seen a lot more attention paid to this kind of thing in recent months, regardless of patient and staff member gender. My physical therapist works in a small practice, and we're often the only people in the office when her assistant steps out. They just posted signs at the clinic stating a new policy like yours. The first time we were alone in the clinic together, she asked if I wanted another staff member to come from the next building. I laughed- I'd already seen her ten times by then. But yes, I think this is getting more and more common.

Here's the other problem with asking around- let's say disciplinary action is taken against him. Now, for just a minute, let's assume that he's gay (or a racial minority, or older, etc....something protected by the EEOC). I'm not trying to infer that his behavior *means* that he's gay, or, if he is, that his sexual orientation has anything to *do* with it. I'm throwing these out there because, if he were to get fired *and* he has a legal reason to sue for discrimination, you don't want to have your name come up as someone who 'asked around' about his behavior. Tazzi is right, you need to report him to the NM. state your observations very objectively. I would make sure to say something to the effect of, 'I have observed Mr. Nurse touching patients in a manner that appeared inappropriate' instead of 'Mr. Nurse has been touching *male* patients inappropriately'. Again, just to CYA. The patient that deflected your questions about being uncomfortable with this nurse makes me so sad. If the patient *did* feel weird, I can totally understand that he would be reluctant to say so. Men are far less likely to report *any* kind of abuse, and that's very frustrating. I worked with a nurse who had been in a facility where this sort of thing was going on, except the nurse was female, patients were male. The nurse was fired, but I don't know what else happened. My friend said staff had noticed behavior similar to what you described- for a long time- but nothing ever came of it until one patient complained. Definitely, definitely report him. This makes me very sad.

I work for a large cooperative nonprofit company that, among other things, offers health insurance to members. I do a lot of research on new drugs, new clinical practice guidelines, new disease info, trends in healthcare, etc, and design programs (preventive health education, disease management programs, etc.). I also write articles on some of the aforementioned topics for member publication. I have a lot of autonomy, I'm salaried (that can be good and bad), and I make twice what I made as a hospital nurse. I like it a lot.

patients or family members who want to talk partisan politics. for some reason, I ran across these types a lot- in the neuro ICU, it was the SAH or MG patients who were totally alert, but stuck in their beds- I refused to engage, and tried to diplomatically change the subject, but this type just gets more riled up when you do that. (And I'm talking about conservatives *and* liberals- regardless of how I feel, I'm not going there at work!) I usually found myself wanting to get in and out of their rooms at lightning speed- name calling is name calling, but people (patients or not!) somehow think using the terms democrat, liberal, republican and conservative as pejoratives is totally acceptable. no thanks. oh, and family members who don't want the terminally ill patient, who is clearly near the end of the line, to receive pain meds because they 'might overdose them'. Huh?? Sometimes this is cleared up with a little education, but I've seen plenty of family members (sadly, a lot of parents) refuse to allow us to make the patient comfortable. It hurts me to see someone suffer needlessly like this.

also, research nursing, and case management/utilization review for insurance companies. if it weren't so late I could probably think of a few more!

I've never ever given anyone a hard time for having an opinion- I'm just pointing out that some of the things you state as facts aren't true. As for the poll of non-medical folks- I assume you mean I should ask them if nursing is 'only' hospital nursing. Well, it's likely that most laypersons think that way- but is nursing defined by what the public thinks? If so, all nurses do is clean up poop, get the docs coffee, and wear skimpy white dresses to arouse the male patients. oh, and don't forget the sponge baths. Please. As for my indignation at you suggesting I shouldn't be called a nurse- yup. I think it's a silly idea. I'm a nurse, I'm practicing as a nurse. Had I not needed a nursing degree to become a research *nurse*, I would've just gone straight into research without bothering to go back to school. I'm not sure where you got the idea that research nursing hasn't been around for long, but my mother in law was a cancer research nurse for 30+ years. And no, she didn't consider herself to be a cancer researcher who also happened to have a nursing degree- she was a cancer research nurse. I'm a research nurse. One can get a MSN in research nursing. I suppose you think that shouldn't be considered a nursing degree, right? Who do you think should be doing all the myriad activities involved in research? Academic PhD types? MDs? I think your view is coming at it from the wrong direction. It's as much about nursing expanding to include more hard science, autonomy, research and critical thinking than it is about 'corporates' saving money by utilizing nurses in research. As for some of your other statements: LVNs/LPNs are licensed nurses. Are you saying men shouldn't be in nursing? And why is it bad that your neighbor became a nurse because he could make more than he could as a police officer? As for the wages dropping- he** yeah, I'd leave if I were suddenly unable to make a decent living as a nurse. And frankly, I don't know a single nurse who would stay under those conditions. It's ridiculous. Nurses are already underpaid, especially hospital nurses. And your insinuation that any nurse who isn't doing direct patient care is somehow less dedicated to nursing is illogical and completely unfounded. I get the impression you think wages should drop to keep out those who don't feel nursing is a 'calling'. Okay- enjoy your tripled patient load. I don't normally have such a strong reaction to posts here, but I think your attitudes are the *very* reason nurses are misunderstood by society. Perpetuating the angel of mercy martyr nurse stereotype reinforces the belief that nurses aren't highly educated professionals who can do more than hand out tylenol and change bedpans. And that is a *big* factor in why nursing isn't getting the respect it deserves.

AMEN. You hit the nail on the head.

I don't know Canadian law, so one of the Canadians will have to respond to that. I have a tough time believing it. Your first statement, though, is specious. How is your health insurance company demanding power to oversee *your* healthcare any different? How can ANY entity oversee healthcare without looking at your private information?

:yeahthat:

yeah....but we *shouldn't* have to put up with any of the above. We continue to get treated this way because we allow it to happen.

Forgot to mention that when I did staff development/employee health, I caught flack for sending sick employees home. Sorry, if you have a high fever, massive diarrhea, and have to keep running to the bathroom to puke, you don't need to work. I'd find people crouched in corners or the supply closet, trying not to faint, running temps of 101. Sorry- they need to go home. They were always shocked that I felt that way. This is one of my pet peeves, and hearing how you're treated there really makes my BP skyrocket.

One of my first patients as a PICU nurse was a shaken infant (maybe 3 weeks old). The DA wasn't able to press charges for attempted murder because they didn't have enough data about who shook the baby nearly to death. The only way that was going to happen was if the baby died. This poor kid was never going to regain any function. He was incapable of surviving off of the ventilator. We took pictures of him to submit to the DA, trying to get the court to have care withdrawn. That wasn't happening, so the plan was to send him home to specialized foster care. Several potential foster parents came in to be interviewed, but they all left in tears after seeing him. Not one said they could handle it. The baby eventually died in the hospital, and I'm not sure what happened to the parents. It was hard to see this. I'm sure this was incredibly difficult for you. I agree with the other posters encouraging you to seek out a trusted advisor or counselor so you can talk about how this is affecting you. It sounds like your actions and intentions were the best they could possibly have been. I've worked with nurses who simply didn't want assignments with these kids because they couldn't control the anger they felt towards the abuser. You sound like someone who would really shine in pediatrics. Seeing abuse patients is hard for everyone- the important thing is learning how to process your own feelings about the situation so you can provide effective care, and keep your sanity.

I briefly had the responsibility of infection control at a LTC facility. To prepare for the job, I was sent to an IC certification course. Lack of compliance in hand hygiene is a HUGE problem everywhere, and there are evidence-based surveillance practices in place- including monitoring consumption of hand hygiene products. I don't think it's silly or a waste of management's time at all. It beats trying to directly observe all staff, all the time, to check for compliance. *that* would be expensive. We also had a big problem at my facility with sharps being thrown in the trash- I was pushing for a way to effectively monitor compliance with OSHA guidelines, state infection control guidelines, and CDC recommendations when I left. There aren't a heck of a lot of ways to monitor that, y'know? I say kudos to your facility for doing this. Also, the cavi-wipes are much more effective for cleaning equipment and work surfaces than alcohol foam. If your facility is being gung-ho about infection control and don't offer them, I'd suggest it to them.

She's an idiot. Sick is sick. You're endangering your own health by being there, and that of your patients. And she had no business asking about details of your illness. When I started working outside of bedside care, I'd been so accustomed to 'pleading my case' with management when I called out (frequency of BMs, temp, descriptions of every symptom) that I did it automatically the first time I got sick. My supervisor said, 'um....i *really* didn't need to know that. If you're sick, you're sick. Come back when you're well enough to work.' Check your state labor board website and see if you have any legal footing here. I'm pretty sure the details of your illness are legally none of your business. She's on call, it's her job to get your shift covered. If she can't find anyone to come in, she has to. Too bad. That's part of her job (and I did it when I had a job where I was on-call. It sucked, but I did it.) You're sick regardless of how you got the shift. Do you know the policy for absences due to illness at your facility? If not, get a copy of the policy. I'd venture to guess that it doesn't say, 'anyone who calls in sick will be diagnosed over the phone by the DON, who will decide if the employee's illness is severe enough to warrant an absence.'

Here's a question (seriously not trying to confrontational, I simply don't know the answer): What is the financial impact of providing healthcare to illegal aliens (undocumented workers, if you prefer) in the US? What is it in other countries? For the record, I am all for national healthcare coverage. Right now, we're in a vicious cycle- healthcare costs in the US keep increasing, so few (if any) uninsured people have the means to pay for the care they need. They often end up catastrophically ill, and end up in the hospital anyway, but with far more costly care. Since they can't pay a $30,000 hospital bill any more than they can pay for a $900 ER visit, the prices charged by hospitals to insurance companies rises. Meanwhile, the skyrocketing costs of treatment are passed along to the insurance companies- which they pass along to employers. (This is true for both for-profit and non-profit insurance plans.) Our employers then turn around and stick the employees with the bill. Our benefits are decreasing, and our own costs- through co-pays, premiums, and deductibles- increase dramatically. So what happens? Even those with access to employer insurance plans have problems affording care. I can't count the number of people I know who simply can't afford the premiums their employers charge, just like tgb3rn. This infuriates me even more- the SAME people who are PROVIDING THE CARE can't afford to receive it??? If anyone has seen the series 30 Days on A&E (with my hero, Morgan Spurlock), you may remember the episode where Morgan and his fiancee tried to survive on minimum wage for a month. During that time, two *very* minor problems- a UTI and a sprained wrist- cost them close to a thousand dollars! At the rate of pay they were getting (even with one person working 2 to 3 jobs), it would've taken several months just to pay off those bills. For one ER visit, Morgan was charged $40 for an ACE BANDAGE. Imagine what it feels like to *really* live that reality- and what about kids? The primary reason I took my current job is the health insurance (it's a nonprofit insurance cooperative, so I get the same benefit our members receive, and they're excellent). I really like my job, but frankly I would've taken it even if I were lukewarm about the job itself. I simply can't afford a lapse in coverage. During the time I was unable to work over the last two years due to health issues, I had to pay COBRA rates to keep my coverage- to the tune of $600-$700 a month. Maintaining access to coverage cost me as much as keeping a roof over my head. I depleted my entire savings because of this. Here's the bottom line- the 'free market' version of healthcare isn't working. The terms 'free market' and 'socialized healthcare' are bandied about, mostly (I think) to arouse negative associations with the latter, because 'socialist' = 'evil' in the minds of many Americans. Nevermind the fact that our 'free market' system is anything but. How many of us- even those working in the better-paying states for RNs like California- could *really* afford to pay for our own healthcare without employer-sponsored insurance? How much would *you* have to make to do it? My husband and I have a combined income of $137K right now, and my recent surgery would wipe us out if we had to pay what the hospital charged my insurance company. So how could the family with the US average household income (which, I believe, is around $40K/year) do it? And all those people earning minimum wage?? Where would the government get the money to pay for national healthcare? I know of at least one endeavor costing us two BILLION dollars a week that the government could cut. Kudos to outcomesfirst and talaxandra for posting these informative links. If more people took a hard look at the data instead of subscribing to politically-driven dogma without suggesting viable alternatives to our broken system, maybe we Americans could turn the tide here. I'm not taking potshots at the posters here, either. EVERYONE in the United States has a stake in this, and we owe it to ourselves to get informed and actively fix our problems.

First off, nurses are not broken up into RN and BSN- an RN is simply an RN, no matter what educational path got them to the point where they could take the NCLEX-RN. Also, you should check your facts on the 'old school' nurses who all went to school for 4 years- hospital nursing was evolved from hospital training programs. There was actually a lot of resistance to the notion of college education for nurses back then. And don't forget that in the early days of hospital nursing, a LOT of the work was actually being a maid as well. Yes, doctors did a great deal of the work that nurses now do. It wasn't just technology; it was training, skill level, and the perception of nursing as a low-skilled job, not a profession. I don't understand the comment about being proud to call yourself an administrator. I suppose I'd be called a 'paper pusher' as a researcher (even though I rarely do anything involving actual paper, y'know?). But I'm a registered nurse. I am practicing nursing as a part of my job. I haven't stopped being a nurse because I utilize my skills and knowledge away from the bedside. So I'm going to continue calling myself a nurse- because I *am* a nurse. And, for the record, I *did* have to interview for my nursing school program. I was completely honest about my desire to work in research. I felt no need to do a song and dance. I knew what I wanted in a nursing career, and I was willing to do whatever I needed to do to make that happen. If my goals were a problem, they would've kept me out of the program. One more thing- I have a question for anyone who says that money doesn't figure in to their reasons for being a nurse. Why aren't they working for free?

They are obligated to show you a copy of the policy manual, period. Even without the other horrid crap you're going through with them, it's absolutely insane that they think they can prevent you from seeing the policy manual!! WTH? Read up on labor laws for your state. I'm almost positive they're breaking laws. And here's the awful part- if you ended up making an error because of the exhaustion they're causing for you, you'd still end up holding the bag legally. The threat of terminating you for calling out won't matter a whit- you'll be seen as working when it was unsafe for you to do so, of your own volition. No matter what, don't miss your daughter's appointment for these people. Seriously, I can't see them firing you- imagine all the shifts they'd have to cover, since you're there nearly all the time! Do get out of there as soon as humanly possible. This is a bad situation that is only going to get worse- and they only reason they're continuing to pile it on you is that you haven't quit yet. That sucks so much. I'm so sorry you're stuck in this mess.

OK- question for you. All of the non-bedside jobs that nurses can (and do) have, like telenursing, utilization management, case management, clinical research- why are these not nursing jobs, if (a) the job requires a nursing license, and (b) the nursing knowledge of the individual is an integral part of the day-to-day work? I worked with some clinical research coordinators who *weren't* nurses, and every single one of them had problems doing the job well. What about the nurses that work in pharmacovigilance for the drug manufacturers? I would much rather have a nurse working in that sort of job. The fact is, modern healthcare not only has more opportunities for nurses away from the bedside- it has more opportunities, period. As for the spiritual growth that comes with cleaning someone up- it sure didn't do that for me. I didn't think I was above doing it, and I'd signed up for the job- but no, it certainly wasn't any sort of zen-like experience. As for the aversion to dealing with patients- yes, some people specifically seek out non-bedside jobs because they feel patient care is beneath them. I'd argue that most of us who work away from the bedside had different motivators. Did I *like* doing bedside care? Nope. I did not. For a number of reasons- but not because I thought it was 'beneath' me. It's just not my bag. I knew it probably wouldn't be, and I didn't plan on doing it for very long, as I knew I wanted to go into research. I don't like 'hands-on' nursing care. Not just the excrement, either- I don't like starting IVs, ambulating people, passing meds, and the like. It's the 'hands' part of 'hands-on' that doesn't work for me. I'm not touchy-feely, either. I'm much happier in a job that requires a ton of reading, analyzing, writing, teaching- not doing stuff with my hands. And I'm a lot better at it, too. Drop me in front of a computer all day, and I'm happy as a clam. Does that mean I provided lazy, substandard care? Not at all. I gave 110%, because that's what I do in my work, and my life. A preceptor once told me I did the best assessments she'd ever seen in a new grad. I have a keen ear, and frequently caught pulmonary issues very early. But if you handed me a bunch of stuff to set up for a CVP line, for instance, I'm all thumbs. I stink at replicating physical tasks that someone shows me. I always have. I need to write down the steps and intelletualize it. I also function very well when I'm not given deadlines or schedules- I'm the type to wake at 3 AM with a great idea and plop down at the computer to write. I'm *not* good at following multiple MAR schedules, planning how much time it's going to take me to do other tasks, and dealing with six million interruptions from people who need me to do things NOW. Do any of the traits I just listed make me smart/stupid/a good nurse/a bad nurse/a good person/a bad person? I think not. They *do* make me better suited for research than for bedside care. I firmly believe people should play to their strengths. There's no benefit to hammering away at something if you're simply not right for it. There's a show on Discovery right now about a group of men climbing Everest. A couple of them had to turn back before the summit because- for various reasons- they weren't physically able to go further. Were they to push on, they would probably die. I see nursing in much the same way. I don't think I'm going out on a limb to say that those of us who don't 'fit' at the bedside are likely to make mistakes. I say all of this because Pfleger23's post, like many others, narrowly defines the field of nursing. I've heard many, many nurses say things like, "I 'just' want to stay at the bedside," or "I 'only' want to be a floor nurse, not NP/CRNA/etc.". What the heck? I think statements like these demean bedside nurses as much as the title of this thread. They reinforce the opinion held by much of the public that bedside care nurses are low-skilled buttwipers. By regarding nurses with other interests and aptitudes as more- or less- 'nursey', we continue to perpetuate the 'nurse as angel of mercy' myth the public believes. Whether you're an NP, CRNA, bedside care LPN or RN, case management nurse, research nurse- you're a nurse *first*. That means far more than the number of rear ends you do/don't clean. It's about your knowledge, your training, and your skills, regardless of where you use them. The sooner we start acting like it, the sooner the public will understand our profession.

whoa! Does the maalox/tape allergy thing work? I only ask because I've been stuck with no paper tape in the house and needed to use some plastic tape on myself. I have a horrid rash after (small town, no 24 hour stores). These are fascinating, btw! I often heard seasoned nurses on the floor refer to some of these things and had no idea what they were talking about- and it took me six months as a CNA to figure out what the bedpan hopper was (not in use, obviously, but still in every soiled linen room in the hospital).

I had a similar situation with a coworker- but the ranting maniac was the RN, I was the CNA. This guy was *notorious* on the unit for being grouchy and mean to anyone except the handful of people he liked (maybe 5 of them). He was always trying to tell the doctors what to do (and I don't mean helpful suggestions based on good nursing observations, but order-barking). An attending once walked in on one of these rants (directed at a group of residents) and said, 'wow, jim, you're an MD now! congratulations!' this guy, for whatever reason, hated me. no idea why. He'd report me for 'not following orders' all the time, but wouldn't give specific examples (I'd never refused to do anything I was asked to do, unless I was already assisting with another patient, and I would explain I'd help them ASAP). He would yell at me, bark orders, and demean me for absolutely no reason. Apparently (and this was the general consensus on the unit), he wanted people to bow down to his mighty intellect. He was smart, but an a**. Anyway, I was 15 minutes late one morning because of ice on my street that i literally couldn't cross (sat there spinning tires the whole time). I'd called the charge and she knew about it. (The unit secretary, meanwhile, was pregnant and said the was late because she didn't want to slip on ice and fall and hurt her baby...she was 3 HOURS late.) When telling another coworker about the ice, 'jim' said, quite loudly, 'there wasn't ice at my house. I don't believe you. You're a liar.' (for the record, he lived an hour away from me, so how the heck did he know?) I said, 'i've put up with your intimidation and attitude long enough. When you can speak to me respectfully, like an adult, let me know. because I'm done listening to this.' I walked away and continued with my day. For months, we would work together and he would only say the minimum he absolutely had to communicate to me. After 4 months or so, he started, slowly, showing me respect and pointing out learning opportunities for me with his patients. We were never buddies, but he eventually found some civility somewhere. I've never understood bullies (and I believe this PCA is definitely bullying you). My mother would smack me silly if she saw me pitch a fit like that in a public place- let alone at WORK!