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RockSolid

RockSolid

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  1. RockSolid

    50 years old : I want to be a nurse

    I agree with Tommy5677. I went through a very very tough BSN program when I was quite a bit older than you. It was grueling, although I did extremely well. I'm glad I did it because it got me into a job quickly, and d/t my age the idea of spending more years doing an on-line RN to BSN was not realistic. But - to anyone who has time - and believe me, you are young! I also recommend getting an ADN and then going the RN to BSN route. Many ADN programs require a CNA, but if your chosen school does not, they may give you credit for other schooling and for your chaplain work. Otherwise, be aware that the CNA will add time to this process. Beyond that, you'll probably have to take pre-requisite courses for either Associates or Bachelors program. Things like Anatomy and Physiology, in some cases things like Microbiology, Organic Chem. For my BSN all of my prereqs took 3 FULL semesters, at 4-6 classes each. A ton of work. For most associate programs, there are fewer prereqs, so you'll start the program faster, too. Once you have an ADN and get your RN, you can work as a nurse and start an on-line RN to BSN. Some hospitals pay ADN's less than BSN's and a few in large cities don't want to hire ADN's, but believe me you will be able to find a job. My hospital, a rural regional, doesn't pay any more for a BSN and hires ADN's all day long. So, my recommendation is also to take the associates degree path. You will save time and money. In terms of the CNA, it is very valuable experience, but it's also ok to skip it if you can. Regarding being hired at a hospital after working as a CNA - maybe, maybe not. One very large hospital system I know of uses a third party testing service for employment choices, and they brag that they don't care if you worked for them in another capacity! In other cases, working there as a CNA might help, but ask yourself, do they already know you as a chaplain? If so, might that help just as much? Bottom line - if you want to be a nurse, go for it. You are not too old by a long shot. Check out the options, talk to admissions counselors, gather info. Be mindful of your full plate and what your support system will bear. Don't sabotage yourself by making things more difficult than they need to be. If you can manage a BSN, that's great. But the ADN is just as viable and it will get you working as a nurse, in most cases, faster. An ABSN is great, but only if you can check out of your life for the year it will take you to get it. Literally, you won't see your kids, or anyone else except your cohort, teachers, and patients. If you can manage that then it's an option. But, from what you said about your situation, I wouldn't recommend it at all.
  2. RockSolid

    MD-RN Relations -- There is Hope

    I work at a rural acute care 80-90 bed hospital. We're by no means a teaching hospital unless you count the nursing students who rotate through for clinicals. About half my patients are surgical (pre and post), the rest step-down, and med-surg overflow. About a third of my patients are pediatric. As such I constantly interact with hospitalists, surgeons, and pediatricians on a daily basis. Probably in total around two dozen docs or NP's, including around ten surgeons of various stripes. And these are mostly "older" practitioners, most of them in practice for at least 1-2 decades and probably more, with a few close to retirement. With only one exception they are great to work with. Several of them make it a point to talk with the nurses about their patients before making rounds, others will seek you out afterwards to discuss new orders, patient progress, or care. On some occasions I've been asked my opinion about meds, whether a patient will be ready for discharge, or a diet change, or other aspects of pt progress, care and condition. Whenever I have questions or concerns they take what I have to say seriously. This is my first hospital job, but there's nothing special about this place. I mean, we're rural, understaffed and underpaid. The "big" hospital (level 5 trauma, etc.) is about an hour and a half away. Friends that work there (for a few bucks more an hour) tell me that the docs there generally horrible and abusive to the nurses. So, at least in some places the horror stories are true. Still, I tend to think the culture is changing, albeit slowly. Smart docs, NP's, PA's, and surgeons do best when they depend on, and work collaboratively with, smart nurses (and with other med professionals like RT and PT, etc.). The smart ones are learning that. Anyway, at least in my hospital, nurses are respected and treated as part of the team. Now, if only we could get the (mis-)managing MBA's to respect what we do and what we bring to the table...
  3. RockSolid

    Why should I become an rn instead of a pa?

    Attitude? "All the factors that might possibly go into such a decision..." will be very different for each person. Rather than ask people why they like being one thing or another, get as much information about what it takes to become an RN/NP/PA, or fireman, for that matter, and what they each DO. And then think about what turns YOU on, what fires YOU up.
  4. RockSolid

    Why should I become an rn instead of a pa?

    First of all, get clear about terms. PA vs RN is like banana vs basketball. I'm assuming that what you are really asking is how Nurse Practitioner differs from Physician's Assistant. If you think you want to be an NP, then becoming an RN is the start of that track. If you want to be a PA, then go to PA school, not nursing school, but you'll usually have to have hundreds of hours as an EMT or ED tech, or Army medic, or something like that, before you can apply to PA school. As an RN, once you have a BSN (and experience) you can continue training and education and become a Nurse Practitioner. Generally an NP is Masters prepared, although this is changing and will likely demand a doctorate level degree soon. There are some programs where you can get your BSN and Masters in sequence and come out as an NP, but most NP programs (wisely, I think) require at least a year of RN experience just to apply. A Nurse Practitioner incorporates both the nursing framework AND the medical framework. A PA is trained, often in medical schools, in the medical model. PA's are physician's ASSISTANTS. NP's are nurse PRACTITIONERS. NP's generally have more autonomy. (This is very important!) There are more differences, but since this is about your future take time to continue researching until you are clear in your own mind. Good luck on whatever career path you ultimately decide to follow.
  5. RockSolid

    How Do I Apologize to Professor?

    I agree with most of the other comments. Clinicals take priority. Period. No class meeting is important enough for you to miss clinicals and I'm somewhat surprised that the professor signaled that you should go on to the meeting and and then come to clinicals late. Whatever... that's that professor. Overall, step up to the plate. Be responsible, be early to clinicals, don't miss clinicals. For that matter, be on time for class, too. If you must put a communication "on record" in the middle of the night, send an email. Don't assume that someone will turn their phone off at night. I use mine as an alarm clock and never turn it off. This prof may not be one you can have a more personal relationship with. The best way to repair whatever damage that was (or was not) done, I believe, is to be hyper professional. Impress them with your seriousness and your commitment. At some point (you'll know when it's appropriate) you can let them know how much you are learning from them and how much you respect them. In the meantime, just be on time and professional. The rest will take care of itself. Good luck in school and in your future career as a nurse!
  6. RockSolid

    Am I stupid for not doing the ABSN?

    Absolutely! Good luck to you, too... Follow your heart, it's the best GPS there is!
  7. RockSolid

    Am I stupid for not doing the ABSN?

    No, you're absolutely not stupid for taking the traditional program route. ABSN is a great option if you're restricted by time and money, and if you're willing to bury yourself in school for 12 or so months without a break. ABSN is fine if it's what you want and you can make the sacrifices. But a traditional program will allow - if you want it - to go into more depth with your studies. In an ABSN program you're goal is to keep your head above water. It's a sprint. A traditional program will give you (a little!) more breathing room, and also give you more clinical experience (very important) and give you more opportunities for summer employment (VERY IMPORTANT) and even summer work-study experience. If you apply yourself you'll have good job offers (conditional, of course) before you graduate. You may also have the chance to do some nursing oriented school trips during spring break. My school has a for-credit spring break where we go down to Jamaica and do public health stuff with nurses down there. They also have another for-credit spring break trip to do clinicals in a hospital in Europe, and meet with european nursing students, etc. You will probably not have the chance to do any of this in an ABSN program. I'm not knocking ABSN - I'd planned to do it myself but the state cancelled funding and it was suspended for a year. So I went into a traditional program instead and in retrospect I'm glad I did. Finally - it sounds like you're gut is comfortable with your decision. Don't let your mom, or anyone else, mess with your head. Sounds to me like you made the right decision. Congrats!
  8. Sorry, Blue Devil, if I offended you. I got interested is all, sorry it that was off topic for your thread.
  9. RockSolid

    You're going to think I'm nuts

    I guess I'm one of those people, too. I love my program, I love what I'm learning, I love my professors. It's a very tough program to get into, and occasionally someone flunks out. But the professors give 110% and if you meet them halfway they will do everything they can to help you succeed. I've read a lot of posts where people tell horror stories about their programs, so I know there are bad ones out there. So, one thing I would say to prospective nursing students is, "Choose Wisely!" (I guess that quote gives me away as a non-traditional, older student :-) But I mean that. Talk to current and former students, and if possible talk with local employers. There is one local community college program that is not very well regarded. I spoke with someone from a local hospital the other day and they said that they don't even interview RN's who graduated from that program. On the other hand, there is another community college program nearby, and their ADN graduates are highly sought after because their program is excellent. I know, too, that sometimes you just don't have a choice. Like, there's one community college in a hundred mile radius, you have kids and responsibilities and you take what you can get. That brings me to my second thought. Even if you don't have much choice about which program you can attend, you do have a choice about how you go through it. Half of it is attitude and the other half is sweat. If you are eager to learn, then at least one of your professors will respond. If you apply yourself sincerely, then you will see results. (And I agree with the original post - it's nice to get A's, but B's are fine, too. If you're worried about having a B average, then do some extra volunteering, or take on some organizational responsibility in school. Enthusiasm is contagious and most employers like it.) Stay focused and don't get hooked by the inevitable drama of school, whether it involves students or faculty. Stay focused and don't let yourself become intimidated by the work, or by a crummy school or a poor professor. Also, and I think this is important, allow yourself to become inspired by someone: a professor, a preceptor, a nurse who you've interviewed or met somewhere, a nurse who's cared for you, a nurse you read about... let yourself be inspired and you will have more energy for school, and for your career. There is no getting around the fact that nursing school is work, but honestly, it can also be a blast!
  10. I did check medscape... For example, "The authors write that individual comorbid conditions, as well as cognitive and functional status, should be considered in determining glucose goals, but in general they recommend a hemoglobin A1c (HbA1c) target range of 53 to 59 mmol/mol (HbA1c 7.0% - 7.5%) on treatment." from: New Position Statement on Diabetes Mellitus in Older People Medscape: Medscape Access Do you happen to have a link or citation? This very issue came up recently so any backup info would be appreciated. Thanks.
  11. " A patient of hers came back from the diabetic educator saying they told her an A1c of 8.0 was OK. She went berserk and was about to call the BC-ADM and tell her what an idiot she was; I let her know that that is the new recommendation for A1c in older adults." Just curious - who/where is the recommendation that an HgA1c for older adults of 8.0 is OK? My understanding is that tight glycemic control is less warranted for adults 70+ and that for older adults who are already diabetic that a range of > 6.0 and 8.0. See, for example: Medscape: Medscape Access - based on this I would think that even if the pt was already diabetic, a level of 8.0 might warrant concern. I've also read that older adults may tolerate higher blood glucose levels without adverse effects because they often have generally lower glomerular filtration rates. But my understanding still is that a healthy, non-diabetic, older adult with a life expectancy of > 10 years should be looking at a target HgA1c of So I'm just wondering about the evidence in this case for 8.0 levels being recommended. Also, about this particular patient: were they already diabetic, particularly frail, etc. I'm not discounting your points about EBP, which I support wholeheartedly.
  12. Absolutely get your books now. As others suggested, read at least the 1st 2 chapters; more if you are able. Doing this always made a difference for me. It's overwhelming enough when you start back to school, so getting a head start on the material, gaining a comfort level with it BEFORE you get into the classroom will serve you well.
  13. RockSolid

    ATI Fundamentals exam

    Take the first practice exam and study all the material it lists for you when it creates your results report. It may be a dozen or so chapters, but go through them and do the questions at the end of each chapter. Take the first practice test again and see where you are. BTW - talk with your faculty about this 72 hour lockout thing - as far as I know you should be able to take the practice exams as often as you want to. That shouldn't be happening... AFTER you've studied and retaken practice test 1 at least once or twice, do the same with practice test 2. As I recall, many of us initially got in the 60's or 70's the first time we took the test. Do not despair. After studying a bit and retaking the practice exams you will get your practice grades up significantly, if only because by now you've 'memorized' the practice questions. That's OK. The main thing is that you have studied the book in areas you are weak on. ALSO - use your Foundations or Fundamentals textbook. If you have Potter & Perry or another, use it to bone up on anything you feel weak on. Remember, you just have to hit the grade ranges for the levels, you don't have to make a raw score of, say, 92%. Don't stress; study, use the practice exams, be calm, you'll do fine.
  14. RockSolid

    CEO compensation

    You were very courageous to raise this issue in a company meeting. Really. The stuff about "high stakes game" and "driving the ship" is just a rationalization, something to say. It' s meaningless, and the person who said it may not even believe it themselves. But it sure is hard to listen to when you know that what you do actually does have life or death consequences. With all due respect to any CEO's out there, what they do simply does not. It's all about greed and what you can get away with, which has somehow become OK in our society. For a quick insight into this, see: Where The Productivity Went - NYTimes.com It wasn't always this way, and maybe things will turn around and we can regain our bearings as a society. But in the meantime it isn't fair and I know that if I think about it too much it just breaks my heart. What helps, I think, is to focus on the tremendous difference you make as a nurse for the patients you work with and the families you come into contact with. This is what it's about, really. This is what counts. But still, it ain't fair...
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