RNPD

I have to agree with Tom. It is difficult to say w/o more info whether or not you can be effective as an addictions nurse. I also think the assumption is there that a person in recovery makes a good caregiver simply because it is felt that such a person can relate to what the addict is experiencing. I also saw that in the replies, but not necessarily in your question. I have seen both sides. Sometimes the person in recovery can relate better, but all too often I have seen them "relate" so well that they unwittingly are playing right into the addictive behavior. They lose their objectivity and become over involved on a personal level. You would not believe some of the instances of lack of boundaries that I have seen-sometimes I can't believe what I see and hear myself! OTOH, there is no reason why a person who has never had an addiction problem can not be just as effective-and sometimes more effective-as a caregiver. Just because I never had cancer doesn't mean that I can't be an effective oncology nurse, as long as I am able to have compassion for my patients and have the technical skills and knowledge base necessary to provide their care. So I would say that for a recovering person to be an effective caregiver in an addictions setting you would need a minimum of 5 years clean (one year is WAY too little time IMO), a very strong sense of who you are, have your "issues" and personal life well under control, and have a good sense of boundaries when it comes to relating to patients. As a nurse, you will have the added issue of the availability of opiates and benzos which you will administer on a daily basis. If you have "all your ducks in a row" so to speak, I think you could be a very effective addictions nurse. Good luck to you!

There is no definitive test for rosacea-but a doc can dx it based on how it looks. There is no definitive test for depression-again a dx is made based on what the patient reports and how the patient acts. Until MRIs were widely available, there was no definitive test for MS except autopsy-but the disease has been around for ages. How about Meniere's disease-dx by patient's reported symptoms and the doc r/o other dx that are definitive. My ophthamologist has to take my report of what I can and can not see to dx my myopia-he has no definitive way to do so other than the reported line I can see on the eye chart. I'm glad he takes my word for it and I don't have to wait for a "definitive" eye test before I can be prescribed eyeglasses! Those who need a "definitive" test to believe in fibromyalgia are just proving their ignorance and lack of knowledge of scientific theory & practice. The pressure points used to dx fibromyalgia are not merely sore when someone "pokes" any area with too much pressure. These are specific spots and the pain is overwhelming-a 9 or 10/10. This pain occurs form the lightest of touches in the pressure point areas. I have had my husband give me a back massage and he inadvertantly pressed a pressure point with his thumb. I can nearly scream with pain-and the severe pain remains long after the pressure ceases, much longer than it should. He can press even harder on a non pressure point and nothing happens. I don't wish that pain on the worst skeptic here. The pain has nothing to do with over-use or muscle strain-it occurs in the absense of activity that might cause discomfort. It is a deep and generalized aching, coupled with sleep disturbances. The point is that many people may come to the ED seeking pain meds for fibro (as well as countless other conditions causing pain). Some are drug seeking, but many are actually legit. Still thousands of others, like myself, have never visited an ER for pain relief, have never taken a narcotic for pain relief-but that doesn't mean we don't have pain. Just like there are degrees of severity with MS, so it is with fibro. Some have it worse than others. I too was quite disappointed to see the judgemtal attitude of some on this board but with a few that is nothing new. It is difficult to change ignorance and intolerance. I was heartened to see many more who are compassionate and up to date on recent developments with fibro and other auto immune disorders. I wish everyone who suffers from this disease a painfree night.

Really happy for you Cherry (and jealous!) You should take your original post and send it to every news agency in the country. What a wonderful description of the job of the typical staff nurse! Much luck and happiness to you in your new job!

The following quote from the website of the NYS Office of the Professions-Nursing-will give you some idea of the reasons for the change. It is part of the published results of a survey of RNs in NYS from September '02. The address is listed after the quote if you are interested in the entire survey results: Baccalaureate degree recipients now make up increasingly smaller "shares" of the basic nursing preparation degree pool, as associate degrees have grown in popularity in recent years. Furthermore, since the average associate degree recipient defers the timing of her/his basic education training until the early thirties while the baccalaureate recipient typically completes her/his degree around 27 years of age, these timing differences suggest that baccalaureate degree recipients have potentially greater career longevity than holders of associates degrees. More importantly, based on our findings, baccalaureate degree recipients are more likely to extend their educational training to the master's or doctoral level than their associate-degree counterparts. These discrete educational strands suggest that especially aggressive efforts must be made at the high school level to attract and recruit prospective baccalaureate candidates for the nursing profession. Promising high school candidates must be apprised of the growing variety of scholarship, loan-forgiveness, and other financial incentives that are increasingly available to such candidates. http://www.op.nysed.gov/nursing-survey-final-regents-report-nov.htm another site with info: http://216.239.37.104/search?q=cache:wFDicBxFiXYJ:www.aacc.nche.edu/Content/NavigationMenu/HotIssues/Nursing/New_York_Table.pdf+New+York+State+nursing+board&hl=en&ie=UTF-8

The New York State Board of Nursing has asked the State Education Department (the licensing body In NY) for regulatory change to require future graduates of ADN and diploma nursing programs to obtain a baccalaureate degree within 10 years of their graduation from the ADN or diploma institution. The graduates of the ADN and diploma programs would receive a "provisional" license to practice nursing that would expire in 10 years unless they earn a BSN. If they don't earn a BSN, RNs with ADN or diplomas will be demoted to LPNs. Those already licensed as RNs when the law goes into effect would not be required to obtain the BSN. From NURSING 2004 (March) I know this has been mentioned in this forum previously, but it was still in the planning stages. Now that the Board has voted on and passed this proposal, I think the State Ed Dept will go along with the Board's wishes. Comments?

Melanie-the carbs are used for energy to endure an intense workout. Carbs do not build muscle-only protein builds muscle. I don't think you can compare an extreme-i.e bodybuilder-to an average human-even a body that is at optimal weight and with good muscle tone. The low percentage of body fat and high percentage of muscle that is characteristic of a bodybuilder is not something that most of us aspire to. The average person wants to be fit and of normal weight for his/her size. I am also talking about restricting simple carbs, not complex carbs. Most complex carbs are good for you and only need to be eaten in moderation. I have plenty of energy on this diet, much more than when I was eating loads of carbs. Carb loading is again, only for intense workouts that require extraordinary amounts of energy. For the rest of us, it isn't burned-it turns to fat. sbic-my diet actually isn't Atkins, but it is low carb. It is actually the Curves diet, and seems to be working well for me. The weight loss is slow but as Melanie said, it tends to stay off when you take it off slowly. I agree that quick fixes aren't the best-but what I do like about low carb diets that do work quickly is that when an overweight person-especially an obese person-sees a large loss rather quickly it does tend to motivate to continue. I was unsuccessful at traditional diets-I couldn't lose on 1200 cal/day-my body would simply slow my metabolism down even further and unless I went down to 800cal/day I couldn't lose. And you know that no one can stay long at 800 cals! I would get discouraged with no results and start to eat-especially since I was always hungry and always felt deprived. With this diet I am neither and I really don't see a problem eating this way for life. I am quite confortable with my routine, I am not hungry, I can eat out w/o ordering special foods, I feel well, and I see results. The diet that Melanie described sounds great-for her! I tried similar diets and just didn't lose. If I stay away from carbs the weight comes off. I don't pretend to know the reason I am just happy with the results. And truthfully there is no way I could eat like Melanie decribed forever. My way I have no problem. In the end whatever works for the individual is the way to go as long as it isn't harmful. And this works for me!

"Talk to any bodybuilder/fitness professional and they will tell you that you NEED carbs to build muscle."~RNnTraining1973 Talk to a medical professional and they will tell you it takes PROTEIN to build muscle. Carbs break down into sugar which is used for energy but not used to build muscle. Amino acids, which are what comprise protein, are the building blocks of the human body. In order to gain muscle and burn fat you need to have sufficient protein and fewer dietary carbs because with too many ingested carbs the body uses those for fuel and never gets to the point of burning the stored fat. "I don't see eating like a pig on bacon, meat and such as a solution at all. It makes no sense to me."~SmilingBluEyes My breakfast today was a packet of instant cream of wheat made with 2/3 cup fat free milk and sprinkled with half packet of splenda. I drank a cup of decaf tea with another tbsp fat free milk. 17carbs + 12carbs Lunch was 1/2 Atkins bagel toasted (4.5 carbs) and 2 oz ham and american cheese with a small salad with a vinagrette dressing. Snack was small pear 23 carbs Dinner will be 4 to 5 oz rotisserie turkey breast with another vinaigrette salad and steamed broccoli. About 10 carbs in the veggies Snack at night-handful of peanuts or celery sticks with tbsp peanut butter, or sugar free jello with cool whip or a low carb treat such as Atkins ice cream 4-5 carbs Other than decaf tea and decaf coffee I drink only bottled water or seltzer. Tonight I will not eat any snack carbs because I will have already had most of my allotment so I will probably opt for the jello. I do occasionally eat eggs and bacon-maybe 2, sometimes 3 times a week. But I hardly eat like a pig nor does the diet suggest that you do so. I have one egg and maybe 3 slices of bacon and half a toasted Atkins bagel as an alternate to the hot cereal. I enjoy eating this way and it has become a habit for the past 7 months that I haven't tired of. I also do strength training 3 times week-the only way to tone and actually build muscle, as well as for cardio fitness. "Even when supplimented (with fiber) they were never able to fully discontinue the use of stimulent laxitives due to the free water restrictions of the diet"~kids-r-fun My diet suggests 64 oz of water a day. I haven't had any problems with free water intake, constipation, renal function etc. Actually we all should drink 64 oz of water daily, unless contraindicated by a medical condition. I think that if the diet is done correctly no one with normal metabolic function will have a problem. Of course if one chooses to "eat like a pig" that's a different story.

Although I do realize that studies can be flawed, the preceding post seems to be very positive as far as the safety and efficacy of a low carb diet. I do know one dietitian who admits that it works but states "I am not supposed to say that" when she discusses it. I myself have been low carb (~60 grams a day) since June 2003. I have lost 20 pounds. Would prefer it to be more and faster, but I have been unable to lose at all on traditional low cal diets no matter how strict I was. The nutritionist I consulted stated that as you cut calories your body goes into starvation mode-not knowing that you are dieting, it merely thinks that fuel is unavailable and it is starving. Your body therefore reduces your metabolism to even lower rates and weight loss halts. You feel sluggish, and fatigued all the time. It becomes a vicious cycle leading to slower and slower metabolism and greater and greater weight gain. That is why yo-yo dieting is so dangerous-you diet for a while, then go off because the diet is impossible to maintain and because you have stopped losing due to decreased metabolism. You regain all lost weight and then some. If this continues you find yourself with one of 2 options-perpetual dieting or increased weight each year. That is why it needs to be a life style change. Diets work only in the short-term and if you don't stick to it actually cause more harm than good. You would be better off never dieting. Low carb has become a way of life for me. It is a way of eating I can stick too. It isn't difficult once you make your choices. No, you can't eat anything you want anytime you want. That is reserved for a very small percentage of our population blessed with extremely high metabolism. For the rest of us we need to make choices (I prefer to say I make choices rather than that I deprive myself! So much more positive). You can have snacks, fruits, veggies, even breads if you need to if you make wise choices. It is basically about cutting out white foods-sugar, bread, rice, pasta, potatoes (although potatoes are healthy choices-just don't eat them daily or if you do you need to figure that into your total carb count. A medium white baked potato has about 25 grams of carbs so it can be eaten and is very nutritious) Atkins and Weight Watchers have low carb breads and bagels out there that taste good once you get used to the fact that it isn't Wonder Bread anymore! My endocrinologist is thrilled with my numbers and progress. He states that this is working great for me and not to change a thing. I agree. It was hard at first-as is starting any diet. I read the diet and cried. Said I can't do this. Put it away for 3 weeks. Finally decided to try it one day at a time. It took about 3 days for me to stop craving carbs but it did happen. (Most literature I have read says it takes a week or more to stop the craving. The term "sweet tooth" is very literal I believe. The more sweets and simple carbs you eat the more you crave. I believe it is because of the sharp spikes in BS-and as anyone who has ever been hypoglycemic knows, you desperately crave something sweet!) It took about a month of reading every label to know what were good choices. It took about 6 weeks for the diet to become a habit. I don't feel deprived and feel I can stay on this for life. At Christmas I ate what I wanted, and didn't count carbs. I just ate it in moderation, still making the good choices that had become my habit. One or 2 cookies was enough whereas before I would eat 10. I went back on the program after Christmas and lost the 2 pounds I gained and 2 more. I was once a disbeliever and very against this type of eating. I was wrong. I do suggest you check with your PMD before starting to make sure that you can tolerate slightly increased amounts of protein/fat-that your renal function is normal, etc. I do not believe that a sensible low carb (not no carb) diet could CAUSE the type of cardiac damage described, although I do believe it might exacerbate an existing problem. I also wouldn't be so quick to believe that someone didn't use diet stimulants such as appetite suppressants just because they denied that they did. I do take an MVI daily and use TUMS for calcium. Other than that I feel great, look good, haven't had one hypoglycemic episode (had them at least weekly) and all my numbers have either improved (where they needed to) or remained stable (where they were WNL). I truly think this way of life is saving my life and I am so glad I decided to try it.

sbic-a low carb diet isn't for everyone. It did work for me and I did need to lose weight. I have read research that followed people on low carb diets who ate the same amount of calories/day as traditional dieters. At the end of the research period the low carbers averaged 7 more lost pounds that the traditionla calorie restricted dieters. It may be that the low carbers have better insulin resistance control and that they avoid blood sugar spikes allowing for better metabolism of the same calories. Your diet sounds quite healthy for you and I agree that if you aren't a meat lover you will have a difficult time being satisfied on this diet. As I said in my first post, whatever works for you is your ideal diet! I do think that low carb diet or not, everyone can benefit from staying away from simple carbs and refined carbs such as white breads, sweets, and huge amounts of pasta/rice, as well as trying to eat foods with a low glycemic index. Once I lose all the weight I need to that is the type of diet I intend to follow for life. If I add carbs and see my weight creeping up, I'l know I need to cut back further. But I am hoping to enjoy my Sunday spaghetti and meatballs once again in the not too distant future!

"Still, I beleive we need the nutruients in fruits, whole grains and vegetables and the low carb diets don't allow enough of those foods to satisfy those requirements." -sbic56 Diet is a lifestyle and if you choose wisely you can eat low carb for life and still eat all the poster above mentions. On a 60 gram carb/day diet I have almost unlimited amts of veggies-I do watch carrot intake and don't eat corn-but I enjoy lettuce, cukes, celery, onions, green peppers, mushrooms, etc. As for fruits, I prefer to eat carbs rather than drink them so I stay away fom fruit juice but have an apple, or a pear a day-or maybe a handful of grapes or berries. If you like bananas, by all means, have one-just subtract the carbs from your daily total. There are low carb whole grain breads and bagels out there if you look for them-they provide fiber, protein, and and taste pretty good. Atkins and Weight Watchers are good. My typical diet is Breakfast: oatmeal or cream of wheat made with nonfat milk (not water) and tea or coffee with nonfat milk, alt. eggs with breakfast meat (bacon, sausage etc). alt. low carb bagel with cream cheese lunch: salad with chicken, tuna, turkey, cheese, or ham (sometimes small amounts of two or more) snack: fruit or small amt peanuts or slice of cheese dinner: meat, fish, or poultry and a salad, sometimes sauteed veggies as well. An occasional baked potato or sweet potato-maybe 2 or 3 times week. snack: fruit (if I didn't have it earlier), or a low fat low carb ice cream or sugar free jelo I drink only water (at least 6 glasses a day) decaf tea or decaf coffee. I am satisfied, have lost 20 pounds and rarely crave carbs, although if I do I have something forbidden such as a cookie or two. That is usually enough to satisfy me. Depending on what I eat the rest of the day and the choice of sweets I make, I usually don't even go over 60 carbs that day. I admit, I don't eat rice or pasta (although I loved both). I haven't been able to find an acceptably tasting alternative. I can't see myself ever going back to my high carb diet. I am quite satisfied, my last cholesterol was down to around 180, I have great energy most days, work out 3 times a week at a gym. I also did not think I could do this. In fact it took me about 3 weeks after I "officially" started to actually start it seriously and then about a month before I got comfortable with my choices and way of eating. Now it has become a habit and I don't choose any new foods w/o first reading the nutrition label. BTW if you live near a Subway, the new low carb wraps are excellent and satisfying for luch. I highly recommend them! I ws unsuccessful at weight loss until I started this diet 6 months ago. It works for me and I think that is the key-find what works for you-a diet that can become a lifestyle-and exercise. That is the key to weight loss.

I applaud this new resolution and think it is a fair way to gradually change RN licensure requirements to a BSN. Either the staus quo continues with multiple educational tiers permitted to sit for N-CLEX, or we gradually begin introducing the BSN and raise the status of professional RNs to a level more in keeping with that of other similar professionals. BTW-I am an ADN.

obgrn-you still haven't explained "coalition building" , and how that would be accomplished w/o a union. Are you now satisfied that CNA is indeed a union? Have you checked out UAN? You need to educate yourself before you can form valid opinions. Just because PNA does not choose to engage in collective bargaining at this time does not mean that NO SNAs engage in collective bargaining. There are probably a couple of dozen SNAs that engage in collective bargaining at this time-check out UAN for the exact number and list as I don't have the inclination to do it now. I know that since NJSNA does not, nurses in NJ have joined NYSNA for the express purpose of union representation. As far as new grads making those salaries quoted-they need to work quite a bit of OT in order to do so. I think most of us would prefer a fair salary for a fair workwork-i.e. no more than 40 hours. But to each their own.

thanks for the clarification, spacenurse. I applaud all of the excellent work that CNA and other SNAs are doing. That transporter and especially that LVN should be ashamed. I truly have never run into that situation while working in healthcare, although I do know personally of such stories involving union members in other professions. That LVN especially is a disgrace. The transporter is probably an uneducated, low level worker-but the LVN is licensed and presumably more intelligent than that. What a shame to use their unions for their own selfish reasons, instead of to better conditions for themselves, their colleagues, and their patients. Unions are only as strong as their weakest members-and those members certainly leave a lot to be desired!

I'm not sure I understand. Was the union transporter also an LVN-that is, was it one person or two? In the role of transporter, the LVN only had to transport the patients, not assist with transferring them back to bed? If that is so it is sad. To obgrn, I didn't mean that the ANA is a union. It is the American Nurses Association and although it is a "union" of nurses it does not engage in collective bargaining as the ANA. The labor arm, or collective bargaining unit, of the ANA is UAN-United American Nurses. UAN is made up of individual state nurses associations such as NYSNA that engage in collective bargaining and act for all intents and purposes as a union. I was unaware that CNA had opted out of UAN. Thanks for that info spacenurse. Yet the fact remains, that independent or not, if CNA engages in collective bargaining it is therefore a nurses union. Unless I am mistaken and CNA does not engage in collective bargaining. Please clarify this for me. Thanks!

Not sure what you mean by "coalition building" but it was a nurses' UNION that accomplished all that Space Nurse listed in her post! Please check out the ANA website and follow the link for UAN-the labor arm (and union) of the ANA.