chanie911

I work in a special ed preschool and all the TA's change diapers, but my nephew had this "problem" when he started school (eventually he transferred to a special school in because of other issues)...he just finished kindergarten and still in diapers bc of severe GI issues after Hirschsprung's surgery at birth... When he first started school at 3 1/2 he needed to be changed, but the past year or 2 they've been working with him to change himself (with help/supervision)....I feel like, especially if there are no other limitations for this child, that should be the goal....Let the assistant supervise in a location NEAR your office in case of a "problem" if they want? But even when they WANTED a "medical para" for my nephew (when he first started school) to change him that was ONLY bc he used to get bleeding diaper rashes that needed 3 types of skin barrier creams....which teachers probably can't do. It makes no sense to make you, the nurse, change a 6-yr-old's diaper.

I've always talked about working in a NICU "someday" (before actually going through nursing school, I was freaked out by the acuity level....now not as much). I've just finished my Associate for the RN (waiting to take NCLEX hopefully by the end of next month or sooner if my ATT comes through). I have my LPN meanwhile...and I was supposed to be starting a BSN but my cohort got postponed until Sept. Most of my employment experience has been in my previous career as a geriatric social worker, or babysitting kids with medical special needs. Now that I'm looking for jobs, though....trying to figure out what the best "progression" to a NICU job would be....look to start immediately in peds? Adult med/surg (and/or adult critical care)? I found myself surprised by how much I loved my adult ICU rotation in school (they didn't let students into the NICU sadly....I kept asking!)....Is having critical care experience or just general peds experience "more important" when looking ahead towards wanting to be in a NICU job within the next 5 years. (I know I need some kind of experience first....I wouldn't be marketable right now). Thanks!

I just finished the "RN" (ADN) portion of a 3-year program: the first year gives a certificate in practical nursing, and we sit for the LPN. The second year (which I just completed) gives an ADN and we sit for the NCLEX-RN (which I plan to take end of Jan/early Feb--depending on how long it takes to process paperwork, etc). I'm now moving on to the 3rd year, which grants a BSN. So my question is this.....I need to start looking for a job, since the BSN year is part-time and we all know school (and life) is not cheap! Do I start NOW and look for an LPN job? Or wait until I've taken the RN NCLEX and look for RN jobs? The way I see it, the risk with an LPN job is they might see my resume/education and assume I won't stay. (Which isn't necessarily true--experience is experience). The risk with waiting is 1--sitting and WAITING, but also 2--being a newbie and only ENROLLED in a BSN (though I have a bachelors in another field) puts me at a big disadvantage in the NYC RN job market..... Thoughts or advice appreciated.

I am a new grad (I will call myself an "RN" when I pass NCLEX ) and am starting to look into what the job market looks like....I also have severe gastroparesis/CIPO and about 5 weeks before graduation had to "give in" and go for a j-tube placement. (I tried SO HARD not to need it.....but it definitely makes a difference!! Instant improvement!) Anyway....now realizing how important getting nutrition and hydration by tube are going to be for me, I'm wondering how this will affect my ability to work.... Does anyone do bedside nursing with a tube? If so, what have your experiences been? My specific concerns are --lifting? (maybe this is only because my tube is so new, but I worry I'll dislodge it) --feeding during a shift? (I use a pump for the j-tube. I have a backpack, but I don't know how it's possible to hide it completely....???) It's much easier to run fluid through the tube to keep me hydrated than to have to stop every hour and drink (and then feel sick or actually get sick) like I was before the tube--I have a POTS-like dysautonomia/hypotension that is best controlled with meds and hydration. Anyone with any experience to share would be much appreciated. I absolutely loved every moment of my clinical experiences in school--and I know "real life" nursing is much harder, but I am determined to make it work somehow! Thanks

I'm finishing my ADN next month, and have a previous BA and masters in another field. I know I need at least a BSN now to be competitive job-wise....and I have hopes of someday maybe working in NICU, so I thought I'd just bridge to my MSN (because if credits were $$ I wouldn't need loans! What do I need with 2 of every degree?) But...after hearing some classmates discussing their choices, I'm wondering....do you "need" an MSN for critical care, or "just" experience? And while I'm at it, how important is it that a BSN program be accredited? (My school just started a BSN, they don't have accreditation for it yet--many people aren't staying for that reason.) I have never felt SO confused. Help?

Thanks for this....I also have GP and CIPO (and esophageal hypomotility) but mine is enteric neuropathy (not myopathy--which seems to make a big difference when it comes to treatment options....). I'm actually very familiar with Oley (also ASPEN)--I used to get Peptamen OS from their supply exchange when it was still around (insurance wouldn't cover it)..... They ended up changing their mind about the tube....my malabsorption is too severe (combined with IgA deficiency which makes a tube at least double the infection-risk). Going for another workup after this semester ends at the end of July, but the consensus seems to be that I have too many conflicting comorbidities to come up with a solid plan. Doing my best anyway....I didn't come this far to give up!

Last year my school told me I couldn't come in if I was doing an NJ trial (which never happened, but again, long story)...maybe because NJ would come out more easily? That makes sense....I want this SO BAD--I have overcome so much and gotten so far, I don't want a stupid tube (which would be keeping me alive!) to keep me from achieving my dreams....thanks for the encouragement.

The short version: I'm 2 semesters away from finishing my RN (got my LPN in Dec). I have refractory gastroparesis and multiple other GI issues (possible GI failure, esophageal and intestinal dysmotility, malabsorption, etc). I'm constantly in the ER for rehydration, so we'd planned to put in a port for home IV hydration, but now they're talking about trying a j-tube instead (there are a million reasons we didn't go tube first, and we're not sure it's the best option now, but for brevity's sake....) My question is: is it possible to work with a tube? Does anyone know anyone who has done it? I know I need to do whatever it takes to maximize my health in order to finish school and work as a nurse, but I'm scared that having a tube will keep me from getting a job and accomplishing everything I worked SO hard for....

Although I don't have CP, I do have several serious medical issues and I very much relate to your story. I am in my second year of nursing school now--passed my LPN, and am going for the RN (which, 5 months ago....heck, 3 months ago, I didn't think I'd be able to do!). From my experience, I'd unfortunately have to say that I'd reccommend "downplaying" any limitations or accomodations until AFTER you get into school. Get in on your MERITS, then stay in with accommodations you need--that's what I did. (By accident, but still). Hopefully the school you go to will be more open-minded than mine has been, but everyone told me I wouldn't be able to do it, or SHOULDN'T do it (like you, I figure I'll get through school and work in a less-physically-demanding area, and I've said so from day 1, even though my heart has always been in NICU or peds--I know my body may not be able to take it)...once they accepted me, they legally have to make reasonable accommodations (obviously) and as long as I put in every effort to do what's expected and meet academic and clinical standards, I pass....I actually have done well. And I was very lucky last semester (when I was sicker than I'd ever been and almost had to drop out of school 6 weeks before LPN graduation) to have a clinical instructor who was incredibly encouraging and supportive and believed that it was possible for me--or anyone--to be a nurse even with medical challenges (she was always telling stories about co-workers with various health issues...after the semester ended I found out she had her own she was dealing with). The physical demands that I personally have found challenging have mostly been in clinicals--the long hours of activity without breaks to sit/eat/drink and super-long days really did a number on me. Depending on your state's scope of practice, there may be some fine motor coordination skills involved--I don't know if that's something that you can "improve with practice" (I actually asked my cousin, who is an OT, for help with some of that because I found I had trouble from muscle weakness/"disuse" after several years of acute illness...I'm hoping it will help ME somewhat going forward!). Things like injections and fingersticks are easier--confidence is really the most important thing there, I've found--manipulating IV tubing and mixing meds can be a little more intricate (and some "procedures"....suctioning, catheters, sterile dressings...sterile anything!).... Best of luck to you...I think if you want it badly enough, it can happen!!

I am one of those who is becoming a nurse because of the nurses (the good ones) who impacted me (and continue to) as I've dealt with both chronic and acute illnesses for the majority of my life....it's sometimes an odd "balance"--I'm the student nurse in clinical all day and then the patient all night/weekend (literally....sometimes when the ER is busy I do both, and manage my own IV's!), but I have to believe that knowing how it feels to be in that bed helps me care a little more, be a little kinder, and hopefully be one of the "good ones".....(and for better or worse, dealing with GI failure and associated chronic issues, I'm never too far away from getting more "experience" on the other side to brush up on my empathy skills )

You don't have to be in nursing school to DEMAND that whoever is treating you perform proper hand hygeine. There actually was a study done that most patients want to see their docs/nurses/etc do it but are too scared to ask. So don't be! I actually find that, for the most part, telling my nurses (I'm doing LPN-RN now) that I'm in nursing school makes them more responsive to me as a "person" and not just a "patient"--with a few exceptions (who probably just shouldn't be in the field to begin with!)....gives us stuff to bond over (like how bad docs are with IV's....or school, clinicals, where I hope to work....)--as someone with chronic illness I'm a patient often, I actually find the nurses generally appreciate my knowledge AND my appreciation of how hard they work.....I think it's all in your approach....

self-care hard work an incredible instructor who believes in me

From a student perspective (though I can of course only speak for myself), I don't necessarily agree that a poor evaluation is because of a poor grade--nor is it necessarily due to a strict instructor. I value greatly the professors who have high expectations of me and my class, because I know I will ultimately learn the most from these professors, even if my grades aren't "perfect" (and in my program we ARE under immense pressure to maintain a high GPA, so I don't say that lightly). To me, the difference between a "good" instructor and one who might ultimately not get a favorable review from me is how invested in the class/material/students s/he seems--there are professors that we've ALL struggled to pass, but who are immensely passionate about the material, and I give them great reviews. Likewise, there have been courses that I would not have gone to if attendance wasn't mandatory, had the highest grades in, and felt as though the professor was reciting her material from a script she'd memorized a decade before--THAT professor got a less-favorable review. (If she doesn't care about the subject, what's to inspire us to?) Just my 2 cents....I'm sure not all students agree with my take on things, but I think it's less about "easy" and "grades" and more about being IN the experience with the students that makes a good professor.....

Monroe College in the Bronx. (I'm currently in the LPN cohort, but it's 1 year LPN, 2nd year RN, and there's a BSN unofficially in the works)