Youda

Before there can be a change, nurses (all of them!) have to first figure out there's a problem. We talk about these things at allnurses, but the percentages of nurses willing to work for these kinds of wages and benefits, and tolerate a 2.6 million salary to management far exceed the few who find this obscene.

25-33% of every healthcare dollar spent in the U.S. goes to upper management salaries, according to the World Health Organization. This is nothing new. It has been going on for years. Odd that people are just now figuring it out.

Maybe I'm being pessimistic, and would like to continue this discussion. No offense intended. But, I don't think saying "No" or "negotiating" solves the problems for individual nurses. This seems overly simplistic to me in view that very few employees have an input into decision-making within their work environment, conditions of employment, expectations for workload, benefits available, stress level, staffing ratios, adequate equipment and supplies, insurance plans, retirement benefits . . . The assertive approach is one that I can certainly appreciate; and it works well in certain circumstances. But when an entire industry is ailing, being assertive falls short of fixing the problems. For example: if I go into work and say, "Hey, NM! I will no longer take more than 4 patients, and I will need another $5.00/hr. to bring my salary up to the median wage for nurses of my educational level. Also, since my birthday, I've started to worry about my retirement; so please arrange to have a retirement plan for me. Oh, by the way, the deductible is a little high on my health insurance. Please take care of this as soon as possible, OK?" Now, assuming I could muster up a tactful and assertive and positive way to say this, and also assuming I had input into decision-making, I can guarantee you that I would find myself unemployed by the end of the week. Perhaps it is different for a traveler, because they need the nurse bad enough to pay agency wages in the first place. But, for a long-term, until the day you retire? You wouldn't get those options, and if you did, they'd get rid of you at the first possible moment. The problems of nursing can't be solved by just saying, 'no.'

I hear the negotiation, stand-up-for-yourself, etc. What do you suggest when that has already been tried? I run up against budgets, cut-backs, etc., etc., etc. The answer is NO. If you leave, they hire someone else; and you go somewhere else and encounter the same mandatory OT, staffing ratios, poor bennies, etc. You can only negotiate if someone views you as valuable; nurses aren't seen as valuable, in my experience.

I was the happiest I've ever been in nursing at my last job. The difference was one of the best human beings, and nurses, that I've ever had the pleasure of working for. She encouraged everyone, was always positive, fought corporation tooth and nail, defended her staff, and demanded to run nursing the way it should be run. They fired her. It only took a couple weeks of the new DON's corporate attitude to ruin an excellent place to work, and a mere 4 weeks before the state Division of Aging showed up and gave the place 3 J tags, two G tags. (Immediate jeapordy and actual harm). Every nurse quit or walked out except four of us. We were all eventually driven out, too. Well, I wanted to say that because it isn't WHERE you work, it's WHO you work WITH! And most managers that are good nurses never survive the management BS.

You just go up to your local printer, look in the yellow pages, and you can find plenty of places who will make custom bumper stickers. So what should it say? (I like the idea above). Make a dozen and hand them out to nursing friends? I have no idea how much it would cost, but wouldn't cost a fortune. The schools around here do it and give them to parents of students on the honor roll "My child is a honor roll student at So-So Junior High." So, if a school district can make a few, we surely could do it for ourselves.

Everyone agrees there is a huge problem. Most nurses are willing to help. Not to bash the ANA, but even with state and national organizations, change isn't happening. I agree the need for changes must go to the general public, because fighting politically through Congress isn't getting it done. Changes needed to be made last decade, and we're still fighting about unsafe mandatory OT! (And -jt, before you say anything, please remember that most nurses don't have a union!) Yes, a grass roots effort seems to be necessary and about the only real chance to make changes.

I'm on sabbatical because my job "sucked the life out of me" (a good description of how I've felt, quoting Mattsmon from another thread). It wasn't nursing that did me in, it was the corporation and the realization that I could not be a good nurse and a good employee at the same time. My ethics and morals were in direct opposition to my need to get a paycheck. I know, like Anne, that this experience is not unique. In fact, I suspect it's quite common! I'm one of those 500,000 nurses who refuse to do bedside nursing anymore until some of the problems are fixed.

As a diabetic, I will tell you that if anyone tried to give me an insulin dose in a standard syringe, I'd have to smack them alongside their heads just to hear their shrunken brains rattle around. Insulin syringes are designed to give, accurately, very small doses. This isn't just due to the markings on the barrel, but the shape of the barrel, the shape of the plunger (flat instead of curved), and the amount of med that is still in the syringe. A possible alternative would be a TB syringe because it is also made to deliver small doses. The only exception would be in an emergency situation when the BG's were dangerously high, you were going to give it IV, and it would be more important to get the BG down quickly. Even in that situation, 8 units isn't going to do much for bringing down a critically high BG! If the doc wanted to use a standard syringe, why did he want a goofy amount like 8 units? Why didn't he say he wanted .25 cc's or whatever? What was the patient's BG, just out of curiosity?

It depends on the setting. In nursing homes and long term care, leather or four-point restraints are forbidden by law. In an emergency room or psych unit, I think they are still used (someone help me here?) as a temporary measure to control violent patients until medication takes effect or they can be transferred to another setting. I've seen EMTs use leather 4-points to keep a violent patient on the guerny while being transferred to the ER . . .

:roll :roll

The kind of stripe and style of cap is chosen by the nursing school. Wide black velvet stripe might indicate you graduated from St. Mary's College of Nursing, two narrow black satin stripes if you graduated from University of Texas, whatever. Usually black was for RNs, blue for LPNs, but that wasn't always exact. Some RNs schools used red stripes, or other colors. I have no idea if schools still have a designated cap for new grads? Here's a link about the history of the nursing cap, it's symbolisms, etc.: http://www.civilization.ca/hist/infirm/inevo01e.html

You are so right, Kevin. It hasn't been so long ago that I reported to work at a LTC. To make a long story short, I didn't clock in, did not get report, and refused the assignment. I was told that if I didn't take the assignment, I would be fired. I thought that was a real good idea, so I told them 'thank you' and left the building. Mind you, I'm in uniform and ready to work. I drove two blocks to another LTC, walked in the door. They hired me on the spot because they were desperately short. I went to the floor to help pass breakfast trays; and I only lost about 30-minutes pay. (BTW: the new facility hired me at more than I was making at the other one!)

Just to answer this question... The LPN programs in Missouri now include IV certification as part of the program. The older graduates (before IVs were included into the curriculum) have to take a 40-hour certification course. Also reciprocity LPNs whose original out-of-state school did not include enough IV hours to be certified in Missouri have to take the additional class. But, even with the certification, an LPN has limitations on doing IVs as I mentioned above.

Good for you to decide to go back to school! The differences in what an RN can do vs. what a LPN can do in Missouri are: LPNs don't hang blood LPNs don't do IV pushes LPNs cannot start IVs except peripheral with the cath LPNs cannot administer certain IV meds such as chemo Hummmmm, I think that's about it. A good rule of thumb is that if you haven't been trained, and/or don't have experience doing something, don't do it. The choice between going to LPN or RN is really your decision. All the things you talked about (family, expenses, etc.) are part of it. I would just recommend that any LPN program that you attend be a "step" program where your hours can be applied to the RN program should you decide to continue. If you take an LPN program where the hours don't automatically apply to the requirements for the RN program, then you basically have to retake the same information again. Also be aware that even in some of the "step" programs, if you don't go on for your RN within 5 years, you start all over, also. Leave the options open to continue for your RN, if you go LPN first. And find out BEFORE you enroll in the LPN program what will apply to the RN program you plan to enter. Good luck to you!