Nurseworks

Yes, because this is such a productive and classy comment. I'm voicing genuine concerns and trying to foster a dialogue wherein I may broaden my views and you chime in from the peanut gallery with this holier-than-thou tripe. Stay classy, San Diego. BostonFNP, thanks for the thoughtful response. I'll try to answer back to some of your points this weekend. Don't hold your breath on my providing any citations as most of my research time is focused on areas that directly affect my daughter, specifically seizures and apraxia at the moment (moment being the last 7 years). That said, I do owe you a response to what clearly has taken you a bit of time and effort. Again, this is about dialogue/discussion. I understand the science (not so much all the statistical analysis) and I also recognize there are some legitimate concerns voiced as well. Every doc (or RN) on this board can pooh-pooh anecdotes, but I know what I witnessed, and for that reason will always have my doubts. As I've said in my previous discussions on this subject, I get the flu shot every year as mandated as a part of my employment (civil liberties notwithstanding, another time), and my children are both fully vaccinated. Still doesn't stop some of the cranks on here from acting, well, like cranks. Again, thanks for the great response.

First off, you're kind of making my whole point about "the science has spoken crowd" with a response like that. Secondly, I made that statement in response to yours wherein you suggested that it was more important to produce cheap vaccines, something I disagreed with since the companies are bearing little to nothing in the form of responsibility for when something goes wrong. You keep hiding behind datasets as some way of justifying a questionable ethical partnership between the government, for-profit manufacturers and healthcare consumers. Sorry, I have a moral objection to that, not to mention concerns about the aforementioned company's motivation to provide a quality product or improve upon one. Billions of dollars is billions of dollars. You completely avoided my point which quite clearly showed manufacturer's motivations (profit via the use of multi-dose vials and preservatives) and the government's willingness to defer to such judgement. Not sure where you're getting the idea that ROI for employers is significantly increased through vaccinations. Don't bring the flu into this, because we both know that the CDC's numbers are based on "flu and flu-like symptoms", so... Thimerosal, AFAIK, is still being looked at for various neurological syndromes. As for the ethyl vs methyl argument, both can cross the BBB, which is concerning enough, but as you said, methyl is ingested. Route matters, always... It's still a tax burden, one that seeks to absolve billion-dollar companies from having to pay out. That's not just about lowering costs (R&D costs for the most part have seen ROI many times over already), it's supposedly to protect against unwarranted litigation, which leads me to... Ok, I'll take your word for it. I have no data for either, TBH, nor am I inclined to hunt a bunch down. Diseases are bad, vaccines, for most people, are good. Really not sure why you felt the need to make that statement. Yea, I never even intimated that you were a shill, so let's put aside the e-outrage. You're staunchly pro-vaccine, I have no problem with that. I simply stated that given that position you were more than familiar with those quotes from those sources, something I do have a problem with, and something you assured me was quite incorrect as far as scientific stances go. What data shall I post, and for what position? That I have a moral objection to how the vaccine program is handled in the USA? That I believe there should be more done to improve vaccines and make them safer? If there's data about how that's being done, please let me know. I'm not as ensconced in the topic as some here. So, you're saying that the MMR was the only vaccine ever looked at as causative for autism? But all vaccines are in the clear? Hmph, I'm confused. Again, I'm not a buff, but I think there may have been a study on Hep B, but I think the source wasn't peer-reviewed. Still, that really doesn't speak well for the whole "question has been asked and answered" crowd. That's being a bit disingenuous when you put it that way, but fine, statistics rule. Keep in mind though, this isn't mathematics (even though some treat it that way), and statistics and epidemiological studies as the sole source of support is kind of like calling a code while looking at a Tele monitor as opposed to checking the patient first. As for wtbcrna, I don't believe that to be the case. In our previous exchanges she has demonstrated an unwillingness to concede any reasonable points or critique anything that put her "side" in a bad light (yes, there are a few). Her responses are continuously dogmatic with walls of data thrown in to overwhelm/exhaust the reader (like me!). Again, I have no real time to delve as deeply as some of you do into this topic. That you have lives that allow for this, kudos. Mine is not as forgiving. That is why I ask to discuss, not debate. My concerns about the DeStefano paper are that there was reportedly data sets that were excluded and subsequent studies relied on the included data. I know you know what I'm speaking about, but you are instead asking me to jump through hoops while pretending to be obtuse? That's very nice. HHS says it's underutilized. Anecdotally, I know for a fact my pediatrician didn't report my daughter's AE. But hey, she took one for the team, so don't worry. Why would I support a system that protects a manufacturer? How is that "out of an abundance of caution?" I don't think you're being particularly sincere. Your response feigning(?) ignorance to what my concerns were about the DeStefano paper lead me to believe I'm right. Am I?

I'm very familiar with the existence of the VICP and the process. What that has to do with the analogous example I put forth I cannot see; in fact it flies in the face of it. Additionally, the goal of administering vaccines should first and foremost be that it is done in a safe and effective manner, not to protect the bottom line of those who are profiting from its use. From what I remember, vaccines have an extremely high ROI. But to entertain your point, for decades manufacturers have used multi-dose vials for administration so as to cut costs, with the by-product having been the inclusion of thimerosal. Now they use it sparingly, huzzah. Was that a good idea? Probably not, but the science isn't completely in on just how harmful thimerosal can be. Want to say it doesn't cause autism? Go right ahead. Just remember that some of the studies that have been put forth declaring its safety lean heavily on some dubious research. So in summation, your position is that you're ok with manufacturers not being fiscally liable for a for-profit product that is endorsed/mandated by the government so long as taxpayers pick up the bill when something goes sideways for some unfortunate person or family, right? People die from vaccine-preventable illnesses every year, some of whom were previously vaccinated. People are killed, maimed or injured by vaccines every year. That you are apparently comfortable with that against the benefits to the majority answers my question without you having to say it. I get why that can make someone feel icky, but the truth of the matter is that is the argument consistently put forth, that it's for the greater good. Funny how when that's put up against a minority that doesn't involve vaccines, like say peanut allergies, then that gets all turned around. Like I was saying, it's a ethically challenged position to say "everyone must get vaccinated", especially with caveats about manufacturer's profits or litgation. Umm, if you hold the stance that you do and can e-tell me with a straight face that "the science has spoken" or "the question has been asked and answered" isn't a bell-cow quote for Offit, IFLS, Orac, Seth Mnookin, Forbes, etc, then we can just stop the conversation now. All but one was about MMR? The assertion was that vaccines (all) have 100% of the time been shown to have no correlation to autism. I contend that is a false statement. Without diving too much into the semantics, if someone suffers a table injury which results in a diagnosis of autism, that's a correlation. Is it causative? Who knows, no one is really looking. Also, just how many of those MMR studies relied on data obtained from the DeStefano paper? Surely that there is a question over the procedural methods utilized in that study we can agree there may be some concerns in its continued citing? VAERS is a voluntary reporting system, not a mandated one, whose underutilization has been covered before. That vaccines have their own system for adverse reaction compensation is precisely my point. As for my belief, it was OR, not AND. Second time in this thread I've had to point out that distinction. But yea, let's critique my understanding, that's more fun. Again, if you guys would rather not discuss (not debate, not fight, just talk) about the points and concerns I made and instead brow-beat me with studies and talking points, just let me know and I'll just drop the whole thing, seriously.

That's simply not true.

I specifically said "or". If the first part is unappealing (it is), then the second option I suggested should be a requirement. Hell, I'll take it a step further and forget the civic/ethical argument and speak to your capitalistic side; do you think it makes good sense as a buyer to provide your supplier with a continuous revenue stream while not requiring them to assume responsibility for their product? At the very least, wouldn't you be concerned about stagnation (again, trying to avoid the obvious ethical pitfalls here)? Throw in the mandated part and it makes it a bit more complex (ethically) than what you are putting forth, wouldn't you agree? Similarly (and somewhat simplistically), car seats for children are mandated. The companies who make them are motivated by profit, responsible for R&D, are required to meet certain guidelines put forth by the government and yet they are able to handle the "burden" of being held responsible for their products. Furthermore, they continually are improving on their designs and will voluntarily recall a product should it be discovered there is a flaw, either through injury/death or post-marketing testing. But when someone is injured or killed by a vaccine, the wholly inappropriate mantra of "it's for the greater good" is offered up. Why is that? It's that very minority which we should look to protect, thereby not only ensuring a safer product but also possibly improving it. But no, all I ever hear is the same thing, that nothing is 100% (never asked for that) and that this is necessary (easy to say when you're the safe majority). Like I said, there are some on here who's minds are made up on this topic, the "science has spoken" crowd who berate anyone that questions their dogmatic stances. Those aren't the people I'm trying to establish a dialogue with; instead I am hoping for a more moderate discussion about the points I've raised. If there's no interest in that, I'll quietly step away and move on to another conversation.

Ugh, still with this? I truly get a kick out of seeing purported people of science throwing around absolutes when it comes to healthcare. Just to clear up a few things; the choice to make vaccine manufacturers exempt from lawsuits resulted from their (rightfully) being sued for adverse effects from their products (DPT, polio to a lesser extent), not because they weren't making enough money off of them. Those suits did in fact threaten their existence (and by extension the stability of the national vaccine supply), so the government stepped in. Vaccine manufacturers cannot be sued for adverse (not 'normal', lol) reactions, nor are they civilly responsible for design defects (de facto, as the studies regarding various ingredients vs conditions are woefully inadequate), although I believe they can be sued criminally via negligence. Yes, nothing is 100% safe, even water (love that analogy). But unlike water, you aren't mandated by the government or your employer to drink it (hell, some managers will put you on report for even having a water bottle!). But should you drink it? Of course, it's going to keep you alive, and some vaccines may do the same. I say some because not all vaccine-preventable diseases are deadly or seriously injurious to the majority of people, just as some vaccines are not deadly or seriously injurious to the majority of people. But the exceptions, how we love to harp on the exceptions to make our points. Such pathos is why this debate rages on. When the prevailing rhetoric seeks to improve the current system while lending credence to concerns vocalized by a moderate base, we will see this debate quiet down. But for now, the scare/shaming tactics really aren't helping anyone. As for "being exposed" to antigens, surely an RN can recognize that the type of antigen and how one is exposed to it can profoundly alter any subsequent reactions. Magically, this little caveat falls by the wayside because some doc who made millions off a vaccine said otherwise. But when two docs go on TV advocating for a change to the schedule, well obviously they are pandering, not that other guy though. As for Trump, he's a blowhard, so no surprise about his blanket assertions. My tl;dr position; we need a vaccine program, those healthy enough should participate and if something is to be mandated by the government the private sector should A) not profit from it, or B) be lawfully responsible for any adverse circumstances (just like every other capitalist venture). I know even my moderate stance is grounds for "anti-vaxx" evisceration, so flame away, vaccine templars.

I feel it is imperative that nursing as a profession develops some sort of sub-specialty, not just for autism, but DD in general. Too often there is simply a hodge-podge of Psych/Peds/MedSurg that is square-pegged for a patient with DD. If psych patients are afforded their own sub-specialties, so to should those with DD, perhaps moreso. JMO. My school offers a graduate degree in neuroscience with an emphasis on autism. Something worth pursuing, but I feel more is needed to help this underserved population.

This guy gets it. That said, what I find effective is to ask the individual how they would feel if I addressed something in a derogatory manner according to their ethnic/gender makeup. The campaign against the "R" word (Google it) handled this with aplomb. In the same vein, I do not have an issue with people using descriptive language when talking about my daughter (who has autism/is autistic). It is a defining characteristic for her, same as being a brunette (sure, she can have brown hair too) IMO. Outside of being a human female, it unfortunately is her most identifiable characteristic, impacting her life in most every way. Sucks, but that's the truth. What I get a kick out of is what someone early in the thread said; those that hem and haw the most about it are those who are part of the proverbial choir. They are also the same individuals who self-identify to the point of proclamation/pride. Rather ironic.

I was a bit all over the place with Kaplan. I did very well on the diagnostic (70), and decent on the readiness (62). The last two trainers (higher level questions) I scored a 63 and 58 respectively, the latter supposedly being pretty close to what you could expect on NCLEX. Sample tests 1-3 were 52, 62 and 77. The last thing I took was the Test Drive and I got a 62 there as well. By then I had pretty much moved on to UWorld, where I found myself being more consistent (mid 60s) with what I and everyone else agreed was more difficult content and better rationales. Do your questions and remediate everything you answer, right or wrong. You can do this. Thanks for the congrats, everyone!!! :)

First off, thanks for the wonderful article you wrote. Secondly, my oldest (who is also on the lower end of the "spectrum") unfortunately had some cavities that needed to be filled. While we are diligent about her oral hygiene, we do let her eat sugary foods (she truly enjoys it, and who am I to deny her a simple pleasure?). What really took its toll were her anti-seizure meds, however. Naturally, a trip to the dentist that entailed fillings filled us with dread, particularly my wife who had decided to take her on her own. Of course, our daughter threw us for a loop by not only having an easy of time of it, but also allowing the dentist to do one more filling than planned AND by being almost as good about it for the SECOND visit!!! Just when I think I have something about her figured out, she throws another wrench into the works.

I agree with what has been said so far, that the BSN offers no real advantage with regards to NCLEX. That said, the stat-lovers will tell you otherwise as, according to NCSBN, the passing rate is roughly 4% higher (at least this year) in favor of BSN vs ASN.

Well, in what seemed like an interminable amount of time this morning, I finally got my results and found that I PASSED!!! Beyond ecstatic! Any of you taking yours soon, best of luck. Stay focused and calm, you got this.

Took the test in Manhattan as it offered the soonest available appointment. I used Kaplan (in-person) and UWorld along with tons of remediation. I finished the exam at 75 questions inside of an hour, had about 25 SATAs and only one exhibit. UWorld content was definitely harder, but NCLEX was a bit more vague in getting at what they were asking of you (which was difficult in another way). Now I am waiting for the option of quick results tomorrow to find out how I did. Here's hoping...

I've used all three and am sorry I was late to the party with uWorld, it's that good. NCLEX Mastery is very good but their questions can be a bit leading at times since they include so much information. Kaplan has a fair amount of errors and/or rationales that only offer "just because" types of answers; not the most helpful for remediation. As for uWorld, I found their rationales to be helpful and consistent and the level of questions seem to be extremely high. I'm taking my NCLEX this Thursday, so I guess we will find out soon enough just how accurate my assessment is.

Penny and I are sending good thoughts your way, Esme. You are easily my favorite person on here and I hope you feel better soon.