Cricket183

Thank you! This is exactly what I was looking for but couldn't find!

I have a question. I'm in the process of renewing my RN license with the state of Texas. I've been on SSDI since July 2020, having had Covid with respiratory failure and severe cytokine storm. More than likely I'm permanently disabled but I do hold out hope I'll be able to use my license one day maybe for technical writing or perhaps to return to work in some non-clinical role. (I did it once before after 11 years of disability for CRPS so nothing is impossible!) Anyway, one of the questions is: Have you practiced nursing by using your nursing knowledge, skills and abilities within the past four (4) years? Indicate the month and year that you last practiced as a Registered Nurse. How do I answer this? Can I legally answer yes? I have not been compensated or signed my RN after my name since July 2020. However, I technically use my skills all the time-I access/de-acess my port monthly for infusions. I give myself biologic injections weekly. I set up my husband, my dad, and my medications bi-monthly. I help my dad with his disbetic care. I do my dad's wound care from his recent big toe amputation. I help take him to his appointments and do his advocating. (Not to mention my own advocating.) I am currently helping provide hospice care for my husband's uncle who has metastatic pancreatic cancer including administering Morphine & Ativan through subcutaneous ports. So, yes I am using my nursing knowledge. But I'm not being compensated or signing anything as RN. So thoughts on this? I definitely don't want to end up in trouble with the BON down the road but I also don't want to inactivate my license. (I did that last time and it was a huge pain to reactivate it.)

I looked at transferring programs after the first year of nursing school, not because I was unhappy but because we were moving due to my husband's job. There was a nursing school where we were moving but their program was set up very differently and I would have had to go part-time for 3 semesters losing my scholarships in the process. Instead, I transferred campuses of TWU from Houston to Dallas, even though it meant a crazy 2 hour commute and staying some nights away from my family for my remaining two semesters to get my BSN. Best thing to do is check with the school you want to transfer to. But don't be surprised if it isn't easy to transfer. I know it might seem like an insurmountable obstacle right know to finish where you are because you aren't happy. I remember thinking I would never make it through 8-9 months commuting and being away from my family so much. But really it went by so incredibly fast and it was so worth it in the end. It required sacrifices and hard work but no regrets.

I've worked in two small, rural critical access hospitals. One with a 20 bed acute care M/S unit and one with a 30 bed acute care M/S unit. There is absolutely no way I would be comfortable with situation! Critical access hospitals are stretched thin as is and nurses are often asked to wear many hats. I don't about where you are but on any given day at our 20 bed unit we might serve as an overflow for postpartum if our L&D unit was full; and if outpatient was closed for the weekend, holiday or sickness/emergency of staff-we did all the wound care, IV antibiotics and blood products as well. We also had an adjacent 4-bed special care unit we opened when needed for higher level patients not needing to be transferred out (DKA on insulin drip, some cardiac drips, chest tubes, etc). It wasn't opened all the time, but once every few months on average and if you were trained you worked there. (Also floated to ER & PACU). My guess is most critical access hospitals are similar. (Can't really compare the 30 bed hospital as I only worked there during Covid). My point is, we are already stretched thin & asked to do so much. And while I enjoyed the challenge and variety, sometimes it was also scary and unnerving and at times it felt very close to the line of putting my license at risk. The added responsibility they are asking of you-definitely feels like it crosses over the line to me.

I went into nursing with the specific intent and focus of being a NICU nurse. It was my desire from the time I was very little. I was a NICU baby, weighing 2lbs 14oz at birth-which by today's standards isn't that surprising of a survival story but 57 years-it was! My mom use to tell me stories of the NICU nurses who cared for me-one in particular affectionately called "Granny" that was remarkable and I wanted to be just like her! I even spent my senior practicum in NICU. The problem arose when I graduated because where we lived the hospital did not have a NICU, just a level 2 nursery. I had commuted 2 years for nursing school (and had planned to after graduation) but with a husband and 2 boys in late elementary school/Jr high who were becoming very active in extracurricular activities-I just was not willing to do it any longer. There weren't any openings in the Level 2 Nursery so I took an opening on an inpatient medical oncology unit thinking I would get a year's experience and then transfer when there was an opening in the nursery (and eventually start commuting again to work high level NICU once my boys were out of school). I ended up falling in love with oncology; it quickly became my passion and I never looked back! I obtained my chemo certification and obtained my OCN. I spent most of my career there-until we moved to a small rural town with only a critical access hospital where you become jack of all trades (working anywhere & everywhere from M/S to ER to "ICU" (although true ICU patients are transferred out) to L&D/PP overflow to outpatient on holidays/weekends or any other time they can't be available, LOL, to pre/post op to anywhere & everywhere else they might cross train you!). That was actually a really cool experience! Once in the same day I had a patient who was 2 hours old and one who was 102 years old! Unfortunately, I am no longer able to work do to medical disability. Nursing is a broad field and there are so many different areas you can pursue. You will find your niche!

Absolutely take the time to be with your littles! Nursing is one of the careers that is very easy to re-enter into without it derailing your whole career. I ended up having to take off 11 years due to disability. I was required to take a refresher course to reactivate my RN license but even after 11 years, I easily re-entered the workforce in 2019. *Just a side note-for your OCN you have to have a certain number of working hours in oncology to qualify for that certification so you will have to wait until you return to work and have worked for awhile before you qualify for that certification (but you certainly can study for test and work on the other requirements).

I'm assuming the Woman's Center patients would include gynecological & breast surgeries. I would anticipate some additional training in those areas and maybe some meetings with the surgeons as far as their postoperative expectations the same as when any new surgical service comes on board a unit. There's a bit of an adjustment period until you get use to each other so to speak. I don't see them (woman's center patients) being any more complex than your standard post-op M/S patient if that's what you are asking? In most small hospitals that don't have a separate Woman's service department, they would be on a standard M/S floor with your other surgical & tele patients. I think asking for additional training regarding the new patient population is absolutely appropriate. Expressing concern about the nurse patient ratio, will unfortunately, likely not get you anywhere with upper management, no matter how appropriate your concerns actually are. Sad but true.

I am on SSDI. It's a bit unusual/complicated. I had previously been on it & approved for CRPS and had returned to work under their trial work period in 2019 as I had begun a new treatment and my condition was very well managed. I was 8 months in to the 9 month trial work period with plans to go full time as of Sept 1, 2020. I had been working PRN (although putting in more than full time hours due to the pandemic). I got Covid July 2020. SSDI had already set it to conduct a full review since I had returned to work and I completed that in September 2020. Given everything they determined me to still be disabled and continued my benefits so I never lost my Medicare benefits and my payments resumed seamlessly. I had another full review about a year later and again, they determined based on all my previous and new diagnosis, that I'm fully disabled and put me on a 7 yr review cycle. Every once in awhile I get a crazy notion that I could do a WFH position-care management, utilization review, etc. and then I end up in a bad flare or with pneumonia and hospitalized and I'm reminded that I would not make a good employee. It's a hard reality to accept. I am exploring the idea of something like free lance writing. Something where others aren't necessarily dependent on me and my ability to be available-if that makes sense.

I miss a lot! But I also did not get to go out on my terms and I think that has a lot to do with it. I was 52 and in July 2020 contracted Covid at work. Wasn't significantly surprised I got it-I had taken care of a patient who tested negative on admission and because of supply shortages and N95s being allotted only to nurses caring for Covid patients, I had cared for the patient using just a standard precautions (surgical mask & gloves). The patient spiked a fever later that night and retested as positive. Two days later, I had Covid. Five days later I was in the ER and in short order in the ICU in respiratory failure fighting for my life. I have never had any breathing issues prior to this but it did a number on my lungs. I required home oxygen for 13 months and periodically thereafter (mostly for exercise and for frequent bouts of pneumonia). I was relatively healthy prior to Covid. I do have CRPS which is well managed and I did have preexisting autoimmune issues (Palindromic Rheumatism, which often a precursor to RA) that we falsely thought was in remission. Thankfully, I survived but the end result has been a significant impact to my health: uncontrolled Rheumatoid Arthritis (even on biologics) with Interstitial Lung Disease & mild Pulmonary Hypertension, POTS/SVT, PACS/Long Covid, Secondary Adrensl Insufficiency, ME/CFS, PEM, Chronic migraines, essential tremors, chronic gastritis/gastric ulcers, and cognitive dysfunction. All of which has meant, I am now medically retired (disabled) much sooner than I had intended to be. What I miss most about nursing though are the things that I continuously hear exist less and less in nursing from former colleagues and on forums such as this-so maybe I got out just in time where I still have a very fond memory of it.

I'm so sorry this happened to you. I hope once you've had time to recover from your surgery you will have the opportunity to reach out to hospital management and share your experience so they can hopefully take steps to improve. I've been hospitalized multiple times this past year for pneumonia. (3). I contracted severe Covid in July 2020 from work and went into respiratory failure (in ICU then required home oxygen for 13 months & periodically thereafter.). It did a number on my lungs and I was left with interstitial lung disease & mild pulmonary hypertension. I have preexisting autoimmune disease (RA) that we thought was in remission but since Covid it has been uncontrolled, even with biologics. The biologics and steroids (initially for my lungs, now for adrenal insufficiency) mean I catch anything & everything (even when careful) and my lungs are most susceptible...all of which equals frequent pneumonia. Anyway, every time I've been hospitalized it amazes me how infrequently nursing assessments are done-like hardly ever. I can see not doing a complete head-to-toe assessment if pressed for time-although you can do one pretty quickly-but to not do even a quick focused assessment specific to my diagnosis? Hardly any one listened to my lung sounds! (But I'm sure they charted they did!). My first admission the only ones who actually listened to my lungs-or even brought a stethoscope in the room-were my PCP and one night-shift nurse. I had hoped bringing it to management's attention might have a positive effect but unfortunately, two subsequent admissions over the next few months didn't have any different results. (I live in a rural area with only one hospital to choose from unless I want to drive over an hour away.). It's really scary. Now, I was awake and alert enough to speak up and tell them had there been a problem but what about patients who aren't? I definitely agree with what others have said, I would not let a loved one be alone in the hospital. And if I were under anesthesia or in anyway incapacitated I would request a family member or someone be with me. It's just too scary out there anymore.

I don't have any stellar advice just some commiseration. Covid destroyed my nursing career (which I had just gotten back). It's a bit of a long story but I had been on disability for an extended time due to CRPS and autoimmune conditions. With new treatments and lots of hard work through PT/OT I was able to return to nursing in 2019 with my CRPS under good control and my autoimmune conditions in remission. Eight months later in July 2020 I contracted Covid at work and went into respiratory failure. It has been devastating to my health and career. At 56, I'm medically retired. I have discovered, I am not alone and there are very few resources (at least in my state) for healthcare workers affected by Covid.

I think the things you mentioned are OK. But maybe also go with some high protein, low sugar options. Protein & Kind bars, trail mix or nuts in snack size packets, etc. High sugar and salty type snacks csn definitely be more appealing (and often cheaper) but high-protein, low-sugar will keep them full longer without the high carb/sugar crash later.

I realize this is an old thread but thought I'd add my 2 cents. I worked oncology the majority of my career. My absolute favorite patients to work with were leukemia patients. Perhaps because they were with us for such long periods of time and so frequently (induction chemo-4 to 6 weeks, subsequent rounds 2-3 weeks) that we really got to know them and their families. Also because I really found blood cancers fascinating. The chemo regime was intense and they required frequent blood product transfusions (especially during nadir). Mostly had AML or ALL patients but occasionally would get one of the rarer forms (hairy cell, prolymphocytic).

To answer the questions asked (which seem to imply I'm young, inexperienced, and have no clue in the ways of the world): I'm 56. I've worked since I was 16 minus some time on disability. I've been a RN for 21 years next month. In full disclosure, I've not worked since July 2020 due to contracting severe covid from work and suffering permanent lung damage and multiple other complications. I'm not so naive as to think that bullying, NETY, maliciousness, etc does not exist in healthcare. I've not seen it on the large scale with which you imply it exists. Not that it doesn't happen but I did not see anything in this particular scenario that indicated maliciousness, intentional harm or retaliation. The OP fell asleep. She didn't just nod off for a minute while charting-she was asleep for an extended period of time. By her own admission the oncoming charge nurse did not have previous interaction with her or know her. OP was acting out of sorts-possibly due to being startled awake-but impairment is another potential explanation. The charge nurse had a duty to report suspected impairment. In the same way you're asking for benefit of the doubt for OP, you have to extend benefit of the doubt to the charge nurse that she was acting in good conscience. She was put in a difficult situation. When OP was taken to the ER for testing the physician who saw OP was concerned enough to order a CT scan. As I said in a previous post-take out the CNA who fell asleep out of the equation-and the symptoms described by OP herself were enough to warrant further work up. You now have two independent people concerned with OPs actions/reactions/symptoms. I have a hard time believing everyone involved was conspiring to end OP's career. I just don't see it. And you are mistaken in your assumption-I DO see the potential for a ruined career and as I said previously, I feel for the OP. It had to be scary and humiliating. But I have to go with the "but for" argument here. But for the OP falling asleep, none of this would have happened. That's another reason I don't see the maliciousness and evil intentions on behalf of OP's coworkers. (Again, not saying it doesn't exist out there, just that I don't see it in this particular case.) I don't see any where others were targeting OP or trying to set her up and ruin her career. If you see something I missed please point it out to me.

Can someone explain to me what I'm missing? I'm not being facetious; it's an honest question. I don't understand where the advice for the OP to consider legal action, to quit-no call/no show, etc. is coming from. I will be the first to admit I sometimes see the world through rose colored glasses and can be naive and too trusting at times so what am I not seeing that others are?

This! I don't find the CT scan to be outrageous. Let's not forget the OP originally went to the relaxation room with complaints of a headache and fell asleep (unusual, never before behavior for her). Add to that her symptoms in the ED-eye twitching, dilated pupils and reportedly not "acting like herself", and being emotional (crying)-a CT was a good call by the ER physician. Take the CNA who fell asleep out of the equation and just look at it as any patient who came in with those symptoms and denies intoxication as a cause. Most, if not all, would get a CT to rule out an organic cause. I can also understand the concern by the charge nurse for impairment upon finding a staff member asleep. This wasn't a slight nod off, she was asleep for an hour. Intoxication is, after all, one thing that could explain the situation (so is just being tired from going to nursing school and working NOCs!). We all have a duty to report if there is suspected impairment. By OPs own admission, the day charge nurse didn't have previous interactions with the her. She didn't have anything to go by other than what was in front of her. It wasn't outlandish that she suspected impairment as a possible cause. I'm sure she didn't relish the situation either. As far as the ride/taxi and OPs refusal necessitating a welfare check by the sheriff's dept.-it's all part of the litigious society we live in. Everyone has to CYA. The OP did exactly what she should have given the situation and submitted to testing. Was it embarrassing and stressful to go through all of this? I'm sure it was. Do I feel for her? Absolutely! But was it overreaction and mistreatment requiring legal action-not at all. All and all it turned out the best way possible. Tests proved there was no impairment restoring OPs reputation and OP was able to keep her job (where many would have been fired). OP by her own admission learned a valuable lesson in the importance of making sleep a priority.. OP I'm so sorry you went through this. It must have been very stressful and scary at the time. Maybe one day it will be a funny story you can share with the future nursing students you mentor.

This! I agree 100%. OP, "it wasn't a big deal" to you but it was a big deal to the patient who was in pain. Waiting for medication when you're in pain can seem like an eternity. You seem to think the patient overreacted (and possibly he did) but you broke trust with this patient and you seem almost flippant about it by saying I'm not even the worst nurse in the place. Yes, you made a mistake. It happens. We've all failed a patient. Mine was a quadriplegic patient who needed to be cleaned up. On my way to get supplies there was a chemo spill in another room. The spill obviously took priority but when I was finished cleaning it up (which took awhile) I went and filled out an incident report, completely forgetting about my patient who needed cleaning up. It was right at change of shift (it always happens at change of shift!) and I gave report to the incoming shift and went home. When the oncoming shift made rounds, the patient was very upset. Rightfully so. It was the next morning when I received report back that I was reminded by the outgoing shift that I had forgotten the patient and he did not want me as his nurse that day or ever. I was mortified. I immediately went to the patient and apologized. I explained what happened but that it was no excuse for me not coming back and I was very sorry. He was very gracious and forgiving and he did allow me to be his nurse again but I never forgot that feeling of failing him. I had a responsibility to him. Our patients rely on us. You made a mistake. Own it, apologize and then move on. Harboring resentment & hate toward the patient will only further escalate the issue for both you and him.

Beautifully said. I spent most of my career in oncology and loved it for all the reasons you mentioned. We ended up moving to a small, rural area and I went to work at a small community hospital bc I did not want to commute 1 1/2 hrs one way into the city. I primarily worked med-surg where we also did outpatient care on weekends & holidays (ie, wound care, transfusions, IV antibiotics, etc) and acted as overflow for post partum when L&D became over-full. I also spent time in the ED, special care unit (cardiac & insulin drips, ect). My years in oncology taught me how to handle all of that!

Congratulations! TWU alumni here! I attended my first year (2001-2002) @ the Houston campus and my second year (2002-2003) at the Dallas campus (my husband's job caused us to move and I was granted permission to transfer). It was a great experience! @egarza don't give up hope-I wasn't accepted first round either but as you can see-I did get in and graduated!

The nurse residency program is online? What?? Is this a thing now? I graduated a long time ago (20+ years). It was very different. We had classroom during our 6 week orientation but it was one day a week (8a-3pm) and then one day (8a-3p) was spent doing skills, mock codes, working with and/or learning about interdisciplinary teams (PT/OT, pharmacy, social work, IT, lab, radiology, etc). We also spent two 12's on the floor each week with a preceptor. First week we followed our preceptor. Second week we took 1-2 patients (with our preceptor's oversight) and helped with the preceptor's other patients as able. Third & 4th week we took 3-4 patients. After 4 weeks we were through with classroom & skills and spent the remaining 2 weeks on the floor doing three 12's (basically taking a full patient load with the preceptor following us and available for questions, support, advice, backup, etc.). Occasionally they would extend orientation if needed but usually 6 weeks was enough. As far as your question about quitting-only you can decide what's best for you. Leaving during orientation will likely burn a bridge with your current hospital system. If you aspire to ever work for that hospital system again just know leaving during orientation will probably result in you put on a "do not hire" list. That said, at only a week & a half in (which is way too soon to determine you're unhappy IMO), it honestly doesn't sound like they have invested a lot into your nurse residency program at this point. Again, only you can decide what's best for you. Just as an aside, I originally wanted to do NICU. Spent my senior practicum in NICU. I took a job in medical oncology because it's what was available and I absolutely fell in love with it. It's where I spent most of my career, eventually becoming OCN (national certification in oncology). Best of luck with whatever you decide.

It needs to be reaccessed and flushed asap

I agree. You don't necessarily need to do a complete head to toe assessment every time on every patient and there's a lot you can assess by observation-mental status, moves all extremities, skin color, etc. but heart, lung, and bowel sounds can only be assessed by a stethoscope and they are major things that should be assessed every shift. Things can change rapidly! Vital signs can look stable on a patient with heart issues or pulmonary issues because are bodies are wonderfully adept at compensating to keto homeostasis-until suddenly they're not! And especially since I was in with pneumonia severe enough to require supplemental oxygen-how do you not listen to the lung sounds? I get that nurses are busy and overwhelmed and sure-we end up cutting corners at times to get everything done but this is one area where don't think corners should be cut.

WOW! That comment was uncalled for. I would love to go back to nursing. Unfortunately that isn't an option. I contracted severe covid in July 2020 FROM WORK and wound up in ICU with respiratory failure which caused permanent damage (interstitial lung disease and pulmonary hypertension). I required home oxygen for 13 months and will likely be going home on it again (hopefully temporarily). I also developed SVT and POTS. Steroids caused severe chronic gastritis and gastric ulcers, secondary adrenal insufficiency and cataracts. I'm now permanently disabled. I've been a nurse for 20 years. I know how crazy it is out there. I know nurses are overwhelmed. I'm not naive. I still always assessed my patients!

Indeed it is. And I will be discussing it with leadership. Very sad.

I'm a RN, although not currently working. I caught Covid in July 2020 from work and ended up in ICU in respiratory failure. The fallout from that and long covid symptoms have left me unable to work. I had not planned on retiring at 56 but that's what it currently looks like. I've been hospitalized multiple times since Covid for various things and am currently in the hospital with pneumonia. I've been here a couple of days, and with the exception of the ER, not a single nurse has done an assessment on me. They've checked vitals but no one has listened to my heart and lungs or checked for swelling or anything else. I've noticed this before on other admissions but it was more hit and miss, not everyone! Frankly, it's extremely disturbing. Thoughts? Has anyone else noticed this trend?