Mia415

Hello fellow Public Health Nurses! Could you please tell me if your local public health dept. provides IN PERSON live interpreters for your services to non English speaking patients? What about optional services and NON mandatory programs? If you are comfortable, please share which programs and what county? I am with an optional program, Nurse Home Visiting Program with Maternal Child Adolescent Health. We have a full time Spanish interpreter on staff (her actual title is community outreach worker, so she does other stuff too) but she's on our payroll and Spanish is not an issue. We also have Urdu, Vietnamese, cambodian, laoatian, Hmong, ma'am, Farsi, and Arabic clients that we basically cannot provide in person interpreters for. Because we have had to turn away quite a few patients from our program due to lack of interpreter, we are trying to get our major insurance carriers/managed care plan, to pay for an interpreter for their patients to participate in our services/program. We don't have a budget to pay for the cost of interpreters ourselves and if that needs to be changed we would need at least 1-2 years notice probably to change our state budget :/ The insurance plan told me that usually if one of their patients wants to take a "community health education class" that the plan would cover an interpreter for them to attend that class. We have been in negotiations with the health plan for over 4 months now. They are asking us why our optional program is *required* to provide interpreter services. I'm waiting for my boss to reply to them. Any advice would be appreciated! Especially from any nurse home visiting programs. Thank you!!!

Just want to add on the topic of taxes, for those excited to claim work expenses in their tax return. In order to receive this deduction you have to 1. Itemize your deductions and 2. Meet a requirement called the 2% floor, meaning that your "work expenses" must be MORE than 2% of your AGI which for me would have been more than $1500 in work expenses and no matter how many scrubs I bought it wasn't $1500 worth lol! we don't even itemize our deductions anyways so I cannot claim any work expenses on my tax return.

i agree they are are totally not required to reimburse. Yes I am lucky hehe :) I feel it's definitely worth asking just in case.

Yes in general you should never hide information about a patients medication compliance. If I was the rn I would inform the MD next time I saw that doctor or put a note in the chart. As a student you should mention this to your rn. that being said, I'm sure this is not new information to his doctors as he probably has a history of doing this. All you can do is show concern and educate what is happening to his body and the risk of early death.

I would ask if I will be able to communicate... To the the scariest thing is being awake and conscious but not to have some sort of speech.

I'm so sorry and yes please find a good doctor or OB and a therapist to talk this over with. I'm very very concerned that you said you hope you don't wake up. Please hang in there and get help. In the mean time have you tried ginger chews? Ginger helps a lot of people with nausea. Maybe nursing school can wait for a little while until you are past the nausea or maybe even till after the baby? P.s. I saw a lot of vomit in nursing school just so you know... Best wishes to you and I hope you get though this stressful time. Congratulations on the baby!

Just some ideas, research nursing, public health nursing (in the communicable disease department), epidemiology, immunology, etc, but honestly you haven't even started your program so you will be surprised how much of nursing is understanding pathphysiology and understanding the immune system. You need it daily in your work in most specialties. But look into research nursing or anything for the health department!

I watch too much judge Judy... But I probably would have said that "before we started our appointment I did not agree to reimburse you for your services to me. That's not how these appointment work, I'm sorry" dont over think it! I can see you are genuinely concerned for this patient and that's awesome. But you are certainly not obligated to say anything else. You could offer him resources for food or shelter if appropriate.

I'm just gonna throw out a bunch of words without further explanation: rest Netflix Facebook interesting documentaries cleaning laundry dishes friends family vacation (or vacation planning) shopping walking hiking swimming wine tasting cooking ... That about sums it up. I don't have kids and barely find any free time though lol

My fee was fully reimbursed! I work for a county public health department. So yes ask your boss! She told me it's a condition of my employment so yes they do reimburse where I work...

There sure is a lot of harsh replies here telling him it's a ridiculous questions and he's sooo insecure. So I'm just gonna say - hey dude, don't worry, it's not a big deal, and you will find love eventually! No wonder some people are insecure when there's so many rude people out in the world making fun of someone for asking a question or seeking support. Sheesh relax people!

Very big questions and of course the answer is, it depends where you are willing to work. Southern CA is a big area so are you willing to relocate to the next county over if Orange County is not in demand? Also do you know what department or aspect or population of public health you want to work in? For example I'm in northern CA and our county is in demand. But some department do NOT hire often and others do. For me I knew I only wanted to work in maternal child health and I was willing to move. There are plenty of roles for a "white male without Spanish" ... TB/CD, HIV/STD surveillance, foster care, etc. i think it's fine to do a preceptorship in in... But it's also perfectly fine to do a preceptorship in the clinical setting to get some more experience with the very sick and with the medical field in general. I found my preceptorship in a busy postpartum/nursery unit extremely useful in my obstetric knowledge and my ability to help the population I now work with. I also want to point out that I would try to avoid statements like "I already know I'm not going to like _____" you should always try to be open minded about everything you will learn and every clinical experience is important. even if you "know" the area you want to work in, try to see each clinical rotation as important to your well rounded education and your diversity of knowledge. I hated working with the elderly but I learned so much. Good luck!

Here's what I learned: the "official" way is supposed to education then license then certification. BUT in the setting of your job, it is the accepted norm to put license right after your name so in a chart you can see what kind of person wrote what. If an MD wrote a note, I wanna be able to quickly see doctor John smith, MD. Or see Jane Doe, RN or see Jane doe, LCSW. I don't care at the moment what kind of advanced certifications or additional education they had BUT if I am at a conference or learning from someone, then I would like to know their level of education and specialty certifications because it clarifies their level of expertise. I work as a PHN. On my business card, my email signature, and on any PowerPoint presentations I do I write the "official way" of Jane Doe, BSN, RN, PHN - so people get a clear sense of my education license and certification. BUT in my charting I simply write Jane Doe, PHN because within my department we know all our PHNs have a BSN RN and everyone else has a different job title than PHN. Does that make sense? Hope that helps!

I think the key is you need to be confident - even if you feel nervous then fake it lol. Be clear and concise. Feel free to practice the conversation before you call. It gets easier with practice and when you are out of school!

I'm in the Bay Area which had the first $15 minimum wage and is also the #1 highest cost of living in America. New grad RNs in Northern California start off between $45-65 per hour right off the bat. Advance practice nurses like my sister make well in the triple digits annually. I've been getting a raise of $2 per hour every year at my job and additional increase with a small promotion. I know not everyone is so lucky. I worked at above minimum wage in San Francisco for about 7 years at $14 per hour and our studio apartment in the ghetto was $1350 per month and there were days that I literally went hungry. San Francisco had a MW increase BUT they also have rent control laws so rent doesn't go up. But if you want to buy a home the median home is over 1 million dollars anyways, I have dozens of thousands in student loans. I chose to be a nurse for the joy of it - I cannot imagine doing anything else! And hey it also happens to pay the bills enough to live paycheck to paycheck in our current 1 bedroom apartment of $1950 per month, with a 1 hour commute to work. I live here because I love the Bay Area and do not want to live anywhere else. I just accept being broke as a part of my life. I love my job, I love my city, and I'm loving life. Everything else is just details :)

I've come to a place in my life where the grammar mistakes of others do not bother me. I'm much more bothered by the way people drive!

Glad to hear you are doing so well since the MI! There are no restriction as long as you can perform the duties. if your visions hearing and mobility are fine then you have nothing to worry about. I do not know the specific laws about people with disabilities obtaining their license (as many rn positions do not require you to work with patients at all!) but most jobs working with patients will require you to be able to lift 20-50 lbs, and not have a major vision or hearing disorder. They will drug test you as well and make sure your vaccines are up to date. As long as your medications are not opiates or benzos you will be fine. You do not have to provide a list of any medications you are taking as long as they will not show in a drug screen, if they do show, you will be asked about prescription meds. Hope that helps!

Great answer above. I do not think home health is required. I went into public health as a new grad. Some hiring managers and positions will require specific exprerience and others will not! We have people with almost every type of background experience. Have you thought about what type of public health role you want to work in or which department? I'm in maternal child health and I do home visits providing education and assessment, case management. Public health is amazing :)

I know this happened over a month ago, but just wanted to add my experience as a public health nurse who visits a lot of these babies in the home. It does sound like a situation where a SW or discharge planner should have been invloved, and hopefully connected to resources after discharge. Of course you did the right thing by giving them formula! But maybe should advise social work or supervisor to make sure someone calls them in a few days to make sure the family is doing okay, and make sure they went to their pediatrician appt! 2 things I can tell you our county does in these situations, we have a Nurse Home Visiting program through public health maternal child health, where nurses come visit these high risk babies for at least an hour and weigh the baby, assess feeding, assess social situation and parents, provide them with ongoing resources, education on health and infant care (and many topics!) and developmental assessments until 1 year old. Another thing our county does is we created a form that hospitals can fax to WIC that says "I authorize ____ hospital to inform _____ WIC office that I have delivered my baby and we are going home on _____. I authorize WIC to contact me for me to schedule urgent appointment. Special feeding instructions for my baby include:" i.e. Breast pump or order for 22 kcal formula, etc etc. you can only do so much as the NICU rn! Get to know what family resources are available in your area to help at risk parents succeed. Some are CPS referrals but many are not that are still at risk for neglect but not enough to have CPS involved.

Any update? Did you apply? I am working for a similar nurse home visiting program, just not NFP. Happy to answer questions if you are still interested!

Okay ... I believe that is exactly what I said - that some are specially trained to do it, and it's generally something doctors do. You made it sound like I said that nurses never do it and it's exclusively a doctors task which is the opposite of what I said. Despite my "small" experience which my profile doesn't fully provide for you, I was just sharing my experiences that I saw in 3 years of nursing clinical at excellent hospitals as well as from what I hear from the many friends I have working in many inpatient specialties. But I don't really know any ICU nurses so maybe that's why I haven't encountered it. Maybe it's less common where I live in the Bay Area in CA... Especially in lower risk units.

Wow. What you're feeling is totally normal. I'm sure I would feel the same. You paged your doctor multiple times and you were understaffed. Agree wth all other advice to get some counseling and keep assuring yourself it was not your fault. We all have that one case!

We got a new apartment that was bigger that cost us $700 more per month than our last studio. We bought a new car so I could commute (0 downpayment!) and we got married so basically all extra money went to the wedding... We are living paycheck to pay check... But we are "comfortable" and we take at least 2 budget vacations per year. for the first time in my life I can afford birthday presents or Christmas presents for all my friends and family. That's amazing as I always had a lot of guilt that I couldn't afford gifts for people.

yes this!! Me too! No more ramen noodles for dinner. Sometimes I even splurge on the $2.00 extra for a side of guacamole at Chipotle

I did a traditional "in person" BSN so I don't know about accelerated programs. This is really interesting because in my school the word capstone did not mean project... It mean your final senior preceptorship on your favorite unit - I had 225 hours in post partum / well baby. Basically 2-3 times per week in the hospital, 8 hour shifts, 15 weeks long. taking on 3-4 patients independently... It's was like clinical but double the hours of all the previous clinicals. Yes we did have a major senior project, which we were to present to the staff nurses on our unit. Mine was titled "the role of the RN in supporting breastfeeding mothers on postpartum units" it was lit review on the problem and the need for more BFing support, and very specific actions nurses should take to promote exclusive BFing not only in the hospital but long term success. I presented it to my staff in small groups and they were polite but kinda did the "aw that's nice...don't care too busy" attitude lol. But the whole 15 weeks of basically working in the unit 3 days a week... Where I really learned most of my crucial RN knowledge - that's what we called our "capstone"