eagleriver

when i was a young 'un, i drove a school bus for a while. i was fascinated that the guys who hauled produce made 3x as much money as i did transporting "yuppy larvae." (terminology courtesy of dan ackroyd)

i am one of those "sorry saps" and grateful for the honor! ethical prostitution or compassion for dollars is heading down the wrong road!

very good idea!!

take another look at what you wrote here. i don't believe you really feel that way. i suspect that like the rest of us, you do your best for your patients, regardless of the crap you are putting up with from your administration. our strong ethics are exploited, and if there were no avenues of recourse besides compromising patient care, the exploitation would go on forever, while becoming increasingly more extreme. i believe we are advancing in strength and negotiation savvy, therefore, reducing exploitation. one of our greatest allies is public awareness - even in the form of a salary hall of shame.

thanks for your perspective. i do admire those who come from other countries, learn our language, listen to our crap (or remove it), care for our bedridden and are usually pleasant about it. it's becoming quite a revalation, that most entries for the salary hall of shame are coming from florida! i thought there'd be a few other states out there competing! i am thinking about sharing the percentage of salary hall of shame (shos) entries to lawmakers and other interested parties, but only as an "aggregate," so nobody can ever discover who individual respondents are. somehow, i think florida institutions will come out the winner by a landslide! what is the political implication in having the number one retirement state also be the one with the most embarrassing nursing salary statistics? i love florida nurses because they do not allow oppressive wages or counterproductive leadership attitudes to influence the quality of care or compassion they express to their patients. what an elegant statement of character!

The American Chambers of Commerce Researcher's Association has most of Florida in the 96-98% range of the national cost of living index. Tallahassee is .1% higher than the national average. Major cities like Miami and West Palm are at about 104.5% of the national average. Another "calculator" indicates that if you make $100,000 in Decatur Georgia, you'd need to make $132,185 in Jacksonville to maintain the same standard of living. By the way, Jacksonville's cost of living is 5% lower than in Tallahassee! In Florida we have the SMALL bucks and the BIG cost of living!

The American Chambers of Commerce Researcher's Association has most of Florida in the 96-98% range of the national cost of living index. Tallahassee is .1% higher than the national average. Major cities like Miami and West Palm are at about 104.5% of the national average. Another "calculator" indicates that if you make $100,000 in Decatur Georgia, you'd need to make $132,185 in Jacksonville to maintain the same standard of living. By the way, Jacksonville's cost of living is 5% lower than in Tallahassee! In Florida we have the SMALL bucks and the BIG cost of living!

If you are the only one willing to require decent treatment from the doctors, you may not succeed in changing things. Also, to what extent will your supervisors support you? There is no status disparity among any category of worker that justifies "ass kissing." Anyone who is expecting that kind of treatment is exposing their immaturity and insecurity. Therefore, don't take it personally. Consider also that doctors, like all of us can become cranky and stressed. They may not realize how much of an ass they are being, especially if nobody "calls them" on it.

If you are the only one willing to require decent treatment from the doctors, you may not succeed in changing things. Also, to what extent will your supervisors support you? There is no status disparity among any category of worker that justifies "ass kissing." Anyone who is expecting that kind of treatment is exposing their immaturity and insecurity. Therefore, don't take it personally. Consider also that doctors, like all of us can become cranky and stressed. They may not realize how much of an ass they are being, especially if nobody "calls them" on it.

I grew up in and around Detroit. Tell me something, if you become snowbound at your facility, or others can't come in to relieve you, do you get paid for as long as you're there?

I grew up in and around Detroit. Tell me something, if you become snowbound at your facility, or others can't come in to relieve you, do you get paid for as long as you're there?

Lets look at this salary situation another way, by taking a poll of who is working for the least amount of money, or has been offered the least in recent history. For example, in January, 2003, as an RN,BSN, I was offered $15.35 per hour base at a "large local facility." Who can beat that for a sucky offer?

I agree, we need to be careful, but not excessively fearful. With the millions of "case studies" that exist, a person could make up anything or report anything and have SEVERAL individuals whose situations resemble that which is presented. Case studies are the primary medium through which ethical standards evolve. They are essential.

Well, you posted in November and it is now March, so you probably have seen me at the Nursing School once in a while. I'm the young looking guy with lots of grey hair. :chuckle If you have any questions, feel free to ask. [email protected]

I have never looked at the possibility of practicing home health nursing independently, but this state is steeped in bureaucratic red tape, so make sure you have all the bases covered before attempting it. The pay sounds comparable here though.

You must be like me, wanting to sleep late! However, I suspect that most home health agencies in your area would hire you and pay well for psych case management.

I'm not familiar with that requisite, because I'm an in-state nurse, but I imagine it means you need to document 2 years of employment as a nurse. The nursing process is just a systematic approach to problem solving, the most basic being that of collecting subjective and objective data, using that information to form an assessment, then formulating a plan, hence called the SOAP approach. Most programs add outcome evaluation, subsequent planning and additional intervention (if needed). Another aspect that is usually tied to nursing process is evidence based practice, which means to base interventions on the latest valid scientific research. I hope this helps.

Debo, that's really impressive that an agency nurse can work in hospice. I don't think it's possible in Florida, at least not in Tallahasee. I'll bet they checked up on you quite a bit before offering you the chance to work hospice. One of the greatest benefits of working hospice is that finally and forever, one learns not to sweat the small stuff!

by Sally Karioth PhD, RN I've learned that nursing is the hardest and easiest thing I've ever done. I've learned to take my job seriously but myself lightly. I've learned that everyday I've held a hand but forgotten to chart vital signs I still may have come out ahead. I've learned that nursing is extraordinary because we do ordinary things so magnificently. I've learned that if 1 don't get emotionally involved with my patients it's time for me to change professions I've learned that when you're 92 you shouldn't have to beg for the salt shaker even if you have CHF. I've learned that a patient doesn't get Cancer, a family does. I've learned that a good physician is one who will say, "I have no idea what's going on with this patient. come help me figure it out." I've learned to help people see the 'gift of cancer.' I've learned that if my child tells me she has a bake sale 'tomorrow' at 8 a.m. - to be thankful that it's a bake sale and not a teenage pregnancy meeting. I've learned that whatever you need in a hurry will be in someone else's room. I've learned that when the narcotic count is off, it's usually I who forgot to sign something out. I've learned that healing the spirit is as important as healing the body. I've learned that if I don't take care of myself I can't take care of anyone else. I've learned that hospital food must be a punishment for our sins in a previous life. I've learned that a body believes every word you tell it. I've learned that the nurse 1'd like to have take care of the person I love most should be me or you. I've learned that time flies whether I'm having fun or not. I've learned that reality is what is, not what I would like it to be. I've learned that if I can't cure, I can still care. I've learned that patient-centered care doesn't mean amenities it means empowerment. I've learned that one of the gentlest things I can do is attend all my patient's funerals. I've learned that If I'm there before it's over that I'm still on time. I've learned to separate between a minor event and a major episode. I've learned that it's usually better to beg forgiveness than to ask permission, especially if I'm taking a St. Bernard to see a child in ICU. I've learned that good nurses aren't measured as much by punctuality as by compassion. I've learned that the spirit of the law may be more important than the letter of the law. I've learned that every day 1 can make a difference in someone's life and that I choose to make it a positive difference. I've learned that if I don't celebrate the exquisiteness of each day that I've lost something I'll never get back. I've learned that what helps most when diagnosing patients is never walk behind or ahead of them. but rather walk with them and listen very carefully. I've learned that the more unloving a patient acts the more they need to be loved. I've learned that knowing when to stop treatment with a morbidly ill patient may be more important than knowing when to continue. I've learned that some things have to be believed to be seen. I've learned that addiction to pain medication is the least of our problems when a patient is in pain. I've learned that professionals give advice but healers share wisdom. I've learned that meditation, group work, nutritional savvy and massage are as integral to a cancer patient's care as radiation, surgery and chemotherapy. I've learned that wearing red polka dot underwear under my uniform may not be the best choice. I've learned that grief knows no rules. I've learned that there is no room for bullies or whiners in nursing, I've learned that you don't have to meet all the objectives to learn a whole bunch. I've learned that nurses without a sense of humor should try to find a job as a shepherd. I've learned that having to work two weekends in a row is a minor event when my breast biopsy comes back benign. I've learned that I can work with almost any body fluid but mucus. I've learned that student nurses will do something every day that I didn't think was possible. I've learned that no one promises us tomorrow. I've learned that medical students get anxious when I assign them nursing care or try to see if their chakras are open. I've learned that if a confused patient accuses me of "poo-pooing" in his bed I should apologize and promise never to do it again. I've learned that no one says on their death bed, "I wish I'd spent more time at the office". I've learned that if a child is old enough to love, he is old enough to grieve. I've learned that a lot of patients get well in spite of us but even more get well because of us.

It is hard to watch someone suffer, especially if there's nothing that can be done to make it better or to help the person understand and/or accept what is happening. I feel that it is an honor to be with someone during their last hours and at the moment of transition, sometimes holding hands, stroking, and even holding them in my arms when it's appropriate. Effective nurses Love ... through all of our functions, that is the common feature. We don't "create" Love. Instead, it flows from and through us. Like a river that widens and deepens until it accomodates all the water that flows in it, our capacity to Love increases as we express it. Essentially, we channel Love from it's inexhaustible Source. Knowing this, I am free to be totally committed to the dying patient, with no fear of becoming too attached or burned out. Never doubt your strength. It is there when you need it.

It's possible that additional oxygen can cause a patient to stop breathing. If the patient has used oxygen before, has emphysema or something else that has their blood gasses messed up, their system may be attuned to oxygen demand, rather than C02, like those without breathing problems. We actually breathe to get rid of CO2, which results in additional oxygen supply to the RBCs. If our body responds to oxygen instead of CO2, increased levels of oxygen signal the body to stop breathing. That's why oxygen is virtually never set above 2.5L.

I went right into a small memory care facility, where most nursing skills languish, but I was continuing on to get a master's degree, so I didn't worry about it. I don't understand why someone can't get the clincal experience at their convenience, rather than feel like they have to dive into it immediately after graduation. If there's a problem with waiting, I guess I'll experience it, but so far, so good. One thing I'd be concerned about in your situation is, how the other nurses will treat you. I did both CNA and home health work prior to becoming an RN. Some of the RNs who "knew me when" seemed a bit sullen toward me after I got my RN license. It seems that some people just don't like to see others change roles, particularly when their new role places them at an equal or advanced status. Here's something hilarious. When an agency CNA is working on a unit, the regular staff CNAs often try to get the charge nurse to assign the agency person all the most difficult patients. They will unashmedly do this right in front of the agency person. These same folks blame the agency CNA for anything that goes wrong, if possible. They do other mean stuff, for example, after I got all the patients up on one side of the hall (12 of them), they told me I had to switch to the other side, where all the patients were still in bed. Anyway, I'd worked at this facility just a few weeks before getting my RN license. A few weeks after getting my license, I showed up at the facility. I had the RN tag on, and two of the CNAs hightailed it into a shower room and stayed there, occasionally cracking the door to see if I was still just outside at the nurse's station. I guess they thought I had gotten a job there, and figured that I'd be out to "get them," because of how they'd treated me just a few weeks before. I made it a point to hang around outside that door for as long as I could. Actually I was working for a case management company and was checking charts. In this instance, I took a bit more time, with a smile on my face as I watched from the corner of my eye, the door cracking every now and then.

You may end up having to press charges against the County Attorney for not doing his job! I suppose you could drag this kicking, screaming monster child to the Attorney's office and see what happens.

I have been a CNA and HHA for about nine years. I finally got into the BSN program at FSU. I can easily understand why some folks stop their education at the Associates level due to life circumstances such as money, family responsibilities or whatever. However, if both options exist for a person, they'd have to be an economic masochist to choose an ADN over a BSN. Besides, even if there's a deficiency in the clinical training of BSNs, they will still end up in charge. Isn't it better to be the dingbat-in-charge (DIC) than the DIC's subordinate?