SerenityKris

I find that many new nurses have this skewed reception of what a 'real nurse' does. Nursing is unique in that you can take it in lots of directions. I guess I'm not what you would consider a 'real nurse' but let me tell you this. I LOVE MY JOB. I work Monday-Friday 8:30-5. FROM HOME! I have nights, weekends, and holidays off. I make more than a lot of my nursing school friends that work in hospitals, and I have the opportunity for almost unlimited overtime if I want it. When I turn my computer off at 5 o'clock I don't have to worry or think about work again until I clock back in. This all means my family, including our two adopted toddlers get their best version of their mom - not a stressed out, overworked, holidays missing mom that works in a hospital. You really need to reframe reality here and realize that your thinking is flawed, and quite frankly - offensive.

I was actually diagnosed with cancer in the middle of nursing school. When I spoke to my instructor and explained that I wanted to wait until summer to have surgery she actually did an instructor level withdrawal from her class so I had no reason to wait on getting treatment. I can't speak on the legal issues associated with this post, but I do agree that you need to deal with your health issues before taking on nursing school. Usually there is very little wiggle room when it comes to missing clinical time. I had a very difficult time when I went back the next semester. I managed and I'm an RN now - but it was very very rough going. Good luck.

Halfway through nursing school I found myself in the hospital with a cancer diagnosis. I was in denial that I was going to have to take at least the rest of that semester off. I can remember calling my instructor and explaining to her that I was going to delay treatment until Christmas break so I'd be back in class soon and her telling me that she was withdrawing me from her class so that I wouldn't wait. I was devastated. I remember the nurse that came in that night better than any other nurse. She took one look at me and said, "You need a shower. You'll feel better after a shower." She then wrapped everything up so it wouldn't get wet and told me she was going to sneak me into the shower, since I wasn't supposed to be allowed. She was right. I felt like a new person. It didn't make everything all better- but I felt like life might get back to normal some day. Later I ended up doing my clinical placement on that same unit. She didn't remember me, but I sure remembered her. Sometimes that's what makes the difference between a good nurse and a great one - the ability to know when to bend the rules.

In the end we did end up getting him set up with home health and meds. We've had another since and the Dr refused to sign the order for home health. I ended up calling the ortho for it and it all worked out. I just don't see the sense in making an unsafe discharge even unsafer by not providing the same services we would if they waited for a proper discharge.

I am new to Case Management (only about a month in). I'm doing discharge planning for short term rehab patients. It seems like a lot of the ortho patients seem to decide when they are leaving almost before they get here and I just had my first patient leave AMA yesterday. There seems to be a lot of debate on what we can do for them when they leave AMA. Home health? Calling in prescriptions? The ARNP is working on getting the policy clarified from the corporate office on this as it's never actually been spelled out as far as we know. In the meantime we are in a grey area. Does anyone know where we stand legally on this? The softie in me says that even though it's an unsafe discharge at least home health and prescribed medications make it a little less unsafe. The other side is... if we are setting them up the same as a regular discharge aren't we essentially encouraging and condoning the behavior? Thoughts, opinions, facts are all welcome. Like I said I'm new to case management, and a new grad RN (graduated in Feb). I love this job, but a few years of floor experience would have been VERY helpful. Thanks in advance.

My first time in college I completely tanked. When I left at 20 years old my GPA was a 2.4. Fast forward about 15 years... I wanted to be a nurse. I sat and calculated exactly how many credits worth of As I would need to get my GPA up enough to apply for nursing school. It took some time but eventually I got it where I needed it to be. From the time I went back to the time I started nursing school I got nothing but As. Colleges should be more forgiving when it comes to someone going back to school 15+ years later. You aren't the same person at 18 that you are at 40.

I recently graduated and just started my first job as an RN. I turn 40 soon. While I do think everyone should follow their dreams I think you need to be realistic about what that entails. I was lucky enough to have a partner that could support us. I worked part time on the weekends and I had a grant from Workforce Solutions that covered tuition/books/uniforms etc completely. You can make it work financially if you set your mind to it, but I can't imagine doing it without a supportive partner. I found myself apologizing a lot for not pulling my weight around the house while in school. I found myself apologizing a lot to family and friends for gatherings I didn't attend, left early from, or sat on the couch studying during. Even if I did none of those things my mind was on all the studying I should have been doing. I'm not saying you shouldn't do it but if you want to survive nursing school with your sanity and your marriage intact you really need to get him on board.

I got my nursing license in March, and I happened to already work at an ALF that hires only LPNs, though in more of a clerical type position. I agreed to work there for the salary of an LPN even though I'm an RN because it was better than nothing at all. They knew it was only temporary until I found something as an RN. I applied at every hospital within an hour's drive of my house with no luck. I ended up applying at a SNF with rehab and because of my background in medical coding and clerical work at my old facility they offered me a position not on the nursing floor but as the RN case manager. I'm sure it helped that the LTC community here is very small and my references all happened to be very good friends with the ED and they gave me raving reviews. I started in the position and I absolutely love it. Everyone is telling me how amazing it is that I got this opportunity as a new grad and that they are willing to train me with no prior experience. I feel valued and like I can really make a difference and I haven't really felt that way since I started nursing. I even had been questioning if I chose the right career. One week after starting I got a call from the hospital to interview for their novice nurse program. Everyone is so adamant that you need hospital experience that I am so torn about what to do. Long-term I don't want to be a floor nurse. I want to go into management of LTC. I start the bachelor's program in August. I just wish there was an easy answer to this. I'm afraid if this job doesn't work out the hospital may never give me another chance if I turn them down this time. Any words of wisdom out there?

To clarify - I worked there for 2 years NOT as a nurse. I just got my license a few months ago and transitioned to the nursing position shortly after that.

Honestly, some of it is over my head. I think it would make more sense after I've been in the job for a bit. At least I do have medical billing/coding in my background from before I went to nursing school so that does help with some of it.

I've been working at an ALF for the past few years. When I graduated and got my license I transitioned to nursing there. As a brand new grad I was suddenly responsible for 48 patients and I was the only nurse. I had no backup to ask if I was confused or concerned about something. It's hard work. I run from the minute my shift starts to the minute I hand the keys over to the oncoming nurse. I love it, but I don't think it's good for a new nurse. I really needed a support system in place. That said - I managed and I learned a lot about picking up on subtle signs that something is wrong. Unfortunately though, My lack of experience usually left me telling the next nurse 'Something's just not right but I don't know what exactly. She's just behaving differently than normal.' I love it, but as a new nurse I feel like it's important to know that you're somewhere that you'll get enough support. That said - my last day there is in a few days. SNF would probably be a different story because I'm sure they have more than one nurse per shift.

In my nursing school we were taught never to wear gloves in the hall, period. You put them on in the patient's room and you take them off before you leave. The state auditors will penalize you for anyone wearing gloves in the hall. They assume they are dirty gloves.

Thank you! I've ordered it and purchased a few other books on my Kindle. I've been reading Case Management: A Practical Guide for Education and Practice by Powell & Tahan since pretty much the day I got the job offer. I do have an interview in a few days with the local hospital. I am hoping they may have a per diem position I can work on the weekends to get more experience with acute care. When I was in my 3rd semester of nursing school I was diagnosed with cancer and the surgery caused adhesions that were causing me a great deal of pain during 12 hour shifts of floor nursing during my practicum. I was so afraid that I'd suffer through nursing school and not be able to handle the job physically. When I handed my friend my resume to take to the ED where she worked I had no idea what the position was other than an RN. I guess I kinda feel like maybe this is the bigger picture for me. It was meant to be, and I very much want to succeed.

I was offered a Case Manager position with a LTC facility that also has short term rehab patients, and I've taken it. I start training at a sister facility next week. The ED knows I'm a new grad and seems willing to work with me to teach me what needs to be learned. The DON has promised to pull me to the nursing floor enough to give me some bedside experience so I can build up my clinical skills at the same time. Are there any books or newsletters out there that anyone would recommend to help make this learning process for Case Manager go a little more smoothly?