Mr Pitstop

Don't do it! At 42 years old you will still have at least 5, maybe 6 years before you get your Bachelor's Degree, which you will need in order to get hired. This will bring you close to 50 and unless you plan on retiring at 75, expect to work for the rest of your life. In any event, you will need at least one year experience in the hospital setting to get any type of permanent position which can take a few years to accomplish. Before you know it, you'll be 50 in a field recruiting 25-year-old new graduates. I can only give you my opinion based on my experiences. I decided to "start a new career" at 43 and it was the biggest mistake I've ever made. After nearly 5 years, first taking all the required prerequisites (sciences have a 10-year expiration so any science you've taken in college years ago, will have expired and you will have to take them over) then getting through a two-year nursing school program, and finally passing the NCLEX on the first attempt, I was still not able to be considered to be hired unless I enrolled in a Bachelor's program, which I did. After enrolling at a state university and beginning the program the best I could get was a job in a nursing home with a 40-1 patient-nurse ratio. Since I was a new nurse, I couldn't keep up with the 3 minute per patient med pass pace and it did not work out well. I resigned before I ended up losing my license. After many attempts to get hired at a hospital, I took another Nursing position at a nursing home, this time as a charge nurse. Unfortunately for me, my med pass nurse had a med error and in the nursing field, if a med-pass nurse is fired so is the charge nurse, since I was responsible for what she does. So, at this point, at 48, I have no references, no hospital experience and I still don't have my Bachelor's degree. But here is the worst part; I can no longer afford to finish school so I am one semester shy of graduating. I cannot afford to "look for work" which is a full-time job in and of itself sending out resumes one hundred at a time, and I have spent my life savings to the point where I live day to day working part time as an auto technician, the field I spent 20+ years in and what got me to the point of deciding to become a nurse. Moreover, I hate being a nurse. Go on any thread here and you will read all the horror stories, and they're all true. Overworked, overtaxed, understaffed and under-resourced. And no matter what I do, how I do it, it always seems to be wrong. Don't do it that way, do it this way. Don't do it this way, do it that way! You document too much, you don't document enough, you need an order for that, you don't need an order for that, whatever! I'm done with it. I am 50 years old now. I wasted eight years of my life and a hundred thousand dollars. I alienated all my friends and family buried in books and sleeping in the library, studied all night for tests that have no correct answers, only most correct, and wrote papers on subjects I couldn't care less about; all for nothing. I worked nights and slept away my days and I never even finished obtaining my Bachelor's. Soon my registered nurse license will expire and I have no desire to renew it. I went back to my old field, I now work full time repairing cars, overhauling transmissions, diagnosing check engine lights and doing head gaskets on Dodge Durango 3.7 liter engines at least once a month. And I love it. I should have never left the field. I'm giving you the other side of the coin. Sure, it's noble to grant you best wishes, "go for it," you only live once. There are so many success stories to go by. But there is not always a happy ending. Think long and hard about it before you take the plunge because the day you start nursing school you will be treading water and one dosage calculation problem could mean sink or swim. But that's just one man's opinion.

Yeah, that's it in a nutshell. The thing is I am looking to get into management, but I was thinking more in the clinical setting. The funny thing is, skills are my best attribute. I get lines started quickly, first try, never fumble with tubes, knock out catheters, chest tubes, PEG feedings, as a former auto tech my hand-eye coordination is key. But when I did my Psych rotation in school I loved the idea of not doing all that. Well I have to decide soon, thanks for your input.

This is exactly the topic I have been looking for. My comment is long, but I would really appreciate some input. I posted it in another area; Nursing Student, so I will post it here. Thanks in advance. Hello all, I am fairly new to the site and this is the first thread I have posted. In fact I am new to nursing, which leads to my topic. I am asking for input about two separate nursing disciplines, which I have been offered a position. I appreciate your reading this and giving your input since it is a long comment. After graduating as an RN in the AAS program (Associates Degree) and passing my NCLEX, I am working in a nursing home setting as a charge nurse. I hate it! Be that as it may. I have been offered two new positions: The first is as a Reassessment Nurse for a reputable health insurance company. Let me be clear, this is NOT a home healthcare nurse position. What it entails is performing UAS Assessments for New York State, at the patient's home, and can be described as assessing whether or not a home care patient's needs are being met, for instance; whether the caretaker is able to efficiently care for the patient; if there is food in the house; is there heat, air conditioning, adequate leisure, sleeping arrangements; if the environment is infested with bugs or rodents; the stage of disease, illness or pressure ulcer; are the meds being distributed properly and timely; the performance of the home healthcare nurse...and assessment in that nature. It also includes 6 month follow-ups (follow up from hospital discharge) and assessing whether a patient should be placed in a nursing home (LT) as well as collaborating with all other disciplines to propagate a stable plan of care. A boat load of computer work. There is no detail that includes IV therapy, catheters, wound care, enemas etc., in fact, there is no need for a stethoscope. Here's the pros and cons from my perspective: Pros: Wear regular clothes, 9-5 Monday thru Friday weekends off; starting salary 81,000/year ($40.00/hr) plus overtime (time and 1/2; $60.00/hr) after 11 cases per week; full benefits with moderate cotribution, 401k (company matches up to 6%), PTO (paid time off) 29 days per year; 3 to 5% pay increase per year available; bonuses for exemplary performance. Cons: Travel time and expense; I live on Long Island (Suffolk County, Long Island is the only place in the world you live ON and not in) and cases are primarily in the 5 boroughs, office is in Manhattan, near WTC 19th floor (Tribeca);The company will pay for all travel occurring after the first case and until the last including tolls and MTA card, so getting to and from my home care cases or to the office is on me (approximately $3,500 per year); hard to continue BSN program (unable to get "clinical classes" in, can possibly use my PTO), 9-5 M-F and only leaves weekends for extra work to repair limousines and transmission overhauls (extra 30k/year) or, for instance, take on a job at a doctor's office; NO hospital experience what-so-ever. The other position is as a med-surg nurse on a telemetry floor at a prominent university hospital, the same at which I attend school. I don't think I need to explain the position detail, you know what it entails. Pros and cons: Pros: Hospital position, 3 and 4 day work weeks (80hrs per 2 weeks); easy to finish school; no travel time, I live literally 2 miles away; overtime available at time and a half (extra day per week); night position 7pm-7am, time to work another job (not much time to sleep, though). Cons: Less pay, base pay $77,000/year ($37.00/hr); must work every other weekend; vacations are given as per seniority (which means my vacation will be in November or February); 6-8 sick days per year, 3 week vacations but not consecutive (so the same as above); health insurance comes from the ACA Exchange, so it costs a lot with a high deductible; and anybody who is a med-surge nurse knows what a *******' pain in the ass it is! No need to elaborate. So that is the deal. I am fortunate to have two positions available after having NO positions available for some time. Many of these may be seen as pros and not cons or vise-versa. There is one more caveat, I am no spring chicken. After working for 25 years in the automotive business as a technician, humping cylinder heads and automatic transmissions, I have successfully reached the age of 48. I am in very good physical shape but I don't know if I have 20 years of med-surge in me; the reassessment nurse position has potential for management positions, so I thought I might just add that. Any input will be appreciated and I am anxious to hear about your own experiences. Until then...Fuhgeddaboudit

Thank you for your input. Actually at the nursing home I do a lot of inpatient care, like 13 hours a shift! It's a 40:1 patient to nurse ratio, and even though I am mostly on the desk (charge) I still do all the IVs, flushes and assessments that LPN aren't authorized to do. It's funny that you mentioned retirement, I'm 48 years old, I've already retired from Ford, I'm on my next career. Where do you think I should post this thread, please advise?

Take a deep breath. Here's how you learn: You watch, you do, you teach. That's three times. If you are messing up after the third time then you need to evaluate your skills. Before you do anything you should watch it being done, either from a video or someone actually doing it. Then you do it, preferably without being rushed, then you teach it...even if it to yourself. When you teach someone how to do something, you learn it even more. I used to teach the patient, I'd explain everything I'm doing: "I'm going to check your blood sugar, I have to wipe the first drop with alcohol and get the next blood drop okay?" Explain everything, you are teaching yourself. "I have to go look at the sliding scale so I know how much insulin to give you" The patient might be like, "yeah, I know" Just keep talking through it. You have two pockets on you scrub top, stuff them with everything; gloves, sterile caps, scissors, tape, flushes, hammer and screwdriver, whatever you think you will need, then double it! Then stuff your pants pockets, alcohol swabs, 2 pens (which you never lend out) temp dots, whatever. It's all there...and tape, can never have too much tape. When you do a wound care bring 3 times what you need because you will probably need it...and always bring TWO Foley's, you can put one back. Charting takes time, it's not something you just get right away. Chart by exception, if something is good, leave it out, if it's bad, include it.Charting is probably the hardest part when it comes to time management. Hurry up and tear things down, get the old dressing off quickly, then take time redressing. Get the old primary line off and out of the pump quickly, then take your time setting up the new one, NEVER rush a med, a carpenter's saying goes, "Measure twice, cut once." Once the wrong pill goes down there's no getting it back. You are still a student, you have time, once you get in there you will be doing three Foley's a day, forget blood sugar...after day one you'll wish you never saw another glucometer again, insulin pens...make sure you prime with 2 units and MAKE SURE you crank that baby down to the dose, I've seen some nurses prime then forget to reset it. It's hard to feel it when you're injecting 4 units. And remember, some patients get a standard dose on top of the sliding scale. Check blood pressure manually, not with the stupid machine with the dead battery thats in the next hallway. The BP cuff will be on your med cart or in your pocket or around you neck, us it, it's quicker and more accurate when you get good at it. The more you do it the better you get. I can see a Right Bundle Branch Block from down the hallway but in Med surge I couldn't tell a RBBB from a PVC, look at them 12 hours a day and you'll get it. You're going to see the same things day after day, everybody gets a cardiac med, almost every woman gets synthroid and I can count on one hand those who don't have diabetes. Flushing IVs is second nature and you'll get better at starting IVs as time goes on (it's one of my best skills). I was slow when I was in clinical, but I rarely made mistakes. These tricks I learned from other nurses and CNAs. (Note: make friends with the CNAs, they will bail you out of a lot of tough situations...CNAs are your friends, not your subordinates) Good skill, because luck has nothing to do with it.

I have read most of the comments and perhaps I can add to the discussion. I think what you are doing is concentration on memorizing the material. That's great, that got you through nursing school, but the NCLEX is not about facts and material, like another poster commented, it's about critical thinking. What you need to do is look at the question and think, what would I do if the patient was laying on the floor in the room, or if it were my child, or parent; or what would I want if I were in that situation as a a patient; how would you feel if someone said that about you; which one of my fellow nursing students would I assign that detail to? That's how you have to approach the questions. After I passed (on the first attempt) a former nursing instructor asked me to send an email to her about my experience, she shared it with her class. This is an excerpt from that message: For the most part the NCLEX is a test of "critical thinking." In fact, I cannot remember one question in which I knew the answer without even thinking about it. It was not a fact-based recollection test but, instead, a test in which you need to "figure out" the answer based on the information in the question. When I walked out of the testing unit I texted everyone I knew that I had failed and failed miserably. I had to take all 265 questions! Every question seemed to be a decision of whether I should second guess myself or go with my gut. Thankfully, you cannot go back and change answers because, if I could, the outcome may have been much different. Apparently I am a good critical thinker. Each test is taylor made, that is it is responding to a certain number of preliminary questions you answer. For instance, maternity is one of my weak points, so I noticed I would get a few maternity questions in a row. Cardiac is a strong subject for me so I received a few sporadic rhythm strips to evaluate. With that being said, the question was not, "which rhythm strip is atrial fibrillation?" Thats not a critical thinking question, that's fact based. The question was worded more like, "in which rhythm strip would the nurse question a diet consisting of green leafy vegetables and kale?" You would need to connect A-fib with a warfarin prescription and a contraindication of Vitamin K--think critically! Know your generic names, NOT the trade names, trade names will not appear on the test! Know furosemide, not Lasix; enoxaparin, not Lovenox; phenytoin, not Dilantin. Get into the habit of calling the drugs by their generic names. One problem with study guides (ATI especially) is they always give you both names, one parenthetically. Block that out, only use the generic name for your own good. Know your labs! Not just the numbers but what they mean. If BUN is high, great, dehydration, but the question would ask, "in which lab would the nurse question a med order for furosemide?" Know when and when not to raise head of bed and, for goodness sakes, if you encounter a flat line on a telemetry screen at the nurses center, check the leads first! Study management and delegation. If you were a charge nurse and had a maternity nurse as a replacement for the day, which patient would you give her, an elderly man with a hip replacement or a middle aged woman being prepared for an epidural? If you hear other nurses discussing a patient in an elevator, what would you do first? Run to the CEO's office or confront the nurses? Know what an LPN, CNA, PCT or volunteer can and cannot do, then apply it to a critical thinking question. Know your ABG's! Don't just know the ABG reading but how you would treat it, or more commonly, what treatment you would question. If a patient was in respiratory acidosis, would you give a potassium supplement? And remember COPD and "hypoxic drive," that question will be there. Don't worry so much about dosage calculations, I've learned they don't attribute to your score much anyway. If you're worried, practice converting from micrograms and dealing with micrograms per kilogram, and if the answer has you set the pump to 1.5 mL/hr it's probably the correct answer, especially if your dealing with a NICU patient (I redid the question for 20 minutes only to find out I was correct, wasted a lot of time!) What you do need to know is that jello is a liquid! And know all the other things that don't look like liquids but are part of a liquid diet. Know your nutrition! More specifically, drug-nutrition reactions. Know iron supplements are given with vitamin C to increase absorption, then know which foods have vitamin C, then think of a critical thinking question pertaining that information and, viola, you have an NCLEX question. So, how did I prepare? Well, I'll be honest, I sort of crammed it but I don't condone that. I was working full time in the shop so this is how I did it: ATI, ATI and then after that, ATI! I took at least 90 questions a night for 5 nights a week (say three, 30 question tests) then took a long test once a week. I did this for one month. I scored horribly on every one, 67%, 70%, I think I scored an 80% on one test, but don't despair. Here's my secret; after I took a test, I took it over and over again until I got every question correct. So, for instance, I would take a 30 question test on respiratory and score a 67%. Go through it and read the rationales. Take it again! Score a 96%, go back and take it again until I got every question correct, then move on to the next one. On average, I took each test twice so thats 180 questions a night but the second run through goes quickly. Keep in mind, of the 15 million questions you have already taken up until this point and the 1000 you will take to get ready for the NCLEX, you will not, I repeat, will NOT see any one of those questions on the NCLEX. There are no repeat questions in nursing school land and don't focus on selecting the correct answer, focus on selecting the MOST correct answer. So, I'll leave you with that email and good skill, since luck has nothing to do with it.

Hello all, I am new to the site and this is the first thread I have posted. In fact I am new to nursing, which leads to my topic. I am asking for input about two separate nursing disciplines, which I have been offered a position. I appreciate your reading this and giving your input since it is a long comment. After graduating as an RN in the AAS program (Associates Degree) and passing my NCLEX, I am working in a nursing home setting as a charge nurse. I hate it! Be that as it may. I have been offered two new positions: The first is as a Reassessment Nurse for a reputable health insurance company. Let be clear, this is NOT a home healthcare nurse position. What it entails is performing UAS Assessments for New York State, at the patient's home, and can be described as assessing whether or not a home care patient's needs are being met, for instance; whether the caretaker is able to efficiently care for the patient; if there is food in the house; is there heat, air conditioning, adequate leisure, sleeping arrangements; if the environment is infested with bugs or rodents; the stage of disease, illness or pressure ulcer; are the meds being distributed properly and timely; the performance of the home healthcare nurse...and assessment in that nature. It also includes 6 month follow-ups (follow up from hospital discharge) and assessing whether a patient should be placed in a nursing home (LT) as well as collaborating with all other disciplines to propagate a stable plan of care. A boat load of computer work. There is no detail that includes IV therapy, catheters, wound care, enemas etc., in fact, there is no need for a stethoscope. Here's the pros and cons from my perspective: Pros: Wear regular clothes, 9-5 Monday thru Friday weekends off; starting salary 81,000/year ($40.00/hr) plus overtime (time and 1/2; $60.00/hr) after 11 cases per week; full benefits with moderate cotribution, 401k (company matches up to 6%), PTO (paid time off) 29 days per year; 3 to 5% pay increase per year available; bonuses for exemplary performance. Cons: Travel time and expense; I live on Long Island (Suffolk County, Long Island is the only place in the world you live ON and not in) and cases are primarily in the 5 boroughs, office is in Manhattan, near WTC 19th floor (Tribeca);The company will pay for all travel occurring after the first case and until the last including tolls and MTA card, so getting to and from my home care cases or to the office is on me (approximately $3,500 per year); hard to continue BSN program (unable to get "clinical classes" in, can possibly use my PTO), 9-5 M-F and only leaves weekends for extra work to repair limousines and transmission overhauls (extra 30k/year) or, for instance, take on a job at a doctor's office; NO hospital experience what-so-ever. The other position is as a med-surg nurse on a telemetry floor at a prominent university hospital, the same at which I attend school. I don't think I need to explain the position detail, you know what it entails. Pros and cons: Pros: Hospital position, 3 and 4 day work weeks (80hrs per 2 weeks); easy to finish school; no travel time, I live literally 2 miles away; overtime available at time and a half (extra day per week); night position 7pm-7am, time to work another job (not much time to sleep, though). Cons: Less pay, base pay $77,000/year ($37.00/hr); must work every other weekend; vacations are given as per seniority (which means my vacation will be in November or February); 6-8 sick days per year, 3 week vacations but not consecutive (so the same as above); health insurance comes from the ACA Exchange, so it costs a lot with a high deductible; and anybody who is a med-surge nurse knows what a *******' pain in the ass it is! No need to elaborate. So that is the deal. I am fortunate to have two positions available after having NO positions available for some time. Many of these may be seen as pros and not cons or vise-versa. There is one more caveat, I am no spring chicken. After working for 25 years in the automotive business as a technician, humping cylinder heads and automatic transmissions, I have successfully reached the age of 48. I am in very good physical shape but I don't know if I have 20 years of med-surge in me; the reassessment nurse position has potential for management positions, so I thought I might just add that. Any input will be appreciated and I am anxious to hear about your own experiences. Until then...Fuhgeddaboudit