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  1. I disagree. If NK lauches a nuclear strike, they are going to throw everything they have at us, small numbers or not. We will retaliate, which means nuclear bombs dropping on China's back door. Do you really think China is going to say, "sure go ahead and incinerate our nearest neighbor as we're quite sure it won't affect us". Of course not! China will retaliate and we will have World War III, despite a very short war! Do you also think that Russia wouldn't hesitate to join in the "fun" and launch their missiles as well? The whole idea of a limited nuclear war is propaganda and an attempt to distract us from what is and has gone on the White House!
  2. This is what happens when you have a leader who is desperately looking for distraction and will use every channel in the federal government to do it! Do you think if a nuclear bomb falls, it will be only one? We would retaliate, which means China and possibly Russia would retaliate against us. We're talking nuclear holocaust . . . not a survivable event.
  3. areensee

    Student nurse dismayed by bedside nursing attitude

    You have q good point. Many nurses complain and they have good reason to. Our health csre system is operated by those who measure success in dollars, not in people. That being said, compromising patient care becsuse of one's attitude is not OK. Instead, get involv3d and work for change. Join nursing organizations, get politically involved and vote as a nurse. I have been a nurse for 22 years and I don't regret it.
  4. areensee

    Leaving first job, did you have a pay increase?

    It depends on what area of nursing you moving to. I have taken several pay cuts, but did so in order to chang3 my focus. When I left the hospital for a hospice position, I took a pay cut. When I left hospice to teach nursing, I took a pay cut. If just depends on the situation.
  5. areensee

    Why do LPNs only make $40K per year?

    I disagree with many others. Depending on the funding you have available and your need to work, getting an LPN and bridging to an RN program may be just what you need! For example, in Utah, it is possible to obtain an LPN certificate in one year, and pay only about $4500 for the entire program. Several colleges in Utah have excellent bridge programs which enable LPN graduates to get credit for their LPN year. In fact, some of our LPN graduates can actually earn their LPN, earn an ADN and a BSN in only 3 years, which is a year less than the traditional 4-year BSN program. Look for LPN programs at local vocational/technical colleges. Before you apply, find out what it costs, find out what their NCLEX-PN pass rate is (ours has historically been 100%), and decide which colleges will provide you with the best bridge program. If you do your homework, you may not only save money, but time too! Good luck!
  6. areensee

    Should I leave this racist town?

    Been there, done that. It is harder to find a job if you just up and leave a position, but like you ChutneyFries, it was the only thing to be done at the time. I did recover and found a new position. I pride myself on being a nursing professional. If the environment I am in doesn't allow me to be at my best, I will shake the dust off my feet and move on (to borrow a biblical metaphor). I am better than that, and I expect my employers to be better than that! I can't even imagine working in such a hostile environment as the founder of this post has. To add to it, it sounds as if it could be very dangerous working there. That adds even more fuel to "get me the H*** out of here" mode!
  7. areensee

    0200 BP's - Dealing with Tired Rude Doctors

    Nursing care is always a balancing act, as is medicine. We try to do the most good and least amount of harm. If you do a search of research articles you will find a great deal of evidence that interrupting sleep does do harm to patients. Now that isn't to say there aren't times when the scale tips in the other direction, and vitals every 4 hours are beneficial, but those decisions should be based on medical necessity, not a blanket policy. We need to move away from doing things because "that's the way we've always done them". If there isn't real proof that what we do is best practice, we can't just pretend that it is and do it anyway. I'm afraid that is the case for routine Q4 hr vitals. Such nursing is not much different than was done in the 1950's and fails to keep up with what we call the science of nursing.
  8. areensee

    0200 BP's - Dealing with Tired Rude Doctors

    WHAT EBP, give me the sources!
  9. areensee

    0200 BP's - Dealing with Tired Rude Doctors

    I don't doubt that you can catch problems, but that can happen any hour of the day. There's nothing magic about 0300. Besides, as I challenged, where's the evidence based research? Anecdotal evidence is just that, anecdotal. The telemetry unit I worked on also had BP designed to go off automatically, we didn't even need to step in the room, unless the cuff had been removed. I would also question what symptoms of a stroke did you see and how did taking a blood pressure lead you to that determination? And again, give me some sources! Even if you catch one stroke in your lifetime, does that justify the damage done to dozens of other patients through disrupting their sleep?
  10. areensee

    Nurse Bullying

    I am a clinical instructor and I understand your concern. It appears to me that students are coming into nursing programs less prepared than they used to. That isn't the fault of the nursing programs but rather our elementary and high school systems. Our kids aren't learning what they should be learning. On the college level I expect that students understand at least the basics of grammar and know how to spell common words. What I find is that they often can't spell even common words and have no understanding of punctuation. As far as your observations of clinical instructors, I can't speak to all of them, but that's not how I operate. It is important that I be as involved in the student's clinical experience as possible. Some limitations are actually imposed by the facility. For example, in one facility neither the students or the instructor are allowed to provide hygiene care. This must be done by the facility's CNA's. How can students learn if they aren't allowed to lay their hands on the patients?
  11. areensee

    0200 BP's - Dealing with Tired Rude Doctors

    By subjecting patients to unnecessary sleep interactions are we helping or are we increasing the incidence of problems? Give me a source that shows that doing vitals every 4 hours is GOOD for patients! Also, patient's in telemetry are monitored around the clock. If anything goes wrong with the vitals, it is most likely going to be picked up by the person monitoring the telemetry, not the nurse in the room. I'll look into this, but I'm pretty sure there is ample evidence to show that sleep disruption is bad for patients and effects the outcome. If you can find anything to the contrary, post it here. Let's start a real evidence based discusssion.
  12. areensee

    0200 BP's - Dealing with Tired Rude Doctors

    Wake me up at 0300 and my blood pressure is likely to be abnormally high! Why should this surprise anyone, and why do vitals at 0300? Does it really provide any useful data that can't be obtained 3 or four hours later? Obviously the ICU would be an exception, but in routine acute care! The reason that vitals are "routinely" done every 4 hours is because of the lawyers, not because there is any real evidence to suggest that it is necessary or helpful. I for one reject senseless application of "nursing" tasks that are based on sacred cows and not real scholarly research!
  13. areensee

    0200 BP's - Dealing with Tired Rude Doctors

    Aside from the fact that the hospitalist in this case is a first class jerk, I've been thinking more about the practice of frequent vitals and all the other horrid things we do to people in the middle of the night. Here's an interesting question. I worked acute care for 15 years and have done vitals at all hours of the day and night. My question is this, is there any evidence that doing so makes any difference in the outcome for our patients? Is there any best practice, any, evidence based practice guidelines? If so, I've never seen them! SO . . . how about some nursing research into the subject? Any takers? Are we simply doing what the administration thinks will open up a bed sooner ($$) or do the things we do actually improve the lives of our patients?
  14. areensee

    Complaints only, please!

    So who authorized the enema on the dementia patient? I'd want to have a word with them. Being a hospice nurse this sounds like something that should not have happened. This very well may have BEEN an assault. It angers me to no end when the right to dignity and comfort are forfeited just because a patient suffers from cognitive impairment. Why wasn't the patient at least given medication to relax him prior to the procedure. Don't we do this much for our pets? Why do we treat our elders with such disdain and dishonor? This is one of the big reasons I left hospital nursing after 15 years. I just got tired of trying to convince people they needed to have painful treatments done that they didn't really want.
  15. areensee

    Nurse Bullying

    I can see something of both sides of the issue, however I think sometimes we forget all about the growth and development theories we learned in school. New nurses are entering the workforce at a very different level than I find myself in, being an RN of 20+ years. Erikson's stages of development would place most new nurses in the "intimacy vs isolation" stage (age 20-25). In this stage, the individual is just learning about the complexities of relationships and learning the value of tenderness and loving. If we approach a person who is working through this stage and tell them "it isn't about your feelings", we ignore the realities of what the new nurse is struggling to learn. It isn't just about learning how to do nursing tasks, it's learning how to relate to a myriad of diverse relationships, colleagues, doctors, patients, families. In response to this, a little understanding and a lot of compassion goes a long ways to retaining and encouraging our new nurses. To do otherwise is not only detrimental to the new nurse, but to the future of nursing as a whole!