.4**

I may not make any friends with this but when did nursing become a career based on $$$ instead of a calling. I am lucky to have 2 pretty good careers and neither were started based on the amount of money I was going to sock away. The first was Law Enforcement which I certainly didn't choose to get rich. After coming out of the military during Vietnam I started at 369.00 a month. I waited for my 21st birthday to become a cop. I made around 40,000. Of course with raises and OT I was comfortable. Having worked in ESB. When I hit 41 my time was in and chose to become a nurse. I wasn't making a million dollars but working my butt off. I was divorced with 3 girls and paying child support I could make a round 90,000.. Ive been around nurses all of my adult life. I've seen the attitudes change. Most of the time I wasn't impressed. I fell out of bed and broke my face. I spent 5 days in the hospital and the care was superb. These weren't 5 or 10 year nurses they were at the bottom rung. Maybe Im just an old guy who is stuck in the stoneage (I was a Hospice Nurse) and now my oldest daughter started like the old days. 2 years in med-surg, 2 years in a specialty, now she's in Hospice working on her FNP. She will make her money but she had to work her butt off. My question is when did nursing stop being a calling?

Unfortunately the hospitals dont share their intentions. We get the call do the admissions settle the patients and family and many times we are just as surprised when the family calls us to advise us of immediate discharge. Some times we were lucky enough to have a contract bed available. Its not that we tried to keep the patient in the hospital but not only did we have the family to settle we haven't figured out how to snap our fingers and make DME appear.

Joy That was directed at one Hospice Organization only. I worked for a wonderful one as does by daughter who works for one on the other side of the state. Sorry if it seemed otherwise. At 59 my Advanced Directives, Living Will, and ahealthcare Surrogate (my 27 year old RN BSN who next year will be an FNP) are all signed with Hospice as my choice.

For Veterans there is an option called the Veterans Foster Home Program and the VA contributes 1788.00 per month to assist. Unfortunately as a former Hospice Nurse I witnessed the suckiest pardon the word) Hospice Organization I have ever seen. They are located in Orlando FL. And are called Cornerstone. I was invited to a free luncheon at a reputable facilty but when I was told Cornerstone was sponsoring it I refused.

Yes I was one and now my daughter is.

This is an issue that will never go away. No matter how many times it is explained at admission people believe we make the rules. As cold as it sounds you can't always get what you want.

Try being the opposite. Im 6 ft tall 235 lb retired SWAT team member. In many cases pts looked at me like I was the Angel of Death. Forget 12 years in Emergency Service Bureau. Delivering babies, crawling through burning buildings running toward gunshots they were afraid of me. Once they new me I was a highly requested nurse. Forget about what strangers think. Teach them to love your competency and they wont be strangers

Again your looking at an MD/DO with an extended residency. Although I have met quite a few Phsycologists who think they are Psychiatrists they do have control of Therapeutic care plans

And don't forget better bedside manner.....

It's a personal decision if you feel comfortable do it. To me I feel it's a good place to learn and believe in mentorship. Being a mentor doesn't end in a year or 2 it lasts through your career. Give the kids all the help they need so that they can pass it on

I think I am tired of one half shooting their mouth off with nothing but an opinion. I saw an excellent post including citations to back up her opinion. Enough with the Kool-aid crap. I notice there was no respose to my statements of this Lil ole nurse running circles around first year residents. My experience and desire for knowledge made me a damn good nurse. I told an ARNP to go pound sand today because I don't feel she's in a position she belongs in. Does that mean all NP's or PA's are bad? Hell no. If your good at what your job is you have the respect of my 30+ years experience. If you don't put in the effort find another career. As a Nurse I can run circles around my 25 year old daughter. But I know my kid and I know she has the ability to become a damn good FNP because she works hard and practices harder. She has 2 great mentors her mother in law with 35 years experience and a dad with 30. To wrap it up she won't belong in critical care but she will kick butt in a Family Practice. I don't prefer MD'S I prefer DO's does that mean one is better than the other? Get real. Put FNP's where they shine. Good night yall gave me a headache

I guess my CRNA comment needed an lol. In my time in special procedures I had the pleasure to work with many talented Anesthesiologists and Anesthetists. My point was if all they had was book knowledge would you be comfortable not that they didn't have working experience. I feel strongly about work experience as I started as a Paramedic before there was an EMT-P designation. I wanted to learn so I took a bus man's Holiday to the Shock trauma institute at University of Maryland yes I'm that old. I know my lab values backwards and forwards, I read x-rays and Im, fairly competent at MRI's. I have assisted in the reattachment, of 3 severed fingers in the ER with the Chief Resident of Plast is and just little ole me. No one can ever present a case to me that a solid background round in nursing practice should be required for advanced practice. Call me a dinosaur if you like but hard work and thirst for knowledge gave residents and attendings alike enough faith in me to grant me a considerable amount of autonomy for the times

Just one small statement. In the late 70s BSN students were taught that they were going to be bosses. This I know as my college girlfriend was a student at Adelphi University perceived to be the top nursing school in the region. These 4 year RN'S didn't see a clinical until 3rd year. Meanwhile the Associates degree nurses were considered inferior and we're not hired by private hospitals but by county hospitals. If it was my choice an Adelphi Nurse wouldn't touch me unless I was unconscious. I was in the law eforcement time of my career and was assigned to ESB and it not only my preference but most of the residents also to work with a 2 year RN. Over the last 35 years I don't see much of a change in attitude although a dear friend of mine after 10 years as the Director of a large hospitals ICU department which covered all. Decided to get her Master's in Healthcare IT

I worked in Palm Beach County Florida and we have 2 not for profit Hospices one in the North part of the county called Hospice of Palm Beach County and one south called Hospice by the Sea. Both provided excellent service in our county and neighboring counties. Palm Beach County is the largest county east of the Mississippi. The most important part of Hospice besides the patient and family is education. Our Social Workers were out on events non Hospice related. We had contract beds in quite a few hospitals and in one an entire floor. This made it possible for us to come into contact with the Drs. And explain what was available. On occasion when staffing was low nurses ended up covering shifts in Assisted Living Facilities. The Doctors would come in on rounds and we would give report and their demeanor changed when they realized they were talking to licensed professionals. Don't think I'm putting down CNA'S I'm not they work hard and many were studying to be LPNS or RN'S. When the doctors asked why we were doing "babysitting" work. We used that opportunity to educate. Once they understood that we were available at home, in, acute care, in assisted living and had our own facilities as well as Medicare guidelines they researched it themselves and we four more referrals. The work is hard and requires a lot of reading especially on pharmacology. At a certain point the Drs. learn to trust your judgment and took your advice some if you proved to be reliable enough even let you write orders and sign them later. We had a department that handied after hours calls and if a nurse was needed you went. Some families called us to inform us they were out of morphine(we used sub cutaneous butterflies and taught the families how to administer morphine) we had an arrangement with a 24 hour pharmacy to allow us to call it in for the family to pick up. We wrote the scrip, put it in a pre addressed stamped envelope,, left a message on service and it was signed and mailed. Being a Hospice nurse doesn't end with your shift. I am Catholic and was a lay minister. I served communion to the sick in most of the hosptals in the area. Many of the doctors recognized me either fom church, coaching my daughter, or from my first career as a Deputy Sheriff. When they asked me what I was up to I used it as a time to teach. I probably could have said à lot less

I think a major issue that is being overlooked is practical experience. Jumping from RN to FN with no pause for working experience seems to be the culprit. School to school with clinical don't prepare anyone for anything but a piece of paper. Their has to be some work experience involved. In the case of my daughter it was 3 years on med-surg and 2 years at Hospice. In the olden days there where no GN's in specialties. You did your time on Med-Surg then moved from there. I understand there is a shortage of RN's but PT safety shouldn't suffer. Think carefully your going in for surgery and the Nurse Anesthetist was never a working nurse. I leave a trail of poop getting my butt out of the OR