DebblesRN

Am I in the twilight zone, or did Lil'mama just say the EXACT SAME THING that many of us have been saying throughout this whole thread?? No-one has said they do not respect LPNs or we did not need LPNs or that they are not professionals. It has been pointed out that the education and skillset is different. If RNs have to delegate to and sign off on and supervise the job duties of the LPN, then why SHOULDN'T the RN make more money?? Bottom line, the RN can do EVERY aspect of your job. You cannot say the same. Not trying to come off as having the "great and elite" mindset--just pointing out a fact. Just like as an ADN, I cannot work in administration higher than a charge nurse. If I want the "management" career path, then I need to get at least my BSN. It is what it is. The best option is to continue your education. Not only is it a better option for your career outlook and salary, it is better for your patients.

Saying an LPN should make as much money as an RN is like saying an RN should make as much money as a NP. Doesn't make any sense. There are different skill sets and education for all involved. It doesn't mean that they are not EQUALLY valued for the skillset and education that they bring to the table. There is a place for everyone, and EVERYONE is a part of the team. We need to respect and value each other as members of the healthcare team instead of belittling each other, or whining about our limitations.

It is not the necessarily the RN's misinterpretation, in most cases, it's management's. They make the rules in each facility based on their interpretation of the baby friendly initiative. You should feel blessed to work in a facility where you are given the power to use common sense and good nursing judgment. Not all of us are so lucky. I refuse to berate or lecture anyone on their infant feeding choices. Formula is not poison, and I will not make a mother feel guilty for using it. They have their reasons. Educating is one thing, forcing them to sign a form saying they are a bad mother for giving it opens a whole new can of worms. OP, I feel your pain. It is frustrating.

I would encourage you to apply. I do not work with any male nurses at this time, but have in the past and they did just fine. I will also say--I had a hysterectomy a few years back and had a male nurse take care of me post-op. He was great and very professional and it did not bother me at all. Jobs are hard to come by as a new grad. If you can sneak in and grab a job on OB/GYN because they are hiring--do it. If you don't like it--stick it out until you can transfer to another unit. Once you got your foot in the door, you should be able to get a job easier internally. You may decide you love it though and stay forever. :) Good luck to you!! Got my fingers crossed that you get a job quickly. :) Oh, and as far as OB/GYN patients being needy--I've worked in MANY departments, those ladies aren't any needier than any other med-surg patient. If you ask me, they are much nicer to deal with. LOL

I was never in trouble in clinicals for something a fellow classmate did wrong. My grade and record reflected my own actions and no-one elses. When a mistake was made, and they were rare, the instructor would talk to us about it and make it a learning opportunity. No-one else was chastised and no-one else's grade was affected by the mistake unless they were directly involved with the error. So, it doesn't make sense to me that the OP feels her entire clinical group "gets in trouble" for the mistake of one person. And as far as three student's making med errors--where was the instructor?? We were never allowed to pass meds unless the clinical instructor was present with us while we did it. Has nursing school changed this much??

Bottom line, the Instructor handles med errors, or any other error that occurs during clinicals. Not you. You seem to be pointing fingers, and at the same time forgetting YOU are ALSO a student. NO-ONE needs to be schooled by you. If a fellow student forgets to give a dose of insulin, and you somehow have direct knowledge, report it to your clinical instructor, then DROP IT. It is no longer your problem. People are going to make mistakes because they are students who are still learning. It is up to the clinical instructor how to deal with the problem. When you go to school, the best bet is to look after your own interests and the interests of the patients you are directly giving care to. You are not babysitting your classmates, nor are you responsible for their errors or mistakes. I am SURE the instructors know EXACTLY who made which errors and deal with that on an individual basis, and discuss it with the rest of the group as a learning opportunity. I can't believe your grade is suffering for something you had no part of. As for the Facebook Post, that was not professional and unnecessary. You are lucky that they did not do anything more than talk to you about it. I'm not trying to be mean, and I don't mean to come off so blunt, but other people have tried to explain this in nicer terms, and you argue how you are right and how somehow, everyone posting a response that does not agree with your side of it lacks morals and ethics. Not the case at all. Med errors need to be corrected and dealt with. Making yourself the nosy nelly and tattling to the instructor after reviewing things you were not asked to do or are responsible for makes you look like a pot stirring troublemaker and you will not be popular with your classmates or your instructors should you continue. Take care of YOU. You have four months left, let it go and get through it the best you can.

She wasn't referring to you. Two other posters on page one mentioned sticking toes for blood glucose checks.

I think some of it depends on where you live. I'm in Florida, and they do not hire PAs to work with babies in the nursery, sick or well. We have a Neonatal Nurse Practitioner who sees sick and well babies in the hospital setting. She works with the Neonatologists and always has an MD on backup. Also, Neither PAs nor Nurse practitioners deliver babies here. Only MDs and CNMidwives deliver babies in the hospital setting. Licensed Midwives will do the home births and some birthcenter births. If you are wanting to only see well newborns, it might be a better idea to work in a doctor's office setting. There are plenty of pediatric and family practice nurse practitioner programs, and I am sure they have the same type of specialization in the PA programs (but I will say I know next to nothing about PA school because it has never been an interest of mine.). There was a group of PAs here that would lend themselves out as surgical assists, but only came for C/S deliveries, and they were like a nurse first assist. The doctors eventually stopped using them because it cost too much and they could better utilize the RNs for that role. I think if you were wanting to work in the hospital setting, the NNP role would be a better fit. If you were going to work in the doctor's office, either the FNP, Pediatric NP, or PA would be fine, but since you are already on the Nursing path, it might be easier to go the NP route. Either way, whether you are a NP or a PA, you will be working under the supervision of an MD, so I think you should research the programs, find out which will be more cost effective and less time consuming for you, and go with your best option. Good Luck. :)

That's a good question. I was also not sure it was a PAC since the P waves are absent and the T wave is mostly normal looking. That's why I was suggesting in a previous post that it could also be a PJC. Keep in mind also, it could be difficult to tell if these are PJCs vs PACs due to lead placement. That is why I said this could be diagnosed better by switching chest leads or by a 12 lead. It could be a PAC or a PJC. The OP came back and posted that the first strip was SR with PACs. A PJC can have an upside down P wave, a buried P wave, or no P wave at all, so that is why I was not sure which it was. PJC: Premature Junctional Contractions - Cardiac Rhythm Interpretation Review

In the 1st beat, the PRI is about .14 secs. kinda hard to measure on a computer screen. :) if you measure the PRI in the heartbeats that are not early, they are all about the same, .14 secs. You cannot measure a PRI in the 2nd beat because there is not one. It is a premature contraction. The P wave is probably buried in the T wave. Here is a neat little reference. PACs: Premature Atrial Conctractions - Cardiac Rhythm Interpretation Review

The R to R is irregular ONLY because of the early beats. if you look at the strip where there are no early beats, the rhythm is regular. sinus arrhythmia is a slight variance in rhythm where P, QRS, and T are consistent. You barely notice a sinus arrhythmia, and it can a normal finding. The OPs rhythm strip has a significant irregularity, and since the P, QRS, and T waves are consistent everywhere except in the early beats, there is obviously more going on here than a sinus arrhythmia. PACs: http://cardiac.northbayhealthcarenursing.com/premature-atrial-conctractions.html Sinus Arrhythmia: http://cardiac.northbayhealthcarenursing.com/sinus-dysrhytmia-arrhytmia.html

I agree with many other posters here, strip #1 looks like SR with either PACs or PJCs. Since the rate is about 80, I would lean more towards PACs, but I agree maybe with a 12 lead or switching lead placement, you will be able to tell better whether they are PJCs or PACs. Strip #2 looks like SVT with a sinus arrest, then conversion to NSR. I have seen a sinus arrest this short with adenosine before, but on average, the arrest will last about 3 seconds. Scariest three seconds of your life when you watch it happen, too. LOL

I always thought that things you did as a juvenile were sealed. I would think that if you had committed a crime at 16, it should be gone from your record/not searchable. I would contact an attorney and see what they say. Most will give free phone consultations.

I'm not sure why this is such an issue for people (the praying thing), but if it is, maybe you should bring it up with your manager instead of brooding over it and being uncomfortable. You do not have to practice any religion to sit and be respectful while others pray. Maybe they can change things around and have a "moment of silence" instead of an announced prayer to make everyone feel more comfortable. I have friends who practice many different religions, and I try to be respectful regarding their beliefs, even if I myself do not agree. As far as the comment that a patient is having a difficult time with EOL due to a lack of a belief system, I don't think staff is trying to be insensitive at all. I think they are addressing a concern that is valid, and a spiritual need of a patient (whether it is a Christian, Muslim, Jewish, or Atheist) that needs to be addressed in order for the patient to relax, make peace, and let go. Some people are afraid because NO-ONE knows what happens after we die and when you are faced with your mortality, it is a scary thing. I would hope that someone addressed that need and comforted me in the best way for ME to be at peace; religion aside. If you feel that isn't happening where you are, then you should speak up! Everyone should have their spiritual needs met based on their belief system. If they don't have a faith based religion, they should be counseled, not to change their viewpoint, but to give them peace and help them through the EOL transition.

We do peer evals where I work. They are supposed to affect your merit raise, but I can't say they have because since they started doing them, no-one housewide has gotten a merit raise. LOL Bad economy you know, so only administration gets raises and bonuses. That aside, I think they suck. I have tried to keep in mind that the person whose eval I was filling out may have their raise affected, as well as the peer eval goes in their personnel file, so I was always nice and fair with the negatives (we are required to leave at least one thing that a coworker needs to work on.). I'd leave something like--work more towards accepting more difficult assignments, however, great improvement seen over the last year in this capacity. If I got an eval for someone I never work with, I passed on the eval to someone else who worked with them regularly to be fair. Where I work, we are not allowed to pick the people who evaluate us. The manager selects them and it is always another RN that evaluates us. I have found that my coworkers use these evals as a time to get back at each other. I consistently have a poopy peer eval. I am not sure if it is one person who keeps getting mine, or people think that I am an abhorrent nurse, or a mean hateful person in general, or what. Mine may have some really nice positive statements on it, but then some really negative ones on it as well that far outshine the positive ones. I have said to my manager every year that If I am this big a problem and/or have this many people thinking I am a bad nurse, maybe I should be fired. My manager says she doesn't agree with the assessment on my peer eval at all. I am left to feel that there are an unknown number of people that I work with who are out to get me that smile to my face and croon about how nice I am to work with, yet stab me in the back with nasty peer evals. I have found myself being nasty on evals now if I suspect they may be one of the people who was so hard on me, and have to go rewrite them to be fair. I personally think peer evals do absolutely NOTHING to promote teamwork or to help people improve their performance. I think it promotes a culture of hostility and mistrust between coworkers and they should be done away with. I feel like if you can't say something in the peer eval you are filling out to your coworkers face, you shouldn't be adding it to the eval at all. I also think it is stupid that if a coworker has been doing something that applies to the entire year, instead of addressing it with them and/or the manager, they wait until the annual peer eval to address it. How can someone correct a problem if it is not known until the eval?? Also, why should one isolated event apply to an entire year's worth of work and bring someone's peer eval into a bad place? I have to say as well, when you are in a management type of position and have to make some decisions based on patient flow, needs of staff, and/or request of management, it doesn't make you popular at all and zingers appear on your eval left and right.

Oh thanks!! My son has a severe fireant allergy and our pens will expire at the end of the year, so we will be able to use this. :)

he he--yeah--if you have jiffy store feet--you need a shower. With soap. LOL

I think my favorite was the girl who came by ambulance (no lie) because she was 18 weeks pregnant and her breasts were leaking. The best part was that she had an entourage FOLLOW the ambulance to the hospital. You mean that one of them could not have brought her in since they obviously had a car?? EMS needs to be pulled from an EMERGENCY for colostrum leaking from your breasts?? I also appreciate people who come to L&D and KNOW they are getting a lady partsl exam but have not washed in at least a week. I will NEVER understand that.

My grandmother is in LTC and had to have a straight cath done. It was done clean instead of sterile (per documentation) and that sample grew nothing. 4 days later after the straight cath, she became confused, febrile, and she had a raging UTI that grew out antibiotic resistant bacteria (this was from a second sample as the first never grew anything). She ended up in the hospital for 2 weeks in ICU on BIPAP with urosepsis. Had a PICC put in and was on IV ABX for quite a while due to their "clean straight cath." So yeah--all of them should be done using sterile technique as far as I am concerned. And the policy changed at that facility after my mother and I had a meeting with administration.

Florida = yes to both. Here is what I found on the application for endorsement. *In the last five years, have you been enrolled in, required to enter into, or participated in any drug or alcohol recovery program or impaired practitioner program for treatment of drug or alcohol abuse that occurred within the past five years? *In the last five years, have you been admitted or referred to a hospital, facility or impaired practitioner program for treatment of a diagnosed mental disorder or impairment? *During the last five years, have you been treated for or had a recurrence of a diagnosed mental disorder that has impaired your ability to practice nursing within the past five years? *In the last five years, were you admitted or directed into a program for the treatment of a diagnosed substance-related (alcohol/drug) disorder or, if you were previously in such a program, did you suffer a relapse within the last five years? *During the last five years, have you been treated for or had a recurrence of a diagnosed substance-related (alcohol/drug) disorder that has impaired your ability to practice nursing within the past five years? http://www.doh.state.fl.us/mqa/nursing/ap_endorsement-RN-LPN.pdf

RN.com is pretty cheap and has a lot of maternal child health CBLs. You can pay per course, or get an unlimited membership for like 30 bucks for one year.

Maybe you are allergic to the betadine (iodine allergy) since even smelling it makes you start to sneeze and sniffle, or it could be the latex gloves. A nurse where I work also had trouble with the latex gloves. she was getting hives and bad skin reactions, so they switched her to vinyl gloves, or something similar. She got better, but went to be the baby nurse in a C/S one day, and had an anaphylactic reaction that put her in the ER. The doctor said it was from the latex gloves the docs and surgical techs were using--and that the powder from them got airborn and that is why she had such a problem. Apparently, the ER is the only place we use the latex gloves anymore. She doesn't go to C/S deliveries anymore. So it could be latex, could be the betadine, could be mold in the ceiling, could be a lot of things. I would contact employee health and see if they can help you rule out what it is. And definitely see a doctor. Hope you feel better!!

I had a dad tell me recently that his wife was making so much milk because he had "primed the pump" (and yes, that is how he described it) by sucking her boobs the whole pregnancy. It confused me because I couldn't understand why he thought I might like to know that.

Well goodness, is it the full moon yet where you live, because your attitude is STELLAR!! ? Get a sense of humor. We are only half serious. My comment wasn't meant to rile anyone up or get the evidence based practice police on high alert. Of course I don't have "hard evidence." I don't find it important enough to keep a log, or measure mean, crazy, or stupid. I am well aware it is just my opinion. Yeah, this kind of stuff is why I don't post here often.

In my experience, it hasn't been the amount of patients that was the problem during the full moon, or the degree of sickness. It was the TYPE of patients that came in during the full moon. I always see more mean, crazy, drunk/drug addict, and stupid people during the full moon than at any other time of the month. LOL Agreeing with Esme12--after 17 years working at some capacity in health care, I don't need the statistical data. I have hard evidence every month. LOL