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emmawdhous ~ First of all, kudos to you for your achievements !!! lol ... And thank you for your encouragement. You're right, I bet my kids and their friends,(in their 20's) don't know what "xerox" means. I've been looking into online programs and see that some require current practice. I have not been in practice for ~ 8 years. Though I have kept my lic. current in "active" status. I think I want to finish my BSN, just so I can say I did. I was looking at my transcripts and I can see, through the years, all the "life events" that took place while I was working on my BSN. (before online courses were a thing) They portray both, my ability to juggle life's challenges and adventures while working as an RN, raising kids and pursuing advanced education ... as well as those circumstances causing me to fail in completing some of my goals. It's a double edged sword, it seems. So now, (~25 years down the road) I'm not much interested in bedside practice, but I am interested in Public Health, Research or some kind of professional advocacy. ( I guess that would mean legal course work.) But actually, I think I'd simply like to finish for the sake of finishing. I'm just not sure it's worth the expense, time and effort. I hope I can share your success story regarding keeping fit ! Thank you for sharing.

herring_RN ~ Thank you for sharing those articles. They highlight my point. That being, patient outcomes are directly determined by Nurse / patient ratios. Likewise, patient outcomes, ultimately, determine a hospital's profit margin. Re~admission is more expensive than initial increased RN/patient ratios. Not to mention the legal fees expense often incurred by a hospital regarding complications requiring re~admission. When statistics clearly show relationship between patient outcome and RN/patient ratios, I don't understand how/why administrations get away with compromising patient care/safety. Not to mention the safety and professional accountability of everyone involved.

I agree with others who have said if you're not able to perform at your best, you should call in. As a patient, especially a post~op patient, I would not want my Nurse attending to me if she/he were sick. As an RN receiving assignment on your scheduled shift, I would not want the burden of your coming in sick, taking assignment , then leaving mid shift, causing added burden to the rest of the staff. Likewise, it is easier to cover the shift if staffing issues are known ahead of time. Your administration may require a Dr's note if you call in a number of days in a row. If fever is the criteria for an excused absence, then call in and say you're running a fever. Nothing else needs to be said. Never feel guilty for calling in. But always cover yourself if you do. I was fired for "excessive absence". I had one day over their designated number in a period. Even though I was per~diem, was not guaranteed hours nor did I receive any benefits. They used it to terminate me because I was calling attention to unsafe staffing practices. (But that's another story.)

That there are studies quantifying the cost effectiveness of better patient / RN ratios in measurably "better outcomes" should drive the arguments. And I think they do on the RNs side of it. But maybe what needs to happen is to cut to the purely economic perspective for the CEOs of these "Health Care Industry" leaders. What they respond to is profits. If we can make the statements, based on scientific accounting data analysis, that smaller ratios leads to increased profits, ( That is ... there is an inverse relationship between better ratios and profits ... because better patient outcome, ultimately, costs less ) then maybe the message will be better received and more effectively acted upon. Put it in a simple diagram accompanied with a basic, but pretty graph that accentuates the profit margins and I think we'd see smiling faces across the board room table. ( ok ... please ... forgive my, somewhat non~professional and sarcastic jest in that last sentence. )

I remember being advised to fill out ADO's. I also remember thinking, at that time, how that was going to add to the, already too long it takes to get the charting done for my patients. (In the days before computer charting.) I did fill out ADOs, as much as I thought I could. But it didn't matter. And, unfortunately, what you say is true. For those just starting out in their careers, with much to lose at that stage of the game, I can see how doing so feels too risky. But for those of us, like me, on the other end of that road, it is our voices that should be sounding the alarm and the call. We, most likely, have the time, experience and risk to venture in doing so. Then those who are able to can join in. Like these Nurses in the article I've shared in the post. But those cries for attention on the issue sound no different than when I was first hearing it two decades ago. What we say and how we say it, obviously, needs to change if we truly hope to facilitate any real change. What that is and how that sounds, I'm not sure of.

I probably should have sued my hospital for what they did to me. (I told that story in response on another thread. ) Laws for safe staffing have been passed since that, which I am glad for. Though I'm not seeing that they are having their intended effect. At the time, I was so burned out from having to defend my lic. and the safety of my patients, I was just glad to be out of Nursing. Now, I am beginning to realize what a trauma the whole circumstance and it's consequence for me has been.

Rose_Queen ~ That is exactly what I think too. What is surprising to me, is that nothing has changed, regarding that, since I first went into Nursing ~ 28 years ago. I find that both difficult to believe and discouraging. How can the people of a profession which, simultaneously, devotes itself to and prides itself on the concept of "advocacy and caring" be so, profoundly, ineffectual at doing the same for it's own ? That is astounding to me.

This is a current CNA press release regarding safety standards at an LA hospital. RNs Warn Safety Standards Eroding at Kaiser LA Medical Center | National Nurses United This piece could have been written 20 years ago. Even in light of legislation, (California) H.R. 1821 - Registered Nurse Safe Staffing Act of 2013, (and others before it) these issues continue with, seemingly, little progress made. Why do safe staffing issues continue to plague Nursing practice ?

caliotter3 ~ Thank you for your reply. Yes, unemployment in general is not statistically depicted accurately / authentically. But I am curious, specifically, about experienced RNs as it applies to the Nursing profession. I guess it is just a "sub~set" of the larger picture. But I'd love to see those numbers. When I went into Nursing the "controversy" of the "business of Health Care" was just beginning to be articulated. The advent of the "DRG" was hotly debated among Nurses of "my day". Now, most hospitals are administered by big Corporations. With policy and procedure designed and implemented by administrators who often have no education or experience in health care in general, let alone the Nursing profession. I would think someone in Nursing interested in promoting progress in their profession would want to know what this picture looks like currently. I witnessed the struggle and eventual success of getting ratio standards defined and implemented in the Med / Surg arena of acute care Nursing. (In Ca.) It was certainly a long time in coming. As the landscape of Nursing changes these days, I see an opportunity for Nurses to reassert themselves in defending and promoting the professional standards we, as Nurses, represent and struggle to uphold. I'm curious if anyone else sees it that way. ?

I have been reading post after post, article after article about experienced RNs unable to find Nursing jobs as "re~entry" Nurses. Along with that are the many stories of RNs working in other fields. From retail sales, through housekeeping ... to those who spent the time, energy and money to obtain ~alternative~ education for other professions. When I went into Nursing, ~28 + years ago, it was exactly the opposite. I was one of the youngest students in my class and most everyone else was entering Nursing as a "2nd profession". I have been out of practice for ~ 8 years now, while keeping my Ca. lic current and active continuously throughout that time. I am wondering what the statistics look like for RNs who work in other fields now. From what I've been reading that should be a pretty sobering statistic. And when anyone in Nursing administration tries to suggests there is a "Nursing Shortage", or tries to justify their inability to provide needed staff, such statistics should quiet their argument. In a cursory explore, I did not find statistics that depict the issue of experienced RNs (with or without "active" status) who are either unemployed or working in other fields. I see articles and studies related to New Grads, but not experienced RNs. I am very curious what that "picture" looks like. (For RNs who are "pre~retirement" age.) Does anyone know of any studies done like that ? I think light needs to be focused on the amount of education and experience that lays "in shadow" with regard to the Registered Nurse.

Jules A ~ I know what you mean. I go out to do those things I've always done and find, to my surprise, they are more challenging for some unknown reason ... lol I agree that much of our society buys into the marketed image of who we "should" be rather than finding the courage to be who are authentically are.

NurseGizmo~ I'm curious how you decided on the program you've chosen. There are so many advertised and I'm not sure what criteria, other than accreditation, to look for. Good luck with your program.

hppygr8ful ~ Thank you for your reply. I participated in an RN run open clinic providing a variety of holistic care Nursing therapies. We offered Jin Shin Jyutsu, Therapeutic Touch and guided Meditation. I saw some amazing results for our clients during that time. Including people with long term chronic pain coming off of heavy medications and returning to routine ADLs after having been bedridden for years. I found it difficult to bring those therapies into my Med / Surg practice. For lack of administrative support and time. Though I was able to do so on a very limited level. I did assist in teaching a couple of TT seminars for health care providers with an RN who acted as our Supervisor for a while. Unfortunately, she did not stay with that facility very long. It was all very interesting. Good luck to you in your endeavors.

As a New Grad, Interim Permittee, my first employer asked me to cross a CNA picket line to come to work. They told me they would bring me in the "back door" and that I could sleep there so as not to be seen by the picketing RNs. I politely declined, knowing I needed those experienced RNs "on my side" and as my resource as a new RN. I maintained the job and went to work as soon as the strike was over. I'm glad I didn't cross the line. As a new Nurse, you ~need~ those seasoned RNs to help you and back you up.

I completely agree with RNNPICU. What ever happened to Interim Permittee programs ?

Melissa ~ I hadn't thought of that. Thinking I had to earn the BSN first. Thank you for sharing your thoughts.

Spidey's mom ~ Thank you for sharing your information.

amzyRN ~ I am so sorry to hear the troubles with safe staffing practices at your hospital. My advice is to do what your conscience tells you regarding protecting your patients, staff and self/license. Having said that, let me tell you my story. After which, you may choose to disregard everything I've said. I have been an RN for ~ 28 years. I haven't been practicing for ~ 8, though I've kept my lic. current / active. I was fired from my per~diem job of 12 years with that hospital for "excessive absenteeism". I had one day over the maximum days allowed. Even though they were requested "1st cancel" days. (My mom was ill with Cancer.) And as per~diem, I was not guaranteed hours nor did I receive benefits. That's the "official" story. The story that needs to be told is more complicated and relevant to your post. My hospital had a "lock ~ down" unit, separate from the Med/Surg unit, where inmates from a local prison were admitted for acute medical / surg care. That ~ 8 bed unit was included in the bed count of the, physically, separate med / surg unit. So our med/surg staffing covered the lock down unit as well. Though it was physically a different unit and a long hallway with multiple locked doors away. The general practice was to assign an RN to that unit along with several patients on the med / surg unit. Unless the lock down unit was full and the RN assigned there would be doing primary care, alone, for those inmates. I always had trouble with this because of the physical distance between patients when the assignment included both lock down patients and med / surg patients. But I originally never said anything or acted on it. Since I was one of the most senior / experienced RNs I was often assigned to that unit. And I was often Charge Nurse and so responsible for assigning other RNs to that unit. I made no complaint, until I had several "incidents" directly related to that staffing practice. I had a couple of times where an inmate patient got into trouble while I was attending patients on the med / surg unit. Requiring sending those inmate patients to a higher level of care. After that, I refused to take assignment that included taking patients from both units, simultaneously. Likewise, As charge Nurse, I refused to assign my RNs patients from both units simultaneously. Administration did not like it. I was very clear about my concerns. I told them I had no problem taking assignment on either unit, but to assign patients from two physically different units simultaneously, was unsafe and since I'd already experienced the consequence of that, I would no longer accept or assign patient care that way. It wasn't long after all of this that my supervisors began trying to call me in for conference, without Union representation while doing patient care. Which I also objected to. They even went so far as to float me to ICU and try to call me in for conference and away from my ICU patient without representation. *note* ... I am ~not~ an ICU Nurse. Finally, I went in to take assignment one day and was called into the office and given my termination papers without forewarning. The unit had to scramble to cover my patients and so were short staffed that shift. My Union reps contacted me to encourage me to contest my termination. I did so reluctantly. I was pretty fed up with all of it by this time. But after several "meetings / hearings", my Union rep literally disappeared. And I never heard from them again. That's how I came to leave Nursing so many years ago. Safe staffing practices have been / still are ~the~ number one issue for RNs. It is rather disgusting that that is the case, but it is the reality. And RNs deserve accolades and kudos for working in such difficult "political" environments while displaying the courage it takes to advocate for their patients and colleagues safety. Kudos to you. I hope you're able to successfully work your issues out without suffering the consequences I did for standing up against unsafe staffing practices. What ever you do. Do so with great thought and document ~everything~.

I know I'm late on the response here, but here goes ... I've had my license since 1987. I haven't been working, due to family issues, for the past ~8 years. But I still keep my license current/active. I almost let it go this time due to California's renewal / licensing issues since 2013. But finding and reading this site inspired me to keep it current. Now I am considering enrolling in an RN~BSN course. Or an AALNC course. I figure if I am going to spend money and time keeping my license current I might as well get something out of it beyond CEUs. Who knows, though I'm not interested in going back into acute care clinical Nursing, I may find a position that lets me use all that "new knowledge" ... lol I figure it took too much time, blood, sweat and tears to earn and keep my RN license through the years. At 55 and ~ 20+ years down that road, I'm not ready to let go of it yet.

I think home care Nursing requires a lot of independent, self reliant problem solving that new grads, without clinical experience, have not honed yet. And to be expected to take that kind of assignment "where they needed coverage", sounds like it would be in a "short staffed" situation and so, without much back up or support. Something new grads need and deserve. I agree the ad is poorly worded and represents and agency I would be very leery of working for. I would go one step farther to say the wording is actually insulting to the profession. *my two cents* Tamara

Does anyone have advice on what aspects to look for in a part~time, online program ? I am in California with a CA lic. and not familiar, at all, with online coursework. (Except for online CEU courses) But an online program would be best for me now. Some of them I have looked at say their programs are a mix of online and in person classes. I am near Sonoma State University. And that is where my previous course work was completed. But they only accept full~time students into their RN~BSN program now and I am not able to pursue this full~time.

caroladybelle ~ Kudos to you !!

caliotter3 ~ Thank you.

elkpark~ Thank you, so much, for your story and the encouragement ! I was beginning to think that it wasn't important to me or not worth it. I had trouble renewing my license this passed cycle due to the issues California has been having. I almost let it go. Until I found this site and have been reading various articles. I am reminded that it ~is~ important and valuable. Thank you !!

Wow !! Congratulations on all of your accomplishments. Thank you for sharing your story and link, I will check it out. I guess I should request copies of my old transcripts, if they still have them. Happy ~early~ Birthday !