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M/S, Pulmonary, Travel, Homecare, Psych.
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AutumnApple has 12 years experience and specializes in M/S, Pulmonary, Travel, Homecare, Psych..

BSN with a wide variety of patient care experiences. I currently work in psych, which I never thought would end up being my niche. Avid movie watcher and reader who may contribute an article or two..........

AutumnApple's Latest Activity

  1. AutumnApple

    Time to step down from management?

    I've been in management roles three times. First: This position ended because I moved. It would have ended eventually for other reasons not at all unlike the ones that made me step away from management in the future. Lack of autonomy (nurses on the floor think this is a problem.........whoa it gets so much worse in management roles) in decision making, lack of staffing (this place simply refused to admit their short staffing was leading to bad outcomes..........it was always someone else's fault) and a general comfort level with poor outcomes by those above me that turned me off. Second: This was the one I wanted to work. It did not. I stayed in this position much longer than I should have. Same things I mentioned above were the problem: People above me were too comfortable with poor outcomes, facility refusing to staff itself and not being able to make my own decisions on too many things. Third: I'm not one to keep walking into the same wall and expect a different outcome. I was begged to take this position, and it was a temporary position. I did it for nine months, a month longer than I was supposed to. They had trained my replacement before I left. Left on good terms but......... .......everything I mentioned above was going on again, and had I not known it was temporary and going to end..........I'd have ended it. Most admin. in medical facilities like to hire, what I call "lever pullers" into middle management. They want people who pull whatever lever they're told to pull without question or regard for how it affects the patient outcome. They do not want out of the box thinking or anything else. Just pull they lever you're told to pull, and pull it well. And throw a nurse bellow you under the bus when pulling said lever ends up being the wrong decision. For me, medical leadership has too much of a "Can't have it any way but my way, but it's everyone else's fault when my way doesn't work" approach for there to be improvements on the system made. So, knowing this, I don't join the song and dance with them. I'm not much of a lever puller. I have self will and independent thinking and all sorts of other things that just doesn't mesh with that role well.
  2. AutumnApple

    Stupid hurts.

    Red wine enemas are NOT sexy............ And your partner lying on the ground not breathing is NOT a "great high".
  3. AutumnApple

    Nurses that “only do it for the money”

    Ah, the old debate about "for the money vs calling" nurses. I have a problem with this debate as a whole. Actually I have a handful of them. Ok, it's more like a truck load. * Not many nurses actually fall into either category (for the money or for the calling). While we may associate ourselves with one belief system more than the other, the truth is we're all a bit of both. In short, while we may debate one side or the other, we tend to be more alike than different once the talking stops and we have to go to work. In my experience there really are no pure "for the money" or "for the calling" nurses. * The whole debate is obese with assumptions. Biggest one is that the "for the money" crowd is lazy, and the "for the calling" crowd is harder working. This is so not what I've witnessed. In fact, this assumption is the polar opposite of what I have seen. My experience shows me, more often than not, the loud "for the calling" crowd (or at least the ones who claim to be, me.......again, I don't think the two sides actually exist) is just covering up their work performance shortcomings with this "God says it has to be this way" attitude. Another one is that the "for the calling" crowd are less likely to practice critical thinking or that they can't prioritize their day. How about the one that the "for the calling" crowd is more in touch with their people? Heard the one that people "for the money" call off more? I could keep going. None of them are fact based. * I don't know a single volunteer nurse. Not one. Not one that does direct patient care anyway. Sooooooo....................... We are all doing it for money. If you accept a paycheck, you've done it for the money. * How is the argument from either side even slightly valid? Umm...........nursing doesn't make us rich (as many have pointed out). So, how is it "for the money" or not? I don't know what to say. Truth is, I just find a debate about two teams who don't exist and which one is more right a bit on the pointless side. Reminds me of the comic book fights the boys in grade school used to get into. "Who would win, Superman or Mighty Mouse?". And they truly got in fist fights about it.
  4. AutumnApple

    Say it ain't so...........

    Just a for fun topic. We as nurses see a lot of things during our careers. I know I am considered that person at social gatherings who always has a great story to tell that'll get the chatterbox juices flowing for everyone else. Having seen so many things, and seeing people at their worst, can make us jaded though. Yeah. I said it. Jaded. That buzz word used much too often to describe nurses who are fed up with................well, whatever. But there are instances where it is true. So, I want to pick apart a statement I find myself saying to myself (and yes, I of course have heard it stated openly by others too) that might be considered jaded. Or is it? Consider for a moment when that patient appears in the ER once again and you just know they're going to be admitted. Probably to your unit, again. It's their second visit to the hospital this month, and the last time they were an inpatient was no more remarkable than the ten (eleven, twelve, thirteen.............) times before that they were there. The frequent flyer is about to become YOUR patient again. When this happens, often we say: "Oh, they're just bored, coming in for someone to pamper them a bit again." Or we say something to the like of that. In short, we accuse them of just being there for social reasons. They're lonely, bored, poorly adjusted or whatever else and have no idea where else to take their problems. Do you truly think people check into hospitals just for social stimulation? Or are we jaded?
  5. It's all a symptom of the bigger picture in my opinion. Consider for a second: McDonald's. Super giant of the fast food industry. The measuring stick of every other fast food franchise. Yet, how many of us really think what they are selling is good food? It isn't good food. Not on any level. It's overly simplistic, unhealthy, cheaply made, processed and is generally just not that great tasting. Yet somehow, year after year, they thrive and succeed in the business despite being horrible at the service they provide. It makes no sense what so ever. It's like a sports team who never wins drawing the most fans every year. How do they do this? Simple. Their primary purpose is not good food. It's sales, business and profit. Marketing, convenience and a core knowledge of how to make impulse sales keeps them ahead in the industry...........not good food. Hence, the majority of their leadership is business oriented, not culinary. I don't know any chefs who work for McDonald's in any capacity. I'm sure they have plenty of MBS grads in their administration though. (Actually, I'm willing to bet its primarily MBS graduates). The healthcare industry so desperately wants to be McDonald's. But it does not work in our industry. Never will. I've spoken at length about why the "business" and customer service model doesn't suit the healthcare industry. So, we end up with a healthcare industry that is lead mostly (primarily) by business oriented minds and...................... The outcome is very different for us. The flaws in our leadership and the decisions they make are exposed on a daily basis. Anyone at this point in time care to recall the nursing homes who were shutting off hot water on weekends to save money during the recession? That's just one of a million examples of how our administration and the leadership in healthcare drags us down. Hard to soar like an eagle when you're chained to a bunch of turkeys. Speaking of the recession, at that point in time more than any other, a light was shined in the weaknesses of healthcare administration. Everyone was suffering with low census and having trouble making ends meet financially and no one had an answer for it. They couldn't remedy the problem because they only knew business. They didn't know how to solve any of the healthcare delivery problems they were facing. So, ER wait times skyrocketed, return admissions numbers went through the roof, patient satisfaction scores plummeted and their solution was to........... ...............increase the price of flowers in the gift shop to hopefully make up the difference in lost profit. For McDonald's that style of management is fine. Healthcare requires more than that. McDonald's thrives despite it's goal NOT being good food. The healthcare industry can not mimic this approach and succeed when it's focus is anything other than good healthcare delivery. To remedy the issues the former patient talked about in his letter, you need better leadership. Until the healthcare industry stops trying to be like McDonald's, problems like the ones he addressed will continue.
  6. AutumnApple

    Do I have to disclose mental illness

    And now we get to the heart of the matter of why perspective employers ask this question despite it being borderline unethical. If I choose to keep my past private, then have, as you called it, a "mental health crisis" post hire............... More aggressive, penny pinching facilities will use the fact that you did not disclose your history as a means to say: "Very sorry, we can't help you with this issue. Had we known before hand we could have placed some protective measures in place but you kept us in the dark and that is, in our opinion, why things have gotten where they are now." Then comes the questions of whether you believe you are safe to go to work presently and/or if you want to take a leave of absence until things "are safe for you to return to work". And yes, things are very different for you after you need accommodations than they were before. This I know from experience. I've had a handful of people I know whose "past" and mental illness became inconvenient for their employer and most of the time, the end results are not favorable. I also volunteer twice a week at a suicide hotline. It's not uncommon at all for someone in the office (three or four times for me personally) to receive a call from someone in a mental health crisis who is upset because their employer found out about their problem and are reacting poorly to it. Yes, we have a right to our privacy. Yes, the decision to accept said privacy comes with a price. If we choose to keep things to ourselves, the attitude from others tends to be "keep it that way when problems come up too."
  7. AutumnApple

    Do I have to disclose mental illness

    As one who had to seek treatment post rape, I can share my experience with this topic with you: The answer you seek doesn't exist. It's in that proverbial gray area. One person may decide to reveal their history, and have no regrets. The next person who does reveal their history could very well likely end up wishing they hadn't. What I find it all boils down to is: Will not knowing ever become a problem for the facility? If yes, be certain they will point out that you didn't tell them your history after something happens. If no, then no harm in not telling and probably best not to give others a front row seat to the theater of "my life". That rule, in general, applies to life universally, not just with this specific issue. I've never revealed the history I mentioned above to any perspective employer. I never regretted not doing so. BUT the reason it never became a problem is because..........my past never became a problem for them post hire. The little dirty secret about not revealing you past is (whether asking you in the first place was appropriate or not has no weight on this): Once we decide to keep that part of things to ourselves, it's ours and ours alone to manage. If problems arise post hire, it's up to you to handle them without any accommodations from them. I did once, after my incident, find myself slipping back into depression. I had gone into travel nursing and it was great for me in a lot of ways, but not in others. Being so far from home, away from the familiar and comfortable, had more of an effect on me than I suspected. I had not revealed my history to the company I worked for (and yes, they asked specifically, just like your facility did) nor the hospital they placed me in at the time (yes, they asked as well). So.........I was on my own. I had to seek help but at the same time keep things under the radar. That's the reality we accept when we choose not to give perspective employers the whole truth.
  8. Nursing schools are judged by their ability to put the students in a position to pass boards first try. They are not concerned with fixing the nursing shortage. Hence their focus is on only accepting students who further their agenda. Anyone who doesn't match their criteria that decides who will and won't pass first time exactly.......it turned away. To me, that's the issue. Too much separation between the schools and how they're "measured" and reality. For schools to take an active hand in contributing to the communities around them, we first must stop putting them in a position where they have to do so while also complying with ancient "pass or fail" accreditation. I mean, really. How many of us at some point haven't said "The difference between school and reality is too wide a gap."? So why use a such a flawed measuring stick to accredit the schools? Even more so, why let focus on said test be the core value of nursing education? Change that........and in my humble opinion, a lot of other things will naturally fall in place.
  9. AutumnApple

    Are you discerning with your "likes"?

    OMG. What................ever. No, I hadn't noticed it. Ok, I'm just going to stop talking (yes, is totally aware *that* is news likely to get liked).
  10. I read this and didn't comment but, I'm going to say it: I've worked at teaching hospitals a lot, so I understand your frustration. In the student's defense though, I have to say, I think it's the instructor you should be upset with. That's just me though. I see it as, while the instructor had great hindsight about the student's behavior (hindsight is 20/20, but I'll give her that she apologized for the situation after the fact), that's not where their input was needed. Truth is, while on the unit for clinicals, students have to report everything to the instructor. So, the constant reporting to them was not an issue from my point of view. So, we have a student who is questioning all your advice and guidance. They run to the instructor with far reaching attempts to discredit you. Why did the instructor not correct it while it was going on? I say this was not an issue of Y-ports, pain management or potassium. It was a bad attempt at belittling you. The issue was this need to appear superior to you, not the details (some, rather obvious details at that) of the care. The instructor should have seen that after so many attempts were made to find fault with your viewpoints. Just my two cents but it had nothing to do with your age. If the student hadn't been using your age as their rational for their behavior, it would have been that you took too long in report, or you were talking too fast, or you didn't dress professionally, or............or.............or. Point is, he just picked your age to critique because it was the most convenient stick to pick up and beat you with. If it weren't that, they'd have found something else to bad mouth. That student is passive aggressive, as evidenced by the fact that they were gossiping after the fact in the parking lot instead of making their feelings known at the time. If your age bothered them so much, they should have dealt with it and gone to the instructor about it then. Don't be a coward and complain well after the fact. Since they didn't do that, I can only surmise that it didn't really bother them that much. This student is going to continue to be passive aggressive like this until someone calls them out on the floor for it. The instructor should have assigned them an article to write about the difference between passive aggressive and assertive, with being allowed to attend clinicals on hold until said article is written to satisfaction. THEN I'd believe the instructor's apology.
  11. AutumnApple

    PSA: Don't forget to invest!

    Most of my friends would have answered "I'll be working till I die!" on the poll in this thread. What angers me is how they are critical of those who choose to save for retirement. I've heard all the rationalizations: "Don't you get it, they'll take the money anyway. Another stock market crash, another recession, another bank bail out and all your investing is undone." I get it. You want to "live now". So be it. I'm cut from a completely different tree is all. It's not as if they are happy though. Truthfully, their life choices bring them so much chaos and misery. A good example would be with cars. They overspend on a luxury vehicle (one friend got a maxed out Ford truck for her husband who doesn't work lol) while I drive around in a little putt putt gas economy car. I've hardly had to do any repairs to my car, but they have issues with theirs. Problem is, they can't afford the repairs........they are broke making the payments as it is. For me, saving for the future isn't just about retirement. Being disciplined with your finances leads to better decision making overall. There is much to be learned concerning how to limit your budget yet still be happy. Bargain shopping vs. impulse buying, appreciating what you have vs. looking for the next emotional shopping fix, contentment vs. wondering if this will be the month you can't pay all the bills.............. I just don't see any peace of mind in living paycheck to paycheck just so your SUV has more options than your neighbor's.
  12. AutumnApple

    Professionalism in Nursing? Yes, Please!

    Hmph, this is a peeve of mine. I don't talk about it much because my thoughts on it are never popular lol I agree, there is a dress code and it needs to be adhered to. That should go without saying. I'll even "one up" that and say, there are both written and unwritten rules of attire and they all need to be respected. Dress code policies can't cover every variable, and they shouldn't have to. You're smart enough to pass boards, you're bright enough to know what attire will upset the curve. But I don't think this has much to do with "professionalism". It's a question of maturity when we talk about this sort of thing. I guess you could say a professional has to be mature but that's splitting hairs. Why do I feel this way? Simple: Too many get so caught up in the ascetic version of professionalism and never get onto the clinical/performance side of being a professional. Everyone has seen them, they're young, older, male, female................ Those people who have perfect hair, crisp new shoes at all times, uniform ironed well enough to pass a military inspection and they use all the right etiquette in conversation. But that's where they think being a professional nurse ends. In their minds, their job is done, no room for growth (unless a new haircut is needed, or a prettier stethoscope is available for purchase). They can't function at all clinically though. Meds never done properly and they're always behind, patients call bells going off on their assignment all the time and everyone else has to cover for them, orders not taken off the chart or followed through with............... You'd call them a professional nurse? Not me. I don't consider our appearance to be a big part of us being a professional. THAT SHOULD BE A GIVEN! You have not "arrived" just because you wear the scrubs. I call it politeness, or maybe just maturity.
  13. AutumnApple

    The Culture of Nursing

    I have to respectfully disagree. Much is said about the shortcomings of the "Information Age" generation. I agree with some of the criticisms even. I also see things in them that I wish I had at their age. One of these things is their willingness to remove themselves from bad situations. It seems they have the ability to overcome the fear of change that binds older generations. I've also noticed they are able to execute their exit gracefully. My generation seems to relish making it a screenplay drama. These are just my personal observations though. You say: "We must force nurses to stay put and learn and grow rather than allow them to move around". I hear: "We must make our younger nurses submit to unsafe and unhealthy work environments by trumpeting what the healthcare administration tells us to say (that it's for the sake of learning and growth)". The flaw I see in your logic is: Too many healthcare providers leave us in a state of being short staffed and unsupported. There is no learning and growth going on there. Moving on to better horizons is the only option they have if growth and learning is the goal. I admire your gusto, but believe your efforts are aimed at the wrong crowd. For me, instead of expecting the nurses to accommodate poor work environments and "stay put", I think we as a profession would benefit more by being the catalyst for change in the healthcare industry. For starters, doing away with the ridiculous survey scores you mentioned would be a good start. Healthcare and retail are too different to use the same measuring tools for them both. I'm a big proponent of voting with your feet and I believe the new generation of nurses entering the field are using their rights to do so quite nicely. If anyone doesn't like it, they are well within their rights to change things to make staying more enticing.
  14. AutumnApple

    Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!

    I agree with every word. We have known for years that our Healthcare system was too much of a business and not enough of a service. By "we" I mean those who have optimal pt outcomes first in their mind as opposed to profit. But the powers that be continue to let the fire rage out of control because, well, there is too much profit lost if we change course now (in their eyes). All the while, nurses were degraded and pushed away. They knew we'do be the voice of reason that proclaimed we are headed in the wrong direction. They didn't want to hear it so, they discredited us. To undo the damage we've done will take much time and money. I imagine the solution to all of this is complex aND has layers like an onion.
  15. AutumnApple

    Cancer Made Me a Better Nurse

    " I also gave myself a pink mohawk, because when have I ever had a chance to do that?!" Loved that. And I appreciate hearing your story. As a fellow nurse, I feel you have a better understanding of how to express things so we could get a little insight into what the experience was truly like. Best wishes.
  16. AutumnApple

    Throwing the Rubik's Cube at Nurse Burnout

    In my humble opinion, it occurs because nursing is truly challenging on both a professional and personal level. Sure, many career paths are a challenge. Few of us these days are making 'easy money'. But to be a highly effective nurse, we must have our nursing practice in tip top shape at all times, our personal lives together and every other duck in line. Or so it seems anyway. For me, I can say with confidence, that a lot of my 'diva nurse' tendencies, my belief that I had to be 'super duper princess perfect nurse' were born from insecurities. I saw the task that laid ahead of me, was intimidated by it, wasn't sure I could mange it and poor coping developed. It takes a lot of wisdom, intelligence and objectivity to 'prioritize' one's life. Stepping into nursing made me feel like I was put in a 'do or die' situation and that I had to outperform everyone else. It was as if someone turned the difficulty level of this game called life up to 'expert' but I was only a beginner still. I saw no way to survive other than to achieve what I perceived to be 'the highest score'. And this is where we get into the meat of why my peers, not me, are the heroes of this story. You see, they had the answer to how to prioritize things and I didn't. And they didn't hold it against me that I hurt them a little along the way with my lack of having an answer to it. They understood that work should only take up so much of your focus. They understood patient survey scores matter, but not to the point where stepping on toes is suddenly 'alright'. They understood being 'popular' at work and 'in' with management was nice, but not worth the price. So they continued on with their careers and lives while I tripped and stumbled along the way..........which often included being less than 'nice' to them. And when I was done and had learned my lesson, they took things for what they were..........a girl who didn't know better. They understood the Rubik's cube. Their ability to practice balance put them in a better position to not take me personally and to support me when my diva nurse phase was over. I don't know if we truly can teach the lesson of the Rubik's cube. Often, we are driven to such insecurities and poor coping by this profession, we cling to whatever we feel safe with even if a better way presents itself. But, awareness is the first step, hence my article.