BuckeyeNP

It was publicly admitted by the administration that guidelines absolutely had to be changed due to "constraints" and pressures on the health care system due to high rates of infections of health care workers. True, this has been the case in single-payer countries, but then again, those countries haven't had the outrageous rates of infections and deaths that the US has.

This. Early in the pandemic, several politicians were quoted as saying that the elderly in particular should be grateful to give their lives so that their grandchildren would continue to go to school, work, have an economy, etc. (All while said politicians took actions to protect themselves.) Focus on the economy. Value of things was placed over lives. This continues today. We must continue to produce for our late-stage capitalist oligarchy! During the Spanish Flu pandemic, an already existing eugenics movement took on greater prominence socially. Those who were considered "feeble", weak, intellectually or physically disabled, or just chronically ill, regardless of their work or social status, were considered a drag on society. We absolutely have seen this in full swing in the past two years, whether in Congress or on Main Street. We've also sadly seen this in our own hospitals when discussing treatment and withholding or attempting to withhold treatment for quad and paraplegic or otherwise disabled (particularly intellectually disabled) patients with the assumption that their overall quality of life is already poor. Likewise, we've seen it with our own anti-vax, anti-mask colleagues. The CDC, just like the FDA, is not necessarily by its design present to serve the people as it is systems. The primary system it's designed to serve is the country as a whole (and not really individual safety). But predominantly they're present to preserve the economy which is now the de facto ruler of this country. (And with regards to AIDS, the CDC only addressed the HIV/AID crisis due to the constant disruptions by groups like ActUP, which made it almost impossible for the CDC to ignore. (Remember that eventually the entertainment industry became a threat to the economy as they became involved in the AIDS movement...) We live in an ableist society, one that favors money over people. Our medical industrial complex is really no different. We providers, nurses, etc., are cogs in the wheel, happily sacrificed to keep the money rolling in for management elites and investors, and our patients, particularly those most vulnerable, are no different. COVID exposed the existing fault lines in our healthcare, economy, democracy, and even our supply chain. It also showed a lot of us that the disabled and immunocompromised are considered by an awful lot of Americans to be disposable, something the disabled community won't soon forget. I can understand a knee-jerk response to support the CDC, itself a response to anti-vaxxers and anti-maskers who do everything they can to undermine anything positive the CDC does. However, the enemy of my enemy is not necessarily my friend, whether internationally or domestically. We are sacrificing the vulnerable every day to placate corporatists, investors, the plutocracy of this country, in addition to an increasingly frightening far-right fascistic movement. In a country in free-fall, I'll criticize the CDC as far as I see fit. If you're healthy and low risk, you probably don't see the issue. However, as someone at high risk, trying to do my job and serve others, I can quite clearly see how the system and even many of my colleagues see my life as disposable. Our healthcare facilities aren't even enforcing masking! Please tell me again how this isn't willful human sacrifice. If Bin Laden had killed over 800,000 Americans, I kind of think there would have been a more pointed response.

This^^^ this ^^^ and this^^^ Thank you. This should have far more upvotes.

Absolutely. I think this is key. We are learning in real life. Although...I do think the US and other countries dragged on masking even when China was providing them with data showing it was beneficial. And no doubt about it...this administration frequently placed the economy ahead of science in decision-making in this pandemic, and there are government documents demonstrating that. We've made mistakes. But some just seriously don't want honest debate, it's just scapegoating and a lot of gaslighting to peddle conspiracy theories and anti-science propaganda. I think it's okay to criticize the government's handling. It's just not okay to use a political "foe" as a scapegoat to peddle anti-science propaganda. ...Honestly I'm surprised AN allows some of the stuff I have seen on here. Stunning that a "nurse's website" allows posts against masking and vaccines.

I don't even know where to begin. You don't have any interest in research, or nursing, learning, or honest debate. There are no words when someone starts squawking about liberals liberals after the mention of WSJ and The Economist. You simply have no interest in having honest apolitical discussion or debate about NURSING. This isn't a political site. When I'm on the floor, or working in any capacity as a nurse, my politics get left at home. It's about the science and reliable resources for me. And my patients first and foremost. I ask myself, what we have done in nursing school? What is the foundation of my training. Granted, I have a Master's, but any nurse remembers having to do research papers in school, not just at the graduate level. And even then, sometimes even a reliable source may print something questionable...small n, manipulated p... but generally we do the best we can with reliable sources. I'm not pro-choice, or pro-life, or left or right...I'm just a dude working to save my patients and get them healthy. If you feel so passionately about politics, that's fine. This isn't the place for that. If you have more passion for politics than science and nursing, I would honestly say, leave nursing and get a job in politics, or go back to school and study polisci. It's a fun degree. But it doesn't have a place here. Science shouldn't be infiltrated by either political party or left or right politics. Our practice should be guided by EBP, RCTs, and then lower quality studies (cohort, case-control, cross-sectional, etc.)...not random dude's thoughts on a website who agrees with our politics. Show us where you are putting your politics aside and letting the science guide your clincial practice. Are you a nurse?

I have absolutely no problem with people who genuinely have complaints about Fauci. I can remember back in the day, maybe too early for you, when he was part of the Republican (Reagan) administration's official policy of suppressing data and research on HIV and AIDS. Some people want to remember him as the hero of the story, but I remember friends and Stonewall and ActUP actually having to drag him to the table to get anything done. True, he's dedicated to his career and he did take care of patients. BUT, as someone with a friend who died during that time, it burns me how the government, including Fauci, tried to pretend it away. ActUP saved lives. Everything said about the Trump administration and Fauci is true as well: they gave misleading and contradicting information. Some of the information, probably made in desperation because of the administration's dragging on getting PPE, caused the lives of HCWs. That's a fact. The administration sat on their behind and either didn't know how or wouldn't get sufficient PPE for hospitals and HC facilities. The CDC told us we could work with SCARVES! What. A. Mess. That wasn't just Fauci. That's on Trump, the CDC, and just about every segment of the US government. (People need to remember that the next time they think their particular party has their back.) If you'll think back about the mask debacle, which makes me lose my mind when I think about it...it was the US, including the general populace and governmental agencies, that resisted the idea of wearing a mask for protection. Who was literally screaming to get European countries and the US to start masking? CHINA!! Of all places. They tried to get us to listen and everyone balked from Trump to Fauci to Joe Sixpack at the QuickyMart. Don't care why they said not to get a mask or make one...no doubt about it, it cost lives. But here's the thing... I don't see a lot of people, tbh on either political side, talking about what went wrong AND what went right. It's okay to criticize Fauci and the CDC. They let us down. But that doesn't make either always wrong. I can criticize but also recognize what he did do correctly. Some of the issue is not just shoot being resistant to changes in how we do things (Fauci and the rest of us with masking, for example), but acknowledging that those with whom we disagree or have let us down, can also have done things correctly. Trump did almost everything wrong he could do, too much to put in this post...but it was his administration that fast-tracked for us to get a vaccine. Sticking to a political camp and not acknowledging what's outside of your camp is fine for your personal life, but doesn't advance good nursing. But what a lot of us see isn't legitimate critical debate. Fauci is a scapegoat who gets used in peddling anti-vaxx and anti-mask propaganda. And there is n o r o o m in nursing to play political games. There is no room in nursing for conspiracy theories and anti-science gobbledegook when people's lives are at stake and in our hands. There's no room for nurses who won't mask off duty to reduce their risk of infection and absolutely no room for nurses who won't get vaccinated. It's criminal putting your patients at risk for a potentially deadly disease that causes significant morbidity for many patients who survive or even just have minimal symptoms. Anyone who wants to make legitimate complaints and arguments is absolutely welcome if those arguments are in earnest. But what I'm seeing and others are seeing here is just a slap-dash throw out of Fauci's name abruptly followed by conspiracy theories and anti-science and bullcrap "sources" that would flunk people if they used it in a nursing school paper. Real nurses don't have time for that. (And yes, I see the "true Scotsman fallacy" that one could argue with that last statement...but I said what I said. Nursing is a health care profession, not a place for conspiracy theories.)

Actually, no. If you'd read anything about that chart, you would see that this is something that has been researched extensively, as with the studies demonstrating that those getting their news from PBS, for example, were better informed on accurate data. OK nstead, you fast drew your opinion gun whioe my point being, not looking at your argument, but rather your source. If you had used that source in an academic paper, you would've been asked to use another or take the source out. Nursing should be a SCIENCE and data-driven. If we can't identify good sources (like PubMed resources, for example), then how on G-d's Earth are we providing evidenced based care to our patients. Giving opinion is fine, but like in academia, if these are NURSING opinions, which is the PURPOSE of this site, then use confirmed sources. Again, for everyone in the back, this media chart is r e s e a r c h e d and as you see identifies sources that are diametrically opposed, such as The Economist/WSJ and NPR, as accurate and reliable sources. When you make a comment, and source some weird conspiracy site, it lessens your argument. Either you need a better source, or you might want to reconsider your "opinion." I can't believe this needs to be said on a website allegedly devoted to people with advanced degrees in nursing science.

Regardless of what the conversation is... Just as a point of fact...a the daily wire is not a reliable news source.... Just opinion. As much as Fox is or many other similar. Nurses should, regardless of their political affiliation, know how to find reliable news and scientific data/information. https://adfontesmedia.com/static-mbc/?utm_source=HomePage_StaticMBC_Button&utm_medium=OnWebSite_Button# I personally like this chart a lot because it's equal in showing R and L biases. There is still good journalism in the US, even more overseas, but we seem as a society damned determined to submit to confirmation biases.

Good for you. This particularly person has a pretty long history of abusive, right-wing off-topic attack posts that would be better served on another site than one supposedly dedicated to nursing and nurse issues. Also keep in mind that not everyone on here is in fact a nurse since there's nothing in place that actually verifies us as nurses unlike a lot of websites for health professionals. This kind of discourse that allnurses seems to approve of is exactly why I've ghosted the site for years: frequently completely lacking in any professional benefit, with threads devolving into trolling. Which brings me to another point that people are paid to put out garbledygook trolling on other websites so why not here too? In any case, yep...it's not worth the energy engaging anyone who is clearly disingenuous and not here for actual nursing content or discourse. Nor is it worth engaging IRL either... I was minding my own business a few weeks ago, about to pick up some dinner, and some lunatic got into my space, upset I was wearing a mask. To walk into a place that specifically requested masking, in a city that still requires masking. When I refused to engage him, it made him furious. He started getting really abusive and threatening, bullying, whatever. I told him, I am minding my own business and if you don't leave me alone, I'll call the police. Weirdo even tried to follow me home. I let him know, I had no interest in wasting my time with him, and if he didn't leave me alone, the police could deal with him. When it became clear I meant it, and I started to call the police, he buggered off. And that's how we ought to deal with it, offline and online. I've got better things to do with my time.

No one is even remotely buying that. It's not an issue of being on the left or right, but an issue of being a decent human being. When neo-N@zis marched on the Capitol of my state, they literally had shirts staying 6MWNE... Six million was not enough, and flashing their WP sign. Not ones single soul, whether conservative or liberal, was unclear what any of that meant. Don't wizz in my Wheaties and call it Cream of Wheat.

Amen! And amen to SmilingBluEyes. Once again, we get blamed for the results of working in a broken system. It's going to take a long time for a lot of us to trust the systems in place, whether hospitals, hospital administration, the CDC, or really any governmental agency. There was plenty of time since Ebola to have systems in place to make sure nurses were adequately protected. The will simply wasn't there. It has always been cheaper for administrators to buy insufficient amounts of PPE. Admit it...and I was just talking to my mother, also a nurse, about this...how many times BEFORE COVID did your unit either run out of PPE or you'd have to steal from another unit? Our lives are expendable, and then they want to blame us when we realize this and move on to greener pastures. We "burned out." Uh, no. We found someone who'd actually respect us. It's like blaming the victim for being beaten, but then criticizing them when they leave their abuser. All I'll say it this... If anyone wants to know at least partly why we're bleeding nurses... Watch one of the documentaries about COVID. In particular the one where the BBC went to a hospital where the nurses were wearing Glad trash bags. Literally using trash bags like they did in Third World countries in Africa during Ebola. Even then, usually it was only in individual homes and outback areas where they had to resort to trash bags. The interviewer was flabbergasted. As in, they had never seen nurses have to resort to trash bags for PPE. And that's on the hospitals, the CDC, and the state and federal governments. Remember when the governor in Maryland had to buy PPE from overseas and then have the state police race to keep the federal government from confiscating the shipment? This is insanity! But it's even more insane for fellow nurses to promote administrative self-serving business newspeak that does not address the actual problem. Stop blaming nurses for systemic moral distress. We don't need "peer groups" with Nurse Narc-y Narc tattling on other nurses. We just need someone in power to take safety seriously and to pay nurses what they are worth!

Unlikely. Unlike most programs in universities, health care and law programs have clauses that require candidates for programs and taking boards to have "good moral character", etc. Even after a person goes through a program, if their program finds out the person has done something questionable, they can submit that information to the board and the board can consider the person of questionable character and refuse the person admittance to board exams. All professional boards can revoke the license of an individual over this moral clause. Can they be sued? Of course. Does it mean there is actually a case? Usually no. As they say, a lawyer will take your money...that doesn't mean you have a case. It's not whether or not a jury found reasonable doubt to convict. It's the questionable moral character for me. And I'm pretty sure that'd be an issue for most schools. Just because you have the grades (and I feel pretty confident he probably doesn't or he wouldn't have time to play vigilante in another state) doesn't mean a nursing school or other professional program has to admit you.

This was my thought exactly. Honestly, I think the fact that he was photographed in a bar drinking with his mom, underage, while posing with "fans" and throwing white power signs is pretty concerning for anyone wanting to go into nursing. Then again, he wouldn't be the first white supremacist in the profession.

No. Just no. This is an administrative answer to a deeper problem. In a sense, blame nurses for systemic issues. A lot of front line nurses have struggled with stressors from the pandemic, but most were struggling before from moral distress due to systemic issues that minimize the value of nurses and treat nurses like the disposable panties we hand out to the indigent. Will having peer support address the kinds of issues like not getting PPE for nurses? Or telling nurses to work with COVID patients wearing scarves? Or calling the Board on nurses who tried to speak out and accusing them of patient abandonment? Nurses were feeling pressure from uncaring and unsympathetic administrators AND for their respective boards who sided with administrators (all of whom were working safely from home). And even prior to the pandemic, nurses regularly face bullying from bootlickers and older nurses who seem to enjoy running off younger nurses. It's not the job that runs off nurses, nor the stress. Not even seeing large numbers of patients dying. It's the fact that nurses are still treated like bumwipers by hospital administrators, nurse leaders, and a lot of physicians. It's the fact that the CDC and nursing organizations signed off on making sure physicians had proper PPE but nurses had to work with scarves and low quality surgical masks, if anything. Some nurses were told they couldn't wear ANY masks. And when you spoke up, you were told that you needed to leave nursing! That you weren't committed to the job. That you were too "scared" to work in the profession. And that in a nutshell is why I stopped giving the ANA my money for membership...because where the heck where they when all this was going on? Working from home, not saying a darned thing. But this kind of bullying was commonplace even before the pandemic. Speak out, and get told you need to leave the profession. That you aren't cut out for it. Go against the grain, even if you're 100% right, and you'll get bullied right out of your job and maybe the profession. In a for-profit health care system, nurses are still treated like housekeeping. And sorry not sorry what I have seen from these peer groups has just been more bullying. Peers who didn't like what another nurse said would go to administration and report back, frequently getting that person fired. Or peer to peer bullying to try to shut down the other nurse's (usually legitimate) complaints. In a broken system that devalues nurses and their lives, what's the point of a peer system if not to stomp down the tallest poppies? Or the most vocal? If we're really serious about stemming the loss in nursing we'd demand the systemic changes needed to make nursing a better profession to be in. A lot of nurses got run off when they were told they had to work in unsafe conditions during the pandemic, the exact same reason PRIOR to the pandemic why many nurses left the profession. If you could make more money in a profession that valued your safety, wouldn't you leave? If your employer was telling you to unnecessarily risk your life or leave? How stupid to demand nurses work without ANY PPE in many cases early on in the pandemic! And that's not even talking about the issue of nurse safety and the regular occurrence of hospitals looking the other way when nurses are assaulted on the job by patients, family, even sometimes other staff! That was bullying plain and simple, by nurses too ignorant to understand the complexity and seriousness of not coming up with some sort of solution for the need for some sort of protection. Nurses died in this pandemic from not having PPE. But at least the administration was safe, amiright?! Stop putting on Band-Aids and handing out "solutions" coming straight from administrators. As long as nurses face safety issues and moral distress that are the direct result of systemic problems, we'll continue to hemorrhage nurses from the profession. You say that having a "peer" system in place is evidence-based and proven to stem the tide of nurses leaving. I'll push back on that and then some. Is it EBP, or manipulated data? Because we've had peer systems in place for over thirty years now and yet nurses are still leaving. Hospitals and administrators, government agencies, and a lot of nursing organizations don't want to hear this, but it's moral distress that's the problem. And while a lot of those in power want to claim it's moral distress related to day-to-day issues that arise in nursing, let's be honest...it's moral distress issues that result directly from hospitals and a system that values profit over people. And that kind of moral distress can only be resolved by those in power, not other nurse "peers." We have to start getting honest and serious if we want to really solve the problem, and unfortunately, the problem requires a major structural overhaul of nursing and our health care system.

Do yourself a HUGE, HUGE favor... forget about obsessing over a "residency" or "fellowship" for NPs. They largely don't exist, and many, many of them are questionable at best. Many of them are also focused on specialty care. Unless you are going to do a fellowship with a very big name (think Mayo Clinic or Mass Gen or Sloan Kettering, for example), there really is little value in many of the so-called fellowships for NPs. If you are interested in a specialty such as oncology, a good fellowship may be of some value. However, whether in a specialty or generalist "fellowship", you have no guarantee whatsoever that you will actually be in a learning, fostering environment. Many NPs and PAs in "fellowships" find themselves in situations in which they are learning very little, or learning too specialized a field, particularly as a new grad. You may even find yourself in a situation in which you are taken advantage of...cheap labor, with unrealistic expectations, all with the moniker of being a "fellow," meaning you'll take lower pay than your colleagues in non-fellowship positions. And, unfortunately, I have met and worked with some NPs who've been through specialized fellowships, and was less than impressed with their overall knowledge base outside of the very limited world in which they worked. As NPs, we just don't get enough education to jump right into a specialty, unless you don't particularly care if you have a solid medical/nursing foundation (like what to Rx for specific infections or how to start antihypertensives, etc., while waiting to ship the patient to yet another specialist... not to mention, knowing when emergent care is needed... those can be difficult calls to make your first year in practice.) The best advice that I can give, from my experience and those I've known and met, is to find a position with a good collaborating physician, and request working directly with that physician for x number of hours (you can decide how much you think you need). (In Ohio, we have a minimum of 500 hours required working directly with a physician.) Even if you live in a state without the requirement of a collaborative agreement and/or "externship" hours, consider your first job as a learning experience or residency of a sort, regardless of the position or environment or specialty. As a new NP, you need a great mentor. Make sure you have clear expectations as to the physician's support to be provided to you, number of direct supervision hours, etc., and make darn sure you trust and respect his or her expertise and judgement. Knowing the reputation of the provider is important as well. Another key to success in the first year is using your resources constantly and consistently while working, read voraciously, and give some of your income back into professional organizations and continuing education. I highly recommend AANP and AAFP (the journal only, as an "allied health professional"), and any specialty organizations as you wish. A final word of advice is to think more generally for your first job, depending on your certification. As an FNP or ANP (outpatient), regardless of whether you want to eventually work in specialty, having the experience of working a generalist or family practice/internist position is highly useful. I treat extraordinarily sick patients in an outpatient setting, and regardless of whether or not I go into a specialty later, knowing how to manage uncontrolled hypertension/DMT2/med noncompliance/mental health disorders/etc. is extremely useful. For example, if you want to go into oncology, having experience managing CKD and ESRD patients is quite useful. And, if you want to go into acute care as an NP, having the work experience as an RN is, IMHO, absolutely necessary. Don't obsess (like I did as I was finishing my program) over trying to find a fellowship. You're just looking for a title, without a guarantee of a true learning experience. Focus on the job, collaboration, and benefits, as well as intellectual/emotional investment into yourself, and you will be fine! Experience is experience, and very few employers care whether or not, as an NP, you had a "fellowship" or "internship." Get a great job with lots of support for a new grad, and make your own fellowship. =) Good luck!