versican

We have many patients with lymphedema coming to our wound clinic, but many are not seeing a lymphedema specialist regularly - even when we refer them. Mostly it seems due to few lymphedema specialists in our area, lack of proper diagnoses, or the patients are non-compliant and won't go to lymphedema specialists enough (nor perform the therapy enough). Would it be worth it for a wound clinic nurse to be certified as a lymphedema specialist? Most nurses in our wound clinic are wound/ostomy certified, but I am not. My employer will not pay for certification/training for me to get wound certified. But possibly if lymphedema certification is valuable, I could advocate for that training. I just would like to hear from folks with experience if that is a good move...or is adding a lymphedema specialist to a wound clinic is expanding the scope of a wound clinic too much.

For heavy weeping, have you tried transfer (mepilex transfer) which can last up to a week, covered with abd pad (or diaper)? Secured with roll gauze/tape. Large nylon to hold it-tubigrip for compression over all that. Elevate. The abd pad (or diaper) can be changed daily and prn. Transfer stays in place up to a week.

I am a newer (yet older) nurse. The first year was med-surg days. Understaffed, usually, so 12 hr shifts never ended on time. If I worked consecutive days, it was very rarely the same patients - we float to whatever floor is in most demand. Absolutely hated it. About EVERY day off, we would be called to see if we could come in and cover someone...made me feel guilty to say "no" but I usually did. Second year I got a clinic job -- mostly 8-9 hr days. Love it. Matches my family schedule much better. I'm too out-of-shape for 12 hour shifts...it was too hard on me physically, and I was mentally drained before my shift was over.

I had about a year of med-surg experience and just switched to a wound clinic. There is a lot to learn, and I love it. If you get your BSN, you can get certified as an ostomy nurse and perform cares in a variety of settings. I am thrilled for this opportunity and it's more in line with my interests. I'm happy I found this opportunity as clinic jobs are more challenging to find in my area...I knew med-surg was not for me. And I believe this field is very relevant and beneficial for future interests. However if you are interested in mental health nursing or nicu or ob, this may not be your best move.

I am relatively (self-proclaimed) good at writing. Like someone mentioned, as an introvert I'm much better at the written word than spoken. But nursing school wanted quantity over quality. Once I realized that -- seeing what papers would pass for an "A" -- I saved a ton of time. I usually give 100%, but to get an "A" for writing only took 50% effort. I was so overwhelmed in nursing school (having young children to care for) that I realized true quality writing was unnecessary. I was happy to reduce my time writing papers so I could be a better mom to my kids. I guess I was prioritizing. So, yes, I like writing. But only if it has meaning. And many papers I wrote in nursing school (and there were MANY) seemed like busy work. Quite a poor use of time.

I'd take option #2 in a heartbeat, but guess I'm a granny grad. I'm in med surg and cannot find a clinic job opening...and your option #2 sounds exactly what I would like. I would like to work as a wound/ostomy nurse and that clinic sounds like a good path to start.

My opinion: No, not 2 jobs. You may think "just 2 shifts at one and three shifts at the other", but in reality you'll have mandatory meetings and education requirements at both. You'll be unable to reach your potential at both jobs. Stick with one. Do one well rather than two not-as-well.

I do NSO. It's cheap, especially for new grads. We're in a very litigious environment. My nursing school instructors strongly recommended -- actually insisted -- that we remember to get it. Peace of mind is worth it. Save receipts for tax time -- nursing expenses for memberships, insurance, clothes, shoes, equipment, etc can be tax-deductible. So if you haven't started a folder for tax purposes, start one now.

Forgive yourself sooner than later. The process needs fixed. It was an honest mistake which seems to have no ill-results (and I bet you won't do it again...so make it a learning-moment). Did a physician round? It takes a team to take care of patients -- nurses, aids, doctors, dietary, therapies, pharmacy, housekeeping, volunteers -- so the patient probably had folks coming in. In my job, we get verbal handoff of each patient at bedside, so it's unlikely to miss someone. Whoever has a patient does not leave until they've given verbal handoff of each of their patients. The process of getting your patients may need to be addressed so this doesn't happen again...you did not do it on purpose. If you had bedside reporting for handoffs, this never would have happened. I'm sorry this happened to you, but keep your chin up and see the learning moment -- not just learning moment for you, but for the floor as it needs a process improvement.

I was 38 with 3 kids (ages 6, 8, 9) when I started my BSN. School was a beast, but I slayed it. I did not work while in school, and I had less time for family. Classes/clinicals were mostly during the day when the kids were in school, but I HAD to study and do tons of papers when the kids were at home. I had to give up some house chores -- the kids all do their own laundry now (yes, at those ages they had to learn and help each other) and my hubby had to cook a lot more. It is tough. Perhaps you have a program with flexible class times -- my program was not flexible. Sounds like you're happy right now. Do you have an idea of what specific job you actually want once you get an RN? Can you stay with your current employer since you're happy there? If you are in love with your current job as a CNA, I hope you can feel as fulfilled as an RN. My current job is my first job as a new nurse, and I am overly stressed and not satisfied. But, it's been less than a year so I figure I need to give it more time (med-surg)...though I do always keep my eyes open for a better fit job. Good luck with your decision.

Are you able to go to part time, like a 0.6 FTE (2 12-hrs or 3 8-hrs)? I do (2) 12 hr shifts a week on med/surg. However, I would prefer a clinical position because I would prefer that environment and schedule to med/surg...just they're hiring LPN's and med techs right now, not RN's for the current clinical openings. Holidays and weekends off seem like a dream. I think a clinic would be a great way to get experience if you're considering NP...so it's all valuable.

I got a part time days-only on med/surg. I job searched after graduating and specifically was looking for a days-only shift. I'm in an area where there is a nursing shortage, so that helps find day positions. (I work weekend & holidays too...but days).

Nurse: "Whoops! So sorry I forgot to remove the water from the balloon before removing that Foley!"

As a new RN (BSN grad in Dec 15) who did NOT work as a CNA, I feel I missed out on a lot of experiences. I was required to get my CNA prior to the BSN program, but didn't get a job as a CNA because I have small kids to take care of besides being a full-time BSN student. If you can work as a CNA, that will give you valuable experiences. Some of my fellow classmates did work as CNA's and then got RN jobs on the same floor. Just knowing where the supplies were, the computer system, and the staff was a great benefit for them...so if you have an idea of where you want to be an RN, try to be a CNA there. That's my thoughts -- as someone who didn't get that experience.

...the Zofran didn't work. And I had forgot to leave a emesis bag.