ali9771
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I live and work in a large 55+ community that has its own hospital and health care system. The median age of the patients I serve is about 80 years old. My oldest (and remarkably independent ) patient was 113. We have hospice case workers circulating every day. As a med/tele nurse, I often discussed long term hospice care for patients with life altering conditions. I was unique in this respect. Now, as an ICU nurse, I make hospice referrals often, but usually for short term planning. Most times, the family is welcoming to the idea. Sometimes, families grapple with the feelings of guilt for "giving up". On some occasions, families feel like we are pushing too hard, that hospices kills, that we are just in it for the money.....I often seek to clarify. For the poster who complained about poor service and feeling left alone and unsupported...there IS a very valid issue with patients who do not have imminent death, but still require care and wish it to be at home. I have witnessed this more than once. Many families are not qualified to provide adequate care (although I have never heard of poor med management). In our community, often there are no younger family members locally, and spouses are fragile themselves. Hospice case workers work hard to provide help, crisis care, respite, etc....but often, these patients should be in long term care facility, despite their wishes to be home (defeating the premise of honoring patient wishes). Finances are very often an issue for end of life care, despite hospice insurance coverage. Hospice houses and all who staff them are invaluable resources....we need more long term options.
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if I had a dollar for every time I heard "yes, we have advanced directives, but I am not ready to lose them"......I have only been an ICU nurse for five months. I tell every patient - makes sure your POA is someone who is strong enough to honor your wishes when you lose your voice and sometimes, that is not your spouse or child.
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HRSA recipient here too.....they were not helpful with approved sites....ends up both my sites were approved....I think they make it harder than it has to be. I am done and paid off two years ago.
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no harm in answering "I have yet to encounter that during my clinicals, so I would rely on my preceptor to help me apply my current knowledge and use it to handle the situation appropriately (or charge nurse, or unit manager, or coworkers)". If you have experience in clinicals, use that...even if it is only from an observation standpoint...and it is ok to say you would not do xyz based on observations and knowing the outcome wasn't appropriate....they don't expect you to know all this going into a new job....only that you know where to go to get help when you don't know the answer!!!!
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ok....I lurk here often....finally created profile because I had your scholarship. I didn't read what everyone else wrote....so pardon me if I repeat... First off.....take a DEEP breath. I realize they got a little more rigid since I had mine....but there is STILL flexibility here. There are ways you can be taking NCLEX a month after you graduate. Many of my classmates had seats 30 days after graduation. I was lazy...I went on vacation first. I took NCLEX in July. THEN I started looking for jobs. Congrats for being proactive. I wasn't....and it hurt me SOME. First, look for, and apply to residency programs....sometimes that is all you can get...tho I realize they aren't considered for the repayment last I checked. Next, look at university/teaching hospitals. I was hired at an out of state hospital, sight unseen, after an interview that I did over the phone, while in my pajamas. I actually had flown down, interviewed on other units and didn't get the job....went home, kept applying....and got hired over the phone. Next, part time work counts.....apply for pool or prn, and during interview, ask how many hours you can expect to work and how long before you can go full time. Lastly....DO NOT PANIC. This scholarship is not meant to hang us....it is meant to help us. Initially they screwed up with the tax crap....it hurt....not sure if they worked the bugs out....but once graduated, it was NOT hard to honor my commitment. Look through your options, contact your liaison and find out if they qualify. Most are NOT listed on the website. I worked both not for profit and for profit. I changed jobs after 18 months (I think they told us that was a huge NO NO....but I did it with no issues other than getting my new employer to respond to their paperwork to confirm). This is not as hard as it seems to be.......you graduated top of your class....that speaks for something....you will come out on top of this as well. do NOT panic. Also - willingness to relocate is helpful. I moved from Canadian border area to Florida....but that was already an option in my head. Hopefully your significant other will support you to do whatever it takes to fulfill your commitment. I was part of a FB page for recipients too......look for us. They were helpful. For others - this "scholarship" is gov't scholarship plus stipend that requires us to work in high needs area for two years, with some rigid time frames for honoring that commitment. it is a generous help.....that seems poorly executed at times....as is most things government related. it isn't a loan....but there are consequences if we don't honor our commitment. edited to add - this is a VERY prestigious scholarship....you obviously wowwed a large group of people who had many thousands of applications and very few awards....I know I applied when in it's first years....the first year they had less than 1k applicants or something....the year I applied, year two, they had 4K and only 300 or so awards. you have what it takes....remember that. Internships do NOT qualify towards commitment, but they don't last forever....and they will postpone your start date of your commitment if this is all you can get.