So torn between Nursing and Social Work... advice?

[nybsn]

I'm in NYC at a community college, have about 45 credits. Originally, I was intending to do the BSN. I already have a background in EMS and PCA (phlebotomy/ekg) so it seemed like a logical degree choice. Thing is I heard that most schools (like LIU) give med calc tests every semester and you have to get 100, no less, on each one. I don't know how true this is, but this was a major turn off for me. I mean, so if you get a 90 or a 99 then they fail you? Come on now.

So I had switched over to Social work this past Spring, did two intro classes associated with it. I'm comfortable with the curriculum but I keep hearing horror stories about low pay and it's beginning to worry me. My friend's daughter got her BSW 5 years ago and landed a job making $55k. She got her LCSW about 2-3 years after that and is now making close to $75k. Still, everywhere I look online I keep hearing about low pay, the pay sucks, etc. I don't mind the work involved with being a social worker as long as the wage is enough to live on. I mean $60k-$75k is pretty decent, not rich but it will definitely do. I'm making a little over $41,000 right now as a PCA.

Now that I'm having doubts, my next choice was Occupational Therapy at Touro College. However, they only offer a full time curriculum, even their extended study is a full-time course load. The admissions person said most students in the program don't work and very few work part-time but it depends on the person. I don't mind working part time but she made it sound like it was going to be nearly impossible.

And now I'm back to re-considering nursing again. LIU has a part-time track but like I said, med calc tests that require 100 minimum to pass? I'm sorry, but that's terrifying.

Any advice?

[nybsn]

They have to make sure students can do math. As another poster said, math errors can harm or kill real patients, so nurses have to be proficient at math. That said, with practice, you would master the math.

I understand that but doesn't the computer do the math for you most of the time? I have no issue double checking after the computer but if I have to keep relying on my brain plus a calculator I'd probably go crazy. Especially if someone's life is in the balance.

that's another thing in wondering. As a nurse, do you ever get anxious on the job cuz you might make a mistake and kill someone by accident?

[ahosoda]

At my school you also have to get 100% on the med calc test. However, it is the easiest test you will have in nursing school. Let me give you an example of what the absolute HARDEST question on a med calc exam would look like (most are easier than this though):

"Johnny (3 years old) is your patient. Johnny was prescribed 10 mg/kg/dose of acetaminophen. Johnny weighs 35 pounds. You have an oral suspension of 160 mg/5 mL of acetaminophen. How many mLs of acetaminophen will you give Johnny?"

Again, this is about as hard as the med calc questions get, and you get a calculator. It all comes down to a few simple conversion factors (or dimensional analysis, whatever you call it) and nothing more. The hardest part is just to remember to label your answers. I would say do not let this deter you from the nursing field! You are making a mountain out of a molehill. Also I remember there were a lot of people in my class who were also intimidated by the med calc exam, but there were a lot of resources available to those who felt the pressure from these exams. I don't think anyone in the history of my nursing program has been kicked out due to the med calc exam haha.

It sounds to me by your interests that you have a good heart and work well with people. That is what is most important and I commend you for following your passions. I hope you find your calling and I hope this helps!

[blah_blah_blah]

At my nursing school, the first 2 semesters we needed a minimum of 90 on the math test. After that, we needed a 100. However, if you didn't get what you needed, you were given multiple tries. I think up to 5 at my school so they were a little flexible on it. Maybe call the nursing program and ask if you are allowed to retake the math test if you dont pass?

[direw0lf, BSN]

that's another thing in wondering. As a nurse, do you ever get anxious on the job cuz you might make a mistake and kill someone by accident?

I think every student nurse shares this same fear at some point to some degree! In the class I just had, we were given a lot of case studies. One true story stuck with me. A new nurse had worked 2 12 hour night shifts, then came in an extra morning shift. She was supposed to hang a bag for a 16 year old girl in labor of normal saline. But there was another bag (I believe to induce labor) the same color that the nurse hung instead. It was right next to the normal saline bag. The 16 year old girl suffered seizures and died.

I didn't tell you that story to scare you more. I told it because you are completely justified to be concerned about medication errors, and knowing that, you can take all the precautions you can to make sure they don't happen. So I mean while there is this real danger of nursing errors that result in patient deaths, you will learn the tools and things you can do to be safer.

I also want to ask you, are you sure you want to be a nurse, or is the math do you think an excuse to go another path?

[emmy27]

I understand that but doesn't the computer do the math for you most of the time? I have no issue double checking after the computer but if I have to keep relying on my brain plus a calculator I'd probably go crazy. Especially if someone's life is in the balance.

that's another thing in wondering. As a nurse, do you ever get anxious on the job cuz you might make a mistake and kill someone by accident?

Yes, in most situations, you have a medication administration program, a physician, and a pharmacist all involved in the dose calculation, but you still need to be able to do it yourself with confidence and accuracy for a few reasons. First of all, the dose calculation is usually based on an expected concentration that may not be what you have available- for instance, in my hospital, they change stocked concentrations of various meds quite often, but the docs don't know what we have stocked, so they order based on... habit, whatever pops up first in the drop-down menu, whatever. So the calculation given in the computer may be incorrect for the actual concentration of medication I have available, and I need to be able to both recognize that fact and calculate the correct amount for that dose myself. As an example- many of our doctors habitually order "1 mg morphine" as "1 ml of 1mg/ml morphine" because I guess that's the first 1 mg morphine order that pops up on their order entry program. So the computer will tell me to give 1 ml. But we almost never actually have 1mg/ml morphine in our hospital- it's usually 2mg/ml or 5 mg/ml. So if I gave 1 ml of that, I would be giving 2-5x the actual ordered dose.

Even more seriously, you have to have a confident, quick grasp of med math so you have a good sense of when an order is just plain wrong- doctors and pharmacists make mistakes, but if you administer their mistakenly-ordered massive under or overdose, or if the dose is calculated correctly based on the numbers the computer has but someone entered a number wrong in triage (is your patient 20 kg or 200 kg?) you're still liable for that error. Catching it before it gets to the patient is part of your job.

Here's a (slightly terrifying, but very illuminating) story about a situation where just that- an error missed in multiple layers of review in the computer- made it to the patient and caused harm:

https://medium.com/backchannel/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage-ded7b3688558

That's why they have you take a med test every semester and expect a very high grasp. Being right on this stuff 90% of the time isn't good enough. You need to be confident in it. It's not at all complicated, and it's okay to take your time to work it out in the real world, to use a calculator or a crib sheet from your pocket, and to grab another nurse or a pharmacist to check your work (god knows when I'm giving tpa to a stroke patient, not only do I want the pharmacist at the bedside with me, but we each work it out individually first and then cross-check each other and the computer- and if all our answers don't agree, we go get someone else to cross-check everyone) but you *do* need to know how to do it, and well.

So after all that scary stuff, the answer to your second question is: Yes, I think most nurses do get anxious about making mistakes on the job. I know I do. In moderation, that's a good thing, I think- you should be aware that mistakes as a nurse can be serious or even deadly. People who aren't worried about making mistakes in healthcare are scarily overconfident. Let that anxiety be a guide to double-checking your work and seeking advice from your peers and other resources whenever you aren't certain of something. That's how you learn, that's how you avoid mistakes.

The good news is, there's almost always a way to do that- there are so many resources for nurses, from each other to clinical pharmacology references to allied health professionals to policy and procedure manuals for a facility to... it goes on and on. If you're ever not sure what's safe or right, you can ask. You should ask. Good nurses, especially good new nurses, know that it's much better to admit you don't know something than to plunge blindly ahead in to error out of ignorance. Nobody knows everything and absolutely nobody is expert in everything (As a trauma nurse, am I technically signed off on a lot of critical care procedures that I actually do very rarely? Yes, but I'd still grab a unit nurse to show me if I wasn't certain of best practice- I'd rather admit that it's not part of my regular practice than get it wrong out of hubris). And most people in healthcare are pretty good at collaboration and willing to teach what they know. It's very rare, as a hospital nurse, to be in a situation where you don't know what to do and not have any recourse for someone to ask or a place to look it up.

[missnurse792]

AuDDoc,

Not to sound materialistic, but I think money does play a significant role in choosing what we want to do. It's not the ONLY role, but it's an important one I believe. You need financial security, but you also want to make sure whatever you're doing is something you don't mind doing. So it's like you have to look at money and you have to ask yourself if you don't mind the work involved, can you see yourself doing that, do you like anything about it, etc.

I have a feeling I can pass through the BSW and MSW program with flying colors because I have no more science or math classes to do. But I look at the salaries and that's like a huge deal breaker. I mean for a *masters*? Come on.

After reading these replies, I think I'm leaning more towards OT or RN. I agree what you said about OT, it is a great field with excellent pay. No med math tests involved. Only downside is masters degree, but I can look past that. My only concern is how to work around class schedule with my work schedule. I hope a part time work schedule can at LEAST be doable.

RN of course is also fantastic, well respected with great pay, many options, like you said. LIU has a part-time track which can work great for me.

If I go the OT route, I have to take: Abnormal Psych, College Algebra, English Lit, General Biology I and II, plus 16 additional liberal arts credits.

The BSN route: Microbiology, Chemistry 1 and 2, College Algebra, English Lit 1 and 2, History, Philosophy 1 and 2.

Hmm. It seems like I have less pre reqs to take if I go the OT route, BSN might take longer. So maybe I should go for OT. This BSN track is part time but all those damn pre-reqs are overkill IMO.

I graduated from LIU this past May with my BSN. The only time you have to get a 100 on the med math is the last semester . And they give you a few chances to get it . Practicing med math questions definitely helps. And of course you have a mad math course which is actually really helpful . I'm not that great in math either but practice makes perfect .

[nybsn]

I think every student nurse shares this same fear at some point to some degree! In the class I just had, we were given a lot of case studies. One true story stuck with me. A new nurse had worked 2 12 hour night shifts, then came in an extra morning shift. She was supposed to hang a bag for a 16 year old girl in labor of normal saline. But there was another bag (I believe to induce labor) the same color that the nurse hung instead. It was right next to the normal saline bag. The 16 year old girl suffered seizures and died.

I didn't tell you that story to scare you more. I told it because you are completely justified to be concerned about medication errors, and knowing that, you can take all the precautions you can to make sure they don't happen. So I mean while there is this real danger of nursing errors that result in patient deaths, you will learn the tools and things you can do to be safer.

I also want to ask you, are you sure you want to be a nurse, or is the math do you think an excuse to go another path?

Scary story indeed. I have a feeling I'll probably be overcautious during my first year working. I don't know if that will be the case post-nursing school (i.e. learning everything, getting the tools and confidence) but as of right now, I can say that for sure.

As for your question... well, how can you tell exactly? I know I want to build on my career in healthcare. I've been in the field since 2008. I started as an EMT, I liked the job a lot but I just hated the driving aspect. I always preferred teching as opposed to driving. I did that for almost 5 years then I became a EKG/Phleb. tech which I've been doing for 5 years. RN to me seems like the next logical step based on my experience. I like working with patients, I love the RN hours (as opposed to working 5 days like I am now), I love the fact that its a flexible career that is always in demand and you can pretty much take it anywhere. Those things I love. Also, this might sound a little bad, but just about everyone I worked with in EMS and right now in EKG/Phleb is going for RN, so I think that also kinda influenced my interest just a little bit. Plus I have a couple RN friends who encouraged me to do it. Even my wife says I should go for it and she's a CNA.

As for social work, I think what attracted me to that was the fact that theres no intimidating med math involved. No science courses. Theres no risk of accidentally killing someone. But based on other people's testimony (including on here) it sounds pretty undeserving given the work they do vs. how much they make.

[NanikRN]

My dtr is in ot. She had to take a&p 1and 2, microbiology, chemistry, neuro anatomy 0ne and two. As well as all nonscience classes Not an easy pathway---

[direw0lf, BSN]

Scary story indeed. I have a feeling I'll probably be overcautious during my first year working. I don't know if that will be the case post-nursing school (i.e. learning everything, getting the tools and confidence) but as of right now, I can say that for sure.

As for your question... well, how can you tell exactly? I know I want to build on my career in healthcare. I've been in the field since 2008. I started as an EMT, I liked the job a lot but I just hated the driving aspect. I always preferred teching as opposed to driving. I did that for almost 5 years then I became a EKG/Phleb. tech which I've been doing for 5 years. RN to me seems like the next logical step based on my experience. I like working with patients, I love the RN hours (as opposed to working 5 days like I am now), I love the fact that its a flexible career that is always in demand and you can pretty much take it anywhere. Those things I love. Also, this might sound a little bad, but just about everyone I worked with in EMS and right now in EKG/Phleb is going for RN, so I think that also kinda influenced my interest just a little bit. Plus I have a couple RN friends who encouraged me to do it. Even my wife says I should go for it and she's a CNA.

As for social work, I think what attracted me to that was the fact that theres no intimidating med math involved. No science courses. Theres no risk of accidentally killing someone. But based on other people's testimony (including on here) it sounds pretty undeserving given the work they do vs. how much they make.

How do you find out... hm. I don't know. I could be very wrong, because I was basing my thoughts about your decisions on how I would feel and how I would do in your place. I know that if I didn't love and be committed to nursing 100% that I won't make it. There have been stumbling blocks my way already and I've only had 1 nursing class:laugh: I want nursing so bad that no math class would stop me! I was told not to pursue nursing when I first applied by non-nursing advisers. That they're "looking for a certain type of person" and so disappointed I thought about finding another health care field but no my heart is on nursing, I applied at the end of the semester again and got in. They liked me! The other advisers were wrong, they didn't tell me I only didn't get in because I had to take a intro nursing prereq class first.

Well but I'm not already in healthcare like you are. I think becoming an rn will be easier for you with your background and knowing so many RN's so maybe you don't need to have a huge doubtless drive like I think I'll need to get through!

My advice is do what you think you'll love best and you'll find a way with math or anything else. But don't become anything because someone says yes or no!

[nybsn]

Well after some careful thought and consideration, I've decided not to pursue nursing. I love the money but I'm not too.crazy about the responsibility and the science/math backbone which makes up most of the coursework.

Therefore my options left are to Finish my human services associates (Spring 2016) and:

1. Transfer to Occupational therapy assistant. All I need are 3 pre requisites left. I don't mind the work or the money involved.

2. Get my LCSW but get an MPH on top of it. That should help salary wise.... right?

Or I could just forget about social work, do OTA, get a BS in healthcare admin. Then finally an MPH? Maybe become an epidemiologist with that.

I don't mind social work as long as I can make $50-$60k minimum. I saw quite a few job openings.here in nyc paying that for MSW and LCSW. It makes me feel good about pursuing it. But then I go online and hear all.sorts of low pay stressed out horror stories then I start doubting my decision. Plus I'm a male so I don't know if that makes a difference pay wise (I heard males make more?).

[la_chica_suerte85, BSN, RN]

I understand that but doesn't the computer do the math for you most of the time?

[Margotrita]

I have my MSW and will finish my BSN in 3 months. I didn't consider nursing as something I could do because I didn't enjoy math and science when I was 18 and choosing my major a gazillion years ago. I always worked as a medical social worker (brain injury treatment program, first steps program and teaching hospital). I enjoyed the work but it was a TON of work for little pay. After being a stay at home mom for several years I decided to go back for my BSN and do what I love. Working with patients in the medical setting and providing support to their family members. I am leaning toward hospice nursing and start my practicum at an inpatient hospice facility in two weeks.

There are a lot of transferable skills between the 2 careers. Even more so, if you choose medical social work. There is more opportunity to make more $ as a BSN, without having to get your master's degree. In social work, you will need a MSW to really have any type of career advancement and decent pay. I like that nursing has a lot of critical thinking and "tasks." Social work I rarely felt like I could complete a "task." There was always so much more that needed to be done but limited resources with which to help the patient and family. Good luck to you! Either career choice will be fulfilling!