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May 28, 2004
Dear Nurse Nancy,
I have worked in a pediatric office for the past three
years, and I have just become an RN. I would like to
get into research. How does a nurse function in the
research area, and how can I get into it?
Thank You,
LK
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Dear LK,
Nurses function very independently in the research
area, and are often the most critical part of the team.
They recruit patients, organize visits and data collection,
and are pivotal in patient advocacy. The ones I know
have been experienced nurses, who have taken coursework
in statistics, know computers very well, and are experienced
in both the disease process they are working with, as
well as the clinical skills of phlebotomy.
If you work in an academic medical center, you are
more likely to work with physicians and nurses who do
research, and who are looking for research nurses. Get
some experience, make your wishes known, and network,
network, network!
Nurse Nancy
May 27, 2004
Dear Nurse Nancy,
I've recently started working at a local community
hospital in Florida as a newborn nursery nurse. I wanted
to know if there is a standard regarding admitting older
babies that have been discharged to home into a newborn
nursery.
Thank You,
NS
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Dear NS,
I have looked on both the websites of the Association
of Women’s Health, Obstetric and Neonatal Nurses
(www.awhonn.org) as well as the National Association
of Pediatric Nurse Practitioners (www.napnap.org) and
while they both have excellent position papers, I did
not see anything specific to this topic. I had always
thought that only newborns born outside of the hospital
were admitted to newborn nurseries (called extramural
babies) and they were separated from the “regular”
newborns.
Both of the organizations mentioned have practice councils,
and I would think they could point you to the standard
you are looking for.
Nurse Nancy
May 26, 2004
Dear Nurse Nancy,
I am interested in working on an offshore oil rig
as a nurse (I have my BSN/RN, as well as ACLS and TNCC.).
Can you tell me how one may go about this?
Thank You,
AO
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Dear AO,
Well, if I had an award for the most interesting question
I have ever read, this would be it! While living in
New York City, I don’t have much experience with
oil rigs, I would suggest that you contact the American
Association of Occupational Health Nurses (www.aaohn.org)
who are the nurses who are responsible for the health
and safety for environments such as you describe. They
have an employment opportunities link on their home
page, and you may find something there
You could also see if there is a local or state level
group of AAOHN where you live, and network with colleagues
there. They have a national meeting each year which
also might be a great source of networking. Good luck.
Nurse Nancy
May 25, 2004
Dear Nurse Nancy,
I am a new nursing graduate looking for my first job.
This is my second career and I am not sure about the
differences between résumés for office
jobs vs. nursing jobs. Could you fill me in on what
is important to include in my résumé?
Thank You,
BC
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Dear BC,
Welcome to nursing! You might be surprised at how
many of your colleagues are second career nurses, and
we welcome all of you, as we need you and welcome you
to the profession. I have always enjoyed second career
nurses, as they seem eager to be where they are, and
have worked hard to get there.
By all means, include your previous jobs and experiences
on your résumé. They count. Be concise
in your description, but do let your potential employer
know what you bring to the position. Also list your
clinical experiences as a student, summarizing your
experiences and listing the skills you have mastered
in your nursing program.
Be open to work where you will get a good learning
experience, and I am sure you will find a position you
like. Good luck!
Nurse Nancy
May 24, 2004
Dear Nurse Nancy,
I am an RN who has worked in psych (inpatient and
outpatient ) for 12 years. I am thinking of changing
specialties, but I haven't worked in any other capacity
since I graduated with my RN. Are there any programs
to help nurses transition to another area?
Thanks,
TG
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Dear TG,
You might look into a refresher course, which would
review with you not only the basics of nursing care,
but also the newer technology, documentation, and so
forth. Many community colleges offer these, and I think
you would be welcome. Another option is the orientation
program in the hospital you select; some have separate
programs for new grads, and while you are not a new
grad you could ask to select some of the components
of that which would boost your confidence.
Don’t underestimate your experience, however.
As a strong proponent of transferable skills, I think
you bring those 12 years of experience which many managers
would welcome. Good luck on your new beginning.
Nurse Nancy
May 21, 2004
Dear Nurse Nancy,
I have a friend who has been an RN for longer than
I have. But there's one problem. She smokes marijuana
on a daily basis and has asked me to " give her
some urine" for a drug screen. I have told her
"no" time and time again. She recently did
a drug screen for an employer and was afraid of failing
the
test. She is now worried about being reported to the
state board. Is this true?
CP
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Dear CP,
I think if you have to worry about failing a drug
screen, you need help. Clearly your friend has a problem,
and needs help. Nurses have the trust of the public,
and she is putting her patient's safety in jeopardy
if she is working impaired.
Different states have different reporting relationships
concerning substance abuse. And since nurses are not
exempt from having substance abuse problems,most state
Boards of Nursing have a resource for your friend. Many
have peer
counseling, where recovering nurses can help your friend.
Of course, she is the one who has to go for the help,
but you can assist her in finding out the information.
We have a list of all of the Boards of Nursing on our
site. Go to Education/CE on the homepage, click on Resources,
and then to State
Boards of Nursing.
I hope your friend gets the help she needs.
Nurse Nancy
May 20, 2004
Dear Nurse Nancy,
I am a British-trained RN. I have worked in the United
States for more than 30 years in the OR, licensed in
New York and California. I am thinking of traveling
to Florida and need the website of the governing body
to check out what is needed.
KD
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Dear KD,
Experienced OR nurses are in demand in most places,
so I imagine you will have no problem finding a job
in Florida. We have a list of all of the Boards
of Nursing on the NurseWeek.com site.
This will tell you exactly what you need to get a license
in the state of Florida. Good luck!
Nurse Nancy
May 19, 2004
Dear Nurse Nancy,
I am graduating with a BSN degree in May. Do you see
anything wrong with working at a doctor’s office
for at least a little while? I already have a job at
one and love it there. However, it seems that a lot
of people think that it is a waste of a four-year nursing
education, which has kind of discouraged me. I am 21
years old and just do not feel ready for a hospital
yet. Thank you.
NR
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Dear NR,
Welcome to the profession! While I don’t think
there is anything wrong with working in a doctor’s
office, I would suggest you challenge yourself to begin
your practice in another setting. Where you are now
is comfortable; you will undoubtedly have role changes
that will be difficult there. Not all new grads have
to work in an inpatient area. Given your background,
you might do very well in an ambulatory setting.
I once worked with a wonderful nursing assistant who
became an RN. She wanted to stay on her unit as an RN
and I did not let her, as I felt she also needed to
move from the comfort zone. She left reluctantly to
another unit within our system. A year later, she came
back and thanked me for pushing her, as she was able
to be a new grad and learn so much more without worrying
about what her colleagues thought of her.
You’ve worked hard for that BSN. Please know
that your insecurity is totally understandable, and
your experienced colleagues are here to help you. We
were all new once.
Nurse Nancy
May 17, 2004
Dear Nurse Nancy,
When addressing the shortage, do researchers count
active licenses or do they actually count individuals
who are involved in nursing? By this I refer to the
vast amount of former nurses who left to go into UR,
discharge planning, QI, etc. who are not alleviating
the shortage.
JI
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Dear JI,
While I can't answer the first part of your question,
since there are so many researchers and their methods
may vary from study to study, I would like to comment
on the second part of your question. Implied in your
words is the notion that nurses who work in UR, QI,
etc. are "former" nurses. I would challenge
you to think about these colleagues as nurses who have
transferred their skills to another specialty in nursing.
I don't see
them as leaving nursing at all; I respect and appreciate
their expertise in these areas.
Remember - nursing is a noun as well as a verb.
Nurse Nancy
May 13, 2004
Dear Nurse Nancy,
I have been retired from nursing for four years and
really miss it. Are there any jobs for older nurses
who want to contribute, but do not want to assume a
full load? Thank you for your input.
GG
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Dear GG,
Good for you for wanting to continue your work. I
would suggest that there are many volunteer opportunities
at health fairs, church groups, giving out flu shots,
and so forth. Contact your local health department and
see if they have screenings (BP, glaucoma, cholesterol)
with which you could help.
Also, most hospitals have an active volunteer department
which might have something you can participate in. Blood
donor centers might also have something for you.
Good luck in your search.
Nurse Nancy
May 12, 2004
Dear Nurse Nancy,
I'm currently taking classes at a community college,
preparing for a nursing degree. The next available RN
class starts in the spring of 2006. In the meantime,
I was wondering if I should proceed with LPN classes
(I've already been accepted and classes start this fall)
and work as an LPN while I get through the RN program
at the community college. Or, should I take classes
that transfer for the BSN program at the local university
while waiting for a spot to open up? I'm 42 and really
don't want to drag this along anymore. Any advice is
greatly appreciated.
Thanks,
KT
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Dear KT,
This is a tough question. Along with the nursing shortage,
we are also experiencing a shortage of nursing faculty,
which is likely why you would have to wait until 2006.
I will answer your question by prefacing my answer with
my bias toward the BSN. I went to a diploma school,
and then on to earn my BSN while working. I always side
with the choice of getting the BSN. It just provides
you with so many opportunities.
As for your age – it is just a number, and our
profession has so many second degree people. All those
life lessons and experiences will make you a better
nurse. So relax, study hard, and welcome to the profession!
Nurse Nancy
May 11, 2004
Dear Nurse Nancy,
I am a 2001 grad and have not gone into the job market.
I have a new baby and I am not ready to leave her. My
question to you is the following: Will I still be marketable
if I wait any longer?
Thanks,
RN
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Dear RN,
Relax … the great thing about nursing is that
it is a wonderfully flexible career. You will likely
need to attend a refresher course after your time away,
and these are generally offered at community colleges.
You will have some catching up to do, but if you are
willing to do so, it will all come back. In the meantime,
if you have any free time (not a lot with a new baby,
I know!) keep up to date by reading nursing journals.
That will help you at least know
what is new.
Nurse Nancy
May 10, 2004
Dear Nurse Nancy,
I am an RN who worked as an RN for about 10 years
with HIV and hospice patients, mainly. I also went back
to school and got my master’s in social work (experience
as a clinical therapist). First, I was wondering what
positions in the medical field would or could support
my dual degrees? Secondly, I am interested in returning
to nursing in the capacity of a mental health nurse.
Is it necessary for me to retake refresher courses and
what are my options on this? Any information would be
appreciated.
Thanks,
RG
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Dear RG,
I think you have both the clinical background as well
as the credentials to do several things. As I was reading
your letter, I thought about case management, given
your combined social work and nursing background, home
care, or anything in discharge planning.
As for mental health – any recruiter would love
to have someone with your credentials. My suggestion
to you is to slant your résumé to the
position you are looking for – if it is case management,
I would emphasize your clinical skills, combined with
social work and all the issues related to discharge
planning, home care, and so forth. If it is a mental
health job you are going after, emphasize your clinical
therapist strengths and your ability to work with vulnerable
populations such as HIV patients and hospice patients
and families.
Go for it. I wish you luck; I predict a bright future
for you.
Nurse Nancy
May 7, 2004
Dear Nurse Nancy,
I recently resigned from an outpatient surgery center
which is not following proper disposal procedure from
OSHA. Also, I would like to inform Medicare of improper
care of some of their patients. I am having a terrible
time locating phone numbers to report these things.
Can you help me?
CA
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Dear CA,
Both of these agencies have web sites, and likely
have e-mail addresses for consumers and health care
professionals to write in. I hope you have made your
concerns known (in writing) to the local authorities
before you go right to federal agencies.
If indeed you have data to report, you need a paper
trail of documented events in order to get the attention
of these agencies. But if you have a complaint, you
certainly have a right (and a responsibility) to go
forward.
Nurse Nancy
May 6, 2004
Dear Nurse Nancy,
Sometimes I wonder if there really is a nursing shortage
going on in Florida. I am eager to start my nursing
career, but it seems like no one wants to hire you unless
you have at least one year of experience. I have applied
at several hospitals and I’m still waiting to
get a response from any of them (It's been almost two
months). Do you have any suggestions about what a nurse
with no experience can do to get hired?
Thank you,
TA
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Dear TA,
The shortage is indeed regional. In my area (New York
City), there are many places that not only hire new
graduates, but also advertise for them. You might want
to think of other places of employment outside of the
hospital – long-term care, nursing homes, and
clinics. Some believe you “must” have a
year of med/surg nursing to survive in nursing, but
I have met many nurses who have never worked in a hospital.
Meanwhile, I would suggest you have someone you trust
critique your résumé and review with you
your interviewing skills. Perhaps it is a matter of
how you are selling yourself.
Hang in there. You will find something there, I just
know it. Good luck.
Nurse Nancy
May 5, 2004
Dear Nurse Nancy,
I have been a nurse for 18 years. I started as an
LVN, then got my associate’s degree. I have been
with the same facility for most of these years. My problem
is that at this facility there doesn't seem to be any
reward for longevity. I see ads in the paper for sign-on
bonuses, but nothing for the people who have been here
so long. What is my best approach for bringing this
to the attention of the administration without getting
fired? Many of us are dissatisfied for this reason.
Thanks for your time.
Sincerely,
DC
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Dear DC,
Many nurses feel the same way. Bonus sign-ons only
set up negative feelings from the same nurses who have
been working in the trenches.
I hope you don’t really feel at risk to be fired
for speaking up. I think you should ask for a meeting
with the chief nurse and, in an organized manner, share
your concerns. I imagine he or she would appreciate
hearing from a long-term employee, and perhaps could
help in forming a task force or some group to address
this issue. Do it individually, and I would caution
you to not draw up a petition or letters. The direct
way is professional, mature, and assertive. Be sure
to thank your chief nurse following the meeting, and
be sure to leave the office with a date for follow-up.
Good luck. I think it is well worth a try.
Nurse Nancy
May 4, 2004
Dear Nurse Nancy,
I work on a progressive care unit. Our supervisor
stated to a nurse with whom I work that we should not
need to use assignment sheets when asked a question
regarding a patient. The supervisor believes that we
should have the knowledge at the top of our heads, including
labs, consults, diagnosis, age, everything. My coworker
stated that what she is expecting is impossible when
one may have six new patients and that it is impossible
to have all that information without writing the information
on an assignment sheet. The supervisor says that is
how it was when she worked in ICU. She said she never
had to use cheat sheets. I think there is a difference
in having two patients in ICU and six patients on PCU
plus possibly covering for an LPN and/or being a charge
nurse. I believe this is an unrealistic expectation
on the supervisor’s part. I am interested in your
opinion. Many staff members are highly annoyed by
this idea.
Thank you, BJ
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Dear BJ,
I am with you 150%! The world in which you are working
is quite different from her previous world, with much
less technology. And my guess is she did not work 12-hour
shifts, either. She is living in the past, which is
unfortunate, as her job is to support you and your colleagues,
not chastise you for being conscientious.
Patient safety is what it is all about. When you have
six patients, you really need to write this all down
and be careful. I would just smile and be polite when
she is telling you all this. You know you are doing
the right thing, so just take care of your patients
and do not argue with her. If she has no audience, she
can’t perform!
Good luck.
Nurse Nancy
May 3, 2004
Dear Nurse Nancy,
Can I get a job as a traveling LPN? I can work with
mother/baby and also med-surg.
EF
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Dear EF,
I have gone on several of the traveling websites,
and while they claim to have jobs for LPNs, it seems
to me the need is for critical care/OR and ED RNs. Several
of the sites I looked at had job offers for LPNs, but
not in the traditional sense of traveling.
I think you will have to do some phone calling and
exploring. Traditionally, mother/baby units are well
staffed, so I am not sure that the need is there. You
might be able to find an assignment as a med-surg nurse.
Good luck, Keep looking!
Nurse Nancy
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