June 23, 2005
Dear Nurse Nancy,
I have a very serious question. I have a resident whose IV infiltrated. The IV was removed, and the tubing and needle were hung over the IV pole for 4 hours. When restarted, a new IV bag and tubing were not used; the needle was replaced and the set up was then used. I feel the whole IV was contaminated, as it had hung there for a time. What do you think?
JL
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Dear JL,
I shudder to think of any practitioner – nurse or physician – who would use that set up which was clearly contaminated. With all of the emphasis on patient safety, and prevention of complications, I see no reason why anyone would do this. This is just plain poor practice and should be reported to someone in authority in your organization.
As patient advocates, we have a responsibility to speak up for our patients when we see something that is clearly wrong. If you have an infection control practitioner, please discuss this with him or her.
Nurse Nancy June 22, 2005
Dear Nurse Nancy,
I was recently looking into some malpractice insurance, but a coworker said that if you get the insurance you are setting yourself up for a lawsuit because they know they can get something. Is the insurance a good idea?
BL
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Dear BL,
First of all, very few nurses get sued. I know there are two schools of thought on malpractice insurance, but I have always kept mine. It is still cheap enough (generally less than $100/year) and provides extra insurance for the registered nurse. While hospitals certainly protect their staff, their might be a circumstance in which they would not defend them.
Nurse Nancy June 21, 2005
Dear Nurse Nancy,
How does one find out from a school what will be their title upon graduation? I would like to get a MSN, not a MS.
MW
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Dear MW,
To find out what degree the school awards, just call the school or ask a graduate of the program. You can get a Masters in Nursing without the MSN credential; it depends on who awards the degree. For example, my masters is an MA, awarded from the School of Education at New York University. It is in nursing, but since the School of Nursing is housed in the School of Education, we are awarded the degree that the School of Education awards.
I think what is important is what you do with the masters once you earn it.
Nurse Nancy June 20, 2005
Dear Nurse Nancy,
I am an RN from the Philippines looking for a tool to measure nursing satisfaction in Asian nurses. Most of the tools I have seen have been validated on American nurses. Can you help?
DB
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Dear DB,
I would go to the experts for this information. The Philippine Nurses Association of America is a large organization, with over 10,000 members. I would contact them, as I imagine one of the officers will know someone who can help you. Their website is pnaa@pnaa.org. Good luck!
Nurse Nancy June 17, 2005
Dear Nurse Nancy,
I have a problem with my new director. I stepped down from a stressful position when I realized that what I was doing was not appreciated. Since then, she has gone out of her way to make me feel insignificant and unneeded. I’m sure she wants me to quit by the treatment she gives me. Others have noticed her behavior but I don’t think they would risk their jobs by speaking up. What should I do?
AO
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Dear AO,
To be appreciated is very rare these days. You have two choices – just do your work and don’t let her let you feel “insignificant and unneeded”. Don’t look to her for positives. Quitting will make her the winner, and do you really want to do that? I don’t think so. Ride the wave, take the high road and just don’t let her get to you. Good luck.
Nurse Nancy June 14, 2005
Dear Nurse Nancy,
I have been terminated from my last three jobs, all in the first few months. I am very discouraged, as I have been working for over 20 years and consider myself a good nurse. How do you recommend I move forward?
MS
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Dear MS,
I think you need to get some honest feedback on why you are being terminated. Perhaps with some distance, you can go back and ask the nurse managers who terminated you. From there you can move forward. If they are honest with you, try to accept the news without being defensive. Thank them for their honesty. In the meantime, keep looking and interviewing; you will find that right job one of these days.
Good luck!
Nurse Nancy June 13, 2005
Dear Nurse Nancy,
Is there any financial help for those of us who want to go back to graduate school to obtain our Master’s Degree? Graduate school is expensive!
TW
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Dear TW,
I agree graduate school is expensive, but I consider it an investment in yourself and your future. There is a website called www.scholarships.com which might give you some ideas – alumni associations and specialty organizations often have scholarship money for nurses, and many times it goes unspent since no one applied for it.
Many hospitals offer tuition reimbursement for their nurses. If possible, find a hospital that supports their staff with tuition reimbursement. That helps a lot. Good luck in graduate school.
Nurse Nancy June 10, 2005
Dear Nurse Nancy,
I am a psychiatric nurse with a BSN and I am interested in going back to graduate school. I am interested in the counseling part of the advanced degree, and I was thinking that a MSW would allow me to do that more than a MSN. What do you think?
AS
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Dear AS,
I think there is value in both, and both are excellent degrees. I am partial to getting the Masters in Nursing, as it builds on your BSN. You will certainly have many opportunities with a MSN, and it certainly will serve you well. Good luck!
Nurse Nancy June 9, 2005
Dear Nurse Nancy,
I am interested in reading more about Florence Nightingale. Can you recommend a good book on her life?
ME
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Dear ME,
I think it is a terrific idea! We all need to help each other, and there are so many people out there who just need a little help to get through. You sound like a kind and giving human being, and I know you will be successful in your endeavors. The best of luck to you! Please tell us how it is going.
Nurse Nancy June 8, 2005
Dear Nurse Nancy,
I am an RN who worked my way upwards from LPN in 1985. I am interested in starting a RN/LPN mentoring program for LPNs who just need some help to achieve the goal of RN. My plan is to enlist RNs both working or retired to offer childcare, eldercare or whatever they can offer to these nurses who desire to become RNs. It is said it takes a village to raise a child. I say it takes all nurses working and helping each other to raise the standards of our profession. What are your thoughts?
DB
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Dear DB,
I think it is a terrific idea! We all need to help each other, and there are so many people out there who just need a little help to get through. You sound like a kind and giving human being, and I know you will be successful in your endeavors. The best of luck to you! Please tell us how it is going.
Nurse Nancy June 7, 2005
Dear Nurse Nancy,
I just finished my BSN and am awaiting taking the NCLEX. I have this feeling that I am still not confident to be in the real world of nursing, and was wondering if I should volunteer first. I just want to be confident to handle the responsibilities of a real nurse. My husband is not happy with this plan, and he wants me to start working. What do you think?
GL
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Dear GL,
I’m with your husband on this one. Just about all new graduates have the same feelings you do. You just need to find a job where the orientation is good, and you will have a competent preceptor who can show you the ropes. You will be amazed at how much you actually do know. You have a good basis. Go and pass that NCLEX and start working. Good luck to you, and welcome to nursing!
Nurse Nancy
June 6, 2005
Dear Nurse Nancy,
My question is in regards to feeding tubes and administration of medications, bolus feedings and water flushes. I have been an RN for 11 years and I was taught to administer meds and solutions via gravity. I notice many nurses put everything in a piston syringe and force it down and move on. I know we are all busy, but I am concerned about the effects of this on patients. Have things changed since I was in nursing school? I thought the piston syringe was for measuring residual checking placement of the tube.
GV
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Dear GV,
Gravity is still the way to go with feeding tubes, you are correct. People who use the piston syringes (I have seen them called Toomey syringes also) are usually giving the patient a large bolus of solution too fast. This can’t feel good to the patient, and often causes problems for the patients, like vomiting. Yes, we are all rushed, but we need to be safe with the patients at all times.
Nurse Nancy June 3, 2005
Dear Nurse Nancy,
I would like to work as an independent case manager. I have 11 years experience as a case manager. I don’t know how to get my own provider number or where to start. Can you help?
LR
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Dear LR,
I would start with the professional organization for case managers; Case Manager Society of America has a lot to offer a seasoned case manager as you. Their website is www.cmsa.org. By networking at their annual meeting, joining committees and becoming active, you can speak to case managers first hand for their ideas. Good luck!
Nurse Nancy June 2, 2005
Dear Nurse Nancy,
Do you know of any support groups that deal with nurses on probation in California? I want to ask the Board of Registered Nurses, but feel uncomfortable.
DK
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Dear DK,
Please know that every Board of Nursing wants to help nurses in recovery, while providing protection to the public. They do this in a confidential manner, and it is generally voluntary on the part of the nurse. I looked on the website of the California Board of Nursing, and found many support groups throughout your state. Go to http://NurseWeek.com, click on Career Resources on the right, then Resources. When you get to the Board of Nursing for California and click on Diversion – there is a whole page of support groups.
The best in your recovery, and I hope you find a successful group. Hang in there!
Nurse Nancy June 1, 2005
Dear Nurse Nancy,
I recently took a position with a reputable company. At the time I was hired, there was no mention of a “quota”. There was not a meeting about this. I was terminated because I did not meet the “quota”, but neither did any other nurse in my position. What do you think of that?
MB
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Dear MB,
I have no idea what the quota is about, but it seems unfair to be held accountable for something when you were not given the information. I do know that in most organizations, you can be terminated in the probationary period, and your employer does not have to tell you why. Doesn’t seem fair, but that is the way it is.
Sounds like a “less-than-wonderful” job anyway. Find something more suited to you. When you are open to opportunity, you never know what you will find. Good luck!
Nurse Nancy
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