What has been going on.

Hey All
I have not posted in such a long time, not because I don’t have anything to say it is just because I have not taken the time out to post. I have missed posting. To catch you up on what is going on in my world, first I finished my BSN!!!!! Wow I am so glad to be done with that. I had a wonderful Christmas with my mom here, and my little girl she had a great time opening all of her gifts. So in January the hospital I am working for decided that they were over budget by a great deal and have cut hours, so instead of getting my 36 hours a week I am now getting 32 hours a week. Since my budget is not use to that reduction and I feel very uneasy about the economy right now I have started to pick up as much time in ICU as they will let me have which is about a day a pay period which is enough to cover the time lost. But I was not sure that I would get that time because if there are not any patient in the unit we take call, which is nice but not as much as four hours of pay. So I received an email at work for an LPN instructor at a Tech school close to my house so I thought well hell I could apply it never hurts so I did, they called me in for an interview and the lady said that I they had one more to interview so I thought that there wasn’t a chance for me to get that job but low and behold they call me to teach. I started last Monday I will be teaching on Mondays, for eight hours. So I am treading water with working about 38 hours a week at the hospital 8 hours teaching and three classes toward my master’s degree.
I am excited to be teaching I really enjoyed my first class, since I was kind of hired after the quarter started it is like I am a sub, but I think that if I continue to teach that next quarter will be better I will have some experience, it is OB, and I will start it off.
The master’s program this semester is tough I have research, theory and policy so they are all thinking classes, where I actually have to apply my knowledge instead of just regurgitate what I already know.

GA Board of nursing Licensure by Endorsement

Statement from the Georgia Board of Nursing
“Important Announcement Concerning Statutory Changes to RN Licensure by Endorsement in Georgia

During the 2008 session of the Georgia legislature, a bill was passed that requires all applicants for licensure by endorsement to have graduated from a nursing education program approved by the Georgia Board of Nursing or which meets criteria similar to, and not less stringent, than those established by the Board. This bill went into effect on July 1, 2008 and is codified in O.C.G.A. §43-26-7(c).

The Board takes seriously its duty to protect the public health, safety and welfare and the duty to ensure that nursing curricula should meet stringent, board-approved standards required by the recent changes in the law. Applicants for licensure by endorsement must graduate from schools whose curricula are no less stringent than those standards established by the Board. The Board is not unsympathetic to the plight of the students who have been adversely affected by this new law, but the Board has a duty to uphold the law and is currently doing so.

The Board has established rules that state the requirements for board-approval for nursing education programs. These rules can be found on the web here (See Chapter 410-3, Nursing Education Programs): http://rules.sos.state.ga.us/cgibin/page.cgi?g=GEORGIA_BOARD_OF_NURSING%2FNURSING_EDUCATION_PROGRAMS%2Findex.html&d=1 The Board may waive rules, but only when doing so will not contradict the law. If the Board waived a rule so that applicants whose education did not meet board criteria are issued a license, the Board would be breaking the law and endangering the public’s health, safety and welfare. The Board has a mandated duty to protect the public under O.C.G.A. § 43-26-2, which states, “The purpose of this article is to protect, promote, and preserve the public health, safety, and welfare through legislative regulation and control of registered professional nursing education and practice. This article ensures that any person practicing or offering to practice nursing or using the title registered professional nurse, as defined, within the State of Georgia, shall be licensed as provided in this article.”


As nontraditional student I am acutely aware of the need to have the flexibility in class scheduling. As a nurse I understand that there are a large number of nurses who will be retiring in the next 10 years increasing the nursing shortage. The number of new grads is considerably less that the number of current nurses leaving the profession. The safety of our patients needs to be addressed with either issue lack of nurses or lack of experience in the field. First of all we need to investigate innovative ways to recruit and retain high quality nurses. Second of all we need to protect our profession and the skills require in order to have a safe and effective practicing nurses.
This bill states that in order to apply for a nursing license by endorsement that you had to have graduated from a school with a comparable curriculum to those with in the state of Georgia. This means that schools who do not require clinical hours would have to change the set curriculum to include clinical hours. Currently there are schools that advertise No campus attendance, No waiting list, and Academic Success Guaranteed. I don’t know about you but I had to apply to nursing school, I waited and waited to find out if I got in, they only took so many students, there were qualifications that each student had to meet. Once we got in we were not guaranty academic success, we had to work for our grades, we had to pass test, and we actually had to know the information being taught we did not pay for our grades. As a nursing student I could fail if I did not know how to place a foley using sterile technique, give a medication correctly, or complete a sterile dressing change just to name a few. As a currently practicing RN I have no problem having students follow me, precepting a new grad, or assisting a coworker in a new procedure, but I understand that they have some basic knowledge and have practiced somewhere before they come to me. I am all for nontraditional schools, providing education to student nurses I just feel that there should be some standards for all nursing schools part of that being clinical hours.
Please leave comments on you opionin I want to here from students who have graduated from some of these nontraditional programs tell me why they are just as good as schools who require clinical time. Let me know if you think that student nurses need clinical time.

Travel nursing

As a labor and delivery nurse I was interested to see how many open positions are out there, I really wanted to know how many travel nurse positions there were. I am not looking for a different position at this time; I have read a number of posts about new grads wanting to start out in OB. I think that every new nurse needs to start out on a medical floor; although I did not start out there I started in the ER which is where I worked before I finished school. I think that I am missing a number of skills that a floor nurse has, I would freak out if I had to take care of ten pts for 12 hours. I have no doubt that I could take care of them but I think that I would be there until 9am charting I don’t think that I would have a problem caring for the pts but I think that I would forget how to chart everything. I know that I can prioritize multi task and work efficiently but there is something to be said about floor nurses, I admire them but I don’t think that I could hack it.
I found an interesting web site http://jobs.myspace.com/ I found over thirteen pages of open OB nursing jobs. I could not believe how many open positions there were. I know that there is a nursing shortage and the new grads usually have to have one year experience to travel, but I thought that was a lot for OB. I see a lot of new grads who want to work in OB.
I would like to know more about travel nursing is there anyone who has traveled as an OB nurse?
Is there a company that you would recommend and why?
Are there particular questions that I should ask?
http://jobs.myspace.com/a/ms-jobs/list/q-OB+Nurse/pn-1

Baby Wearing

Ok so Motrin has apologized for this ad at Motrin.com.

So we have all stuck our foot in our mouth and I think that is what they did. If you are a mom who has ever worn you baby in any type of sling, front pack, back pack or wrap then you know how convenient it really is. I was able to get more done when my infant was in her sling than now when she can walk around an make a mess in front of me. So this is not a plug for Motrin by any means but if you have ever had a c-section Ibuprofen is the best home pain reliever.

That a side the true meaning of my post is that Baby wearing is better for mom and baby in my opinion. When my infant was in her sling I knew where she was, she cried less than when she was in her swing. She could hear my heart beat just like when she was in the womb. I could breast feed in the middle of Publix and not many people noticed what I was doing. I say most because a former co-worker saw me and wanted to see the baby and I had to tell her that the baby was eating and so she knew but she said that she could not tell until I said something. So there are a number of slings out there and if you have back problems it is so worth the price to get one because it distributes the weight of your child across both shoulders, keeping your back in line, which is why I like Kozy Carrier. They are supper strong, comfortable to wear and after you use it a couple of times is not hard to put on.
There is a second carrier that I really like for newborns it is ring sling or tube sling, this is the type of sling that I used a lot when I was breast feeding. My little girl slept very well in this type of sling. Since I am a bigger mom it was nice that it was adjustable. I do not think that I could wear a tube sling that did not adjust. I really like Pretty Mamma slings, there are well made and comfortable for mom.
There are a number of different slings out there and if there is one that you really like please leave a comment as to why you like it so well.
Kim

Nursing school Acceptance, Increasing your chances

When I started trying to get into Nursing school I had no idea how to increase my chances in getting in, I thought that is was based just on your GPA, although it is that is not the only thing a school looks at. Most of the students entering ADN programs are nontraditional students, in my particular class there were only two students who had graduated from High school in the last couple of years. So like me some prerequisites required for admission were quite old so think about retaking Anatomy and physiology if you have a B or C it is a good refresher and your GPA will go up. If your worst subject is math think about taking a math class whatever is required for the program you want to get into, because you will have to pass a drug calculations test when you are in pharmacology, although this test was very easy to me, there were some people who failed out of nursing school because of that one test. Nursing school places demands on you and your family that may not be previously thought of, for those of you who are currently working and plan to work while going to school please understand that nursing instructors will tell you not to work while you are attending nursing school, so they go on the premise that you are not working. I was able to work the whole time I was in school although I worked on the weekends Friday and Saturday nights, toward to end of school I was able to increase my hours although my grades fell from A’s and B’s to C’s which was Ok with me because I had a good GPA. If your program requires you to take an entrance exam, we had to take the NLN exam, I bought the book to help me study it did not teach me anything new but it did help me to start thinking about school again and formulas that I might need. The last peace to the puzzle is to have all the information that they requested in On Time. If you feel that you were excluded incorrectly call to make an appointment with your advisor and discuss their criteria and ask ways to improve your chances for next time, this will bring to light your situation for them and they may see something that you did not know about as to why you were not accepted and it will give you an idea of a class to take while you are waiting for the next entrance. If you apply to more than one school and are accepted to both please call your second choice and tell them as soon as you know that you will not be attending so that your slot will be given to another person. If for some reason you have questions about getting into your school ask other students who are currently in the program. If you have general question please leave me a comment, also be aware that these are all suggestions they do not always work but increasing your chances is always worth it, especially if it does not cost you much. Good Luck!

Latching problems things to know before you deliver

I had a patient a couple of weeks ago who had a problem with her infants latch. So I thought since I find this a lot in my practice that I would share some little hints that could make a difference in breast feeding, which could have helped me before I had my first baby.

1. Nothing in the baby’s mouth for the first 6 six weeks but mother’s breast. This helps with nipple confusion, although some people do not believe that an infant can confuse a plastic nipple and mother’s skin. I do not know, but what I will tell you it that practice makes perfect. The more your baby latches on correctly the better, quicker and easier it will be to the point that mom will not have to do anything. My little girl, would latch herself on in the middle of the night whether it was in the right place or not she just wanted to suck.
2. Babies will suck what you give them. If you area mom to be look at your nipples if they stick out all of the time great if they are flat or inverted you might want to talk to your OB about what you can do, find a lactation consultant, La Leche League group in your area. There are nipple shields that can work there is also a product by Phillips Advent Niplette that might be useful. What I used was a breast pump after my baby was born, do not use this before your baby comes or you are 39 weeks because it can bring on labor.
3. Know and understand the feeding policy at the hospital that you plan on delivering at different hospitals have different policies. My current hospital gives infants d5w or Dextros 5% in water (sugar water) then a bottle or breast milk, but if asked the infant can breast feed right after birth if the infant and mother are stable except in the case of c-sections those infants are monitored closely for the first 6 hours of life so the first two to three feedings are determined by the nurse caring for the infant. As a mother who breast fed, I will facilitate breast feeding as soon as mother is back from the OR. If you as the mother want to breast feed ask the nurse to bring your infant to you as soon as you can to nurse.

Biggest hint is to educate yourself about breast feeding before you deliver. Ask friends who have breast fed, your OB, the nursing staff at the hospital you plan to delive, or the La Leche League.

No Sleep for the busy!

Wow! Today was a killer. Up at 6 am to go to class, a test and a paper to turn in, in class from 8:30 to 12:30, the test was not bad I guess because I studied for it most of the weekend until Lena decided to use my note cards to draw on. I turned my paper in and if it was for a grade I would not pass, trust me I did not care about it because hey it was not graded or at least I hope it is not graded. I picked Lena up and to the house for our afternoon nap, to lie down and sleep for a couple of hours how wonderful is that, but alas I could not go to sleep, I tossed and turned fighting the bed. So at five we were up getting ready for work. By 7pm I hit the door running and my first opportunity to sit was around 4am so I am about to fall asleep and it is only Monday.