THE CON of BEING AN RN

sorry, in ca that was nurses not having more than 5 patients.......

deborah in Columbia, South Carolina said: unfortunately the lpn has difficulty with these options. seems fairly dead end to me. in inquiering into travel and various positions, i am finding mostly only long term care opportunities for lpn's. some private duty. i have alot of experience and extra training, but am not deemed as a sutible candidate for these other jobs posted. even doctor's offices seem to prefer rn's unless you have had at least one year of prior office experience.
i am disillusioned with the lpn thing and have been at it for over 20 years. not much room for growth in the end. and i wouldn't recommend it for anyone interested in nursing. you just have to be an rn to survive in the long run. i even got accepted for a travel assignment....with the same pay as my local location offers, and the recruiter slipped up when i asked about per dieum saying, oh, we only offer that to nurses.......can i say 'huh' or 'duh'?

I wish that you would list all those areas and the pay, the experience required, how many NURSE spots they have. I am really tired of hearing about how many opportunities there are. How about REAL facts. How much do you know about this statement?

"Schools, state/govt, health offices, clinics, spas, radiology offices, home health agencies, hospitals, long term care facilities, rehab clinics/hospitals all need nurses"

Schools - need HOW MANY nurses? Do you know the pay? It's a cut.
Health offices - less needs and less pay
clinics - less needs and less pay
spas? Tell me more......less need? less pay?
radiology - less needs - pay variable based on where
home health - don't count this as one of the so many options
hospitals - SUCK
long term care - less pay - more patients
rehab - harder work - harder on your body - they have less funding so what do you think that means.

None of these appeal to be so exciting as so many opportunities. These are NOTHING.

Do you really KNOW much about this topic? That there are so many opportunities? None of these would actually satisfy and nurse that is tired of patient care in a hospital. That is like blowing a puff of smoke up people's butts here.

and that just goes for rn's. what about the REAL opportunities as mentioned for lpn's....enlighten me!!!!!!

JB in Jackson, Michigan said: People act like there are so many options in nursing....there is more reality to that.
1) Most often times you need experience and you don't have it
2) It might require a bachelors or masters that you don't have
4) They don't have as many openings as a hospital does so those opportunities are limited
5) There might be a TREMENDOUS pay cut

Well, the thing is you might have to go back to school to get an advanced degree such as a Masters and so on if you want to advance into other areas. Yeah, you are very LIMITED if you aren't willing to actually go back to school to get a degree. That is with any profession, they are looking for a Bachelor's degree. Also, you have to decide what's important to you. If you want to spend more time with your family and want to have regular hours such as an 8-5 p.m., you might have to consider taking a pay cut. Some people value their TIME more than MONEY. So if you are getting tired of working at a hospital with crazy hours, you might have to take a pay cut to work at a clinic. I see Candace's point. What sense does it make to gripe and complain and stay where you are? There are too many areas an RN can go into. You might have to make the effort to go back to school for another degree, but you should want to do that anyway. There's nothing wrong with furthering your education. I already have a Bachelor's degree in another field, but I want to receive the BSN and eventually the MSN. People would probably wonder why I would want two Bachelor’s degrees, but I recognize in order to move up and advance in nursing that I might need the BSN. Get all the education you can! Even if you have children, it is still no problem to go back to school. They are making it very convenient for people to obtain advanced degrees. There are so many online programs, so really no one has an excuse to not have a degree.

deborah in Columbia, South Carolina said: and that just goes for rn's. what about the REAL opportunities as mentioned for lpn's....enlighten me!!!!!!

Deborah, go on and do the LPN to RN upgrade. They have that program online also. Don't limit yourself because I'm sure you are smart enough to handle a RN's responsibilities. So go on and get the RN credentials behind your name! :-)

LPN: One, long term acute care uses them and some of them aren't that bad.

Definitely, become an RN - don't short change yourself your skills.

Well, home care counts for me. I have vented and non-vented patients. I have trached and non trached patients. There are visits and up to 12 hour shifts. There is full time and part time shifts. I have worked this home care position for 4 years as an LPN and an RN for a franchise called Interim Healthcare. There is not near enough staff to cover the need in Lincoln or Omaha. Before home care, I worked in Blood Collections (as an LPN) for the American Red Cross. We collected (much needed) blood regionally and the benefits were awesome, as was the pay. My first job was in LTC and was the best paying facility in town. The rehab hospital I currently work for pays better than any of the other hospitals in Lincoln, and some Omaha facilities. We employ LPNs and RNs and the work is doable, as previously stated. Of course some jobs pay less than others, clearly the work is not as strenuous. And the demand is much less (holidays off, non-school days off, group benefits of a school system.)

I KNOW my experience. I think nursing is one of the most beautiful and satisfing careers. I am fine with being the target of the angst above. My successes in the field speak volumes. I only have a problem with words being put into my mouth, as is beginning to occur. Winston Churchill said "You have enemies? Good! It means you have stood for something sometime in your life." Nursing is my passion. I realize for some, it is a job. Their perception is not mine and vice versa. The purpose of a forum is to share ideas and not resort to nit-picking-the very thing that has been quoted, several times above, as a reason to not pursue nursing...Are we not doing the same here? Just because a person does not share your opinion, does not mean they "KNOW" any less than you do, Miss Bach. The way which we conduct ourselves, beit online, is indicitive of our character. Any intelligent person, providing they have the ability to read/reason/be objective, is well aware of the fact that you and I are not the only nurses in the free world. And thank God it is a free world, where each is entitled to his own opinion. Good day. And as always, if anyone would like assistance/advice, I am always willing to assist, or point you in the direction of many other fine people we call nurses who would be more than happy to welcome you aboard.

What an interesting forum!! I just started a new job in the emergency department. 95% of my time here has been wonderful. It is indeed stressful, but the staff have been nothing short of amazing. It is overwhelming, and some days you do more sinking then swimming, but it somehow comes together at the end of your shift. Being a male in a female dominated work place has been challenging, but it really doesn't cross my mind while working. There is quite a bit of cattiness and backstabbing that I've barred witness too, and it often makes you wonder what people say about you behind your back. Stick to your guns, show up everyday ready to learn, ask questions, and keep smiling. Thats the advice I would give from my limited experience in nursing.

Candice, you said a mouthful. The truth is that any one pursuing this career and asking about it has the right to know BOTH sides. It is not right to powder puff what this job is like and recruit people into it. That is no better than lying managers and nurse recruiters that pull people in based on lies and then those people are very unhappy about being lied to. Just because YOU are in love with nursing doesn't mean that nursing is a loving career. It doesn't mean that anyone asking about the field will love it just because you do. You are entitled to your opinions just as I and any one else are. But there is more than just your description of nursing and what you say about it can be VERY misleading to people who want to know the pros and CONS. The beginning question of this whole forum asked about the CONS. That is what I answered. I don't believe in the unsafe ratios and I don't believe in lying to people about this career. When people describe nursing the way you do, it is VERY misleading to others. That is NOT what everyone gets out of this career choice. Just because I don't AGREE with you doesn't mean that you have the right to degrade me and say that I am NOT a nurse. I have morals and values and the way nursing is now doesn't fit my morals and values. I have a right to feel that I have been ripped off by learning to do a job that hospitals have interfered with. It isn't always the case that we can HELP people. We are lucky to get our work done and keep them safe and alive.

Again, the beginning question of this topic was asking for CONS. Blowing a puff of smoke up peoples' butts with your version of nursing isn't going to help the problem. It will deceive more people into this field that will have wasted time and money and not be happy. There are hundreds of thousands of licensed inactive nurses that will not step foot back in this field. I'm sure if you asked them, many of them would have the same to say as I have and...

they probably wish they knew the realities of what it was going to actually be like before they wasted their time and money. It isn't for everyone. It is only fair to tell people what the job REALLY looks like on the inside and not kid everyone into thinking it is so beautiful and enlightening and rewarding. You have NO idea how that person asking about the CONS is going to feel about a choice into nursing. If they are asking for CONS, they might have doubts and I would rather see them NOT waste time and money on something that they will regret. I tell it like it is. Recruiting is misleading and unfair to those people. If they can get the picture of what it can really be like and still decide that this is what they HAVE to do with their lives, then they are better off. Not everyone goes into nursing loving it and feeling the way you do. Sometimes what you do for your patients isn't enough to be abused the way we are abused. There is a self care issue when it comes to being a nurse. Intense stress, physical demands, inability to do the things for ourselves that we teach to promote healt, those are very important things to know. When these people get recruited, they will remember what I said and what you said. Odds are they will see what I said to be true and not all of them will feel the way you do.

Again.....the question for this topic was CONS.

And.....I'm tired of seeing people tell others that there are so many choices but no one has ever spelled them out. Again, people have a right to know the truth. You would make a good recruiter, but "enemies" - you will have many people that will not be happy with your misleading stories. It is your right to do what you do. It is my right to do what I do. I am still a nurse and your sarcasm there doesn't take that away from me. I tested you in my post and once again I question which co-worker you are.

Let me add......I didn't test you intentionally. I can see it tested you and you don't respect my opinions or comments and felt the need to fight me because I tell it like it is about nursing or push for an answer about ALL these opportunities.

Interesting replies... waiting for Candice's response. LOL ( Just kidding!)

lol ;)

From Interim Healthcare website:

The Largest Healthcare Occupation
Registered nurses constitute the largest healthcare occupation, employing over 2.4 million nurses. Employment for nurses is expected to increase 27% or more, a much higher rate than all other occupations. With all the hiring activity right now, be sure to keep an eye out for your next great career move.

Patients Give Nurses High Marks
In a recent poll by The Henry J. Kaiser Family Foundation, 84% of health care consumers said that nurses are doing a good job of meeting their needs. Nurses are perceived as doing a better job than doctors at meeting patient needs.

Employment outlook has ALWAYS been good for nursing. Especially considering the number of nurses that leave or are pushed out.

Also, don't forget that many people choose this career because of that statement and then find themselves unhappy with their choice because of the conditions.

Last, the Henry J. Kaiser Family Foundation isn't the ONLY survey out there. What about the surveys that CAUSED hospitals to chart hourly rounding? The survey about falls? The survey about medical errors? They are out there too. Their are hundreds of thousands of licensed inactive nurses that are not working in the field and they are not of retirement or child bearing age.

That - again - is only two pieces of information that does NOT paint the picture appropriately for people wanting information about the field. Again, it is not all wonderful, beautiful, rewarding and fulfilling. Not everyone is cut out for this job. When someone is asking about pros and cons, they want the truth and opinions from others. Not all the glory that recruiters shove down their throats. Deceiving prospects is not fair.

You worked very hard to stand your ground to argue with me. There is plenty of negative information out there. Have you ignored that in your effort to do this? I will repeat myself again and say that people inquiring about this field have a right to know the pros and cons. Just because YOU feel the way you do doesn't mean everyone else does. Your information about the employment outlook is as old as dirt. Maybe one of the reasons it is so good is because of job dissatisfaction. I am sure you didn't bother trying to do any searches on that and you have no intentions of posting those findings. The question here was for cons. Your response was not reality. You are one of the rare breeds that some of us consider a "glutten for punishment" others will call it a "bleeding heart." Not everyone will feel the same way you do.

Not everyone wants to have that much stress in their lives from day to day. Not everyone will feel the beauty of helping people with the other tasks and demands on nurses. There is a shortage for a reason. There is job dissatisfaction and you haven't tried to do research on that because you are so concerned with arguing with me because I posted some cons of nursing. There are other career choices out there that are not so abusive and stressful. Other career choices that people won't find "gross." You are so worried about creating an argument here that you refuse to acknowledge that there are other statistics and other opinions that are different than yours. It doesn't matter what you say or what I say, many people can only see the job outlook and pay and ignore all of the other facts and get into nursing any way. Then, many of those people will HATE IT. It has always been that way. When I chose to get into nursing - two very good nurses warned me not to. One was a manager - since retired and dead and the other is a very good intensive care nurse. She is now spending more time with her kids. She loved nursing and was good at it but chose to be a stay at home mom. She warned me that things were changing for the bad in nursing and it wasn't what it used to be. Things have continued to change for the bad. In order to meet those patients needs, you run your tail off and bust your back and you know it. There aren't that many cushy jobs in nursing and there are no guarantees that new prospects will get them. There is plenty more information out there, why don't you rush back to your search and find the rest of it.

juns.nursing.arizona.edu/articles/Fall%202002/Kettle.htm
Not so flowery - actually speaks of turn over, burnout and dissatisfaction......hmmmm wonder why.

There are more.
"Nurses may constitute the most dissatisfied professions in the United States today."
www.afscme.org/publications/2208.cfm

We know you LOVE nursin

We know you love nursing, but how about answering the question that started this topic....the CONS of nursing.

How is the working environment for a psych, med surg, or LTC nurse?

cavitron in Hollywood, Florida said: Hello,

I 'm a dental hygienist and it's very hard to find a job. I 'm seriously thinking about becoming a nurse. However, before I jump the gun , I just want to hear from different RN of the cons working in this field. I do not want to make the same mistake as I did before. Please help, any advice would be greatly appreciated. Thank you very much.................

I am sorry to tell you this but I have been an RN for four years and I can not find a job right now. I have been unemployed for 2 months. I have four years of med/surge experience, a clean record, and for some unknown reason I cant find a job anywhere. I have applied to over sixty places from AZ to CO.

Try agency if you haven't found a job.

There is a lot of that going on. Not sure why. Turnover and dissatisfaction seems to be the common picture for this field. We have hospitals that are constantly begging for nurses but nurses will apply and never hear from them. Then there are the nurses that get hired and then fired or they leave because of the atmosphere.

The outlook might show to be promising, but job security and satisfaction is GRIM.

psych - can't say but I have met people that love it
med/surg - the worst you can pick
LTC - depends on the facility. Lower pay - managing more patients but most of what you do is pass meds
LTAC - doesn't seem to be too bad. The number of patients you carry isn't too bad. The patients are generally heavy train wrecks and if you have a wound care nurse to do the wounds, that's even better yet.

The main population of patients in the hospital is obese people who didn't take care of themselves and are very ill. They are heavy care and very sick. The second is geriatrics. Of these two populations, most of them either can't or won't take care of themselves and staff does all of their care. Hard - cold fact....obese people tend to have months worth of fecal matter in them - the longer it hides out, the worse it smells when it gets out. If they have skin breakdown, healing is poor due to their chronic problems of obesity, poor vascular, poor cardiac and diabetes. Poor healing wounds smell bad. These people can't wipe their own butts - this becomes your job. Obesity causes skin folds and those grow yeast and smell bad. They might have poor hygiene and no matter what you can't get rid of their odors. Often times, patients are depressed and have no will to live. You do everything for them and they do nothing for themselves. Geriatric patients that gave up on life and won't move around become contracted or are in pain if you do care to them. You can't just leave them. Now, trying pulling stiff patients in order to clean them and don't think it doesn't rip at your back. When your hand and half your arm disappears into a body fold, that is not a pretty thing. Gloves only go to your wrists. Drainage from wounds is foul and smells, yeast smells, personal areas harbor their own odors. What you get to do for these people? You get to perform self care activities that they won't do for themselves. As you are pumping them full of insulin at each meal...

their families are bringing them McDonalds and sweets. It's not just about "helping people" it can be downright gross. Can you take it? Do you want to clean a bed flooded with watery diarrhea? Do you want to pull nasty foul smelling gauze from an infected wound and then clean the wound? Do you want to clean stool from a butt wound? Reality is that it isn't a pretty job and not everyone can do it. The politics are ridiculous in nursing. Clueless people make the policies and those people probably never spent a day as a nurse. What you are expected to do and what you are able to do are two different things by far. Living a lie to cover your ass because of policies. There is more beyond the "helping people" concept that you won't understand until doing it.

^^^ WOW.. you painted a graphic picture! LOL Anyway, thanks for giving me a description of what that job might entail. It is amazing that I hear a lot of nurses say they like working on the psych floor. I had a aunt that was on a psych floor as a patient at a mental hospital. When she was first admitted to the hospital, she was on a severe mental unit. I'm not going to lie, those patients were scary! That is why it surprises me when nurses say they like the psych units. I guess it depends on the level of psych that they work with. Dealing with patients with schizophrenia, I don't understand how they could turn their backs on them. I guess there are so many areas of psych that a nurse could work in, and each area would vary. I wouldn't want to work with adolescents! I guess a drug rehab facility wouldn't be as bad, but you would always have to watch friends/family who come in. They might try to slip some drugs to the patient.

Amy in Glendale, Arizona said: I am sorry to tell you this but I have been an RN for four years and I can not find a job right now. I have been unemployed for 2 months. I have four years of med/surge experience, a clean record, and for some unknown reason I cant find a job anywhere. I have applied to over sixty places from AZ to CO.

Are you married with children? If not, have you considered traveling nursing? There are a lot of openings in med/surge for a traveling nurse.

Holy Cow, I am a Paramedic considering a bridge course into RN and right now I'm really confused after reading all these post. The main reasons I'm thinking of changing careers are pay and physical strains of my job now. The pay is terrible for the amount of knowledge you must have. I know being an RN is physical, but as a medic you have to go places that are crazy. I have had to carry patients up the sides of dams, out of rivers, up stairs and not to mention just lifting some of these morbidly obese patients is wearing me out. I love the job most days, but the pay is terrible in most areas unless you go Fire Department based and that's not an option for me. I have 10 years experience and only make about 36,000 a year working 240 hours a month. At this time their are RN positions open all over the place in this area, but now it makes me wonder why. Is it worth the time and money?

need a change

You basically already know what nursing is with your career.

1) You won't start out making all that much - check starting pay for RN's

2) YES, there is a reason there are openings as well as a shortage

You have been in this for 10 years and you are considering nursing, then you aren't thinking of making a total career change. You get the picture of what patients might be like, add cleaning their butts, dressing those wounds, waiting on them like a waitress, having multiple patients to care for and not just one, their family members, documentation, charting hourly rounds that you can't realistically do - how about doing multiple dressings on a patient that takes over 2 hours - but you are supposed to round on your patients every hour. Realistically, if you round on your patients every hour, that would be the only thing you would do all day because turning them and doing things for them on those rounds would eat up a half an hour or more.....when do you pass your meds and chart? Hospitals bombard you with so many tasks and so much charting that you lie all day long. You predispose yourself to legal ramifications before anything goes wrong. You lie to cover your ass. They know everyone is lying to cover their ass but they will not stand behind you when something goes wrong.

donurseshavethetime.blogspot.com/

2Sexy

Maybe the reason nurses like psych is because they have to be medically stable to be there. Most of your psych patients aren't severe schizophrenics. They are people with emotional problems or depression. You don't counsel. I think the physical labor is lighter. Yes, you do get some experiences. I remember a nurse telling me about a patient that wanted to kill him. That patient found themself locked up in a secure room. That can be scary.

The majority of patients are obese with multiple medical problems because of it and geriatric with age related complications, dementia or no will to live (do nothing). Pediatrics tend to have what they used to call "annuals" which were kids with long term problems that were basically raised in the hospital. Have no idea how pediatrics is now. I, personally, cannot "touch" other people's children after experiencing all that it took to develop trust with a 4 year old that was scared to death as we strangers wanted to perform violating acts on this poor kid. I also experienced high burnout from the nurses on the floor who seemed to lack compassion for those kids and referred to them as brats. I can't speak of ped's though. I think Labor and Delivery would be awesome but it takes experience and who you know to get in. I hear those nurses speak of some of the behavior of women in labor. You have to love that job to deal with that. I understand that labor and delivery brings out the worst in us so I don't think I would mind. Most of my attempts to get into L&D were ignored. Neonatal - you better be able to deal with some sad cases. I had an opportunity to do it but it would have been with a high population of drug addicted babies so I passed. Long Term Acute Care tends to staff similar to a step down unit or light med/surg unit. Those patients are about the sickest of the sick.....too sick to go to a nursing home or home but need skilled nursing - vents, wounds/infections, debilitated.

Long term acute continued...
Some are independent or require minimal help and are their for long term antibiotics, most are vents or people that are probably not going to get better. It is fulfilling to see people get weaned off of vents - not all do though. The acuity of those patients is high, but they tend to staff with ratios that are mostly manageable. Med/surg is the worst. You tend to get a lot of patients and it can be un-manageable. You have to compare hospitals. Any floor - any time you have 5 or more patients, it is getting rough. I think 5-6 should be the most and depending on the patient population, mix of nurses and aides/techs it can be very rough at that. Now consider 8-9 11-15 patients. CRAZY. I refuse to do it. Stepdown units tend to carry 4 but some push you to 6 or even 8. 4 is normally very busy considering the fact that they really don't staff enough techs and you are caught up doing the tech's job and not getting yours done. If you have good strong techs, that can make a difference but the reality is that no all of your co-workers will pull their weight. You can't do anything about that. If you speak up, you are the one that is wrong. I have seen facilities keep dead weight techs even if it means losing good nurses. Never figured that concept out. One of the biggest frustrations in this field is the techs. They can be a pain in the ***. They constantly fight that we can do their jobs - but they can't do ours. They will rebel and retaliate and you get stuck doing their work. Some of them are busy and work hard and you have to help them, others are just dead weight that you can't do anything about. You do their job and then you are stuck over trying to finish your work but overtime is frowned upon. Management usually only favors a handful of people and blows a puff of smoke up everyone else's ***. Very clicky. If you are not in the right click, you won't be staying on that unit for long. Only certain people matter.

I have been "in those clicks" and do no agree with what I learned about the other side. Some people will deliberately get crappy assignments just because they aren't liked. You can hope you aren't one of those. You will always have bad days. The clicks get the cushy assignments. Then, if you are not in the click, every time you turn around you are being reprimanded. Think about the shortage. Managers don't give a hoot about that shortage. They could care less if they are short because they will immediately start recruiting your replacement with flowery lies about how wonderful they are to work with. What you see on your tour of the unit at your interview isn't going to be the truth. Ask to shadow for a few shifts. They probably won't allow it and will schedule around certain people. Watch for complaining, stress, gossip. If you see it shadowing, it will be worse when you are out of orientation. Many seasoned nurses have no tolerance for newbies. That could be why newbies are training newbies. It might be because there is a substantial turnover on the unit and they are tired of newbies. Often it is just because they are prudes. I never participated in evil treatment towards newbies. I don't agree with new nurses training new nurses though. They don't have the experience to enlighten you and think about things they can train you in. Training is very basic. Most of the people I have worked side by side with complained about everything. They deny that they do. They claim they like their jobs but they come in pissed off and nasty. They are in total denial of how they act. They are quick to point out other people's faults. They are sour and breed negativity but take other people down with backstabbing. I have watched nurses come and go in large numbers on all of the units I worked for. The most common was to hear nurses speak of how disappointed they were with the unit, manager or co-workers. Management and clicks are the biggest problem.

I think because the stress level is so high in nursing it just breeds misery. I can count on one hand the number of units that had down to earth employees that were decent to work with. They are far and few between and so hard to find. If you do find it, you might have to put up with other turn-offs like driving an hour, sicker patients worse pay or something.

The reality is that patient care is not just a gratifying or rewarding job as some explain. There is way more to it. Most patient care is gross. Some people just don't want GROSS in their jobs. It isn't right to come into this field and avoid wiping butts and leaving it for others. What if we all did that? Some people can't handle seeing people vomit, odors, stool, bad wounds, blood. Every smell gangrene / rotting or dying skin? Ever smell bloody stools? Ever smell C.Diff? You can't avoid those. Even if it isn't on your assignment, it smells the halls up when it happens. Did you know that hospitals are FRAGRANT FREE? Fragrance is not allowed due to other people's allergies or sensitivity to it. But, you can smell these odors all day long. Know what it is like to do mouth care and try to pull out thick strings of saliva or crustations? None of this is ever spoken of in recruitment. You would be surprised how many people "didn't think it would be like this." I have heard it and seen it for years. I know why there is a shortage. I guess I feel that if you ask about what nursing is really like, you are asking about these facts. I would think that is what you want to know and hear before going into debt and locking yourself into a lifelong career and then wondering what the heck you can do to change your path.

By the way, the great job outlook for nursing is in patient care. That is where they are hard-up for nurses. Think there is a reason? They aren't hard-up for those glorious jobs away from poop and spit. People are lined up for those. They aren't that easy to get and

cushy jobs usually require seniority. You serve your time to get in those jobs. It has become a degrading field to be in because of the shortage, the politics, the type of work. You can't say no - you are subject to anything and everything. It is the last career to address lifting limits.....if it's a patient.....you lift it. Wait til you spend your day running around pulling obese people up. See, hospital beds have heads of beds that go up. Everyone uses them. Then they all slide down and get all folded up at the neck. They don't have these beds at home, but they eat, drink and do everything in that bed and rarely get out if at all. Then, they put their call light on to have YOU pull them up. You don't want to hurt yourself and do it alone so you pull other busy staff off the floor to do it. Chances are this person can stand up and reposition themself but they have no problem asking you to do the work and pull them up. This happens all day long! You are trying to pass your meds and you get pulled to pull a patient up. Add these things together - all that I described - and there is WAY more. Add it up. This is a typical day - all day. Pulling patients up and sliding them to transfer them HURTS. It adds up against your body over years. Now take the non-compliant diabetic on dialysis with an amputated leg due to disease. Got chips and candy in her nightstand. Won't get out of bed. Lays in bed and calls on staff for everything with a huge stash of junk food at her reach. She can reach for her chips but not for her water when you hand her her pills. Doctor insists she gets out of bed. YOU and who ever else has to LIFT her to the chair because she has already made up her mind she isn't doing anything other than eating chips and candy in the bed. Staff bathes her but she can bathe herself. Do you think hospitals are going to let you tell those people the way it is? No....you are in customer service. You service.

Confused patients....
Did you realize there are laws and limits to restraining? And hospitals don't want to foot the bill to pay for "sitters." Now you have a patient that keeps getting out of bed, pulling IV tubing out, crapping all over. Every time you turn around you have to go back, get the patient back in bed, maybe clean up some blood or stool. You have tons of other work waiting on you. They didn't give you less patients or a lighter assignment because of this patient. Most of the other staff are sick of this patient and do not want to be bothered. This becomes your burden. If they fall, you have just increased your work-load. You have to do an assessment, take vitals, call the doctor, maybe wait for a doc to come and make sure the neck isn't broken, clean up some blood or stool, send the patient for tests to make sure nothing is injured, now frequent vitals and more monitoring because they fell and paperwork and continuous charting to cover your ass. Don't forget the family members that blame the staff. They can't handle the patient but you better keep that patient safe along with 7 other patients and meds to pass and charting to do.

Intensive Care is better because you don't have as many patients but don't thing there isn't poop, smells, blood, spit, etc. If these things gross you out, nursing is not for you.

And if any nurse wants to call me a liar about all that I wrote, I would demand that she give you her address and phone number so you can contact her when you find out I was right (or wrong). I know a recruiter would jump all over this and give you her card and office number. They could care less how you feel after they recruit you - you won't be the first they disappointed.

So which areas of nursing would you suggest for someone to go into? You mentioned ICU and Long Term Acute Care. Actually, I thought about Long Term Care, but I wasn't sure of the skills I would learn. Could those skills be transferred into another area if I wanted to change the areas I would work? For example, if I started out working in LTC (nursing home) could I possibly transfer to a Neonatal Unit to work? Do they train people during orientations to help nurses transition from one area to another? I know LTC would be totally different from Neonatal, and I was just wondering could nurses change areas from where they started. Also, what exactly is the difference between Med Surg and Long Term Acute care? I guess I could research the different specialties, but I'm sure you could give me a quick answer.

Also, you mentioned that you didn't want to work in the Neonatal because of the high percentage of drug babies. I know a lady that works in the Neonatal, and she said that those drug babies just cry all the time because they go through withdrawal symptoms from the drugs. Actually, I volunteered at a neonatal unit a long time ago. They would let me go back there and look at the babies. Some of those babies were deformed and all kind of stuff was wrong with them. Yeah, a nurse would see a lot working in a neonatal unit. Eventually those nurses just get used to seeing those premature babies and drug babies. When I volunteered there, those parents constantly called in to talk with the nurse. Those are some stressful times for the parents and they constantly call in to speak to the nurse. That might be some of the negatives about working on that unit, but other than that most neonatal nurses like that unit.

Long Term Care is basically a nursing home. You will be passing meds on about 20 patients and as an RN responsible for medicare charting. You don't get to learn much for skills compared to a hospital.

Med/surg is where you carry the most patients. Avoid that.

Intensive care will get you some really good experience and you won't have many patients - the norm is about 2. That also gets you more money in agency. Progressive care is stepdown and that can be about 4 patients in your better hospitals but some will give you 8-9 or whatever if they are short staffed.

Long Term Acute Care is a combination of med/surg, progressive care, intensive care, nursing home and vents. These are patients that require continued care as if in the hospital but for a long term. They require skills that are not accepted by a nursing home but they don't qualify to stay in the hospital. If you get the right one, surprisingly it is ok. It tends to have a lot of wounds and wound care. If they have a wound care nurse that does the wound care Mon-Fri then that is even better. They don't necessarily have the money to support that but you have about 4-6 patients varying between days and nights. They tend to be a smaller facility so they can have some backstabbers. Find one with a good mix and you are getting a lot of different experience. They might not pay as well - not sure. But it should be better than a nursing home. I would avoid a nursing home because it just doesn't get you all that experience and the pay is much lower. For LPN's nursing home is great because they get to be nurses. Some of the Long Term Acute Cares use them also. It's hard to find places that use LPN's as nurses but I have worked by some great LPN's and have no problem working with them. I feel that LPN's should be looked at to cure the shortage.

As far as neonatal - that is just MY feeling and it was the area that I was offered the job. Inner-city. I probably wouldn't pass up a neonatal

long term care and long term acute care is not the same?

thanks

The great job outlook and shortage is for adult patient care mostly. Once you get into nursing and do adult care, it is hard to get elsewhere. Yes, homecare is nice but there is the wear and tear on your vehicle, the mileage with gas prices high and your trunk tends to be a medical storage unit. One on one patient care is a PLUS there if you get a good area. Again, those go to senior nurses but I think they have changed a lot in trying to set your area.

Peds - again - that was just MY feeling. In hospital settings tend to breed the backstabbing and other politics.

Progressive Care is a good experience but even 4 patients can be busy so you definitely wouldn't want any more.

It isn't all that hard to get hired as a new grad in progressive or intensive care. Don't worry about the feedback that people give that you shouldn't do it as a new nurse. If you are committed to your job you will learn and do just fine. I let that feedback scare me and I have seen a lot of new grads just shine and do very well in ICU. A lot of the hospitals around here have a high turnover in ICU. Most of what I hear is the co-workers that drive them off.

If you like high energy - do ER. That has a high turnover and burnout. If you are an adrenalin junkie, you will love it. I am too old for that pace. I plugged along and waited too long to realize that I needed to make a change. Now it is very stressful because I am tired of adult patient care in hospitals. As far as my previous "gross" descriptions - I don't mind that - I just mind not being able to do the job right. There is more work than there are people and time to complete it and that is what is making this job so bad. Putting up with politics, clicks and managers can come with any job - but add it to the stress of being "understaffed" and it is too much. It's funny that Candice posted that survey about people feeling nurses met their needs because I can pull up and read plenty of articles leading to

articles leading to dissatisfaction among nurses and patients. Dissatisfaction of patients has lead to MORE charting. Hourly rounds stemmed from falls and injuries. IT is a proven fact that medical errors are up with current staffing but no one wants to face it. They would rather play games with charting and rounding to deal with it instead of staffing appropriately so patients get safe care. I read another article where someone advised to pick one of your patients that gets the "extra" care. It kinda just happens that way. Some one will get more of your time and the rest are micro-managed....skimming the top with their care and praying to keep them safe. As far as my other posts, those are for those people that have no clue what kind of things you face day to day. If that stuff grosses you out, think twice about being a nurse. If you can't deal with deformed babies....think.....children in pain....think. See, you don't get all that when people are talking highly of nursing or recruiting. It is a very demanding and stressful job. You are pulled in multiple directions at all times. My best advice would be to avoid a regular med/surg unit. You can get into an ICU or Progressive Care as a new nurse and do just fine. If you want to be in L&D or with babies, try to get in as a tech to get your foot in the door. Stay on applying since you never know when you will get your break and get in. Beware of any unit with repeated openings or multpile openings. Chances are that the dynamics are intense there.

Hopefully, others will be more enlightening to the reality of their experiences and not just throw out there that nursing is SO GREAT. I have been very open and blunt for a reason.

No - long term and long term acute is not the same. The difference is the acute. The acute care is skilled nursing not accepted by typical nursing homes. Nursing homes normally do not accept vents, trachs or IV's. There can be other "acute" conditions that make the patient more skilled comparable to a hospital visit but they have run out of days in the hospital. Long term care is nursing home basically. Long Term Acute gets a variety of experience, is typically a smaller facility which can work out good or bad. Seems the norm is 4-6 patients and you can be busy but not as crazy as many hospital units. I have noticed that most of the aides in LTAC are good. Probably because it is so small and people know eachother. They are very strict about routines and care so a lot of things actually get done and you tend to be able to chart too. Some of the wounds can get to you but it is fairly balanced. Those typically have a fair amount of vents, trachs and vent weaning. Respiratory takes good care of those patients. It seems like a dumping ground and maybe many of those patients are not rehabilitative but if you want to "help" people, there are people there that definitely need help. Good nursing could be the stepping stone to them actually rehabilitating.

What exactly is progressive care? Is that where patients go after ICU? I haven't heard of that before or have seen openings in the newspaper for that. Is that something that they hire people who are within the hospital and not advertise the openings?

Progressive Care is what used to be considered "step-down." It is not so much that patients go there after ICU (though they can), they are more specialized or critical care than a med/surg but not intensive care....for example: cardiac progressive care - stable MI's, post cardiac cath, pre-CABG, post-CABG after SICU

I am a nurse in a long term care unit. My facility has our "regular" long term care and then we have what we call our "rehab" unit. These are persons who are more acutely ill. Maybe they are post op or they are skilled for some reason. They do not always stay long term. Sometimes few weeks or months depending. Others move from this unit to our long term care. So, in this way I can see a difference between long term and long term acute. Don't get me wrong our long termers also have acute illness periodically and require just as much attention and care.

here in south carolina all ltc has an acute or rehab unit. they go together in every nursing home i have been to.seems like they always want me to work those units. vents, trachs, decubiti, dialysis, etc.very sick people and usually about 30 patients on average for one nurse. meds and treatments.i won't touch it any more. and i don't want to get old enough or sick enough for a nursing home either, i would rather die personally as i have seen it from the inside. can you imagine having about 30 skilled patients referred to as ltc/ acute? that's all it is here in s.c. all nursing homes include both. and unfortunately, those are about the most jobs avalible here for lpn's.

funny, they never talk about lpn's in the nursing shortage or in numbers quoted in articles and research. i wonder why that is. here in s.c. there is very little legal difference in the responsibilities and duties of either rn or lpn.
why is the whole country semingly ignoring the quantity and quality of lpn's????

All I've learned from this is do not be a nurse in michigan...

Can't speak for other states. But you better be prepared if you think you want to be a nurse. There are a lot of problems with the field.

liv in Bellingham, Washington said: All I've learned from this is do not be a nurse in michigan...[/QUO

I'm a dental hygienist and I just spoke to one of my long time friend who only has been in the nursing field for three years and she said " there's no moving up, I should have done something else".

I also know someone who's cousin is a nurse and she said she likes her job.

I guess it depends on the hospital and the floor and the people you are working with.

I can't say much because I'm not in the field. I'm just observing ALL the comments right now.

ibflossing in Miami, Florida said: Reba ky,

I'm a hygienist and was laid off in nov.07 and still can not land a job. I've called ALL of the # that are listed in the yellow pages and only 2 reply back. Jobs are VERY DIFFICULT to find in the hygiene area. I have two friends who is a nurse and they love it. Maybe it's the mess up hospital you are working for, try finding work in a diff. hospital. I'm going for nursing and currently taking courses right now.

Good for you......After years of unsuccesfully trying to get into Physician Asst School for years, a friend talked me into nursing school...reluctant at first because you know that stimga "its not a male thing to do". To my surprise we had 10 guys in our class, half of them were paramedics.....I no regrets going into nursing, should of done it a long time ago. Ive tripled my income and the opportunites are endless. I have no student loans to pay back, cause it my tuition was incredibly low(just a side note...I thought about becoming a hygenist before nursing). It will open more doors if you do bedside first, but you are not required to do so. I started in ER after graduation, worked there for 6 years and decided to try something new....Im working at home exclusively as an advise/triage RN (no driving,traffic....). I dont miss any of my kids school or sport functions. As a nurse I was able to travel with a pro motorcycle race team all over the US as part of their medical team (they only recruit RNs)........Yes, you will work long hours and have days hating your job but thats with every job and if you don't like bedside there are so many other things you can do in nursing....travel nursing, maybe work as a RN at Disneyland and so on. Good luck!