I survived my thesis defense the other day. Wow, what an experience that was! I just sent in my final (hopefully) revision and I think that they will sign off on it. I was unable to prove my theory based on the retrospective chart review, but if I duplicate the study with patient’s charts that didn’t develop C. difficile while on proton pump inhibitors, I think I could. That’s for the doctorate at a much later date.
All I want to do now is secure a contract with a doctor so I can start paying some bills. Thanks so much to anyone who has bought something from my Amazon nursing store! You all rock! It’s over there on the sidebar for those who haven’t noticed it yet.
I will be finishing my clinical hours in the next few weeks so I will be incredibly busy and may not be posting too much until after I take the Family Nurse Practitioner National Certification test. Much studying to be done before that. I really think that it sucks that we don’t have a graduate nurse work period. We can’t work in the state of Florida until we are certified. I already lost a great job offer because of this aggravation. I have another contract pending with the original doctor that I wanted to work for. Just waiting on the numbers!
Click on the link for some information about this irritating syndrome.
Wish me luck! Today I defend my thesis!
Hello to all.. Just an update to let everyone know what’s going on in the ongoing saga.
Last episode ended with a lunch interview with things looking pretty darn good. I was awaiting a phone call (still am). It’s not nice to leave NP student in limbo. Limbo is NOT a good place to be with my sleep disorder! Needless to say, no restorative sleep for me or my husband.
Meanwhile, the day that I was supposed to hear from the office manager from the first interview, I got a call at home from another doctor that was looking for me at the hospital. We talked and I told him that I was expecting a call back but hadn’t signed anything yet. He made me an offer that I just couldn’t refuse. He wanted to know when I could start. I went to the office and met the staff and it looks like a great job!
Next glitch! The new ruling that NPs have to sit for National Boards passed this year. Normally, not a problem. I planned to sit for them anyway. I just found out that NPs do not have a Graduate nurse grace period in which they can work while waiting to sit for their boards. NICE HUH?
That means that I graduate on April 27th, wait for transcripts which could take until the middle of May and then it takes a week or two to get the results. Until then, I hold my breath and hope that the doctor doesn’t get tired of waiting and hire someone else.
Oh yeah! I get to continue working at the hospital the whole time as well.. Sigh!
On a good note! I defend my thesis on the 20th at 10:00. Wish me luck!
Arrow posted “As a hospice nurse who works in a free standing hospice it is good to hear that there are nurses like you out in the hospital setting.
Too many times we receive patients who are in the throws of imminent death only to survive for a few hours once they reach our facility. We have even had cases where death occurred in the transport van. This should not happen and is most shocking for the family and not appropriate for the patient to make a peaceful transition.
Hospital professionals need to learn the signs and symptoms of early imminent death and act appropriately and accordingly for the best interest of the patient first and the family second. Most nurses don’t know these signs and symptoms and can not make an accurate early assessment. We know this because we are constantly have to train them in this assessment at our facility.
In our free standing hospice we dread the holidays because we know the hospitals are going to dump on us. The day before major holidays we have upwards of 5 and more admissions. This tells us that routinely throughout the year patients are not referred to hospice as they should be and we suspect because the doctor still views them as a cash cow. But when the holidays come they dump these patients on us because they want their precious time off.
Doctors and nurses need to do more in the hospital setting to evaluate a patients condition more accurately, circumventing false hope and provide a realistic prognosis to patients and families so that hospice can intervene in a timely manner whether in hospital through a community hospice agency or through transport to a hospice facility. When patients come to us with agonal breathing and mottling we know that the hospital team has done too little too late.
We understand that some nurses and doctors fear death and view death as some kind of failure of their work, the system or even of the patient.
It is a paradigm shift to see death truly as a natural process and evolution of the spirit in our face paced hi tech medical world. The death process can be guided so that family and personal issues are resolved in a timely and sometimes expedient manner. It requires trained nurses, doctors and counselors, a team focused on the patient and family, well trained in the hospice philosophy, to assess the pitfalls and provide structure and support for emotional and spiritual transitions as well as proper pain and other symptom management.
This was such a great response to the post below, that I had to print it on the same page. Death and dying are such important issues that nurses should know how to deal with. We are privileged to be there in those times. I only hope that someone will be comfortable enough to make the transition easy for me when it’s my time to fly.
I just had to comment on Kim at Emergiblog’s post regarding DNR status for patients. This subject is one that is close to my heart as well. We must find out patients wishes and follow them! Too many times, I have been doing an admission and the family members try to answer the question for the patient.
Nurse:”What are your wishes regarding sudden death situations like your heart stopping or if you stop breathing? Do you want us to do CPR, shock your heart back into rhythm, put a tube down so you can breathe? etc?”
Patient:”No, I don’t want you to do anything. Just let me go. (Alert and oriented by the way)”
Family member sitting there:”No, Mom wants to be coded. Don’t talk like that Mom!
Nurse:” (Looking back at the patient), This is YOUR decision as long as you are alert and oriented as determined by me and your doctor. You get to make the call.”
(Directed to the family member) “No one likes to hear about losing a loved one, but they have the right to make these decisions and we must uphold those wishes if they sign a DNR order with their physician. If they have a living will, the surrogate can help with those decisions if the patient is incapacitated BEFORE their wishes were made known.” We cannot make a living will out AFTER the patient has become confused.”
Nurse:”It is imperative that we all make our wishes known and to stand by others wishes once they are made. It’s hard to let go but it does more harm than good to code someone when they don’t want it done.”
I have been called the “Angel of Death” by a sarcastic doctor once because I stood up for a patient who did not want to be coded. I told the doctor that I would do EVERYTHING in my power to save my patients but I would also do EVERYTHING in my power to make sure that their final wishes are followed. I have felt that horrible crunch as the frail patient’s ribs have cracked under my hands while trying to code them when no paperwork was available.
That feeling is too horrible for words.
