Used Nurse: Part Deux

Case management?

I am so sorry to hear what your are going through. It absolutely sickens me every time I hear about Health Care Reform. And every time I read someone in the press write about how great the health care field is and how becoming an RN is one of the top 5 professions to get into I just choke! I too am looking for a position after being a nurse for over 20 years, cannot find one. I cannot imagine being a newby, going through the grueling process of becoming a nurse, putting your life on hold all those years, getting loans that you wil never be able to pay off...well, at least not for many, many years.Viva, I'm nowhere near as nice as you and definitely have a temper but I would hope that you forward a copy of your very eloquantly written blog to news. People NEED to be made aware that when it is said by ANYONE that there is a nursing shortage that they (whomever siad it, be it the government, a nursing union, the press or your neighbor) that they are either lying or terribly misinformed. There is a trend that I've begun to notice that the public has begun to blame and criticise nursing for 'having a profession but not wanting to go to work'. REALLY!!! This is what is out there. Not that the new policy for Healthcare reform has taken our jobs or that the hospitals won't hire and are laying off nurses and NOT replacing them or just to try and sell more students on taking nursing courses just to make the schools money. Not to help the student or society.Oh, there I go again! Anyway, as you can see, I am so angered by all of this. So much so that I make people turn away from me when I try to explain how wrong all of this is, but not you Viva. Even in this time of uncertainty for you, you place no blame. Nor do you display any self-pity as so many would. I am so very impressed with your composure and sense of fairness. Why don't you use this gift that you have...and get a job publishing what you write? I have told you this before a long long time ago (though it was a blunder on my part...I told you that you write so well that you should start a blog, not knowing that you were already...here! LOL! And you were so gracious to this first time user of this site! TU). Anyway, yes, I am long winded but Viva, you have a wonderful talent that could use. Writing. You definitely have a way with words and compassion that is huge. Why don't you try this? You wouldn't have to break your body for a profession that eats it's young and throws away those with experience because they make too much or because some fool in office decides to 'help' us little people but destroys our lives instead. People will always read...will always want and need to be informed. And you have a talent for it. Best of luck to you and please keep us informed as we all care very much about you here!

I am sorry to hear about your situation, but I wonder why you think government is the blame. Ostensibly, Medicare has been cut the same amount for all facilities. However, I'm not seiing half census numbers or anyhing close at the many LTC facilities I visit.

So sorry to hear about your predicament. It is certainly a story I hear over and over in my area. As a brand new nursing student this fall, you can imagine it freaks me out a bit. I have come this far, though, and I know what my long-term goals are, so I will keep plugging along. I work in home health and hospice and I know that the HH department is always on the lookout for nurses. From what I have seen through interacting with them, the HH nurses seem to enjoy a job that allows for some security, flexibility, and less strain on the ol' body. That said, however, I do know that our agency has been closely watching the political outcomes to see how it will affect Medicare reimbursements, since the majority of our clients rely on that. Thus far census has remained steady. So, my recommendation for the moment is HH. Surprisingly they are still hiring in my area. Best of luck in your situation.

The job cuts are not due entirely to medicare cuts. As a matter of fact the cuts have been delayed by the Senate. WASHINGTON, June 18 (UPI) -- The U.S. Senate passed a bill Friday that would postpone a 21 percent cut in Medicare reimbursements to doctors.

I am very thankful that I have a job at this stage of my life. Unfortunately the economy is taking out a lot of people and we are finally starting to turn the other direction but it will be years before we see employment levels back to where they were in 1999. Marla and I are the same age (roughly). My BIL-laid off and 2 other friends are laid off. All are in their late 40's to early 50's.People in this age bracket often end up on disability because it is so difficult to start over at that age. Marla to get back on track I think you should check out instructing clinicals for nursing students. Your resume would definitely get you in the interview pool for lpn/cna programs as well as ADN programs. (If Oregon is like MN there is a real shortage of clinical ursing instructors.

Sorry to hear you are in this situation....bluntly put, it just plain sucks.Case management might be a good choice for you; some of the W/C companies and health insurance co's are hiring nurses as case managers for helping subscribers manage chronic illnesses like diabetes, COPD, arthritis, and so on. I know a nurse who developed severe knee problems and had to leave her 12-hr shifts at the local hospital but got into case management. Most of her work is in the office, and she is assigned a territory in which she travels to visit individuals and companies. She does have the occassinal long day (12+ hrs) but most of the time works a M-F schedule from 8a-5p. Since you mentioned you are in a small area, is your location considered "underserved" by primary care providers? You might want to check into this, and look at working at a physician's office or an Urgent Care office. These types of jobs tend to be less grueling on the body, and the clinic I visit (actually, my PCP plus his staff of nurses) is staffed mostly by RN's who do a lot of geriatric management and work regular 40-48 hours. Another option is to be a travel nurse, but since I do not know anyone who does this, I can't really comment on it. I do know it's lucrative, but I also know that it requires one to spend a great deal of time away from his/her family, and the work is kind of sporadic at best.A trend that is developing is towards workplace wellness, and some of the larger companies often have a full-time nurse on staff to handle industrial first aid. If your community has a SHRM (Society of Human Resource) division, they might well know of an organization who needs someone affordable and knowledgeable in health/well ness....and who better than a nurse? It's not traditional, but I have seen the trend emerging slowly over the past 3 years or so. My company is talking about a nurse full-time in the near future (we employ about 1000 ee's).If you want me to review your resume, please email/msg me...I am not a nurse (as of yet) but have 11 years in HR and might be able to help you out with the resume. Best of luck to you, and try looking into the non-traditional nursing gigs and see if any of them fit you and your situation.

To address only part of your really tough situation, the bulk of our healthcare system is "for profit." The private insurance companies need to show a profit to their shareholders, and that puts them in opposition to actually paying for anybody to get the care they need. Having a good universal healthcare system in opposition to a for profit system wont work. It comes down to a battle between the haves and have nots, and the have nots don't have millions to contribute to election campaign funds.

No advice here. You ARE a great writer....not easy to make a living at that, either. Have you thought about teaching nursing or CNAs?

i understand that you don't want to work nights -- only a select few of us do. i've found myself in the position of rotating shifts again, at the ripe old age of three years older than you. surprisingly, i'm tolerating it much better than i did in my 40s, and i even look forward to my night shifts. no management, fewer physicians and the familes get sent home at 9:30! if my unit were hiring for straight nights, i'd be there. at my age, nights are a bit quieter and i don't have to do as much running. further, i'm not "on display" all of the time and can put my feet up while i chart. and since the families have gone home, there's no competition for my chair. (our unit does not provide chairs for families, so they feel free to appropriate our chairs. the 20something nurses chart standing up, but i'm too old for that. my back and knees are too old, too.) if that's all you can find, you might find that it works better for you than it did 10 or 15 years ago.

Thank you, Ruby---I never thought of it that way! I worked nocs for years and loved it; in fact, I much preferred it for the reasons you stated. But when I hit my 40s, I started having horrid bouts of confusion and mental fogginess that didn't clear up until I went to a day shift schedule about 2 years into that decade. I didn't know it then, but I'd also hit perimenopause....which may have had more to do with it than working nights.I'm past all of that now, and other than some normal forgetfulness I'm as sharp as I ever was. Maybe I shouldn't rule out noc shift just yet....again, thanks for putting a different perspective on this.

Hi VivaYou are in an awful situation but honestly its not the government's fault. It's been like this for much too long. Please let me explain.In 1982 I wrote the bestselling book called "The Nurse's Story" where I outlined all the abuses nurses had to suffer in order to practice. I told the stories of heroic nurses and patients and what their sacrifices cost them. For me, nursing was a calling and I didn't love anything more. But after 16 years I just burned out. It wasn't just the patients and the disease and death that wore me down, it was all the fighting, the lack of recognition, the no benefits, the credit given to the doctors and not the nurses and all the notes to cover the "business" of medicine and protect them from malpractice suits. Nursing is one of the hardest jobs anyone can do but have you seen what we get paid compared to stock brokers? I toured with my book to 27 cities and I sold a lot of books (by the way it took 3 years to write that book and commercial publishers only pay between 7 to 10 percent -like $2.00 a book-worse than nursing!) but the point I want to make is that nurse's don't insist on rights given to other professions. We haven't learned yet to separate our need to help people and make a difference with our right to have a good life. We really do need to empower ourselves. I do understand that things have gotten somewhat better...but also worse, I'm afraid. In 1997 I updated my book and in doing the research I learned that as we got paid more and got more benefits, the "business" of health care began replacing us with others who were sometimes trained for as little as 6 weeks. They took us away from our patients and from the bedside. And those of us they left there were overworked and burdened with impossible work loads. So I know it seems like an awful thing to be laid off but maybe you should begin to write, and post and blog (I must have written hundreds of emails to the government during this health care reform) But maybe we have to make the patients aware that they can't even ask the right questions unless they know those questions, and only nurses can act as their advocates. Maybe the tool we need to use is our knowledge. Maybe we need to use the internet to let people know what's going on inside hospitals and maybe we should have patients help us fight for better nurse patient ratios. Maybe they need to know how much they do need us at their bedsides. But in order to do that we need to share with them what's really going on. So maybe V, you can start there. Let's just all begin to tell our stories. Let's tell them what our patients go through. And let's just begin to fight big business and empower ourselves and our patients. Remember we know things that the patients don't, and if we want them to help us, we have to help them and help ourselves! I hope everything works out well for you. xxx