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Traveling Nurse, an Exciting Career

Written by kimmel52 on November 12, 2008 – 12:13 am

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

Today is an exciting time for nurses. The job market is plentiful with positions including the demand for traveling nurses. To be a travel nurse takes a special person. The individual who is a travel nurse is one who likes to see new places and meet new people, face challenges with confidence and work as a team member. Being a travel nurse is not for everyone. Nurses who have family responsibilities may choose to work near their home. However, for those who like to travel and are very outgoing, being a travel nurse is a rewarding experience.
As an experienced nursing professional, you are in a truly unique position. Read more »


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Nures Salaries Increasing

Written by kimmel52 on November 11, 2008 – 11:58 pm

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

In today’s economy with declining employment in many fields that require degrees, the profession of nursing is as solid as it ever was. People with prior degrees are looking to enter the nursing profession.

Nursing careers are appealing for many reasons. One positive aspect of nursing careers is the opportunity to serve others through medical treatment and rehabilitation. Nursing careers also boast a glowing job outlook that has consistently risen along with increasing demand for registered nurses. Plus, nursing careers offer a wide range of employment options within various sectors of the health care field. When you become a registered nurse, you open the door to a variety of nursing career paths, including forensic nursing careers, traveling nurse careers, and nurse coordinator careers.

The salary of a nurse varies greatly. There is really no base salary but a fluctuation across the board. The reasoning for this is a varied as the salaries in nursing.

The base pay of a nurse is determined by many different factors. The first of these factors are the years of experience that the nurse brings to the table. A GN or graduate degreed nurse will start out at the lowest salary of nurse pay. They will remain at this level until they pass their board exam or NCLEX. Upon passing their boards they will receive a small increase in pay anywhere from $2.50 per hour to $5.00 per hour. The most important factor in this scenario is to keep in mind that if the graduate nurse does not successfully pass the board exam the hospital can terminate their employment or extend to them a grace period in which they have the opportunity to pass the boards a second time. In the past years, it was not unusual for a graduate nurse to stay on as a hospital employee for years before finally passing or taking their boards. This practice is no longer widely accepted. Also the graduate nurse is not allowed to pass any medications until they have their licensure. The question remains, what is the typical base salary for a graduate nurse. It is safe to say that the salary ranges in the low to mid forty thousand dollars per year. This discrepancy of several thousand dollars has much to do with the location of the hospital. For instance, in rural communities where much of the hospital funding comes from the government, the pay rate may be higher or lower than a privately funded institution. The mitigating factor is how successful the grant writers are at tapping into government funds, and how much private endowment monies are bestowed to the hospital. Even with these two factors in place comes the process of dissemination of the funds. This is dependent on how the board of directors see fit to use the funds. These funds could be put to the construction of a new hospital wing, or to the purchase of new diagnostic equipment.

Whether or not the nurses are unionized is also another factor in entry level nurse pay. Unions can either work for or against nursing wages. Sometimes non-unionized hospitals pay more.

Shift premiums are also a factor. Read more »


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Nursing Jobs

Written by kimmel52 on November 11, 2008 – 11:55 pm

It has been predicted that the baby boomer generation will be the most effected by the changes health care system with regard to nursing care. The current health care system is in a state of flux. With insurance companies constantly raising rates and premiums, and the hospital stays becoming less frequent, the end result is that health care must extend to the home.

Looking down the barrel of a world wide pandemic, comes the news that there are 135,000 unfilled nursing positions in the United States. By 2015, this number is expected to go to be 683,000 unfilled positions.

Two main reasons are given for these shortages:

1. Nursing hours are long, difficult and stressful
2. There is a huge shortage of nursing faculty.
We are running out of nurses to teach prospective nurses.

The impact of this new era of home care will have various effects on the population that is served. Although it is true that home care has been in existence for almost as many years as the profession of nursing itself, the amount of clients that home care now serves is quite a bit larger than the past as well as more medically demanding. What this situation implies for the nursing profession is a larger responsibility in ensuring that clients who are discharged within one to two days receive the necessary teaching and follow up nursing care to ensure progressive healing and a maximum return to wellness.

In order to help ensure the goal for the client after discharge, the hospital nurse must be acutely aware of what the clients teaching needs will be from the time of admission.

Immigration issues are adding to the shortage of nurses. There is a 6 year wait for nurses to be allowed to come here legally. Several acts are before congress to help speed along the immigration process for those who want to come here to practice medicine. Currently, the only thing stopping new nurses coming here is red tape. Many are standing in line, but the line doesn’t seem to be moving. If something doesn’t change, we can expect to face severely diminished nursing care in the very near future.

The big payoffs of any nursing career include a solid paycheck, reliable employment, and the immeasurable reward of helping others. Outside of these constants, though, the nursing field is spread along a wide spectrum of specialties, paradigms, and settings. These variables subdivide the industry into more measurable salary ranges. But other elements factor in as well:

  • Region of practice
  • Degree attainment
  • Years of experience
  • Public or private sector practice
  • Staff RNs have dozens upon dozens of specializations from which to choose. Each specialty has a distinctly different salary range that also varies from region to region, metropolitan to suburban or rural, and from public to private healthcare practice.  Associate degree RNs earn anywhere from $ 53,000 to $63,000 on a scale of national averages that spans specialties. However, there may be wide disparities outside this margin.RNs in specialties such as Critical Care, Emergency and Trauma medicine, Intensive Care Unit nursing, and OR and Recovery Room Nursing are at the higher end of the salary spectrum, while nurses in Home Health, Long Term Care, and Geriatric Nursing, are most typically at the lower end of the salary scale.

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Reality Shock For Graduate Nurses

Written by kimmel52 on October 10, 2008 – 10:10 pm

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

So now you are close to graduating from nursing school or you have graduated recently. Whichever the case, you will be in for a reality shock when you begin your career as a Registered Nurse. What do we mean by the term, “reality shock”? Well, like the term says, it is the reality that shocks us. The question you may ask is, “so there is a difference in the reality of being a student or graduate nurse”? The answer is an emphatic, YES! First of all, as a student nurse you were given assignments that were not beyond the scope of your practice or ability. In addition to that, you were working under your instructor’s license and whether or not you were aware, they kept a very close watch on you. Therefore, there was a safety net that always hovered beneath you in case you were to fall.

This is not the case as you take on the title, Registered Nurse. There is no safety net. You are out there by yourself, free to make decisions and make mistakes. With those decisions and mistakes you are also, FULLY ACCOUNTABLE. Now imagine yourself with eight or more patients. You may be asking yourself, “What do you mean eight or MORE patients?” Most student nurses never have more than six or seven patients and that is only at the very end of the program. Even then, the student nurses can delegate tasks to assistive personnel thereby lessening their work load. However, there will be time that you will be on a floor, without any assistive personnel, with more than eight patients and no one to rely on except yourself. To compound this scenario, there may be patients that have very critical care pathways that you must follow, incoming calls from patient’s families, doctor’s, operating room staff, and other collaborative care departments requesting information. Now, let’s stop this scenario in its tracks. You probably feel the stress building by just reading the previous passage. If so, don’t worry, it is a perfectly normal reaction. So, relax, and know that there are ways to ease this inevitable right of passage. Let’s take a look at some of the ways to help ease and deal with reality shock.

1. First of all, it is important to understand that, “reality shock” does indeed exist and you will come face to face with it. Knowing what you will face is most of the battle. The task at hand then becomes, knowing what steps to take and resources to use, and how to use them.

2. Learn as much as you can during your in-service training program, which usually lasts up to eight weeks or more. This means familiarizing yourself with every inch of your floor. Know where everything is located, from safety pins to I.V. tubing. You may never know when you may need it, NOW, and the worst thing that can happen is that you spend precious time looking for something as small as a safety pin.

3. Know, who the assisted personnel are, and know them by name and face. Find out who will be the ones that you will be working with during your shift. What usually happens during in-service training is that graduate nurses train on the main shift, which is most frequently days, before transferring to the shift that they have been hired to work. Therefore it is very important to know who you will be working with during your shift. Try also to develop a working relationship with the assistive personnel. Remember, it is not a popularity game, you are not out to make best friends. Your goal is quality patient care, and the patient comes first. Let your intentions be known that your number one goal is to give the best patient care that you have respect for the care team assistive personnel and are a willing and helpful body to them as well. In doing this, you will have disabled the invisible wall that exists between nurses and assistive personnel. That wall is the one entitled, I am a NURSE and you are ONLY an aide. One thing that you must strive for is to use an even tone of voice, and fairness when delegating. You must also remember the rights of delegation, which are as follows, a. the right task, b. the right person, c. the right communication, (must be clear and concise), d. the right feedback, (the person who is delegated the task must comprehend what it is that is asked of them and let the nurse know that they comprehend). By doing this you are ensuring that patient care will not suffer do to a personality glitch, which could have been avoided.

4. Know, know and KNOW where the Policy and Procedure manual is located on the floor. Part of your hospital in-service will include the introduction of the Policy and Procedure Manual. This is the manual that you will have to refer to many times for protocol from everything from changing out a Foley Catheter to transporting a patient to another floor. The final analysis will be in any investigation, “did the nurse use and follow the Policy and Procedure Manual?” You want to always be sure that you follow the rules and protocols contained in your institutions manual. Therefore, you should know where it is located and be familiar with how to look up various procedures and policies, particularly

5. The policy regarding medication errors. Most everyone makes them and it is crucial that you know what paperwork is required to be filled out. It will come in handy. You cannot just, “wing it”, when making a decision, you have to follow protocol.

6. Use assertive communication when interacting with doctors’. Assertive communication indicates that you are aware of yourself and your limitations as well as your liability to the patients that you care for. Using this form of communication with over assertive medical personnel will help you function to your maximum capability and earn respect as an independent care professional. {For more information on the uses and strategies concerning assertive communication, please refer to the text entitled, Nursing Today, Transition and Trends, by JoAnn Zerwekh, Jo Carol Claborn, 5th edition, Co. 2006, Saunders, Philadelphia.}

7. Ask questions. You will have time during your in-service training to ask questions and get answers. It is your right to do so. Remember, not knowing is not an excuse, and you do not want to be in a situation where there will be no-one to ask. This is not to say that you will know everything, but a least you are giving yourself a head start and a good solid foundation by knowing what you can. So don’t be afraid to ask. Also, know who your resources are, for questions that you may have on the shift that you will be working.

8. Find a mentor with whom you can relate. Try to find someone not only on the shift during training, but also on the shift that you will be working. It is nice to find someone who has the experience and understanding as well as someone that you can get along. There might be a time that you will want to call them in the middle of the night and vent your concerns, or just to have them give you positive input in your performance. Mentors are essential to the growth of a new nurse.

9. Lastly, Know, Know and Know, what your State Nurse Practice Act states. This Act, is your guideline for most all that you do as a Registered Nurse. Know it well.

Hopefully these tips will help to ease the reality shock that you will face during your transition from student nurse to full time graduate nurse. Remember, you can’t do it all. You are a welcome asset to your employer, but first and foremost an embodiment of all that Florence Nightingale stood for. Best wishes on your journey.


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