I am the first person to admit that while I can cut into your chest and crossclamp your aorta within about 2 minutes, I cannot balance a checkbook.  I make a mean souffle, but my eyes cross whenever I try to enter even a month’s worth of expenditures into Quicken.  Since I plan on toddling into the nursing home in $800 Louboutin 5 inch heels, I had to admit my weaknesses and seek expert financial advice.

While my husband and I were still surgery residents, we first started visiting with a certified financial planner.  Now keep in mind that in our last year of training, our net worth was somewhere around negative $350,000 since our school loans/car payments/credit card debts far outweighed our meager assets which consisted of….. a lot of used scrubs and some drier lint.  To say I was skeptical about our need to see someone who might pee their pants looking at our bank statements….. you get the picture.

But it turns out that it was one of the best things we ever did.  They helped us set up accounts for important – future- life events such as a college fund (now funds with the addition of daughter #2), retirement planning, investment accounts and a debt paydown strategy which allowed us to eek away at the monster loans while still going out to dinner occasionally.  Now all of these accounts started out with only meager initial contributions, but those little seeds grew over time.  Granted, they got squashed like bugs on a windshield when the markets collapsed a year ago, but they’re now once again worth more than we’ve put in, which cushions us for the future.  And most financial planners charge little for initial consultations or offer them for free.

If I had stuck with my pitiful financial sense and my Scarlett O’Hara-esque sense of “tomorrow’s another day” then I’d likely be shuffling into SunnyShades Retirement on a pair of Payless bargain rack specials instead of plugged into some Jimmy Choos.  So let me please recommend seeking out a certified financial planner (the “certified” part is important – you don’t want somebody’s smelly aunt Franny who claims to be an expert, but got her “degree” from a Bazooka bubble gum wrapper) to help you set up a goal and devise strategies for getting there.  We chose a firm recommended to us by a friend with expertise in advising health care professionals because that was a good fit for us.

A good financial planner will fit your needs.  For those of you starting a new family, I recommend Vita Vie financial planning.  They specialize in helping young families plan their financial future.  I couldn’t say it any better than Kristin Harad, their founder, so check them out at their video link Certified financial planner.

Remember, it’s all about the shoes!

I got the biggest compliment of my life the other day. My little boy who is 10, was playing with his neighborhood friend who crashed his bike. In they come, neighbor kid with a bloody knee and a nice case of road rash. My little boy looked at his friend and smiled then said “My mom is a nurse, she can fix anything.”  I giggled, knowing good and well I wish I could fix anything. We got the injured knee all washed, cleaned and bandaged and out the door they flew only to take on the days challenges that were left.

My little boy was so sincere when he was talking to his friend. It really made me stop and think how wonderful children are and how they look up to us for so many things. It by no means had to do with the fact that I’m a nurse he feels that way, he also feels that way about his dad who is a laborer. It’s the fact that he looks up to us all for guidance and has every ounce of confidence we as parents and step parents can “fix anything”. His dad has taught him so many things, the man literally can fix anything.

Even though we are divorced we are fortunate to have put are children first. I’m by no means saying we haven’t had our knock down drag outs, but we did the best we could.   We are both now with other people so my crew of 2 kids turned into 4. His crew of 2 turned into 5. Our children are so lucky to have step parents that love them like their own. Now being the proud mom/step mom of four, the laundry load has certainly increased but, I love every minute of it!

I know this has nothing officially to do with being a nurse but, I just wanted to share with you the biggest compliment of my life. Sometimes it’s nice just to slow down, take a look around and truly appreciate what God has bestowed upon you.

Most of us have been in the situation where things happen beyond our control. Well….when a patient gets the bright idea to rip out some tube or line or other very important and most often not easily reinserted piece of medical equipment….who gets the blame most often? NURSES. Now, I really do not find this to be fair. While we are the ones that are responsible for those that we care for, we cannot be at the patient’s bedside at all times. We have meds to gather, physicians to round with, charting to do, and yes every now and then we have to use the restroom or eat. Though I can say that there have been days I have not entered the bathroom door at work and I was lucky to shove in a bite or two of whatever happened to be lying on the break room table for lunch. Most of us have more than one patient as well which makes it impossible to watch each one at all times.

Anyway I say all of this because we as nurses get blamed for crazy patients pulling out their chest tubes, central lines, endotracheal tubes, and yes even ventriculostomy drains….NO nurse wants to make that call to the neurosurgeon and tell him such news. I have seen nurses in tears over this. I realize that taking a patient back to the OR on a Sunday afternoon is not fun, but it truly isn’t always OUR fault that these things happen. Most often it is that the patient is not sedated enough (per your orders), has Houdini powers and managed to wiggle out of restraints, or had been perfectly with it until they started seeing the bugs on the ceiling and decided to rip out that chest tube to use as a weapon….It really wasn’t my fault….I’m just sayin…

(This is guest post by Sandra Stevens, a Career Blogger. For more information on Certified nursing assistant Training you can visit her blog over at http://cnatraininghelp.com)

Have you been thinking about a career as a nurse?  Are you looking into nursing schools for your new career or to attend upon graduating from high school?  If so, you might want to consider training to become and working as a certified nursing assistant first.  You might even have noticed that some nursing schools require applicants to have the CNA Certification.

A CNA certification does not take long to obtain.  In fact, you can find many courses that only run for 3 to 6 weeks.  During that time you will have classroom instruction, demonstrations and clinical lessons.  You will learn to perform a variety of nursing assistant skills.  The duties of a CNA depend on the setting in which they work.

Nursing assistants often help to teach patients range of motion exercises.  A nursing assistant will take and record vital signs.  A CNA will help patients with their activities of daily living.  Nursing assistants are often asked to help bathe and groom patients.  A nursing aide can help patients to use the toilet or to change patients who are unable to use the restroom on their own.

If you decide that you want to or need CNA Training, you will want to find a nursing assistant training course that is fully accredited to provide you with the credentials you need to take the examination for certification.  You must attend your classes and make good grades on your exams to prepare for the certification exam.

When it comes time to take the certification exam, you will need to answer a series of multiple choice questions.  After that portion of the test, you will need to demonstrate nursing assistant skills to the person administering the examination.  Once you pass the exam, you will be eligible for your certification.

Consider working as a CNA for a few months before applying to enter into a nursing school.  This will give you time to work as part of the nursing team.  You will learn to provide kind and compassionate care for patients.  The time you work as a CNA will prepare you to move on to a career in nursing with more responsibilities and challenges.

Working as a CNA, will give you time to practice your bedside manner.  You will learn a great deal about how to work with patients who are scared and sick.  Of course, you will also learn how to work with and interact with other members of the healthcare team.  This will benefit you when the time comes to do your clinical rounds when you do attend nursing school.

It will be easier for you to gain acceptance to a nursing school if you have your nursing assistant certification.  In fact, you will find some schools for which this will be a requirement.  You will even find that some of your coursework in nursing school as a result of what you already learned during your training and work as a certified nursing assistant.

When a girl gets married, it is expected that she will take her husband’s name. This may seem romantic to some, like ownership to others. The process though can be quite complicated. The level of complication has a lot to do with where you are in life at the time of your marriage. A young girl just out of high school maybe has to change her driver’s license and social security card and that is it. A woman that is older may have a bit more trouble.

My first marriage was right after high school and I had no problem changing my name…7 years later I was divorced and everything I had accomplished, college, nursing degree and license, certifications, maybe a few credit cards, numerous bills, my four children…well they were all attached to that name. I did not change my name back to my maiden name after divorce for that reason. Then 6 more years passed…and I was married again. I have been married about a month and a half…and still not everything is changed over to my new name. Every week I try to change my name with one of the various agencies that knows me. It has begun to seem like it will never end. I couldn’t change my name at work until my nursing license was changed….so I had to use my old name there, my new name on checks, my old name at school, and my new name somewhere else…it was confusing! Many times at work I signed a medication record with two different initials. I finally changed my name at work, but all my logins to the med pyxis and supply pyxis and computers all still use my old last name…yet another thing to change…

All the while, my new husband has no similar distress to worry about. His name is his name. Some women decide not to change their name with marriage and I think that is understandable, and some men are accepting of that. Though I do know of a woman that kept her ex husband’s name even after 20 years of marriage to someone else…I have already told my new husband that he cant have his name back! This is the last time I am changing my name….not just because I love him with all my heart and am so happy to be with him, but well….it is just too much trouble!

Are nursing unions really necessary? I am trying to look at this from all angles of medicine. The first point of view I am going to take is that of being a patient. I have been very fortunate in my times as a patient to be surrounded by amazing, educated and capable nurses. A good nurse is worth their weight in gold. Nurses are not only the number one patient advocates but, they are the eyes and ears of the physicians. Most of the nurses I have come across in the past 11 years are great but, there are those few that made me wonder how they kept their license but, they did lose their jobs. So, as a patient, does a union make it harder for hospitals/clinics/etc. to fire bad nurses? The reason I ask this is because I was married to a union guy. I have a ton of friends that are union members but, none of them medical. I hear them make fun of the companies they work for saying, “they can’t fire me, I’m union” that has always made my skin crawl! What the hell did they mean by that? The way I was raised if you were not productive, then you simply, got fired. Why would a company continue to pay a lack-luster employee? So as I was reading about the new national nurses union which empowers 154,000 nurses, are the risks the same for not being able to get rid of bad nurses?

Ok, angle number two is going to be that of a nurse. Let me just start by saying that, there are non-unionized nurses where I practice. The number one complaint I hear from my friends that work on the floor is the staffing ratio. Too many patients for too little nurses, this does nothing good for anyone involved. The nurse is overworked and is more prone to make an error. The patient is put at an increased risk from overworked staff; you sure don’t have to be a medical professional to know a small medical error may lead to a huge problem for the patient, sometimes death. A medical error by a nurse means trouble for the hospitals. After all, it’s the hospital that hired the nurse. The attending physicians are drug into this mess as well; after all it was their patient. So in my little simple mind correct me if I’m wrong here but, wouldn’t it just make more sense for a hospital to provide ample staff to ensure the safety of their patients? Would this not lead to an improvement for all? Fewer errors, less lawsuits, lower malpractice coverage and nurses that are doing what they were trained to do, take full care of their patients! Wouldn’t it make sense that if a nurse was caught using drugs that they stole from the hospital they would lose their license? Simple, if you are a dumbass and can’t do your job, or maybe you are late all the time putting immense stress on the staff covering your duties you uh…GET FIRED?

Third angle, MONEY! That being said, nurses from this area make approx 3 times more a year if they work agency to cover strikes. I know many nurses that went agency to work the strikes in California, they banked. But agency nurses that fill in during strikes would not make 3 times the money if, well, there were… no strikes. I know agency nurses that work in specialty areas that make more than the full time hospital employees, usually 1 ½ times-2 times more. Let’s take the operating room for example; it takes a minimum of six months to train a nurse, to cover operating room call. So if a hospital is short handed, it makes more sense for them to pay more to a nurse that is already trained to make up for the shortage until the position can be filled or, a full time staff nurse can be trained to fill that specialized spot. So how much more do unionized nurses make versus non-unionized nurses? I have no idea, I know no union nurses.Well, this could ramble on forever and I don’t have an attention span that long. I was just wondering what ya’ll thought. Are nursing unions really necessary?

In October, at the Blogworld Expo I had the privilege of hearing “Nurse Ratched” who blogs at her site Nurse Ratched’s Place speak on a panel. The most fascinating thing she discussed (at least to me) was a phenomenon she noted of nurses always undercutting other nurses. She had written a blog post about it entitled “nurses eat their young” and she felt it was the most pressing issue facing the nursing community today.

Her main focus was the ever-increasing pressure to further your nursing degree. She remarked that when she started out, a two year plan after high-school earned you a white starched cap and the ability to care for sick patients on hospital wards. You were a “nurse”, you had a uniform and everybody understood your position in the hospital But then came the split between “real nurses” aka RNs and licensed nurses aka LVN/LPN. Then the pressure for a bachelor’s degree. Then a masters and finally now, a movement towards a doctorate in nursing science – a doctor of nursing!

As an “old school” nurse her concern was focused on how inadequate she and her fellows (with many decades experience!) were being made to feel by the insistence that their education was insufficient. I can’t help but agree and wonder whence comes all this spiraling degree obsession. Because I’ll let you in on a little secret: I feel like it kind of demeans the value of my education, too.

Currently there are masters of nursing programs across the U.S. that prepare people with basic nursing training to perform advanced skills – anesthesia (CRNA), baby delivering (nurse midwifery) and primary care (nurse practitioner). And I can certainly understand maybe three levels of differentiation such as LVN (for floor or office nurses perhaps), RN (for more critical levels of care such as ICU or ER) and masters for people who will be assuming a primary role in the therapeutic care of patients without constant/immediate supervision. This progression would allow the choice of length of time spent in school, the amount of responsibility a person is willing to assume and degree of specialization.

But a doctor of nursing? What would that really mean? What extra clinical skills would be taught that are not currently encompassed by the masters programs? There is no evidence in the litterature that the current masters programs are inadequate, so why the push for another level?

Since a lot of nursing masters programs consist of a lot of online training and non-standardized clinicals in non-academic settings, I also wonder if this really meets the advanced qualifications of a doctorate. There are NO doctor of medicine programs that can be completed online, no clinical training that can be done outside of an academic program and there’s always the little matter of clinical training after school – residency. Four years of full-time school (there aren’t any part-time med schools, either) then 3 to 10 years of additional full-time (80+ hours/week) training afterwards to earn the title of “doctor.” I’m sorry but 2-3 classes per semester, taken online over the course of several years should not imply the same depth and breadth of training implied by a doctorate.

But what about nursing research you might say. Well what about it? What is specific to advanced nurse-performed research that is not covered by a more traditional doctorate. You want to do bench research? Get a PhD in molecular biology. Want to do epidemiology or population studies? Then get advanced degrees in statistics or anthropology or genetics or whatever other specific thing is of interest. If you want to be a DON, go get a business administration degree.

But I think it demeans the training of and care by the LVNs on the floor of a hospital to say that you need to have almost a decade of training to take care of patients.  Is there really a problem with the nurse structure in healthcare or do we need to re-vamp the entire system?

I have now had two experiences with colonoscopies….I am only almost 32 but I have a very extensive family history of colon cancer and would like to stay healthy. My father died when he was 50, and he had a brother that died at 40 of colon cancer. His other brothers also had cancer and I believe a couple sisters that were diagnosed with different forms of cancer…I never knew this side of my family so I am not that well informed.

But I try to stay healthy by exercising, not smoking or drinking (too much) and eating….well a semi balanced diet. Colon cancer has always been a fear for me though. I had my first colonoscopy at 24 because of symptoms which I thought were concerning but it turned out normal. I remembered everything and could feel the scope inside of me. They said I fought terribly and was not a good patient. That experience was absolutely horrible though and I waited almost 8 more years to have another one done. This last one at 31 was much better. I remember nothing and everything turned out fine. I do wish there was a way to make the prep a bit more pleasant….

I was upset though that this time for my colonoscopy the insurance company didn’t want to pay for it because they do not pay for screening colonoscopies until the age of 50. I guess they would rather pay for colon surgery and chemo for me when I am 40 than a screening colonoscopy. My dad was dead at 50, and his brother had been for 10 years by that time…so I am thinking that 50 would probably be just a bit late for me….but the insurance companies do not care about such things. My doctor recommends I have another one in 3 years…and every 3 years…that is about 6 more by the time I am 50. Luckily I have a good job and can pay for procedures, but those that can’t like my father are just at the will of the insurance companies…

1)  I could go to work in my pajamas because the hospital provides the scrubs, so I got to change when I got there. I could take a cute outfit to put on after work for any about town errands or about town bar hopping afterwards.

2)  I did not have to fix my hair because I would be wearing a surgical hat. A ponytail knot and I was out the door. There was an ample supply of hair essentials in my locker such as: hair dryer, curling iron, hairspray etc.

3)  I did not have to put on make up, my patients only saw my eyeballs. I would usually put on mascara but there was no reason to put on my full face only to be in a mask all day. Now, if I woke up a little earlier I would put my face on as not to scare my co-workers but, as far as my patients went, they didn’t see my face.

4)  I didn’t have to buy scrubs. The hospital requires that surgical scrubs be processed in a certain way, therefore they provided them and we put on a new pair each morning. If we had a patient that had any type of infection, the scrubs were changed in-between cases. Tell me that does not save some major cash!

5)  A guarantee in the operating room is a fast paced atmosphere and almost always an adrenaline rush. Even if the surgical case was an elective, scheduled case, trying to turn the room for the next case in a quick manner is a must. If you are slow at turnaround, not only does your boss yell at you, your surgeon will not make your life easy. If you bust your butt then not only do your supervisors notice but surgeons will start requesting you personally.

6)  You make some awesome friends because, the operating room is it’s own universe. We may bicker amongst ourselves but let an outsider try and jack with one of us and we would stick together. There are no float nurses in this field because it is such a specialty. The benefit of that is you are with the same herd most of the time. It’s like a family, a dysfunctional family per say but, still a family.

7)  A guarantee you would do something different, every day. You never know what traumas will roll in. You never know what surgeon is going to throw a fit and you never know what new drama has arisen since last shift. The operating room is notorious for some good drama, hehee.

 The operating room is a fun place to be, I think it’s a pre-requisite that you be a little off your rocker to work in this environment, I obviously fit in just fine. One thing you better have is, a skin made of steel because; you will be yelled at on numerous occasions by different surgeons (most of them apologize after their sphincters relax). I always enjoyed yelling back, there’s just something that makes you feel good about standing your ground. Actually, we didn’t yell at each other all that much, only days that end in Y. Then we would go drink a beer an laugh (if we were not on call of course).

Before diving into yet another dry, overcooked holiday fowl this week, I am going to give thanks for getting to attend an old fashioned, rockstar-worthy, hotel-room-destroying party last Sunday night.

We arrived kind of late and the two other party goers with me kept staring out the car window pouting because they thought we’d arrive too late to join in the fun. But after pushing my mommy-mobile close to the speed of sound, we finally made it to the parking lot of the hotel. The girls composed themselves admirably as they walked past the front desk trying to affect a bored, nonchalant look. “Who us? No, we’re not yet another group going up to room 213. Please don’t call the police or the fire marshal……”

Through the hotel room door, I could hear muffled screams and giggles which were quickly squelched when we knocked. The door was slowly opened a crack as the hostess peeked out to see who was in the hall. She swung it open wide when she saw us saying, “oh, good it’s you guys! I thought it was the hotel manager, telling us to be quiet….again.”

We walked in to chaos. There were empty pizza boxes littering the tables, half eaten and abandoned pieces of pizza and drinks lying on every other available space in the two bedroom suite. TVs were blaring, ignored, while the guests ran around jumping on the furniture, acting like they were wired for sound.

Despite being late, we arrived just in time to catch the chauffeured car over to the hotel next door, where the management, in deference to the star of the gig, let our group swim in their heated indoor pool, since it was about 40F outside. After the pool takeover, the ensemble then headed back to the room, where the party continued late into the night with everybody eventually crashing on the floor.

You may well ask why I’m thankful for such a wild bacchanal at the almost rocking-chair worthy age of 41. Didn’t I get the memo that drugs and wild parties were sooooo 1980’s? Yeah, I did, but when the drug of choice is leftover Halloween candy and all the crazy party people in the house are under 4 feet tall, I’ll make an exception to the rule.

You see, this party was to celebrate my five year old daughter’s best friend finally being finished with treatment for a scary tumor her mom, a doctor just finishing her training, found accidentally back in February. Both of the girls had a little cold, but when our little friend had some nausea in addition to her headache, her mom took an x-ray of her stomach and found an advance-stage cancer in her four year old little girl. Nine months later her chemo/surgery/radiation are completed and her blonde hair’s just starting to grow back in. She describes her scalp as feeling like a horse’s nose, soft and a little fuzzy.

So this Thanksgiving I want to pause and appreciate the miracle of a little life saved by modern medicine. I am thankful for all the people who slave away doing unheralded bench-work in basement labs to create medications that heal us. I am thankful for specialized hospitals that have the knowledge and trained professionals to support us when the bottom falls out from under what we thought- just that morning!- was an otherwise normal life. I am thankful to have friends like the moms in our little group, who have never thought twice about doing many special things, big and small, for a family faced with the ultimate horror. And last, I am thankful for my two daughters and the reminder not to take them for granted. Every smile, every pout, every lost tooth, every trip to the principal’s office, every dance recital, all the trips to the overpriced doll store, the long car rides with 50 potty breaks, the weekday mornings filled with frantic searches for books and folders. I am thankful for each and every one.