NursesPTO Making our time off, pay off.

The NursesPTO crew

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Debt consolidation and debt settlement – avoid the scammers

by under Finances

This entry is part 2 of 3 in the series Debt consolidation

Shell game scam

There are hundreds of telemarketers/e-mail spammers/billboards promoting debt consolidation sites. Sounds great right? Like the debt fairy might come and wipe away all your monthly payments into a consolidation as dense as a black hole. And we all know that black holes are really, really tiny. But the reality is that if your credit has already been damaged by a few late payments or a car re-possession, the interest rate you’re likely to get on these loans will be high. So high that while there may be a certain convenience to gathering all your payments together under one umbrella, in the long run you’ll end up paying quite a bit more than if you negotiated with your individual creditors.

Sounds impossible right? How can little old you negotiate with a behemoth like Visa? Well it turns out, you can. Remember the two lists I told you to write in the last post? For now, put the asset list away, we’ll deal with it later. Look at your debt list. Some of the members of that list are highly negotiable. Your mortgage? Not so much. Your rent? Maybe, but prob’ly not. But… and here’s the fun part… most of the rest of that list may well be amenable to renegotiation.

Most everyone who gives out money would like to see it returned, preferably with interest. If you’re defaulting on your credit cards or your Jet ski loan, the banks are big losers. While they can take the Jetski away, credit card companies don’t have any real tangible assets of yours to go after. And in any event, for both the credit card company and the Jet ski-loaner, taking possession of and selling your stuff costs them a lot of time, money and headache. Again, not in their corporate strategy.

One of your jobs was to write down the names of the companies who held your debt and if you haven’t already, add the little 1-800 number that’s listed on the back of your card.

Beware of the scammers.

Almost all of the debt consolidation ads you see on the internet, on Google, on Facebook, on the sidebar of your favorite news site like CNN.com, foxnews.com, etc. are scammy companies. Here’s what they usually do: They charge an upfront fee of $700 – $1000. They negotiate a settlement on your behalf with the credit card companies for about 50 cents on the dollar. Then they charge you another fee based upon a percentage of what you pay back. You can do this all on your own without them and their outrageous fees!

Now go to this website: http://www.nfcc.org/. This is the website for the National Foundation for Credit Counseling, a non-profit agency that wants to help you have a more stable financial future. The website has dozens of articles and tools to help you organize your finances, behavior patterns to avoid and contact information for free or low-cost financial planning. They are not some skanky used car-salesman site. They have a special section on debt settlement alerts because it is such a popular field with scammers. Here is a link to a file in Microsoft Word format that offers information on debt settlement debt settlement questions.

Starting with your highest interest loan (most likely a credit card), call the 1-800 number, dial “0″ to talk to a person and tell them you want to discuss a payment plan with someone. Think they’ll be angry at your presumption? Oh hell, no. They’ll be overjoyed because it means they can transfer you from the bad debt column to the paying customer rolls.

You’ll have several different options: tell them you want a lower interest rate and threaten to use another card if they resist, tell them you want to set up a scheduled payment plan on your existing balance while freezing or curtailing new purchases in exchange for a lower interest rate or overall balance. Your bank may be able to set up an automatic withdrawal feature so this payment goes out every month before you can even change your mind. But don’t give away the farm – remember, you have what they want: your money. Figure out what the best plan is for you in the long run using the tools at the NFCC site and then don’t be afraid to tell them what you’re willing to offer. It’s worked for thousands and thousands of people before, it will work for you.

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Debt consolidation – First steps

by under Finances

This entry is part 1 of 3 in the series Debt consolidation

make-money

It’s been said that the best trauma surgeons have a slower pulse when shit hits the fan rather than the ultra-tachycardia that us mortals achieve when chaos begins. I’ve thought about that a lot lately when I watch the news and see job loss rates in the tens of thousands, month after month. And when I’ve seen the people I work with have to dip into savings accounts to pay off their monthly bills. No getting ahead, just lucky to tread water and stay afloat. I think of the unlucky ones out there whose debt is spiraling, transferring credit card balances to newer, temporarily interest free cards to hope to put off disaster for another month or two.

So what can you do? I mean besides binge drinking and kicking your pets.

The first thing you need to do is stop putting off meeting the disaster. Sit down, shake hands and stare at your financial situation in the face. Most everybody I know procrastinates or tries to ignore unpleasant work or thoughts (except the super-successful folks… gee I wonder if that means anything?). But even if you think you’re ignoring it, most of us carry around this nameless dread in the form of tension in your shoulders, or an upset stomach that is your sub-conscious’s way of saying, “hey!! this is a big deal buster!! We’re in trouble here!!” That tension does nothing to make your life better nor does it actually fix the problems. It just gives you an ulcer.

So sit and write everything down, even if you think you know the answers.

Make a list of all your assets

Bank account, equity in your home or car, possibly disposable “extras” like boats or 4-wheelers. Then open all those envelopes you’ve shoved to the bottom of some pile and write down all your debts – mortgage or rent, car payments, each of your credit card bills, school loans. Then next to each of these items, write down a contact telephone number and e-mail address. In my next post I’m gonna talk to you about what to do with all that information and how to get lower payments for your very own self.

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Nursing students: choose your career.

by under Nursing, Nursing School

tracks
When you are in nursing school you get a chance to visit different types of units and learn about areas of nursing you are not familiar with. This is the time when most students start thinking about where they would like to work after graduation.

Floor nurses

This would be those nurses that work general medical-surgical floors. This type of nursing usually involves a heavy patient load (sometimes as many as 8-12), but typically with minimally sick patients. These patients could be your broken leg, infected wound, and minor surgeries. The RN in this case has responsibility for many patients, but has the help of LVNs and aides. The charting is less frequent and these people go home….

Telemetry nurses

The nurses on telemetry floors have almost as many patients sometimes as a floor nurse (4-8), but these patients are just a bit sicker and just a bit more charting. There are usually still LVNs and aides to help on these type units as well though. The types of patients you may find here are those with uncomplicated heart caths, pneumonia, controlled atrial fibrillation, and of course this is where we send a lot of ICU patients that get too well to stay with us ;)

Labor and Delivery nurses

This is the kind of nurse I always wanted to be but was never given the chance because I don’t have any experience in labor and delivery….Anyway, these nurses have varying patient loads depending on how progressed their patients are in labor. When they have one on the verge of delivery, that one is considered a 1:1, which means, one nurse to one patient. She does not leave that patient until delivery and clean up is done. Some stay and help the mother with breastfeeding if she wishes to do this because getting started right away is very important for the mother and baby bond. Some L&D units may use LVNs and aides, the one where I work does not. Of course I do not want to leave out the post-partum nurses! They are some of the best teachers to new mothers. They get the opportunity to show first time mothers how to care for a new baby and encourage them through the tough times. Some hospitals group post-partum with L&D making it an LDRP (labor delivery recovery and postpartum) unit.

Pediatric nurses

This is one job I know I am not cut out for. Pedi nurses’ staffing ratios are similar to that of floor nurses typically. Many hospitals don’t use LVNs or aides in pediatrics either, so these nurses stay busy. With pedi patients, parents are allowed, and in most cases required to stay with their child, so the parents perform much of the care of the child themselves (however, when I was in school I took care of an 8 month old whose mother would go out with her friends and be gone all night and leave the baby alone!).

ICU nurses

Of course I am somewhat biased here, being an ICU nurse myself, but many of these nurses truly are extraordinary. ICU nurses have lower patient to nurse ratio because of the critical conditions of those we care for. The typical ratio is 2:1, two patients to every nurse. We do have 1:1 patients frequently that will keep one nurse as busy as if they were caring for 3 patients. We are required to chart more frequently, at least every two hours. There is a higher level of stress in the ICU due to grave illnesses and dealing with family distress often. Where I work we do not have LVNs or aides to help, so we perform total care on our patients. I do like this method, because I know what meds they have and when they got them and what their backside looks like and what they ate or didn’t eat for lunch.

OR nurses

I really don’t know much about these nurses. We rarely ever see them, and in ICU it is typically not a good thing when an OR nurse is the one bringing your patient back from the OR because it could only mean one of two things, either they were too sick to go to recovery or they were coding in the OR and were rushed back to the unit so as not to count against the surgeon’s statistics…Either way, we prefer not to see them ;) I know they do wonderful things in the OR and have to deal with the wrath of surgeons, so for this I commend them. BTW, you can read about what it takes to be a good surgical nurse from our very own Dr. Rachael Keilin:Surgical nursing tips.

ER nurses

- These nurses are the bane of an ICU nurse’s existence…Ok, I am just teasing, well a little. ER nurses are another type of special nurse that I could not be. They see the worst of the worst that comes in from trauma to burns to rape. They get very little or no report sometimes on what is headed for their door. They have to be prepared to take on anything that might come in. These nurses care for anywhere from one to several patients at once, depending on levels of acuity. LVNs and aides are used in ERs. I am pretty sure there is not an ER nurse out there that doesn’t have at least one crazy story to tell when they get home.  But some of the stuff can be boring too, like my post on flu clinic.

Now I know I left out many other types of nurses, and you are all special in your own way!

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ER nursing and the flu clinic. Not for me

by under Nursing

sneezeI recently worked a shift in the ER in…… “the flu clinic”…… Now I had never even worked in the ER before. It’s a whole different world down there. This flu clinic is a new short term addition to the ER with the increased number of patients coming in for flu like symptoms. The regular ER just can’t handle the volume. So lucky me, I was volunteered to float to the ER to work in the flu clinic because my home unit was closed.

If you have ever been in the ER you probably know it seems like a big chaotic unorganized place with lots and lots of noise, or at least that is what I would describe our ER as with my limited experience there.

So back to my predicament….I am in the ER and am told I will be working with two other people that aren’t normal ER staff. Well that is just great I think. Two hours into the ordeal the other RN is pulled and an LVN is brought in. It’s me and two LVNs to handle the entire onslaught of flu victims….We had only four rooms to use and mainly dealt with the patients as they sat in chairs in a long hallway. Now as a Surgical ICU nurse, I do not have to deal much with children….I saw so many snotty, puking, coughing kids that day….My decision to become a Women’s Health Nurse Practitioner instead of a Family Nurse Practitioner was validated.

Now if I am lucky I won’t end up with a debilitating case of the flu, but since when does luck have anything to do with nursing….

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How to do the best job as a surgical nurse – from a surgeon

by under Nursing

This entry is part 1 of 2 in the series Being the best nurse

teamworkWhen you went through your OR training for surgical nursing in nursing school, I’m sure that you heard from the experienced scrubs about what made a good scrub nurse and all the many different things you needed to know to become one. I want to offer you my perspective from the other side of the table – what does a surgeon want to see in a scrub? What will make you requested by the doctors and therefore make you the last person to be “downsized” in these uncertain economic times?   (BTW I once heard of a surgical scrub nurse getting fired in the middle of the day, between cases.  You don’t want to be that person.)

I’ll start by saying this: I am lucky enough to scrub with some amazing amazing amazing surgical nurses. How grateful am I? I travel out of town about once a month and always bring back a 12 pack of one scrub’s favorite, but very hard to find beer. Even if this means canvassing seedy liquor stores on the wrong side of a strange town I’ve never been in before. That is grateful.

The number one thing that makes a great scrub nurse is ANTICIPATION. A nurse that looks at the field constantly, who learns the basic flow of a procedure and can therefore get the next instrument ready is invaluable. I trained at a huge level I trauma center and to this day I still remember one of the scrubs who knew the cases better than the residents and who was constantly glancing back and forth: what’s going on? what are they going to need? what do I have and what do I need to get? If blood’s hitting the ceiling, ask for another pack (or three) of laps and a bunch of 3-0 silk. Then load’em up so they’ll be ready ASAP when asked for. The nurse that anticipates instead of responding to a request is a scrub partner, not a scrub assistant.

While a lot of surgeons are relatively fun people (okay, maybe not, but indulge me here), when operating, most of us like to/have to concentrate. TAKE THE TEMPERATURE in the room – not literally on the thermostat, but emotionally in the air. Is the surgeon tense, hunched over and quiet? Then keep the chit-chat to zero. Are they smiling and teasing the gas-passers at the head of the table? Then definitely share the story about your kid’s latest toilet training adventure (I’m not being condescending – I’ve actually done this on several occasions). But always cut the chatter when bad shit starts to rain down. Is the suction bucket filling up with blood like an exploding firework? Is there a sudden and frantic widening of the incision? Then everyone – anesthesia, the circulating nurse and scrub nurses need to stop conversing and get ready to help. ‘Cause nothing pisses me off like a patient in trouble with people in the background laughing at a joke.

Keep a journal and record surgeon’s preferences. Hospital preference cards are random number generators and bear no relation to reality. Keep your own log of what the docs need – is it their favorite radio station to be playing when they walk in (or do they demand absolute silence ’til the patient’s asleep)? Which one likes vicryl ties, which likes silk. This one always uses a Veress needle, that one thinks it’s the instrument of the devil.

Last but not least is advocate for your surgeon. Room turnover time is the A#1 biggest gripe of every blade wielder I know. Even though you can’t control MAFUT (mandatory anesthesia f*@& around time), you can help clean up the room, so the next case can get started that much faster. And you can keep tabs on what’s going on with the patient in holding – bug the nurses there to make sure they’ve been seen by anesthesia, that their meds have been given, that whatever needs to be on the chart or whatever films are needed get to the bedside pronto. Trust me, we’ll notice. And noticing will get you love and love will get you beer. Then we’ll all be happier.

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Ways to make money in your time off. Part II- Direct sales

by under Finances

There are literally hundreds of different companies that now have no (or very few) physical stores but instead use individual salespeople to sell their products to friends and co-workers. But to paraphrase George Orwell, not all companies are created equal. In addition to some really fabulous opportunities, there are also a lot of pyramid schemes whose main goal is to rip you off.

My first piece of advice is a repetition of what I said in my earlier post: make sure you like and enjoy the product(s) you are going to sell. Before you make any commitment, try the products out yourself. For one thing, it’ll give you something to talk about during your sales parties, but it will also allow you to weed out any companies that don’t really exist. What do I mean? There are enough scams out there that I would want to have an actual product in hand, tried out by me personally, before I committed any time or money. You don’t want to hand over money for a “start-up kit” or whatever other introductory offer they might have, then discover that their phone number has been disconnected and their website is now defunct, and your money is….. who knows?

A corollary of this is to be beware of anybody who is aggressively pushing you to be a sales rep for their company. Maybe they’re just happy, enthusiastic people, but maybe they’re trying to force you into a less than solid agreement. If the company is real and the product is solid, there shouldn’t be any kind of rush to have you sign a sales contract in a hurry. Let pushy company reps be a flashing red warning light. If you have any concerns, check out the company on the Direct Selling Association’s website www.dsa.org , which is kind of like a better business bureau for direct sales companies.

Once you’ve made your choice of type of product you want sell, you need to start researching which companies offer you the best compensation structure. Questions you will need answered include:

-what are initial start-up costs?

-what kind of training do you offer? Manuals? DVD? Live classes?

-are there minimum volumes I have to purchase at a time or monthly minimum sales I must make?

-do the reps get a discount on products for themselves?

-what is the sales commission structure?

-Does my commission increase if I reach certain sales goals?

-if I recruit other people to be salesmen, do I get a percentage of their sales?

-what is the contract termination policy? Can I quit at any time?

-what is the company policy towards selling their product online?

-what is a typical sales volume for someone in my size town/region?

A last question to ponder is whether you are a social butterfly or a wallflower extraordinaire? Are you comfortable hosting parties attended by a dozen strangers, or would you rather communicate with customers solely by e-mail? Different companies have very different requirements so if you freeze at the thought of meeting a bunch of new folks and sharing your expertise on the product, maybe you should stick to something on-line or telephone only.

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Quit nursing school?

by under Nursing School

axPeople start nursing school at many different times in their lives. For some it comes right out of high school, for others it is after they retire from another profession, and then for the rest of us it happens somewhere in the middle. I started nursing school after I had my four children and was getting a divorce. I needed a way to support my children. My mother and sisters were all nurses and so that seemed like a good choice.

I am thinking about this because a student nurse at work recently asked for advice about what she should do. She was contemplating quitting school; she only has 6 months or so until graduation. She was telling us that she was too stressed and she just couldn’t stand to be away from her children any longer. She thought maybe she should quit school and get a job waiting tables so that she could be free of the stress and see her kids more. If she could make it 6 months she will be a registered nurse (RN) and be able to support her children on her own.

Nursing school is hard on almost everybody I think. I don’t doubt that most everyone considers quitting at some point, but you really should stick with it, because the rewards will be so much greater if you just get it done. If you put it off, chances are you will never get up the nerve to go back. So, as I said to the student, please don’t give up, stick with it! You will be glad you did!

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