[nursegottabe]

Hi everyone,

I'm a new LPN as of about a month ago but I have medical issues keeping me from practicing temporily. Come Jan., I will attend college again and become an RN. I can't wait. Wish me luck. Thanks for the tips. I think this site and I are going to get along just fine.

Thanks again
Nursegottabe

Originally Posted by gerrihorses

thanks for that whole bit. I'm a student and that really helps.

Gerri

[macspad]

Originally Posted by SmilingBluEyes

Ever have an "I wish I was told this" moment? Well, we all do as nurses regarding school. Here are some things I wish they told me nursing school (and some I wish they had emphasized more)----and what I told another new BSN nurse in a different thread (and it would be the same advice I would give any new nurse/grad):



You have achieved a great thing, graduating and earning your degree (BSN, ADN , LPN or Diploma). Now, the REAL learning begins......

Don't ever pretend to know what you don't. Be a sponge---watch and listen to what is going on around you. Take mental notes. Find mentors and emulate their good habits. Take note of the bad habits and avoid those.

Listen to your patients; they know their bodies better than you do.

Have integrity----be honest with yourself and others.

Stay out of the gossip game/circle. It goes nowhere and brings down morale, including your own.

Be on time! EVERYtime. When you are late, so am I. And I don't like to be late!

Stay organized as possible. Keep up on your charting and tasks as they come up. Dont' save it all for "later"---there may not be time, "later".

Do it right the first time, even if there IS "no time". Believe me, there is no time to "Do it over", either.

Plan for the worst; hope for the best.

Be someone they can rely on---and rely on yourself!

Take good care of yourself; eat well, exercise. It's the only body you got and you are gonna need it. Nurture the self. Nurses have a tendency to martyr themselves and neglect their own needs. Don't be one of them; it's a fast superhighway to burn-out.

Nourish the mind. Plan on spending a LOT of time investing in your continuing education as a nurse. The world of nursing/medicine is changing faster everyday. You are going to have to make a conscious and concerted effort to "stay abreast". It's more work than you imagine right now.....plan on it.

Learn assertiveness if you have not already. Lots of good books and conferences/seminars exist. Learn early-on you no are NO ONE's doormat. Also, know there is a difference between "assertion" and "aggression".

Work hard, yes, but don't forget to PLAY hard too! Have hobbies you enjoy. Your life is NOT your work, and while being a nurse is part of who you are, it need not *define* you.

Believe in your self and good instincts. Sometimes, "instinct" is what lets us know something is amiss or wrong with our patients. Never ignore that gut instinct. It's very often right! BELIEVE IN YOURSELF!!!!!

After 8 years in nursing, these things are things I have learned the "hard way"; hopefully you don't have to.

Warm, hearty congratulations to you and all new grads here. I wish you all good things in your new careers.

What did you first year nursing students enjoy during post conferences...what topics did you think were worthwhile to discuss and helped you learn.....

[peridotgirl]

I just wanted to say thanks for the tips. I hope that really do help do me when I become a nurse. I am a CNA and when I go back to my high school, I will take the LPN class.

[peridotgirl]

awww.. that's very thoughful of you to say that to everyone on the forum. It's no problem helping you. That's what nursing is about: helping and teaching people

[newmom1]

1) Never give a medication if you dont know what it is or what it is for! Seems like common sense but I have precepted people who are about to give a med and when asked what it is and why they are giving it, they dont know. This will help increase your knowlege and improve your critical thinking skills. It will help you stop a possible med error before it happens.

2) If you are unsure of something always ask but from a reputable source. If you are not sure how fast to push a med check your drug book not another nurse. This ensures you have the correct awnser and promotes independance.

3) Always anticipate every possible question a md might have about a patient before you call him, they tend to lose patience and get snippy when you leave them on hold while you locate info they have asked for. Have all the vital signs, have the chart in front of you and be prepared with all the lab values. If the doctor is in house and your patient is critical do not be afraid to tell him to also come and assess the patient (notice I did not say ask I said tell). If you are given a verbal order over the telephone always repeat it back to him, if they hang up before you can do this repage them and very sweetly tell them that it is hospital policy that you verify the odrer back. They will soon remember to remain on the phone long enough the first time.

4) Try to always look at the whole picture. Things get overlooked when you compartmentalize things. If on your rounds you note rales in the lungs and ivf are going at 100ml/hr and when you look at the flow data you notice that the urine output for the last shift was 100 when total input was 800. Put it all together!!! All that fluid is going somewhere the patient is probably in heart failure. To many times I follow new grads and I walk into these situations. When I look back at there notes I notice that that they wrote the rales under lung sounds and the urine out put in its spot and so forth but never put togetther the problem and notified someone. I know that this is the hardest part of nursing to get the hang of. Mds usually come once a day for 10-20 mins. We are those pts lifeline. The sooner we address a problem the less likely it is to turn into a code or a bigger problem.

5) Most of all remember your abc's when prioritizing. A patients sacral decub and routine meds can wait when another patient is having chest pain, or has a low pulse ox ect.

[MrsGPR]

Excellent advice! I LOVE how you used examples to illustrate your point!!!

I do have a quick question: what exactly does the RN assessment consist of - in real life? Is it system specific? Or is there a full "review of systems" assessment for each and every patient on your assignment? I am ashamed to admit how long it takes me to do a full ROS assessment on ONE pt - let alone 7 - 10!!! (Neuro to Integ!!)
Just curious as to how it works once you are on the floor and faced with a heavy pt load...
Thanks guys!!

[november551]

Originally Posted by MrsGPR

Excellent advice! I LOVE how you used examples to illustrate your point!!!

I do have a quick question: what exactly does the RN assessment consist of - in real life? Is it system specific? Or is there a full "review of systems" assessment for each and every patient on your assignment? I am ashamed to admit how long it takes me to do a full ROS assessment on ONE pt - let alone 7 - 10!!! (Neuro to Integ!!)
Just curious as to how it works once you are on the floor and faced with a heavy pt load...
Thanks guys!!

I personally do a head to toe assessment (at least a visualisation). I don't really take it as far as I did in nursing school though. I will focus on areas that have problems though. example: If a patient isn't complaining about their throat, I don't bother sticking a tongue depressor in there to look at it with a flashlight. However, if they were intubated I will sometimes take a look if they are complaining, I hear wheezing, or they sound "froggy".

Another example; Say if I have an otherwise healthy 20 year old patient that is there for a shoulder repair or something and is fully mobile I won't bother checking their coccyx or heels to see if they are "pink and blanchable." However I always check the coccyx and heels on a max assist patient from a nursing home. Does that make sense?

I guess it is more focused, but in a more patient specific way.

[Chloe'sinNYNow]

Originally Posted by NursePamela

Never be afraid to ask questions. If you let people know what you do not know they will be more apt to teach you and nursing is forever a learning field.

I usually get kicked in the head for asking too many questions. I'm so sick of hearing this. It's a catch-22, b/c obviously the person I"m asking usually doesn't have the answer nor the foresight and intelligence to say" I don't know, let's find out"....I actually got into trouble by my preceptor during role transition in my final semester of NS b/c she said I didn't know anything.

[dshawnjohn]

Originally Posted by SmilingBluEyes

Ever have an "I wish I was told this" moment? Well, we all do as nurses regarding school. Here are some things I wish they told me nursing school (and some I wish they had emphasized more)----and what I told another new BSN nurse in a different thread (and it would be the same advice I would give any new nurse/grad):



You have achieved a great thing, graduating and earning your degree (BSN, ADN , LPN or Diploma). Now, the REAL learning begins......

Don't ever pretend to know what you don't. Be a sponge---watch and listen to what is going on around you. Take mental notes. Find mentors and emulate their good habits. Take note of the bad habits and avoid those.

Listen to your patients; they know their bodies better than you do.

Have integrity----be honest with yourself and others.

Stay out of the gossip game/circle. It goes nowhere and brings down morale, including your own.

Be on time! EVERYtime. When you are late, so am I. And I don't like to be late!

Stay organized as possible. Keep up on your charting and tasks as they come up. Dont' save it all for "later"---there may not be time, "later".

Do it right the first time, even if there IS "no time". Believe me, there is no time to "Do it over", either.

Plan for the worst; hope for the best.

Be someone they can rely on---and rely on yourself!

Take good care of yourself; eat well, exercise. It's the only body you got and you are gonna need it. Nurture the self. Nurses have a tendency to martyr themselves and neglect their own needs. Don't be one of them; it's a fast superhighway to burn-out.

Nourish the mind. Plan on spending a LOT of time investing in your continuing education as a nurse. The world of nursing/medicine is changing faster everyday. You are going to have to make a conscious and concerted effort to "stay abreast". It's more work than you imagine right now.....plan on it.

Learn assertiveness if you have not already. Lots of good books and conferences/seminars exist. Learn early-on you no are NO ONE's doormat. Also, know there is a difference between "assertion" and "aggression".

Work hard, yes, but don't forget to PLAY hard too! Have hobbies you enjoy. Your life is NOT your work, and while being a nurse is part of who you are, it need not *define* you.

Believe in your self and good instincts. Sometimes, "instinct" is what lets us know something is amiss or wrong with our patients. Never ignore that gut instinct. It's very often right! BELIEVE IN YOURSELF!!!!!

After 8 years in nursing, these things are things I have learned the "hard way"; hopefully you don't have to.

Warm, hearty congratulations to you and all new grads here. I wish you all good things in your new careers.

thanks for the tips I will remember this God bless

[numalenurse]

What is a 'Sticky'?