shoegalRN 11,629 Views
Joined Dec 5, '06.
Posts: 1,379 (42% Liked)
I got 4 similar repeat questions and I know for SURE I got them all right.
I did NOT change my answers. For example, I got one that asked about a certain classification of drugs. Then 4 questions later, I got the same exact question, instead of giving classification of drugs, it gave a drug name (that was from the classification of drugs) and the question included the EXACT same answers, in the EXACT same order. I selected the answer I selected the first time and kept going.
I think NCLEX do that to see if you will question yourself and change your answer to something that may harm the patient.
Do NOT change your answers!
Ok, here goes. I am a new grad, just graduated on May 16th. I wish someone would have told me how to prepare for the long hours spent studying, the critical thinking skills required, and how to time manage.
I strongly suggest getting a planner and planning out your days, right down to the "naps" you may need to take betweeen clinicals and class. When feeling overwhelmed, go talk to a counselor.
Take one day at a time.
Take time out to relax, read a good novel (non-nursing related) and spend time with family and friends.
Take time out for yourself, join a gym if you havent already.
Oh, and another thing, DO NOT CRAM! There is entirely too much info you have to KNOW (not memorize).
Good luck! The next two years will fly, I swear!
I love working Stepdown/Tele! I am an ER nurse but usually get floated to Stepdown or sometimes may pick up an extra shift to help out when short staffed.
Here's what I suggest:
-Know your rhythms like the back of your hand. Especially the deadly ones like Vtach/Vfib.
-Know how to read a 12 lead EKG
-Know where the EKG machine is kept and know how to take a STAT EKG because you will be doing plenty of those
-Know your cardiac drugs, like metropolol, Cardizem, Hydralazine, amiodarone, -prils.
-Know your diuretics and what to look for, example Lasix, look at K+ level
Last but not least, know where your crash cart is and what is in it!
Take an EKG class ASAP! Become ACLS certified ASAP!
Tele pts can CRASH on you really fast! You need to know how to react in case that happens.
Good luck! You will learn so much on Tele!
I had a pt come into ER as a trauma, young 25 year old girl. Was attempting to play "spiderman" and swing down to the balcony under her because "my friends dared me". ETOH on board. Hit railing of balcony and ended up with a broken pelvis.
About 2 months later, had another girl attempting to swing down to another balcony under her. Was up 4 stories, and instead hit every railing on her way down to the ground, several broken teeth found at scene. ETOH on board as well as other drugs (cocaine, weed). Came in to ER as a trauma. Ended up with a small pnuemothorax, broken leg, and broken jaw. Taken to ICU, left ER talking. Went to oral surgery two days later to fix broken jaw. Was intubated, never extubated upon completion of surgery. Taken back to same ICU. Went into PEA a few hours later. Blot clot found logged into ET tube. Ended up being an organ donor.
I'm an ER nurse and couldnt see myself working anywhere else.
Some of my favorites:
-guy comes in via EMS, backboard and c-collar. States he was "attempting" to rob somebody for drugs, police showed up with guns drawn, he swallowed the crack because he didn't want to go to jail. Now, he feels a little "high" and wants to be checked out. How he ended up on backboard and c-collar? "These two dudes" caught a hold of him as he was running from the police, after he swallowed the crack, and they tried to beat the crack out of him. According to him, he was robbing the drug dealers to try to get "drugs off the street" because he had found God who told him this was his calling. The true story? He was a drug addict who tried to rip off a drug dealer who beat the crap out of him for not paying. Just got released from rehab the same day. Needed a story to tell to his parents who were worried sick.
-guy comes in via EMS, on backboard, bleeding everywhere, obvious open wounds. Guy can not tell EMS or ER what happened. Denies doing any drugs/ETOH. Hooked up to monitor, HR in the 170's, no P waves, slammed Adenosine 6/12/6. Still no change. Pt cardioverted synchonized X 3 after getting some sedation. Pt still denying drug use. Also can't tell us how his legs were sliced or how his fingers are damn near amputated. Police happens to walk by and goes "this is the guy who we are looking for. He's been running for us, jumped out of a 3 story window after we caught him smoking crack".
If that student is allowed to continue on in the program and the nursing director AND school is fully aware about how he feels about gays/lesbians, women, and all other ethic groups, and if they allow him to graduate and he gets into the field and really HURT someone, or worst KILL someone because he disagree with thier lifestyle or skin color, this is just a LAWSUIT waiting to happen. I would send an letter to the State board, along with a copy of the student handbook, as well as a restraining order against this student. If the school won't do anything to protect your safety, maybe he won't be allowed to sit for boards once he does graduate. I don't know if that will happen, but it's worth a try.
I'm sorry you are going through this. Good luck to you!
My advice is to wait until AFTER nursing school to find a boyfriend. I'm dating a guy right now and I'm in my first semester of nursing school and I'm seriously thinking about ending this relationship before we get to clinicals. I simply don't have the time and he's not very understanding of that. So, to avoid going through a break up while in nursing school, I'm just gonna not put him as the priority. I can't worry about that now. I left a very stable and well paying job of 14 years to go to nursing school full time and I have a son depending on me to succeed. I can't be worried if I didn't call him back when I just pulled an all nighter and I'm dead tired and have to be up at 6am the next day for class.
So my advice is to focus on your studies. It's nice if you want someone to go out with here and there, but relationships take WORK and so does nursing school, so you have to decide which one is more important.
You know, I'm starting to think people are hired or not hired based on SOMETHING the interviewer PERSONALLY doesnt like or like about them.
I've been on 4 interviews since February and have not been job offered. After each rejection, I would kindly send an email to the interviewer asking for constructive feedback so I may correct it for the next interview. I only got ONE response, and the interviewer basically stated it wasnt my interview skills, they simply decided to go with someone who did clinicals at their hospital.
Now, I'm wondering if that was a load of crap.......
The thing is, I went on a couple of interviews in corporate america, and nailed it. I didnt do anything "different". The interviewer basically went by my "experience".
Nursing is totally different, it's all about if you "fit in" personality wise. I can understand this to a degree, however, I think some managers take some things personal when it comes to interviewing a potential employee. It could be something like you remind them of someone they didnt like, or in THEIR eyes, you are the "new, young, petite, attractive nurse" and this could be a threat. They could have had an issue with a petite person in the past, and now everyone who is petite is a threat.
I didnt think things like this existed prior to me going to nursing school. I have a corporate background where I was judged on my work ethic, my qualifications, my senority, and my skills. It wasnt "who you know", or if they "liked" you or not. I don't care how much you tried to "kiss up", it was a process that was followed. Maybe because I worked for a union company.
I am shock this manager was bluntly honest. I could accept that, although, it's nothing you can do about your looks, over some canned response that "we went with someone who better fit our needs". Atleast you know it's not your interview skills, or your experience, or lack thereof, it's an OPINION of someone and you can't change THEIR preception of you.
Working a busy ER:
Bed 4 came in via EMS with chief complaint "he's cold and **** his pants", ambulatory, wants thermal boots, waiting on social worker.
Bed 5 is from a nursing home. Per nursing home he is "more cranky than usual" and attempted to hit a nurse. He has a sitter at the bedside. He is bat **** cray.
Bed 6 found down in the aisle at the local grocery store with a can of tuna and a tomato in his jacket. Has nasal airway inserted, reeks of ETOH. GCS of 13. The most we can get out of him is "f you".
Have a good morning!
I have found this to be true as well being a traveler working in the ED. I usually work trauma centers, I have TNCC and ATCN as well certified with doing EJ's, art and fem sticks. I am also Triage First trained as well and I do SANE. The trauma centers I usually work requires travelers to have TNCC and PALS but will not allow travelers in traumas. It was ok for the first two assignments because I didnt know the trauma teams, nor the trauma policies for those facilities. If I didnt have my home job in my level one teaching facility that I work in between assignments, I would have lost all my trauma skills.
I have learned that in traveling, specifically in the ED, you are either given the most sickest patient (ICU hold waiting on bed assignment), or you are given the psych holds waiting on placement. There was an assignment I completed where they started putting me in the critical area towards the end of my assignment. They asked if I wanted to extend if I would be willing to continue to work in their overflow trauma and critical area. I declined.
When I interview for an assignment, I will ask how many patients are holding in the ED and does that facility uses travelers to take care of those patients. I will also ask what is expected of the traveler in relevant to the skills they are requiring of the traveler.
This one really chaps me:
-Any man who comes in the ED with chief complaint of STD, then attempt to hit on me. No, I don't want to go out with you. When I say "I'm married", I hear, "you are not wearing a ring". Then it goes to "sir, you are here for penile discharge and painful urination after admitting to having unprotected sex with "some woman" you just met last week. Why would I be interested in you, even if I wasnt married? I don't have to explain why I don't wear a ring". I even told a pt this before.
-Making sexually overtone comments about my profession, stop it, it's not cute and it don't score brownie points with me.
-Clearly taking things the "wrong way" because I'm being nice to you. No, I don't want to go out with you, just because we are discussing sports while I'm inserting your IV doesn't mean I'm interested in you personally. So please don't ask me about my personal life.
Anytime a pt starts a chief complaint with "see what had happened was....."
I immediately tune out.
My pet peeves:
-How long is the wait?
-How many people are in front of me?
-I need a medicaid cab back home (after coming to ER via ambulance for toe pain X 1 year)
-I can't breathe! (As they are yelling to the top of their lungs)
-I have 10/10 pain (while on the phone, laughing, chatting with other pts in the waiting room)
-I've been having this issue for 2 months (what makes it an emergency at 0300 AM on a Saturday night?)
-I need a bus pass (after observed outside smoking and buying coffee from the vending machine)
Just the ones from the top of my head right now. But I have plenty.
[QUOTE=exit96;7570744]When the CEO walks through the department and attempts to say "hi." Like he gives a rip about anything but his wallet?! Gag me!!!!!
At least your CEO will speak. Ours just walk through with a group of people while he points out how dirty the floors are while there are two traumas going on. Forget saving a life, those floors better be spotless! I can't stand him!
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