psychonaut 6,153 Views
Joined Dec 8, '06.
Posts: 339 (42% Liked)
More than anything else, understand what a differential diagnosis is. This was something that tripped up many of my colleagues, regardless of years of RN experience. This is a new skill set for RNs. Pathology, physical diagnosis, pharmacology...these are not conceptually different (just different in terms of breadth and depth at our new level). Learning to make a differential, then narrow it down based on history, signs and symptoms, labs, is a new thing. Having it clear at a conceptual level will serve you well in NP school.
Step 1 review materials...Golgian, etc. Look on amazon. "Rapid Review" got me through pathophys. Look up the topic, and boom there you have a nice outline form all the s/s, tx, labs, etc.
I picked up this suggestion way back from a MD poster who used to troll the boards. I honestly don't know if the suggestion was sincere or some NP joke I didn't get, but the advice was golden. Plus, the thing is wayyy cheaper that any of the required texts.
I got First Aid too, but it was not as useful as Golgian (of course, I was not using it for it's intended purpose, i.e. to prepare a med student for their first boards).
You can find the answers, each test lets you have about 90 seconds per question. 60 seconds to understand, 30 to possibly find somewhere in the book. I rented it online, which is searchable. I also had a friends older version, who had cut out the index, tabbed it up, and placed in a folder for quick looks ups. Now all this is for online only, I do not know if they offer it via "brick n mortar" style anymore.
My favorite instructors in NS generally got the poorest evaluations by most of my fellow students, and for the same reasons: being tough, no-nonsense, and having very high expectations from the students. These were generally the instructors with many years of bedside experience (especially critical care in all its forms), topped with APN and/or PhD training.
These were the instructors who were "mean," "insensitive," and "too difficult." These were the instructors who had to be bullied by students into giving detailed study outlines, and who would dare to do things like include material on tests from the text that wasn't explicitly covered in lecture.
These were instructors like my critical-care clinical instructor who expected me to have a basic understanding of vent settings my first week of ICU clinical. We hadn't even covered that in lecture yet! Guess what: I should have read up on it anyways. The next week, she got me for not knowing (basics) about chest tube care. Third week, she did NOT get me on hemodynamics/lines related to the CVICU, because I had jumped ahead of the lecture and studied the cardiac chapters like mad.
That clinical instructor is a CNS in Trauma who first-assists in trauma surgery. She was awesome, busted my chops and got me to learn. I was very proud to have earned a modicum of her respect by the end of that clinical experience.
She was not invited back to teach the following semester. Too many negative evaluations from students. She made them work too hard, it was our last semester, several weren't even interested in critical care nursing in the first place, and of course...she was "mean."
In a nutshell, the "ideal nursing instructor" will vary by who you ask, and if the majority of the students surveyed are a bunch of whining, entitled brats, then well...you get what you ask for.
Legally, I don't know, but as a condition of employment? And working with the sure knowledge the "clinic" will NOT back you up if you deviate form said algorithm? I would definitely be wary.
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