Latest Comments by WineCountryRN

WineCountryRN 3,637 Views

Joined Sep 26, '07 - from 'California'. WineCountryRN is a peds step down, RN nursing school ADN program. She has '20' year(s) of experience and specializes in 'pediatrics, ed, public health'. Posts: 70 (14% Liked) Likes: 20

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  • 4
    emmawdhous, KaylanJ1404, poppycat, and 1 other like this.

    Honestly, I think children (and pets) really pick up on OUR emotions. If we go in uncomfortable with a skill or procedure or are mad at our charge nurse/ spouse, the cold coffee in the cafeteria, and the child (or worse, parent and child) picks up on it then it so hard to put anyone at ease.

    Here are some examples that I have tried.

    I worked in a clinic and gave immunizations. I bought cute bandages and allowed the child to pick out one or two. I told them that it would hurt but it would be fast. (I even made ice packs with ice cubes in disposable baggies) . I explained everything and gave them permission to scream and cry. I would count loud and scream mildly quietly with them. I was quick (had it down about the first billion) and then it was over. No shame, no lying, no threatening. My director said that when I did IZ clinic there seemed to be less crying/screaming.

    I use the dang iPad or even phone for mild procedures (this is when they were new).

    Ask a child life specialist for help if you can!

    Head to Toe Assessments...least invasive stuff last (that means BP or 'down there" area last ). Everything is playful. A sticker on a tongue depressor for visual fields/tracking . Silly words for hearing (stand behind them and whisper jokes, whatever is age appropriate). Jokes for opening mouth ("how would you stick your tongue out at the doctor.. " bam, mucous membranes color and hydration, tonsils done) . Lungs, heart, and belly ("Do I hear a dinosaur in there? Or, DUDE what DID you eat for lunch,etc") I left them check me (after cleaning ear parts of stethoscope).
    It has to be fun and quick. You have to put the parents at ease too.

    Be honest with them.

    I let the kid tell me what to do...how shall we start this? Offer choices "What flavor juice for the meds."

    I listen when they are having a bad day. Sometimes kids with chronic conditions are OVER it. They are sick of being sick and in the hospital.

    Of course there are times that nothing would work and we would have to play good nurse and mean nurse ( the holder) and get through it.

    best of luck,
    made you look,
    SAS

  • 0

    As a Pediatric CNS, I know for a fact that PICU and Pediatric Units (and NICU too) that take CCS $ in California are required to have CNSs on staff. I was told this my the faculty member at UCSF who teaches courses for the APRN programs (this was in 2010).
    I really don't know about the role of adult CNS but I have seen job posting locally for acute care CNSs. I am sorry that you were misinformed.

    Here is a cut and paste from California Children's Services

    Regional NICU Clinical Nurse Specialist
    There shall be a minimum of one full-time equivalent clinical nurse specialist
    (CNS) for the Regional NICU.
    a.
    b. The Regional NICU CNS shall:
    1) be a R.N. licensed by the State of California;
    Issued. 111/99 Chapter 3.25.1 -11
    CALIFORNIA CHILDREN'S SERVICES MANUAL OF PROCEDURES
    Regional NICU Clinical Nurse Specialist

    There shall be a minimum of one full-time equivalent clinical nurse specialist
    (CNS) for the Regional NICU.
    a.
    b. The Regional NICU CNS shall:
    1) be a R.N. licensed by the State of California;
    Issued. 111/99 Chapter 3.25.1 -11
    CALIFORNIA CHILDREN'S SERVICES MANUAL OF PROCEDURES

    CHAPTER 3- PROVIDER STANDARDS Reaional NICU

    2) be certified by the State Board of Registered Nursing as a CNS, as per the
    California Business and Professions Code, Chapter 6, Section 2838 of the
    Nursing Practice Act;
    3) have at least three years of clinical experience in neonatal nursing care at
    least one of which shall have been in a facility with an NICU that is
    equivalent to a Regional or Community NICU;
    4) have current certification in Neonatal Intensive Care Nursing from a
    nationally recognized accrediting organization, i.e. the NCC; and
    5) have evidence of current successful completion of the Neonatal
    Resuscitation Program course of the AAP and AHA.

  • 0

    Please Share FloTrac Sensor Competency- I like to look at different ones from different hospitals to development mine. thanks so much!

  • 0

    Here is what my mentor (professor of nursing at another campus wrote) The standard is a minute per question but if they are higher level questions or ones that take lots of critical thinking like math or multiple thinking steps. I would have 3 minutes for those type. I think the BRN is much more generous with
    Time than we are. I admit to leaning towards more time. So. No standard answer. Each exam should be considered individually.

  • 0

    I just started to teach at a local community college and have the first test scheduled this week. I was taugh to offer the students one minute per test question but some are complaining that this isn't long enough (of course I am giving them a 10 minute break after).
    Just wondering, how much time should I give them for each test question?

    Any words of wisdom to share?

  • 0

    Now this is something I can use! Great ideas! As an educator, I struggle with keeping my 90 minute lecture interesting and engaging. Balancing a lot of content with a lot of students is no easy task. My teaching is like my cooking some of the 'stuff' has been canned and then I spice it up. Is it OK for the instructor to discuss one topic in depth, allow for interactive activities at the expense of not covering the other 60% of the topic/chapter?
    I am am going to check out my Mac program now. Thank you!

    Quote from marycarney
    What you provided your students is called a 'graphic organizer' in the homeschooling world.

    And I know a chemistry instructor who provides these to her class of remedial students with tremendous results.

  • 0

    I work at two different hospitals and due to budget constraints, they are both requiring that more and more education via computer based modules be completed while the RN is working providing direct patient care. It is obvious that the RNs just want to skip though the modules and just get it done without really learning anything (going as far as to share their answers). It is really a discouraging to know that the regulatory bodies who want to see that education is being providing creating only more and more checklists of things to be done and that there are less financial resources to give the staff time for skills or to learn. Any comments or suggestions on what to do about this?

  • 0

    I work at two different hospitals and due to budget constraints, they are both requiring that more and more computer based modules be completed while the RN is working providing direct patient care. It is obvious that the RNs just want to skip though the modules and just get it done without really learning anything (going as far as to share their answers). It is really a discouraging to know that the regulatory bodies who want to see that education is being providing creating only more and more checklists of things to be done and that there are less financial resources to give the staff time for skills or to learn. Any comments or suggestions on what to do about this?

  • 0

    I think it is great that hospitals require clinical instructors to be competent. Should a staff development dept (or the dept. that oversees orientation of staff and volunteers) make that final decision to see who will be leading the students in THEIR facility. Recruiting nursing faculty is not easy. The pay cut and hours and not optimal and the recruitment pool small. I 100% agree with lig on this one. I was happy that the next childrens hospital I will instruct at requires orientation but I am extremely disappointed that the SON is not paying for that orientation.

  • 0

    Reading all of these lovely responses to a new nurse is so encouraging! Some say that nurses eat their young...not in this case! Best of luck to our new grad...would love to have you in our ED! Just the fact that you are asking for help and trying to prepare says a lot.

  • 0

    Lovestolurk-
    just as an FYI. Sumguy who wrote that rude response is a student (hopefully not nursing) and he works with his mother. See his/her other post. Now that to me is really concern. Here is a quote from his/her other posts. You can find them all with the the little magnifying glass icon below their screen name.
    " Where im doing my clinical practice for school is the same unit my mom works on. We've even worked together sometimes. No one has an issue with it. It's all about facility policy.

  • 4
    RHC81, TabKC, Spidey's mom, and 1 other like this.

    As an ED educator, all I can say other than sorry for having to deal with someone mean spirited people and yes they are out there. One of most beneficial presenters that we had in our ED was a former cop/head of our security who teaches on de-escalation in the ED. If you plan to stay in the ED keep in mind that ALL of the patients in the ED are under stress just by virtue of being in the ED and second, there are stages when a patient is 'escalating' and one of those is to strike out both physically and verbally to the nurses. The ED can be very hostile and ED nurses are often assaulted by patients, family and their colleagues. May I suggest that you look up Crisis Development Model and learn the stages and how you should respond as a provider. It sounds like this person was being defensive and acting out (verbally) and you were in the line of fire. Being a working mother in a new role is very stressful. You don't have to apologize for your feeilngs or your weigh. If nothing more, seek out your Employee Assistance Program to help you through some of the stress and find healthy ways to cope.

  • 0

    Did you get the job? Do you what to chat about some ideas to mix it up? I have been doing education for 4 years the last 1.5 being in the ED. The ED is a different breed of nurse...teaching needed to be brief and interactive. I would highly recommend attending a National Nursing Staff Development Conference for some GREAT ideas. good luck and PM if you have questions.

  • 0

    OR you could ask the hospital to see who has accessed your chart and when (all this electronic business leaves a different kind of fingerprint). Most hospitals have a security department for this and all concerns could be brought up. I have known nurses who have cared for patients with the same last name (no relationship) called in by management to ask why they were looking in that chart. The nurse has to respond accordingly and often it was just because it was MY patient and I needed too. I have known of people fired for looking in charts of famous people as well as ex-s. Unfortunately your so called friend would be in trouble for a HIPPAA violation but if they had no business being in your chart then they really are not a friend to begin with.

  • 0

    So far great advice from the other posters. Sometimes there are reasons beyond your control that you will not be advanced to the position you want b/c it is about timing and often, not what your know, who you know. Does your employer have affirmative action in place and have to hire demographical? You knows but who cares b/c you really need to find the right spot for you. It is hard to not take it personally...yes, most nurses want to please and care for others and when they can not it is personally very frustrating for them.‎"Your time is limited, so don't waste it living someone else's life. Gosh, here are some helpful words (I hope)
    Don't let the noise of others' opinions drown out your own inner voice. Have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary." - Steve Jobs
    So maybe there is something else for you out there or maybe you will have to ride it out. I have been told that once that my manager didn't like competition and she micromanaged me and threw me under the bus more than once. Yes, you young go-getters can seem threatening even through you don't mean to be. All I am saying is that there are many reasons why you are getting over looked so just look elsewhere. In the mean time, take whatever experience you can (performance improvement projects, join a committee, take all the free classes the institution has to offer). Best of luck to you.


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