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Gem0607 6,448 Views

Joined: Feb 16, '09; Posts: 351 (4% Liked) ; Likes: 31

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  • Sep 17 '13

    Whether the rhythm is regular or irregular should not affect counting the heart rate. You still count the P's for an atrial rate, and the QRS for a ventricular rate, regardless. If you are still confused I would try to find an EKG workbook with a solutions manual so you can practice (or seek out 1:1 help with a TA, professor, or another student).

  • Sep 11 '13

    "Well, unfortunately, people get sick and need care at all times of the day and on all days of the week"

    That is the mentality that got us into this mess.
    OP has a government mandated FULL TIME commitment.

    Administration should NOT be allowed to force her to work overtime for THEIR needs!

  • Sep 10 '13

    Hello everybody! I had an interview 2 weeks ago for a surgical clinic through a hospital. I am a new nurse, so to even get an interview at a clinic I was psyched! Well two days after my interview they called for a second interview which I had last Thursday with the unit charge nurse/manager. She was very nice, and I got a tour and was also able to meet some of the nurses that work there. I let her look at my clinical evaluations from when I was in school and I appreciated it that she took the time to read them and ask me questions about them. I had asked if she had a card for contact info and she said she did not, but she gave me a sticky note with her name and telephone number. She said she had a few more candidates but wanted to make a decision soon. I figured I would give it a week and give her a call this Thursday. Today HR called and told me that I am one of the final candidates and that they would like to move forward and call my references (my current employer at the pharmacy and my clinical instructor from school)! She said it takes 2-3 days and then they will call them and then I should hear from a recruiter about the next step! I am so excited and honored to even be considered for this position! I am hoping to hear from them by the end of the week, and I am praying for the best!

  • Sep 6 '13

    "Hey, Flo! You're getting a new admit in 206-1," says Mel, the charge nurse. "ETOH, admitted for detox, alert and oriented times 1-2. He's got an IV but ER says it won't last long the way he's picking at it. He's coming up in five minutes---they've gotta get him outta there 'cause he's stinkin' up the place."

    Flo, of course, has her hands full with six patients---three of whom are total care, two of whom are high-maintenance types who can't reach the water pitcher without an RN's help, and the other is merely a little needy. She explains this to Mel, who asks her friend Alice (with only five patients) to take the admit, while she runs off down the hall to see what 204-2 wants.....again.

    "What'll you have, Mrs. A?" she asks in as cheerful a tone as she can manage. "It's about time for some pain meds, isn't it?"

    "You're an hour late," growls the patient, a lady of indeterminate middle age with a bad dye job and an even worse attitude. "I want Dilaudid, right now!"

    Flo scans the eMAR, finds only orders for Tylenol, ibuprofen, and Norco, and informs Mrs. A. "I'm sorry, ma'am, I can only give you one of those three. Which one would you like?"

    "I said I want Dilaudid," insists Mrs. A, becoming somewhat agitated. "Now go get it, or I'll call someone who will!"

    "Sorry, I don't have any to give you," Flo replies. "If you want Dilaudid, we have to ask the doctor for it. In the meantime, would you like Tylenol, ibuprofen, or Norco?" In a snit, Mrs. A refuses all three and tells Flo to get out of her room. Flo heads down the hall to her next patient, a COPD frequent flyer who is at least as endearing as he is annoying. "Hi there, Pete," she says cheerfully. "How are you doing today?"

    He proceeds to give her a lengthy---and exquisitely detailed---description of the quality and character of his most recent sputum as she assesses him with a practiced eye. She's dealt with fellows like him all her working life, and she's as familiar with what really ails him as he is: it's loneliness. Right now, however, he needs nothing more than a cup of hot coffee and a breathing treatment, which she provides with a smile and a few kind words before she has to be on her way to her next "customer".

    Before Flo knows it, it's time for her lunch break, and she asks Mel to cover her hall while she's in the lounge. It's crazy out there, as it is on every day shift, but the teamwork is good and she never has to worry about whether her patients are being taken care of. Unlike her previous hospital, the charge nurses here don't take patients, allowing them to cover for breaks and lunches as well as emergencies; this ensures that the nurses actually get time to eat (and even PEE---what a concept).

    By the time she gets back, Mel has medicated everyone and even handled the brittle diabetic in 202 who'd cursed at her and the CNA earlier that morning about the "lousy service". As a matter of fact, he kicked the matter upstairs to Charlie, the department manager, who had promptly informed the patient that his behavior was unacceptable and he would be discharged if it continued.

    "Charlie just handed him the AMA papers and showed him where to sign," says Mel, grinning. "He told the guy that this is a HOSPITAL, not a Shilo Inn, and said he was free to check into St. Elsewhere across town if he wants better 'service'. Charlie's got our backs---nobody gets to treat us like that and get away with it!"

    Back on the floor, Flo and the aide turn and change two of their three total cares before Mrs. A's light comes on. This time, she tells Flo that she herself spoke to the doctor, and he'd ordered Dilaudid. Flo searches the computer records for the order, and of course, finds none. It's time for a little reality check.....but instead of taking it all on herself and risking a big ugly confrontation, Flo pages Dr. Awesomesauce to the floor.

    He has to come from the ICU, but eventually he does get there and Flo can't resist the temptation to listen to the conversation from behind the door. Sure enough, he orders the Dilaudid, but not before he discontinues the Norco AND gives Mrs. A a little speech on how medication orders are carried out. "The nurses are the ones with the keys to the med dispenser," he reminds her, "and they check every order to make sure that it's right before they give a medication. It's in your best interests NOT to lie to them, or make them wish they didn't have to come in here."

    (Remember, this is a fantasy!)

    Eventually, the shift ends and Flo gives report to the oncoming nurse, a part-timer substituting for the regular night nurse who's ill with bronchitis and not allowed to come to work. (Administration doesn't like the bad PR that results when the staff make the "customers" sicker than they were when they came in.) As she drives home to her comfy apartment, she sighs with satisfaction, for although it's been a long, hard twelve hours she can sleep tonight knowing that she's done a good job, made people smile.......and earned some pretty decent money while doing it.

    And tomorrow, she gets to wake up at 0500 and do it all over again. Some things NEVER change!

  • Aug 19 '13

    I would absolutely start working. There's no guarantee you'll get into a residency program anyway so why give up on the year of experience.

  • Aug 19 '13

    For the first few months, you're in class four days a week. Once you're finished with the intro courses, you typically have two days in the classroom and two days in clinical. Schedules can vary (in a recent peds class some students had only one day a week off), but you're definitely not expected to be in class or clinical for seven days a week.

  • Aug 19 '13

    One more thought, you itemized YOUR priorities (correctly). The teachers don't see those things and frankly don't care. Stick to your guns, you know what's more important. Head check a whole school in the first week? Absurd.

  • Aug 16 '13

    Quote from applewhitern
    I can't believe how lenient these comments are about just skipping class. When I was in nursing school, we could only miss 2 days, period, throughout the entire program. I personally wouldn't want to miss one single thing that could make or break it for me.
    Our school only is serious about attendance when it comes to clinical hours. They don't babysit us for lecture. If you are in nursing school you are an adult...which means you can decide when to miss/attend class. If we miss too much class and fail, that is on us.

  • Aug 16 '13

    Quote from applewhitern
    I can't believe how lenient these comments are about just skipping class. When I was in nursing school, we could only miss 2 days, period, throughout the entire program. I personally wouldn't want to miss one single thing that could make or break it for me.
    For a lot of ppl, the two absences rule is only for clinicals and/or labs. It is silly to hold adults to only missing two days in two years. People have families, jobs, medical problems, etc. lecture can be recorded and ppl can sit in if they get instructor approval.

    Personally, being able to buy food, pay rent, and have a car to get around is just as important as school. Except for if I didn't work full time, I would not be able to go to nursing school PERIOD.

  • Aug 16 '13

    michellern--have you actually spoken to schools that require 3.0? It's ridiculous that a school with that requirement would not make an exception for someone with so much experience. A 2.99 with 20+ years experience is much different from a new nurse 2.99. Sounds like their priorities are askew. ( Yeah, what else is new, right?)

  • Aug 16 '13

    Well I attend Loyola University New Orleans. It was in the top schools of the south. I did not have to take the GRE. I do not appreciate your insinuation!

  • Aug 15 '13

    I'm a seasoned RN BSN for 21 yrs. My overall is a 2.99 (very frustrating since some schools will not even consider me). I would prefer not taking the GRE if that's option. Some school that sound promising seem quite expensive $$. Any suggestions?

  • Aug 14 '13

    While 3 months may not be a "fair trial", I will tell you after 6 years that I have been pretty beat up by the nursing profession. I don't think it is fair to tell someone that they have to wait 3 or 5 years before they can come to the conclusion that nursing can be very stressful, and that nurses are often not treated very well. Maybe a really astute person only needs 3 months to figure that out. I wish I had talked to more nurses before I got into the field. I talked mostly with masters-level and ARNP nurses, and of course, they were practicing with much more autonomy at a different level. Most of the line nurses and mid-line manager nurses (unit managers, supervisors etc) I know now would really like to find something else to do, esp. those that have been at it for 3+ years. When I was graduating nursing school in 2005, I read an article in a nursing magazine describing a study of 200 new nurse grads that had been followed for 3 years after graduation. The article reported that after only 3 years, 65% were no longer in nursing. I was in shock and disbelief. Not any more. I know how hard I worked to get my nursing degree and license, and at the time, I could never imagine ever not working as a nurse, but it sounds really appealing nearly 6 years later. The nursing system is broken, and there will never be any true health care reform without major changes in the way we train and employ nurses. If the patient/nurse ratios were legislatively forced to reasonable levels, the true nature of the nursing shortage crisis would be revealed, and hospitals would have to close whole units, but maybe we could stem the tide of nurses burning out and existing the field. I read recently that if every RN in the US actually activated their license and went back into practice, the nursing shortage would end overnight. The problem is not that there aren't enough nurses. The problem is that we keep burning through them quicker than we can train their replacements. I personally believe that true health care reform must first include a revolution in the nature of how we insure health and pay for care, which must first begin with eliminating all for-profit insurers and providers. All health care should be non-profit. I believe for-profit is in direct conflict with highest and best care. And non-profit must be re-defined legislatively to be really not-for-profit, where CEOs aren't paid in 7-figure salaries and income goes to cover only the costs of actual provision of care. Obviously, this will not solve all of the problems with health care but it is a start, and it would go a long way to improving the workplace for nurses. I truly enjoy working with and helping people, and get jazzed by making someone's life better. However, nursing has become too much about the bottom line, over-regulated and understaffed. I am afraid that if something isn't done soon, the shortage of nurses is only going to get worse, esp. in the acute care fields like ER/Trauma and ICU's. Unfortunately, the regular loss of experienced, skilled, competent and caring nurses will probably continue.

  • Aug 14 '13

    I've tried posting under other topics and hoping under this topic may elicit a better response...

    I'm still trying to figure out what I want to do when I grow up and I'm thinking of pursuing a Family Nurse Practitioner degree.

    I already have a BSN and am finishing up an MM (Masters in Healthcare Management). I miss the human element as I'm working in Quality doing abstraction, etc.

    I'm looking to get the pros and cons from individuals that are Family Nurse Practitioners. I know there are pros and cons to everything, but looking to see what people say. Are you happy with your decision to become an FNP?

    I'm am looking for flexibility with a work schedule and the ability to work in a variety of settings.

    Your feedback is greatly appreciated. Thanks!

  • Aug 12 '13

    I remember being new to nursing school and I remember freaking out about how difficult nursing school was going to be for me, especially after reading many posts on here. I was stressing out the entire summer before my first fall semester and I kept doubting that I would be able to get through these classes.

    A lot of people on here say that nursing school will suck up all of your time and you will be studying 24/7 and left with no social life. Now, I understand that everyone is a different type of student, but DON'T go into nursing school thinking that it will be pure hell to get through. EVERYONE is different. What may be difficult for some may be easy for others. Don't stress about it so much ahead of time. It may be easier than you think. You won't know until you experience these classes on your own. This website is GREAT for advice, but I just wanted to advise you not to stress out over what people say about how hard nursing school is. Not saying it is a walk in the park but I don't find it too bad so maybe you may not too!

    Good luck!