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JBMmom, MSN, RN 9,208 Views

Joined Jun 24, '09. JBMmom is a Nurse. She has '4' year(s) of experience and specializes in 'Long term care; med-surg'. Posts: 501 (43% Liked) Likes: 912

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  • Feb 22

    Evidenced based research shows that it is seldom based on evidence other than bias associated with what result the researcher is seeking.

  • Feb 7

    Quote from ruby_jane
    Um....that one's real, as is the general knowledge that all manner of oddities happen during a full moon.
    We are in luck for the entire month of February HAS NO FULL MOON.

    (Just a minute bit of trivia I have been dying to work into normal conversation.)

  • Feb 6

    I love being an NP. The only thing I'd do different would be to have gone to med school early in life. Not that NP isn't amazing, it is. But I went back to school later in life making it not really that practical with family and expected work years left for me to justify med school. This job is so easy that getting paid twice as much for doing almost the same thing would have been nice.

  • Feb 6

    My sense of humour has become much more dark and twisted

  • Jan 27

    Quote from JBMmom
    OP, I appreciate that you started this thread, I have found much of it very interesting. I'm just starting out on my NP journey and am interested to hear the experiences of others. I am at an on-line school and I will have to find my own preceptors, however, I'm very happy with how that seems to be working out for me. I chose to go back to school because of the NPs I have had the opportunity to interact with in my RN role, so I've got preceptors lined up in a few different roles in the hospital including ED, hospitalist, surgical and palliative. I had some concerns about an on-line program initially, and hoped for a brick and mortar program but that didn't work out. Then I realized that in any of my previous jobs, my education didn't prepare me to step out and work independently on day one. It prepared me with the broad tools I would need to be successful and it was up to me to do the rest. Whether a school has proctored exams or not doesn't impact my experience. I had classmates in nursing school and in my first graduate program that cheated right in the middle of the proctored exams. Did their cheating impact my education? Not really. I've had great professors at community colleges and crappy ones at expensive private colleges. Other than being frustrating at times, did they really impact my ability to be successful after school? Not really. Once again, I'm going to get out what I put in. There will be awesome NPs that had to attend a school that others will turn up their noses at, and there will be NPs from the fanciest of schools that patients don't want within 10 feet of them. So much of it is up to us as the learners and new practitioners that I think we can find success in many ways. All the best to you on your journey.
    Greetings JBMmom !

    Thank you! I am so glad you shared your story. I think what the points you touched on are very important. A lot of people will look down their noses on NPs based upon where they received their education. I think it is absolutely unprofessional and unacceptable. I completely agree with you, no matter what program one may attend - it truly is up to the individual to make sure that he or she is putting in the time and effort to not only understand the material, but to really know it - and to have integrity and in regards to exams whether they be proctored or not. You made some valid points, and I am glad your shared your experiences thus far.
    Thank you, and good luck to you in all of your future endeavors!

    Kindly,
    MrCleanScrubs

  • Jan 24

    Quote from JBMmom
    Do you REALLY ask every patient to state their name and date of birth before every medication that you administer? .
    I do before every time I give a med, but not for every medication (e.g. if they're getting three meds at the same time, I don't ask before each med). But yes, every single time I give a med.

  • Jan 24

    Aside from everyone's personal preferences, you should be teaching an orientee to ask with each "occasion." By that I mean ask once when you are in the room on one occasion to give 3 meds. But if you are giving a med and then an hour later giving another, the ID verification should be repeated. We all must get into a deeply-ingrained habit of doing this step when we have separate occasions and have been doing 50 other things in-between those occasions.

    The orientee can adapt his/her practice after training is complete and the rules have been drilled in and well incorporated. Not before.

  • Jan 24

    Not as dumb as a med error makes you look. It's no big deal to explain to people, if they ask, that this is a safety measure for their protection.

  • Jan 24

    Maybe confirm with the patient that their name and date of birth on the wrist band is correct at the start of your shift, and then visually match their wrist band to the medication before you hang it? It should be a pretty easy step since you are scanning their band anyway, and it is less disruptive to the patient than asking them again.

    I feel that matching the wrist band to the *med* is the most important step. I want to make sure I brought the med for the correct patient to the room. Many times any old Zosyn will scan right, but I don't want to have accidentally grabbed room 4's antibiotic for room 5. Hence matching the band to the med.

    Incidentally, I always match a lab label to my patient's wrist band before I place the label on specimens as well. One of my OCD worries has always been that I will mis-label a specimen, and this sets my mind at ease

  • Jan 24

    It depends on what I'm giving, how much potential it has to cause harm, how familiar I am with the patient, etc. I think they actually have seven rights in California ...couldn't tell you what they are though.

  • Jan 24

    When I'm giving meds to the same patients all night I find that asking them once is sufficient. I also ask once for allergies and explain side effects .

  • Jan 18

    US needs to expand Program of All-Inclusive Care for the Elderly to ALL states:
    Program of All-Inclusive Care for the Elderly | Medicaid.gov

    The Programs of All-Inclusive Care for the Elderly (PACE) provides comprehensive medical and social services to certain frail, community-dwelling elderly individuals, most of whom are dually eligible for Medicare and Medicaid benefits . An interdisciplinary team of health professionals provides PACE participants with For most participants, the comprehensive service package enables them to remain in the community rather than receive care in a nursing home. Financing for the program is capped, which allows providers to deliver all services participants need rather than only those reimbursable under Medicare and Medicaid fee-for-service plans. PACE is a program under Medicare, and states can elect to provide PACE services to Medicaid beneficiaries as an optional Medicaid benefit. The PACE program becomes the sole source of Medicaid and Medicare benefits for PACE participants.
    In PA/NJ/DE program is called LIFE (Living Independence for the Elderly)

    LIFE is an option that allows older Pennsylvanians to live independently while receiving services and supports that meet the health and personal needs of the individual.

    Living Independence for the Elderly (LIFE) is a managed care program that provides a comprehensive, all-inclusive package of medical and supportive services to help keep a person living in own home/apt. PA has 35 programs throughout the state. Our health system is largest provider of LIFE care throughout the US. Through this program, my father was able to live at home for 2 1/2 yrs until no longer safe to be alone at night due dementia.

    Services provided in own home or at Adult Daycare Center include:

    Medical Services


    • Primary care and physician specialist services
    • Nursing care
    • Prescribed medications
    • Physical, occupational and speech therapies
    • Dental care
    • Vision care
    • Hearing care
    • Foot care
    • Medical equipment
    • Personal emergency response systems
    • Mental health services
    • Hospital services
    • Nursing home care (if it becomes necessary)


    Support Services

    • Light housekeeping, laundry, cooking and help with bathing and dressing
    • Meal planning and nutrition
    • Spiritual counseling
    • Personal care assistance
    • Medication management meds provided without copay.

    Transportation is provided to daycare centers and to medical appointments.

    There are income levels under Medicare/Medicaid programs with private pay option available.

    Find a PACE Program in Your Neighborhood | National PACE .

  • Jan 7

    I wanted to share my adventure to taking boards- even though it will likely be a reiteration of many posts here. First off I want to make something clear, I am NOT trying to put down any of the resources out there, I'm merely stating what helped me. I've already had someone in my graduating class be offended that I didn't agree with her opinion that a certain person's review course and test bank wasn't the "absolute best". Everyone learns differently, so here is what I did:

    1. In nursing school, I made the mistake of waiting until graduation to sit down and study for boards. I figured, "I need to get through this program first." I felt overwhelmed and it took me a LONG time to wrap my head around the information. I didn't have a problem with the NCLEX at all, but I feel it was a mistake to wait. So, this time I started off with Liek's and Fitzgerald's books/phone apps. I worked with these on my down time for 2-3 months. After that, I purchased the APEA Q Bank and Barkley's CD's for his review and worked with both for the remaining 9 months of this year. I did at least 5 questions a day for at least 5 days a week at the very least to keep myself thinking. I was using the random function and wasn't studying anything specific.

    2. Liek's book/phone application- I actually loved this originally when I started studying and it is a great tool to start with. She gives good rationales and has good questions. However, the issue with her material is that it was easier than the actual board exam. So, my recommendation is use her to start, then move on to APEA and Barkley's review. I couldn't go to her review, since she didn't come near Chicago anytime I could go.

    3. Fitzgerald's book/phone application/review- I strongly dislike her material. This is what offended my classmate- since she LOVED her. No doubt, Fitzgerald is REALLY smart and is good at what she does, she comes off arrogant and condescending- which is hard to listen to for hours. I found her questions informative, but seemed to focus SO MUCH on small details and lacked a good review of concepts, which I would rather have. Overall, her questions where nothing like my exam, and I am glad I stopped using her materials. Don't get me wrong, I respect her and what she's done for our field, but I didn't benefit from her material.

    4. Barkley's review- AMAZING. This man is hilarious and is VERY efficient in explaining the information that you need to know. I got the CD's and listened to them throughout the summer during traveling to and from clinical (I think the review is 18 hours-ish?). After I listened to his review three times over, I started with the APEA Q Bank and did 150 question random tests for several days. Why did I do this? APEA keeps track of your weaknesses and analyzes areas of improvement. When these were identified, I went back the using the Barkley's review CD's in those areas. I actually was hearing his voice during my exam with his pointers, and I can honestly say that his 'side note pointers' helped me answer 10-15 questions on my boards when I was stuck between two answers.

    5. APEA Q Bank- another great investment. I paid for either 3 or 6 months, I can't remember now, but it was the most I could get. Expensive (600$-ish for Barkley's and APEA Q Bank for 3 or 6 months), but totally worth it. I can honestly say that I think the people who write the APEA Q Bank questions must contribute to AANP, because many of my questions were strikingly similar to APEA Q Bank questions that I've seen.

    I hope this is of help, good luck, and study hard- but remember that you've made it this far and you know A LOT more than you think.

    Msufan3710, NP-C

  • Jan 5

    I love Chux. I would buy Chux a drink if I could. Chux has saved many an ass, including mine!

  • Dec 29 '17

    I smelled it as soon as I saw this headline.


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