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BostonFNP Moderator 33,726 Views

Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care. Posts: 4,040 (58% Liked) Likes: 9,193

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  • 4:32 am

    Quote from CountryMomma
    I don't mind it but I'm skittish about Tylenol use in liver disease patients.
    Even in end-stage cirrhosis doses up to 2.5g/day are safe, safer than NSAIDS.

  • May 4

    I'm not sure that using an illicit substance to treat the symptoms of a chronic disease caused by used of other illicit substances is a solid platform for an argument.

    Regardless of personal opinions, using marijuana in any form, is against federal law and could result in a loss of license. Most of us, I would assume, have too much invested in our careers to risk it on a cheap high. Even more concerning is the issue of patient safety, as numerous studies have demonstrated cognitive impairment evident up to 4 weeks after use. It is highly lipophilic and is altering at very low concentrations in the blood stream.

  • May 4

    Quote from writerartistnurse
    Yes that is harsh. I am playing neutral party here, but it's not like she injected heroin, diverted meds from a hospital, or sold drugs. She took an ativan.
    Playing devil's advocate here, but why wouldn't the BON or the nursing program say "if he/she would take a pill without a script from a friend would they take a pill from the hospital or street?"

  • May 3

    Your investment in your education is a significant one: it is an investment of your time, your finances, and perhaps at times, your sanity. Studying smart helps you capitalize on that investment.

    Having been though a significant amount of undergraduate, graduate, and doctoral education myself along with being involved in didactic and clinical teaching, here of some of my personal and professional thoughts about how to study smart.

    1. Learn don't cram and build a strong foundation.

    Cramming may help briefly but it does little for you in the long-term. Nursing education builds on what was learned in previous classes and this results in having to try and cram more and more information each class. If you cram on the anatomy of a nephron then next semester when you are learning about the difference in mechanism of action between thiazide and loop diuretics or the homeostasis of blood pressure via the JGA action on the RAS system you are going to struggle. If you have a strong foundation, it is much easier to understand what causes a disease, what symptoms it will manifest, and how you can treat it and what complications you might expect.

    2. Diffusion doesn't work.

    It would be wonderful if studying worked by simple diffusion but it doesn't, it requires active transport. It takes effort to learn. There is no way around putting the effort in, so be smart about it!

    3. Have a plan and a schedule.

    Having a daily and weekly plan to review material and study well before the exam allows you to be efficient in the effort you put into your studying. You read and review a small amount of information each day in a controlled manner and by the time the exam comes you understand it all. If you were going to pour a precious liquid into a

    4. Remember that you are smarter than you may feel.

    The material will be hard, the exams will challenge even the brightest students, and there will be a competitive environment but you were given this opportunity because you made the cut. You have the potential to be great, and at times it may be easy to doubt that if you let yourself.

    5. Remember that you can always know more.

    Nursing is a profession of lifelong learning. You will never be "done". Each chapter, each case study, each assignment is a change to broaden your knowledge. Each patient is a chance to apply your knowledge. You are a student and this is your time to learn; ask questions, do all your readings and your assignments, because they can all help you on nursing exams and more importantly in practice.

    6. Everyone falters and fails.

    Be easy on yourself and be constructive with yourself. Don't focus on the error instead on the rationale. You can learn more from a wrong answer than you can from a correct one if you stay constructive.

    7. Use what you have.

    Nursing exams may ask you about something you have never even heard of, and that can be frustrating if you let it. Approach each question and each topic with the mentality of applying what you do know rather than what you don't. Start from the basics if you are unsure: what would Maslow and ABCD say? And hope you didn't cram that day but actually learned about Maslow and ABCD, because in nursing education, they are often the solution.

    8. Study in a group.

    It takes a village mantra works well for nursing school. Your group allows you to divide and conquer. It gives you motivation to review material prior to a session. It supports you when times are difficult. It lets you see other approaches to the same topic. It corrects you when you have misunderstood something. Most importantly, it helps you enjoy learning.

    9. Seek help when needed.

    If you are struggling with a concept or a class, seek help from a professional early. Most programs have free access to tutors. Most professors are willing to give you some 1 on 1 time. Just like cramming, waiting to get help may mean disaster in the end.

    10. The golden rule: Be a Student.

    You are investing heavily in your education, take the time to actually be a student. That means putting effort into studies. That means making mistakes. That means admitting to yourself that you are on a long road as sometimes just putting one foot in front of the other is what it takes.

  • May 3

    Quote from Jewe
    There are schools that take lower GPA just takes time to find them
    And they kinda do us all a disservice.

  • May 2

    Quote from sailornurse
    Hi Boston;
    I'm familiar with contracts for controlled substances but had not considered testosterone as requiring one. Can you explain why testosterone is on the list?
    It's a schedule III with abuse potential as an anabolic steroid and abuse puts patients at significant risk; it is also dangerous for children if exposed. Our contract sheet just states it's filled at a single pharmacy from single provider, patient agrees to monitoring (CBC, T levels, PSA, etc), agrees to keep medication locked and take only as prescribed, no early fills or replacement scripts, and acknowledges the risks associated with routine treatment as well as misuse.

  • May 2

    Quote from writerartistnurse
    Yes that is harsh. I am playing neutral party here, but it's not like she injected heroin, diverted meds from a hospital, or sold drugs. She took an ativan.
    Playing devil's advocate here, but why wouldn't the BON or the nursing program say "if he/she would take a pill without a script from a friend would they take a pill from the hospital or street?"

  • May 2

    Quote from Studentnurse365
    Can you get a prescription from your doc? Tell the doc how anxious you've been and that you think you need an rx for lorazapam. Then if the doc gives you a rx you have the rx to show them and you won't have to take your mom's anymore. Win win.
    This is a really bad piece of advice.

  • May 1

    Quote from fawnmarie
    I don't think she has any idea that it is a controlled substance, and I doubt she knows that some medications are "controlled." It's a cultural thing.
    It may be a "cultural thing" but the blame falls on the prescriber. Controlled substances are dangerous medications if used inappropriately and the prescriber is responsible for clear patient education. Most offices have (and all offices should) have a signed controlled substance agreement which details the risks of use and that sharing medication is considered a breach of contract.

    As for the OP, it's a bad situation. The school could even report it to the BON I would think which would make future licensure difficult. Best of luck. I would be honest if asked...

  • May 1

    Quote from sauce
    None of them had any clue how to diagnose, prescribe, or even really do a true physical exam. Basic stuff they should have learned in nursing school, much less an MSN program.
    This is what your job is as a preceptor when you agree to take first semester students. First semester NP students need to learn proper physical exams, basic differentials, diagnostics, and prescriptive practices. RNs don't learn how to diagnose or prescribe. They might not even learn a proper physical exam.

    The NP program I precept for has a structured standardized patient experience semester prior to clinical rotations so this isn't an issue or me in clinic.

  • May 1

    Quote from Jewe
    There are schools that take lower GPA just takes time to find them
    And they kinda do us all a disservice.

  • Apr 30

    Quote from writerartistnurse
    Yes that is harsh. I am playing neutral party here, but it's not like she injected heroin, diverted meds from a hospital, or sold drugs. She took an ativan.
    Playing devil's advocate here, but why wouldn't the BON or the nursing program say "if he/she would take a pill without a script from a friend would they take a pill from the hospital or street?"

  • Apr 30

    Quote from fawnmarie
    I don't think she has any idea that it is a controlled substance, and I doubt she knows that some medications are "controlled." It's a cultural thing.
    It may be a "cultural thing" but the blame falls on the prescriber. Controlled substances are dangerous medications if used inappropriately and the prescriber is responsible for clear patient education. Most offices have (and all offices should) have a signed controlled substance agreement which details the risks of use and that sharing medication is considered a breach of contract.

    As for the OP, it's a bad situation. The school could even report it to the BON I would think which would make future licensure difficult. Best of luck. I would be honest if asked...

  • Apr 30

    Quote from sauce
    None of them had any clue how to diagnose, prescribe, or even really do a true physical exam. Basic stuff they should have learned in nursing school, much less an MSN program.
    This is what your job is as a preceptor when you agree to take first semester students. First semester NP students need to learn proper physical exams, basic differentials, diagnostics, and prescriptive practices. RNs don't learn how to diagnose or prescribe. They might not even learn a proper physical exam.

    The NP program I precept for has a structured standardized patient experience semester prior to clinical rotations so this isn't an issue or me in clinic.

  • Apr 30

    Quote from Slhengy
    We can make those same claims with the use of alcohol and even more so, per multiple studies. There is absolutely no difference.

    There is a difference, alcohol is federally legal and marijuana is not. Alcohol also does not accumulate in the body and impair function several weeks out from a single use, there could be an argument that chronic alcohol abuse does have lasting cognitive effects, but again, the law is the law regardless.


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