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Double-Helix, BSN, RN 29,375 Views

Joined Apr 5, '11 - from 'New Jersey'. Double-Helix is a Nurse, Children's Hospital. She has '6' year(s) of experience and specializes in 'PICU, Sedation/Radiology, PACU'. Posts: 3,151 (53% Liked) Likes: 5,880

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  • 2:00 am

    You can get a decent refurbished laptop at best buy for around $200-250. I would expect an honest person to take responsibility for the consequences of their actions- even accidental- I can understand why $650 might be impossible for a single parent in nursing school. Asking her to pay for the cost of a laptop that will be functional for your, even if not equal to the one that was broken, may be a good compromise. But it’s likely you’ll have to get someone else (like a lawyer) to get her to give you money. She’s clearly avoiding your texts in hopes that you just drop it. And if you end up paying a lawyer $200 to get her to pay for a $200 laptop, you really haven’t gained anything. So as you decide what to do, be sure to weigh in the costs of potential legal fees.

    P.S. Simplistic, just because the damage was accidental doesn’t absolve this woman from culpability. If I accidentally rear end someone with my car, I’m still liable for those damages.

  • 1:20 am

    I don’t think OP provided nearly enough information to make the assumption that the nurses on the unit don’t teach because they possess inadequate knowledge. I agree with meanmaryjean that it’s rather unfair to say in this scenario, or any other. OP didn’t actually say that he/she was assigned to a nurse on the unit who refused to teach. The statement was:

    Quote from SRN2018
    I'm only 2 days in and I really dislike the way the nurses have approached having students in the unit.
    This makes it sound like the issue is more about unit culture, not individuals. With only two days experience, OP certainly hasn’t had enough interaction with the nurses to generalize that all of them are unwilling to teach. My guess is that this a unit that is feeling understaffed and overworked. They may have had poor interactions with clinical rotations in the past. Notice, I didn’t say poor interactions with nursing students, though that may be a possibility as well. Not all nursing instructors are good at communicating with the floor nurses. I’ve seen instructors show up with a class, assign the students to patients and send the students to start their daily tasks without ever checking in with the floor nurses. The floor nurse doesn’t find out until a couple hours into the shift- when she has already started planning her day and pulling up medications- that a student wants to assume partial care of that patient. Or it could be that this particular unit gets clinical students from four different nursing schools throughout the week and is simply burned out from being asked to constantly accommodate nursing students without any compensation or recognition for the extra work it adds to their day.

    SRN2018, my advice to you is to communicate clearly and respectfully with the nurses on this unit. Introduce yourself in the morning, explain your role and your goals for the day. THANK HER for the opportunity to be on her unit and ASK HER to let you know if you can help her with something or if there is something you may benefit from watching. Even if the nurse doesn’t teach you directly, observe her practice, listen to how she communicates with patients and physicians, write down questions to research later, and make yourself available. When you’re finished your assigned tasks, check in with her to see if you can help. Don’t be caught sitting at the nurses station or chatting with your fellow students. If you can’t find a nurse who needs/wants help, ask a CNA. They are a wealth of information for a new nursing student and often very grateful for the help.

  • Mar 25

    I don’t think OP provided nearly enough information to make the assumption that the nurses on the unit don’t teach because they possess inadequate knowledge. I agree with meanmaryjean that it’s rather unfair to say in this scenario, or any other. OP didn’t actually say that he/she was assigned to a nurse on the unit who refused to teach. The statement was:

    Quote from SRN2018
    I'm only 2 days in and I really dislike the way the nurses have approached having students in the unit.
    This makes it sound like the issue is more about unit culture, not individuals. With only two days experience, OP certainly hasn’t had enough interaction with the nurses to generalize that all of them are unwilling to teach. My guess is that this a unit that is feeling understaffed and overworked. They may have had poor interactions with clinical rotations in the past. Notice, I didn’t say poor interactions with nursing students, though that may be a possibility as well. Not all nursing instructors are good at communicating with the floor nurses. I’ve seen instructors show up with a class, assign the students to patients and send the students to start their daily tasks without ever checking in with the floor nurses. The floor nurse doesn’t find out until a couple hours into the shift- when she has already started planning her day and pulling up medications- that a student wants to assume partial care of that patient. Or it could be that this particular unit gets clinical students from four different nursing schools throughout the week and is simply burned out from being asked to constantly accommodate nursing students without any compensation or recognition for the extra work it adds to their day.

    SRN2018, my advice to you is to communicate clearly and respectfully with the nurses on this unit. Introduce yourself in the morning, explain your role and your goals for the day. THANK HER for the opportunity to be on her unit and ASK HER to let you know if you can help her with something or if there is something you may benefit from watching. Even if the nurse doesn’t teach you directly, observe her practice, listen to how she communicates with patients and physicians, write down questions to research later, and make yourself available. When you’re finished your assigned tasks, check in with her to see if you can help. Don’t be caught sitting at the nurses station or chatting with your fellow students. If you can’t find a nurse who needs/wants help, ask a CNA. They are a wealth of information for a new nursing student and often very grateful for the help.

  • Mar 25

    I don’t think OP provided nearly enough information to make the assumption that the nurses on the unit don’t teach because they possess inadequate knowledge. I agree with meanmaryjean that it’s rather unfair to say in this scenario, or any other. OP didn’t actually say that he/she was assigned to a nurse on the unit who refused to teach. The statement was:

    Quote from SRN2018
    I'm only 2 days in and I really dislike the way the nurses have approached having students in the unit.
    This makes it sound like the issue is more about unit culture, not individuals. With only two days experience, OP certainly hasn’t had enough interaction with the nurses to generalize that all of them are unwilling to teach. My guess is that this a unit that is feeling understaffed and overworked. They may have had poor interactions with clinical rotations in the past. Notice, I didn’t say poor interactions with nursing students, though that may be a possibility as well. Not all nursing instructors are good at communicating with the floor nurses. I’ve seen instructors show up with a class, assign the students to patients and send the students to start their daily tasks without ever checking in with the floor nurses. The floor nurse doesn’t find out until a couple hours into the shift- when she has already started planning her day and pulling up medications- that a student wants to assume partial care of that patient. Or it could be that this particular unit gets clinical students from four different nursing schools throughout the week and is simply burned out from being asked to constantly accommodate nursing students without any compensation or recognition for the extra work it adds to their day.

    SRN2018, my advice to you is to communicate clearly and respectfully with the nurses on this unit. Introduce yourself in the morning, explain your role and your goals for the day. THANK HER for the opportunity to be on her unit and ASK HER to let you know if you can help her with something or if there is something you may benefit from watching. Even if the nurse doesn’t teach you directly, observe her practice, listen to how she communicates with patients and physicians, write down questions to research later, and make yourself available. When you’re finished your assigned tasks, check in with her to see if you can help. Don’t be caught sitting at the nurses station or chatting with your fellow students. If you can’t find a nurse who needs/wants help, ask a CNA. They are a wealth of information for a new nursing student and often very grateful for the help.

  • Mar 25

    How old are you? If you’re under 26, you can still be covered under your parent’s health insurance plan.

    The university that you want to attend for your BSN may also offer a student health insurance plan you can purchase.

  • Mar 25

    You can get a decent refurbished laptop at best buy for around $200-250. I would expect an honest person to take responsibility for the consequences of their actions- even accidental- I can understand why $650 might be impossible for a single parent in nursing school. Asking her to pay for the cost of a laptop that will be functional for your, even if not equal to the one that was broken, may be a good compromise. But it’s likely you’ll have to get someone else (like a lawyer) to get her to give you money. She’s clearly avoiding your texts in hopes that you just drop it. And if you end up paying a lawyer $200 to get her to pay for a $200 laptop, you really haven’t gained anything. So as you decide what to do, be sure to weigh in the costs of potential legal fees.

    P.S. Simplistic, just because the damage was accidental doesn’t absolve this woman from culpability. If I accidentally rear end someone with my car, I’m still liable for those damages.

  • Mar 25

    Law school and med school are both graduate programs. I think the majority of people who have chosen those career paths have a good understanding of the level of work and commitment that will be involved if they are to be successful. In contrast, students that enter nursing programs don’t really know what to expect. I think many of them think that nursing school should be easier than it turns out to be. Some younger students may believe that nursing school is just an extension of high school; older students may think there’s no way nursing school could be a challenge given what they’ve already accomplished, so neither group anticipates needing to dedicate several hours of time and effort outside of class to learning and applying the material, or struggling to make the grades they did in their prerequisties. It’s not that nursing school is actually harder than the other degrees you listed, it’s just that the students’ perspective is different.

  • Mar 24

    Law school and med school are both graduate programs. I think the majority of people who have chosen those career paths have a good understanding of the level of work and commitment that will be involved if they are to be successful. In contrast, students that enter nursing programs don’t really know what to expect. I think many of them think that nursing school should be easier than it turns out to be. Some younger students may believe that nursing school is just an extension of high school; older students may think there’s no way nursing school could be a challenge given what they’ve already accomplished, so neither group anticipates needing to dedicate several hours of time and effort outside of class to learning and applying the material, or struggling to make the grades they did in their prerequisties. It’s not that nursing school is actually harder than the other degrees you listed, it’s just that the students’ perspective is different.

  • Mar 24

    I've only been a PICU nurse for three months, but I have gained a huge perspective in that time! Being a PICU nurse is exciting, heart-breaking, frustrating, scary, and wonderful all at the same time.

    Imagine taking care of a child on ten seperate medication drips who is on a ventilator, has three central lines, arterial line, a CVP and a foley. You're drawing hourly blood gases and blood glucose levels, counting all of your I&O's hourly, monitoring the ventilator settings, constantly alert for any changes in vital signs, making sure your syringes of pressors don't run out, hanging so many medications that you are running out of lines to use. You're giving updates to the docs and making adjustments to your drip rates based on their orders. You need to turn your patient every two hours, which requires two other nurses to help move the patient and keep the breathing tube in place. To top it all off, you have angry family members scrutinizing everything you do and demanding that certain non-essential things be done immediately.

    Being a PICU nurse is never boring. There is always something new, something that needs to be done. I've taken care of kids with so many different diagnoses that I couldn't possibly list them all. Our unit is a 19 bed PICU that takes all different kinds of kids. Our hospital has a pediatric cardiac surgery program, so we always have at least a few cardiac patients with various congenital cardiac defects. Depending on the season, we usually have a couple kids with viral illnesses, particularly RSV in the winter months, one or two babies on observation for apnea, asthma exacerbations, ex-preemies with chronic medical issues and heme-onc patient. Most of the pediatric surgical cases bypass the PACU and we receive them directly from the OR. So we get tonsillectomies, thoracotomies, traumas, amputations, appys, cardiac cath's, neuro surgeries, etc, etc. Our general peds floor does not have monitoring systems, so any patient that requires continous monitoring of any kind (HR, rhythm, O2 sats, respiratory) comes to PICU.

    Skills:
    Solid assessment skills are crucial. Kids can't tell you when something is wrong. You have to know what's normal and what isn't and be alert for any changes that might indicate the child is deteriorating.
    Critical thinking: why is this patient presenting like this and what does it mean? What am I going to do if this kid goes south? What do I need to have on hand in the room in case of an emergency?
    Prioritization and time management: You've got a lot to do. You need vital signs on all your kids at noon time and you also have three IV meds to hang, several po/GT meds, one kid needs an enteral feed and the other needs labs drawn and another has an infiltrated IV. What's most important? What can you get done early?
    Communication: With docs, with parents, with the kids. Parents of sick kids are nervous wrecks. They have a lot of questions. You need to be able to explain what is happening in terms that they can understand. You need to explain things to the child. You need to convince a sick and scared child to swollow their medications. You need to explain to the doctor why you think one of your kids needs a different type of treatment. A big part of your job is communicating. And don't forget giving and receiving report.

    My day begins at 6:45am and on a good day I leave at 8pm. Most days I eat lunch at the nurses station in five minutes so I am never far away from my patients. If I use the bathroom once I am lucky. But these are "my" kids, as I refer to them. They are my responsibility and whether I've taken care of them for an hour or three shifts, I love them. There is no other specialty like PICU, and there is no other place I would rather be working.

  • Mar 23

    1. Stop studying with her. She is clearly not benefitting you as a study partner. Let her know you’ll no longer be studying together and encourage her to visit the campus counseling center for help with her anxiety.
    2. Report her behavior to the nursing school. Once they have been informed, it will be their responsibility to take action if they deem it warranted. Even if drinking diluted 3% H2O2 is relatively low risk, drinking enough that it makes her vomit is a serious health concern.

  • Mar 23

    Night shift works well for some parents, specially if the children are school aged or they have some support at home to help with child care. Working nights, you're home in the morning to get the kids ready for school, can sleep while they are in school and are awake and home for dinner time. You mentioned the commute is longer, though, so you'll need to figure out exactly what that means. If you're scheduled 7p-7a, but you have to leave the house before 6 to get to work and don't get home until after 8, the benefits of night shift may not be worth it. With younger children, you would need someone to care for your son during the day after your shifts so you could sleep, and you would need someone that is home at night time. Working night shift can also be very physically and emotionally difficult for some people. It sounds like you've done it before, so you're the best judge of whether it's something you're willing to take on again. Your kids are only young once, so my personal advice would be to choose the position that allows you to spend the most quality time with your family. Opportunities to transition to women's health will keep coming up, especially with ICU experience.

  • Mar 23

    I doubt you’ll find this schedule in a BSN program. However, there are several evening/weekend ADN program options. If you can only attend school part time and your goal is to be an RN with a BSN, I’d suggest enrolling in an ADN program that suits your schedule and then advancing to an RN-BSN program.

  • Mar 23

    A patient with a trach isn’t going to get gastric distention during bagging because the tracheostomy is below the epiglottis. Patients bagged via facemask are at risk for gastric distention because air is forced into both the esophagus and lungs when a breath is delivered.

    A self-inflating bag (commonly called ambubags) can be used without an oxygen source. But, as others have said, using these bags without oxygen is really only helpful if the patient is not breathing or not breathing adequately. Your patient was breathing, but not oxygenating well, so what she really needed was more oxygen. If 35% was her normal O2 requirement, bagging her with 21% isn’t going to help her.

    It’s also important to assess WHY the patient suddenly became hypoxic. Did the trach get occluded when she was turned, preventing her from getting any air? Did the trach become displaced? Was there a mucous plug that required suctioning? Asking questions like that help you get to the root of the event and correct it more quickly.

  • Mar 23

    A patient with a trach isn’t going to get gastric distention during bagging because the tracheostomy is below the epiglottis. Patients bagged via facemask are at risk for gastric distention because air is forced into both the esophagus and lungs when a breath is delivered.

    A self-inflating bag (commonly called ambubags) can be used without an oxygen source. But, as others have said, using these bags without oxygen is really only helpful if the patient is not breathing or not breathing adequately. Your patient was breathing, but not oxygenating well, so what she really needed was more oxygen. If 35% was her normal O2 requirement, bagging her with 21% isn’t going to help her.

    It’s also important to assess WHY the patient suddenly became hypoxic. Did the trach get occluded when she was turned, preventing her from getting any air? Did the trach become displaced? Was there a mucous plug that required suctioning? Asking questions like that help you get to the root of the event and correct it more quickly.

  • Mar 22

    I agree that you need to disclose the situation to your supervisor and have another nurse take over as his key nurse. You are doing yourself and the patient a disservice by remaining his primary caregiver. Your feelings are understandable, and not something you should be ashamed of, though it might be helpful to talk through it with a professional to get to the root of the attraction and learn ways to cope with similar situations in the future.


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