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bebbercorn, BSN 9,608 Views

"Raise your words, not voice. It is rain that grows flowers, not thunder." ― Rumi

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  • Oct 11

    As a Muslim I have traded Friday's for Sunday's, Christmas for Eid... I have mostly had good luck. If you can speak with your rabbi then this may help, if you have to alternate fridays is this acceptable for you? I have worked in ED, Trauma, and have held pressure on bleeding wounds, done chest compressions, and held hands right through when I'm supposed to be praying. I'm no religious scholar, but I know in my heart that this is not a problem. I pray it goes well for you , if this is the best job meant for you!

  • Oct 11

    As a Muslim I have traded Friday's for Sunday's, Christmas for Eid... I have mostly had good luck. If you can speak with your rabbi then this may help, if you have to alternate fridays is this acceptable for you? I have worked in ED, Trauma, and have held pressure on bleeding wounds, done chest compressions, and held hands right through when I'm supposed to be praying. I'm no religious scholar, but I know in my heart that this is not a problem. I pray it goes well for you , if this is the best job meant for you!

  • Oct 11

    As a Muslim I have traded Friday's for Sunday's, Christmas for Eid... I have mostly had good luck. If you can speak with your rabbi then this may help, if you have to alternate fridays is this acceptable for you? I have worked in ED, Trauma, and have held pressure on bleeding wounds, done chest compressions, and held hands right through when I'm supposed to be praying. I'm no religious scholar, but I know in my heart that this is not a problem. I pray it goes well for you , if this is the best job meant for you!

  • Sep 9

    Anders, one of my favorite professors did this. It was completely optional, but you could do a "visit" with her, where she would give you VS, pertinent history, and chief complaint, then go from there. I loved this learning method and it was so helpful. She had a ton of experience as an NP and was one of those who really facilitated learning. We need more of those!

  • Sep 9

    Quote from IsabelK
    I precept. I don't like to precept first semester clinical students because they don't have enough internal medicine knowledge to make the leap to geriatrics. What I find is that I get NP students coming through who have the book knowledge the school gives them about prescribing, labs, etc, but that previous preceptors many times don't let them practice working with any of it. Physical exam skills tend to be good, but the actual "exam, then do" is lacking. When my students are there I make them sit with labs and med lists and diagnoses and tell them to "figure it out". Generally that starts with them talking through it with me and as the rotation goes on it's them coming to me with assessments and plans, including meds, future labs, and reasons why. I won't take "it's the guideline". Ok, nice, but why??? I also let them practice writing prescriptions for everything from PT/OT (I work in LTC) to actually writing the controlled substance scripts. Since the facility still uses paper, they have to think and can't rely on an EMR to populate meds. This means they have to know how to look up dosing guidelines. This is from a school that does weed out people (I've had students set up to come to clinical and then be told they're not coming because they failed a mock physical exam with SOAP note, failed a written exam, etc).
    You sound like an amazing preceptor!

  • Sep 8

    Quote from IsabelK
    I precept. I don't like to precept first semester clinical students because they don't have enough internal medicine knowledge to make the leap to geriatrics. What I find is that I get NP students coming through who have the book knowledge the school gives them about prescribing, labs, etc, but that previous preceptors many times don't let them practice working with any of it. Physical exam skills tend to be good, but the actual "exam, then do" is lacking. When my students are there I make them sit with labs and med lists and diagnoses and tell them to "figure it out". Generally that starts with them talking through it with me and as the rotation goes on it's them coming to me with assessments and plans, including meds, future labs, and reasons why. I won't take "it's the guideline". Ok, nice, but why??? I also let them practice writing prescriptions for everything from PT/OT (I work in LTC) to actually writing the controlled substance scripts. Since the facility still uses paper, they have to think and can't rely on an EMR to populate meds. This means they have to know how to look up dosing guidelines. This is from a school that does weed out people (I've had students set up to come to clinical and then be told they're not coming because they failed a mock physical exam with SOAP note, failed a written exam, etc).
    You sound like an amazing preceptor!

  • Sep 4

    Quote from IsabelK
    I precept. I don't like to precept first semester clinical students because they don't have enough internal medicine knowledge to make the leap to geriatrics. What I find is that I get NP students coming through who have the book knowledge the school gives them about prescribing, labs, etc, but that previous preceptors many times don't let them practice working with any of it. Physical exam skills tend to be good, but the actual "exam, then do" is lacking. When my students are there I make them sit with labs and med lists and diagnoses and tell them to "figure it out". Generally that starts with them talking through it with me and as the rotation goes on it's them coming to me with assessments and plans, including meds, future labs, and reasons why. I won't take "it's the guideline". Ok, nice, but why??? I also let them practice writing prescriptions for everything from PT/OT (I work in LTC) to actually writing the controlled substance scripts. Since the facility still uses paper, they have to think and can't rely on an EMR to populate meds. This means they have to know how to look up dosing guidelines. This is from a school that does weed out people (I've had students set up to come to clinical and then be told they're not coming because they failed a mock physical exam with SOAP note, failed a written exam, etc).
    You sound like an amazing preceptor!

  • Aug 28

    Quote from IsabelK
    I precept. I don't like to precept first semester clinical students because they don't have enough internal medicine knowledge to make the leap to geriatrics. What I find is that I get NP students coming through who have the book knowledge the school gives them about prescribing, labs, etc, but that previous preceptors many times don't let them practice working with any of it. Physical exam skills tend to be good, but the actual "exam, then do" is lacking. When my students are there I make them sit with labs and med lists and diagnoses and tell them to "figure it out". Generally that starts with them talking through it with me and as the rotation goes on it's them coming to me with assessments and plans, including meds, future labs, and reasons why. I won't take "it's the guideline". Ok, nice, but why??? I also let them practice writing prescriptions for everything from PT/OT (I work in LTC) to actually writing the controlled substance scripts. Since the facility still uses paper, they have to think and can't rely on an EMR to populate meds. This means they have to know how to look up dosing guidelines. This is from a school that does weed out people (I've had students set up to come to clinical and then be told they're not coming because they failed a mock physical exam with SOAP note, failed a written exam, etc).
    You sound like an amazing preceptor!

  • Jul 9

    Your post is a little off-putting with the emphasis on accents/being from the same continent/etc. I am going to side with the charge nurse on the "I need you to..." comment. I try to remember just how hard CNA's work and are as human as I, and I try to ask "Hey, Janet. I'm a little slammed with xyz. Would you mind bringing some water to pt B? Thanks." The wording "I need you to..." can come off the wrong way.... Just my two cents.

  • Jul 9

    Your post is a little off-putting with the emphasis on accents/being from the same continent/etc. I am going to side with the charge nurse on the "I need you to..." comment. I try to remember just how hard CNA's work and are as human as I, and I try to ask "Hey, Janet. I'm a little slammed with xyz. Would you mind bringing some water to pt B? Thanks." The wording "I need you to..." can come off the wrong way.... Just my two cents.

  • Jun 26

    Don't forget the anxiety component. Here are some things I check as an ER nurse...

    1- is the room spinning? Are your ears ringing? Did your hearing change (check with a whisper test, for example). This could be vertigo or inner ear problem, menieres...

    2) do you feel like you may pass out - r/o cardiovascular cause... orthostatic VS, heart sounds even, regular, peripheral pulses strong/weak, cap refill...

    3) Disequilibrium - tripping over feet, problems "turning on a dime" etc to check for gait abnormalities or peripheral probe (unlikely in healthy teens, more with things like Parkinsons or peripheral neuropathy

    4- "Lightheadedness" or vague complaints can be psych related.

    Check for euro hx - migraines, etc. Do they take meds? Pregnant? A million causes for "dizziness," if nervous, get them to a doc! Good luck!

  • May 21

    You will find that many people, nurses included, can be very toxic against NPs. Keep your head high and put your best foot forward. We are advancing on what was historically their territory, and I hate to say, giving a lot of power to women in a traditionally male dominated field. There's a number of reasons to be defensive about it, but essentially, that's the way healthcare is moving. Study after study proves we give as good care or better than doctors across the field. And your teacher is full of snot.

  • May 17

    Any nurses or NPs working in a mobile clinic setting? I know that starting a business definitely have lost revenue, but I'm trying to estimate how many patients one would see in a large city in a day? Is 8 a fair estimate... (for a newbie) And do you travel to them or do they come to a site? Thanks for the input.

  • Apr 4

    Your facility is required to allow you a pump break. Texas Mother-Friendly Worksite Program - Breastfeeding Laws

  • Mar 20

    I am so sorry for your rough day!!! From ED perspective (and I don't think this is necessarily right), generally the admitting MD orders it, and it is started on an inpatient basis. Unless, the admitting MD asks the ED to start it, or the patient holds in the ED. Then we can access inpatient orders.

    You had a day from hell and made it. You would have well been within your rights to give some of that attitude right back for calling you at 11 pm! Years in, I still make mistakes. Of course, I internally beat myself up, but externally, thank God, I have reached the point where I can just say "Yes, you're right. I should have done XYZ. Good catch. So, how's the gardening going?"


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