Latest Comments by Here.I.Stand

Here.I.Stand, BSN, RN 32,140 Views

Joined Nov 18, '13 - from 'Midwest'. Here.I.Stand is a RN. She has '13' year(s) of experience and specializes in 'SICU, trauma, neuro'. Posts: 4,466 (75% Liked) Likes: 16,192

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  • 0

    I attended my ADN program before ebooks were a thing (and I had to walk in waist deep snow a mile uphill both ways... sorry, I couldn't resist!)

    I agree with Shanimal though, it really is about preference.

    I love ebooks for pleasure reading -- actually it's thanks to Audible I have time for pleasure reading! But for in-depth study I like to have a book I can write in and dog-ear. My 15 yr old daughter is a heavy tech user as most teenagers are; her school books are all on her school-issued iPad. However for AP US history, she HAS to read her heavy reading assignments from the physical textbook. She says it's easier than reading off a screen.

    For stuff like pharmacology, I tend to utilize the tools my hospital has (Lexicomp and Micromedex), or I will ask the pharmacist. I haven't used a Mosby's type drug book since nursing school in the early 2000s.

    Occasionally I will Google something. One example: Le Fort fractures. I had never heard the term until I had a pt with a type III. So obviously wanting to know what part of his face was broken, I Googled it.

    How I could see ebooks being a good option is if lugging a bunch of those huge tomes is too difficult.

  • 0

    Quote from KrCmommy522
    Instead of worrying about how to fight this policy, suck it up, focus on studying the material, doing well on the exams, and then you will pass
    Sage advice!

    OP, do you not agree that one who holds an RN's responsibility should be held to a high standard? If it were you or your loved one in that bed, wouldn't you want to know that your nurse had proficient knowledge aeb A's and B's in school?

  • 0

    You should ask the school's admin. I wouldn't *think* changing majors would be an issue alone, but you would still have to complete nursing prereqs.

    Consider what each option would cost in time and money: 1) finish the psych degree you won't use, and then do an ABSN program (which are typically expensive). 4 yrs in first BS/BA program, plus 1-2 yrs in the ABSN. OR, 2) change majors, possibly spending 5 yrs on your BS/BA; pass NCLEX and start working upon graduation.

  • 2
    not.done.yet and Ambersmom like this.

    Quote from nurse83522h
    why is eveyone ignoring the fact that the instructor wrote to us "Never assume I have made a mistake in the answer options. If I have made a mistake it will NEVER count against you". The instructor made a mistake in her question and I am simply following her own directions given to us.
    I didn't ignore that part...

    Quote from Here.I.Stand
    I would think that the prof's vow not to hold you accountable for her mistake would refer to her believing "C" is the correct answer, but student can argue EBP says "D" is most correct. NOT that she can make what is clearly a typo, and you are absolved of your need to critically think.
    And actually I see this lack of critical thinking a big issue. To be honest, this indicates that more time in nursing school would benefit both you and future patients... especially given that you were on the bubble well before this test.

  • 2
    h00tyh00t and kakamegamama like this.

    Maybe I live in a sufficiently diverse area, but since 2003 I've never observed a need for adjusted visiting policies... the pt's family/support system is is who the pt says they are.

    In one case though, I got the feeling this woman had had trouble in the past. It was a lesbian couple in their 60s; the pt was going to the OR and her partner was on the cot in the pt's room. The partner asked me how to get to the OR waiting room from the unit. I hesitated -- because I'm severely directionally challenged and was trying to picture the route in my head, so that she didn't get lost. Not even 2 sec had elapsed, and she said "I'm her partner of 30 years, we are each other's POA..." like she thought I was hesitating based on their relationship.

  • 0

    Everywhere I have worked, FT and PT staff have worked alternate holidays.

    Either we work Thanksgiving AND New Year's, OR Christmas. Where I am now, Christmas Eve and Day are "Christmas" -- we work both or off both. That way every other year, we're free to actually make out-of-town plans.

    I don't mind working holidays, and my kids have gotten the "count our blessings" speech if they complain about me working. But I would be completely unwilling to work BOTH Thanksgiving and Christmas.

  • 0

    Don't let a snapped "I'm busy" have this much effect on you. You will hear maaaaaaaaaaaany sharp responses over the course of your career. Frustrated or jerk pts and families, fellow nurses, other members of the care team...

    I once even had a CNA yell at me in the resident dining room -- she was mad that I hadn't gotten this lady dressed after I had helped her on the toilet. Now I'm not above ADLs, again I had just toileted her. But I needed to get on with med pass, and ADLs were of course her primary job. But she thought since I was in there anyway, I should have done all a.m. cares myself, and she decided to start yelling at me in front of 20 people.

    It did hurt my heart a bit; I didn't like her perception of my work ethic. It was embarrassing besides, and PLUS I really didn't have time for conflict. Rather than let it bother me, I immediately put a stop to the behavior. I did go to the BR for a 5 minute breather, and then let it go.

    If your morale was good before this incident, I'm guessing she was ok previously? Honestly I would show her some grace, especially if this was an isolated incident. Maybe she only slept 2 hrs during the night, maybe she doesn't feel well, maybe she's divorcing, maybe a loved one was dx'ed with dementia... any number of things that can affect one's mood.

  • 1
    rileowski likes this.

    Excess serum K+ impedes electric activiy, so you'll see brady-arrhythmias/BBBs etc. if K+ is high enough. Now most healthy people will excrete some of that; someone with renal failure however, is unable. That's why you see those dangerously high levels >6-7 in pts with renal failure -- and unless level is reduced (with medical shift like insulin&D50, or with dialysis), the pt is at risk for cardiac arrest

  • 4
    Ambersmom, Nurse Leigh, chare, and 1 other like this.

    I would think the time to bring it up should have been during the exam: "Professor, is this supposed to be 'burn,' not 'bun?'" Rather than assuming the answer is wrong. I mean I can't think of how the word "bun" would make it a REASONABLE wrong answer.

    Q: Which of the following is indication for mechanical ventilation?
    A) wrong answer
    B) correct-ish answer #1
    C) correct-ish answer #2
    D) full thickness buns on the pt's face and neck
    Um.... "Bun" as in someone's butt? Buns as in the pt spilled his White Castle bag on his face? While in the absence of the typo, D is a clearly correct answer.

    I would think that the prof's vow not to hold you accountable for her mistake would refer to her believing "C" is the correct answer, but student can argue EBP says "D" is most correct. NOT that she can make what is clearly a typo, and you are absolved of your need to critically think.

    As for the 2nd incorrect answer, well you have already appealed; she probably reviewed everything with a fine-tooth comb to ensure the accuracy of your grade. She could just as easily found an incorrectly-marked WRONG answer and said "Good news! This isn't necessary, because I found a point on an earlier exam you didn't get credit for, and you passed! I'm terribly sorry about that, but glad you brought it up."

  • 7

    Nope! It's not your job to staff the unit. Enjoy your Daddy time.

  • 0

    Not sure of the specifics of this pt's fracture -- anterior, posterior, spinous or transverse process, involvement of facets, compression fx, burst fx... Was he fused? I'm assuming his SCI is incomplete since he is ambulating. Jewetts are used typically with stable anterior fractures T12-L2

  • 1
    CelticGoddess likes this.

    knowledge deficit The pt may well have a knowledge deficit.

    rt diabetes condition r/t refers to the etiology; DM is not the *cause* of said knowledge deficit.

    as evidence by DKA These are your observations that support your nursing dx. The presence of DKA doesn't prove a knowledge deficit.

  • 1
    NurseBlaq likes this.

    Quote from maxthecat
    How do you reconcile "charting by exception" with "if it wasn't charted, it wasn't done."
    Well what is "done" *is* that exception -- you still document any wound care, collaborative interventions, meds given, etc. If abdominal assessment is WNL, just click the WNL box, vs. writing out the "bowel sounds audible and normoactive in all quadrants, soft/nontender, contour unchanged from baseline, pt denies nausea/vomiting/pain. By clicking WNL you are acknowledging that you did perform the assessment

  • 7
    anitalaff, mt9891, KelRN215, and 4 others like this.

    My mom's licensed massage therapist is an RN who worked at the bedside for years. Obviously that would require more schooling, but this woman's nursing knowledge puts her a cut above other LMTs in the area. She also does diabetic foot care in her practice.

  • 1
    Ambersmom likes this.

    Quote from Al Kalosis
    A lot of people seem to be trying to validate or invalidate the actions of the nurse, but this is not really the question here. There may be valid reasons for quoting or not quoting in chart notes, and had any of us been in a similar situation, our actions may have aligned with this nurse's actions, or not.

    The question is: Is it acceptable for a physician to demand that a nurse remove part of his or her charting based on personal vanity? This particular doctor is a narcissist and a bully. He is accustomed to amassing control by threatening and intimidating others. His behavior was unacceptable, and it is no exaggeration to say that he is dangerous.
    You make some pretty significant assumptions of someone who isn't here to defend himself. If you truly consider it narcissistic to not want a statement connecting you to impaired practice... I don't even know what to say about that.

    Would you truly feel peachy keen if you read in someone else's note: "Pt's mother states, 'Al Kalosis is such an idiot, he MUST be smoking something.'?" If this mother sued, do you honestly believe that a standing-to-profit attorneys would look at the notes, read the above statement and say, "oh I'm sure this mom is just being irrational; Al Kalosis is a highly competent nurse?"