Dear nursing student - page 3
Dear clinical student, I am your soon-to-be instructor. Know that I love this profession and have dedicated my life to it and to my patients. I consider this profession to be a calling. I did not... Read More
Mar 21, '10 by A New StartQuote from dudette10There's no doubt. You're right. There WILL BE tattoos on the aged patients of the future. There's also no doubt they too will have their own socially acceptable and unacceptable opinions. But, the question is will there be young nurses scaring and provoking those (tattooed, but old and frail) patients? Or will there be humble young people willing to lay down their pride and their rights of expression for 8-12 hours and care for those that have lost much of the control in their lives?Liked the letter, and I laughed at this part (not in a bad way).
There will come a day when all the patients are tattooed and have the tell-tale pinprick scars of youthful piercings. Just you wait and see....
I could be wrong. Marty correct me if I am, but what the instructors like him are saying to us is "It's about the patient." We can express our individuality in a hundred ways when we're off duty. I'm from the hippie generation, I understand and speak rebel very well. But when I chose to become a nurse, I gave up some of my rights in the interests of frail and injured strangers.
Think of your favorite old person in the whole world. Do you want anyone scaring or provoking them just so they can express themselves? No, you wouldn't do that. I'm sure you're going to make a great nurse and you'll do the right thing. Whatever that is.
Good Luck! A New StartLast edit by A New Start on Mar 21, '10 : Reason: spell correction
Mar 21, '10 by A New StartQuote from HJS27I like the thinking here as long as it doesn't result in cookie cutter treatment, bad assessment skills, and thoughtless evaluation. I'll try it and see how it helps my thinking. Thank you. I used Excel in business for the same reasons. I'd rather work with the data than be fussing with the method all the time.:smackingf Seriously? Eight to twelve hours on a single care plan is just too much. There is no particular merit in time lost to mindless busy work.
There are excellent resources available that allow a fabulous care plan to be put together in much less time. This, in turn, allows time to actually think critically about the information. Yes, putting the care plan together does get the juices flowing, but looking up each factoid and handwriting them simply wastes your precious time. It is just as effective to read a completely pre-prepared care plan document for each NANDA and choose & adapt each part to fit your particular patient's needs. The process is still an exercise in critical thinking. I particularly like an Evolve resource, the online care plan constructor that comes with “Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care”, by Ackley & Ladwig, from Elsevier.
For medication information, the Drugs section of Epocrates Online in an exceptional resource. The basic application is free, the medication information is broken out into categories making it a simple task to pull the information for your care plan, and the Diseases section is excellent as well...concise, complete, and also broken out into sections.
Being a well-rested nursing student/nurse is a good thing, and is not to be under estimated. Do a little research on sleep deprivation if you don't believe me. :zzzzz
Congratulations on some good creative thinking. But let's all beware of going to sleep with our eyes open!
A New StartLast edit by A New Start on Mar 21, '10 : Reason: Need an English class
Mar 21, '10 by marty6001I guess my thinking is old fashioned when it comes to piercings, tattoo's etc in that if we are attempting to advance ourselves as a profession, we have to uphold ourselves to the highest level of professionalism to our patients... That being said, we all have the right to be individuals, and to exercise that in anyway we wish. I myself have tattoo's, but when I am in clinical, either working or teaching I wear a shirt that covers them in respect to my patients, my institution, and most importantly my profession...
As to the care plans, I still stick to the belief that as a student, researching the patient, gathering the data, and writing the plan should take 8 hours. Yes, I do add in the researching part. Doing a complete chart and online review, then going home and defining the terms and writing the plan should take a mininum of 8 hours... That's just me, but I will say that I've never received a bad score from a student and I expect this level of work from them all.
Mar 22, '10 by angel_bear_4670I am an EEN (Endorsed Enrolled Nurse) in Australia, and have just undertaken to upgrade to do my Registered Nursing through University. I'm an oldie too .. 48yo. My first placement is nothing short of a nightmare. I'M LUCKY .. I've got an ex-colleague I get to work with, but one of my fellow students is a naive 19yo, who has NO floor experience and doesn't know how do *decode* a taped handover and missed the hourly urine measures. She had a patient load dumped on her as her RN found students to be "a nuisance" and then got screamed at (yes, I heard this woman screaming at the students) for missing the measures.
Necessary? No. No amount of screaming is going to teach this young thing how to decode a taped handover (god bless bedside handovers). Thank the Lord I have an advantage in that way.
Then again, where some see me as a "useful student" cause I have floor experience, others see me as 'painful' because I've got experience and assume I'm a know-it-all (I'm not .. I do realise RN's are significantly more trained than EEN's on so many levels it's frightening).
so .. to my preceptor .. THANK YOU for knowing me, trusting me and teaching me the finer points .. to my fellow students preceptor .. retire or refuse. Making somebody cry on their first day is NOT the way to encourage somebody.
Mar 22, '10 by SaraSRNWow, I have to admit that while in nursing school I would often have 20 page care plans that usually took 12 hours to complete (8 hours the night before my clinicals and 3-4 hours post clinical). Everything had to be in my own words and APA refrenced to a T.
I will also admit that the amount I slept while in nursing school was minimal as I had a heavy work load and much studying to do. The best advice I can give you is to slowly learn to be overworked and exhausted with a smile on your face and a skip in your step until you graduate. It eventually gets better, good luck.
Mar 23, '10 by RPN_20123. If you haven't spent 8 hours on your care plan it is likely incomplete.
Mar 23, '10 by RPN_2012I'm starting nursing school in sept , so I need to know how much time I'll be spending on care plans
Mar 23, '10 by hiddencatRNWow- you guys have some intense care plans! Ours is (this quarter) 2 nursing diagnoses, one psychosocial and one physiological, with one goal each and 3 interventions each. We have to provide a rationale for the intervention. Our prep sheets are more time consuming than our care plans- those are where we have all the lab values and a progression of hospitalization.
We get to clinical, find our patients and go to work, so all of this is due the next week. Logistically, I'm glad we don't go in the night before to prep, but it does often mean you're presented with something it would have been better to have time to look up ahead of time.
Mar 23, '10 by A New Start[QUOTE=HJS27;4189735]
There are excellent resources available that allow a fabulous care plan to be put together in much less time. This, in turn, allows time to actually think critically about the information. Yes, putting the care plan together does get the juices flowing, but looking up each factoid and handwriting them simply wastes your precious time. It is just as effective to read a completely pre-prepared care plan document for each NANDA and choose & adapt each part to fit your particular patient's needs.
Not for me! Tried it. Thanks for some new tools, but cut and past plans don't give me the personal investmentt I need to make the material stick.
Admittedly, I don't want to sprend 8 hrs for every 8 hrs I work on EACH patient I treat in the future! But for now the discovery process is important.
Thanks for sharing! A New Start
Mar 23, '10 by A New StartSorry. For some reason I keep double posting with my handheld. Murphy lives!
A New StartLast edit by A New Start on Mar 24, '10 : Reason: double post
Mar 23, '10 by OceangelOn the yelling part - yes in a perfect scenario I would prefer to be privately counseled on my areas for improvement. However, as a student with someone's life in my hands, if I am about to administer meds to the wrong patient or perform any other act that could kill them - there is not always time to pull me away and "nicely" explain what I was doing wrong. In the midst of the sometimes chaotic treatment room - if I screw up - YELL away - it may jolt my self-esteem, but it will save my patient.
I think people are a bit too thin-skinned nowadays.
Mar 24, '10 by vegas2009[quote=marty6001;4178287] dear clinical student,
i am your soon-to-be instructor. know that i love this profession and have dedicated my life to it and to my patients. i consider this profession to be a calling. i did not come to this profession for money, for prestige, or for the title.
wow, thank you for this. i would definitely make a printout of this article. it puts things in perspective. hopefully, i can use it and remind myself not to take things personally. well, i'm not really that sensitive to begin with -- but i don't like being yelled at either. i have no problems respecting instructors, since i know that they had to go through a lot of things themselves.Last edit by vegas2009 on Apr 23, '10
Mar 26, '10 by mspontiacOur care plans easily take 8 hours to create, after we get home from patient pickup. Our instructor insists they are fully complete when we arrive at clinical at 6:30 am, with the exception of follow-up information. The follow-up information is to be completed by the end of clinical at noon...but we are not to work on paperwork during clinical because "that is time dedicated to working with your patients, not working on paperwork." Do the math, and if anyone can tell me how that works without breaking the rules, please let me know because I still haven't figured it out. Generally I finish and get to bed about 2 a.m., and get up at 4:30 a.m.; I always worry what kind of mistake may occur because of my short-circuiting, sleep deprived brain that could compromise patient safety.
Our instructor is far from a leader. She is punitive and will cut you down in the blink of an eye, and yet makes mistakes regularly herself. Heck, it's 11 weeks into the semester and she is still calling myself and another student by the wrong names, and doesn't know what work each of us have done because she confuses our names every week. She is harsh enough that one of my fellow students had a patient tell her they felt sorry for her after the instructor left the room. If she gets stressed, watch out because she is going snap at you and humiliate you in front of a patient, guaranteed. I'm a mature 40 year old, plus I am bright and work very hard, so I have pretty thick skin in regards to criticism. I just wish she could learn to deliver it in a slightly more constructive fashion, or at least pull me away from the patient to vent her frustrations.
But I digress - my point is, respect goes both ways. Instructors can be wonderful mentors, provided they view us all as individuals and not as nameless rabble who have no idea what we are doing academically.