Latest Comments by futurernfarmer

futurernfarmer 3,189 Views

Joined: Sep 23, '09; Posts: 62 (16% Liked) ; Likes: 28

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    Can anyone advise what the workload is like? How many years did you take to complete the RN-BSN? Was it stressful to work full time during the program? Was the coursework intense/unclear/otherwise frustrating? I had some surprises with my ASN program (CCAC) and am hoping to avoid a repeat experience! The other RN-MSN program I'm looking at is through Penn State.

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    From Wikipedia (I know, but I've been looking and looking...)

    In 2004, The American Association of Colleges of Nursing (AACN) in conjunction with the National Council of State Boards of Nursing (NCSBN) recommended that advanced practice registered nurses move the entry level degree to the doctorate level by 2015.[3] Accordingly, all APRN training programs are required to convert their master's degree to a Doctor of Nursing Practice degree by the year 2015. Although The American Association of Nurse Anesthetists approved this recommendation, it is not requiring program compliance until the year 2025.[4]
    The majority of programs will grant a Doctor of Nursing Practice (DNP).[3] Because 45% of the nurse anesthesia programs are located in Schools of Allied Health, these programs will award a Doctor of Nurse Anesthesia Practice (DNAP). The Doctor of Nursing Practice will be the direct-entry, minimum academic requirement for advanced practice registered nurses; it is a clinical/practice-based doctorate but because it is not the entry degree for the profession of nursing (which includes advanced practice registered nursing), it is a terminal degree.
    [edit] Grandfather exception

    The future Doctor of Nursing Practice requirement will apply only to those who are not yet licensed and practicing as APRNs. Those currently licensed as APRNs will be permitted to maintain their current level of education and certification. Some APRNs who have been in the profession for many years have been grandfathered into continuing APRN practice and licensure even without a master's degree. For example, the first Nurse Practitioner program was created by a nurse educator, Loretta Ford, Ed.D, RN, PNP and a physician, Henry Silver, MD, in 1965 at the University of Colorado as a non-degree certificate program, and all the early NP programs were initially established as these type of certificate programs before transitioning them to master's degrees in the 1980s.[5]
    Every state has different laws, rules, regulations, licensing and certification requirements for Advanced Practice Registered Nurses, thus some states may not have a grandfather clause in their State Board of Nursing laws, in particular as it may relate to transferring a license from one State to another. The US National Counsel of State Boards of Nursing (NCSBN) continues to work on a collaborative muti-state compact licensure agreement for advanced practice nurses to be able to work in multiple US States with a singular active home State license.[6] there are on-going discussions on expanding that type of licensure nationally[7][8] similar to the existing Nurse Compact for recognition of RN and LPN licenses.

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    I'm in 201/202 at allegheny right now and they are still irking me. My advice: get used to it, it gets worse for 102 and 201 (some of you know who I'm talking about!) Also, use the resources available:
    nrn computer lab - make friends with Mrs. Bell and she'll hook you up,
    open lab (it sucks to stay at school longer than you have to, but trust me it will be a huge asset),
    and study groups, tutoring, or the RN acheivement classes if you think they'll help.
    Don't get behind or you'll never catch up, but don't get too overwhelmed: many people graduate and pass the NCLEX every semester.

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    I'm halfway through my ADN, and I got the same speech. "You won't make it in this program if your family doesn't help you." "Studying will have to be your full time job." "You'll get no sleep the night before clinical." I'm pretty sure most of their warnings were to weed out the people who couldn't handle the stress inherent to the job. That being said, it's not easy! Keep your nose to the grindstone. If you pay attention, study effectively, and prioritize, you will do well.
    Some tips:
    Take pre-reqs first; it will ease the burden and prevent overload... Just remember to retain the information!
    Don't procrastinate! Study/practice a little bit every day or it will overwhelm you.
    Practice NCLEX questions every day or at least every week. The best way to go is to incorporate them into your study routine. Studying pharm? Practice related NCLEX Q's. Most books will be sectioned off conveniently.
    Find a PCT job; it's like clinical you get paid for... except you'll be kept too busy to get much nursing insight. You will get some in passing, and it will still make clinicals easier-- allowing you more time to practice skills.
    Reward yourself when you deserve it. Take time for yourself, and don't think you can NEVER go out during school. You just have to do it around school.

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    SNB1014 likes this.

    That's weird. I try to pick male partners in clinical, assuming they'll be better lifters... esp in med-surg where half the pts are obese!

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    NO NO 1000 times NO! For profit schools are a waste of money at best and a scam at worst. Ask around in your area, or other areas if you want to relocate to a good program that fits your needs. There are hospital based programs that will train you for free if you agree to work for them. Check with big hospitals, community colleges, and non-profit learning centers. Ask around. Not only can you go through PCT training for FREE, you might be able to swing nursing too. If all else fails, EMT and CNA are basically equivalent to PCT.

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    Update: I saw two pts with pigtails draining to IV fluid bags. It seems to just be an alternative to a JP...

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    I've bee a PCT on an abd tx unit for 2 months now. I figured drains should be emptied as often as possible/reasonable. Some RNs harass me to empty their pts drains when I am doing other things and it's not more than half full or near end of shift, while one told me something different. There is a pt on our unit with an abdominal jumbo JP that fills up less than an hour after you empty it. An RN told me only empty it Q4H to prevent the pt from losing too much albumin. I think the pt was already running low. However, no other RN has found this important even when I tell them what the other RN said. I'm wondering if this is situation specific or if there is a rule of thumb. I'll be asking my unit director, but I was hoping to get more opinions on the subject. This pt also has Alzheimer's and tends to run hyponatremic with confusion varying from mild to severe and aggressive/ anxious. I mention this because he has opened and spilled his JP a few times. Once when he was NPO and I was in the room and asked why he was trying to open it, he told me he thought it was a drink.

    Any insight would be appreciated, as drains are something I've been struggling with. I've seen:
    JP/jumbo JP
    hemovac (always seen draining blood from site in orthopedic pts, why aren't JPs and hemovacs interchangeable?)
    foley (recently saw foley-bag-bag with bladder irrigation... had to empty it every 30m-2h depending on the flow rate)
    peg-tube (what is that draining?)
    NG tube-feed or suction (those kind of scare me- I drained one and forgot to turn suction back on when I was done emptying until about 5 min later)
    ostomy, fistula ostomy? (didn't assess her abdomen to check, but researched this and believe it is still an ostomy.. pt had tubing running down her pants leg and collection bad was tied to her ankle... when she was NPO it smelled like vomit, whereas when she was eating the odor was like any other ostomy... not sure if there's a connection.)
    As far as I can tell, drains can go anywhere there is excess fluid or no other way to release fluid, and what drain/bag the surgeon/RN places is their call, although the amount of fluid putting out narrows it down. I guess my main question with drains is usually, what is that draining and when do you know your pt needs drainage? For example, I've seen distended abdomens where one pt had an NG-tube-suction putting out thicker, slightly chunky green fluid while one had a jumbo JP putting out yellow-orange fluid with occasional clots. Also, with so many bag types and sizes, how do you decide which to use if it is your choice as an RN and your facility carries different types? Is it just personal preference, MD orders, etc.?

    Sorry, I'm not sure if this is a dumb thing to be stuck on but I'm a stickler for details. I failed an exam in OB lecture bc I got so caught up on how/why the menstrual cycle lines up with the hormonal cycle and the luteal cycle, I didn't study anything else!

    Also please correct me if any terms I've used aren't nursing appropriate, as that is something else I'm struggling with in clinical. Thanks!

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    Some tips I've learned in the two months I've been working on an abdominal transplant floor...

    If your unit uses cordless/cell phones, tape/sticker RN's, PCT's, and any other frequently needed #s/information to back of phone. I usually write RN # with room #s, along with Q4VS and BS times.

    Clarify if you are unsure. Better to sound stupid asking a question than look stupid making a mistake. RNs, other PCTs, and your charge or unit director may all tell you different things. Always go with the top dog and your best judgement.

    Don't put up with slackers and mean people if you don't have to. Tell your unit director in a way that isn't complaining or whining, specify patient safety. My unit director is great with this, you'll have to judge yours for yourself. Trust me, you will run into these people everywhere!

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    Wow. They treated their patients like objects rather than people. They were clearly in the wrong line of work, so it's good thing their licenses were revoked. If I want to do something to make the next shift smile, I do a little more work than I have to.

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    BelleNscrubs04, lindarn, and tewdles like this.

    Wow. They treated their patients like objects rather than people. They were clearly in the wrong line of work, so it's good thing their licenses were revoked. If I want to do something to make the next shift smile, I do a little more work than I have to.

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    Here's my background: <1 year as a receptionist/registration clerk at psychiatric ED, an EMT cert, 2 semesters of an ADN program both with clinicals, and I was hired two months ago as a PCT on an abd tx floor. But others I work with have only had clinical experience, or went to a week-long hospital program. With my background I had a four hour skills training workshop and three weeks of orientation. I haven't seen this with a PCT yet, but a new grad RN (maybe she's even still a GN) is currently going through an extended orientation because she's not strong enough on her own yet. They don't just throw you away or throw you to the wolves, at least where I work. Not to say we aren't overworked. It's a hard floor, and RNs get 3-5 pts, while PCTs get 11 or 22.

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    Quote from jjjoy
    I'm sure you see a lot as PCT and asst, but I know when I was working as a PCT, I was so busy with my job responsibilities that I had little time to find out anything beyond what I needed to know as a PCT; so student clinical time for me was best used focusing on issues beyond basic care. I'm very grateful for my nsg asst experience as I never would've learned so many 'tricks-of-the-trade' or gotten as comfortable with basic patient care just on student clinical time.

    I can second this. I work on an abd tx floor, and I rarely get a chance to sit down and chart, let alone ask my RNs to let me watch them do skills or answer questions or explain things to me. I'm starting to think HUC (unit secretary) might have been a better job to familiarize myself with the daily routine, get comfortable with MD/pharmacy/other calls, have time to ask RNs questions, etc. Maybe I can cross-train... Either way, PCT-ing has been a great experience to feel more comfortable with clinicals, just not being a nurse exactly. I am now proficient in MANY drains, giving baths, and linen changes such as for pts on bedrest (it took a while taking lead from RNs and experienced PCTs), which is more than I could say in clinical last semester. So hopefully in my last two semesters of clinical, I will breeze through those aide skills and have the time and energy to pester the RNs to let me do/watch their skills.

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    Coworkers are like all other people, some are great and some are mean/lazy/etc. Chances are, if you're concerned about issues like being passive, you aren't being lazy, just busy. Things occasionally get passed to the next shift. Your coworker knows this. That isn't to say you shouldn't stay late to finish your charting or emptying linen and trash bags if that's your responsibility. That is expected, but if it's a stool sample when the pt didn't have a BM or you had a difficult shift and couldn't get all baths or lab draws done, that's reasonable to leave for the next shift. Just like in the rest of life, try to give more than you take. If you feeling like you're giving and still getting attitude, I would politically bring it up to your manager. Be specific, and specify that you want to be on good terms with everyone and you're seeking advice, not necessarily a reprimand. Probably, your unit director is already aware of the problem people.