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GrumpyOldBastard RN

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GrumpyOldBastard has 39 years experience as a RN.

GrumpyOldBastard's Latest Activity

  1. GrumpyOldBastard

    Getting off the "do not hire" list?

    An employer may not care if the allegations were true or not. It may simply be that you were too much hassle to have around.
  2. GrumpyOldBastard

    Has anyone gone through nursing school with depression?

    BRAVO for asking for help! That is SO IMPORTANT! Get a psych evaluation promptly! There is much that can be done to help you. You are far, far from alone in your situation. There are thousands and thousands of doctors, nurses, pharmacists, physical therapists, and others who suffer from similar mental health challenges. If they can be successful in school and effective in the workplace... you can too! As nursing instructor I have heard stories like yours many, many times. The successful students are those who seek help and who follow the prescribed plan. On a personal level, I admire your reaching out for help early in life. I “toughed it out” with my depression from my mid-teens until I was 52 years old. The quality of my life is SO MUCH better since I got treatment! Good Luck!
  3. Based on what you have reported, I think you have mastered the content. However, it appears that your emotions are the biggest threat to your success. Pick the emotional control tool that you find works best for you: meditation, visualization, cognitive behavioral therapy, prayer, etc... and use it twice a day, every day between now and the exam. When you get your emotions under control, you will do just fine on NCLEX. 👍
  4. GrumpyOldBastard

    The “Light Bulb Moment”

    I have been teaching nursing for a long time. I teach in the last course of an associate degree program. It might surprise many students what I am REALLY looking/hoping for in clinical. You may think that you can find it listed in the course objectives or the clinical evaluation tool. Nope. You may think that it is something that I want you to say or do. Nope. You may think that it is a perfect care plan or paper. Nope. What I most want is for the “light to go on”. That is a phrase that many faculty use to describe the moment when a student understands what nursing is and what the role of the nurse really is. Once a student understands this… everything else will fall into place for them. Until this occurs, students often see everything in nursing school as mere obstacles or busy-work… not as having purpose. This awareness occurs at different times and different ways for various students. Students can have different responses to this awareness too. The good students often seem to be more confident and at ease after the light goes on. They know that there is much more to learn… but they understand why and are eager for it. Some weak students find the awareness to be frightening. I remember one student who had “floated” through nursing school. He had done the minimum required, and had promptly forgotten what he had learned. When the light went on for him… he was terrified at the enormity of the responsibility of a nurse, and lamented that he had wasted so many opportunities in nursing school. I don’t have an easy way to accelerate this process of becoming aware. Certainly more clinical contact with patients is helpful. Thinking deeply about the patient’s situation and the care needed will move students along. Watching really good nurses in action can be really helpful. Sometimes asking experienced nurses “What do nurses do?” is helpful. Often it takes a combination of the above and a dose of luck for the right situation to trigger the awareness. Do you remember the moment that the light went on for you? Tell me about it. If you are faculty, do you have any interesting stories of the light going on for your students? Smile, Breathe, Relax.
  5. GrumpyOldBastard

    California to Texas - Transfer

    1. Many Nursing schools in Texas are quite competitive too! However, the state has set up grants to pump money to nursing schools that increase enrollment. If you can find one of those schools, it might be easier to get in! 2. You may want to meet the requirement to be classified as a TEXAS RESIDENT, if you intend to attend a state funded school. “Out of state” tuition is much more expensive. Good Luck!
  6. GrumpyOldBastard

    Clinicals Advice

    Welcome to where the “rubber meets the road”.... the bedside! I absolutely agree with all the “DO IT!” suggestions already offered. That behavior is good for all of the obvious reasons... and for a less obvious reason. While there is no doubt that your instructor has a huge impact on your clinical experiences.... so do the staff nurses. If the staff nurses like you, and see you as well prepared and eager.... THEY will connect you with opportunities that your instructor may not know about. (Caveat: “DO IT” is within the limits set down by your instructor and the institution. I am advocating courage... not recklessness.) When I was a student, I found it useful to write out a 3x5 card with the assessments that I needed to do for a specific patient... I could take that to the bedside and use it to keep me from missing things. When doing assessments remember: “If god didn’t put it there... you are responsible for it.” In other words, your assessment is NOT limited to the patient... but includes ALL the equipment attached to the patient too! Pull back the covers and LOOK. It is very common for nursing students to be uncomfortable pulling back the covers and REALLY looking at the patient. Unfortunately, there are a great number of bad things you will miss if you don’t look there. Remember: “As a nurse, you have the authority and responsibility to look where Momma taught you not to look!” (Of course, you do this in the context of providing privacy and asking the patient for permission.) Remember that a huge part of a nurse’s job is to prevent, detect, and intervene to prevent REALLY bad outcomes. As you think about your patients, ask yourself... What are the really bad things that could happen? What can I do to prevent them? How would I know if they are happening? What do I need to do if they happen? Knowing what your school’s reputation is among the staff can help you understand their response to you. For example, there is a school in my community that has a reputation for most of their students being quite clueless and useless at the bedside. As a result, the strong students from that school have to fight past that reputation with the staff. Knowing that can better prepare you to understand the situation and overcome it. Put down the clipboard! There is one behavior that often telegraphs a whole set of the wrong messages to the staff...... holding your clipboard to your chest with your arms folded across it. Having a clipboard may be OK.... using it like a shield makes you look scared and useless. Perhaps a story will help put the above in context: My wife was a nurse in an inpatient hemodialysis unit. As you can imagine, it was really busy. As a result, she didn’t have time to mess with unprepared, scared, or useless students who were there for an observation experience. She used to give students about 60 seconds to show “signs of life”.... if the student was engaged and eager, she would bring them into her activities. If the student was unprepared, scared, or disengaged... she would move the student aside and carry on without them. You might wonder: “How can I show “signs of life?” Simple, put down the clipboard, and ask: “How can I help you?” Understand the value of asking GOOD questions. You can’t know everything. Nobody expects you to. However, we do expect you to TRY to learn. Sometimes we know that things are confusing and if you ask about them... we know that you tried. For example: If you were with my wife in the hemodialysis unit and she said “What do you know about hemodialysis access sites?” If you say “I don’t know”.... that is not a great answer. On the other hand, if you say “I am confused about the difference between an AV fistula and an AV graft.” That is a GREAT answer! How can it be a great answer if you are saying that you don’t understand? The reason is that you obviously TRIED.... or else you could not have asked such a great question! (The AV fistula and AV graft are similar and easily confused by the novice.) In other words, often your questions tell us that you tried or you did not! Another hemodialysis example regarding access: You say: “I have read about assessing the bruit and thrill... but I don’t really understand.” It is VERY likely that at that moment (time permitting) you will be dragged to the bedside and shown what those are! You would be amazed by how much staff are willing to invest in in you..... IF you show interest and are trying to learn. Of course, the best questions go beyond “What” into “Why”..... “If an AV fistula is so desirable, why would a patient have a hemodialysis catheter?” BINGO! That sort of question is GOLD! Understand the first hour. Many students find that staff can be abrupt and unfriendly during the first hour of the day. Why is that? There can be many reasons but some key reasons are: Feeling a need to get organized before getting behind with tasks. Feeling an urgency to see all the patients and determine that they are not trying to die. Feeling an urgency to check a zillion things in the patients’ rooms. An example is identifying any IV bags that are almost empty. Acute caffeine insufficiency. Often staff are more approachable and friendly after they get through those immediate tasks at the start of the shift. GET A GOOD NIGHT OF SLEEP BEFORE CLINICAL! EAT A GOOD MEAL BEFORE CLINICAL! SMILE, BREATHE, RELAX.
  7. GrumpyOldBastard

    Chemistry - how much is used in school?

    Should you verify that unlisted courses are acceptable? Only if you want to be admitted! The easiest way to sabotage your application is to take the wrong classes. Leave nothing to chance... you are competing for slots against smart, obsessive, detail oriented people who will happily take your seat if you are sloppy in your preparation. VERIFY
  8. GrumpyOldBastard

    TX BON and DO's followed by Forensic Eval & Poly

    Look at it this way... these tests give the board a way to say "YES". The board needs a way to justify awarding a license to someone with your background. With ONLY your background information I bet that they would say "NO" . However, these tests give them external evidence (not just your story) to support "YES". I suspect that if your story of having turned yourself around is accurate, the testing will show that, and you will get you DO. Unfortunately, that process can be SLOW. Good Luck!
  9. GrumpyOldBastard

    adult industry past? nursing a no?

    For every school that I am aware of, this would ONLY matter if it resulted in criminal charges. If you haven't tangled with the criminal justice system over this.... you should be fine. GOOD LUCK!
  10. GrumpyOldBastard

    Finally pass after 7 attempts with 75questions

    Texas used to have a similar rule that strictly limited the number of NCLEX-RN attempts (I don't remember the number). The Texas Board of Nursing changed that rule when they figured out that it wasn't working. Applicants figured out a way to work around that rule. If an applicant had used up all their Texas exam attempts, they would apply for licensure in Oklahoma... which allowed many more exam attempts. After earning an Oklahoma license, they would simply apply for licensure by endorsement in Texas! Since the rule wasn't working, Texas changed to a much more liberal policy.
  11. The issue here is that you see the OB course as training for a specific workplace. It is training for a specific patient condition, REGARDLESS OF WORKPLACE. Several of us have made this point which you choose to ignore.
  12. GrumpyOldBastard

    U-world for senior nursing students

    U World is "da bomb"! It is EXCELLENT. Get it now and use it religiously! It will help you in school and NCLEX.
  13. GrumpyOldBastard

    Feeling discouraged about nursing school

    This is a great time to understand what can be your greatest asset or weakness. It is neither your smarts nor your skills. Your most powerful tool is your emotional intelligence. It is the ability to use your emotions to help you rather than undermine you. How you talk to yourself about this first experience is important. "I do not feel my skills are as good as they should be" is reasonable. But if you let that morph into "I'll never get this" or "I am not as good as the other students"... it can become disabling. Be a realist about what happened and why... and craft a positive attitude and self-talk.
  14. GrumpyOldBastard


    It is very easy to get swallowed up by the minutiae of a myriad of skills. One of the best things that you can do is identify and master the PRINCIPLES that underly why procedures are done in specific ways. This is critical to success at the bedside. At the bedside the situation may not allow perfect adherence to the procedure as described in the book. However, if you understand and apply the principles.... you can execute the skill effectively and safely. I see this all the time when working with students at the bedside. Those who simply memorized long lists of steps usually forget the list and are useless. Those who understand the principles, are able to solve the puzzle without the list.
  15. GrumpyOldBastard

    Nursing School Drug Testing

    While the vast majority of nursing students who are drug tested only are tested ONCE, every drug testing policy I have seen has included "testing for cause". In other words, if at any time there is reason to suspect that a student may be under the influence of substances, the school (or clinical agency) can demand a drug test. Some schools and agencies might even have a policy that defines "cause" as a student's involvement in a clinical incident even if there is no other suspicion of substance use. I would also anticipate that many programs have policies that allow "random" testing. Random tests are not commonly used in the civilian nursing world* due to their cost. I suspect that you will find that tolerance by nursing schools for illicit drug use or abuse of legal drugs by nursing students to be essentially non-existent. * As a military nurse I was drug tested quite frequently.
  16. GrumpyOldBastard

    First day of Nursing School

    Congratulations on surviving day #1! This is a great time to understand what can be your greatest asset or weakness. It is neither your smarts nor your skills. Your most powerful tool is your emotional intelligence. It is the ability to use your emotions to help you rather than undermine you. How you talk to yourself about this first experience is important. "I already feel behind in lab" is reasonable. But if you let that morph into "I'll never get this" or "I am not as good as the other students"... it can become disabling. Be a realist about what happened and why... and craft a positive attitude and self-talk. Good Luck! GrumpyOldBastard