RikkiLynn

You didn’t know, and now you do. So next time you can inform the patient without having to ask. Don’t beat yourself up, the doctor has likely forgotten all about this by now. I very often have to call the doctor because the patient insists, even if I know they are not going to do anything. Because you are right in saying in the off chance that they would have done something, and you didn’t call it would be on you. Next time when you're not sure and want to save face don’t ask for what the patient is demanding, instead phrase it like; “hello I’m calling because pt is still experiencing itchiness despite the medication and is very agitated, I just wanted to confirm if there is anything else we can do for them.” That way it’s up to the MD to decide, you are just telling them the situation.

Oh I think I understand the confusion! It's because I said nursing assistant right? My apologies, you say CNA for care aids, but in quebec a care aid is PAB or (formerly "orderly"). A nursing assistant where I am (which is not a term used anymore anyway) is an LPN. Thats what I was referring too.

I really think it would be best to start in an inpatient floor, you will be exposed to the more acute side of oncology. Generally patients who visit the clinic are much more stable then the inpatients. A nurse on my floor wants to move towards the same path as you but she turned down a clinic job to get the experience of inpatient.

What? I'm confused here... A nursing assistant is an LPN, who have a license, and can most certainly do wound care, assessments or medicate patients, I never said that. Your sentence contradicts itself. I only said that LPN's don't work on MY floor because the patients are critically ill. We have the nurses, and the PAB's which is the french term for "care aid". LPN's work as LPN's on the floors they work on, not as care aids.

What?

From what I recall you would only have to transfer your license, most Canadian provinces do the NCLEX as well.

I didn't say that at all... care aids are PAB's. I said LPN's don't work on our floor because of the acuity, but on the floors they do work they work at full scope of practice...

I'm a new grad as well, I work in Montreal Quebec on a high acuity oncology/hematology floor. I have honestly never seen an RN only unit in all the hospitals I've done stage at in montreal. On my floor we have 3 pods and each pod has 3 nurses with 4 patients each. Each pod is assigned what we call a PAB who takes care of all of the feeding, cleaning, changing, answering call bells etc. we have a free nurse during the day who is not assigned patient but goes from pod to pod and assists any nurses who may need it. The assistant head nurses also pitch in and our nursing educator helps as well . Some other floors also have LPN's (nursing assistant) but ours is too high acuity. All floors in the hospital have a similar situation, some even have more PAB's then we do. I really think it might be your specific hospital.

Just want to say it really sucks how much you have to pay in the states for a good education... in my province the top school costs 4200 tuition and fees and assuming you attended CEGEP (which is like 400 a year) you only need to do two years for a bachelors. I can't imagine starting my Nursing career saddled with 100K of debt. For the one year I did take out loans it ended up being 3/4 bursaries so I have very little to pay off. Hang in there and try not to let it rule your life, you have enough on your plate being a new grad.

I'm a student in Quebec in my Internship. 90% of the time the meds come already reconstituted at my hospital, even pipercillin-tazobactum comes prepared in a syringe ready for the syringe driver.. The only medication I've ever had to reconstitute is Pantoprazole, and at my institute the pharmacy includes specifications on how to reconstitute the med on the MAR. I woulden't worry about it though i'm assuming wherever you work you will see a lot of the same things and if not you can always call pharmacy for their recommendations or check a med book or digital med book.

Hello from Montreal!, not speaking french should not stop you from working here, you can always learn!. I have someone in my program from Australia, who didn't speak a lick, but after 3 years can now get by quite effectively. There are quite a few English hospitals in Montreal and you can always take french courses which would get you out of having to do the the exam. Problem with Canada is that its so bloody big, so if you want to be anywhere near driving distance to Montreal you'll need to live in Quebec. The only other option is perhaps alexandria or belleville in ontario, but not many major hospitals in the area,

I'm still a student, so my story might pale in comparison... but. In my second year, my teacher loved giving me the difficult pt's. It was a running joke with the other students. So anyway, I had this one pt a few times; mid 70s, CHF on high doses of diuretics who refused to believe she was incontinent. She was in the hospital because she kept slipping and falling on the puddles of urine in her apartment because she refused to wear incontinence diapers (and also was non compliant with meds). The social worker charted that she would simply go wherever she was standing and she was A&Ox3. So in hospital she would make use of a bucket beside her bed and just go in that instead of walking to the toilet 5 feet away (she would do this by peeing on the matress and just letting it waterfall into the bucket). But sometimes she would just go in bed without using the bucket and the staff could not keep up with cleaning it since she was urinating near constantly. The section of the ward she was in smelled profusely of urine. I was standing next to her bed one day, and noticed something was falling off the bed onto my shoe. It was crystallized urine her mattress and bed was covered in them, the underside of her bed was like a cave with stalactites but made out of urine. The last I heard of her the hospital was trying to get a court order to have her moved to a LTC facility because she refused to go she was also quite verbally abusive to staff. The profuse amount of urine had caused all the floor tiles under her bed to peel off, not to mention she had been storing food all over the room to the point that it developed an ant problem. An interesting experience to say the least.