OneWhisper

For an outcome, you are stating the WHAT of your project. WHAT you are going to acquire, accomplish, produce, deliver, etc. This is specific and - hopefully - MEASURABLE - accomplishments of your project. To VALIDATE the outcomes, you give the measurable info. Basically, you are saying how valid the outcomes are. Giving evidence of that. At least, that's my take on it!

I know it's very discouraging to fail a course and have to retake it! I failed one, and it was right before my last semester, so it was really discouraging! But, I was so close to the end, it wasn't even a consideration of whether or not to finish! If it's something you really want, you definitely should continue on with it. If it's not something you really want, then you might want to consider something else. That's something you have to look inside yourself to find the answer to! If you had a specific example of a question, I might be able to help you better. But, I'll try with what I think you're asking - If you have a question, that is asking you what you should look for in a pt that has a specific disease, in order to answer that question, you need to know the disease process. You need to know what would be EXPECTED with that disease process. Then, you can figure out what you would be looking for in regards to that disease. If the question is asking something about, what you would report related to a disease process or something along those lines, then you would need to know the disease process and what would be EXPECTED, so then you would also know what is UNEXPECTED, and when something occurs that you aren't EXPECTING, you would want to report that or assess the pt further. Even if it's something you EXPECT with the disease process, if it is causing the pt DISTRESS, then you need to assess the pt further and figure out what to do from there. I feel like I'm getting off track here! Lol! That's why I felt if I had a specific example of a question, I could help show you how to break it down!

Mark Klimek review is really good. He explains things in a easy-to-understand way, giving you principles to be able to answer questions.

Okay, so it's just important to know to elevate and keep hip aligned to reduce contracture. So, do you elevate with pillows or by elevating FOB or either?

It's just like Guy in Babyland said. A preceptor is WITH you. He/she will be with you most of the time. Overseeing you give meds, caring for pts. Eventually, once they see how well you can handle things they will allow you to take pt assignments with them supervising. I had to have 2 preceptors for my practicum, and 1 was totally hands on and was with me at every minute. The other had seen me with the other preceptor so said she knew how I could handle things and I only went to her when I needed something. So, whoever is your preceptor will FIRST be with you, watching you, guiding you, helping you, seeing how you can handle things. Then, as they feel you are ready for it, they will loosen the reins and supervise you while you care for patients. But you are never all alone. You always have that person if you need him/her.

I say you go for what you want! Your age doesn't matter! It's how you feel and what you feel you can do! I had people in my BSN class that ranged from just out of high school to those who had their own children in college. Just like the ages ranged, so did how well they did. There were many that were younger that didn't make it to the end, but all the older students I can think of made it to graduation with me! Good luck with whatever you decide on!

That's exactly how I read it as well. You explained it exactly how I was thinking it! But, I could be wrong too! The OP didn't say what the instructor said was the correct answer?

Agreed. As I said in my previous post, when I was in nursing school we had rubrics for our papers. However, included in those rubrics would be specific points we had to hit on, for example (this is from one of the rubrics I used I had for a paper I had to write in nursing school): Identifies and explains x 4 points if x is very clearly identified and described so that a complete and full understanding is possible by the reader 3 points if x is identified and described so that a sufficient understanding is possible by reader 2 – 0 points if x is not identified and/or described OR is plagiarized. Difficult for reader to understand x. Analyzes data/evidence. Justifies own perspective and position linking and supporting analysis to/with journal articles, course textbook readings, class discussion, and lecture. 4 points if information from current, reliable, peer-reviewed journal articles and course textbook is incorporated into analysis, relevantly supporting data and evidence. Complete and comprehensive analysis of supporting data/evidence. Clearly distinguishes factual data from opinion. Analysis is completely supported by relevantly linking case data to course readings, class discussions, and lecture. 3 points if adequate analysis of supporting data/evidence. Distinction between factual data from opinion is muddled. Analysis is adequately supported by linking case data to course readings, class discussions, and lecture, with most links being relevant. 2 – 0 points if information from current, reliable, peer-reviewed journal articles and/or course textbook is mentioned, but irrelevantly incorporated into analysis OR no support of data and evidence with any sources. Analysis of supporting data/evidence is weak or absent. No distinction between factual data and opinion. Analysis is not supported by linking case data to course readings, class discussions, and lecture, or links are completely irrelevant. And those are just 2 examples of what we were taken points off from. So, you can see if, as ProperlySeasoned, stated, the content isn't strong, your topic isn't fully explained/answered, original thought or analysis is not displayed, you do not display evidence you truly grasp the subject, or just things like (in my example above) you didn't distinguish factual data from opinion. Points can be lost from many places, not just from grammatical and spelling errors.

He had to have an angio done - What can result from that? What nursing diagnoses would you relate to that? He has to have open heart surgery - Why? What is leading to that? What nursing diagnoses could you relate to what is leading to him needing open heart surgery?

Oh yes! So clear! Hahaha!

When thinking of priority diagnoses, think - What will kill my pt the fastest? Also, think of ABCs - Airway, breathing, circulation. So, using that, what do you think your top 3 would be and in what order? If you included more of your assessment, I could provide more help. It's had to say what other nursing diagnoses you could have and if there are more important ones than what you have without seeing more assessment data. Depending on the assessment data, I'm thinking there are more important diagnoses you could be using for your top 3.

I am SOOOO confused by this. If someone could just clarify this for me and tell me which is correct I would be SOOOO GRATEFUL!! I Read This: Care of Amputations (Mosby's) Elevate FOB briefly (usually first 24 hrs) if ordered by HCP to decrease edema. AVOID elevation of residual limb on pillow to prevent hip flexion contractures. So Mosby's is just referring to amputations in general – not specific to AKA or BKA. It says first 24 hrs, elevate FOB and AVOID elevating residual limb on pillow to prevent hip flexion contractures. Amputation of Lower Extremity (Saunders) During first 24 hrs after amputation, elevate FOB (residual limb IS supported with pillows but NOT elevated because of risk of flexion contractures) to reduce edema. So, Saunders speaks of BKA – During first 24 hrs, elevate FOB (like Mosby's), but then it says residual limb IS supported with pillows (which Mosby's says NOT to do) but NOT elevated because of risk of flexion contractures. So... Mosby's says in first 24 hrs, elevate FOB. AVOID elevating residual limb on pillows. Saunders says in first 24 hrs, elevate FOB. Support residual limb WITH pillows but do NOT elevate b/c of risk of flexion contractures. So, they agree to elevate FOB. But then Mosby's says avoid elevating residual limb on pillows and Saunders says support residual limb with pillows but do NOT elevate. AKA: First 24 hrs after AKA, do NOT elevate stump as this may cause flexion contracture. On NCSBN Learning Extension Website, an instructor says: Using Brunner and Suddarth's Textbook of Medical-Surgical Nursing for BKA & AKA Post-Op Care: Residual limb is raised on 1 - 2 pillows for first 24 hrs after surgery (to decrease swelling) After first day, residual limb should be flat on bed to prevent contractures (may be ok to raise FOB – there will be orders for positioning pt and bed) Pt may sleep in supine position, but care should be taken to prevent flexion of knee (which will delay being fitted for a prosthetic) May be orders to assist pt to change positions (from supine to either side) but pt MUST be in prone position for about 20 mins, at least twice a day PT and ROM exercises begin almost immediately (usually post-op day 1) Brunner and Suddarth's says (for BKA & AKA), raise residual limb on 1 – 2 PILLOWS for first 24 hrs. May be ok to raise FOB. Saunders says elevate FOB. Support residual limb WITH PILLOWS but do NOT elevate Mosby's says elevate FOB. Do NOT to support residual limb with pillows Then, someone responds to this instructors post and says he/she read in another post where the instructor answered the same topic that said do NOT elevate residual limb on pillows. So, asked which was the correct action – Elevate on pillows or raise foot of bed. Instructor replied: "Wouldn't you have to use 1 or more pillows to elevate the residual limb? If someone is missing a limb, then raising the FOB will do nothing for that residual limb...there's no foot/lower leg to elevate." So, I don't understand? They say elevate but do not elevate. Raise with pillows, do not raise with pillows. So, what do you do with AKA and BKA amputations? Elevate or note elevate? Raise with pillows or not raise with pillows?

You said you don't have much experience doing IV meds in clinicals so far. Do you pick your own patients? If so, try picking pts by looking to see which ones have IV meds that you will be able to give. If you don't, speak to your clinical instructor and ask if he/she can give you pts with more IV meds so you can learn. When I was in nursing school, we picked our own pts. I chose my pts based on what I needed to work on. If there was a condition I needed to learn more about, if we were learning about a disease/condition in class that I wanted to know more on or wasn't really grasping, or when I needed med admin practice. I chose my pts based on what I needed. When we first learned IV meds, I first looked for pts that had some disease/condition we were learning about in class, then from those I found which had the most IV meds that I could get practice with. The best way to learn is by doing it, so try to get as much practice as you can with it! As for reconstitution. In the U.S, we have Lexicomp. So, before giving my pts meds, I would research each of them using Lexicomp (in the pts MAR, you click on the med, and can get to Lexicomp). Then, you can find the reconstitution instructions there. Do you have something like that in Canada?

As WanderingWilder said, if it is graded on a rubric, you should be given a copy of it and be able to see what aspects of the paper were being looked at for your grade. When I was in nursing school, anytime we had a paper, we were given a rubric and we went off that when writing the paper. Then, the instructor used the rubric when grading and gave us a copy of that so we could see exactly where the points were taken from. You have the right to ask what points were taken off for. Of course, like you said, you can't go in saying something like you don't think you deserve the grade you got or that you deserve a better grade. You have to approach it correctly. Like the other said, say you'd like to see what points were taken off and why. Explain that you would like to be able to improve and you're not sure what was wrong with the paper, so without knowing you can't improve. IF the instructor is unwilling to meet with you, then you move up the chain of command. Don't just jump to the top of the chain. Move up it. And ONLY if you absolutely have to. Always try working it out with the instructor first.

I had an assignment like this in my leadership class for my BSN. I asked some of the nurses during one of my clinicals if they knew of a nurse manager or nurse in a leadership position that would be willing to sit down with me and answer some questions. They were very helpful. You might want to try that. If that isn't an option, you can go to one of your local hospitals and ask to speak with a nurse manager/nurse supervisor. You could even look at linked-in and find nurse managers/supervisors at one of your local hospitals to know who to contact. You could even actually ask your instructor if he/she can put you in contact with a nurse manager/supervisor. Those seem like better options than posting on here. You don't know for sure if the people who respond are who they say they are. It would be better, IMO, to interview someone in person.