schen12

Dear Mursepe, How wonderful it is that you already have 6-year experiences in health care industry! I see some positive features that you have with you: 1.Acute care setting experience- quick critical thinking skill 2.Care for clients with wide variety of background and age- luxury experiences 3.Teaching skills developed (every time I taught, I review and I solidify the knowledge) 4.Still working- up to date healthcare policy, technology and skills These features add to your nursing study, because you can relate whatever you learned to the experiences you had. Thus, you can retain knowledge better. One thing that I have witnessed is that sometimes the previous experiences also play a obstacle for learning new concepts, especially nursing fundamentals. Nursing fundamentals contains philosophy of nursing care and basic requirements for safe nursing practice. Sometimes, even though you know that is true or that is what you concerned, you, as a nurse, are not allowed legally to say it. For example, medical diagnosis! Medical diagnoses are given by the physician after assessments. We nurses can critically think of what our client is experiencing right now in front of us, and we would asked questions or direct a data gathering process. We can then advise our client to seek physician's attention, or we can contact physician for that; however, we cannot give any medical diagnosis. Message like "Ms. Brown, when you have experiencing heart attack, you ....." is not legal for us. (believe or not, this was once a NCLEX-RN question, and many nursing students who have years of experience in EMS and nursing assistant make this mistake because past experience). Depending on how you learn better, books might be more comprehensive to you, but power point can be more quick-to-the-point. Since you are still working, I can imagine how limited time you have to fulfill the role of nursing student. May I suggest that you divide the materials into sections and fit each section into 15 minutes of study time? Begin with power point as a guide, then read related materials in textbook but limit time to only 15 minutes. Then, use your experience- your strongest ally. Always see if you can relate the principle in nursing fundamentals to your actual experience. 30 minutes before bed time is the best time for studying materials that require some memorization. Good luck! You can absolutely do this. I have witnessed immigrant (big cultural barrier for him to accept fundamental nursing concepts) murse with 20 years of CAN experiences got his LVN license when he turned 62 years of age! So I know you can! SChen

Dear FutureCPNP-PC, I found that the drug guides are usually organized like a dictionary; i.e. the information is organized in alphabetical order. Thus, drug guide is a good tool for clinical. When confronting new medication, you can use drug guide to learn one medication in 5 minutes. The nursing schools usually has designated a textbook for pharmacology. In every textbook, the medications are actually organized in order of categories already. For example, the textbook we used in the past was Pharmacology and the Nursing Process by Lilley, Harrington, Snyder, published by Mosby Elsevier. In this textbook, After Part I (general knowledge of pharmacology), starting Part II, medications are organized into categories according to its function. Chapter 10 introduces Analgesic drugs and it include opioid and non-opioid analgesics, Chapter 10 is General and Local anesthetics...Thus, medication that works on our central nervous system is included in part II. Part VII introduces medications that are fighting against infections. And you will find penicillin and cephalosporin are included in chapter 37. And guess what? These two medications share cross-sensitivity issue. Thus, if a patient is allergic to cephalosporin, then penicillin is not recommended. I am pretty sure the textbook that your school chooses for pharmacology has similar "category-organization" for medications. I feel that when learning pharmacology as it is an entity of knowledge, a systemic approach would be more helpful. If your school do put pharmacology together with another nursing or pre-nursing subject in the same semester. You might want to kill two birds with one stone- meaning, if you study anatomy and physiology or pathophysiology in the same semester with pharmacology, when you study cardiovascular system, it might be helpful to at the same time do some research on meds that work on the same system. If your school put med-surg nursing or pediatric nursing in the same semester with pharmacology; then, you would remember the diseases; symptoms better and learned well how medication can help alleviate the symptoms when you match the two subjects together I am also glad that you mentioned about NCLEX. It's really encouraging to see young nurses are taking this profession seriously. I thank you for that. One thing that I have found about NCLEX exam is that this test is looking for nurses who can meet minimum safety bar for nursing practice. Which means questions asked can be tricky and can be misleading, but ultimately the questions require your critical thinking based on "principle" and "fundamental" reasoning for safely practicing nursing. If your school starts your nursing training in pediatric nursing, make sure that you learn the fundamentals of child development well. The Developmental milestone and the psychosocial characteristics for various age can help you find the right answer to the questions. I know you can do it, FutureCPNP-PC. You are going to be a great nurse! And a great NP!

Dear FutureCPNP-PC, I like how you know what helps you learn better and what seems the challenge. :) From your post, I summarized that you are pretty logical, and you learn well when information is broken down and made rationalizable. Test of a jammed information or bulked information that are not related much (growth and development and calculation) make it challenged.? I am guessing that your nursing curriculum is organized according to the stages of human development? I feel that you can try to find associated information at once and then learn the information together when you study for pharmacology. Make connection! We adult learners learn better if information makes sense. Also, we tend to remember and retain information better if there is emotion attached. In other words, making connection of information makes learning a bit more meaningful for a logical learner. What I did in the past when I studied child development, I pay attention to their unique developmental milestone or health concerns; then I made connection of special ways of administering medication to them with their age. For example, a school age child is able to understand concrete idea, we will provide short and solid information when giving medication. For an older age adolescent who comprehends abstract idea, we give information for them on what would possibly happen if the precaution is taken. We can also utilize idle when approaching adolescents who are at the age for identifying themselves with movie stars, athletes and singer. For a preschooler age child, imaginary friends can help us. We use a teddy bear to help them understand procedures. Also, we give choices (limit to two) to toddlers by asking them if they want to take medication with water or juice. I also make associations among medications. All meds are from families. They all have family names. The family names gave me an idea of what type or category the medication belongs. For example, aminoglycosides is a group of antibiotics, and they all have the same last name of ~~mycin or ~~cin. I studied and compared gentamycin, neomycin and amikacin together and I make special note on these meds: Aminoglycosides- otocoxicity and nephrotoxicity. !! creatinine and BUN!! (and of course I memorized the normal values of BUN and creatine at the same time). I highlighted Neomycin in this group because it reduces ammonia level for hepatic failure (and checked on ammonia level). Cephalosprins is another group of antibiotics. It's last name or more like a first name is Cef~~. medication such as cefazolin, cefotaxime, ceftazidime are in this family. Cephazolin can be given via IM, deeply into large muscle masses is highly enouraged. Knowing that this medication can be given IM but it is irritating, rotating site becomes an important nursing implication. And if I take pediatric patient into consideration, I would also remind myself that best IM site for toddler is vastus lateralis (I drew pictures on my med cards and mark the site). I would remind myself that a toddler roams. The implication for this developmentally-appropriate concern would be comfort. Measures that facilitate comfort after IM Cefazolin is important. One last thing to share is the best time to study pharmacology- 30 minutes before bedtime! This is the best time for "memorizing type of learning". I hope that this help. And I apologize for being too chatty.

Is the doubt for nursing new? Triggered by the clinical instructor? Or have you actually been on and off kind of not so sure about nursing profession? I ask these question and I hope that you calmly examine deep inside of your heart. I don't think nursing is for everyone, just like teaching is not for everyone. I also believe that each one of us possesses our unique tenant and passion, which is very important. These unique indivual qualities we have make us good at certain jobs. I am happy to see that you ask yourself a very important question now. Perhaps you have experienced enough to make you doubt. And this doubt is also very good for you. I highly encourage you to revisit the initial moment in which you made a decision to pursue nursing profession. I also want to say to you that I admire your self-doubt. Because it gives you the chance to learn more about you and nursing. I agree with VampyrSlayer- nursing really is a versatile profession. You can branch out to be a nursing educator, which your passion and previous education training would be very helpful. You can pursue higher education in law and specialized in healthcare regulation. You can serve in school settings... I would encourage you to re-examine your intention of pursuing nursing. Please search. The answer is inside you.

Do you mind sharing what subject has been the challenge? When you ask for reference materials for studying, are you experiencing difficulty in comprehending the textbook or handouts? 2nd and 3rd and 4th semesters are still to come. You are really close to pass. And if I read your post correctly, you actually pull up your grade from a previous test?! I think you have great potential to make it. We just need to figure out what the real (perhaps underlying) problems are before we can construct a better plan. :)

Let me see if I can make it a bit clear. For problem 1, you have gotten 4 mg/ml. Next, you multiply 4 mg/ml by 30 ml/hour - this result get you 120 mg/hour. Yes, at this step, you established the fact that in an hour, the patient received 120 mg Lidocaine IV. Last, let's divide 120 mg/hour by 60 minutes/hour - you get 2 mg/minute. For problem 2, you have a good start. Let's move on by multiplying 145 kg body weight by 8 mcg/kg body weight/min- this gets us 1160 mcg/min. Thus, in each minutes, the patient should receive 1160 mcg dabutamine. The, let's figure out how much would he receive in an hour. We, then, multiply 1160 mcg/min by 60 minutes/hour - we get 69600 mcg/hour. Last, we can use the other number that you figured out initially, the concentration of dabutamine, 4000 mcg/ml. Let's divide 69600 mcg/hour by 4000 mcg/ml, and we get 17.4 ml/hour. When I do drug calculation, I pay attention to conversion among different measuring units. Thus, I like to place my measuring unit in front of my eyes by writing down mg/ml or mcg/hour....etc. By doing so, I can easily cross off the repeated ones and see the new measuring unit forms in front of me. These measuring unites, mg/min, mg/ml, ml/hour.... explains to me what step I am in and what step to take to reach my goal. If I can use problem 2 as an example to show what the measuring unit help me solving same problem in a different way: After we established that the patient should receive 1160 mcg/min dabutamine, we can also figure out exactly how many ml that is! Thus, we divide 1160 mcg/min by 4000 mcg/ml, and we would get 0.29 ml/min. The patient gets 0.29 ml every minutes. Now, there are 60 minutes in an hour. Last, we multiply 0.29 ml/min by 60 min/hour, and we get 17.4 ml/hour. I feel that you have already gotten the first few steps in both problems. You can do it. :)