smuin538

I am frustrated seeing some people commenting here and saying it's always been this way or that it's been this way for a while, considering this is fully dependent on where you live and/or are trying to work. In my area, where I graduated in May with my ADN, there are a lot of large networks/hospitals as well as a few smaller facilities, and everyone in my graduating class was hired straight into the acute care setting--and about ten of us into higher level care (stepdown and ICU). In addition, there are about 10 nursing (RN) programs in the area (mix of ADN and BSN as well as one diploma program), and it is my understanding that there is little difficulty for new grads from other schools to get jobs in acute care as well. I am starting on my unit with 6 other new grads all from other schools in the area. I'm so sorry to hear about what you are going through. It must be so frustrating and upsetting. Obviously I'm sure you don't want to move, but know that there is a shortage of RNs in many places in the US and it is much easier to get hired into an acute care setting in these locations. I wish you the best of luck in your journey.

Unused blood products should be returned to the blood bank. Sometimes it's difficult to maintain sterility, particularly during emergent/uncontrollable situations. Sticking patients while they are sleeping is dangerous and incredibly rude, and I can't imagine that any facility (or patient) would be okay with it. As far as the number of attempts to start an IV, that may be facility specific, but is she employed by the facility where she teaches your clinicals? It sounds strange to me that a clinical instructor would be inserting an IV--but to be fair, in PA, nursing students cannot start IVs and therefore our instructors would have zero reason to even attempt it. As long as you don't see a patient being put at serious risk for harm, I would just use this as an experience to learn what NOT to do and how NOT to treat patients/approach your job. You can't make anyone follow protocol or develop respect for their career path, but you can make these choices for yourself. During nursing school, I've used experiences like these to really reflect on the risk to patients/staff/families/etc. and decide on the kind of nurse that I would like to be.

If you are using regular tubing, then you find the rate with this formula: volume / time in hours For drip tubing: volume * drip factor / time in minutes The first part of the question is asking you to find the total volume of fluids the pt has been given in 12 hours. The second part is asking you to find the rate of administration of 500 mL during the last 4 hours. You're going to have to memorize formulas in order to do med math. If you don't have the book "Calculate with Confidence," I recommend it. You can get it for a good price used. ?

I agree with all of this and would like to add--don't do anything you aren't comfortable doing! I know instructors/programs vary somewhat in what they allow students to do at clinicals, but if you are not comfortable doing something, let the nurse you're working with and your clinical instructor know and ask them to either show you or work through the skill with you step by step.

Actually, I am about to graduate from an ADN program and quite a few of my classmates have Bachelor's degrees. Of the ADN to MSN programs in my area, some will use your non-related Bachelor's and some will not. If you find one that will use your Bachelor's, you may just have to take more classes than someone who has their BSN would. I agree with @chare's suggestion, and you could also add "with bachelor's in another field" to get some more specific results.

There are, of course, many avenues of nursing in which you would very likely be able to avoid being close to death/dying patients after you graduate. However, as a student about to graduate from an ADN program, in my experience nursing school is very well-rounded. You will have rotations in long-term care, critical care (ICU, possibly including the neonatal ICU), med-surg, possibly oncology, etc. You will almost certainly come into contact with death/dying in your clinical rotations. In addition, I would imagine it would probably be difficult to get into a job where you do not come into contact with death or dying patients without having prior experience in an acute care (hospital) setting. For example, I would be willing to bet that the "Volvo nurse" worked in other settings as a nurse for a good chunk of time before he/she was hired with Volvo. Of course, the available jobs really depend on your area. I would suggest meeting with an advisor on campus at whatever school/schools you're interested in attending and expressing your concerns to them. They may have valuable insight specific to your area. I don't think this is necessarily something that should keep you from the field, but it's definitely something that requires you to do some soul-searching and self-education before you make a decision. I also agree with what previous posters have suggested related to figuring out why you are affected this way and perhaps considering counseling.

I am about to graduate from my nursing program, and my suggestion is to go buy a $1 simple calculator from Walmart and keep it in one of your pockets. Some med math can involve multiple steps and trying to calculate everything in your head just seems unwise, unrealistic, and frankly, unsafe.

I graduate from my ADN program at the end of May and a woman in our class just got hired as a graduate nurse into the ICU at a MAGNET hospital in our area that typically prefers BSN nurses. The woman in my class is in her 50s (I think she is closer to 60 but I'm not 100% sure). Not everyone gets their dream job right away, but she sure did!

Thank you for the responses! So in the case of a head injury is it considered best practice to simply not treat nausea/vomiting pharmacologically?

Hello! I had an ED rotation this morning and during morning huddle the attending was discussing the differences in treatment of subdural versus epidural hemorrhages. He mentioned in passing that ondansetron is contraindicated for patients with either type of hemorrhage. The nurse I was following nodded knowingly--I meant to ask her before I left why ondansetron can't be used in these patients, but we were dismissed early due to the snow in our area and I didn't get a chance to ask her. Now I am trying to figure it out on my own, but I can't find anything in my drug guide or any articles online that would explain why ondansetron wouldn't be used to manage nausea/vomiting that might be present in these patients. Is someone able to explain this to me? I would very much appreciate it!