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happerhiker44

happerhiker44

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  1. happerhiker44

    Anxious About Clinicals

    In addition to talking to your instructor about this, one thing that I recommend you do if able is get a job as a nursing assistant (PCA/PCT) at a hospital (per diem/part time--whichever you can handle). If you have time before you start school. I have been a PCA almost two years now, (I did a year full time prior to starting my nursing program because my hospital has a program to help nursing students financially which requires full time employment for one year). I have to say this helped me immensely with first year of nursing school. As for clinicals, it gave me the confidence in many ways--because I know the process admission, I know how to turn people with numerous drains and broken bones/people who are quadriplegic/paraplegic, etc. I've seen majority of the drains and chest tubes. It gave me background knowledge of blood pressure parameters to certain conditions (in the case I don't have a chance to see in the orders), it also helped me understand what the important questions are that we need to ask and prioritization as well. So my advice is to you is, if you can, get a job in hospital it may help reduce a lot of potential anxiety. This doesn't only help with clinical though, it helps with the classes too-working my floor has given me so much knowledge, and made it easier to remember the things the professors would teach because I could connect something I learned when I'd go to work. Along with that, try to be as involved with the patient your given as possible, don't be afraid to ask questions. Get a read on the nurse that's taking care of the patient, if they seem willing to teach or explain things, try to ask questions and be proactive. In the case the nurse isn't overly friendly and appears like they don't want to deal with a student (sadly this happens a lot, even though they too were students once) try to ask your instructor and make tons of initiative to with the patient, and tell the nurse ahead what your going to do with your instructor. Communication is key and I know nurses (either the "annoyed ones" or the nice ones) appreciate students that communicate and are considerate. I've had those nurses that are annoyed, and have managed to stay on a good side with them, and a lot of them still would allow me to do things with them. Because you care so much, you will do great! I knew a lot of the skills we got tested on the first semester, and helped me with the knowledge during the classes as well beyond the foundations of nursing. Having just those skills ahead of time made me feel less anxious about
  2. happerhiker44

    Integrity - Should I say something

    I would only tell administration of the objective things you've seen, such as cheating on a test and stealing. I wouldn't mention the recording, because he may not mean it in that context. Stealing and cheating aren't things that should be taken lightly, if he is able to become an RN cheating the whole way through--what will he be like in the real world setting? In the end I'm sure it'd catch up to him. Regardless of how the school responds to it, this will be better off for him. They could either talk to him and give him some type of punishment (like a probation and having to be present to open lab for a certain amount of hrs/week), or get him kicked out--which probably can't happen unless there is evidence, or they follow up and pay closer attention to him. Either way, this could help him take things more seriously and/or make him realize that nursing isn't the best career path for him.
  3. happerhiker44

    Need help with manual blood pressure readings

    I'm in nursing school too and I work as a tech where we do a lot of manual BPs on people, and a lot of our patients are in some form of kidney failure/fluid overload (edematous), subdural or subarachnoid hemorrhages in which they bleed out--thus all of these reasons for weak pulses making it hard to hear manual blood pressures. There are different things I do in this situation. ( I first try moving the diaphragm around until I hear a pulse prior to inflating the cuff--that usually indicates you've got the right artery (in addition to your knowledge of where it is of course), I add as much pressure with the diaphragm (this works a lot) but if it doesn't I'll try the other arm. If it still doesn't work, I'll do the manual in the forearm and put the diaphragm of the stethoscope over the radial artery--in most cases this works. If not, you can also do a manual on the leg--I can honestly say I've done it successfully (although not ideal). If all fails, you can use a doppler, but that only helps getting the systolic BP. I'm sure for your situation a lot of it is nerves. It's extremely stressful being watched by an instructor-but in addition, nursing school doesn't cover these topics too much or even these alternative ways to get the manual BP.
  4. So a little background. I am currently an unlicensed nursing assistant, (PCA at my hospital) on a trauma floor--have been for two years. The hospital is a level 1 trauma center so I can assure you it's extremely busy. 95% of the patients consist of elderly who have fallen and have dimentia, GSW victims in gangs, car accidents that have patients with xfixes, ORIF, traction, etc. We get bariatric patients that have been up to 800 lb with unstageable pressure ulcers, patients with severe TBIs that are out of control, as well accidents either MCA or MVA related to drug overdose and dealing with them detoxing) and we have plenty of total care patients, and it's rare an assignment even has one independent patient. In my first year of working on this floor I did three 12s on overnights, and we'd constantly be understaffed--where it'd be just two of us (18 patients each) or just me (36 patients total), and even on night shift there would be plenty of nights where the call bells are going on the entire night and you don't get to sit down for even a minute. Anyway, since I've been in my nursing program I switched to days because night shift really interfered with my pre-reqs. However, it's been a year now since I've been on days and nurses are very uptight about everything. I assure though I am not discrediting them that they are busy. They most definitely are. On day shift the standard staffing is 4 PCAs, however, many times there's 3 of us with 12 patients. Now this isn't saying nurses are being lazy or anything. Just want to clarify. They can have 3/4 or out of 5 patients be total care patients, and they are always busy charting and all that. I feel burnt out, majority of our patients are 2-3 assist/hoyer out of bed and require a lot of additional care, a lot of the day nurses won't help with any of the "PCA work" as some actually say which I know will always happen everywhere of course, and I know a lot of the nurses are burnt out themselves, however, it's gotten to the point where it's interfering with patient safety; nurses don't even help each other out--, one nurse has a rapid response and is in the room for two hours, three of her patients need medications--no one will help her other patients meanwhile the people at the nursing station are looking at youtube videos.. All four PCAs could be in rooms with patients and bed alarm goes off, nurses ignore it, nurses try to tell us two assist patients are a one assist and won't help, meanwhile they're texting at the nurses station. If one nurse's patients IV is beeping and the nurse is in with another patient (who is heavy and will take a while to get out of the room) other nurses generally ignore it and roll their eyes if they get asked to fix it. Some nurses even press the patient's call bell and walk out of the room with the bathroom or emptying a urinal. Nurses will ignore bathroom bells, and complain that they can't find the PCA or think we're "ignoring" them even though we're generally busy other patient rooms, or can't answer because we're cleaning poop in a C.Diff room. I don't want this to sound like a rant against the nurses, there are a lot who don't want to do anything besides "nurse duties", and then there are very burnt out ones, and very helpful ones of course, and on the flip side I know there are a lot of lazy PCAs/Techs/Aides that hide or talk in addition to not getting any of their work done, but most of us are very hard working--I do 40 hours a week when I'm not in school, and majority of the time I don't get time to drink water, pee, take a break, or even sit down. (I think a lot of the stress too is because I picked up a lot of overtime for the entire month of July) . I've felt burnt out for awhile, and I've been so negative-I don't want to have this attitude, I want to be the way I was in the beginning-wanting to help people, being quick at responding, etc. (I still do all aspects of my job, but I don't go as fast because I'm always exhausted). An even bigger fear of mine is that I'll hate nursing. Can any of you tell me what your experiences were like and what it was like transition from PCA to RN? For me the main thing about being a PCA that's made me feel this way is the amount of patients we get and the amount of physical labor, and in addition it's so hard to get time off. My manager approved a 10 day vacation in March, and then less than two weeks before my trip (in June) she told me I couldn't take it because I didn't have enough CLT even though I paid for $2000 already and the floor had the coverage--I had another trip after that I planned which i switched shifts with people to get so I could do it, however, she made me work all the time for my original trip plus extra hours so I could do my other trip because apparently I couldn't use an oz of CLT. I am aware that it is my responsibility to be aware of our CLT, but it doesn't accumulate at all, it takes two months to be able to get one 12 hour shift covered and on top of that, unpaid time off isn't against hospital policy--it's manager's discretion. In my two years there, I've only taken one whole week off for vacation, but even with that, whenever we request time off they make us work a ton more hours in the days before and after our time off, so it just seems we can't even get a real break. I would like your feedback. I really hope this is just burn out, because I don't like how I've been lately. Thank you!
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