TooterIA

At my current employer, I am required to make the assignments eary. One instructor prefers the afternoon before clinicals happen the following afternoon. My clinicals start at 1330 and I have their assignment to them by 1230. The only things I really want them to have looked up before they come are meds they will give that shift. I think this teaches students better to get ready to roll with the punches. I look forward to them one day changing it to you get your assignment when you show up.

Whoops, I meant 3,000/month. We tell these patients to establish care with a Ob/Gyn until we are blue in the face, and they just dont. As far as I know, if you call, you can get in for an appointment without problems. Our providers very rarely type in their own info on EPIC.

I work in a 28 bed ED with an average of 3,000 patients/year. We see many patients with lady partsl bleeding and we either confirm a miscarriage, or threatened abortion. The DC instructions these patients get are preprinted from our computer program, EPIC. They are very generic and in my opinion, not very useful. Can you share with me what type of DC instructions you give your patients or where I can look for info to add to ours? Many of these patients come back several times, in my opinion, because they dont receive enough education. Additionally, if the miscarriage is confirmed, do you have any referrals to grief groups or anything you give out? I am trying to look in my local area I can refer patients to, but online would be great. Thanks in advance Jessica

My coworker interviewed for one of the local NCLEX positions. She was told the class is about 5 days long. And you could not have classes for weeks, then all of a sudden have a class. So if you can afford to work very parttime or if the one in your area is busier where it would be steady, I would think it would be a good gig. But in my area, (Iowa) it just isnt regular enough to provide a paycheck, and not flexible enough to work with another job (unless you can randomly take 5 days off at a time at your other job). Hope that helps!

I have taken TNCC. It is not in my facility, it is about a 3 hour drive away. So I would also be forking out money for one night in a hotel.

1:5? Ouch. If fully staffed, we are 1:4 and I usually run my ass off all 12 hours. I came from an ED that only saw about 400 pts/month to my new job where we see 3500/month. I have only been there since June and these are my tidbits. Dont be afraid to use your techs/CNAs/whoever you can delegate to. Your time will be better utilized assessing and providing care rather than taking the pt to the bathroom (unless no one else is available to do it, obviously). Chart in the room, while you are doing the work. Or you will forget. Double check pt labels, I have had several mislabed urines and been handed the wrong discharge instructions. Teamwork, teamwork, teamwork. If you have a minute, offer help to others. You will learn in a heartbeat who will help you if you helped them. By the same token, if you are busy and someone is trying to pawn off their work to you, politely decline. Dont let yourself get behind trying to do someone else's work. Easy ways to **** off the oncoming shift: not labeling your IV lines, leaving your rooms trashed, not having the patients in a gown. Multitask. You see your patient needs an IV and meds? Grab your meds and fluids, then go in to start the IV and hang meds. Going in once to start in then again a minute later to give your meds is a waste of time. Lastly, customer service. My patients are much easier to please and leave happier if I can grin and bear it, put on my smile, get them the glass of ice for the visitor, tuck the cover under grandma's shoulders, etc.

My hospital claims to be offering to pay for a CEN review course by Jeff Solheim, who I have read good things about. I would have to pay for the course, the hospital would reimburse me, the money I get back would be taxed, so I will already be out some money. It is unknown if the hospital will cover the cost of the exam itself. I have been in a very small ER for 7 years and am now in an ED that sees about 3500 pts/month, so I am seeing things I have never seen before. Would going to a 2 day CEN review course help my knowledge level in my everyday work? Or is it truly just a course to prepare you for the exam? I am tempted to take the course just to learn more about how to take care of ED pts, and then not take the test (or at least not until I find out if the exam cost is covered, which will be after this review course is already over) Thanks for any insight Jessica

We go live in November, I am very interested to read the replies!

How did you hear about the behavior? Did you hear during the day or after it was over? I have students on Med/Surg with me, then also in ER, surgery, home health, hospice, etc. So I also have some in many areas, so miles away that I cannot monitor. Staff that the students work with fill out a form on the student at the end of the day, specifically addressing if the student was professional. Students are informed of this at the beginning on clinicals. Like it or not, I take the word of the employee they follow, and if I receive poor feedback from that employee, it will be reflected on them and they may be in danger of failing clinicals or disciplinary action if their behavior was bad enough. You are not being too trusting, it is the nature of the beast that cannot monitor student's every single action, there has to be some trust there.

WOW, you only see each student two times/day in clinic? What level are they? Do they pass meds without you? I see each of mine probably twice/hour. This. Mine are about 30-45 minutes and the above covers it. I find myself doing a lot of teaching from the day: lets say one student had a patient who was scheduled for surgery but we were supposed to administer Coumadin, we caught it, we talk about it. I find there are usually several teaching points each day that can help the other students. For first level students, we played a game each postconference. They LOVED it. Each student had to make up a game and we played one each day, we played BINGO, Jeopardy, crosswords, etc. Most of the games were centered around medications as the first level students really needed to learn meds. I think if you hate it, the students will pick up on that very quickly. So find some aspect of the postconference that you like, and run with it. 2 hours for a postconference sounds like a huge waste of time for the instructor and student.

Failed clinic. There is no excuse for not calling. Call the clinical site and leave a message for the instructor to call the student, call another student and get the instructor's number, call the school and ask for the instructor's number (or talk to another instructor who could call the clinical instructor), and my number is written on their papers I give them on the first day of clinic. There are MANY ways to obtain the instructor's phone number. No excuse. It is clearly written in the course syllabus that a no-call no-show results in failed clinic.

Ditto to not taking it. I really do understand if you need money and a job, but there is NO WAY I would take that job as a new grad.

IMO, online job options for MSN only are non-existent. I finished my MSN last May and have been looking for online prospects since and have found next-to-nothing. Almost all of them require a PhD, and most of them require in-person classroom

Ditto using rubrics and handing out an APA example. I hand out an example f an APA reference page, yet still get students who cant get the reference page right. I am also clear about references and tell them they should not be citing every sentence, they should have enough of a grasp on the info that they can paraphrase and cite the source. I can understand their frustration if each paper is only worth 5 points, is one whole point of that for APA? With only 5 points possible, it seems you would have to write a pretty darn great paper to earn all 5 points.

We usually have at least 4-5 Ca Chlorides and bicarbs. Yes, our infusion is in the crash cart. Night shift is required to do crash cart checks, there is a list that says :Drawer 1, Drawer 2, ets that lists the contents. Mock codes should be required and staff should be required to open up the cart and learn where stuff is. On the outside of the cart, there are also stickers for "IV fluids, meds" etc, so we can usually guess pretty quickly which drawer we need to start looking in. Why arent your floor nurses taking responsibility and learning where to find stuff in your carts?