swee2000

Not at my hospital....or at least not on my unit(Med/Surg). In fact, hiring LPNs has become my manager's new "fad". :wink2:

If I were you, I'd consult your student handbook and see what it says about students on prescription meds & in the clinical setting. Also, I don't know if this is necessary, but maybe ask the prescribing doctor to write a letter to your instructors explaining why you're on the Adderall. Same thing for employers. But by no means should you hide, or feel that you have to, the fact that you're on this medication. Especially when its use & effects on you are being monitored by the prescribing doctor. As an FYI, I also take Adderall 2x/day for Narcolepsy. When I returned to nursing school in January 2006, after a one-and-a-half year absence due to issues r/t my undiagnosed-at-the-time narcolepsy, I did not hide that I was taking a prescribed, controlled substance or for what. In my opinion, there was no reason to. Plus, the medication allowed me to function, concentrate, and be me....which boosted my confidence level immensely. (At the time, I was actually on Ritalin; I didn't switch to Adderall until 10/07). Luckily, most of my instructors were supportive, happy to see me back, & also very relieved that the docs figured out what was wrong with me. The best part was when I finished the semester & graduated with a 4.0, yet knowing how close I was to the opposite end of the spectrum in 2004.

Here are my hospital's isolation policies using the original poster's situations: 1)Suspected &/or positive for C-diff: patient placed in Contact Isolation, which requires the wearing of isolation gown & gloves whenever in patient's room. Strict handwashing with soap & water(NO using the alcohol foam) is a MUST before leaving the patient's room(at minimum). Lastly, the isolation precautions MUST remain in place until the patient has 3 negative(for C-diff) stool results. 2)MRSA/VRE in urine: patient placed in Resistant Contact Isolation, which requires same precautions as Contact Isolation 3)MRSA in a covered wound: same as MRSA in urine 4)MRSA in sputum: same as MRSA in urine & covered wound, IN ADDITION to wearing a mask **These precautions apply to EVERYONE, including staff, doctors, family, other visitors, law enforcement(in the case of a patient who is also a police hold/inmate & requires 24hr monitoring by law enforcement), etc. And just like other posters who mentioned their struggles with getting family members to comply with isolation precautions, I've also noticed MANY doctors at my hospital who DON'T follow the policies, either(except for the infectious disease doctor...he's always gowning & gloving). I'm not sure what their rational is for this &/or why they don't follow policy like everyone else.

All I have to say is "Thank God for caller ID & voicemail"!!! Seriously, in my first year at the hospital and particularly during the winter season when we were constantly on "Emergency Bed Status" & short-staffed, I picked up LOTS & LOTS of extra shifts. At one point, I believe that I worked 80+ hours in a ONE week timeframe. Yes, I knew how excessive & extreme it was & I definitely learned how exhausting & taxing it was on/to my body. But because I was new and wanted to show I was a team player who cared about her job, the unit's ability to function, & more importantly, the patients, I kept on agreeing to work extra shifts every time they asked me. Plus, the extra $$$$ from overtime, extra-shift bonuses, shift differentials, etc was so tempting, even if Uncle Sam would end up with some of it. Now, 4 years later, they would practically have to beg me to work beyond my scheduled 8/shift or 32/week. Especially when in the past, they've ripped employees off by not paying out the extra-shift bonuses come paycheck time or when they've ONLY offered double-bonuses(on top of the extra-shift bonus) to the RNs, while leaving the LPNs, CNAs, & NIs hanging out to dry with the pizza that management ordered in. (The funny thing is I hardly ever got any pizza because I was too busy trying to get my work done & caring for patients that I never made it to the breakroom in time!!)

Finding myself in it every now & then!!

Thank you for your response. Honestly, until I found allnurses.com, I don't think I had ever heard of Excelsior, let alone looked into it. Is it accepted by every state board of nursing? How does it impact job opportunities? One day, I would love to finish school and become an RN. As much as I enjoy being an LPN, it isn/t, wasn't, and never will be, my dream. And I'm not the type of person who likes having to settle for "second best", so-to-speak. Plus, I don't think my co-workers will let me put-off school too much longer, seeing as they constantly make comments about what a good RN I'd make/be, that I have more than what it takes, what am I waiting for, etc, etc. It's very comforting & reassuring to have such positive support from the people I work with every day.

Something similar to the OP's scenario also occurred during the last week of my 2nd semester in the LPN program. Our normal clinical instructor had to abruptly take a leave of absence(the last week) due to a family emergency. Taking her place, was the Associate Dean of the Nursing school/program, whom none of the other students in my group knew, talked to, or had ever formally met, where as I already had the advantage of knowing her as an instructor from when I was in the RN program a couple years prior(long story) prior and before she became Associate Dean. Unfortunately for everyone else, the Assoc Dean was NOTHING like the original instructor, who was typically fun, carefree, and easygoing. In the past, when students would turn in their self-evals to her, most everyone would score themselves high, to which this instructor would also do the same(it was a very rare occasion when she didn't). Well on the last day, after the Assoc Dean handed back all of the self-evals, she basically ripped into the students about how she couldn't understand why any of them would feel they deserved/earned "5/5s" or even "4/5s" in any area. Basically, she felt that, unless you were God, there would always be room for improvement, no matter who the person was, how long they'd been doing a job/skill, and especially when it came to students. Another words, no one was perfect or flawless at what they did, regardless. Also, when it came to students, her opinion was that they only deserved "1s and 2s" because they were just starting out & way toooo new to the Nursing world. In all honesty, I don't think I ever saw so many pale, white faces with eyes so huge they were about to pop out of their sockets. For the students who were doing well & guaranteed to pass, their anxiety level turned on at that point. For the remaining students, who were already anxious beyond words because they were struggling & desperately needed a good score on the final exam(in 2 days, mind you) in order to graduate, their anxiety levels went through the roof/off the charts. Luckily, everyone made it out alive. However, I'm sure they will never look at a self-eval the same way again &/or dread having to do them.

Here are the start/end times for 8hr & 12hr shifts at my hospital: Days: 0700-1530 or 0700-1930 PMs: 1500-2330 or 1900-0730 Nocs: 2315-0715(they don't "technically" get a 1/2hr break) 12hr shifts: 0700-1930 or 1900-0730

Yes, I actually fit your description to a "T". I originally started at a 4-yr university in Fall/1997, taking under-graduate classes while awaiting my turn on the "student waiting list". Then, in 1999 and due to personal reasons, I dropped out until I could get life under control. About 1-1/2 years later(~2000), I returned to school and the RN program, only now I was at a 2-yr technical school. During the time I was away, I continued dealing with severe fatigue, which had been present since the summer of '96, after coming down with mono. Since then, I've been battling constant, excessive/severe fatigue, which is present 24hrs/day & regardless of how much sleep I get. At the time, no doctors could figure out a cause. It was during the 2nd semester of the program, when the fatigue became so severe & intrusive, that I said "Enough was enough". I couldn't retain info, my grades were starting to slip, I was falling asleep in class & at home while trying to study, and my confidence was taking an all-time dive. While I was determined to keep going & fighting thru, I also did not want to screw up my nursing career or make some detrimental mistake. So I gave in and dropped out, again, with the intention of not coming back until SOME doctor could tell me what was wrong &/or treat me for "it". In January, 2006, I had my health problems resolved and decided to give it another "go". Unfortunately, at the time I was registering to come back, there were no spots available in the 2nd semester of the RN program. So the school offered me a spot in the 2nd semester of the LPN program, which they said was comparable, and I accepted. In the end, I finished the program, graduated at the top of my class, & have worked as a LPN ever since(and enjoying every minute of it). **As a side-note, I still have intentions of one-day finishing a RN program. It's just a matter of "when?", as life has stepped in the middle, again, to say "Now is not the right time for you &/or your family".

Annie: I've been an LPN since 2006, also, and currently work at Waukesha Memorial(I've actually been there for 4 years).

What part of WI are you in? I'm in Waukesha County, just outside of Milwaukee.

Here are some more traits of a good preceptee: *Have confidence in yourself & show it *Be prepared, on time, & reliable *Always show a willingness to learn *Take initiative/be assertive *Ask questions if unsure of something and don't do anything if unsure & w/o asking first *Don't try to be "super-nurse" by taking on more than you can realistically handle *Be willing to ask for help *Don't act like a "know-it-all" *Keep an open-mind to suggestions(incl how to do something differently than what you're used to) *Show your teamwork attitude *Be respectful of preceptors, other co-workers, patients/families, etc

WitchyRN: Regarding my comments, they referred to new, graduate nurses being hired to work on the Med/Surg unit ONLY. I have no clue what the other specialized units in my hospital(like OR) do with new nurses that have absolutely no experience. But here's a curiosity question for you: While I respect those who feel there's no benefits to working as a CNA while in nursing school, I wonder how working as a unit clerk or in medical records, for example, could be any better? What true, patient-care experience does one get out of these positions that will help in nursing school & beyond?

Well put!!

While this doesn't apply to everyone, here is a real example of why it may be beneficial for some, if not all, students to work as CNAs(or other patient-care positions) before &/or during school. Last summer, my manager hired an inexperienced, new, graduate RN to work on the Med/Surg unit. And when I say "inexperienced", I mean she never worked a day in her life as a CNA. She had taken the CNA training & certification course prior to starting the nursing program, but that was several years prior & only because it was a requirement. Otherwise, her only other patient-care experiences came during clinicals. While there's nothing wrong with the decisions she made, it became very apparent during nursing(RN) orientation that she could not, or did not know how to, do simple tasks.....like manual BPs, making beds, etc, let alone some of the more important, complex ones(like starting IVs). This resulted in LOTS of frustration all around, from the new grad to the preceptors to the manager. However, one can't entirely blame the new grad; rather, if management had thought these things through & before they spun out of control, the orientation may not have been extended or resulted in more $$$ being spent trying to bring the grad up to speed. From that point on, management decided that ALL new, graduate RNs, and regardless of prior healthcare experience(including as CNAs)**, would have to spend at least 1 week(during the beginning of their orientation) working with, and as, a CNA on the unit. This way, the unit educator & the grad's preceptors would get immediate feedback via observations of what the grad did or didn't know(especially in terms of "the basics"); in turn, the new grad would become accustomed to the unit's system & way of doing things. **The only exception allowed is if the grad worked as a CNA on this unit or somewhere else in this facility and received good evaluations(per management's discretion).**

I beg to differ. Not all technical schools rely on just the "wait-list" system. At the technical school I attended, CNA training was(and still is) a requirement of the LPN or RN nursing programs AND had to be completed before a student could be accepted into/allowed to start a nursing program. No exceptions were made.

Me too!!!

Does your facility &/or unit use bed alarms/checks? If so, are they set-up and plugged-in correctly? Does your unit utilize sitters to stay with the patients? At my hospital, we do not need a doctor's order to apply a bed check or to have a sitter with a patient. But I realize that's not the case everywhere.

JJJoy: You are correct & I apologize to you & the OP for my mistake.

This is an awesome post(in my opinion)! :-)

Deleted message...

I apologize if this sounds mean or snotty, but the original poster needs to lose the "Being a CNA is just about butt-wiping" attitude, or he/she will be in for a rude-awakening come nursing school/clinical time and when they step into the "real world" as a nurse. Nursing is not, and never has been, all about administering medications or listening to hearts & lungs. Assisting patients w/toileting is also a part, and a very important one at that....Honestly!!! There is sooo much one can learn from wiping someone else's rear. And this applies to CNAs, nursing students, & nurses!!! For example, one can visually see what their skin looks like, what color it is, if there are any open sores, what do they look like, how big are they, how deep do they go, what does the urine &/or stool look like, are their any abnormalities with either, etc, etc, etc. The list is endless!!! Getting to the whole point of the original post, depending on the school, one may or may not have to work as a CNA before &/or during nursing school. My school's only requiremnt was for students to be CNA certified and prior to the 1st day of the 1st semester of the nursing program. Otherwise, you couldn't go on to day 2. As for working, there was no stipulation regarding this, but it was highly encouraged. Most of the students were already doing this anyways....except for me. So taking my personal experience as a "nursing student w/o CNA-job experience" into account, I'll be honest & say that it was very hard trying to keep up with all the other experienced students. I mean, there was a noticeable difference in how they looked at clinicals compared to me. I was breaking out in sweats, they were calm as can be. I was shuffling through papers, they were organized to a "T". I was always the last with med passes, they were always the first. Etc, etc, etc. Personally, now that I've worked as a CNA & nurse for almost 4 years and have seen other new nurses(w/o prior CNA experience) struggle, I can't stress enough how important & beneficial it can be for students if they work as a CNA either before &/or during nursing school....even for just 6 months. Not only can one learn how to interact & care for patients, you also learn: time-management, organizational, & communication skills; how to be a team player in a healthcare/patient setting; how to recognize &/or respond to emergencies; how to & ways to increase one's confidence & knowledge base; get 1st-hand experience with all different areas of illness, disease, & nursing, etc, etc. Again, the list could go on & on & on.

I work in a hospital on a Med/Surg unit and actually encountered this situation earlier this month. My husband, who has Chronic Lymphocytic Leukemia, had a CT & PET scan done towards the end of January d/t an enlarging spleen. On Thursday, 1/31/08, we were told by the oncologist that my husband's spleen had enlarged so much that it was in my husband's best interest to start chemo ASAP....like the following Monday, 2/4/08. Unfortunately, I was scheduled to work that weekend AND on Monday, 2/4. Since I had VERY little time and was limited on who I could ask to work for me(many of the employees are students who had returned to school the previous week), I was not able to get off of work. I had thought about calling in sick, but most of the weekend staff knew my dilemma & I was afraid one of them might call my bluff. So against my better judgement, I planned on working knowing full-well that my husband was scared out of his mind & would be going to his 1st-ever chemo treatment ALONE. Talk about feeling like the worst wife ever. On that Monday morning(2/4), the 1st day of my husband's chemo, I woke up around 4:30 a.m. with this sharp, knot-like, gnawing pain in the middle of my stomach. I also had this uncomfortable feeling of nausea, but when I got up to the bathroom thinking I had to throw-up, nothing happened. So I went back to bed and tried to relax. Unfortunately, the pain & nausea did not go away. In fact, when it was really time to get up & ready for work(at 5:30 am), the pain in my stomach & feeling of nausea became more intense than before. I figured it all had to do with nerves & stress r/t that day, especially when I felt completely, 100%, fine the night before. But within 2 minutes of stepping into the shower, the feeling of intense nausea turned into 3 vomiting episodes. At that point, and regardless of why this was happening(meaning nerves/stress vs stomach bug), I knew I shouldn't go into work. But the last(and only other) time I called in within 2hrs of the start of my shift, the nursing supervisor yelled at me from all directions about how difficult finding a replacement would be & with very little notice. So, instead, I fought through the nausea, vomiting, & pain and went to work. Once I got there, people kept telling me that I didn't look good. Duh!!! I didn't feel good, either. Apparently, my face was very pale and there were 2 episodes where I nearly passed out. About 5 minutes after the second one happened, which was around 10:15 am, my blood pressure was only 80s/40s & I was running a low-grade fever. At that point, one of my co-workers told the charge RN that I needed to go home. It wasn't until an hour later when I was told someone would be in by 12:30pm to replace me for the remainder of the shift. Even though I was worried about having exposed patients, visitors, & other staff members to whatever bug I suddenly came down with(if it was one), quite honestly, I was more concerned about whether or not my husband would get sick, considering his immune-system would be greatly compromised as a r/o the chemo and because he was told by the oncologist just the week prior "You NEED to avoid sick people".

Not to dispute Piki's comments above, but I wanted to mention that I work on a Med/Surg unit at a hospital and there are several different types of lift equipment machines, including 2 bariatric ceiling lifts(built right into the "bariatric" rooms), kept on our unit & available for use at any time. In fact, I'm on the "Safe Patient Lifting & Handling" committee and we encourage the use of this equipment as much as possible &/or when appropriate in order to maintain safety for both patients & staff.

My hospital just implemented the "Bedside Report" system last week. So far, I've heard more grumbling, groaning, & complaining from either the nurses coming on for the next shift or those finishing up the current shift. And, like another poster said, sometimes one nurse has to report off to 2 or 3 different people, plus go to each patients' room to do the beside report. That leaves other nurses frustrated & getting mad because they're waiting to hand-off report or get report from one of the nurses in the patient rooms. Good idea, but I honestly can't see it lasting or being done routinely.