DSplendid

Just wondering if anyone else has paramedics working in their ED. We just started hiring Paramedics; as techs.. Thus Far they can: Start IV's Transport mon. pts to tele, or other departments (non-icu) Defib, Pace, give meds per ACLS protocol (if warranted) As well as tech duties,...splint, undress, collect labs, ekg...etc. some grey area of collecting Triage data??? That has yet to be clarified. My question is what are they allowed to do in your ER? Because it is still new and grey to us. For example; I was orient. a paramedic well known to our staff who was just hired. That night I had a very difficult IV and the doctor let the paramedic put an EJ in. Without blinking he dropped that in like nothing. (no doubt he has done it a million times before) the MD said he would sign it off on his orientation skills check list. Unf. I told him, it was not on his skills list. Nor was intubation later that night, when we had a another diff. tube. Nor was hanging a bag of NS. All which the MD as well as the nurses assumed he would be able to do. We all assume in time as they grow within the ED so will there scope. I mean personally, if your allowed to transport mon. patients and use ACLS drugs...why not a bag of NS. Any feedback would be great. Thanks.....

oh this is fun, lets see.... copied a whole chart for a transfer...on the wrong pt. while giving report to the most experienced rn...i said: "mrs. so and so is legally blind, i mean she totally can't see!" i had the whole department laughing....:roll walked a symptomatic bradycardic (hr 30-40's) to the bathroom; and then was surprised when she started to get dizzy :smackingf let a surgical pt, which was literally on the way to the or, have a sip of ginger ale. :smackingf placed a pt on a neb treatment and...oh, i don't know, let it continue to run for about 4 hours...worse part is...she still was inhaling from it. lastly, during an emergency...i took emergency meds ordered by the doctor out of the pyxis...and didn't realize the whole time taking out the meds. i was under another pt's name...which by the way, was being d/c'd. :uhoh21: there is more....trust me! :smackingf :selfbonk:

Oh... this is fun... If I was not a nurse... I would be the highest paid actress in major motion pictures. I would also be the most recognized portrait photographer with such clients as Brad Pitt, Aerosmith, and Catherine Zeta-Jones. I would also have my own clothing line, called Honey Kat Co. In my spare time, I would whisk off to my wine vineyard in Tuscany which produces the most exotic tasting wines; known around the world, for its rich smooth body test with a hint of sweetness. When I have the time, I correspond with my Columbian coffee producers. Yes, I also have my own line of premium smooth coffee blends... And as a treat to my hard work, I vacation on my private island in Hawaii.... Wow that was great....now back to reality...screaming teenager, hungry husband, dirty house and my 3-11 shift tomorrow; beside the most angry Doctor known to Emergency Medicine.....

Hey Kirs, Let me first just say,...I have no exp. in L& D other than my own internship during nursing school. ( 7mo's ago). IMHO, don't beat yourself up over it. It sounds like it was madness in there, which can lead even the most veteran nurses to make mistakes. You admitted, you coached when you shouldn't have, and that shows taking responsability; and, now it kind of sounds like some just want to point fingers. As you describe, whether you enc. her or not would not have made the difference. If this was truly a precepitis birth, you telling her to stop; wouldn't have changed that baby coming. During my internship, I was picking up a 37 wk. G1P1 mom from the ER who had SPROM at home, while in the elevator...she stated and I quote...."I think, I'm pushing. I paniced and told her not to, and closed her legs...yes, closed her legs. As I was wheeling her on the unit, she began breathing heavy and saying something doesn't feel right. I told her to deep breath, we were almost there. I grabbed a nurse and headed to the traige area. Little did I know as I removed her sheet from her legs to place it on the bed......she was crowning! Later the nurse needless to say, chewed me up one side and down the other....I admitted, all my fault...just a poor judgement call. The right thing to do was get her back to the ER on a stretcher and have staff eval her and move only if safe and with staff. My primary RN told me a precip. birth can not be stopped! She then went on to ask me..."You're not thinking about working in Maternity when you graduate....right?" So don't worry, things happen...its not like you turned on her pit...hahah...I know its not funny, but I truly believe things just happen, we are not perfect. Good luck.

well...just an update... i have completed exactly one week of nursing as of today.... i must say it is getting easier everyday...but, everyday i still seem to be scared out of my mind...lol. i'm very lucky, my preceptor is an angel, and she makes me feel very comfortable. even when i make a mistake, she doesn't come down on me, she just tells me: "ok, now you know...and next time you won't do that." she also, gives me my space, its funny though, i can see her hiding sometimes outside the door etc. well so far so good, i'll keep you guys updated. what i've learned so far....trust your instincts, and believe in yourself. you really have to have some confidence. the hardest thing so far.....dealing with families, ( for me anyway). good luck to all~

Wow...that is new to me...I'm doing something different. I'm doing 3 days of classroom..to start...orientating to hospital equipment etc. then working 3 months with my preceptor, and then 2 months of more classes on and off. It used to be (stopped just as I started) orientation with a preceptor was 6 mo. and 3 mo. of classes....I don't know what happen...I just hope I feel comfortable in 3 mo.

Thank you so much DaytoNite.....

Same here...I was getting 94% on the Mosby...then I went upto 99%.... Passed my boards with 75 questions... Some classmates were getting 84%...and also passed the nclex.. Good luck

congratulations!!!!!!:balloons:

hello... i just had a few questions for those who have started working as an rn or have been for awhile. first...i start orientating in 2 weeks. i've already worked at this hospital and this department for about a year as a nurse tech/aid. the way it works, i guess..is i will do a hospital orientation, then go off and work with my preceptor (6mo total) i'm not new to health care...i was an emt for 11 years, and on & off in put pt. dept., clinicals, hospitals etc. i feel very comfortable with the staff i'll be working with. furthermore, i do feel confident with my skills i gained in school and knowledge from already working in that dept. i.e. were things are, the computer system, routines, etc. but my questions are this. is it normal to be scared out of my mind ? i'm so scared, i'll look like an idiot! i have this recurring nightmare that my preceptor asks me something/do something so simple and i mess it all up; and everyone gets mad/laughs at me.... do the preceptors expect a lot from you? i mean i'm a hard worker, and i learn fast; moreover, willing to learn. but just starting off, i need to absorb first. i mean, i don't know what i mean. i think i'm just scared they're going to except me to know everything, esp. since i have a little exp. and worked there already...and of course i feel as though i don't know anything. how did you feel, and when did you get comfortable? i know this is going to vary by person and on the type of nursing. but just some feed back. like when did you fell as though you had a grasp on what was going on. how did you feel while being precepted? when did you feel ok, being on your own? i won't be on my own for 6 mo. which is fine with me. any advice...any at all is welcome. i'll be working in the ed, which i feel very comfortable in like i said...however...tips, advice, suggestions, tricks..lol on just being a "new grad" in general would be great. (don't feel as though you can't commit if your not working in the same dept. as me...i want to hear it all.)

Buddhanah.... Picking up the pieces after a such a dissapointment; is always the hardest part. Every single emotion you feel is not only normal its expected. The pain your feeling right now must be horrific; but this too will pass. For now, take time for your self; your entitled to it. But then you must get back up. Start with a plan, decided what and how you want to handle this..do you want to take a review course, do you want to use suz's plan. If there is another student in your same boat, think about if you might want to get together. Focus on the positive, (although hard right now) , that even though this is a set back, your not out of the game. As far as telling your friends, I can understand why you wouldn't want to. But know this, there is no shame in failing, the shame comes from being knocked down; and staying down. I don't know you, but I can bet you have had a few let downs and hardships before this; and you have always over come them. Don't let this be any different. You made it through Nursing school, now just go and show that damn computer why! Keep your head up, make a plan, come back here often for support, and then do it! I'm sending you positive vibes and prayers your way....and a great big hug! ~D

Hello...congrats on getting excepted, and lucky you to have such kind friends. I have to tell you, IMHO a littman classic is 10 times better than sprague, as for a Cardio?? I don't really know what they mean. I have a littman master cardiology it too was a gift, but I find it just as good if not the same as littman classics. If your really going to get into heart sounds, and advance practice...I would then say perhaps invest in a steth that specializes in that. Otherwise, I think yours is great. Good luck

Your so not alone..... I passed and felt just like you did at 75, however, 3 friends of mine just passed one with 140, and 2 at 260+. So keep strong, keep busy, the way you feel is the way everyone feels...sending positive vibes your way ~D

I'll tell you, I'm glad you did...I really liked it, some questions are easy...some are not. What I really liked was seeing how you get stronger as you go throught the chapters, I didn't finish the whole book by the time I took my NCLEX, but I felt very comfortable answering the many priority questions I received...and I think..no I know it was because of that book.

first let me say congratulations on your acceptance, that is the hard part...:balloons: as far as maintaing a b...you can do it; if you really want it! it will be hard, your going to have to study and work for it, but it is possible. just make sure you get everything in order for september, ex. if you have children who will watch them etc. for clinicals. if you have a family, make sure they know home cooked meals everynight might be out of the question. if you work....well that is a tough one...i found that i could not work more than 8 hours a week, plus family and school. if you can't work, how will you manage or will there be support know your study habits and learning styles now...ex., if you need to read and re-write things plan on that. if you like to tape lectures plan on that etc. whatever you do...keep organized...there is nothing worse than spending 2 hours just finding your stuff even before you get ready to study...lol. good luck, you can do it!

I bought the Mosby book...It's called Priority/delegation...really excellent, there is chapters for each area and system...i.e. cardiac, pain, home care, and case studies.... http://btobsearch.barnesandnoble.com/booksearch/isbninquiry.asp?z=y&btob=&pwb=1&ean=9780323044073 I really recommend it!

Yep...a friend of mine just passed at 265...

JMHO I must say I see this arguement time and time again... The "I took 4 classes at a time" vs. "I took 1 class at a time" Those "who went for the money vs. Its my calling" The "they failed out" vs. "I could have had their seat" When really...its just about not getting accepted into the Nursing program! Which of course just stinks!!!!! Here is a program that has limited seats, and thousands of applying. Don't get me wrong...I felt the same way you did. I was placed on the waiting list, and was angry!!! There I was, an A student with experience, blah, blah, blah, and didn't get in; as I saw, what I believed to be less "worthy" getting in. The funny thing is, once I was in...those "less worthy" become my best friends, and I never once thought about the admissions process again. It's normal to feel the way you do, students kill themselves to get in, and when they don't. It's better to blame the system, or to find a reason, any reason, to make yourself feel better. I know, I did it. One girl went as far as to say, students can only get accepted "if they know someone" or a minority...which is just not true. Know this, people go into the field for a variety reasons, some have good grades so don't, some have exp. some don't. And yes some will fail. In the end, run your own race; and be true to yourself.

JMHO... Skip the CNA college class, if you have to work for now, do something until the free class opens up. Waitress, Mcdonalds, clean houses, whatever you can..not worth paying for it. Or, many times you can work as (I don't know about your area) without the Cert. just as a personal care attendent. I would also skip the phlebotomy. If I'm understanding you, the goal in the end is to become a Pedi NP, so get the CNA, so yes you can work while in school...but start school for nursing. Honestly, you could even skip the CNA, and just work any job, while your taking nursing classes. The more classes you take; other than nursing or nursing pre-req's is only going to take you longer, the more cert.'s you obtain, and better jobs, are only going to make you comfortable, and question whether you should go part-time to get your nursing. Trust me, as I was getting raises and better job offers, I kept putting nursing off. If you have a goal, work towards it, not around it. JMHO...but good luck, sending you positive vibes and prayers.

i would have to agree, chemistry was not required for my adn; so of course i didn't take it...(i hated the thought of taking it). but, looking back; had i, i would of been a much stronger candidate to get excepted, not only in my own program, but i would have been able to apply to 3 other schools. if your already accepted into a program, then its up to you...see if its worth it. i plan to get my bsn, but it still would not have been worth it for me, because i just found out i'm already over the allowed credits to transfer, so even if i took it i would not be able to transfer it over to the bsn. however, thats my suitation, it may be different for you. as far as it helping in nursing, it does i think a little..many labs, and drugs use chemistry symbols..or what ever they're called, i.e. k+, mso4, ca+, fes04...some i knew just from taking a&p, some i had no idea, but my fellow classmate who had taken chem, did now. there maybe more ways it helps, but i don't really now, since i didn't take it. i did make it thru- without it, but classes like that can only make you stronger. if your able to take it without killing yourself..i.e. it doesn't conflict with other classes and pre-req's than i say go for it. you can always get tutoring, or study groups to get through. if you can do a&p and micro, you can do chem. good luck---

i have to agree, saunders is great for review...i was doing the end of the chapter review exams, and when i didn't score well, i would review the chapter. i also did many many quizes from the cd, i like that i could pick the area and only had to comit to 10 questions at a time. kaplan however, is great for answering questions. an example is how to eliminate certain answers, or how to use your abc's and maslow etc. i personally like the online mosby cat, great boost to you confidence (if you pass) and to me questions were simillar as far as level of difficulty to the nclex... http://www.us.elsevierhealth.com/product.jsp?isbn=0323032524 good luck.

well...i just first want to say...sorry, i think that is crap that you have to pass the hesi in order to graduate. :angryfire esp. considering the hesi has not proved accurate many times on determing success rate on the nclex. many students in my class believe it or not, scored 500...and went on to pass mosby's cat and the nclex...so schools really need to reconsider the exit hesi...ok, sorry enough ranting...:angryfire i had many friends at other nursing programs, also have to pass in order to get their degree. i was lucky in the sense that our school gave us the hesi for our own study use, it wasn't a graduation requirement. i can tell you many of my friends just practiced with nclex cd's. such as mosby, saunders and kaplan, doing questions and then reading the rationales. they also, swapped nclex cd's among themselves, so in total; a group of them were doing over a 1000 questions from different sources. i.e. davis, ncsbn, mosby...i wish you the best....i would also if you have time, review saunders chapters on any of your weak spots, when i took the hesi it gave me a print out of weak areas, i don't know if they do the same for you. good luck, sending prayers and positive vibes your way.

here are some things that worked for me.... get it out now - i'll tell you, days before the exam, i did all the crying and ranting, denial, fear and all the other emotions you swing thru. i was set on letting it now, rather than the day of the test. the day before - give your self only 2 hours to get out your last "study". i know they say, don't study the day before...etc. but if your like me, i felt too guilty, and paranoid, i felt that one more day could be the difference in passing. don't do it, but instead set a limit, for example, i was still paranoid about meds, so i reviewed them 2 hours that morning. then - rent funny movies, eat what you want, laugh, laugh, laugh, and enjoy the day...and let go............. the night before - try to go to bed early, it will be hard, but you have to. say your prayers, deep breath, and sleep. that morning - eat a good breakfast, but no so much carbs in it that you feel like your going to fall asleep at the test. arrive early, and stay calm. i sat in my car and listened to relaxing music, deep breathed, and chanted i can do this, i can do this. during the test - deep breath, slow down and read, take a few minutes to deep breath with your eyes close after so many questions if you feel panic set in. and then again repeat, i can do this....millions of nurses passed, so can i. i really think the talking to myself, and believing it; i can do this helped.... i'm sending you positive vibes and prayers your way...good luck

pass - 75 try to stay calm (easier said then done). i know exactly how you feel. trust me, but even if the next hundred replies tell you they failed at 75,..that doesn't mean you did. the nclex is computer adaptive, my 75 is not your 75, my area of strengths are not your areas. you have done all you can do up until this point. take some much needed you time, and think positive. sending you good wishes....

i have to say honestly.... i didn't focus until nursing classes were over, including graduation ceremony. then i picked up books, and tests, i carried mosby flash cards, which had questions on them...i glanced here and there for about 2 weeks; until my review class started. my review class was 2 weeks long, and during that time....i went nuts, i studied as if my life depended on it. after that, my test was scheduled 4 days later, which again cont. to study like mad. so over all, i studied about a month, 2 weeks being the most serious. passed at 75 questions...