Kenneth Oja

You'll most likely need at least an associate or bachelor's degree in nursing, but each nursing regulatory body (NRB) has their own eligibility requirements. Contact the NRB where you want to take the NCLEX to find out their specific requirements.

Check with your clinical instructor or the dress code policy of your nursing program to see if there are any specific guidelines for wearing your ID badge. They may also have suggestions for how to wear your ID badge if your scrubs don't have an upper chest pocket.

Both are used to remove excess fluid from the blood, but they work in slightly different ways. Ultrafiltration only removes excess fluid from the blood – not waste products. The process involves the use of a pressure gradient across a semipermeable membrane to pull fluid from the blood. With sequential ultrafiltration, excess fluid and salt are removed from the blood in two stages. In the first stage, a hypertonic solution in the dialysate pulls fluid out of the blood through a semipermeable membrane. Then, a normal dialysate solution is used to remove waste products. The two-stage process helps avoid pulling too much fluid too quickly and bottoming out the patient's pressure.

It's not as uncommon as you might think! Many hospitals have policies that allow patients to go outside and smoke, as long as they sign a waiver and aren't actively being monitored. I get how it can be concerning to nurses, though. Allowing patients to leave the unit unmonitored to smoke, or engage in other activities, is risky for both the patient and the hospital. Yes, they can sign a waiver, but not being monitored by their nurse puts them at risk for injury or harm, and the hospital could be held liable. If you have a concern with the policy, bring it to your leadership team. I don't think there's anything wrong with voicing your concerns about something that can impact patient safety and quality of care!

Smart move in doing a little research and learning the different methods in which you can write your end of shift note because it's going to vary by facility and type of unit / department. What's consistent across facilities is that a nursing end of shift note is a communication tool to update the oncoming nurse about the patient's status and any changes that occurred during your shift. They're important for continuity of care and making sure that everyone involved with the patient's care is aware of any relevant information. The ANA's Principles for Nursing Documentation is a good resource. Other things to consider include: Be Concise: You don't need to include every detail of your shift. Stick to the important information that the oncoming nurse needs to know. Use Clear and Objective Language: Avoid subjective language or making assumptions about the patient's condition. Stick to the facts and don't make judgments. Include Vital Signs: Document any significant changes in the patient's vital signs, such as an increase in blood pressure or heart rate. Document Medications: List any new medications that were started or discontinued during your shift. Note any Assessments or Interventions: Document any assessments or interventions that you performed during your shift, such as wound care or patient education. List Concerns: If you have any concerns about the patient's condition, document them in your note and notify the healthcare team. Also, you're still learning and that's OK! It takes time and practice to find the right balance between including all relevant information, being concise, and following the guidelines for a specific facility or unit.

I took AP I and II in two consecutive semesters and found II to be more difficult because of the endocrine system. I also had a heavier load the semester I took AP II along with other challenging courses (like Microbiology) and a clinical rotation. Having lectures in person as opposed to online helped, but that's my own personal preference. I also did not work full-time, which is another factor to consider. You did well with AP I and the two other classes, so I would recommend sticking to that for AP II! Especially since you also have the nursing entrance exam to consider.

I would imagine there are some RN jobs that do not require the COVID-19 vaccine, depending on the employer and location. Do a search for jobs that are labeled as "remote" or "telehealth" as these positions might be less likely to require in-person interactions with patients and, thus, the need for the vaccine. Overall, most healthcare facilities and employers are requiring the COVID-19 vaccination for RNs. However, the situation is constantly evolving, and policies may change over time. Good luck with your search!

Depends on the brand / manufacturer. PICC lines might have one, two, or three lumens. Typically, with a triple lumen PICC, the proximal port is white, medial is blue, and brown is distal. Although it may appear to be one line, since they are all enclosed in one sheath, each lumen (line) allows for separate infusions. So, no, medications going through different ports will not mix within the line. Each line also typically has a different exit port so not all infusions come out at the very tip of the PICC. This is to further reduce the risk of mixing. I would check the information from the manufacturer to confirm for the specific type of PICC you're using at your facility.

Yes, it is simply IV potassium. Not sure when, where, why, or how this term originated, but it's safer and more accurate to use correct terminology. Think Five Rights of Medication Administration. "K Rider" does not address the right drug name, the dose, or the route.

I don't see anything wrong with this. It's clear, concise, relevant, etc. Maybe clarify what your preceptor means by "paint a picture.” If you're following appropriate facility and other guidelines for documentation, such as the ANA's Principles for Nursing Documentation, you should be fine.

I don't see why not. We need to get out of the mindset that all new grads need to start in a specific setting or have a certain amount of experience in one area to practice in another. It also depends on your goals. Do you want to be an OR nurse? Most practice areas, including the OR, have an orientation process based on level of experience. This could range from new grad to 20 years of experience. When I started working in critical care, I went through an extensive orientation process even though I already had many years of experience as a nurse. So, I was oriented more as a "new grad" even though I was already an experienced nurse. When I worked as a hospital nurse educator, each of our service lines (med/surg, critical care, OR, etc.) had different pathways for orientation depending on experience and most of them, including the OR, had a pathway for new grads. Check with the hiring organization to see if new grads can apply for positions in the OR. Especially if this is where you want to work!

There are multiple factors to consider here, and this is where nursing clinical judgement comes into play. Use your nursing knowledge and assessment to think beyond the written order and the task of giving or not giving the medication. What is the patient's blood pressure trend? Are they showing any signs/symptoms of hypotension? Is the blood pressure reading correct? How long has the patient been getting furosemide? What is the usual effect of furosemide on this patient's blood pressure? Why does the patient have furosemide ordered? What are the patient's current labs? This list could go on, but my point is that there is so much more to consider beyond the actual number in this situation. Just make sure to keep the proper people informed of your decision and rationale, especially the ordering provider and your charge nurse.

Depends on the brand / manufacturer. PICC lines might have one, two, or three lumens. Typically, with a triple lumen PICC, the proximal port is white, medial is blue, and brown is distal. Although it may appear to be one line, since they are all enclosed in one sheath, each lumen (line) allows for separate infusions. So, no, medications going through different ports will not mix within the line. Each line also typically has a different exit port so not all infusions come out at the very tip of the PICC. This is to further reduce the risk of mixing. I would check the information from the manufacturer to confirm for the specific type of PICC you're using at your facility.

It's great that you want to get extra practice, but my first recommendation is to use the equipment provided by your school. See if your nursing school lab has open lab hours if you feel you are not getting enough practice during scheduled lab time. If you're unable to do this, or still feel you are not getting enough time for practice, start with the banana! Your classmates were right in suggesting this, as banana skin can do an impressive job of creating the feeling of IV insertion. Or, if it is within your budget, order an actual IV practice arm or pad.

The PACU, Post-Anesthesia Care Unit, is where patients go directly after surgery. They are closely monitored by the nurse as they wake up from anesthesia and are then transferred to another unit once they are stable. It's a specific type of unit specializing in promoting a smooth transition from anesthesia to full consciousness. PACU nurses typically monitor vital signs, manage pain, and assess surgical sites for one or two patients. Check with the recruiter about what they mean by postoperative care unit. It is most likely a medical/surgical type of unit where patients further recover from surgery AFTER they are transferred out of the PACU. So, they could be on the unit anywhere from a day or two to several weeks. Nurses on medical/surgical units typically provide ongoing postoperative care for a group of five or more patients to promote recovery, prevent complications, and plan for discharge from the hospital. You will probably need more specialized training and skills to work in the PACU such as ACLS and critical care experience.