blackdog

Hello, I am about to start my third semester towards my ADN and while reviewing some videos and procedures I realized that I forgot a step/detail in the urinary catheterization process. I only did one catheterization last year so I can't recall for sure what the answer is. When placing the sterile drape under the client's legs/buttocks does the shiny side go down or up? I know, its a stupid question and one not likely to be a big deal at all if I do it either way, but I hate it when I can't recall details like this. Thanks. -Blackdog

Thanks for all of your replies. My support network is pretty good, however since my best friend quit to attend a different program it's got a bit of a hole in it. This site is great for "support" and learning as well- the kind of learning you don't get until clinicals or the real working world of nursing. This time I have learned I'm not alone, and that my initial and later thoughts of the situation were pretty much right on track. -Blackdog

PickMePlze, I said that exact same thing to my 2 instructors as they took me to task. My main instructor had a look on her face like I said "I will destroy you" or something postal like that. I'm 36 years old for crying out loud with a good family life and no criminal record. I could maybe see her reacting that way if I was 18 and had a juvenile criminal record with a cocky attitude but that isn't me. So I'm learning what I can from this and moving forward. -Blackdog

Bala Shark, That definitely is a bunch of bull. It's as though we are not worthy of decent and fair consideration in these matters. As a student it makes me wonder if it'll even be worth it to be a nurse. I'm still optimistic for now though. How certain patients can be like this after our treating, and caring for them with courtesy and respect is beyond me. It's like I told my nursing instructors after they acted as though I hit the patient -"as Ricky Nelson said, "you can't please everyone"". Of course they did not like it when I said this to them. I'm a 36 year old father of 3 with a good marriage and good kids for crying out loud and they act as though I was some careless 17 year old laughing off the situation. But if things do not improve for you or I we need to remember that this road goes both ways. Our tuition helps pay their salaries and we always have the choice to take our money elsewhere for our nursing education- even though it may make things harder for us in the short term. -blackdog

Thank you, Daytonite, Lizz, and rehab nurse. Your experiences and ideas on why this thing happened to me sound right on target... Unusually stressed out client, can't pinpoint my name, oriented x3 but a shaky 3 at that- could only get the date right to within a couple of weeks, asked me at least twice why he was there. I'm not going to take it to heart. My skin has been thick at past jobs, and even though I did not think that I'd get "stabbed in the back" so to speak as a nurse, now I know better and will have thicker skin for it. -Blackdog

allthingsbright,Coopergrrl, Thank you for your insights. Coopergrrl, I basically did what you suggested would be good to do, i.e. ask for details, and allthingsbright my instructors did inform me as to how to improve which I thanked them for. The thing which disturbed me most about this was how to me it seemed that my instructors looked on this as a cardinal sin even to the point of them asking me if nursing is right for me. I will continue to do my best, the worst part however is the seeds of doubt that are in me now. I'm a 36 year old father of 3 and going back to school, (living off of my 401K and wife's income) so this is very expensive and time consuming for me. I'd hate to have done it and then have it be the wrong field for me.

It came to my attention today that while on clinicals last week, a patient I was taking care of was unhappy with me to say the least. The funny thing is, I was very, very considerate to the guy, and communicated to him the what and the why concerning my full assessment of him. He was an older man, and never once did he express- he was very capable of communicating, oriented x3 (not 4) and all of that- that he was getting tired of my assessment (he was dyspneic). And because I am a student, I even stood there and let him talk and expound on his family and everything without cutting him off even though I probably should have politely eased out of there at that time. If I had done my assessment the "proper" way that nurses should do assessments I would have been out of there in less than half the time that I was. Enter today, one week later. Two of my nursing instructors, one of whom is my advisor, take me aside and talk to me and basically tell me that this guy was quite unhappy with me. I don't know exactly what was told to them by the hospital staff, but they acted as though I had told the guy to go get f*#&^d or had twisted his arm behind his back! I know I am in clinical under their license, but it all seemed unreal to me. They even asked whether or not nursing was right for me. So here's my question: 1. How common is this type of thing? 2. I am a male student nurse. Could that have anything to do with it? Is there much of a bias against male nurses out there both in the world and even among nursing instructors? I've just gotta ask. What happened seemed totally unreal to me. -Blackdog

Thanks for all of the replies. They have all been significantly more helpful than what I was told by my instructors which was basically "you'll have to develop your own system". I feel much better now.

Hello. I am an LPN student just starting hospital (med-surg) clinicals after completing nursing home clinicals. In the nursing home we only needed to do 1 complete head to toe assessment of all the body systems on 1 client. Now in the hospital we need to do one per day and I am at a bit of a loss. It's probably a stupid question, but here goes: When doing a head to toe assessment on all of the different body systems do I try to assess all of the body systems as I work my way down so that I only work from head to toe once? Or do I basically do a head to toe for each body system (as required for that body system)? I am trying to assimilate all of the body system assessments into one large head to toe assessment and also do the least invasive (palpation) techniques last and basically I am just getting mixed up. The 2 patients I have had so far have been patient with me but I can't keep doing it in this mixed up way. Thanks in advance. -Blackdog

I just started med-surg clinicals and am having trouble with head to toe physical assessments. The problem is that I am not quite sure of the best way to do a head to toe full physical assessment while: 1. covering all of the body systems as I work my way down 2. going from inspection to palpation. 3. assessing the painful areas last. 4. trying to do all of the body systems thorougly (each with its own assessments). How do I do all of this at once? Working off of my cheat sheet which is separated by body systems is taking me a long time. Is this normal? Before med-surg clinicals we only had to do one full head to toe on one client only. Now I need to do a new one each day on a new client. So is it best to go head to toe on each separate body system? I really have been putting my clients through a workout while taking this long time. Any helpful advice would be appreciated. Thank you. Feeling overwhelmed, -Blackdog

I would like to find out how important NLN accreditation is. The director of the nursing program at the technical college near me (let's call it "college A") tells me with grim foreboding in her voice that the program which I have chosen to attend (not hers) is not NLN accredited and this can make it harder on me when looking for employment when I graduate (knock on wood). The director of the program which I am attending at a local community college (let's call this one "college B") tells me that it is no big deal that her program is not accredited and that the only reason why they are not accredited is because they are a small community college and it is too costly. None of this bothered me until I found out with reasonable assurance that the cost of my community college to be NLN accredited would be about $1100- mere chump change compared to the price of textbooks and tuition for one student yet alone a whole community college with an enrollment of about 1000. Who am I to believe? Which program director painted the more accurate, truthful picture? Where I live and the locations of these two colleges as well is rural so the best answer may be affected by this. Are they both just looking at me with dollar signs in their eyes? Any advice or comments would be appreciated. I just don't want to have a handicap while seeking employment. I am presently starting my second semester at the non-NLN accredited school but if I have to start over again next year from square one at the NLN accredited school in order to have better long term employment propects and income, I will. -Blackdog

Tony, listen to teeituptom. His response would get you the best results. I was beginning to wonder how many replies it would take before you got one that actually had some teeth in it. Oh yeah, and document, document, document for your own records of this going on. I personally have witnessed a federal trial go down where it was merely one person's word against a whole facility's. The person who won- and they won big (like a million dollars big)- kept a diary of all of the bad crap going on and it paid off literally. The facility which lost ate crow. Not a darn one of their policies mattered. The winner had a law firm with guts representing them too. That always helps. -blackdog