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SWtooth -- that was my original thinking. how can we reduce the workload of student nurses without sacrificing the quality of RNs produced?? (BTW, i'm all in favor of getting rid of nursing diagnosis -- they were invented for a healthcare system that hasn't existed for 20 years -- but that's another thread.) i don't have the answers -- but i do think that something radical needs to be done. given the amount of work, responsibility, and lack of cache as compared to other degreed individuals / professionals, well -- focus groups need to be formed. Ilg -- well-stated. but reflects the traditional view of academia. nursing is so unlike other jobs / professions. i just think we need to re-think the whole thing -- like having summer internships that count toward the degree -- and leave nothing off the table.

a nurse attorney stated during a presentation that Associate Degree Nurses should be awarded a Bachelor's degree b/c of all the work involved in becoming an RN. This was a EUREKA!!! moment for me. have often thought of how much work it was to become an RN. all the assessments, writing, and care plans, etc. -- EVERY WEEK! and one to two full days each week in clinical. i myself started out in an ADN program -- and it was a lot of work!!! and what other professionals work THIS hard and then look forward to working weekends, holidays, summers, and rotating shifts. and when was the last time you heard that a chemical engineer, teacher or a lawyer was sued for malpractice? so . . . why can't the 2 year student be awarded a Bachelor's degree? (and by the way, who really completes a "2 year program" in 2 years?) i've done some research into course requirements (and "clinical") for chemical engineers, teachers and lawyers. the total number of hours required are less than those required for nurses. a close relative graduated law school a year ago. law school is 3 years beyond a bachelor's. the first 2 years are intense. the 3rd year is considered a "waste" by many. Some law schools are toying with the idea of doing away with that 3rd year. others are offering a doctorate degree (J.D) at the completion of the 3 years. my point really is -- why shouldn't the degree be COMMENSURATE with the amount of WORK (again consider all the time, written assignments, care plans, clinicals, etc.) that it takes to beome an RN?? a 4 year program could award a Master's or a doctorate. WHY, given the amount of work involved in becoming an RN, should we restrict ourselves to the traditional notion of 2 years equals an ADN, and 4 years equals a BSN???

ACCESS to health care is unethical. i believe the USA is the only industrialized nation without universal access to health care. many of us have children who are 23 y.o. and kicked off the insuramce role. they/we must forage for affordable health insurance coverage and self-pay. if they are without insurance and need an expensive diagnostic test such as an mri, it's cash up front -- or no mri. and the average ER visit is about a thousand dollars. at the other end of the spectrum -- look how many 70 and 80 year olds (and older)are on cholesterol-lowering drugs. WHY??? given the cost (which is being transferred to taxpayers now) and the age, haven't these drugs ALREADY done what was intended? they lower cholesterol in order to prevent a cardiovascular event. their effectiveness is measured in DECADES. so, one who starts on these drugs will see the actual intended effect about 10 years down the road. i don't get it.

Bottom line clinicals are what YOU make of them. You have to be willing to soak up everything you can. i agree. i graduated from an ADN program (during a time when all of my instructors had come out of a Diploma program) -- so it was pretty much a 'diploma program culture'. Went on to an EXCELLENT BSN program (where i had to take all but the fundamentals course) -- and then went on for MSN -- and now Teach in a Diploma program. i am biased toward Diploma programs though. i think there are several advantages to them. their relationship with the hospital means fewer constraints in med admin and participating / performing various procedures. the hospital has a vested interest in producing graduates who can function with relative independence in a reasonable period of time. also, lots of clinical hours = lots of hands on experiences. i always say 'i can read a book on how to swim -- but that doesn't mean i can swim'. also, i can know the recipe, but that doesn't make me a cook. how does anyone get good / or better at anything? practice. practice. practice. but, no matter which program a person attends, it comes down to what YOU make it.

Titration. Titration. Titration. Titrate O2 delivery with SpO2. Giving what is needed while not exceeding the patient's baseline or usual spO2. so, yes we can give higher concentations of oxygen. and remember that early signs of hypoxia are restlessness and anxiety. think about it: how would you feel if you couldn't breathe?

i woke up during surgery. was intubated. unable to move (probably pavulon), eyes open just a slit and covered with ointment -- so everything was blurry but i was aware of light. could hear every word of their conversation. tried to take a breath and couldn't. tried to move fingers and hand but couldn't. being an RN, i figured out what was happening -- but i'm not sure i would want to be a lay person experiencing that!

i compared the information on a few drugs commonly used (such as lasix) drugs in the med-surg setting in 2 popular drug guides. am somehwhat of a pharm nut -- love it -- so i could honestly say -- at least on these drugs -- that i know more about them than is in the drug guide. i found that there were some differences in the information given. of course, also differences in the organization and pressntation of that info. from there, i chose a drug guide for guick reference -- but always prefer researching them in a couple of good pharm texts. btw, i did find that one was better than the other -- i landed on the davis drug guide! so, i guess it just goes to show you -- it depends upon inidividual preference and what you're looking for.

what happened here is truly tragic -- but given the complex, understaffed and over worked conditions in most hospitals, well -- it, or something like it, could happen to many of us. the nurse's name is "Julie". there is a link at this web site to email support to this nurse. Please join me in letting Julie know that we are with her. ALL nursing organizations need to address this -- and muster as much support from other professional organizations to STOP THIS MADNESS of pressing criminal charges against a nurse who made an honest mistake. by the way, where is the ANA?????????????? Since When Is It A Crime To Be Human? ismp.org says it so well: "The belief that a medication error could lead to felony charges, steep fines, and a jail sentence can also have a chilling effect on the recruitment and retention of healthcare providers--particularly nurses, who are already in short supply." Please use this link to give support to that RN.

i read a thread not that long ago that dealt with this topic. there was a link to a legitimate organization's website that had recommendations regarding cleaning solutions -- walls, floor, etc. used in hospitals -- and that they should not be noxious to health care workers. unfortunately i did not book mark the site; and have done an exhaustive search here at ALLNURSES and cannot find the thread. please, help! :redlight: had an incident in clinical yesterday in which the floor stripper / wax being used by housekeeping triggered an asthma response and burning eyes and throat. others on the floor also developed symptoms, including nausea! :angryfire we called our employee health nurse who eventually had to come to the unit b/c of all the calls and complaints. this has been an ongoing issue with the director of our housekeeping ("environmental services") department. he is contracted out by the hospital and is not responsive to any requests / complaints / issues taken to him by nursing. anyway, if you could help me find that thread or web site -- i would be most grateful!!! :redlight: i cannot imagine being a patient with no where to go and having to put up with those smells! :angryfire thank you!

i wish you well and much success. take a break. and maybe...part time nursing outside the hospital will be in your future?? also, consider auditing / working for insurance companies. or look into state or federal jobs. the retirement benefits are usually worth it. it's tough every where, but especially in hospitals.

the general rule of thumb is: if the patient has an inch to pinch, then pinch' otherwise, don't.

thank you both for your input. scribblerrn, i will share your school's method with the rest of faculty at our curriculum workshop. all of our graded papers have scoring guidelines with points assigned to each section of the paper. the guidelines are distributed to the students who are then suppose to attach them to their finished paper. of course, some faculty do write comments on them more than others. i suppose like both your schools we do need to come to some consensus among faculty thru-out the program. again, thank you both. (it helps to know that other faculty have wrestled with a similar issue). :)

as is the case in any nursing program, several instructors are involved in the grading of written assignments both within a single course -- and throughout the program. some students feel that it is unfair to them when they have a "tough" grader vs. other students whom they perceive as having an "easy" grader. Have any of you (Nurse Educators) had a similar situation? and if so, did the entire faculty address this "concern"? and if so, how? what, if anything, did you or your faculty do? personally, i know that my colleagues are conscientious and excellent nurse educators with many years of experience. i do not question their integrity in grading; i also personally feel that such "concerns" of this type are more often raised by under-achievers and the immature -- and our time and energy should not be spent on this. what do you think? also, should such a "concern" even be addressed by faculty? thank you. i would really appreciate any input you may have.

the answer is "D. all of the above". i get that question at least once every semester -- and my response is "I don't teach to a test. I teach you to be Nurses." :)

to avoid contamination of a sterile field from a sneeze, i sneeze toward the floor. perhaps we need to implement a new policy re: gas passing. interesting . . . i can just see physicians and nurses dropping to the floor . . .

don't like www.cybernurse.com definition of nursing. it perpetuates the layman's understanding of nursing, makes us subserviant, and makes us "invisible" in the healthcare system. just needed to get that off my chest.

thank you. i needed that. (bad morning) emailed it to a colleague

if the H&H are both falling, indicative of bleeding -- therefore, just testing a common site of bleeding among ortho patients

this link may be helpful. http://www.ins1.org/publications/index.html

i am so-o-o sorry. you are in my prayers. of those thousands of med errors around the country that you mentioned, the SYSTEM has been found to be at fault. please don't shoulder all the blame. anyone of us could do the same. we should seldom make major life decisions bsed upon a single event. you cannot count the many, many good things that you did over the past 15 years! all the patients you have rescued from the brink, all the families you have consoled and supported, etc. the list is endless. i hope and pray that you will connect with other nurses who have had a similar experience. God be with you

Gossip. agree with logan. it has a negative connotation. i avoid, ignore, and remove myself from negative talk about others. and like corvette says, never repeat it.

there will always be issues with other faculty b/c our students get jobs -- their's do not necessarily. re: salary differences -- there are differences in hours worked -- and in risk and liability. what is the history (or english, sociology, etc.) professors risks and liabilities?

nurses wanted id bands at our facility -- but docs vetoed. docs felt that patient would receive less care.

first, it is recommended that im's not be given in the dorsogluteal. as far as, when do we "know" we hit muscle -- we don't! we use landmarks, techniques, tools, and feel to identify the location of specific muscle tissue. we aim -- and hopefully the depth of the needle makes it to the muscle -- but research has revealed that many of our intended im injections end up in sq tissue! need to use appropriate length needle to penetrate the fat pad (the depth of the sq tissue) -- and most needles (1 1/2 inch) are not long enough to penetrate sq on many of our obese patients.

the DORSOGLUTEAL site has fallen out of favor. the more recent fundamental nursing textbooks are recommending that the dorsogluteal site not be used because of the inherent physiological risks associated with its use (the significant variation in fat pad, thinness of the muscle, proximity of the sciatic nerve and large vessels). this recommendation first appeared in the nursing literature in 1995. an internet search of "ventrogluteal" will yield this information r/t the dorsogluteal site. we are no longer teaching the dorsogluteal site in our nursing program -- and the local hospital has changed it's policy to delete this as an injection site.