Both nursing boards and hospitals can legally ask about pertinent mental health histories, you can quibble over the exact wording of how it asked and how you have to answer, but generally for those in "safety sensitive" rolls such as nurses (and nursing students), mental health history is legally considered a pertinent to the role of a nurse.
Since nursing programs have to abide by the requirements of the facilities where students will be doing clinical rotations, usually the same requirements as an employed nurse at the facility, this may require things like drug testing (which can legally include prescribed medications) and mental and physical health screenings.
There is certainly the chance that such information will be used to discriminate against a student, although this can be legally challenged, but lying about it or failing to disclose this type of information is reportable to the BON which can prevent you from ever getting a license at all.
You probably came off as standoffish and confused about the directions because you were standoffish and confused about the directions. On the upside, it doesn't really sound like your instructor came down particularly hard on you.
1) Be less standoff-ish. If you instructor spends some time talking with other clinicians or instructors rather than passing meds with you on a day you're not scheduled to pass meds, don't begrudge her. She knows what she's paid to do much better than you do. It's likely enough that your attitude shows through. Do your best to adjust it.
2) Apologize sincerely for any confusion, and ask sincerely if there's anything you can do to perform better. A brain fart is just a mistake, like any other mistake. Do what you need to do not to make mistakes. Go to sleep earlier, drink more or less coffee, ask for advice. Brain farts happen to everyone, but that doesn't excuse them.
3) If you're still confused about your duties and responsibilities, ask away.
Stop talking about "brain farts" and stop blaming things on them.
I would've filed formal discipline against you for blatantly ignoring my instructions in favor of your own reasoning, which you used even though your whole post is about your brain farts and the things you have misunderstood or "not heard" so far in clinical.
Lets get a few things straight:
You do not "help" a licensed nurse pass meds because she is getting behind.
You do not pass meds if your instructor clearly tells you that she doesn't have time to supervise you. You knew you were not on the schedule to pass meds that day, and you also knew that you needed your instructor's supervision to do so. You knew that you needed to ask permission. You received all the answers you needed and you did exactly what you wanted to do anyway. If I were instructing your group I would refuse to instruct you further and insist that you be out of my group. That's the same with any orientee/preceptee I ever work with. If they will not follow my instructions I will not have them for a student or orientee. Period.
IF (and I mean one huge ginormous "if") you have something to be disgruntled about with regard to this, then you handle it properly in the manner that a hopeful professional would. You do not go around and do what you want as a nursing student based on your own rationales.
I know I am being very blunt, but your time in school will be exceedingly short if you keep this up. You are very lucky you aren't done and out already based on your medication stunt.
If it were me, I would pass on wearing it to class. While it might not "get you in trouble," it is likely that someone is going to find it offensive.
You should also consider this. If you have to ask is "something is okay" or question whether doing something is "going to get you in trouble" you should probably pass.
Best wishes with your education.
If these pills were so expensive, like $1000/pill that they had to be kept locked up with the narcs and counted like narcs why didn't the pharmacy bubble pack them? If you have to dump the pills out to count there is a risk of possibly losing pills? And there is no way that I'd ever try to retrieve anything from the sharps container let alone pills to give to a patient.
If you are replacing the NG output, this is 500 mL. The order to replace the output with 20KCL in 1L of R/ L isn't telling you to use the entire liter, this is how the fluid is supplied.
When working this type of word problem you are usually provided much more information that you need. The first step is to determine what you are being asked to solve, and to extract only the data that you need.
Read the problem, and then decide what exactly you are being asked. In this problem you have to identify three variables,
First, you need to determine a replacement volume for the patient's gastric losses. In practice, you would measure this at the end of the shift, but here you were provided this infotmation: 500 mL.
Second, you are to administer the 500 mL over 11.25 hours. With the information provided calculate the infusion rate in mL/hour. Solving this first will make it much easier to calculate the drip rate.
Last, to calculate the drip rate you need the hourly infusion rate, which you just calculated, and the drop factor. You have gtt/min 10, shouldn't this be 10 gtt/mL?
In the kindness manner possible, reading your post, I would hesitate to respond because there are some grammar problems.
If you are a new company, you may not be able hire marketing services but you can find people to proof and read your advertisement.
To attract professionals, it needs to be highly professional.
Med/Surg is a stepping stone to critical care specialties, floor nursing in those specialties is a stepping stone to critical care specialties, but I have never seen ED as a stepping stone to critical care. But then, I've worked in critical care since 1983, and have been precepting since 1985, and I've only had one orientee that was previously an ED nurse. And he was getting critical care experience so he could transition to flight nursing.
offlabel, the ones who need this ^ information are the instructors who seem to believe that one should not make the mistake of saying the sky is blue unless a nurse has published a research article saying so in the last 5 years.
So...As you become more experienced you'll find that, for the vast majority of our practices, no one has ever decided to establish a scientific basis for doing or not doing something. We get the impression that this is not so with the tsunami of papers that are published, but a stark minority have any validity or meaning.
The vast majority of what we do is based on reason, need and many years of experience.
You might call that "opinion."
Need proof? Ask someone more experienced than you to give an example of a practice that fell out of favor for seemingly good reasons that then, over time, came back into use when the utility was "re-discovered".
You'll never find what your looking for in a published paper on this topic. But search away....
You are going to have to give up something...give up the military, give up becoming a nurse practitioner, because you sure as heck can't give up being a wife and mother. That trumps everything else.
Remember, as cold as it sounds, just because someone has children doesn't mean their weekends are more important than those that DON'T have kids. I felt that way when I was single, and I feel that way being married with two children.
If you want to work as a nurse, you are going to have to pull your share of weekends. It is a CHOICE for you to do the military along with nursing. While the law requires they allow you to have off for active duty, it doesn't mean your employer has to give you a free pass otherwise.
I would take a break from the military, get your NP, then go back in if that is what you desire. But you can't do all of it.
I think the dose may not have been a big deal, but the rationale was less than sound.
Using that rationale, you could have also given some ativan for vertigo and some valium for a muscle spasm along with both doses of xanax if they were ordered PRN.
Then after they stopped breathing, you could have given some romazicon, but given the likely benzo dependence,they would seize with no effective med available.
It sounds to me as though you're working in a teaching hospital. Ever watched the cardiac surgery team round? This sounds like the way they teach their medical students and residents. I'm not seeing micro aggression here. It stands to reason that the providers would teach you this way -- it's what they know. They may not be able to teach any other way.
Newer preceptors who haven't yet developed a good teaching style may default to the teaching style they see demonstrated around them. I'm not saying it's right or desirable. It may even be an ego thing -- especially among those who are relatively new to nursing or who are inclined toward more direct communication styles. I wasn't there to witness any of this, but perhaps you are being a bit oversensitive.
With the providers, the best thing to do is have all of your ducks in a row before you call them, or before they show up. Be ready to answer the questions they are most likely to ask. When placed on the spot, take a few seconds to think through how you want to answer the question. This sort of quizzing usually tapers off as the providers get to know you and trust your judgement.
With preceptors, if you know them well you might choose to invite them to coffee and have the conversation with them. Most preceptors want to do well as preceptors and want you to do well. They don't want to scare you away from the unit. Newer preceptors may not realize how they come across.
Most large, top rated teaching hospitals have an enormous turnover and CT surgery especially is a feeder unit for anesthesia school. There may be relatively inexperienced nurses drafter to precept, and they may or may not be good nurses or good preceptors.
I had 27 years of experience when I started my last job, and the preceptor they assigned me had less than two years. She used to brusquely order me to do something (hang KCl, draw a lab, whatever) and then immediately open the chart and chastise me when I hadn't done it yet. I was at my wits end, in tears as I drove home at the end of each shift, ready to quit. Then one day a patient needed nitrates for chest pain. The order called for a "Tridil drip" and I approached the ICU pharmacist for the stat order. He printed out a stat label and handed me a premixed Tridil drip, slapping the label over the manufacturer's label. I hung the drip, titrated it and was calmly charting the patient's response when the preceptor and my manager approached me.
"Sally says you hung the wrong drug," my manager told me.
The pharmacist had labeled the Tridil drip correctly as "nitroglycerin", and I had charted a "nitroglycerin drip." The preceptor didn't realize that nitroglycerin is the generic for Tridil. She kept insisting that I had made a major drug error, was incompetent and needed to be fired. The pharmacist got involved. The preceptor had written an incident report, and the pharmacist wrote one as well.
The preceptor transferred to an out-patient position closer to her home. The pharmacist and I worked together for many years.
I guess the point of this story is to bide your time until you're off orientation . . . things do get better.
In order to get appropriate venous return to the heart, it requires the use of the muscle pump action in the arm. If one is flaccid, that is impaired. Thrombosis and venous stagnation are two concerns. So, no, this is not an arm you want to place an IV catheter into.
I can understand your dilemma. Best advice I can give is make sure you are talking to an AMEDD recruiter and not an enlisted recruiter. They are different. Some key things you said are throwing big red flags. 1. Nurses commission and do not enlist. 2. They do not take the ASVAB 3. it takes months to get selected for the Nurse Corps. From what I am reading, your recruiter is pushing you to take an enlistment for probably something medical but it will not be nursing. To give you some back ground on myself, I was just selected for the Navy Reserves with an ED specialty (took me about a year but I had medical issues to work through that delayed me 6 months). I am 38 with no prior service. I believe the Army reserves allows entery til 41, Navy is 47, Air Force is 47 (I think) to include the Air National Guard. My advice would be to contact an officer recruiter for each branch you are interested in and ask some questions before you swear into something that isn't what you are looking for.
My experience has been that most of the "peds" units in my area were just a few designated beds on an adult gen-med floor. Really not the best set-up and frankly the peds patients scared the crap out of the nurses. We have 5 tertiary pediatric centers in my state. Kids aren't little adults. I see no need for adult hospitals to treat them IF there are peds facilities within a reasonable distance. I have too many horror stories to think otherwise. YMMV.