CSNS

I am a new grad on a onc/med surg unit. I just started orienting two days ago and I am already sinking. I am not sure if it is the preceptor or just the beast that nursing is. My preceptor intimidates me. She is good at what she does but I feel like I am bothering her. An example, she will be charting, once done (which BTW she hasn't explained a thing about what she was doing) she just stands up and goes to the patient's room to go do something. Or go to the med cart and pull meds and go hang them, or goes and chart...and I am following like a puppy. She doesn't just say "hey come with me I am going to do this" or "let's go do this. I know I should approach her but I am not sure what to say, I don't want her to get mad and make it worst. Or maybe I am the one wrong, but I am scared that after my 6 wks orientation like that I will be lost taking care of 5 patients! HELP! My anxiety is going awire so much that I think about it constently spoiling my time off. Also, has someone developed a check list of different tasks to do during the day? Or could you tell me what your organization is? Thank you so so much.

Thank you very much. I really appreciate all of your help!

Well, I did not do an assessment yet because we haven't had clinicals yet. Our teacher asked us to find nursing diagnoses and interventions to work on prior to clinicals. I did read the doctor's notes. I meant 1-2 characteristics per diagnoses. I forgot to mention he came in (and still has) hyperkalemia because he missed his dialysis. His BMI is WNL, he has no dysrthymias, BP under control thanks to meds, he also has some weakness in L leg (neuropathy) but is not diabetic. I came up with a few more diagnoses, hopefully that will be enough and I can get more data when I actually see the patient.

Ok, I am trying to come up with NDs but the only ones that I have found are those, which are mostly risk for and not actual: Run down: The patient is 42, Male, has end stage renal failure on dyalisis, cortisol and ACTH deficiency because of total protidectomy a few months ago, hypothyroidism, chronic constipation, htx of pancreatitis, chronic N&V, chronic constipation, and htx of hypocalcemia. NDs: -Risk for fluid volume excess R/T compromised regulatory mechanism secondary to renal failure. (No edema, no ascites, 5 10 and 160 lbs) -Ineffective health maintenance R/T spiritual distress secondary to illness (came to hosp. with K of 5.5 b/c missed dyalisis. -Risk for decreased cardiac output R/T altered contractility secondary to hyperkalemia and hypocalcemia. -Ineffective copin R/T chronic illness. I don't know why but I feel I am missing something and also, my defining characteristics are like 1 or 2. Any ideas? Thanks a bunch!

Ok I am getting confused. My teacher explained to us how to treat Aflutter/Afib. but she juggled "stable" and "unstable" with "contolled" and "uncontrolled" so now I do not know what is what. Here is what I got out of it, please let me know if it is right: -If a patient has a controlled rate -If a patient has an uncontrollable rate >100pbm and is stable, then you control the rate (cardizem...), if they have been in the rhythm 48 hours, you send them home on anticoagulants for at least 3 weeks and they will come back for an outpatient cardioversion (?) Ok here is where I am not sure what to do? -When a patient is unstable (hemodynamically compromised) you immediately cardiovert (?) regardless of how long they have been in the rhythm? and whether or not their rate is controlled? OR -When a patient is unstable + uncontrolled rate + >48 hours ???? -When a patient is unstable + uncontrolled rate + immediate cardioversion???? -When a patient is unstable with a controlled rate (is that even possible)? .....I am lost on those ones! Please help...thank you!

Thank you so much for your answer. Now I have to figure out dates that will fall within those 90 days.

Hi everyone, I am trying to plan a trip back home for this summer (haven't been in 4 years.) and I am worried about the NCLEX date. At my school it seems people receive a letter telling them when they are scheduled to take it (it seems no one has any say so in it), roughly 2 month after graduation. I am worried that the date will fall when I am out of the country. If that, happens is it possible to reschedule? Thanks y'all!

I work at ochsner as a PCT and love it!! I will graduate in may and will plan to work there. My unit is awesome and I think it will be an easier transition for me to work there right out of school. Goodluck everyone!

Everyone at school talk about different hospitals and no one wants to go to Ochsner because they say the salary and benefits suck compared to other hospital around the NO area. I have heard they pay $19 (as a new grad) and if their health benefits are the same as for a PCT, they are not that good. So far, Touro seems to be paying the most $23 and have a loan repaiement plan as well as ok health benefits. I think University downtown is the best as far as retirement (it is a state hospital after all) and a little bit more expensive health care...anyways I hope this help! Let me know if I can help in any other ways and good luck

NO he did not... ...put eye drops on a glass eye. (Yep he did and the patient exclaimed..."euh...scuse-me but I am blind on this side")

I am wondering: What makes Charity nursing school so special? Now that the hospital is no longer there, has the value of Charity's education dropped? Is it still an honor to be a Charity grad? What about LSU, Holly Cross and other schools...any ideas anyone?

Be organized, that is the key. Don't read the book in Basics, it is useless and as far as pharm, just learn the big categories of meds and their action. You will do fine believe me.

I do not personally work there but I am currently in my second rotation there. They are high-tech, computers and all which makes things easier, particularly looking drugs up and stuff. The Pediatrics floor I am currently on is great, the nurses are very nice and helpful. Some nurses I talked to said that they work there because they like the unit but that unfortunately, the benefits might not be as good as some other hospitals. I don't know whether it is true or not, just passing it along. On average, each nurse had 4-5 patients. Not sure if this helps. Let me know if you have a specific question I might be able to answer to.

What is an acceptable pediatric KVO rate? Does is differ according to the age? Thank you everyone!!

Hi I started my third semester of my ADN program. 3 weeks of OB, 3 weeks of Peds and 8 weeks of Mental Health. I have been suffering from anxiety every since I started nursing school. I can't sleep or eat before I go to clinicals, I am a nervous wreck. I feel that I did not get a chance to have as much experience as other people (with IVs in particular) who got to work as nurse tech over the summer. I have never been around kids / babies...I am so worried. I feel sick and tired of this anxiety but nothing seems to help. Everyone at school looks at me like "oh you're always nervous pfff" I feel so inadequate. They seem to be doing great and are eating and sleeping unlike me. I know I need to give it time but so far it has not improved one bit but rather got worse