Cosper123

The important thing is we have each other. lol.

Yeah you can and I would. I chose to wait until after my boards as I didn't want to get a job and then not be eligble for it. That was a huge mistake as many got a jump on me and by time I was ready to apply I was behind the curve.

Was there a way to validate that the pain medication was given? Who ultimately was responsible for this patient? I'd chart it as you did with just sticking to the facts and not adding anything additional to the info. For example I wouldn't put "screamed in pain like I've never heard before." I'd put it as "patient expressed pain" and then put anything they may have said verbally if it is pertinent. I'd have asked the patient to rate the pain and inquire if there was pain AFTER that needed to be addressed still. But yeah basically how it happened short and sweet. Name the nurse that removed it since it wasn't you like such - I cut suture. Janice RN removed drain. The only hangup I really see is that the other staff verbalized that pain medication was given. I wouldn't put that they merely stated it, I would make sure it was actually done before charting as such. But I'm new, and look forward to the input of those more experienced.

Actually no way in any form was I ever an accomplice. I reported it verbally to a supervisor and that is the extent of my responsibility per the BRN. More is expected of the Charge Nurse as I understand it. Because it wasn't my job. Between three tele patients, two FTT, three dementia and one detox (6 pt total, not nine separate conditions fyi) I was busy enough with my load. A more senior Nurse was answering his call lights. The complete and total extent of my responsibility was in telling the Charge Nurse who notifiyed the Nursing Supervisor who did nothing. I've got enough to worry about as a new graduate keeping my head above water and ensuring that my patient's are safe and well cared for. It is not my responsibility to keep track of what everyone else is doing. It was the Charge Nurses choice to wake him or not, and I don't hold myself accountable for what they did or didn't do. Yes very regular. And he's been very unpleasant about it all when woken up in the past. He's even filed harassment complaints in the past. He's a manipulative bully. This the rock and a hard place senario. On one hand he really deserves it...on the other hand the Manager is going about this is totally the wrong way. If not for the threat from NM....well I'll take the very wise advice given to me here and not talk to anyone about what my choice was or what else all is going on :heartbeat And yeah...next time someone is sleeping I'm at least going to take the time to throw something at them

She pulled me into her office and said that someone else had told her that I and a few others witnessed this occure, and asked what I saw. Did not realise at the time I'd be pulled into this nonsense simply by doing the right thing. In any case yeah I'll simply contact the board and worst case senairo write the most benign-yet-honest letter I can come up with and wash my hands of it. One step closer to becoming jaded, grrr

Yeah good idea Castlegates. And good advice all around, thanks everyone.

Reason I am uncomfortable writing it is that this person has been here awhile and has friends up the chain. He's already gone after another person after learning they had reported him for a similar incident. This is a bunch of immature nonsense and I really just want to do my job. Not looking to backpedal, I would admit what I saw to anyone that asked....but putting something to paper is entirely different. Which is why the question was is this an incident that could get me reported or have I already done what I am legally required to by telling the NM what I honestly saw?

There's a fellow RN on the job who is suspected of sleeping on the job. NM calls me into the office the other day and says that my name was given as a witness to this incident. I told her yes that it appeared as though he was sleeping. She states that she would like me to write up a report on it. On one hand fine...the guy's eyes were red and puffy and he was sitting there for two hours with his eyes closed. I do believe he does deserve to get fired but she's gang-ho about reporting him to the board. Then she tells me if I don't write him up then she's going to report me too, and that the BRN would take away my liscence for it. Her reasoning was if I didn't I would be an accomplise(sp?) and that it is the same as if I saw him stealing drugs. I am not the guys supervisor, so feel as though by reporting to her what I saw was my only responsibility. I am a new graduate with limited experience and this creates various problems with me...having a family to support and various other issues. Quite frankly I don't feel comfortable writing this report, and feel insulted by her threat to report me. Would the California BRN see it as a reason to take away my liscence, or was reporting what I saw to her enough?

Yeah it's tough, took me an entire year to nab a job. Granted I messed around for awhile, we moved...and for a good amount of time my job searching was half-hearted. Once I got serious it still took six months until I finally lined one up. Firstly you have to be willing to move/travel. I'm currently 3.5 hours from home (in good weather) and it's harsh but I'm working and getting experience. Coming from the Bay Area and working here in Reno it's rough, we have a new baby and all. But it is what it is and it is only a matter of time until I have enough experience and I'm closer to home. Anyhow, the average cost to train a new grad is anywhere from 80k to 120k...depending on the department. As an orientee you're not counted in the staffing, and require the coverage of a preceptor even once you are taking the full load. Some places actually do pay a preceptor more as well, it's usually like a buck an hour (not worth it imo for some departments...or orientees hehe). Add to that all the inservices/classes/training materials/etc. and the cost to train makes more sense. So yeah onto the useful information. Some things really stand out on a resume/Cover letter. Don't be afraid to use appropriate humor...my fav thing to put on a cover letter is that as a new graduate I have not yet had the opportunity to become jaded or develop bad habits. References from clinical instructors hold more weight. And pretty much any thing you can do to stand out is a big plus. Once I got my ACLS I noticed suddenly I was getting calls for interviews. Four serious months of searching with no interview whatsoever...and suddenly I had three. So do yourself a favor and pad that resume with pertinent certifications. Take a strips class, ACLS, PALS...whatever it takes. That really stands out and holds huge weight. Also do some time in a SNF if you have to. Heck I got so desparate I was even applying for CNA positions. Not sure how it works here in Nevada but legally in Cali an RN can work as a CNA...I looked it up Anyhow main thing is don't give up and just keep plugging along. Make sure each and every one of your cover letters is unique and tailored to the facilty and job you are applying for. Every little details matters as for me it was application 458 (not joking, over 100 applications to Sutter hospitals alone) that finally got me the interview for the job I have now. Oh and check out the Reno VA they have been hiring tons of new nurses as GNTs. St. Mary's is hiring a lot of new grads in spurts as well. Good luck folks and hang in there.

It is what it is....and that's all that there is.

Well they aren't basic infection control like what gear to wear in this situation. You're given, for example, a bunch of diseases and need to know how each on transmits. Other ones are you have a patient with this, who do you room them with, that sort of thing. If you used a Qbank or other such program that throws a bunch of NCLEX questions at you, you can expect them to be like the harder ones you have faced.

Yeah I just took it today and feel horrible about it simply because of how it started out. 9 select all that apply before hitting question 18...talk about a quick slap in the face. By the end of the test I had 17 out of 75 that were SATA. Seeing as how I do the absolute worst on these, I'm not too optimistic. Overall had three math questions, and yeah I got a bunch of medications that I had never heard of before and couldn't discern from the generic name. Was most worried because on a couple of "who would you see first", nobody really looked that be in THAT bad of shape...which then gets me concerned with what I'm missing. Overall I'd have to say it was a horrible experience, and I'm really worried that it cut off at 75, because if I do fail, that means I bombed hard. I would feel much better about it all if I had at least made it to 200 questions or so. Oh well, nothing I can do about it now. I'll just have to wait and see.

Ditch the fun for sleep. Hang in there, you have worked very hard to get to this point and you're almost there. One more giant education hoop to jump through, then you can move on to the hoops of hospital politics :)

"I don't think it is his obligation to help me out, but I feel he should." You need to switch your goal to politics

I too disagree with the "sad but understandable" view. When I walk into that room, I am a professional and expect to be treated as such. The only thing I found "sad but understandable" during my nursing school rotations were women giving birth who didn't want me in the room. But for routine care on anything else I can't think of anything as "sad but understandable". I see it as a stupid policy that makes me more useless and puts more work on the back of my female co-workers. I COULD understand teaming a male with a female to do the job...that would provide the chaperone and we'd move quicker as a team...not putting any undue stess on my female co-workers. But this as it stands is not understandable by any means. It's stupid, plain and simple. It's as stupid as press ganey, it's as stupid as handing out vouchers for free coffee to people in the ER who had to wait longer than 30 mins, and it's as stupid as any other customer service BS that doesn't recoginize that what a PATIENT needs and wants aren't always the same.

The run probably did ya some good, nothing like a good bit of excercise to get the brain motivated hehe. And kudos for thinking of the flowers for the holiday inn employee, ya might want to do it regardless of whether or not you pass Good luck!

Hopefully there's more current information than that, as the test was changed again in 2007. I'd be curious as to what the pass rate is now for first time takers, I'd imagine that it has dropped. I too have heard that it cutting off at 75 is a good sign a majority of the time. And if you do fail at 75, you have cause for concern. It is better to fall short around 265 than it is to fall short around 75.

is risk for violence a proper nursing diagnosis? don't have my book here so just going with what you have, but if you haven't looked it up yet you may want to. sounds like it should be something more like risk for trauma/risk of violence directed towards others. but again, not 100% certain. here some i used during my psych rotation. btw if you haven't created a collection of interventions and rationales you may want to start saving them in a word document or something. cut and paste can really be your friend. plus, when you get further along in the program you can look back and it's freaking amusing to see how dumb you were when you started also, if you are having a great deal of trouble in general with careplans there are many good careplan books out there. overall though you should be ok with a basic pocket sized nursing diagnosis book. interventions [color=#3366ff]rationale decrease environmental stimuli, avoiding exposure to areas or situations of predictable high stimulation and removing stimulation from area if client becomes agitated. [color=#3366ff]client may be unable to focus attention on only relevant stimuli and will be reacting/responding to all environmental stimuli. continually reevaluate client's ability to tolerate frustration and/or individual situations. [color=#3366ff]facilitates early intervention and assists client to manage situation independently if possible. provide safe environment, removing objects and rearranging room to prevent accidental/purposeful injury to self or others. [color=#3366ff]grandiose thinking (e.g., "i am superman") and hyperactive behavior can lead to destructive actions such as trying to run through the wall/into others. intervene when agitation begins to develop, with strategies such as being verbally direct, prompting more effective behavior, redirecting or removing from the provoking situation, voluntary "time out" in room or a quiet place, physical control (e.g., holding). [color=#3366ff]intervention at earliest sign of agitation can assist client in regaining control, preventing escalation to violence and allowing treatment in least restrictive manner. communicate rationale for staff action in a concrete manner. [color=#3366ff]agitated persons are unable to process complicated communication. ignore/minimize attention given to undesired behaviors (e.g., bizarre dress, use of profanity), while setting limits on destructive actions. [color=#3366ff]avoids giving reinforcement to these behaviors, while providing control for potentially dangerous activities. offer alternatives when available ("i don't have any coffee. would you like a glass of juice?") [color=#3366ff]uses client's distractibility to help decrease the frustration of being refused. encourage client, during calm moments, to recognize antecedents/precipitants to agitation. [color=#3366ff]promotes early recognition of developing problem, allowing client to plan for alternative responses and intervene in a timely fashion. assist client in identifying alternative behaviors that are acceptable to both client and staff. role-play if indicated. intervene as necessary to protect client when behavior is provocative or offensive. (refer to nursing diagnosis [nd]: impaired social interaction.) [color=#3366ff]client will be more apt to follow through on alternatives if they are mutually acceptable. practice in a nonagitated time helps client learn new behavior. client may become physically violent with others when behavior is socially unacceptable/rejected. provide reinforcement/positive feedback when client attempts to handle frustrating incidents without violence. [color=#3366ff]increases feeling of success and the likelihood of client repeating that behavior again.

Yes I agree a NCLEX book like Saumders that has summaries and such would do ya a world of good. I used the chapter reviews as a foundation as they do a great job of summarizing what you need to know, and it makes taking in your chapter reading and such so much easier. Also, In my experience...most of the questions we received throughout the nursing program were focused on medications, and care specific to nursing (not as heavily on the pathophys, UNLESS it could manifest in something you as a nurse should be able to pick up on). So pay special attention to any careplans that show up in your book, and take the end of chapter reveiws after you are reading so you know where you need to focus more attention. Actually go back at that point and brush up on the area.

i'm sorry but those mean nothing to me. are these theories around nursing and communication. what exactly is it you that you need here? were you given an outline with more details than this? these appear to be very broad criteria and without being given more details i could go in so very many different ways with this.

You're not being ignored, I am sure there are plenty here like myself who are confused by what exactly you need. Language barriers are tough to get through, and kudos on your English btw...it is better than many who use it as a primary language :) However, I don't understand what you are asking.

This part here really highlights what is wrong with you people making such a big deal out of this. Filling a cavity takes MUCH more time, special equipment, and other resources. The same goes for a catering a wedding for 300 (way to take things to an extreme, btw), and again for the architect "example". And the other guys accountant example too. When you have to take things to such extremes, do you really have a point? Of course not. If ya feel as though you'd have some liability then ok whatever, I can understand that. Yes this is akward but geez some of you people are really taking this way too far. And yeah, I agree with the person who said don't tell anyone you are a nurse. I can't help but point at laugh at the silly people with the nurse themed liscence plates and bumper stickers, talk about asking for trouble

I doubt the issue here is from college to college, but as I pointed out...professor to professor. Not sure how things are done in your area, but where I am from the basic curriculum is the same regardless of the school. I noticed a BIG difference in the difficulty between AnP 1 and AnP 2, and it was due to the professors. I had the unique experience of having three AnP instructors since one bailed on us in the middle of AnP 2. In that class alone I saw a HUGE jump in the difficulty, as the expecations of that professor was insane compared to the one who started the class. So a single class, with nothing whatsoever changed about it other than the instructor, became WAY harder. As for hard science, I never saw more "hard science" in Micro than the Physiology portion of AnP. I'm thinking at this point that you either had some really easy-going AnP professors or that you had a really difficult Micro professor. Beyond that, perhaps you just have more of an affinity for what is present in AnP, the stars aligned against you, or whatever In any case, you are seriously the only person that I have ever heard say they didn't enjoy Micro and only the second person that I have ever heard say that they found it more difficult. And even if this thread were to bring many more with your opinion, the vast majority that I have heard would still be opposed to it. In any case, sorry you didn't like Micro. With all of the experiements and stuff it's very interesting and loads of fun to most. Well, as fun as most any college class can be :)

Yeah I could see where AnP would be easier for ya if you have a solid memory. I'd also consider that the professors may have been an issue here. And thank you for your comments, they add perspective :)

Do you have an associate's degree in nursing? If so, how long did it take to complete your pre-reqs and your nursing program? I am going for my associate's degree and when I graduate in May it will be four years total. But I was working full time during my pre-reqs so I think that if I had a part time job and could really buckle down I could have gotten them done in a year (counting Summer school and taking AnP1 or 2 concurrently with Micro)...which would have made it three years all up. I plan to go back for my BSN as noted by previous posters, I believe this to be the most productive way to go about it. Any other tips on nursing school in general? (i.e. how to get through it, study tips, financial advice?) What I did was research the pre-reqs needed to apply to various programs in my area. Firstly I completed the path of least resistance, being the program(s) that required the least amount of pre-reqs...the plan from there was to then take the additional courses required by the other programs while waiting to hear back from the first ones I applied to...And I applied to various programs in my area and some not-so-close as I was in a position to move if need be. I applied from Sierra College up by Sacramento to Los Medanos in the Bay Area. As for how to get through it...you just have to want it bad enough. It is by far the hardest thing that I have ever done in my life. The amount of studying involved in insane, the expecations are high...and you will come out of it humbled and exausted. The good news is, it's totally worth it. Just be as prepared as you can be, and if you get to the point where you have taken all the pre-req classes and have nothing else to take...take some pharmocology or medical terminology classes to make it easier on you. Any time you have a break...be it Christmas break or Spring break...take some time to go over medication flashcards. Basically do any and everything that you can to gain an edge. For studying...get together a study group. I HATE study groups...and don't have much time for them as I have kids and I am the primary caregiver...but boy are they useful in the nursing program. Not only do they keep you on the ball, but other people will think of things that you don't...and that is very useful when you are drowning in information. I know this is personal, so don't feel compelled to answer, but for those that don't mind sharing: did you take out loans to get through nursing school? And did you work during nursing school? Nope didn't take out loans...I worked until our first child was born and then became a stay at home daddy. Thankfully my wife makes enough that this was possible for us...as daycare is so freaking expensive I'd basically be giving 3/4 of my paycheck to a babysitter. There are plenty of people in my program that work though, some even do so full time (I wouldn't though). I would look into the various scholarships and grants that are out there....there are quite a few for nursing students. IM me your e-mail and I will send you all my study sheets and brain sheets that are great for students. Good luck and keep up the good work.