nay537

The other students in my class are also struggling. THe notes from the profesor are very vague and not even in complete sentences. We are using Guyton and I'm not impressed by it at all. There online reference is not as good as I have seen for other books. I've even had a few docs at work tell me it's not their first choice for a text. Oh well I just have to forge ahead.

Does anyone know of a good patho review book? I did not do well on my midterm and got very little feedback from the professor on how to study better for the final. She told me I need to pick more right answers this time. That was a lot of help. One of the MDs at work suggested a review book but it seems very geared towards the boards he had to take. I was wondering if anyone has used a good review book. Thanks.

Rutgers University does not require them nor does Monmouth Universtiy

So I started a masters program online this semester with the goal of obtaining my Family NP. I was going along ok until I bombed my advanced patho midterm. The professor has not been much help when I asked how I could have studied differently etc. A few MDs at work have suggested a review book, but the ones they mentioned are geared towards their boards. Does anyone know of a good patho review book? I really want to do better on my final. Thanks.

Update: Things have gotten a little better. We had a rush of ICU patients so we had a few weeks of only ICU patients. Now we only get the occasional non ICU pt. Of course with summer coming and being 2 blocks from the ocean who knows what lies ahead. The census house wide has plumeted in the last month with 2 units being closed for weeks at a time. So who knows what the future will bring. In the meantime I'm working on my grad school application because I don't think hospitals as we know them are long for this world.

Up until last week I worked in a 12 bed ICU. We used to be 18 beds but 2 years ago they closed 6 beds because of a low census. Since then we do nothing but try and move people out because someone else needs a bed. Over the summer the senior managment informed us that those 6 beds would be reopend has a Concentrated Care (step down) unit and staff was hired. Right before Christmas and on the last week of the new staff's orientation we informed that there was a change in plan. The 6 beds would become a "clean" surgical ICU and the staff we had just hired would be given positions in other departments. Our origianl 12 beds would be broken up into 4 ICU bed, 4 concentrated care beds, and 4 beds that would start out closed and flex open depending on need. Also the ICU staff would be covering all the beds regardless of pt. type. So last week the nightmare began. An ICU nurse is preassigned each shift to care for the concentrated care patients. Sometimes we have a PCA and we have one secrtary for both sides of our unit (when all the beds used to be ICU we had 2 secretaries). The MD's didn't know about this plan and were trying to figure out why their patients were in ICU. There we were trying to explain that they weren't. We labeled our central monitor with ICU and CC tags to no avail. Then this week the hosptial census jumped and they opened the 4 closed beds with regular tele paients. So now we need ICU nurses to work overtime or nurses from other units are floated down to care for these patietns. We have different order sets for the different types of patients and since we're a teaching hospital our ICU residents are telling us they don't cover the other patients. It's such a mess. My boss keeps telling us that these multi-level care units are the wave of the future. I have yet to find a journal article about them. (if you know of one please let me know). We have no computerized charting, or medication barcoding in our hospital. Every weekd they add a new form to meet Joint Comission recomedations. It's hard for us to chart less and we've decied you can't take the ICU out of the nures. We are having trouble managing our time and senior managment hasn't even come around to ask how its going and get any feedback. It's like we're invisable to them. If anyone works in a functional multi-level care unit please let me know how it works. There aren't even enough of us to cover lunches right now. Thanks for listening to my rant.

http://www.greatnurses.com It's her website.

I just received a renewal notice for my New Jersey license. The cost for 2 years is now $120. Starting with those who are up for renewal in 2007 you have to be fingerprinted for an additional cost of $75. What is everyone else paying?

Our mix med/surg ICU has on PCA that works 3-11 mon- fri. We wish we had one of her on each shift. She helps pass food trays, baisc care, turning, transporting our patients up for transfer out of the unit. She also stocks gloves, and supplies in our rooms and med rooms and keeps our equipment room organized. Each shift could use someone to help with turning and stuff. When you have several 300+ pound patients it's hard for half the staff to be in the room at one time providing care.

I took it last June and missed by 10 questions. I'm going to try again later this year. The first time I went to Laura Gasparis"s 2 day review class (very infomative and entertaining). I watched her DVD religously. I also bought the Pass CCRN book which was very dull and overwhelming. I am going to a 2day reivew that our local AACN chapter is sponsoring in May. This time I'll be more prepared.

I'm am working with a small group of nurses who are going to be presenting nursing as a profession to two 8th grade classes and I'm not sure where to begin. We have a video from Johnson and Johnshon that we got from their website, but I'm not sure how to engage the kids. Also someone suggested them giving bookmarks or something at the end but I'm thinking 8th graders don't want bookmarks. Any suggestions would be greatly appreciated.

I often refer pts. to websites after a diagnosis for further information. Especially sites for organizations like the AHA. Also some sites have great instructions for things like insulin admistration, which we don't always have time to effectively teach before discharge.

I want to thank everyone for your wonderful words of support, your thoughts, and your prayers in response to this post.

I work in a medical/surgical ICU and we take care of postpartum patients on occasion. A few weeks ago I had a 28 year old woman who had an emergency c-section at 32 weeks. The next day she started to hemorrhage and had a total hysterctomy. She came to our ICU vented postop. The pulmonologist determined that she was in ARDS so we had her sedated and on a paralytic. They also thought she might be septic and started her on Xigris which was stopped after 48 hours because of decreased pulse ox and the potential need for a chest tube. On day 10 postup she started to desat and brady down. Her heart rate went from 120s to 40s in less than 3 minutes. During our 55 minute code he had a tension pneumo and chest tube was inserted we gave her every med in our code cart and tried everything anyone present could think of. In the end we did everything we could but it didn't make it easy when the husband came in and learned that his wife of 12 months had died and now his 12 day old daughter has no mother. We are having a grief session this week with the hospital chaplin. My only saving grace was that the event occured on a week day and I had social workers, case mangers, and clergy readily available. In the end I cried my whole way home and I'm still shaking now as I type this. THaks for listening.

In the ICU I work in we have had little success with Xigris but we tend to wait a while before starting it. In order to get it we need two docs (one an intensivist) to order it which can delay the process. We haven't had any major bleeding problems in the patients on it.