catlover13

I have found the smaller hospitals to be a more nurturing atmosphere. Yes, they may consider a less experienced nurse. The med surg may be a very appropriate area for your level of skill.

Yes, I currently work in Gonzales. Hubby relocated in april, and I did not look for work until i finished the semester in mid June. I've not heard a peep from seguin, but was able to begin working in gonzales.

Gonzales is hiring. The pay is good, and so far the staff and facility have been above average. They have er, med surg, ob, and surgical areas. Pm me if you'd Like more information.

Hi, I landed in rural west Texas as a new grad LVN in December 2006. I settled in, took (and passed - yipee) boards, and began working at our local rural hospital in November 2007. I found that the personal introduction works effectively at some of the rural hospitals. I'd plan a trip out to meet and introduce yourself to the DON's in several counties that are within driving distance. Dress professional. Drop off your resume with the DON. Ask to speak to the DON, but don't tie up a bunch of time, just spend a bit (maybe 10 - 15 minutes) introducing yourself and relaying your strengths and what shifts you are available for, etc. Any extra training and certifications, I'd bring documentation, and point these out as strengths, as you need to be able to do a bit of EVERYTHING! That would include ACLS, PALS, IV certification, etc. What is a reasonable driving time for you? For me, it's up to one hour. I work PRN at two rural hospitals, and plan to apply PRN at one more. I love the variety of the work and the work environments. I learn something new every day that I work, and I can flex my schedule. I also like helping the hospitals fill their work call offs and gaps in scheduling. At all three of the hospitals, the DON is always looking for additional PRN nurses, both LVN and RN. Often, the PRN position may turn into a full time offer. For me, I prefer to remain PRN. I love the rural challenges and opportunities. I think that I have found my nursing "niche," and plan on remaining in this specialty. I hope this helps to give you some ideas. Good luck in your job search.

Hi, I graduated from Ivy Tech, Fort Wayne in December 2006 through their LPN program. I passed my boards on the first try in Spring of 2007. I had a wonderful experience with my education and clinical experience through Ivy Tech. I think you get out of the nursing school experience what you put into it. Are you willing to work hard? Ask extra questions? Look for opportunities to observe and/or participate in procedures? I've since gone on to complete my RN, and am now continuing on for my BSN/MSN. I rely on the skills and knowledge that I gained at Ivy Tech every shift I work. I've not heard of anything wrong with Ivy Tech Nurses. Just the opposite.

I know that the rooms are supposed to be stocked, but... I always try to check at the beginning of the shift... IV tray full? asst sizes of cannulas? an open ns, and a full ns. Tape, alcohol pads, etc. And do I have all sizes of bp cuffs on the dinamap? And is there a cuff, in case the dinamap is misbehaving? Pedi supplies. O2 cannulas, masks, etc. Hope that helps give you a direction to go...

What about WIC? Women, Infants and Children?

Sorry, I thought of more...grin. How does your center handle children with medical needs? Asthma, diabetes, cystic fibrosis? Are there medication administration areas? How is this governed by the State and your RN license? And you could help move your center to be more inclusive. It can be hard to place children with special needs. Your expertise as RN could really shine to develop a center that cared for special needs children. And what an opportunity to help all the children you care for learning about the needs of others. Good luck!!!

Hi, What a great place to post this question, here on allnurses. And welcome to the world of child care. :-) I'm a new nurse, LVN, now working on bridging to my RN. Before attending nursing school, I was a licensed child care provider for 7 years. After that I worked for 7 years at a social service agency that held a contract with the CACFP (the Child and Adult Care Food Program). I worked for 5 years in the field with other child care providers, and the last two years as director of the program. It was nice to take my hands on experience and use it to work with other child care providers. Now, with some nursing education behind me, there are some areas that you can bring your RN education and experience and have an impact on your child care business. Food - it's a huge part of the kid's day. There are tons of resources through the CACFP, and I think that if you are licensed you are already using their guidelines? The CACFP is part of the USDA FNC - the food and nutrition service. This is the food pyramid, the alternate food pyramid, and I think now they even have an exercise pyramid? It is also the overseeing body for what is served in school breakfast, snacks and lunches. The licensed centers in the States that I was active in were, and the guidelines are federal, so I'm guessing that you have guidelines as to how often to serve and what types and quantities to serve. But, here's the neat thing, and where your RN experience can make a difference. You and work with your food service staff and help make your menus the healthiest. Eating, overeating, and unbalanced meals and snacks are a huge issue in the US, and our kids are subject to commercials with all sorts of unhealthy choices. You can review your meals and snacks and bring a higher nutritional standard to what you are serving. You have most of your children for breakfast, am snack, lunch and pm snack, so you are feeding them the majority of their nutritional needs for the day. There are some great resouces regarding kids and food. If you've never read Ellyn Satter, she is awesome regarding children and development of food habits. (not affiliated, just a FYI). I've seen her speak, and if she's on dvd, she'd be a great resource for you and your staff. I also got my kids involved with food and their food choices. It was fun, and kids as young as 3 enjoyed having input as to what foods would be served. Kids can grasp the choice of two of the old four food groups to choose for snacks. It also is a good opportunity to discuss what healthy choices are. As director, you can work away from the traditional cheese and crackers, (nothing bad with that), and help introduce the kids to new tastes and textures and combinations. Food is also a great way to explore other cultures. You can also work with your staff on how to incorporate more gross motor movement into the kids days. Another component in our overweight US is our lack of exercise. And our kids are getting bigger, and reaping the negative health benefits. Odds are, your kids spend a fair amount of time outside your daycare time sitting. In the car, in front of the TV, etc. While you may have children in your care 5 days a week, from 7a - 5p, you can have huge impact on just getting them to MOVE!!! And kids are designed to move. Culturally, we spend a lot of time getting kids to sit still, but really, kids want to get moving, wiggling, etc. And wouldn't it be great, if you and your staff could incorporate exercise/movement into your program. With the hopes of bullding some lifelong habits and enjoyment of exercise? Staff development and retention are another huge area. There are some really great people who dedicate their lives to working with children. Mentoring them and encouraging them to continue their personal education goals will only enrich the environment of your center. Educational standards may be quite low for the qualifications of your teachers, having staff that continue to learn and grow will impact the quality of your center. Hope that makes sense....and have a a great time with your new position!!!

Also saw this report. It does not mention the Red Lake, but it is a picture of health care in many Indian Reservations. Broken promises: Reservations lack basic care Health clinics don't have enough money to deal with high rates of disease http://www.msnbc.msn.com/id/31210909/ns/health-health_care// Dr. Lynelle Noisy Hawk examines a patient Oct. 14 at the Standing Rock Indian Health Service in Fort Yates, N.D. On some reservations, the oft-quoted refrain is "don't get sick after June," when the federal dollars run out. Again, not about Red Lake, but it seems to be a timely article.

Red Lake is an independent Indian Reservation area. They have their own government, law enforcement, etc. There are several Indian Reservations in the area. Red Lake is much more of an independent area. As for weather, the winters are long, cold and dark. My daughter lives nearby, and although the last freeze date was listed as June 1, it froze 4 nights after that. All her tomatoes are dead due to the freeze. If you enjoy gardening, the season is short. If you enjoy winter, there is an abundance of winter snow. If you enjoy daylight, and summer, those winters are long and isolating. There is heavy snow, and the counties routinely close for a period due to the severity. Also, because of the extreme cold temperatures during the winter, many businesses close. You do have the opportunity to see the northern lights. Hope this helps!!!

Just to clarify: Even though you are administering one injection, that injection contains two different drugs. Regular insulin and NPH insulin. That's why there are two peak times. Hope this helps!

It's not just this question...all your questions will follow this same format. The question will give you information. Take the time to read it! And then the question will ask you for something. Figure out what the question is asking for. It just takes practice. And a different way of thinking about testing. And it will help you when you do sit for the NCLEX. :paw:

First, all of the questions will be formatted in somewhat the same manner. Your nursing instructors are using your time in nursing school to help you understand how to decipher the questions. Nursing school is different from any other school that you've had. You've got to think about the answer! So, don't panic. What does the question tell you? A diabetic client receives a combo of regular an NPH insulin at 0700 hours. So, what do you know from the first part of the question? You've got a diabetic client, that receives insulin injections. The 0700 insulin injection contains two different types of insulin. What does the question want you to answer? The nurse teaches the client to be alert for signs of hypoglycemia at: What causes hypoglycemia? The peaking of the insulin... Now, apply what you know about insulin. Each type of insulin peaks at a different time. When does regular insulin peak? 2-5 hours. When does NPH insulin peak? 6-12 hours. So, your patient should peak, with the regular insulin between 0700+0200=0900 and 0700+0500=1200. And your patient should peak, with the NPH insulin between 0700+0600=1300 and 0700+1200=1900. Which answer fits these two parameters? That is with hypoglycemia risk r/t peaking of insulin ? That is, which answer peaks between 0900 and 1200. And peaks between 1300 and 1900? 1.)1200 and 1300 hours 2.)1100 and 1700 hours 3.)1000 and 2200 hours 4.)0800 and 1100 hours It looks like B. Does this help?

Hi 3kittiesRN, This is my first position as a new grad. In a small, 22 bed, critical access, rural hospital. I love it!!! Hospital was always my first choice, but I was scared to jump into the world of nursing. But, this position has been a great learning experience. You never know what will come in thru the er door... A snake bite? Gunshot? MVA? Sore throat? And, if there is trouble, there is no one else to call. Pulling a bell to notify of a code blue? Nope, you and your colleagues are the code team, trauma team, and whatever else is needed. I would not trade the experience for anything else!!!

Try WIC, Women, Infants and Children. I have a friend who, as a new grad RN, was hired by WIC. This was/is her first job. Hope this helps!!!

13. the nurse is preparing to administer labetalol (normodyne) iv push for a patient diagnosed with hypertensive crisis. which intervention should the nurse implement? (best answer) a) monitor the client's labetalol serum drug level b) keep the medication covered with tin foil c) administer the medication slow iv push over 5 minutes d) teach the client signs/symptoms of hypertension answer: ___________ we think c or d hi, i'm getting ready to walk out the door for my job...but i've got a few minutes, and i thought i'd post. i also thought it might be more of a help for you guys, if you got the reasoning behind the answers, not just the answers. and i'm not trying to be sarcastic or a smart a** here, but i might use some stuff to try to get the emotion, or the thoughts behind the answers...really, i'm just trying to help. so, i skimmed your post, and this question jumped out at me...pharm is my weakest area, so i've learned what works for me, and that can be important for you too - to learn what works best for you. now, i'm going to pick apart the question.... 13. the nurse is preparing to administer labetalol (normodyne) iv push for a patient diagnosed with hypertensive crisis. which intervention should the nurse implement? (best answer) here's your information, well, almost all of it, you get some additional clues in the a,b,c,d answers, but first what is the question asking? really, no joke here, what is the question asking? you have a pt dx with hypertensive crisis!!! what does this mean? really? it means, that there is a pt, who just had their vitals taken, by a health care professional somewhere...and that the healthcare professional recognized that the pt was is hypertensive crisis. that is, the b/p is so high, that the pt is in imminent danger of stroking, resulting in possible death!!! what else do you know from the question? there has been an order given...so there is a pa or doc somewhere who has seen the sky high b/p and has made a decision to give a med as the immediate intervention... do you see where this points you? you, a nurse, have been given an order to give a med...so your question really focuses on the giving of the med. the question even tells you the med...labetalol (normodyne). and the question also tells you how to give the me. iv push. a) monitor the client's labetalol serum drug level b) keep the medication covered with tin foil c) administer the medication slow iv push over 5 minutes d) teach the client signs/symptoms of hypertension answer: ___________ we think c or d now read your answers and see which fits the question.. one at a time... a) monitor the client's labetalol serum drug level does this fit? is this the best nursing action? what is a serum drug level? it's a level that pops up in the blood, after administration, and you're not going to have to worry about that right now. remember, you're pt is in imminent danger!!! worry about this later, if it is a concern with this drug. b) keep the medication covered with tin foil hmm, as i'm typing, i have not yet looked up this drug, so you're getting my reasoning (i'm hoping this helps you understand how you answer these questions). my gut reaction - you've got to get this med on board your pt. unless it's such a sensitive drug that between the time you draw it up, go to the pt and administer, that you need to keep it under foil, i don't think this is your best answer. c) administer the medication slow iv push over 5 minutes ding,ding,ding!!! i think this is correct. you've got a med order, it needs to be given now, and you know that it is to be given iv. you must do no harm, and there are iv meds that must be administered slowly, so as to not hurt your pt....i'll look it up after i finish typing... d) teach the client signs/symptoms of hypertension look, this is a good answer, if, the question asked you about a pt coming in with a history of hypertension, and they had been keeping a log that showed that they had recorded high b/p's several times, but had not notified the primary care giver. if your pt is in hypertensive crisis, you've got to do something now to keep them alive!!! and not stroke out, etc. i hope this helps... anyone else out there want to tackle a question by giving the reasoning behind the answer? i think that lots of us can just give you the answer, a, b, c, d. but, you've got to know why that answer is correct. please let me know if this helped!!! try this link: http://ccn.aacnjournals.org/cgi/content/full/23/3/30 from the article: recommended dose and administration labetalol is administered by repeated bolus doses given by slow intravenous injection or by continuous infusion until the desired blood pressure is achieved. got to run....really did this help?

Hi, I always did very well on my careplans, and was given the following format to follow: one r/t pt safety r/t disease one r/t pt psychological/social needs also r/t disease and One on disease process or other outstanding needs demonstrated by the pt and how it impacts that pt. It made it easier for me to then look up nursing dx and r/t to the care plan when I knew what to look for, not just the whole nursing dx book. So if you've got AD, not knowing the pt in the movie, you might have one r/t pt falls if there is some concern there (safety). And one on social interaction, with the memory loss (psychological/social) and depending on what that particular pt may need, maybe fluid deficit if they are having trouble swallowing or remembering to drink fluids. Again, it would depend on the individual. Hope this helps!!!

I always use gloves. And I always take 2 paper towels with me. One to set on the floor, put the graduated container on top of it, just to keep the area/and the container clean - floors are always "dirty". And you can use this floor paper towel to wipe up any odd drips on the floor. The 2nd paper towel, I use to wipe the stem of the drain after the cath bag is mt (empty). Just part of good cath bag care. I don't wipe the inside of the stem, just the outside. One important point, never let the stem touch the sides of the graduated container - helps to not spread germs back into the cath bag. And another thing that I do after measuring the contents of the container (on a flat surface), pouring the urine out, is to put a squirt of soap or bleach and water in, give it a swish and a rinse and let dry. Helps keep down on odor. And if 2 patients are sharing a room - MARK the container with a sharpie!!! You wouldn't share a container any more than you'd share a bedpan!!!

Hi, At my facility, a small rural hospital, we do mix KCL in IVF. Also mix IV antibiotic therapies. It's been a great learning experience. :paw:Can't resist the pawprint!!! Catlover13

Hi, I've landed in a rural area, our nearest "big city" of 75K is almost 1 hour away, and I've been balking at the idea of applying for a job there. Don't want the commute... We do have a local county hospital in my city of 1,500!!! I've been nervous, being a new grad about applying. Would this be a good place to start my nursing career? Or should I pursue some "big city" opportunity? Thanks.

Which Ivy Tech are you accepted at? I don't know what your other program is by the initials. I can tell you about Ivy Tech, Ft Wayne. I just graduated in the LPN program, Dec 2006. And I would highly recommend Ivy Tech's program. I had also looked at taking the Ivy Tech program in Merrillville, Gary, Michigan City, South Bend - We were moving around the state at the time, and I landed at the Ft. Wayne campus. The courses were small, overall. The teachers above average (with a few so so thrown in, but I think you get that anywhere). I found the staff approachable, willing to work with you. I had major issues, and they helped me meet my goal of graduation. And the pass rate is nearly 100% !!!! For both the RN and LPN programs. Ask your programs what their pass rates are???? Talk to your program director, meet with a teacher, either in person or by email...get a feel for your staff. I spent a lot of time looking into programs, talking to nurses, and learned of some other programs where you could enroll, be accepted, pay $$$, big bucks, graduate (sometimes with great difficulty), BUT, THE PASSING RATE FOR THE NCLEX WAS HORRIBLE!!! So some of the students spent time, effort, money, and then could not pass their boards...I knew of more than one student who was in this position. The LPN program is 1 year, RN 2 years...and the cost at Ivy Tech is an incredible value!!! Ivy Tech is a state run community college system, so their costs are awesome. I've now moved away from that area, and am missing the opportunity to complete my RN at such a fine school and at such an affordable price. Talk to financial aid, they are experts on helping you with your college loans. If you have a government loan, and it sounds like you do, you may choose to spend your $$ at any campus, just has to be one college a semester. So they can tell you how to transfer to whatever college you choose to attend. It's a coding number on your web account??? I think??? It's been a while since I had to change the coding for the college I was attending, again, ask your financial aid dept. I can't state how happy I was with my educational opportunities at Ivy Tech, and after, my classmates are well received in the work force, since Ivy Tech has such a great reputation for teaching, and having their grads pass boards. Hope this helps!!!

Hi, I think it sounds like you are on the right track. Everyone doubts their actions sometimes, and I think that this can be a positive. Are you a bad NA? IMHO, NO. Ask yourself these questions.... 1. Would you have treated the pt differently r/t his being disagreable? That is, if this was the nicest pt, it's easy to interact with him....it's a sign of a good NA that you still chose to positively, repeatedly interact with a difficult or disagreable pt, and not just ignore him or the situation. 2. Were you actions based on patient care? You recognized that this pt needs to void.... 3. Do you care about this patient? I see aides leave without another thought as to their pts, and this does not suit my personality. I see your asking about this situation as wanting to learn from it. Things you might have done, they may or may not have made a difference. 1. Document your attempts and their outcomes r/t pt not voiding and refusal. Without knowing what is the problem, it's more difficult for you and this pt's nurse and dr to address. Just state them factually...your phrasing and the pt's response... 2. Let his nurse know....Perhaps this pt has underlying issues (as it seems later you learned of the end stage AZ dx). His nurse may have more info that makes helps to understand this behavior. It also gives you, his nurse, and the dr (eventually), a chance to develop a care plan that addresses this issue. Don't forget - you are a vital part of this pts care, and you are the eyes and ears for the nurse and dr, report, document, allow this pts staff to be aware of the problem. 3. Yes, I know you're just back, and it was busy...it sounds like you are doing a great job. And that you've recognized that it's in the little things that can make a big difference. Keep up the good job!!!

Hi, What worked for me.... I was working full time days, then going to school part time at night. Kids, husband, grandchild (all of us living together). My husband's grad school, daughter's college, son's high school, my nursing school, and an 8 month old grandchild that we all coordinated schedules so we could watch her too - it was a zoo!!! I studied every day!! I had to. No choice. It wasn't like I could just study whenever I wanted, so I had to be very, very dedicated and organized. I'd read the chapter before lecture, follow along in the book as the lecture progressed, then re-read once more in prep for exam. So by the time the exam rolled along, I'd have read the chapter 3 times!!! Every morning before work, I'd get ready, then spend time-usually 1/2 to 1 hour. Usually the house was quiet, and I found that the little bites of studying added up. I'd study at night too, until I dropped from being tired, and I missed all my favorite TV programs for 2 years - could not take the time to follow them... Just picked up my diploma, and (pats self on back) received my degree magna cum laude - my only B was in pharmacology. Good luck!!! Hope this helps!!!

The above was a combination of several different types of head to toe checklists. This format will fit into 3 columns, with boxes for each section. This is meant to be more of a check list, with ____ next to each entry. I think I even had it set up so you could do a couple of assessments for the same patient, but at different times on the same page. I printed out one for each patient I had, stapled them together, so I worked with a sheaf of papers, just had to flip to the patient I wanted to see. There was room at the bottom for info from report, or on the back if you needed extra room. When I wrote the narrative, I just began at the beginning, and went section by section. Added any other comments as needed, or at the end. You should be able to copy and paste it, then tweak it into boxes. There will be extra room to write special findings in the boxes too!!! The formatting did not translate when I copied and pasted. This form worked well for me, but you'll have to find the one that works best for you.