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Blueorchid

Blueorchid ASN, RN

Trauma ICU
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Blueorchid is a ASN, RN and specializes in Trauma ICU.

Blueorchid's Latest Activity

  1. Blueorchid

    Nursing: The Caring Profession

    Interesting article. And I agree that maybe caring isn't the best word to use in this situation. Obviously as nurses we all should include some form of compassion in our care but taking personal responsibility for your actions is more of an accountability process (imho). I'm learning all about that in Fire I class and while the fire and hospital world are very different, there are plenty of situations where we have people's lives in our hands. On the flip side I would comment that we unfortunately live in such a litigious society nurses do have to keep a constant reminder of the legal actions someone could take (whether you feel they are justified or not). I still remember having a lecture from lawyers (who had once been nurses themselves) in nursing school who stressed to us the importance of documentation to essentially cover our behinds. No one followed this up with a comment of "you don't realize how important your actions will be to this individual years down the road if you really screw up." It was more of a "the world is out to get you." And yet with that being said, I follow the saying a mistake is only a mistake if you do the same thing twice. If you make an error (as I know I have) you should own up to it, as embarrassing as it may be sometimes (and realize the impact it could have caused or did cause). Accept responsibility and move on with your life.
  2. Blueorchid

    Keeping Trauma nurses employed

    "Hold my beer and watch this!"...yep :)
  3. Blueorchid

    Warm Fuzzies Story

    Thank you all. Serenidad2004, I am humbled, I'm still a baby nurse working on my third year :) Your comments mean a lot!
  4. Blueorchid

    Warm Fuzzies Story

    Your story isn't unlike many others I've read, carefully reading the printed handwriting on your flow sheet as the night shift nurse gives me a detailed list of your injuries. You're young, I don't need to see your birth date to know that as I glance up from the cubby outside your room to look at your face, only nineteen years old and your first trip to a level one trauma center. You were the driver in the accident, I'll later see pictures of your car wrapped around a telephone pole on the local news station. It was pretty bad, you weren't breathing on the scene so the first responders got to you ASAP. Your 15 year old friend in the passenger seat was taken to a different hospital and discharged a few days later but you, the sickest, you came to see us. And your tox screen was pristine. The accident was in no way your fault. But it left you with a laundry list of injuries: a broken pelvis, long bone fractures in your leg now placed in traction, and a sneaking suspicion of mine that your head cracked the windshield when you so abruptly stopped. I'll tell your mother who is dutifully keeping watch in the back of the room that we needed to fix the things that would kill you within the first few hours before going back to fix your leg. Its hard to believe that when a traction set up is the first thing that hits you when you come into the room but at one point and time you were that sick. You're still on a ventilator that first morning of three when I'm your nurse. You have a nasogastric tube and a central line with a pretty basic list of medications, pain meds, sedation, and fluids. and your vent settings are low enough that I know your lungs didn't take a beating through all of this. Its a good sign, they might even be able to extubate you soon if only you would start following commands. So I start my day like any other, gathering information from the computerized charting, the list of systems. and any concerns given to me by the night shift nurse. Its time to wake you up, coaxing you slowly out of the propofol haze so I can try and get you to put your thumbs up when I ask, wiggle your toes, stick your tongue out- anything so I know you're hearing me in there and can understand me. I encourage your mom to help when I wake you up, sometimes I think hearing that familiar voice helps keep you calm when you can't talk and are breathing through a soda straw as multiple people scream at you. We know its not a good idea to yell at someone rapidly coming out of sedation but sometimes we do it anyways... You respond little by little, the slight shift of a foot, you even crack an eye open at your mom's voice. I go slowly, remembering the previous shift's warning that "he wakes up like a bear." That adds to my suspicion you might have a head injury. Not breathing after the crash, lacerations to your head, and that snap- like turning on a light switch from a groggy propofol daze to "WHAT'S GOING ON?" in 0-6 seconds...yeah, its not confirmed just yet but we nurses don't give someone the term "head-ey" without doing out research. Fortunately the "bear" doesn't rear his ugly head and I get enough of a response that I'll consider that almost following commands- for now. Unfortunately it doesn't get any better than that for me, I can't give you the highest neurological assessment every time I pause the sedation, but every once in a while I do. And I can lower your sedation to give you the best chance to respond without the risk of you yanking your breathing tube out. Your vent settings come down even further. Things aren't so easy that night. Apparently you have a few episodes where you thrash around and try to self-extubate- a four letter word in any ICU. It scares your mom because the night nurse who comes in to tackle you back down to the bed doesn't have anyone else behind her, so there she is, pinning one arm down as the nurse takes the other and puts you back to sleep. The cavalry it seems, is either busy at those moments, or they can't hear her. You happen to be one of the lucky patients in a corner room which makes things even more difficult. Your mom starts to feel obligated to stay and the sedation goes back up, you follow commands sporadically when its safe enough to pause the sedation but fortunately your vent settings stay low. Family members come and go on day two because your mom looks exhausted and your family all agree she needs sleep. But the second day I have the same success, I start to bring your sedation back down. Your friends even come in, your buddy from the accident is in a wheelchair but he's doing okay. I later text my boyfriend (who I learned was at the wreck and transported your friend) that your buddy looks well. And then the tipping point happens where I think we might actually be able to take that tube out. Your sedation is low enough that when the trauma team rounds on you in the mid afternoon the second day I hear their attending ask why you aren't extubated. "He isn't following commands, we're working on it though," I say, representing the critical care side in the ICU. There goes the trauma attending, a tall and imposing military man who scrubs with hand sanitizer, walks in the room, puts his hands on your traction frame and barks out in his best drill sergeant voice "open your eyes!" Oh...well hello there. Caught between thoughts of men...and you little... I watch as you wiggle your toes, put your thumb up, and stick out your tongue. Okay...you're one of those guys. The night nurse and myself were women, so is your mom (obviously)...maybe you just need us to be mean...or men. And note that neither myself, nor the previous nurse, nor your mother are soft spoken...you apparently just like to listen to guys instead of us. Your mom and I share a satisfied glance and she starts to tear up and hug the doctor...its a sign you're getting better. And I could tell you plenty more stories. When you actually were extubated neither the Drill Sergeant Attending nor the nurses could get you to say anything although without the propofol you did follow commands. In fact the only word I got out of you was "broccoli?" immediately after you were extubated and started spewing green florets everywhere (where were you packing that by the way? I had your NG tube on suction for a full hour before we took the tube out). Or the time where you, acting head-ish, (which we would later learn was because you were sporting a DAI...) wiggled all of your 6 foot 2 frame to the edge of the bed while in 30 pounds of traction and tried to flip over on your stomach. Oh yeah you were strong...strong enough that when I called a nurse in to help fix the sheets you nearly picked me up off the ground as we turned you on your side and you somehow got your arm around my waist. Frankly I'm not sure how it happened either, but by the end of the third day your mom was asking where she could leave a comment card about my care. And in the week after she always took time to say hello to me in the hallways, as did your brother and your aunt. I even remember one night where I helped your brother who was panicking because he saw your arterial line go flat (you were flapping your wrist around) and I kept your arm still as he helped me re-zero the line. You came in once for a follow-up visit too. You were talking then, all the lines and tubes out of your body, and a knee immobilizer on your leg. Your voice was still soft and quiet as your mom introduced me. You didn't remember me specifically but I have a feeling you knew you had spent some time there. It was okay, I had the biggest smile on my face. You're only the second patient I've seen that came back to the floor and recognized me in some form or another, even if it was your family. It felt good. What feels even better is seeing the segment of you after I saw pictures from the accident, 8 months later, where you and your friend are standing tall. There's not an ounce of hesitation or softness in your voice, just a little hitch in your step as the camera pans out. We fixed you up and in return you're hosting a blood drive to give back to the community. I keep staring at the screen as I watch and notice my eyes getting a little misty. You can bet I'll be there. I can't tell you how it feels to see someone I've cared for look like he blends right into the crowd. Oh I know things aren't the same, and this experience will probably shape you for the rest of your life. But I'll look back on that day and when the shift is rough and things are going to hell in a handbasket I'll be able to say this is why I do what I do and know that every once in a while, I do make a difference.
  5. Blueorchid

    How would you handle this..?

    I had a similar experience when I was in nursing school (and a tech in the ED) to which I always hear the resounding words of my clinical instructor. You are the nurse and you protect your patient. Having just done an extreme dressing change I would question the need for the MRI BEFORE I went and did anything. Was there a concern about spinal cord compression? A mental status change? If he's moaning in pain I'm guessing he's not intubated or he's coherent enough to ask you to clean the blood off. Explain to the doc how much this is going to hurt in a patient who's likely still in shock (both from the hypovolemia related to the fractures and the fluid loss from being charbroiled). If his vitals were stable Im guessing they weren't after that dressing change (I would be tachycardic as all get out). Maybe a halfway point could be reached ie. if he needed the MRI for a neuro exam you could show the doc that he is oriented or possibly do a sensorimotor exam far faar away from the burns. Most of the time when you word it correctly the docs try and think of ways to work with you. If all else fails then you medicate medicate medicate. Friend of mine had an Assistant Vol FF Chief badly burned in a flashover. He had third degree to his arms and a good portion of his torso. To put pain meds into perspective this man was never intubated but cleaned the transport helicopter of its entire narc supply while they flew him to a regional burn center.
  6. Blueorchid

    Feeling like Im back in high school...

    Updated: I took a deep breath and reported to my manager how my shift report was a load of BS. I put it nicely that I was concerned if she was getting an incomplete report from the OR that there might be a communication breakdown. I mean, what if the guy had herniated? Regardless, it was refreshing to hear someone else say the maturity on the unit is obscene at times. I don't know if anything was said but the nurse in question seemed rather pleasant to me as of recent. I'm still keeping my ears open. He said they were working on the clique part and that it will take some time, but it will get better. We'll see. Either way, the stubborn part of me does not want to be chased out of my job so Im gritting my teeth for now and looking for something potentially PRN. Its hard though when you love the complexity of a sick ICU patient (with that little childlike voice in my head giggling "I have so much to think about...yay!") as opposed to not knowing what's coming through the door and having to gogogo with a sick ED admission. Ah choices... Thanks for the support guys :) PS. EchoRN, its like a secret ambition of mine to do cardiac massage haha. I've only seen one cracked chest on our floor but plenty of thoracotomies. Maybe one day
  7. Blueorchid

    Clinical Preps Rant

    Hahaha oooh I remember those days. My Med Surg instructor was the same way. We would go on the unit the day before our clinicals with our patient assignments, look up lab values, meds, medical history, and anything else pertinent and be expected to have it all recited the next day. And we would be quizzed for at least a half an hour. We also had to think of problems for these patients (at least 3) and what nursing interventions we would use to fix them. Listen, it really does make you a better nurse. You don't think it will now but there is a purpose to all this leg work because one day you'll be able to pick up on why the chronic drinker who fell with a head bleed requires a head and abdominal CT, why he's in four point restraints because he keeps trying to crawl out of bed and understand why his platelets and coagulopathy are crummy and need to be watched. And additionally why his serum ammonia is through the roof and you're giving him lactulose. Keep your head up and try and keep your answers short and sweet with the bulk of information you're expected to know. It is alot but sometimes it helps cut down on the time.
  8. Blueorchid

    Feeling like Im back in High School

    Reposted this here because I think I might get better responses. If that's a problem someone let me know :) This isn't the first time I've seen a thread like this but I would love to hear opinions from other people to get a better grasp on reality. Coming up on February of this year I will have been an ICU nurse for 2 years in an inner city trauma center. I started in the ICU as a new grad and prior to that had experience on the floor for an additional 1.5 years as a student/ student resident. When it comes to the patients I love what I do. There are days it's exhausting and draining and you can't wait for that next shift to come in and give report but I haven't had a day yet where I've gone "I wish I'd taken a job somewhere else." I also genuinely love being a nurse. Now, that is in reference to the patients themselves. My coworkers on the other hand are driving me up the wall. Last night I had a breakdown with a little cry in the report room so I didn't go out and blow up/scream at other people. I've been trying to make a concerted effort to take sicker patients as of late to challenge myself. And having spoken with several of the senior partners on my floor, nurses who have 20+ years of experience they agree that I'm ready and encourage me to use them as resources on the floor- which I already do. Unfortunately the days that those senior nurses aren't in the numbers or on the floor I feel like I'm at my wits end. I'll be the first to admit I'm not part of any clique on my floor and I'm not there to become best buddies with anyone, my job is to take care of the patient. That doesn't mean that I'm going around kicking someone who invites me to lunch but I honestly think it's more important to turn off the beeping IV channel first before sitting down to watch a movie on the computer. Having a string of three shifts in a row I'll just give a quick sample of the things I've run into where I swear I've backslided into high school. Report was given to me on a pedstruck admitted from the OR (who I was encouraged to take) where the nurse had absolutely no idea what was going on, no charting was documented, and all I had to do was check the patient with a head injury's pupils to see what she was telling me was a crock of s**t (cause are they supposed to be two different sizes?...hmmm). She then refused to take the patient back the next day because she told the rest of the shift she was there until 8PM doing work (while she was chatting with three other nurses as I stood at the door and asked for a glucometer and a clean draw sheet). I managed to keep said patient from going on dialysis with myoglobins in the 11,000s, monitored ICPs, drain output from a broken pelvis, Grade II liver, and IVC, drew labs, started him on insulin, kept his temperature normothermic, took him for a repeat CT scan, supported the mother, father, and wife, along with the 10,000 other family members that came in to see him and then some and when people asked if I needed help and I mentioned simple things like "could you help me turn" and "could you go get this" I was refused. The next day after spending an hour scrubbing him down during his bath (he was covered in blood) the family complained because there were still dried flecks on his hands. Granted, when I asked for help, the people who were supposed to serve as "resources" were nowhere to be found. I did the best that I could in the time I had. The third day with said patient after coaxing pharmacy to send me a medication that was several hours late I notice another patient on the floor has a kangaroo pump that's beeping empty because the tube feedings are done. His nurse is nowhere to be found and the patient's brother keeps coming to me because I'm the only nurse on that side not eating pizza and Chinese food. Instead of changing the patient's bag I turned the pump off and made sure that he wasn't on insulin before tossing a word down to the nurse and going back to my own work. I get reamed out for not doing additional work to help him when I'm busy as it is with my own combo. Another nurse who had the same combo (and is in a similar situation- we'll call her Lucy) was going to be reprimanded by her charge nurse that day because she resourced another nurse to help her second patient while dealing with this sick guy. The other nurses? They were watching a football game. But that was "over-delegating". Now I'm being told by Lucy that I should report the things Ive been seeing to my nurse manager since they're apparently reporting crap about me (I wouldn't be surprised if I heard that when this patient was admitted the nurse I received report from was there for hours helping me because I couldn't handle things- which is a flat out lie.) But throughout all of this Im thinking "really?" Has it come down to me tattling on one nurse because she'll do the same to me and more? I've had my ups and downs with my coworkers- the first year I took it really hard when I clashed with different personalities, the second year I decided to start standing up for myself. However now with standing up for myself and a desire to take things further and learn I feel like this lack of support is going to hold me back. Because Im not a part of the "in-crowd" whenever I ask for a challenge Im going to be treading water on my own and it makes me worried my patient care is going to suffer. This begs the question should I find another place to continue learning? I don't want to leave the ICU/critical care setting and my heart has always belonged in the ED, but Im wondering if this culture is just specific to that area or if there exists a place where people can work together for a common goal and get their heads out of their rectal cavities? I also know jobs are still hard to come by, how long do I have to stick this out? Replies are welcome. Thanks!
  9. Blueorchid

    Anyone used music as an intervention?

    I knew an old Neuro ICU nurse who swore by Frank Sinatra for her really sick heads. She said the tones decreased their ICPs. I think there's benefit for both the nurse and the patient so I'll frequently put on AOL Radio at night and turn the volume up on our bedside computers accordingly when Im giving baths or doing something that requires me to be in the room for a longer period of time. During the daytime I usually ask the patient's family members what kind of music they like listening to and so long as its not death metal or really bad gangsta rap I'll see what I can do. We also have Music Therapy that can be requested if the doc puts in an order for CAM (contemporary alternative medicine/modalities). Its somewhat like a request for a bundle where you can get music (guitar, harp, cello), reiki, and a few other things. I look forward to the day when that includes pet therapy :)
  10. This isn't the first time I've seen a thread like this but I would love to hear opinions from other people to get a better grasp on reality. Coming up on February of this year I will have been an ICU nurse for 2 years in an inner city trauma center. I started in the ICU as a new grad and prior to that had experience on the floor for an additional 1.5 years as a student/ student resident. When it comes to the patients I love what I do. There are days it's exhausting and draining and you can't wait for that next shift to come in and give report but I haven't had a day yet where I've gone "I wish I'd taken a job somewhere else." I also genuinely love being a nurse. Now, that is in reference to the patients themselves. My coworkers on the other hand are driving me up the wall. Last night I had a breakdown with a little cry in the report room so I didn't go out and blow up/scream at other people. I've been trying to make a concerted effort to take sicker patients as of late to challenge myself. And having spoken with several of the senior partners on my floor, nurses who have 20+ years of experience they agree that I'm ready and encourage me to use them as resources on the floor- which I already do. Unfortunately the days that those senior nurses aren't in the numbers or on the floor I feel like I'm at my wits end. I'll be the first to admit I'm not part of any clique on my floor and I'm not there to become best buddies with anyone, my job is to take care of the patient. That doesn't mean that I'm going around kicking someone who invites me to lunch but I honestly think it's more important to turn off the beeping IV channel first before sitting down to watch a movie on the computer. Having a string of three shifts in a row I'll just give a quick sample of the things I've run into where I swear I've backslided into high school. Report was given to me on a pedstruck admitted from the OR (who I was encouraged to take) where the nurse had absolutely no idea what was going on, no charting was documented, and all I had to do was check the patient with a head injury's pupils to see what she was telling me was a crock of s**t (cause are they supposed to be two different sizes?...hmmm). She then refused to take the patient back the next day because she told the rest of the shift she was there until 8PM doing work (while she was chatting with three other nurses as I stood at the door and asked for a glucometer and a clean draw sheet). I managed to keep said patient from going on dialysis with myoglobins in the 11,000s, monitored ICPs, drain output from a broken pelvis, Grade II liver, and IVC, drew labs, started him on insulin, kept his temperature normothermic, took him for a repeat CT scan, supported the mother, father, and wife, along with the 10,000 other family members that came in to see him and then some and when people asked if I needed help and I mentioned simple things like "could you help me turn" and "could you go get this" I was refused. The next day after spending an hour scrubbing him down during his bath (he was covered in blood) the family complained because there were still dried flecks on his hands. Granted, when I asked for help, the people who were supposed to serve as "resources" were nowhere to be found. I did the best that I could in the time I had. The third day with said patient after coaxing pharmacy to send me a medication that was several hours late I notice another patient on the floor has a kangaroo pump that's beeping empty because the tube feedings are done. His nurse is nowhere to be found and the patient's brother keeps coming to me because I'm the only nurse on that side not eating pizza and Chinese food. Instead of changing the patient's bag I turned the pump off and made sure that he wasn't on insulin before tossing a word down to the nurse and going back to my own work. I get reamed out for not doing additional work to help him when I'm busy as it is with my own combo. Another nurse who had the same combo (and is in a similar situation- we'll call her Lucy) was going to be reprimanded by her charge nurse that day because she resourced another nurse to help her second patient while dealing with this sick guy. The other nurses? They were watching a football game. But that was "over-delegating". Now I'm being told by Lucy that I should report the things Ive been seeing to my nurse manager since they're apparently reporting crap about me (I wouldn't be surprised if I heard that when this patient was admitted the nurse I received report from was there for hours helping me because I couldn't handle things- which is a flat out lie.) But throughout all of this Im thinking "really?" Has it come down to me tattling on one nurse because she'll do the same to me and more? I've had my ups and downs with my coworkers- the first year I took it really hard when I clashed with different personalities, the second year I've decided to start standing up for myself. However now with standing up for myself and a desire to take things further and learn I feel like this lack of support is going to hold me back. Because Im not a part of the "in-crowd" whenever I ask for a challenge Im going to be treading water on my own and it makes me worried my patient care is going to suffer. This begs the question should I find another place to continue learning? I don't want to leave the ICU/critical care setting and my heart has always belonged in the ED, but Im wondering if this culture is just specific to that area or if there exists a place where people can work together for a common goal and get their heads out of their rectal cavities? I also know jobs are still hard to come by, if this is what Im stuck with how long do I have to stick this out? Replies are welcome. Thanks!
  11. Blueorchid

    Needle stick injury

    Well, to all those who wanted to know everything came back negative :) :) :) After an unpleasant weekend wondering what to do next I went down to employee health and was told I was extremely low risk for any kind of transmission in the future. I'm still going to get tested for peace of mind but for now I'm going to put it out of my head. Thanks everyone for the well wishes. I consider this one my "freebie" and will try to be more careful next time. -Blue
  12. Blueorchid

    Needle stick injury

    Never one to do things halfway- the second night off orientation I manage to stick myself with a 21 G butterfly needle. I was drawing an ABG on a patient that required multiple measures of sedation- he'd had Haldol, Ativan, and I'd been watching my Precedex gtt with a tech at the bedside holding his leg as a final safety measure. Of course the first two times I feel the pulse and he doesn't move- we're short on staff that night so when the tech is called for a transport I look at prioritizing and give him the chance to leave...the guy hasn't been moving right? Wrong! Third time's the charm. I'd gone into the skin, pulled back to the point that the needle tip was just under the skin when this guy kicks his foot straight up and I fall forward to catch myself. The needle goes back through his skin and nicks mine. (And I was wearing gloves!) I'd never drawn a flash- I bled the wound as soon as I saw it and washed my hands multiple times before talking to my charge nurse. Blood has been drawn, consent was given, and so far I know he's HIV negative. But the guy has been incarcerated multiple times before and has lots of tattoos. I get to find the results for Hep C on Monday but I already feel like he's high risk. Any ideas on whether or not they would encourage me to take the meds anyways? This is terrible. Everyone on my floor who found out has been super nice. I've even talked with someone who took meds for a HIV positive patient and she's offered to help if I need it. But I think the worst part is the waiting. I called my boyfriend at 8 this morning and burst into tears at a coffee shop when it all finally hit me. I'm really easy at thinking worst case scenario. He's HIV negative but I could still convert...and the guy has a lot of risk factors but I know I don't know anything for sure. And I haven't told my parents yet because I want to wait till Monday, I know how they get and I don't want my mom to go around lamenting that her daughter's going to die- they have enough on their plates as is. Needless to say it sucks. Support would be greatly appreciated and any advice/opinions as well. Thanks.
  13. Blueorchid

    The Patient I Failed

    Amen, Our unit is going through something very similar with a patient right now and siblings that just can't seem to get it together. Meanwhile this poor woman is slowly melting into a hospital bed. The plus side is that the attendings have absolutely refused to withhold pain medication at the daughter's request because "she's getting better." But she's being transferred to another hospital like a car going to a new auto-shop because they're still holding out for something. Regardless, sometimes I just want to pull the family into the room and make them do nursing care so they realize what kind of life she's going to have until something finally takes her. If you're keeping someone alive for whatever reasons you might have then you don't get to leave when you're upset by a dressing change or procedure. You need to know everything about the life you're now responsible for and if we've explained that we've done everything we can you also need to realize everything is not always about you.
  14. Blueorchid

    OK we get it STUD, you're straight

    To answer the OP's question how do I know my classmates are straight/gay/and or otherwise? I don't! This just reminded me of my graduation ceremony and a guy in my community clinical who I was friendly with. I knew he used to box in his hometown, I thought I remembered him telling me he won Golden Gloves when he was younger, and before he was a nurse he worked in a family business making materials for sailboat sails. Come to find out as we're all lining up to get pinned that his SO is a man. I'd heard him talking on the phone before and saying "Goodbye honey" so many times I just assumed he was talking to his wife. Just goes to show you what they say about assuming is true And the hell with it! He's a great guy and he'll make a fantastic nurse. If you're one of them I sure hope you're referring to all of us in the nursing population because sexual preference should not matter. Signed, One of the ladies
  15. Blueorchid

    Lend me your ears...

    Hello my name is Blueorchid and I'm a hoarder...no not that kind of hoarder. I just happen to compulsively save notes...and textbooks...its a habit. And I now have a hefty selection of NCLEX review books that were once listed as -required- reading for a med-surg class from a former drill sergeant (that we coincidentally never really used) and things I bought this last semester because they sounded like a good idea. So here I am trying to narrow the list down. I've looked over the site and I know a lot of people recommend Saunders...got that. I'm also in the midst of taking the Kaplan review class. I'm not really a fan, but I hear the Kaplan questions are most like the NCLEX and the hospital I'm signed on to work for is paying for it- so I'm taking it. I notice Kaplan doesn't take alot of time for content review. And while I feel pretty good for content I still think its not a bad idea to do more. I've also got LaCharity and Davis (which I bought this semester...those were it I swear!) My plan thus far is: 1. Content- Saunders has chapters in the book before their questions explaining the topics...sounds like good review material. And I like to look over the rationales of any questions I do because if I find something I'm not really remembering, I think its a good idea to refresh my memory. Hoping to create some kind of schedule where I do so many chapters a day. 2. Kaplan- If its the most like the NCLEX I want to get used to it. I haaate the questions but people pass with the class so I'm going to do it. I figure the Qbanks can be chiseled out while I'm taking the class (that will finish the first week of January) and I can plot out 50 or so questions in conjunction with Saunders to review (or more if I find I'm just tired of content) which I can build up to the actual test. I'm just wondering if I need more at this point. I hear Davis is hard and I have the book...should I add in questions from them? And LaCharity- the smallest book I have, but they have prioritization and delegation questions which are certainly on the test...what else am I missing? I don't want to leave anything out but I know I can just as easily jump from one thing to another and get so ADD I don't retain any of it. My goal is to plan a schedule and hopefully take the test at the end of January. Any thoughts? Thanks for your help guys!
  16. Blueorchid

    Man catches Home Nurse's tragic mistake

    Awful, just awful I understand the home health environment is different than a hospital but regardless, you don't go touching machines if you don't know what they're for. This reiterates to me how much nurses need to understand vents- I've had several tell me "ask the respiratory therapist" when an alarm sounded and I wanted to know what it meant. I know I learned about the standard 15mm adaptor when I started taking EMT classes- basic life support. Granted it doesn't work with every trach (metal ones...ugh...) but she can't put two and two together to learn squeezing this bag here, and connecting it to that tube there?