Arievilo

-When to contact the doctor about your patient - I discovered its better to **** off the doctor than not contact them when you need to clarify something (orders, plan for the patient, ect.) about your patient. Better safe than sorry...you and your patient will sure be happy you did. Very often if a doctor makes a mistake and the nurse follows through with the order...the nurse is also at fault...don't put yourself in that position. You would be surprised how many mistakes are made on a daily basis. -Organization of your day - this took more time to get down...several months of practice of poorly organized shifts before you get something that works for you. Every hospital is different, every unit is different, every day is different. Its all about your ability to adapt to your patients. A good rule of thumb I go by: see your easy patients before your more difficult patients. Usually those easy patients will only take maybe 5 minutes to look them over and pass meds. Its easy to get caught up with a heavy patient for a long time and neglect your other patients if you don't see them first. -Time management - again...this comes with time. I remember my first few days off orientation running around the unit desperately trying to get stuff done. Learn how to prioritize. Say...passing essential meds and admitting your new patient is more important than a dressing change or a bed bath that can be done anytime. -Signs when your patient is heading south - ABCs...Airway, breathing, and circulation. In that order. If you got these, you are usually okay for the time being. Its the more subtle clues that are harder to see. This is still something I struggle with...because you dont have coding patients everyday...at least on my unit. -How to talk to doctors - they are normal people just like you. Its easy for a new grad to be intimidated at first. I know I was. Remember, you are your patient's advocate...its about them...not you. This goes with the first point...when to contact them. -How to utilize the resources available to you - other nurses, PT, OT, physicians, pharmacy, lab, mid levels, social workers, care coordinators/case managers, CNAs...they are all essential to your day with your patient. Its important to understand their role in patient care, when to find them, and how you can utilize their expertise. - Understand that very often the patient looks to you for information. Doctors come in and the patients pretty much nod their heads and smile. They they often turn around and ask you what the heck is going on (or you can easily tell they are clueless). Know what is going on with your patient, the plan, the medication they are on, treatments, procedures they are scheduled for, etc. Be sure to explain it in as simple terms as possible - patients don't get medical mumbo jumbo. Patient education is probably one of the most important aspects of being a nurse. I'm only 6 months out of school, and these were things I found most important. I am still learning everyday I am on the unit. These are things you don't normally get much exposure to in nursing school. Good Luck to you!

I understand what you are going through. I am 6 months out of school and I went directly into oncology because that's what was offered to me. I have a hard time disconnecting myself emotionally from all the sad stories. Just this week we have lost several patients. The horrible thing about inpatient oncology is that you tend to see them from diagnosis to death. You get to know these patients looking perfectly fine with a new diagnosis of a new cancer like leukemia. You see them through their first chemo, then when they come back with neutrapenic fevers. Then more chemo when the first one doesn't take. Then their BMT, then for more chemo if their BMT fails. Then all of a sudden they take a bad turn and they are completely different from when they came in. And soon they make the decision to go on hospice, and some choose to die in the hospital. Or sometimes something horrible goes wrong and they die unexpectedly... You get to know their hopes, dreams, you become close with their families, and they tell you things they would never tell anyone else. It helped me once when a co-worker pointed out to me that impatient oncology mostly sees the worst case scenario. We see the bad cases, the ones where everything goes wrong. We tend to forget the patient we saw once for impatient chemo and they go home and we never see them again. Outpatient sees the success stories, the healthy ones, the ones who beat their cancer. It takes a special person to be an inpatient oncology nurse. Showing compassion to patients while at work and trying to let go of all the emotions at the end of the day proves difficult. I haven't figured it out yet how to not bring the emotional baggage home. I'm not sure if I'll last too long before I reach burnout and have to make a change...and I'm only 6 months in.

I completely understand about injection fear! I don't think I've ever given an IM except in nursing school...on a baby. I work on a unit with immunosuppressed cancer patients who also have really low platelets, so an IM is usually a big no no there. However...this population also tends to be very thin and frail...so one SQ insulin injection I gave a few weeks ago...my patient had very little fatty tissue...and the needle went straight through the skin/tissue right into my finger. (Arg!) Heh...so the past few weeks...I've been rather scared of injections.

I found out today that I passed mine too! :-D Totally worth the $7.95 to get the early results! So Happy! It will be so nice to sign RN next to my name now. Haha

I just took mine today and it shut off at 75 questions!! I was thinking it would. I got so many of the same type of questions! I kept thinking...OMG, am I answering these continuously wrong so they are giving me the same type of question over and over again? Only time will tell. Two agonizing days until results can be seen. Good luck!

Human disease course? Do you mean pathophysiology? If so...thats the toughest class you'll have and has the highest probability of flunking out of it. Its pretty much the weed-out course. Its rough, but study a lot and you'll be fine. Clinicals were mostly in the general West Chester area, with two being in delaware, and one being in Bryn Mar. This could be changed in the future becasue their clinical sites come and go. Im taking NCLEX soon, have not gotten my athorization to test yet. I feel pretty well prepared, but WCU will not hold your hand throughout the preparation, a lot is independent study. I know the first cohort had a 100% pass rate. But again, a lot of that is the personal motivation of second degree students. I think their traditional undergrauate pass rate is somewhere in the 70s. Yes, we had to take HESI in order for them to sign off on our paperwork. I passed...which was all I cared about. I think a few people didnt pass it, then they either had to take a Kaplan review course or retake in again this week. I swung myself around the summer/fall/spring scheduel because, well, I pretty much had to to pay bills. I had a flexible employer who was very good to me and my schedualing. A lot of people who worked 9-5 jobs tended to only work once a week in the summer, or got tech jobs. If you plan to work for more than 20 hours/week, expecto to have NO life. Your world will revolve around school, classwork, clinicals, and work. No room for play. It is in no way fun, but it is doable. I'm thrilled to have my weekends back now that I'm finished. I paid about $3600 a semester for tuition - thats in state tuition. about 2200 the first semester (fewer classes). It really is the cheapest second degree BSN program around. I was originally accepted into drexel's program, but couldnt pay the $36000 up front. I think I answered your questions. Let me know if you have more!

Hello WCU BSN 2 Advance hopefuls. I just wanted to see what you think about the program and am updating my post from about a year ago. I just graduated a little less than a month ago from the program. I found the program to be very unorganized. Very often we found out about important stuff at the last minute, like clinical times, clinical instructors, when stuff was due, etc. They tended to push more policies they made up as they went along on us. The communication was terrible. But, the instructors were decent. And its worth the money...since its so cheap for an acceleration program. Just be ready for a lot of headaches along the way. I can't believe they want to up the cohorts to go up to 35. That is way too high! They would have to hire many more clinical instructors to keep up with that many students. Or maybe they are planning to weed out 1/3 of them the first semester. A lot of schools tend to do that now. Good luck, and keep me posted how it goes! If you have any questions about the program, please post or message me!

Graduate on Sunday from second degree program just outside oh Philadelphia PA! Just passed my HESI exit exam today!

Wow! 181 applicants! But that's the story of new graduate positions today. *crossing fingers*

I understand what everyone is saying. I have no experience except for clincials in school. I graduate this December, have been applying everywhere and everywhere is saying the same thing. I am in an accelerated program...so no externship and no time to work as a CNA. The job market right now is an uphill battle. Haha. Its funny that when I started my acclerated BSN program I was promised my pick of jobs, specialties, hospitals, with hiring bonuses and loan forgiveness. Not anymore...now I'll be happy with any RN position which comes my way.

rewrite your notes - I always find that helps me!

Good Luck! Learn lots! :)

Wow, I thought my white scrub top and pants were bad! A scrub dress is in no way practical in clinical.

I would think you'd get this in any profession. But I have already seen it quite a bit in clincials already. I had one rotation where the floor nurses wanted nothing to do with students, constantly complained we were getting in their way, and we were going everything all wrong. But I have also come across nurses who have been wonderful and took us younglins under their wings and really showed us stuff we could never learn in a classroom.

I remember feeling that way before I started clinicals! Everyone feels nervous! Just go in with as open of a mind as possible and it will come! I remember my first rotation - I was at an assisted living facility and I almost froze up the first day when placed face-to-face with my assigned resident who wanted nothing to do with me. It does get better with more experience, promise!