BuckeyeRN07

I was a graduate nurse when I hired on for FT nights, and new grad orientation is 12 weeks (give or take depending on the individual). My first 8 weeks were strictly day shift, then I switched to nights for the remaining 4 weeks. For my floor, I think the way orientation is structured for new grads is ideal. When it comes to experienced nurses being hired on our unit for nights, I think they should scale WAY back on the amount of time spent orienting on days (no more than 3 weeks, IMHO). The remaining 3-5 weeks should be devoted to nights, allowing the BTDT nurses to learn the rhythm of our floor and how best to plan their shift in light of the skeleton-crew support staff we're taken down to at 2300!

Sorry, I didn't think of that as a potential problem! Yes, I think PM's are part of the membership upgrades...

We've all been in your shoes, and I know I've been blessed with many helping hands as I learned the ropes. Anything we can do to help a future colleague out (without actually doing the work for you :wink2: ) is worth the effort!

You're definitely on the right track - good job! You may want to put any ostomy related care plans aside for the moment. He's had a colectomy, but there's no mention of an ostomy at this point (unless you simply overlooked adding that bit of info to your original post). Regardless of whether he has an ostomy or not, his elimination patterns are going to be different. Aside from the obvious (altered elimination :wink2: ) what else goes along with having a portion of your bowel removed? Considering his history of IDDM and the current problems he's facing with this admission, is there anything he might need to know in terms of continuing to successfully manage his diabetes?

This patient has a LOT going on, which makes it somewhat easier to develop his care plans. What nursing diagnoses are you considering at this point?

I'm so sorry that you're dealing with this. I've been through it once and am eternally thankful that my story ended on a good note, despite the patient's rapid-HIV test coming back positive. I was a sleep-deprived nervous wreck until the last of the results rolled in. I was finally given a "clean bill of health" once the follow-up testing was completed just a few short months ago! Hang in there - I'll be keeping you in my thoughts! :icon_hug:

Thanks for the tips! Orientation starts next Monday (strictly classroom/skills testing for the first couple of weeks), and I'm sure I'll have access to the many libraries scattered across campus once I'm "in the system" as an employee. If I strike out there, maybe I'll get lucky with some of our local booksellers (there are numerous colleges & universities within a 30-mile radius) by browsing through their medical textbook aisles... Someone is bound to have at least one of these titles available for review! In the meantime I'll also drop a line to my new nurse manager for any recommendations she might have. I'm sure she's had requests for learning resources from other nurses on her unit, especially with the number of clinical trial participants they see admitted!

Though I don't often post, I visit this site (as well as these forums) quite frequently and am never left wanting for helpful information! I'm hoping that someone out there would be willing to recommend a textbook, reference book, journal... some form of printed material... that has helped them along in terms of learning how to provide the best care for oncology patients. The reason I'm asking is simply that I'm trying to stay ahead of the curve as I change directions with my career. I've been a RN on a bustling med/surg stepdown floor for awhile now, and recently accepted a position with a different hospital on a med/surg oncology unit. This floor's census is primarily solid tumor diagnoses, and they quite frequently have patients participating in clinical trial treatments (all phases). I'm VERY excited about this change, but am not ashamed to say that I'm quite nervous at the same time. My experience with onc patients has been limited, and I've NEVER taken care of someone actively receiving chemotherapy. I'm confident that my new employer's orientation program will give me all the tools I need to safely care for this population, but I'd certainly feel much more prepared to "graduate" from orientation if I can supplement my on-the-job learning with extra reading that can be done at home. Any help is greatly appreciated! :)

I've been a nurse just under a year, but the unit I work on has provided quite an array of oddball admitting dx... But the ones that really get me riled up aren't always bizarre, they simply fail to offer much insight as to what is ACTUALLY going on with my patient. A few of my favorites: 1) UCA - I quickly found out this meant Unacceptable Cosmetic Appearance, and my patient had been admitted after extensive surgery to remove excess skin. She had a grand total of 6 JP drains and the sum of all her incisions totaled over 60 inches in length! 2) Fever - This patient was a transfer from a rehab center with a ETOH level of nearly 0.40 and he was already scoring in the 20's on the CIWA scale by the time he came to us.... but since his temp ranged from 97's to 104's while he was in the ER, they chose "fever" as the primary reason for his admission. 3) Altered mental status - Young woman with no significant medical history exhibiting extreme variations in mood/behavior upon arrival to the ER. All tox screens were negative. She came up to our unit and a quick assesmment revealed focal neurological deficits, plus she was becoming increasingly withdrawn and lethargic. Within hours, an array of physicians had been consulted and this patient was actually found to be septic! :angryfire 4) Peyronie's disease - Granted, this truly was an accurate diagnosis for my patient. However, I think that s/p penile prosthesis revision would've been MUCH more appropriate as the primary reason for admission! :imbar I could go on and on...

I work nights on a med-surg telemetry floor, and our goal ratio is 1 nurse to 5 patients. Unfortunately, that ratio doesn't take acuity into consideration when making assignments... I've seen assignments go as high as 7:1 (on days as well as nights), but thankfully that doesn't happen TOO often.

Saunders Comprehensive Review for the NCLEX-RN Examination, Third Edition (book and CD) ISBN: 9781416031994 Kaplan NCLEX-RN Exam 2007-2008: Strategies for the Registered Nursing Licensing Exam (book and CD) ISBN: 9781419550980 I started out with the Kaplan book to refresh my memory on how the exam is structured/administered. Once I had a pretty good grip on the process for analyzing and answering questions, I moved on to content review. All in all, I'd estimate that I spent less than 10 hours overall with this book (didn't end up using the CD much). The majority of my study time centered on reviewing content with the Saunders book. As my exam date neared, I found myself using the CD much more frequently than the book... I liked being able to put together quizzes on varying topics, and used the test function to hit my weakest areas. In case you haven't seen it yet, here's a link to "Suzanne's Plan" for exam prep (posted in the NCLEX forum): https://allnurses.com/forums/f197/new-revised-first-tip-suzannes-plan-195774.html I didn't have enough time to follow "step 1" in its entirety, but it did help me focus my studying on content areas I felt I struggled with the most. GOOD LUCK!!!

Columbus, Ohio - Med/Surg Tele unit, nights

i just received the "unofficial" word from the quick results online service... i passed the nclex-rn! that was without a doubt the mother of all nightmarish testing scenarios, and i beat it! :w00t: i wanted to drop by this forum for my first official post as a member of allnurses and say thank you to each and every one of you! over the last 2 months, i picked up a lot of good study habits here and walked into that testing center feeling as prepared as was humanly possible. when i walked back out feeling utterly defeated and in complete shock over the content of my exam, i came back here and read countless threads of encouraging words. without the calming influence of this group, i don't know how i would've made it this far with my sanity intact! :bowingpur