debRNo1

I am planning to take the exam in Oct. I applied for membership with AMSN as you receive a discount on the price of the exam and study materials. I have just about 2 years med-surg experience and I am accustomed to "independant study". I am waiting for confirmation of my membership before I send in the application. I am starting with an outline I found on another website AACN ? using my trusty med-surg text, skipping the stuff I already know. They will reimburse me for exam WHEN I pass and I will get more $ per year for the cert. Not too sure I need any other study stuff kinda feel that it would be a waste except for a few practice questions after all med-surg is med-surg RIGHT ?? deb

"they" say every nurse should do a year of med-surg !!!??? Well my anniversary is rapidly approaching 1/6/04 I was an LPN then an RN in LTC, I have done every position available in LTC when I became a "nurse manager". This was not for me~ Now Im back on the floor a busy busy hectic floor and for the most part I do love it !!! Isnt this insane that I and many others thrive on the chaos and hectic enviroment ? When I contemplate leaving I have to remember that i really do love the floor and the actual hands on of being a nurse. As far as the negativity that goes with the territory I think~We have a little running joke that when things get really bad one of us will say to the other, "have I told you that I LOVE my job?" You can further add to that comment by saying, "I LOVE NURSING !!!!" Theres a place in heaven for EVERY hard working nurse !!!!! I'm not going anywhere anytime soon I do love my job deb

:imbar here we go again........... why is it that every thread related to an "online" program has to turn into a prolonged argument generated by someone who is not currently in such a program ?????? i see this as a put down to all non traditional students and discourages students contemplating a degree online. we are all by well aware that lizz hates excelsior and for some unknown reason loves to bad mouth excelsior and its nursing program. for some unknown reason she feels compelled to jump into every discussion where excelsior is mentioned although she is in a traditional program herself. no matter how or where a discussion begins it seems to end here~lately. there is more to this story im sure but that it seems will will never know. we could try~ why are you so bitter and angry towards nurses trying to upgrade themselves to rn thru excelsior ???? tell us a little about yourself and what you did prior to choosing nursing as a career ???? lgflamini~ill waste a little breath here (you know i have to)............ :roll the program is not for everyone and i doubt that most students who are not nurses will succeed in the program either, many nurses with years of experience may not succeed either, they do not put you on "east street" towards a degree and you are not "buying" a degree either. it takes alot of hard work devotion and dedication to persue and comlpete an online degree. there are no instructors or professors to "hold your hand" you are on your instructor and basically teach yourself what you need to know. imho~ you need experience as a nurse to complete this program. yes i am pro-excelsior and proud of myself and others for completing the program, passing the boards and working as an rn's. we (excelsior grads) as a group have previously stated that we havent had any difficulties obtaining positions or functioning as rn's. i was a ltc lpn for many years, i held a position meant for an rn as an lpn and unfortunately the facility benefited by paying me as an lpn and when i applied for my first hospital job as an rn with my excelsior degree, mostly i found that "mgt" was impressed not afraid that i would endanger a patient, nobody looked down on me for having an independant degree either. im the rn i am due to my experience mostly as an lpn, not my degree alone. i would never have been able to complete the program if i hadnt been an experienced nurse. im not commenting on the ca or chiropractic issue. like kim said all programs send bad nurses out into the workforce and i have met a few that cannot draw up a meds correctly or properly assess a patient. good thing i was there ~me and my excelsior degree to stop my new grad orientee from killing a patient with an overdose of insulin~drawn up in a tb syringe. and good thing i intervened (at the familys request) when a new grad left a pt burning with fever for hours and hours without giving a med or calling a doctor~ i did assist in the transfer to icu and honestly i did have trouble sleeping that night !!! :imbar deb rn proud excelsior grad 2001

I think what you are referring to is: black and white Its an oldie BUT a goodie !!! It is a mix of 30 cc MOM with a shot of cascara 5 cc. Unfortunately after all these years I hear now that cascara isnt available anymore ?? Somehow R/T cardiac difficulties in the elderly The last 2 years at the LTC facility that I worked I spent doing "bowel audits" after a BAD survey and a huge problem with OUR bowel protocol. Sometimes you cannot push fluids and some of them dont eat or drink too good anyway. Try colace-pericolace-MOM-lactalose-sennakot-Dulcolax supp or a dulcolax tab maybe. Cant tell you how many impactions Ive seen in the hospital and in LTC facilities-not a good thing at all. good luck

Im with you HEATHER and like lgflamini said, Its NOT worth it This will be my final response (cant resist) and I suggest others do the same. LIZZ~ its amazing just what a wealth of knowledge you are. Im not the only one thinking this Im sure.......... Did someone call you CONDESENDING and a CONFRONTATIONAL BONEHEAD You are way too BRIGHT and know way TOO much to be about so many things to be condesending. Its not condeseding and its not a personality disorder. Dont you all see that this is a very smart person who knows alot of STUFF. Im sure there is plenty that a wanna-be OOPS student nurse like you could teach us old experienced nurses. We are all very impressed with you and your never ending wealth of knowledge on so many topics. You arent RUDE and fresh, ignorant or unknowledgable, spiteful or psychotic, argumentative or mean. You are not unprofessional and inexperienced. You live in southern California and maybe that makes people jealous ?? Im sure that SOMEONE will JUMP to hire you and give you more money than the experienced nurses! You are worth every penny you get................ A confrontational or personality disorder ? I think not !! An inferiority complex or a lack of common sense and COURTESY ? NAH !! ARROGANCE ? NO! You are intelligent and very very friendly bet you have more friends than all us EC grads put together, people must bother you all the time for the right answers to lifes mysterious questions !! dont you all see that we have GOD's gift to nursing here You arent cocky or overly confident, you arent a squeaky wheel or an empty wagon, you should toot your horn and honk as loud as you can ~ you are THE master communicator and its just great that you have found an outlet here to share what you know. Bet you shine in your classes and clinicals. :roll Bet your nursing instructors are just as impressed as we are. Im sure you will graduate at the top of your class with the highest GPA and be the best nurse EVER. Your fan club is growing.........All together now YES MAAM Welcome to Allnurses.com

In 1996 I paid $60.00 to take the A&P exam for which I received 6 credits. $10 a credit~ I give up :imbar

Well said.................lgflamini My worth as a nurse is using what I have learned~however I learned it ~ while working my but off as an LPN or independantly studying for my degree. Heather~Im with you and you said it well. Some people have issues that have nothing to do with what they are currently spouting off about. And you are right on the money that a person who is compelled to argue, wont listen and needs to have the last word and always has to be right is certainly a neon sign of what kind of nurse they will be. Honestly its not the nurse I would want as GOD forbid an orientee, a coworker or taking care of me or my loved ones. Could be intimidation, jealousy, or a personal issues but ignorant, obnoxious comments and put downs IMO are uncalled for; and my resume looks better than yours statements sound childish and immature. :imbar Nobody should ever be discouraged to further their education or better themselves. Nobody should be looked down upon because they went to one program or another. Every day as a nurse is a learning experience from day one in ANY program right till the day you retire. You could go a prestigious university, pay thru the nose and put it on your resume but if you refuse to LISTEN and learn you might just find yourself unable to perform as a nurse when you graduate. Rumors and myths certainly DO exist regarding an EC degree and THIS is what I commented on and seemed to agitate someone. I have experienced rumors, myths, and gossip regarding the program, I sorted it out, put them to rest, completed the program and now I am an RN. I commented on what I have experienced first hand and nothing else. I had a positive experience with this program, however, I would highly recommend researching ANY nursing program you intend to apply to, graduate from and PAY for. I did EXTENSIVE research prior to applying to this particular program and found it best suited my needs, schedule and goals as an experienced LPN attempting to upgrade to RN. My comment about the final answer coming from Excelsior was misconstrued by someone and taken out of context. If I lived in California and there was an issue I would certainly do my best to fully research, investigate, and use every resource available to any obstacles in my way but frankly I couldnt care less about it because I dont live there and NEVER commented about THAT issue anyway. I did comment on the pass rate for the CLINICAL componant of the program and this too was misquoted, misconstrued and taken elsewhere. :chair: wow BTW Here in trendy New York the nursing programs are HIGHLY competative very EXPENSIVE and have LONGER waiting lists. :imbar

guess that someone would be me you did put me (and others) down and you are dead wrong that rumors dont exist. i live in ny and already have my degree and didnt comment about the california issues at all~ just the general rumors about the program i chose not to listen to the nay-sayers like you and complete my degree in this manner and im proud to have completed the program. proud of my persistence and determination to complete the program. i spent five long years listening to rumors and myths and managed to sort them out and obtain my degree regardless of the massive amounts of misinformation out there regarding this program. so your statement is way way off and my "claim" is valid and comes from my personal experiences. if you havent had first hand experience with this topic then please dont comment+ post put-downs. your misinformation, put-downs, and negativity just prove what i have "claimed" in my completely innocent post. i guess the first thing a hospital will do when a nurse puts a patient in danger is to see where they got their degree :roll i didnt intend to start a debate at all just sharing my personal and first-hand experiences with what i will continue to call "rumors and myths" related to the program. i researched the program extensively prior to enrolling, i knew i could study independantly without an instructor or professor to tell me all the answers and point me in the right direction. this program is certainly not for everyone as i have previously stated but if you are an experienced lpn it is a good way to get your degree without fighting/waiting for a seat in a nursing program and committing yourself to a set schedule of classes. empty wagons rattle the loudest

-------------------------------------------------------------------------------- Originally posted by NursePerson I have been told that OR, ILL, CA, And at least 3 hospitals in Ut. won't hire them due to some of the student not having enough or no clinical experence at all. Anyone else know about this? ____________________________________________________ WHO told you that ? I do beleive it is probably just ANOTHER myth about the program. There are so many rumors and myths that it really could discourage you from applying to or completing the progam. I suggest contacting Excelsior for any and all questions. Their answers should be the final answers to any and all debates. There are study groups available and nurse educators to answer your questions. As an independant student you need to take full advantage of every resource available. DONT LISTEN TO THE RUMORS and keep on taking your exams. Both traditional and nontraditional nursing graduates take the same exam for our RN licsenses. I didnt have trouble when I began my search for a job in a hospital (with LTC experience only and my EXCELSIOR degree) in fact one of the nurse educators where I "chose" to work was impressed because she knew of the program and whats involved. During my weekend, out of the 6 who tested 2 (who were obviously unprepared) failed. Thats about 66-67 % pass rate ? I would say thats about average and depends on the students preparation. A big rumor when I tested was:o "dont go to NY~"they" are failing everybody there" I went and defied the rumor but know of students flying out of NY to test elsewhere. Another debate was about the degree of the bed during an abd. assessment and what area do I get ?? It seemed as if the instructor would whip out a measuring device to check the degree of thebed I sweated this one out because I couldnt lay my lady down the way she was breathing and the instuctor was with me on that one~not an issue at all. You must show that you can safely and competantly provide nursing care to a patient. Maybe someone who cannot get hired due to lack of experience has NOTHING to do with their degree at all. I was an experienced LPN and basic nursing/pt care wasnt an issue for me. If a student is lacking basic nursing knowledge and hasnt EVER touched a patient ~or~ If you are someone who cannot move on without a professor or instructor confirming the right answer~maybe try a traditional program. Another problem is if you are unable to take on the Excelsior way as your way, you must follow their directions and do things the way they have them laid out without deviation. I studied the exam itself as well as preparing for it. I knew exactly what to expect and exactly what was expected of me and I passed with no repeats. :roll Good luck to all who are currently testing............................

I haven't heard of any EC grad having trouble finding a job. I am an Excelsior grad 2001 and proud of it !! I think that I was probably better prepared for the boards then a traditional student. There arent any professors or instructors giving us hints as to what will be on the next exam. There are no gimme's at the CPNE either it's sink or swim !!! You swim alone........... Many people dont understand HOW the program works and there are many myths that arent true. EC students must prepare for exams without benefit of guidence and work independantly to learn what they need to and then pass these exams for credit. Initially I took A&P and Micro, if I was able to pass intense subjects like this I figured I could finish this program and I did. Yes it is a difficult program and not for everyone. Some people feel it is an easy way out and try to rush thru the exams to get to the boards. Not a good idea and most will not stay with it. Two friends of mine started with me and were "scared" off~long before the CPNE. They went to traditional programs BUT we all took the same exam for licsensure. Now we are RN's. One myth is that you CANNOT pass the CPNE without hospital experience NOT TRUE. I was a LTC nurse for many years and I had ZERO hospital experience. I practiced on my LTC residents for my assessments and VS, I passed the CPNE without repeating a lab or even a PCS. I know many EC grads and have NEVER heard of anyone not being hired. When I applied at the hospital last year one of the nurse educators (who herself had an online MS) was very impressed. Maybe there is more to the story. Sure you can complete either a traditional or "virtual" program and pass the boards only to be lost on the floor. My LPN experience is part of who I am today and the RN that Ive become. I am proud to have completed the program. Kudos to those in the midst of it now and good luck to those awaiting CPNE or the boards. Put all the myths aside and if in doubt call EC and get your info from the "horses mouth". deb

This weekend I noticed that we had a "frequent flyer" back on our unit. She wasnt in my district so I was glad about that. I do beleive she is one of these "drug-seeking pts" who may even be "doing" something to herself to cause infections and/or surgeries. I had an unpleasant experience a few months ago with her............. She was in a private room due to an "infection" SP some minor surgery. She was on every narc in the cabinet. MD writes an order for discharge but she refuses to leave. Cant get daughter on the phone she is giving me phony numbers. Son is "drinking" today and cant pick her up. Has to take a shower before she goes, has to have MORE ms and a valium NOW !!!!! It got to the point where she wouldnt let me in the room and had the door blocked with a chair. This goes on for hours and hours..... Supervisor comes and we have to call security. Shes like a bag lady and has a ton of bags in the room, she is now screaming that we cant touch her stuff. She wont leave till she gets her meds. Shes calling a lawyer, her daughter is a nurse yada yada yada.....We pack her up and she is escorted out of the building. Saturday low and behold who has been moved to the empty private room in my district !!?? So I bite the bullet and go in cause her bell is lit. I introduce myself and ask what she needs and the argument begins~the bell isnt lit~YES it is~what do you need~the nursing supervisor~what is wrong~what do YOU think~YOU kicked me out and wouldnt give me my meds last time I was here, I dont think your my nurse today.................. GET OUT !!! So I go call Sup and tell her, think shes heard enough about this woman, who caused such a fuss they put her in that room. I traded with another (float) nurse who had the time of her life that day. Roaming the halls following the nurse BEGGING for meds, sneaking out to smoke, pulling out her IV, she had a list of meds for doc and he refused to order them. Shes dressed to kill wearing tight jeans, big shoes and lifting up her shirt so everyone can see just how red her belly is. Funny thing is there is no psych hx documented on this woman !!?? At first I felt a little insulted, Ive never ever had anyone refuse me as a nurse~ this is a first. BUT Im glad though because I wont ever have to deal with this woman again. I documented word for word what she said and that sup was aware. I just hope shes gone by WED so I wont have to witness her being escorted out again. Too bad for her because Im the smoker who will take the smoking pts out and I REFUSED to take her out with me. Sorry but Im not getting involved and taking her out when she already had a valium and 10 mg of MS.....................no thanks I can refuse too. I just hope they "escort" her out before I go back on WED.

illegal

:roll A Graduate Nurse throws up when the patient does. An experienced nurse calls housekeeping when a patient throws up A Graduate Nurse wears so many pins on their name badge you can't read it. An experienced nurse doesn't wear a name badge for liability reasons A Graduate Nurse charts too much. An experienced nurse doesn't chart enough. A Graduate Nurse loves to run to codes. An experienced nurse makes graduate nurses run to codes. A Graduate Nurse wants everyone to know they are a nurse. An experienced nurse doesn't want anyone to know they are a nurse. A Graduate Nurse keeps detailed notes on a pad. An experienced nurse writes on the back of their hand, paper scraps, napkins, etc. A Graduate Nurse will spend all day trying to reorient a patient. An experienced nurse will chart the patient is disoriented and restrain them. A Graduate Nurse can hear a beeping I-med at 50 yards. An experienced nurse can't hear any alarms at any distance. A Graduate Nurse loves to hear abnormal heart and breath sounds. An experienced nurse doesn't want to know about them unless the patient is symptomatic. A Graduate Nurse spends 2 hours giving a patient a bath. An experienced nurse lets the CNA give the patient a bath. A Graduate Nurse thinks people respect Nurses. An experienced nurse knows everybody blames everything on the nurse. A Graduate Nurse looks for blood on a bandage hoping they will get to change it. An experienced nurse knows a little blood never hurt anybody. A Graduate Nurse looks for a chance "to work with the family." An experienced nurse avoids the family. A Graduate Nurse expects meds and supplies to be delivered on time. An experienced nurse expects them to never be delivered at all. A Graduate Nurse will spend days bladder training an incontinent patient. An experienced nurse will insert a Foley catheter. A Graduate Nurse always answers their phone. An experienced nurse checks their caller ID before answering the phone. A Graduate Nurse thinks psych patients are interesting. An experienced nurse thinks psych patients are crazy. A Graduate Nurse carries reference books in their bag. An experienced nurse carries magazines, lunch, and some "cough syrup" in their bag. A Graduate Nurse doesn't find this funny. An experienced nurse does

One of my coworkers; a CNA, who is around 40 YO, has 2 grown children, got pregnant and began to list her "demands" before the sperm even reached the egg :imbar Her hands havent left her belly since~she holds on to it, rubs it, pats it, and CONSTANTLY talks about it !!!!! The best was our NM took us all aside to tell us that "she" is having a "high-risk" pregnancy so we should all help her as much as we can. (Not like she ever DID work too hard.) What OB doc (in his right mind) would let a CNA actually WORK with a high risk pregnancy !!?? Or was that a lie that NM fed into? Had an amnio and was told to stay in bed X2 d where was she the next day C/O cramps and twinges Q2 minutes ? Of course on the job !! Shes out now maybe her high risk turned into a higher risk.

Key word here ? WORK ETHIC :kiss hard to find and MUST be appreciated keep up the good work.......................

We have one too. We did have the "happy" ward clerk but the grumpy one was soooo mean and angry toward her that she finally gave up and left. WC talks too much, doesnt order supplies, leaves STAT orders sitting for hours and then doesnt sent a copy to pharm for the meds we need !!! Shes a dinosauer and its time to go. I usually check my charts periodicly (knowing her ways) and I just p/u any orders I catch. When we get a float WC on the unit we nurses are amazed at how EFFICENT and friendly they are !!! NM has promised to "deal" with her when she returns from vaction-we'll see............. The WC/secratary is a vital part of an efficent unit, they welcome the pts and families and should try to be helpful to all for the good of the unit................

I worked with "empowered" CNA's for many years and I agree with the post that stated the DON created this enviroment. When the DON is "afraid" of her staff it is a recipe for disaster and scary for the nurses trying to run a unit. They could disappear for hours and get a slap on the wrist, they could punch each other in and out and get paid when they werent even there !! One CNA was forging a nurses initials on her time card and if I was in charge she would have been out the door, nah she just got scolded like the rest. They broke into the "files" and then ranted about the salaries of me and the eve NM !!!!! They kept a watch on the nurses, waiting for a tx not to be done or see or hear something that they could hang over the nurses head. When the DON feeds this fire it will soon race out of control and the good staff WILL go- I did..... ............and you will be left with the brainless, lazy, uneducated, backstabbing staff who couldnt care less about the reason why they are there in the first place the RESIDENTS. The nurses who stay have the same attitude and mentality- cant beat'em join 'em Loud-mouthed arrogant "know-it-all" cna's were one of my deciding factors to leave LTC for good. For 8 yrs I dealt with them and their petty BS issues while the residents suffered. There was always a rant about some nonsense and they were always threatening to call the news stations !!! Their mentality led them to beleive that the news stations really would care if you didnt get paid for last thurs when you called in HAH !!!!! I had one CNA threaten to "report" me for taking O2 off a deceased resident and argued with me in the hallway in front of the family about how I didnt have an MD order to remove the O2. Not sure who she was going to report me to maybe GOD !!?? One CNA made a habit of getting chummy with the families and "visited" outside the facility, This one was real good at bad mouthing the staff and manipulating the family to like or dislike a staff member- depending WHO their target was that day. It was unbeleivable when I now had this angry family in my face, talking nonsense just like the staff !!!!! I am a firm beleiver that a good CNA is worth their wgt in gold and they certainly are the backbone, eyes, and ears of the unit BUT when they take over and attempt to intimidate and control the licensed staff this is where I get OUT. I do beleive in teamwork and appreciate it when its there but you cannot have it when most of your staff is on a mission to destroy. They were an evil bunch and seemed to live to hurt others. Nevermind the time and energy this takes and nevermind the fact that there are poor old souls who need there assistance. If they have such a chip on their shoulder and want to be "me" then go to school, pass exams, graduate, sit for the boards and pass that exam- then you can be a nurse too. What is stopping you ? maybe if you put the time and energy into schooling and education VS attempting to intimidate and destroy people you might graduate at the top of your class. I sent a CNA home who backtalked me and refused to do what I asked (change some pages around in acct books) when DON came in she called her and asked her to came back in !!! I told her I would leave and she let CNA stay home and never gave her the write-up I prepared. Another slap on the wrist. This was the beginning of the end................. My eyes were finally opened and I saw that nothing would change and I couldnt hang around in this upside down and backward world where nothing was what it seemed to be. Guess I could have stayed as I was offered ADON position when I resigned (talk about a bizzaro world ) Thought I could take out all my revenge as ADON and FIRE them all BUT I just couldnt- it was easier to leave and not look back. During my last three weeks I became the target, the DON sent her no-good-doers out to get me !!! They tried so hard to hurt me and I held my head up high and remained a professional as I knew there was a light at the end of this tunnel- my new med/surg unit !! On x-mas eve a week after I left I received a hand written hate letter to my house, on facility stationary with a facility postage stamper. They couldnt leave well enough alone and because they couldnt hurt me while I was there they decided to send me a hateful letter, which DID hurt . MISSION accomplished !! Well I am on a mission now !!! I will "steal" the few good staff members to work at the hospital with me, Ill save them from the torture and help them escape from that HOSTILE enviroment- my revenge ??? And yes I have a bitterness about the whole LTC scene-sorry for the rant/vent :imbar deb

Well good luck to those who attempt this and we Excelsior grads are proof that YES it can be done. Coldfoot is right check the website provided and always make the final word that of Excelsior and dont listen to the rumors. There were students jetting around the country to avoid a particular site. "THEY" dont fail you at certain sites and for every failure there is a reason and its NEVER the site just an error in judgement or not following the rules of the "game". I started way back in 1996 and finished in 2001 and many things have changed so always keep updated and enrolled students have alot available on the website, there are also nurse educators that you can "annoy" with questions too. KIR: I dont remember waiting all that long to be enrolled. I did my CPNE at St Peter's in Albany. If you have already checked your eligability then Im sure you will be accepted and hear from them very soon. I used the med surg text I had from LPN program (keane) and it was fine. Good luck and I hope you hear from them SOON !!! Batmansnurse: CPNE is a three day "evaluation". You arrive on fri eve and get orientation and do your "labs" There are four lab stations and you will have a chance to repeat in AM should things not go well. That eve they will assign PCS #1 (pt care situation) You have a chance to write care plan that night and bring with you in AM. You are assigned a pt and certain "areas of care " Do your thing successfully 3 times and your on your way home with 8 credits under your belt !!! I didnt apply for any AID and paid as I went, the exams have risen in price since then. I always researched the exam itself as well as the material. The study guide has a percentage breakdown for each sub-subject so you can kinda figure how many questions R/T a particular area there might be. This way you can figure out just where to put the emphasis on you study time. As far as the CPNE I researched the exam and fully understood what was and was not expected of me. I went there fully and most likely overly prepared to take this exam. At the PB lab the instuctor commented that he thought I may have completed it in record time !! I paid $1200 for the CPNE plus did the workshop PLUS had 5 years invested so I covered this CPNE thing from every aspect I could. You need to be IMO overly prepared and be ready for anything that might come your way. You need to appear confident and knowledgable but not cocky. You are expected to perform as a brand new grad just out of school would. Just know that study guide backward and foward and have the critical elements MEMORIZED so well that in a time of stress its still there somewhere in your mind. I used mnuemonics and the GRID. In retrospect it wasnt bad and I consider myself lucky to have fairly easy areas of care assigned, never had an IV, no tx's and my pedi pt was a BABY DOLL !!! Stress could do you in you need to learn some control method and be able to NOT get flustered. At one point my pt who wasnt so nice got me a little nervous and I told the instuctor I had to "step outside" it is acceptable- I got together, calmed down, bit the bullet and went back in the room and finished up and amazingly passed the 3rd and final PCS, I was on my way home about 10:30 sunday morning I was on the former "study buddy" website too bad its still not around I would say if you could "hook up" with another student who is neck and neck with you as far as the CPNE goes it will do you a world of good. We shared our experiences there and I was able to read past experiences of other students. We would do practice PCS's and care plans and send them to each other for review. When we began to send each other the EXACT same interventions and care plans we KNEW we were ready !! Of the four of us in my little group well we ALL passed and still keep in touch. The encouragement and support did us a world of good. I wrote up my weekend when I got back and it is posted here somewhere ?? There are some other study groups on Yahoo (they too are posted somewhere here) check them out and get all the resources and use them to your advantage. Lots of luck to all............... If I can help please em or pm me deb

I am an Excelsior grad '01 It took me five years at my own pace to obtain my degree, I started shortly after my LPN program. I started with A&P and micro which I studied for independantly and passed both. I didnt use a high-priced "third party publishing company" I used the study guide- provided for FREE, I used a text with workbook. For A&P I used the coloring workbook with the text we used in LPN program. I had ZERO college credits and I wasnt brave enough to "challenge" the general ed courses which I took at Comm. college. The best are the summer and winter "mini" sessions which are kinda like rat races and you complete the course in just a few weeks. The cost of the exams has sky-rocketed over the years and my A&P exam in 1996 cost me $60.00 six credits for $10 bucks a credit !!!! CHEAP !!! Back then you were able to take quite a few exams prior to enrolling and I beleive that has changed now ? Never thought I would see the day when I was an RN but it came, I passed the almighty CPNE (with no repeats ) and then the boards. It worked well for me and glad I didnt HAVE to fight for a seat in a program and commit for too long. If you are able to study independantly I say GO FOR IT !!!!! DO NOT sign with a publishor who promises that you will pass, get a GOOD med-surg and basic nursing text, use the internet theres a world of info at your fingertips. If you have any questions feel free to EM or PM me....... good luck deb

Thought there were 5 too TRAMP T right time R right route A right amount/dose M right med P right patient Guess documentation is the 6th right ?? deb

I get report on a transfer from PCU and its an elderly female, has just about every DX in the book. Im told shes on a "one-one". Obviously I ask WHY ? But the nurse cant tell me !!?? No falls no unsafe behaviors at all................... Well when she comes up an absolutely INSANE, rude, ignorant daughter accompanies her, begins to order us around before they are out of the elevator !!! Daughter is a nut job-no doubt and begins to bark out orders and threats. She is mouthing off to another nurse and I go get momma settled, quick assessment and VS. She can hardly breathe and looks to be knocking on heavens door and has NO DNR. She is telling EVERYONE how 4 yrs ago momma came home from THIS hospital with "bruises and how she took pics !! Now I come to learn that daughter is the reason for the one to one, maybe a kind of reverse Munchausen syndrome type thing going on. She is overly involved but has no clue what she is talking about. She wants me to "push a button- like they did downstairs" to let the urine out of foley because mommas lady parts is hurting her !!! Now we have a 15 min debate and there is NO BUTTON to push but she insists that I dont know what Im talking about. Momma has no complaints. Daughter wants the roommates flowers removed cause momma cant breathe. SORRY- no. There is an AC issue and issues about the room. She wants the door bed-NO She was on multiple inhalers Q 4 hrs, I gave the 1800's around 1745 and she says to grandson, "that nurse is killing grandma-she gave the medicine wrong" Shes NPO but daughter INSISTS she can have ice chips, the order says NPO-period. She told anyone that would listen how "this nurse" is killing momma. Doc comes and tries to explain how sick momma is but she wont hear him. She begins to talk about 1948 and how momma had a stomach ache !! She is screaming in the hall at MD- will she live or die ?????? She called every 5 mins. overnight and was back in early AM. Her husband sat there like a complete idiot and never said a word-poor guy. Usually Im very good with "problem" families and they all seem to come my way eventually. This one I could not take, I despised that daughter and the next day I refused to take care of momma. I watched her do the same thing to the other nurse and was so grateful it was not me. That night she coded, got intubated and went to ICU. They wouldnt let her in and she roamed the hospital complaining and seeking attention from anyone who would listen. She came up to "use the phone" in mommas room. I stopped her in her tracks and said its not mommas room anymore and you cant use the phone, I enjoyed telling her this too. Let her make a complaint on me. GO AWAY CRAZY LADY............... The poor old lady eventually passed and I wondered what the heck this daughter will do with her life now but I hope and pray that I never ever see that woman again. Its a hard enough job but so much harder when families are difficult. I appreciate a families input, care, and concerns but when they are off the wall it takes away from every other patient under my care. I documented it too but could not find ANYTHING written about this situation so I too looked like the only one with a problem ! Sorry for the rant it was a horrible experience. deb

Be careful and look for another job NOW. You have to leave there because most times its the people like YOU that get canned or worse, especially now that you are a whistleblower. They will protect themselves as a facility and let YOU (not the alterer) take the heat. They could claim that you illegally copied the chart. Obviously there were charting "games" prior to this incident or you wouldnt have felt like you NEEDED those copies. IF this nurse takes it upon herself to willy nilly change the medical record then what else could she be up to ? She has no morals and no sense of what is right and wrong. God help those patients. If they condone the alterers actions then they are up to no good PERIOD- get out of there. When they let people like this get away with these types of things they create a monster and she has gotten so bold that she feels she can just change what is written and re-write other peoples notes ???? "She sounds like a nut. Your facility sounds like a gossip factory. Volatile combination..." My former facility was a gossip factory and the kind of place where I could very well see this happening -where the "good" nurse would have her head chopped off and the "bad" nurse would get a slap on the wrist-if at all. I saw a few good people taken down by false accusations and it was pretty scary to see all your coworkers writing false "statements" to condem you. As far as what was reported to you I think that " how the aide tried to talk him into letting her stick her finger down his mouth to induce vomiting! " Im curious did they "make" him vomit or what ? That is ABUSE and should have been be reported. I would leave ASAP and in the meantime be very careful while you are there because they could turn anything you say or do around and get everyone to write something bad about you............ good luck

Im working at a (smaller) North Shore Facility, they have about 13 hospitals-most probably an hour or so from NYC. Been there since Jan. and Im happy there-so far so good. Decent pay+benefits, NYSNA union, not too bad pt ratios, tuition reimbursment. Try the website to apply-thats how I got all my "contact" info while I was looking. Good luck deb

I have walked in you shoes (unfortunately) Im in a meeting and called by DON to ask WHY my resident was being sent out ???? Well the (LPN) charge nurse never did call me to assess the pt and I wasnt even AWARE that she was being sent out (for unresponsiveness) Id been here a LONG time and knew my staff well. Covering charge nurse and CNA who always tries to get her pts shipped out in this senario, furthermore this pt was difficult to say the least. I go to the room to assess her, shes not unresponsive she is ASLEEP. I ask for the vitals- CNA and nurse say "we are getting them now", however MD, family, ER, and amb had ALL been called already Wound up not shipping her out there was no reason what so ever for her to go. Nurse pissed, CNA starts CRYING and saying how I dont trust her judgement. Since when is it the CNA's judgement to ship them out. All this poor lady needed was a diaper change and to stay in bed a little later. This was the saddest CNA I ever knew, was there for 33 years !!! When she ever told me somebody had a temp I would say, "lets retake it- come on Ill go with you............" By some miracle the pt would now be afebrile :imbar The happiest day of her life was the day I resigned. Another time eve supervisor sent out one of my (few) "walkie-talkies" who was sent right back, another case of "unresponsiveness". Went to see her ASAP in AM and she told me they "woke me up and made me get on a strecher" Look at the chart to see what the heck went on, No VS to be found but there was a page-full of documentation about what jewery she was wearing when transferred !!! Great assessment in the diamond district but come on this is scary......... We would work so hard to fill the beds only to have them shipped out. If I call an MD and say a pt is unresponsive- of course he will say ship them out. How do you call MD without VS didnt he ask for them ? Priority inappropriate while you sit at the desk making calls and no staff is actually tending to this unresponsive resident ? Another pet peeve of mine. They would call 911 for "non emergency" type transfers, here would come EMS and the police with sirens blaring to take out this pt who had been running a temp !! How embarrasing and god help the person having an MI while EMS is transferring a febrile demented pt who could be treated at a supposedly SNF. Im in the hospital now and see the other side of the coin. I get the nursing home pts who got shipped out for no good reason. We give them a day or 2 of IVAB then ship them back on PO meds LUNCH whats that ?? Im lucky if I get off the floor for lunch by 3-4 PM To shove food down my throat and my (new grad) orientee disappears for an hour and a half on fri and mon. When he returns he asks me if I gave his 1400 meds for his 2 pts. WHAT ??? He is so un-serious about everything and scared me good when he drew up .7 cc of insulin in a TB syringe instead of the 5 "U" that pt should have gotten. OK he read the scale wrong I realize he is a new grad but shouldnt you know that upon graduation. I tried to stress what a powerful drug insulin is and showed him what 5 u looked like compared to .7 cc and he placed the blame on "whoever" put that TB syringe in the drawer marked INSULIN syringe !!!! Then he whacks me on the back and says what great critical thinking skills I have !!?? Yesterday his ONE pt ( I had 7) had a dry dsg to her foot- I asked did you do the dsg YET (1800) he said, Why dont you walk me thru it !!! Translation- do it for me !!! Cant kill anyone with a dsg so I said just change it................. Lack of knowledge, laziness, of work ethic ? DUNNO OK done venting TY deb

I was mortified as a new nurse to see this abusive way of feeding the residents :imbar BARBARIC describes it very well. Of course it was the MEANEST cna in town who opted to "feed" this resident. Towels wrapped around her neck and liquid mush running down her face as she barely got a chance to swallow. What a horror to hear and see this happening. Wht loss in LTC is a biggie but thank the lord this isn't common practice anymore. It was the most degrading, humiliating, abusive thing I think Ive ever seen done to a PERSON. :stone An appetite simulant could be helpful and the MD should also consider depression as a reason for poor intake or refusal to eat. Sometimes it may take trying different meds until you find the one that works. Ive seen miracles with the right meds and they will begin to eat and put on wht !!! What a difference a tiny pill could make. Sometimes I think putting this HUGE meal down in front of these poor eaters turns them off. Maybe put the tray off to the side and try one item at a time ? Sandwiches, supplements, health shake type drinks work well too- offer a sandwich and a glass of milk or a shake when they wont eat the meal served. A little nutrition is better than no intake at all. Over the years Ive seen way too many residents "removed" from the DR without eating the meal and without the staff offering an alternative. When I was a charge nurse I used to have my little group of poor eaters sitting outside the nurses station, in the afternoon and I would get out the "goodies" I would cut sandwiches up and pass them out with a drink they preferred. Icecream and pudding went over well too. This would piss off the other nurses and the cna's for some reason but if they didnt eat they came to my snacktime. It was my fault they didnt eat because "I" spoiled them and was always giving them snacks !! When I gave them ensure or another supplement the staff would remind me that I needed a doctors order for it !!! I would say, "call the DOH theres a 1-800 number in the lobby!!" deb