kayleighac

My general nursing notes that don't refer to a specific problem look more like this. Resident alert and oriented x 4. Verbally responsive. PERRLA. Skin warm and dry to touch. Respirations even and unlabored. No sob noted. No cough/congestion noted. SpO2 98% at this time. Abd soft and non distended. Bowel sounds normoactive x 4 quadrants. Bladder non distended. Pedal pulses present and strong. Vitals stable. No c/o pain or discomfort at this time. Able to make needs known. Safety maintained. Call light within reach. Will continue to monitor. Now I always look at any tubing attached the pt when I make rounds. Add this to ur general notes such as any oxygen, iv's, foley catheters, etc. Add it to ur charting for ex: f/c drainijng clear yellow output, >30cc/hr. Or contine on O2 2LPM via nasal cannula. Or iv site patent, no s/sx infection or infiltration. Hope this helps!

At my job we mostly only do narritive notes. Here's an example of one of mine. We are charting on the patient for uti. Received resident awake resting in bed. Alert, verbally responsive. Continue with po atb therapy for uti. No ase noted. Tolerating well. Afebrile. No hematuria noted, no c/o dysuria. Good peri care rendered. Fluids encouraged as tolerated. All needs met by staff. In no acute distress. Call light within reach, will continue to monitor.

Okay, I have a situation that I would like everyone's opinion on. I am an LVN in the state of CA. Today I had a patient refuse care from a CNA. We tried talking to her, and she would not change her mind; she requested to have a different CNA. So I used my best judgment, and I decided to give this patient to a different CNA. The reason I chose the CNA that I chose was because she had the closest round to this particular patient. She works down the same hallway while all the rest of the CNAs are in different hallways in different parts of the facility. She has also worked with her in the past and knows this patient well, and the patient likes her. The CNA that I tried assigning to her refused to accept the change. I was going to switch patients so that the two CNAs still have the same amount of patients. She still refused to accept the assignment change. Now, me being the charge nurse, I ultimately have the decision in the end on who gets what assignment. I did not appreciate the CNA arguing with me in the hallway, refusing to take a patient. My supervisor and I decided to write her up because this is the second time this has happened with this CNA in a completely different situation. I think about it this way: She gets paid to be here and do this job. Patients can refuse care from a nurse, but we cannot refuse care to a patient unless it's a special circumstance, such as the patient threatening the staff, which doesn't happen to be the case here. She doesn't want to take care of this patient because it's not a part of her normal round, and she doesn't like it when a change is required, basically because it's an inconvenience to her. Nothing is ever perfect, and when we do get special requests from patients, we have to try to work around them. If my supervisor gave me an assignment to do, I would not dream of refusing it unless I had very good reason to. I would never think of arguing with my boss or supervisor about the work that they give me. This is what we get paid for. Does anyone agree with me?

thank u everyone for the replies and the encouragement. its so difficult still and i hope it gets better.

OMG I feel so overwhelmed, I just got a new job at an LTC and the nurse to patient ratio is 1:30. I felt like crying last night, it was my first night alone as a new grad, and it was a Sunday, so it wasn't even busy, but it took me so long to do my med pass that by the time I was finished with my 5 p meds, it was already time to start my 9 pm meds. Another LVN even insisted to help me last night, and I still got out of there an hour late. I can't imagine how it would have bene without her help!! Any suggestions or tips?? I feel like I'm doing something wrong...

I am a BRAND new LVN straight out of nursing school with no prior medical experience. In school, the max amount of patients we were given was 5, and they only had us pass meds on one. Now I just got a job at a LTC facility and I will be in charge of a whole station of 30 patients!! This is a bit overwhelming for me, and I have 8 days of orientation. Today will be my 4th day and I still feel completely lost. My problem is time management. I don't see how I can possibly pass meds on 30 patients in a 2 hr time frame PLUS charting on about 15-20 of them! Any suggestions??? Thanks!

i dont know if i am the only one who feels this way, but i am so scared to start working. i feel like im going to just be thrown out there on my own, and even though i just completed 18 months of hands on training, i feel so lost! i feel like im not going to know what to do. im also nervous about interviewing...does anyone know what kinds of questions they ask...or any tips in general? thanks!

I am also 20 years old with a career! It's great. The process I used seemed to work since I just passed at 85 on my first try. Here's what you need to do first Buy these books: 1. NCLEX-PN Questions & Answers Made Incredibly Easy 2. Lippincott's Review for NCLEX-PN 3. Saunders Comprehensive Review for NCLEX-PN 4. Straight A's in Nursing Pharmacology Getting the latest edition of these is probably best Our process that worked with about 97% of our school was to basically do 200 questions a day. You start with your best subjects in Incredibly Easy since it's the easiest. Then move onto the next easiest book which would be Lippincotts on the same subject and lastly, do the questions in Saunders, also on the same subject. After all that, you should be an expert on that subject! Grade yourself on every test you take...read all your rationales...just to warn you, when you start out, you will be getting around the 50 or 60 percents. Don't give up...the more you do it, the better your scores will get. After you finish all the subject specific tests, move on to the comprehensive tests. And once you are scoring in the 80's...you should be ready! I followed this process exactly and I passed at 85 on the NCLEX-PN, which is really good. Do this for about 6 weeks or until youve done about 6000 questions. So, say you do 200 a day for 5 days a week....give yourself two days for rest...then you have done 1000 questions a week. When you finish one subject, start on the next one and do the same thing. With each subject you do, try studying the pharma on that subject also. It helps to incorporate it in. Read the pink part of the Straight A's in Pharma, and take the test at the end. If you get below a 70%, then read the whole white part. DO NOT skip pharma. That's probably THE most important thing on the test. I got over a dozen med questions on it. Thank god I studied it. One more good book for pharma if you have time is Pharmacology Made Easy for NCLEX-PN. It's self explanatory. Read it and do the questions pretty much. That's really all you need, is just to do question after question and know the rationales for them. It's going to be a lot of work, nursing is not easy...but I wish you luck and I hope my advice comes in handy!

The process I used seemed to work since I just passed on my first try. Here's what you need to do first Buy these books: 1. NCLEX-PN Questions & Answers Made Incredibly Easy 2. Lippincott's Review for NCLEX-PN 3. Saunders Comprehensive Review for NCLEX-PN 4. Straight A's in Nursing Pharmacology Getting the latest edition of these is probably best Our process that worked with about 97% of our school was to basically do 200 questions a day. You start with your best subjects in Incredibly Easy since it's the easiest. Then move onto the next easiest book which would be Lippincotts on the same subject and lastly, do the questions in Saunders, also on the same subject. After all that, you should be an expert on that subject! Grade yourself on every test you take...read all your rationales...just to warn you, when you start out, you will be getting around the 50 or 60 percents. Don't give up...the more you do it, the better your scores will get. After you finish all the subject specific tests, move on to the comprehensive tests. And once you are scoring in the 80's...you should be ready! I followed this process exactly and I passed at 85 on the NCLEX-PN, which is really good. Do this for about 6 weeks or until youve done about 6000 questions. So, say you do 200 a day for 5 days a week....give yourself two days for rest...then you have done 1000 questions a week. When you finish one subject, start on the next one and do the same thing. With each subject you do, try studying the pharma on that subject also. It helps to incorporate it in. Read the pink part of the Straight A's in Pharma, and take the test at the end. If you get below a 70%, then read the whole white part. DO NOT skip pharma. That's probably THE most important thing on the test. I got over a dozen med questions on it. Thank god I studied it. One more good book for pharma if you have time is Pharmacology Made Easy for NCLEX-PN. It's self explanatory. Read it and do the questions pretty much. That's really all you need, is just to do question after question and know the rationales for them. It's going to be a lot of work, nursing is not easy...but I wish you luck and I hope my advice comes in handy!

The process I used seemed to work since I just passed on my first try. Here's what you need to do first Buy these books: 1. NCLEX-PN Questions & Answers Made Incredibly Easy 2. Lippincott's Review for NCLEX-PN 3. Saunders Comprehensive Review for NCLEX-PN 4. Straight A's in Nursing Pharmacology Getting the latest edition of these is probably best Our process that worked with about 97% of our school was to basically do 200 questions a day. You start with your best subjects in Incredibly Easy since it's the easiest. Then move onto the next easiest book which would be Lippincotts on the same subject and lastly, do the questions in Saunders, also on the same subject. After all that, you should be an expert on that subject! Grade yourself on every test you take...read all your rationales...just to warn you, when you start out, you will be getting around the 50 or 60 percents. Don't give up...the more you do it, the better your scores will get. After you finish all the subject specific tests, move on to the comprehensive tests. And once you are scoring in the 80's...you should be ready! I followed this process exactly and I passed at 85 on the NCLEX-PN, which is really good. Do this for about 6 weeks or until youve done about 6000 questions. So, say you do 200 a day for 5 days a week....give yourself two days for rest...then you have done 1000 questions a week. When you finish one subject, start on the next one and do the same thing. With each subject you do, try studying the pharma on that subject also. It helps to incorporate it in. Read the pink part of the Straight A's in Pharma, and take the test at the end. If you get below a 70%, then read the whole white part. DO NOT skip pharma. That's probably THE most important thing on the test. I got over a dozen med questions on it. Thank god I studied it. One more good book for pharma if you have time is Pharmacology Made Easy for NCLEX-PN. It's self explanatory. Read it and do the questions pretty much. That's really all you need, is just to do question after question and know the rationales for them. It's going to be a lot of work, nursing is not easy...but I wish you luck and I hope my advice comes in handy!

The process I used seemed to work since I just passed on my first try. Here's what you need to do first Buy these books: 1. NCLEX-PN Questions & Answers Made Incredibly Easy 2. Lippincott's Review for NCLEX-PN 3. Saunders Comprehensive Review for NCLEX-PN 4. Straight A's in Nursing Pharmacology Getting the latest edition of these is probably best Our process that worked with about 97% of our school was to basically do 200 questions a day. You start with your best subjects in Incredibly Easy since it's the easiest. Then move onto the next easiest book which would be Lippincotts on the same subject and lastly, do the questions in Saunders, also on the same subject. After all that, you should be an expert on that subject! Grade yourself on every test you take...read all your rationales...just to warn you, when you start out, you will be getting around the 50 or 60 percents. Don't give up...the more you do it, the better your scores will get. After you finish all the subject specific tests, move on to the comprehensive tests. And once you are scoring in the 80's...you should be ready! I followed this process exactly and I passed at 85 on the NCLEX-PN, which is really good. Do this for about 6 weeks or until youve done about 6000 questions. So, say you do 200 a day for 5 days a week....give yourself two days for rest...then you have done 1000 questions a week. When you finish one subject, start on the next one and do the same thing. With each subject you do, try studying the pharma on that subject also. It helps to incorporate it in. Read the pink part of the Straight A's in Pharma, and take the test at the end. If you get below a 70%, then read the whole white part. DO NOT skip pharma. That's probably THE most important thing on the test. I got over a dozen med questions on it. Thank god I studied it. One more good book for pharma if you have time is Pharmacology Made Easy for NCLEX-PN. It's self explanatory. Read it and do the questions pretty much. That's really all you need, is just to do question after question and know the rationales for them. It's going to be a lot of work, nursing is not easy...but I wish you luck and I hope my advice comes in handy!

The process I used seemed to work since I just passed on my first try. Here's what you need to do first Buy these books: 1. NCLEX-PN Questions & Answers Made Incredibly Easy 2. Lippincott's Review for NCLEX-PN 3. Saunders Comprehensive Review for NCLEX-PN 4. Straight A's in Nursing Pharmacology Getting the latest edition of these is probably best Our process that worked with about 97% of our school was to basically do 200 questions a day. You start with your best subjects in Incredibly Easy since it's the easiest. Then move onto the next easiest book which would be Lippincotts on the same subject and lastly, do the questions in Saunders, also on the same subject. After all that, you should be an expert on that subject! Grade yourself on every test you take...read all your rationales...just to warn you, when you start out, you will be getting around the 50 or 60 percents. Don't give up...the more you do it, the better your scores will get. After you finish all the subject specific tests, move on to the comprehensive tests. And once you are scoring in the 80's...you should be ready! I followed this process exactly and I passed at 85 on the NCLEX-PN, which is really good. Do this for about 6 weeks or until youve done about 6000 questions. So, say you do 200 a day for 5 days a week....give yourself two days for rest...then you have done 1000 questions a week. When you finish one subject, start on the next one and do the same thing. With each subject you do, try studying the pharma on that subject also. It helps to incorporate it in. Read the pink part of the Straight A's in Pharma, and take the test at the end. If you get below a 70%, then read the whole white part. DO NOT skip pharma. That's probably THE most important thing on the test. I got over a dozen med questions on it. Thank god I studied it. One more good book for pharma if you have time is Pharmacology Made Easy for NCLEX-PN. It's self explanatory. Read it and do the questions pretty much. That's really all you need, is just to do question after question and know the rationales for them. It's going to be a lot of work, nursing is not easy...but I wish you luck and I hope my advice comes in handy!

do what u gotta do. i say go to the hospital, if they pay ur tuition, u get alot more experience in hospitals too

very true pagandeva, i agree with you

my instructor told me that if the questions keep getting harder, then its a good thing because it means you are passing at the minimum competency so they boost it up the more u get right