goingback

I have a friend who finished LPN school a while ago and hasn't been able to pass NCLEX and now has been out of real like practice in hospital. Is there any "refresher" course that has simulations that could help her refresh her skills and the critical thinking basics of NCLEX--like always check the ABCs first even if the patient has a stubbed toe?

So there is no doubt that in-person nursing skills and health assessment labs are to gold standard for teaching students, student practice and being able to do check offs. But given the COVID situation, and the possibility of needing to possibly stay online now and in future (god forbid another pandemic)--are there ways of doing skills lab and health assessment labs virtually? What are some of your schools of nursing doing now to help keep up these lab classes virtually?

Ugh. I've been a nurse for 20 years--ER always (and some other units). On my feet 8-12 hours a day for 20 years. Now for the last year I got a knee injury and then knee and hip pain. All wear and tear and overuse DX--patellarfoemoral syndrome, piriformis syndrome. It is so hard when you are in pain to work, let alone do your PT and exercise as well. I am one of those who takes care of everyone else before myself and my body shows it. Yes I am overweight--don't exercise like I should, but diet is reasonably ok. Stress has been huge (work and family issues). While work stress is being resolved, family stress (husband) still there. Last year this time--I was working out 4 -5 days a week, had lost 12 lbs, but then got a knee injury which has not involved more things. I can still work, I am doing PT for my hips/knees, but it is very hard to exercise (especially cardio) when I have hip and knee pain I am limited and it is a fine balance of not doing too much so that pain isn't worse (got to still be able to go into work to pay the bills). So when I complain in the evening of my hips and knees hurting husband says "well don't you think its your weight. You need to exercise" He doesn't get it. Yes I am overweight, and that has not helped anything and I am sure made things worse, but so is 20 years of being on your feet. How do I get his to have more compassion for me. I am exercising, I can't do the kickboxing or zumba that I want to because of my injuries. I can't even go up and down a flight of stairs without a lot of pain/difficulty. I can only walk for short amount of time. (I have a complicated condition--otherday I walked around at a festival for 2 hours with no real problems minor pain--but then my muscles were apparently so fatigued I literally could not lift my leg to get into car (my husband just rolled his eyes at me). I am doing best I can. He is not understanding, he resents that I ask him to help out with house or taking groceries in when I tell him I'm in pain. It seems like he is unsympathetic to my pain because he thinks I have caused my problems due to being overweight only. Am I wrong? Lazy? I am doing best I can.

Just thought I would update. I had stayed with the ER. But again the bullying came around, had to get the union involved (I was having health issues and the ER bullies were making it their business to try to get me in trouble with excessive absences (even though MD notes), not being "up on skills", etc.). Union said I had case for harassment. Just not worth the fight anymore--why am I working so hard to try to stay in a place that I love the work and patients, but hate the people I work with--and that constant stress of working with people who are making life difficult for you. The stress of working with those people was affecting my work and my health. I have 2 other areas I work in with no problems and people happy to have me there. So I quit the ER. I am still coming to grips with that, mostly wondering how uncomfortable it will be running into those who made my life so miserable. But it is a major relief not having the stress of working with those nurses. There are others who have left recently also for similar reasons. I wish management would wise up and see they are loosing good people. I really hope those bully nurses will eventually get in trouble for what they are doing. They are not representing the spirit or values of a nurse.

So in the hospital as a nurse you are evaluated based on your performance that is observed, peer eval, maybe your written documentation, your percent of scanning meds, following policy, etc. But how are your evaluated as a clinical instructor? Is it 100% based on the student evals. Apparently I have a rep of being strict., tough grader, demanding too much based on the student evaluations. And the director says that I should pay attention to the student evals--but yet there is never any documentation of me doing things wrong, unfair, etc. Just student complaints. So I feel awkward being told I am basically doing things wrong by administration when they have never shown me anything I am doing wrong, have never come to observe me in person, and have just told me students complain I am too hard. I have taught for over 7 years and never have had a formal evaluation, just told I have comments from student surveys that I am strict, hard. Students have said I have made them cry--so I am a bad instructor. So because I talk to a student outside of a patient room, and tell them the things they did well, but also the things they could improve on, and in some cases things that were very wrong--so if they cry it is because of me? Sorry--I just need to vent frustration here. I want to be a good instructor. I thought I was. What do I need to ask for from by nursing director and how should I approach this?

Thank you all for your posts. They are along the lines I am thinking too. I know that I will need to still continue to keep up my ER critical thinking even if I leave the ER. We will see. If one of the other units offers me a benefited part-time job I think I will take it. I think I need to practice what I preach about leaving stressful situations that make you to be a grumpy unhappy person. I know wherever I work I would want to be there. Thank you all for your support.

So I have been an ER nurse now for 20 years, since graduating from nursing school. I have done many things also besides ER--treadmill lab, gyn/onc, teaching, etc. I love ER--the excitement, the use of skills, pt teaching, etc. But in the last year there has been changes in staff and environment. Bullying. I work in other departments as well. I have had personal stress lately and injury that has limited my ability to work in ER. Is life telling me it is time to leave ER? My concern is that if I left (even though I am only per diem) is would I ever be able to go back? I love all the different departments I work in. Trying to think if the opportunity arises if I should take a benefited position in one of them (get retirement benefits). But the status of "ER nurse" is one thing that is difficult to give up--tell someone you work ER and they treat you with such respect. Family friends come to me for advice because I am "ER nurse". So what am I if I don't work ER anymore? I know that I am and always be a nurse no matter what department I work. Anyone else ever face this idea of feeling they are giving up their identity if they leave their department?

While I may not be young, what can I do about 2 nurses that I work with that consistently talk behind peoples backs and try to stir up trouble for people. Literally they will try to talk about nurses to other nurses to gossip and then talk to the nurse manager and say a person is having difficulties on the job or say something about their demeanor of complain about how they did something. When there are not errors being made--what gives them the right to basically make complaints based on personality, attitude and perception vs facts. The nurse manager says "yes I know and I've talked to them", but is it to the point that I have actually stopped picking up shifts (I'm perdiem) because it is so stressful to work with these 2 nurses. Literally I was called into the nurse manager to discuss my "capabilities" because of an unsubstantiated complaint that they had stirred up. When there have been MANY complaints about how these 2 nurses' negative attitudes and talking have jeopardized the working environment, when do these nurses ever get penalized? I was so insulted, hurt, overwhelmed by there "accusation" I literally could not sleep for 3 days (there was no official write up of accusation or the meeting). I talked a second time privately to my nurse manager and pointed out how these two actually added to a difficult pt case and then also then discussed the pt case factually. There was no way that those two nurses who were involved for the first 15 minutes of the case before I came on shift could make a complaint legitimately about any pt care/lack of care they were not involved in since they then went off shift. What can I do? I am actually afraid to work any shift with them because I am afraid of them making accusations or starting rumors. I already know that they talked about my situation because other nurses came up to me. That is not appropriate. What are my rights? I don't think my nurse manage really understands what to do with them and is not protecting me or her other nursing staff.

So our school of nursing (in California) is revamping the curriculum. Many faculty want to do away with questions that require students to calculate drip rates or pay attention to drop factors. The main argument being that most things are and should be put on a pump. My concern is that there are times when pumps are unavailable or not working. So you need to be able to calculate drip rates. Comments?? Does anyone know if there are regulations that require nurses to know how to calculate drip rates?

Help! I have to do a per diem night shift (haven't done nights since nursing school). Not really sure how to get myself to sleep during afternoon evening. Do I try to take like a melatonin at 3 in the afternoon and put on eye shades and use ear plugs? Do I try something like ativan to relax to sleep? I am just scared about not being well rested.

I need help. I am a new instructor with Med-surg. THis course is not easy--nor are the undergrad students who seem to have it out for me since they did poor on a test. Now I am scared since one of the regulating bodies is coming for our survey and mine will be one of the classes they are sitting in on. I need to find a creative way to teach or keep the students involved in the class (lecture doesn't do it and I am afraid they would try to stump me on purpose. Asking them to do any type of student teach might tick them off even more). Help.

Ok. SO I just gave my first med-surg test online and the majority of the class scored between 70-75%. I thought I had prepped them well--I chose questions that are most practical to actual clinical practice. I made a study guide specifically targeted to the questions on the test, and in a review game I even had some of the actual test questions and answers. They never really taught us in my MSN class how to decide what questions to throw out based on how many people got it wrong. I will look the questions and responses to see if there were traps that students fell into when answering or if they just did not understand the question. Any guidelines on when to throw out a question--like if 75% or 50% got something wrong?

I have the previous syllabus. I can view the slides from the previous instructor--which are way to ICU detailed and I have slides from textbook author. I am trying to view this as I want to make the class my own (not just lecture from author slides), and I want to make it REAL. To me Med-Surg is the management of med-surg patient--you don't need to know absolutely everything about every condition, but enough to understand what is affected by the patient, what to watch out for, what should be expected and unexpected outcomes. I am trying to look into using case studies as a way to understand and reinforce learning and will try to make these up based on my own experiences as a nurse. Any other leads or suggestions?

I will be teaching med-Surg for the first time for a BSN program. I've only done lab classes before. Scared for how to fill a 3 hour class with lecture. Also typical fears of what if they ask me a question I don't know. How do I make things interesting and fun and not just lecture from ppts? Do most of you memorize your lectures? How do not depend on my ppts?

I did mine through CSU Dominguez Hills. The GRE not required. There is no thesis. I only had to go to campus two times. I had a great relationship with faculty and fellow students online. I learned a lot. California state tuition--so it is a bargain compared to other online schools.