almostfearless

Hey there! Yes, you can get an ED position without ED hours, though a preceptorship in the ED tends to be a helpful shoe in just because they know a little about you. I precepted in an ER, though, and did not get a position there. They liked me just fine, but had no available positions. I am no help on the "Where to practice" issue- I'm in Alabama and had no intentions of relocating after, so I'm still in Alabama. =) As for how soon? I precepted a guy just recently who already had a job by the time he got to me, so sending out applications and resumes during the final semester of your school is not a bad idea. You CAN be hired on contingency of having passed the NCLEX within a certain timeframe, and if for some reason you do not pass, depending on your unit's needs, you may just need to take a tech/PCA position until you've passed. I elected not to go that route because I had terrible self esteem and was unsure of if I would pass, so waited until I knew for sure. Obviously, I did pass. =) Don't stay whetted to the idea of "only an ED" though, because you may not get your first choice of job. I swore I'd never work med surg, and then my first offer was just that. I got a LOT of experience and strengthened my knowledge base that way though. Good luck!

There are so many reasons that this is bull--- I eat well, am a constant member of Weight Watchers to make sure that I'm eating well, am a gym rat, used to play roller derby (so tons of cardio as well as drills that ensure flexibility and strength), and try to maintain that level of athleticism. And guess what? I am fat. I am 5'4" and 230pounds, which is more than I want to be, but my goal weight is 200- which still puts me as obese. I am heavily muscled, and do a lot of weight lifting. I have coworkers that are tiny and skinny and healthy looking who tell me how in awe they are of how much I do in the gym and how active I am at work, and wow you eat such healthy foods. SO, SO many reasons that a person's weight cannot be a marker of their overall health. It's disappointing to continue seeing this kind of talk, despite many, many studies that have shown that weight is a poor indicator of health and healthy behaviours.

Also, she is severely anemic. How about this: Goal: Patient will have no falls related to syncope/Nutritional status Interventions: 1) Sit patient up slowly to prevent syncope 2) Check blood pressure before standing 3) Keep bed rails up x2

I'm a second semester (out of 5) ADN student-- And tomorrow is one of the last two clinical days I have left for this semester. Today was preclinical. I'm a bit nervous because I failed one of the two previous paperwork days because of the goals sheet. My professor is wanting good, cut-the-crap kind of goals. I'm having trouble coming up with any. She has beginning COPD, beginning congestive heart failure, hypertension, a diabetic ulcer on half of her great toe that's looking better than I'd expected. I have this one: Goal: Prevent infection of Great Toe ulcer. Interventions: Keep clean Keep Covered (I Can't come up with a third one!!) And I need a second goal, complete with three more interventions. I'm thinking: Goal: Maintain blood pressure at or below 145/85 Interventions: Medicate per MAR ? ? Some of the confusion is coming from the fact that our professor gave us an additional lecture last week that if we write out a goal, our interventions should be only things that DIRECTLY and MEASURABLY effect the outcome-- Like if the problem is edema, you can't say daily weights, because while that is a good thing to do, it does not achieve your goal of reducing edema. Which is understandable. But it leaves me completely blank. AAAH!

I would not have been so angered if only the "right" answers were explained in full rationale. Beleive me, I understand. The expectations aren't always laid out. I'm having the same problem at my school. :) Thanks for the input. I just decided to jump straight into Dr now because apparently my instructors made it clear that-yes, critical thinking is needed, but your thinking further & deeper than a nurse would. I think your thought processes are just highly factual and scientific. Which is not a bad thing! But you have to be able to judge what's really being asked. If a patient starts asking what they will do with their dog while they are in surgery, they may actually be asking "Am I going to be ok". best way to put it is a baseball metaphore- Im up at bat. The entire field is Nursing & Patients. I hit the ball over the fence (homeRun). Where the ball went is great but does no good if the patient cant reach it (understand things). that's a great metaphor! I might share that with a few people I know. :) As for the Digoxin -Inotropic Question- It is true it is stateing its an Inotropic. Yes it does not say whether its Positive or Negative Inotropic because that is irrelevant info because All in all, both my answer & theirs are right. Both are the Inotropic actions. Digoxin simply can not work without decreaseing the HR to what ever extent the doseage is. Do you concur? it is true that Dig slows heart rate and strengthens contractions. But is that what the question was asking? The question was asking "what is its INOTROPIC action" And Im glad you are still willing to discuss this. Because I can guarantee you that med school will do the same thing. (Im not worried or furious with these questions any longer but I do enjoy the debate of these) Wonderful! Because an unexpected outcome of this discussion is that I am reinforcing some knowledge that I'm currently gaining. We had been talking about Dig in class, but this discussion has helped me to remember it's properties better. I learn by talking. :)

I've looked at #3, and I believe that what they are going for is that when you do a VITAL ASSESSMENT, you are searching for not only the pain level, but all possible CAUSES. We are being taught that part of your assessment of vitals INCLUDES a pain scale assessment. In the Digoxin question, they are asking specifically what inotropic means, not the whole effect of the drug. It makes sense that you would overthink those. You just mentioned that you were aiming for Doctor, and I feel that could be quite suitable for you since doctors are more sternly clinical in their thought. Nurses must go a step further and be abstract about the way they think. Not so much "Educate about all of the possible toxicity symptoms" but more of "What education is *most* beneficial to my client?" I hope that makes sense or that I'm not speaking out of turn. I wish you the best, and congrats on Med School!

Thank you. I did do that some, but I've been reflecting a bit, and I could be utilizing that more. I feel that the next clinical will be a bit less stressful for me. However, I'm just a bit irritated that our expectations were not laid out for us. We had no goals or direction. I want to be the best nurse I can be!

I'm confused, and I'm far from the only one in my class that is in the same situation! I am a first semester nursing student, and we just had our first clinical experience on Friday. We were literally told "Your patient is in room... Go meet them." And that was it! While other students got patients that had a lot that needed to be done, and ran around like mad men and women the whole day, a few of us had patients with little or no actual needs. I am NOT complaining. The problem is, I KNOW there is something I'm supposed to do. But What is it? Our instructor asked near the end of the day "Have you assessed each of her pulse sites? If not, you're going to get failed." WHAT? Why didn't you tell me this? YOu've been helping all the students that were overwhelmed and didn't really give us instructions to begin with, so how was I supposed to know that my assessments needed to be that detailed? On top of that, I did try and complete an assessment, but we were told in class that if the patient is tired, come back later. my patient had not slept the night before, so she was falling asleep. She even fell asleep as I was inflating the BP cuff. My instructors assumption was that she was trying to manipulate me, and to get back in there and finish the assessment. SO, I'm confused. Of course, I know the basics of how to assess and etcetera, but we didn't go into the day knowing what was expected. So, let me know, what all is/was expected of you during a first semester clinical?

They've changed things a bit, so you no longer have to make a 90% in the first semester to pass, but they have not decided if the next semesters will stay at 90% or not. So far, the math is really not that hard, and they demonstrate a small bit of it in class before you are expected to take the test. You just have to know what you're looking at. 1st semester has not had it's first Pharm. Test yet (it's this Wednesday), but I'm much less worried now than I was before the semester started (I'm a math-phobe, so that's a big deal) I'd start studying unit conversions, including apothecary measures.

Is anyone else having trouble logging in to Blackboard? I havn't watched those videos, and havn't been able to print the syllabi, but the blackboard login is not responding!

By the way, LeJoy in southern downtown Birmingam (6th and 24th?) gives something like a 10% discount to students, and if you get on their mailing list, they send out some great coupons and notify you of some really great sales occasionally. They are very nice there.

Yeah, meridys is overpriced. My mother gave me one, and I got another one from eBay for $20. The Sprague are the better type for accoustics. Also-- I've been told there is a problem with equipment "dissapearing".

I'm both excited and terrified. I didn't take classes this summer, and things had been very crazy for me (hubby unemployed for 4 months because economy sucks-- he got a job Tuesday though- we celebrate tonight!) so, I'm afraid my study skills have gotten rusty. I hope not! I just keep trying to study now and get distracted with doing something more immediate. It helps when we actually have classes and assignments with actual due dates. Yeah, I had my titers done, and they all came back very good. I had my hep b shot last thursday, tetorifice about 2 weeks ago. Yay! I have a cute little bruise from the hep b shot. :)

Stupid question--- the math packett-- it's not homework, is it? I've been studying it and doing problems and researching how to do difficult ones, but I havnt been trying to complete it. Are we supposed to do anything fancy with it? Am I being paranoid?

Yeah, I did a lot of looking around, and the bundle really was the best price-- plus, I'm a total techie and was totally won over by the ebooks. I study best when there's a computer program to help- mostly because I'm so hands on about stuff. I think in 3-d if that makes sense.