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jjjoy LPN

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Content by jjjoy

  1. I love this! Have you got any other good comebacks like that? Ones that make a point with a bit of humor and without shame or blame lumped on either side.
  2. jjjoy

    is Nursing School HARDER than Medical School?

    I second these thoughts.
  3. jjjoy

    Do I want to be a nurse for the wrong reasons?

    Good advice! : ) OP, the time you spent in the hospital with your mom probably gave you a pretty good idea that you'd be okay with the hospital environment. For myself, one of the biggest dilemmas I have with bedside nursing is that for all of the wonderful technology, knowledge, skills and compassion nurses may have to offer, it can be an endless juggling act. Several balls are in the air at any one time and they are constantly changing in weight and number and direction! Also, there often is literally more that needs to be done than can realistically be done by the nurse. And somethings you simply have no power over but you bear the brunt of being a first-line provider. You've got a bunch of new orders that need to be done, physicians to call, a patient who is nauseated, another patient to prep for a procedure, another patient who needs pain medicine, another patient who was just given a bad diagnosis, is scared and has a ton of questions. Wherever you start, the ever-changing nature of acute health conditions means nothing every goes according to schedule. Anything can be bumped at any time for an emergency. Or it may be more mundane, you discover a patient ate something when they're supposed to be NPO and now the procedure must be postponed. You may now need to get new orders (leave a message for physician, hope that you're available to take the call when they call back sometime in the next hour). While you still need to do that dressing change, change that IV, and find some pillows for your newest patient since the linen closet is empty (again!). Some folks thrive in that environment . Just like some folks are okay in their cubicle M-F 9-5. No one loves everything about their job. Full-time bedside nurses are 12 hours straight, 3-4 days a week, 12 months a year, often working holidays, weekends, etc. Just food for thought! It sounds like nursing might be a good fit for you!
  4. jjjoy

    This Dr. has it right!

    I tend to see it that way as well. For insurance to work you need a large pool of people who probably won't need the service in question. Health care is something most everyone WILL need at some point. Those with pre-existing conditions will DEFINITELY be needing health care services. In either case, it's not insurance that people need, it's health care itself that they need. So the question isn't how do we ensure everyone has access to affordable health insurance, it's how to ensure that everyone has access to affordable health care. And that's not an easy question to answer. It involves determining how to make very expensive services available at an affordable rate (whether billed to individuals, private health care collectives aka insurance companies, or government programs) while still ensuring that providers can make a living and have viable businesses offering these services and developing improvements. What's considered affordable and what's considered a reasonable profit margin? I imagine a lot of disagreement there.
  5. I appreciate your sense of humor, Nurse Educate! And if your students don't appreciate your efforts now, they probably will at a later point. I do wonder if you happen to teach more younger, first-time students as opposed to older, second-degree students. Or maybe they all come across as whiney! Even in pre-Powerpoint days, if lecture was just an almost verbatim repeat of the text, why bother? I did have some non-nursing classes that were dull like that, but most weren't. On the other hand, most nursing lectures were a mind-numbing, very rushed, almost exact repeat of major chunks of the text. Let's see, 30 seconds per page for a three hour lecture, minus a short break... that would 'cover' about 300 pages of text. I again blame the system, not so much the instructors in regard to so much controversy over lecture/text conflict. Instructors have to use NCLEX style questions and so often rely on test banks instead of writing their own. It's not like the instructor is going to read through every page of the 1000+ page text book and then record and listen to every word of their lectures to ensure there aren't any conflicts or inaccuracies between the text, lecture and test questions. Add to that that the test covers just a very small fraction of the content studied, that the wording of some questions is not straight forward and that there's a very small margin of error (eg 82% to pass), of course students will nit-pick every question they get wrong!
  6. jjjoy

    how do you deal with disappointment?

    Dealing with disappointment is not a strength of mine. Growing up, I learned that if you didn't get it right the first time, you're stuck with the negative consequences forever, it's all your fault if things don't work out because you could've avoided it if you'd just been more diligent, and that being happy & satisfied with what is was just asking for trouble. Altogether it's a pretty hopeless perspective. I'm actively working on more positive ways of dealing with disappointment. To set and work towards goals and yet not feel like all hope is gone if the plans don't work out. Sometimes, it all seems like just a mind game. Sometimes, that's a depressing thought and sometimes it's a hopeful thought! I appreciate what people have shared!
  7. Don't blame the Powerpoint! I suspect that so much material is crammed into so short a time that for instructors to cover all of the content the solution too often is to read, quickly and without elaboration, non-stop through dozens of pages of material. Even before Powerpoint became ubiquitous, too many of my nursing instructors seemed to do just that - no time for questions, elaborations, examples, etc. Why bother having students all come together for lecture at all if the instructors are just going to read out loud to them, and read so fast that's there really no time to process the info before moving right along to the next and the next and the next? If I reviewed the material ahead of time, then at least the 'lecture' could function as a mandatory speed review of the reading materials. It didn't help with comprehension or even retention, but it did increase my familiarity with the 'nursing language' and general nursing considerations associated with whatever units we were covering at that time (pediatrics, oncology, etc)
  8. jjjoy

    Help. Is my outrage justified?

    Some people do, some people don't. Ever notice how easy it is over-generalize?
  9. I wouldn't go so far as to say *nobody* from coursework in other disciplines (or that *all* of my nursing instructors) discouraged really digging into things, but in my experience it was all too common for nursing instructors to brush off logical, fact-based questions by dismissively saying "if don't you get why X is the best answer, then you aren't using your critical thinking skills" as opposed to figuring out where the student may have gone wrong... or if the student might in fact have a valid point. Instructors would teach to never accept something just because someone says so. Providing rationales for everything was imperative. I've no problem with that. HOWEVER, if a student then questioned a rationale, some instructors seemed to automatically assume that the student just hadn't thought about it enough (or perhaps had over-thought it) and to answer such a question would be a waste of the instructor's time. I, too, was very frustrated with the instruction and testing at my reputable university nursing school. Not because I was getting bad grades, mind you. In fact, I quickly discovered that for myself intensive studying and in-depth comprehension did NOT help improve my test scores. It's not often that I had classes where 'over-studying' really could make taking the test more difficult! So my frustration was that for all the time and effort that we as students put into school and that instructors put into teaching, it felt more like we were learning how to "keep your nose down and just do what's expected of you" as opposed to how to be independent-thinking clinicians.
  10. My initial read of the question this: pain started in location A and then was later felt in location B, and this is what your client tells you. From the 'correct' answer, though, I have to guess that the question *really* is to be read as follows: Your client tell you "I'm feeling pain in this location", you the nurse know (how do we know? the question doesn't tell us) that the injured tissue (where the pain 'started') is actually somewhere different from the location the patient currently identifies as having pain. The wording of the question is not at all clear in it's meaning! I agree that referred pain *is* the right answer, but I don't agree that the question itself has no problems.
  11. jjjoy

    which specialty does this describe?

    Nurses' are often at the front line of attempting to keep that chaos organized!
  12. jjjoy

    Opinion vs. legality -- a rant

    I think some facilities' legal advisors may be so afraid of liability issues that they *do* discourage students from participating much and that *is* leading to newly licensed RNs with very limited hands-on patient care experience who have an enormous gap transitioning from student who can't do much more than observe to regular staff RN with the same job description, same level of responsibility as a nurse with years of experience.
  13. jjjoy

    % of people failing your program?

    From what I've heard, this isn't that uncommon. When that's a trend year after year, to me it means at least one of several possibilities 1) the program doesn't do a good job in screening applicants who will be successfull and too many students got in who shouldn't've been there to begin with 2) the program doesn't do a good job in preparing its students to pass its own curriculum 3) the program doesn't do a good job in evaluating the performance and potential of it's students and is failing some who don't deserve it. 4) it makes the program look more rigorous than it is since with so many failures who would accuse them of being a "degree mill"? 5) the program is set up to fail out 50% regardless of how well or poor the overall performance of any given class (why? maybe not enough resources beyond term 1 for the number of students accepted to the program and so are forced to fail close to half of each entry class? But little worry about losing students after that first term since they know how tough it is to get back in?) Any one of the reasons doesn't reflect well upon the school.
  14. To me, the terms "best" answer and "correct" answer can be confusing in some cases. Some NCLEX-style questions are such that none of the answers fit perfectly with the question. In such cases, one can imagine several better possible answers but has to choose the "best" of these less-than-best-possible options and that one is considered "correct" even if it's not totally accurate when looked at critically. Is that fair? It's fair in that all nursing students are subject to this style of testing. Do these types of questions, especially non-peer-reviewed test questions, actually test knowledge and critical thinking? I think that's debatable. I hate to call this "over-analyzing" or "over-thinking". In other contexts, the concerns raised by the OP about some of these example questions is considered a laudable degree of analysis and critical thinking, not too much! Again, nursing students *do* need to learn how to identify what's the "best" answer in these types of questions, to ask themselves what is this question REALLY asking as opposed to what it may seem to be asking. Students need to learn to do this in order to do well on tests, but *not* IMHO because it helps them to learn to "think like a nurse".
  15. jjjoy

    Help. Is my outrage justified?

    Some test questions are 'tricky' like that. I personally detest such questions, but sometimes you just have to live with them. I figure that when I get a dumb question like that 'wrong', chances are I also got some other dumb question 'right' just by lucky chance! I think it's lousy way to draw the line between passing and failing, but even as flawed as it is, it is likely that it was more than just this one question made the difference. Sometimes, just the way the student approaches the dilemma can make or break it with some instructors. Coming at the instructor with the attitude of trying to argue for a point is less likely to help no matter how well reasoned and supported the argument about the given question is.
  16. I hear ya, Fitzy. Your program sounds a lot like mine. First year we heard "oh you'll learn that later, plenty of time!" and as we neared graduation at the end of the second year we heard "what? you don't know that? that was already covered!" ... yeah, it was covered in one page of 3000 pages of text. And in lecture? Sure, it was covered when the instructor said "we don't have time to go into that now; there'll be plenty of time later." I do wish there were more options out there for nursing students whose programs were light on clinical and/or returning nurses who felt too rusty to build on their clinical experience without having to jump right into a full-fledged RN staff position. It feels as dangerous as trying to merge from a short on-ramp into fast-moving traffic from a full stop in a small engined car; if I could just have a bit more time to get up to speed, I'd feel a lot safer.
  17. That's true. But here's some advice direct from a "How to Induce Sleep Naturally" guide: "Exercise regularly. Exercise in the late afternoon or early evening but not within two hours of bedtime."
  18. I very much agree! Of course, one still must work with the testing materials and learn how to best navigate them, but I see no reason to defend poorly written questions as honing critical thinking skills, teaching how to think like a nurse, etc. Learning how to choose best answers for this type of question is a skill unto itself; I don't believe it reflects much about one's nursing knowledge or critical thinking skills at all. In fact, I tended to do better on questions where I wasn't very familiar with the content and when I concsciously avoided thinking critically about the question and answers, otherwise, I'd end up 'overthinking' it!
  19. jjjoy

    I think nursing isn't for me.

    I hear ya; the apparently typical clinical learning process goes so against my grain! If I had no choice, I figure I'd survive and eventually thrive. But survival mode takes a big toll physically, emotionally and on relationships. Feeling nauseous, not being able to sleep well, unable to enjoy time off, etc. There's no way to know how long it would take to get beyond that and I *do* have a choice. So far, working in a clinical capacity hasn't been motivating enough for me to volunteer for survival mode for what would probably be at least a year, if not more. Precepting as a licensed RN was overall a *much* better learning and confidence building experience than being a nursing student, but it was also more draining to me. And to go through something similar every time I change positions?! I so admire those who do make that choice! And while the typical system doesn't seem to work well for me, it seems to work well enough for others. Look how many people are successfully and satisfactorily working as clinical nurses! I do have my BSN degree and RN license, that gives me a good foundation for what I'm currently doing, which is in the realm of health information management. Who knows for sure how things will play out as time goes on?!
  20. Here's my take on it... Learning NCLEX test-taking skills is not the same thing as learning to think like a nurse. Still learning NCLEX test taking skills is important because you need to pass the tests!
  21. jjjoy

    Restraint-free facility = FALLS GALORE

    Medical supply stores do sell side rails for regular home beds and people use them. A resourceful family might push a dresser up next to the bed to function as a side rail (I don't recommend it, but I've seen it). There may be many reasons side rails are a bad idea, but the fact that most people don't have them at home doesn't seem like a strong argument against them to me. I understand that a really determined, agitated patient might very well climb over side rails and end up taking a greater fall than without siderails, or get wedged under the side rail and suffocate. Side rails and other restraints certainly pose several risks, but no restraints without full-time sitters poses its own risks, doesn't it?
  22. I tend to agree with the thought that some questions in some classes by some instructors are confusing simply to make it impossible to get 100% on tests. I think these are GREAT examples of NEEDLESSLY "difficult" test questions. Being able to "critcally think" one's way to the "best" answer of questions like these doesn't reflect student understanding of important medical concepts. Confusing point: The "from where it started" is what makes this one confusing. Referred pain may pop up somewhere without having "started" in another location. "Best" answer: referred pain sounds most like the description despite a starting point of the pain having been identified. Confusing point: the choices given are from different categorization levels, Major vs minor, urgent vs elective vs emergent, etc. "Best" answer: restorative Confusing point: "induce sleep" "Best" answer: C because the content is definitely true (but I could easily imagine the words "induce sleep" used as a rationale for another question with different answer set.) Confusing point "if stated by your client" vs "understanding" "Best" answer: B - even though not totally accurate, it shows some understanding on the part of the client (again, I could imagine a 'not totally accurate' answer as stated by client being rationale for another question with a different answer set) Confusing point: discourtesy is an example of (a subset of) unprofessional behavior "Best" answer: A - "behavior"
  23. jjjoy

    School should help with boy's insulin pump, mom says

    Those weren't the only choices in the original situation presented. The mother had a choice of "vanilla" school with on-site professional medical assistance. That seems like a reasonable option given limited district financial resources and liability issues of non-medical staff (teacher/secretary) being forced to take responsibility for programming insulin dosing. If it were just providing a pre-set dosage at a certain time, such as with routine po meds, I'd be more apt to think it reasonable for the school to allow a non-medical professional to be in charge of that.
  24. jjjoy

    Why am I a B student?

    That was sort of my experience. That didn't mean I stopped studying or trying or learning, just that I organized my study time and methods very differently than for other classes. I really found it confusing when instructor or texts would go into physiology, pharmacology, etc on a rationale for the 'best' answer when it really came down something much simpler such as the question word was "assess" and three of the four answers were "doing" interventions.