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jjjoy

jjjoy LPN

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Content by jjjoy

  1. jjjoy

    HR becoming pickier?

    There just aren't any hard and fast rules that will ensure someone gets a job. It *is* very frustrating! It's the unfortunate reality we have to deal with. After venting the frustration, might as well do all you can that might help land a job since to be "in the right place at the right time" you've got to keep putting yourself out there.
  2. That's how it seemed to me at my BSN program. I can't say that's everyone's experience and I'm sure some schools/instructors do a better (or worse) job than others. That would be my message to the OP as well. In my limited experience, solid B students tend to experience less of an overall dip in GPA than straight A students in nursing classes. With the narrow range for grades (eg
  3. jjjoy

    priority nursing questions

    Hmm... the question clearly states it's about priority, not sequence... a) Sterile Gloves - minimize risk of infection to mom b) Put hand in to move baby off cord - get oxygen to baby ASAP c) Put oxygen on mom - increase oxgyen available to baby via cord d) Put towel under mom - for comfort and cleanliness only (not reducing risk of infection, skin breakdown, etc) B is certainly higher priority than C. And both B and C are higher priority than D. So were does A fit in? If we're not successful in moving baby off the cord (if some alternate action must be taken and/or baby doesn't survive), at least mom's risk of infection has been minimized?
  4. OP - I think I understand what you're getting at when you say it feels more like being tested on "find the differences in these two pictures" than on useful, relevant knowledge, understanding and judgement. My experience, too, was that while we given tons of material to cover in text, having studied that material thoroughly didn't seem to help on tests and in fact could end up confusing me on tests as I'd be reading way too much into a question. So I hear your frustration. However, there's only so much you can do while you're in the thick of it as a student. No matter how valid your issues may or may not be, you've still got to get through your tests which means learning to live with "the logic behind nursing exam questions" - which at times may not seem as logical as it could. Personally, my experience was that it seemed some instructors wrote tests such that the only way to get 100% is to have a few lucky guesses or to have flat out chosen the right answer for the wrong reasons. Study the texts and get further background information for your own knowledge even if it doesn't seem to help your test performance. Practicing NCLEX review questions can help "get a feel" for these types of questions. If you continue to have strong feelings about this even after you finish, then maybe you can help influence nursing education for the better in the future.
  5. jjjoy

    "Nurses don't make judgments"...do they?

    Good point about what exactly is the question asking about! That's always something to watch out for on tests. Still, isn't it educational to tell someone that 120/80 is in normal range? Whereas the stethoscope answer sounds more like an explanation (what is the nursing doing?) and the answer is using medical jargon that likely makes no sense to a patient. I'd imagine immediately crossing that answer out as a teaching example for that reason!
  6. jjjoy

    Put on probation first time administering meds

    It does sound frustrating! I'm not saying the instructor was right in putting you on probation. I'd feel it was unfair if it were me based on what you describe. However, assuming she takes you off probation, you might want to let it go til the end of the rotation. Have you heard the phrase "would you rather be right or happy?" Here, the question might be "would you rather have justice or pass this rotation?" Not that it's definitively one or the other but rotations go by quickly and soon you'll have a different instructor whereas having to retake a rotation may put you behind a whole year depending on how your school structures clinicals. Later you may want to file a letter dispassionately questioning the instructor's application of probation to that specific situation, just for the sake of clarity and future student & instructor benefit. If the school gets several questions about this particular instructor or the application of the probation policy, it may make a difference. It also may not make a difference, but there's only so much you can do as one student over one incident. So go ahead and be ****** off and bemoan the unfairness of it to uninvolved parties; but at clincial, just try to just look forward and keep striving to do your best.
  7. jjjoy

    "Nurses don't make judgments"...do they?

    If this is the reason that one was wrong, that makes sense. It's probably not a good idea for a nurse to appear to be proclaiming resolutely that there are no problems with the blood pressure. Still, it's not as clear as it could be. Students should know what is generally considered "normal parameters" (based on evidence of course), but this question doesn't test that knowledge. A student could get this question right even if they didn't remember much about blood pressure. In fact, a student might think that blood pressure is too low or too high and that's why they didn't choose that answer. And how much more confusing if the instructor explained that that answer was wrong because "nurses don't make judgements" and that that comment is essentially diagnosing the patient, akin to telling a patient they have hypertension with one high blood pressure reading. How easy for a student to interpret that to mean as a nurse, you're not supposed to say or think anything except "the blood pressure is XYZ" and nothing else! Additional comment: Saying "Your BP is 120/80, which is within normal range" is not the same as saying "Your BP is 120/80 which means your blood pressure is right where it should be." ----- If this is the first time you've seen this patient and the patient doesn't look to be in any distress, an adult of average height and weight, and this is the blood pressure reading you get, as a nurse you should take into account that the reading was within normal parameters, shouldn't you? "most recent BP within normal parameters" would inform your continued assessment. However, if the blood pressure was crazy high, even if the patient seems okay, you'd want to address it immediately.
  8. jjjoy

    Put on probation first time administering meds

    Nursing school evaluations can feel rather arbitrary sometimes. Perhaps it was just that you said "I don't know" as opposed to "I'll look that up". Or maybe to the instructor, you seemed unconcerned about not knowing the classification, like "so what? I don't need to know that" and the instructor wanted to make a point that while you'll never know everything, it can be dangerous to be complacent and think you already know all that you need to. Or perhaps the instructor just felt that you didn't take her seriously and was flexing her authority. Who knows for sure, right?! Either your instructor is decent and can clarify this for you. Or your instructor isn't that great and you just need to do what the instructor wants to pass and try to make the best of it til you move on. And, as another noted, document, document, document any issues so you can provide details to either defend yourself or prove a problem with the instructor if need be. In all things, remain professional. I don't think it's right for instructors to act unprofessional and it can be unfair if the instructor isn't clear about what the problem is, but some might argue that the main point is that *you* act professionally. And if you come across as whining "It's not fair!" you don't look at all professional.
  9. jjjoy

    priority nursing questions

    Yep, that would be a really bad day! Are we not assuming that the sterile gloves are right there? Otherwise, like the towel, it might take 10 minutes to get the gloves. Yes, it would appropriate in this situation to have sterile gloves at the bedside already, but it would also be appropriate to have oxygen ready to go and towels at hand, right? If we're to assume that our sterile gloves won't be dropped or torn or way too small, then why can't we assume that the oxygen won't take more than 5 seconds to put on mom? Absolutely! But how in the heck do we even know for sure before putting a hand in if the baby's head IS in fact compressing the cord? Presumably the monitor is showing the baby is in distress and cord compression is a likely culprit. But do we know that for sure at that time? And if baby is compressing the cord and must be manually shifted, is it possible that you'd need to continue holding the baby off the cord? And then you couldn't reach the oxygen to put on mom. It's better to have baby off cord than oxygen on mom, definitely. But wouldn't it be even better to have baby off cord AND oxygen on mom? That's why I was wondering if the oxygen were right there ready to go if it might ever make sense to put the oxygen on first. If any student seriously thought touch first put on gloves later, yikes! But a student might think that in the overall big picture, getting the baby's head off the cord might be a higher priority than putting on the sterile gloves in the same way that getting the baby's head off the cord is a higher priority than putting oxygen on the mom. If we put 1) sterile gloves 2) hand in , 3) oxygen 4 ) towel... then are we saying that after everything else THEN we put a towel underneath? That certainly doesn't make sense, either! The sterile gloves don't fix the problem, either. But of course, reducing the risk of infection is also a priority! Is reducing the risk of infection a higher priority than getting baby off cord ASAP? Is that the real question here? I guess what bugs me about these types of question is why not just test knowledge and understanding directly? For this procedure, should you use sterile gloves, or are non-sterile gloves alright? Baby in vaginal passage is showing distress, what might be causing it? If baby head is compressing the cord, what should the nurse do? ----------- Thanks for the dialogue!!!
  10. jjjoy

    priority nursing questions

    bump - anyone else have an angle on this?
  11. jjjoy

    RN Rant Posts are Scaring Me

    Not everyone who became teachers feels as miserable as you do. There may have been some disillusionment and disappointment that their experience didn't measure up to their expectations or the ideals school was promoting... and of course the frustrations of professional politics, budget shortfalls, inane administrators, obnoxious colleagues and the like... but for some it's still worth it to them to keep teaching despite the frustrations. The same goes for nursing. Some get through nursing school and feel just like you do about teaching. But for others, nursing is still worth it for them despite the numerous frustrations. Things you might envy about nursing (overtime pay, leave it all at work) just is not worth it to them in the same way that what others might envy about teaching (summers/holidays off, M-F) just aren't worth the aggravations to you. Unfortunately, we have no absolute guaranteed way to find out if whatever education we pursue will definitely land us in a career that works for us. Fortunately, we're rarely ever totally stuck and can make alterations as we go, though it can be an uphill struggle at times. Best wishes to you as you find your path!
  12. Are you in the Bay Area? That's been a relatively tough area for new grads to get their first break in even before the recession. Still, I'm thinking that in those places that are restricting applicants to those with higher degrees means that they aren't hiring much at all. That new grad BSNs or MSNs, and maybe even some experienced nurses, are also being turned away. They just get told a different reason... "no experience" "not enough relevant experience"... as opposed to saying they don't qualify based on their nursing degree. I imagine if an ADN with the exact skill set and experience to fill an open job walked in, they'd "make an exception" and hire them. It doesn't make it any easier for you; I just don't know that it would really be easier if you did have that BSN.
  13. jjjoy

    whats your honest opinion concerning med aides?

    That's the key there, isn't it? Whether with licensed nurses or unlicensed personnel, if the management isn't effective and prefers to turn a blind eye to problems, the quality of care in a given facility will be at greater risk.
  14. jjjoy

    For those of you in NS

    Instead of just getting by and hoping to never have to do that again, perhaps try to remember that extra writing and math classes can be a benefit to you. Writing is something we can always improve on. And if you don't feel you have strong general math skills, then more practice is a good thing! If you do have strong general math skills, then an extra class is a hassle but not a threat. Of course, a poor teacher can make any class miserable, but most of the time students can get something of value from just about any class they take. It's a useful perspective whatever path one takes.
  15. jjjoy

    For those of you in NS

    I'm a bit unclear here. It sounds like you haven't actually haven't gotten all of your math and sciences out of the way at the college you've been attending. There's still micro and two chem classes. And maybe there's more such courses that aren't pre-reqs to admission to the program but, like micro, would still need to be taken at some point. It sounds like you're still getting info on all the pre-reqs, co-reqs, and core coursework of the programs - as opposed to just the minimum admission requirements. You might feel like you're starting over, but nothing wrong with that if that option otherwise makes sense. It sounds like it would be at least 2.5 to 3 years either way but you'd need to check with both programs to figure that out. It's also worth figuring out if the hospital program is associated with a college. Do graduates earn a diploma or an associates degree in nursing? If it's a diploma program, what would it take to later earn an associates or bachelors degree in nursing? What you described about clinical sounds like many nursing programs. Not all programs do it the same way, but that's not unique to hospital programs.
  16. jjjoy

    For those of you in NS

    Do you know the reputation among health care employers regarding grads from these two programs? If the hospital program is well-reputed and the cost isn't prohibitive, I'd recommend going for the program you've been accepted to already. It can be crazy competitive to get into community college programs, with acceptance sometimes by GPA, wait lists, and/or lotteries. And extra, perhaps more rigorous pre-req coursework can't hurt and might help in the long run. But there are many variables to consider that would make a difference. How much more the program costs than the CC program. What you can afford. The quality of the program. What you would do while waiting another year to apply to the CC program. Best wishes with whatever you decide!
  17. Personally, I've come to realize that I do better with gradual transitions. Nursing rarely offers gradual transitions. Nursing school is a cram course that exposes you to a ton of info but the real learning takes place on-the-job, with lots of real-world responsibilities and at times overwhelming workloads. There's not always much support for newbies, whether RN or LPN. You have a license, you are hired to do a job, if you don't get up to speed fast enough, you're out of luck. For someone like me who does better with gradual transitions, I'd recommend working as a nursing assistant/patient care tech in a hospital. First get comfortable with a "home" unit, and then try to float to different areas to find out what, if any, areas might feel like a good "fit" as well to get exposed to a wide variety of patient conditions and a wide variety of nurses. That would set a solid foundation to build upon, making the mountain of info tossed at you at nursing school a bit less daunting. Another option that probably would've worked better for me would have been to complete a more focused health tech program to begin with. Like being a nursing assistant, it gets you in a clinical environment where you can start getting exposure to working with patients and their health issues as well as observe what the nurses do and if that's a direction you want to head next. For me, already having some clinical experience would also help maximize clinical time as a nursing student. With experience, the student might have a better idea of where they want to focus their attention during the limited clinical time. Those without experience spend the first several clinicals just getting comfortable with the environment and dealing with patients and body functions. The one reason I might recommend LPN, is so that one could start working AS a nurse and still have the opportunity to be a nursing student in a clinical environment again. Much of what we covered in nursing school was completely abstract because I'd never seen any of it before or anything like it. What does dyspnea really look like? sound like? How do you identify if some symptom is minor and to be monitored or more critical, to be prepared for intervention? That's something really only learned with first-hand experience. If you enter nursing school with no experience, you don't really learn that until AFTER you've been working awhile. So there's still a ton one DOESN'T know and hasn't experienced even after earning a license, if that's the only health care experience one has had. Once you're out of RN school, that's pretty much it for general formal floor nurse training. There's little opportunity for any kind of formal "remedial" training if one feels weak in their abilities despite having the license. Just food for thought!
  18. jjjoy

    First Semester Student - is this normal?

    Sometimes nursing school can seem more like a teach-yourself program... the coursework just breaks down various content... 1 week - 4 dozen GI issues (3 hr useless lecture; cover 250 pages on your own; then be tested with a mere 25wacky "NCLEX-style" questions that barely touch on any of the material covered) and trach tube care (show you once, leave you to flounder with each other and then mark you off for minute, inconsequential differences in technique - like the one you reviewed from the school lab's video library). They warned us we needed to know EVERYTHING in the syllabus but didn't teach much of anything. It felt like they crammed everything onto to syllabus as their own 'CYA'. No student can complaing "we never covered that!" ... because in the thousands of pages text assigned, just about everything was touched upon, though maybe just a few words, once as an aside. It actually discouraged me from attempting to get a deep understanding of things like fluid/electrolyte because that would take me hours of study to get and there'd be maybe 2 test questions on it; meanwhile, that would be study time taken away from covering all of the assigned reading, re-writing care plans (since instructors were rarely clear on exactly what they wanted), etc. I found school pretty frustrating, too!
  19. jjjoy

    priority nursing questions

    I'm honestly curious, if the O2 were already set up and flowing and all you had to do was put the mask on the mom... would you put the sterile gloves on and push the baby off the cord before throwing the O2 mask on? Even if that's not right for a test question, what would happen in the real world? And here's some nitpickiness about the use of the word "priority" as well as clinical curiousity... one certainly should put on those gloves prior to putting one's hand in the vagina, but are the gloves a higher *priority* than moving the head off the cord? If by some strange twist of fate you had to choose between putting on the gloves and holding the baby off the cord, (I don't know, an earthquake has just torn the entire room in half, and the sterile gloves are on the other side of a chasm) would you put your hand in ungloved despite the risk of infection? I know, unlikely, I'm just exploring how one prioritizes in less-than-ideal situations. Being able to prioritize is not just about not being able to do everything at one time, but sometimes not being able to ever get to everything period.
  20. jjjoy

    getting mixed info on umbilical cord care! Help!

    Oh well! Maybe just accept that some NCLEX questions will be impossible to definitely get right and move on? Frustrating as it is, sometimes resources do contradict each other. It's not hopeless, though. Have faith that there'll be enough other questions that you *can* get right to pass the test. So keep studying! It's unlikely that your test will have the exact same question about alcohol vs. mild soap and water, but it may have some other question about newborn care. Use the question you have about umbilical care to direct your attention to general newborn care and make it an opportunity to review notes/sections on newborn nursing care. Just a suggestion! You seem studious and motivated and that'll take you far!
  21. jjjoy

    nursin school/vent

    You're right. It's often NOT nurturing and it *IS* like a bootcamp at times. I'm thinking of those weight loss bootcamps... someone uses all their willpower to successfully snack on natural foods and avoid things like ice cream and cookies, and then the coach yells at them for eating too many carrots instead of celery. I don't like this approach myself but it doesn't seem uncommon in nursing school. So make the best of it possible. Find a way to make it motivating to you. You can take it as a challenge. They think you're not up-to-snuff? Well you'll prove your worth by always being two steps ahead! If they don't seem to want to teach you, then do whatever you can to teach yourself and find others to teach you (classmates can help each other since each have different strengths and weaknesses). You will run across a lot of unsupportive people in your life as a nurse and in general, so might as well start now not letting anyone else determine your worthiness. Even failing a class, or being told "I don't think you're cut out for this" doesn't mean you can't be a great nurse. That's up to you. If you really want it, you'll make it happen eventually. And if you don't want it that bad, that's okay too. Just don't blame it all on bad instructors (even if they actually are poor instructors). You can take it as a compliment. Though it may feel unfair and like you're not getting as much support from the instructors, they are in fact noticing you and giving you a chance to show and practice your fortitude, perserverance, problem-solving skills, humility etc. The goal isn't to get everything right, be complimented, and avoid being criticized; the goal is to adapt and learn from even difficult, uncomfortable, discouraging situations. Again, it may be like a coach who taunts the training athlete "that's the best you can do, huh? I thought you were better than that!" Some students have felt threatened with failure right up until graduation, and then surprisingly find their previously discouraging instructors telling them "You did it! You'll be a great nurse!" Personally, I don't like this approach and wouldn't choose a mentor or coach who worked that way, but we may not have much choice in our instructors / preceptors / colleagues. Thinking of what feels like unsupportive criticism as at best well-intentioned harshness or at worst, practice dealing with a difficult person, makes me a bit more tolerant of it and able to work with it a bit. I still don't have to like it, though! Best wishes!
  22. I was in a full-time 'regular' day program and our instructors were not very open to reviewing test questions either. It may just be a general nursing school thing as opposed to being a night student or not. It's hard to tell what the "usual" experience is since most of us have really only been exposed to one program!
  23. jjjoy

    getting mixed info on umbilical cord care! Help!

    I can't tell you what the absolute latest practice recommendations are on that, nor how up-to-date the N-CLEX will be. However, when looking at the sample question, were there perhaps any other problems with the alternate answers, such as "vigorously scrub"? Sometimes, the key to choosing the correct answer on the test is less about what is the exact latest practice and more about carefully reading the question and ruling out the worst options, even if the the "best" option may not be ideal.
  24. jjjoy

    Crossed the line... or expected behavior?

    What you're saying is totally reasonable; but I think it distracts from the main issue here. Even if the student's comments to the patients were too loud, too long, and/or too detailed, before criticizing I think the student ought to be given kudos for being concerned about the patient and doing something about it as opposed to just thinking "if the physician's here, I only do what I'm told to" and "if the physician doesn't seem concerned, that means everything's okay." Could the student have done a better job at it? Probably. There's almost always room for improvement in any situation. I don't know if the student was inappropriate or the instructor was overly harsh or neither or some combination. In general, though, unless it's an egregious mistake or a very clear & precise guideline that wasn't followed, it seems more constructive to me for instructors and colleagues to instruct and advise on how something might have be done better as opposed to rebuking the person for doing it wrong and suggesting that they should've known better. I'm not saying that's what happened here but I've witnessed a lot of it.
  25. jjjoy

    priority nursing questions

    Thanks for an interesting discussion. I can agree that notify the physician is priority. The thing is, I remember getting burned on other test questions where "notify the physician" wasn't the "best" answer because the question was asking about "nursing care" - or something like that. It never was made clear to me because we never had enough time to review tests and really figure out the ones we got wrong. So I just remembered that "notify physician" usually wasn't the right answer for test-taking purposes. So anyway, based on my test-taking experience, critical thinking led to me ask if "notify physician" is a "nursing intervention" since no nursing care is being directly delivered to the patient. Critical thinking would also lead me to ask what "priority" means here. Does it mean "what's more important in the bigger picture?" or "which would you do first if you had mental telepathy?" I mention mental telepathy because critical thinking tells me that to notice the symptoms, the nurse is at the bedside and it would make sense to elevate the arm prior to leaving the room to make the call to the physician. And if someone were just passing those observations along to the nurse, the nurse would first go assess the patient themselves before calling the physician, right? When applied this way, critical thinking becomes "overthinking" and "reading too much into the question". Sigh!
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