chicagrl

i was also going to recommend the cherokee top that is 28.5 inches. One of my fave scrub tops!

I am so confused by it too. As a first year nursing student who is overwhelmed by info overload, I find it very frustrating that all of our clinical paperwork must be filled out according to the Roy Model yet NO ONE has explained it very well. In fact I am beginning to wonder if any of my instructors understand it. I did find the article Daytonite linked while doing my own research - it is helpful but I still can't grasp how it all applies to our Nursing Process Worksheet and four mode assessment sheet that must be filled out for clinicals. thanks for listening to my rant :)

Daytonite: Thanks so much for your explanation and guidance! I don't think I have enough objective (or subjective either) data from my assessment to support the care plan for Ineffective gas exchange. (at least not the way I think my instructor will analyze it) I am going to focus on the Imbalanced Nutrition diagnosis. I feel more comfortable working with that. I am 2nd semester nursing student and we are not too advanced on care plans yet. leslee I

but i don't see any NANDA diagnosis that would pertain to this situation....

nevermind , i see there is a section of them under safety. i will post again with anything i come with to see if i am going in the right direction...

Thanks She had a fire in her kitchen. I did not see a NANDA listing for that type of thing : safety, evaluation of her living situation etc.

Hi I am hoping for a bit of guidance. I have to do a care plan and can't come up with anything so far. My pt was 84 and in for smoke inhalation. She was fine by the time my clinical day arrived. Her vitals were within range, and she had no IVs or oxygen. Her hosp care plan was impaired gas exchange. I have no objective data that points to that. She was ambulatory and able to carry out ADLs. She had low Hgb and Hct levels that were being investigated. Can I write a care plan on that ? I don't really see any NANDA entries related to that though. She seemed most concerned about her futute living conditions. Can I do a care plan on that? I am just feeling stuck . Any advice is MUCH appreciated. thanks lhr

IN chicago Thanks though :)

bump :) anyone on allnurses taking RN to BSN coursework in ILLINOIS? I would love some info from those with firsthand experience. Do any hospitals pay for ADN TO BSN completion? Thanks

Thanks Daytonite! The problem is , I don't have any answers. I was only with her for about 5 hours this am. She had just finished the blood transfusion and SAID she felt better - they drew blood to check her levels but I don't have the results. She had a painful swollen ankle previously, her uric acid levels are in normal range but I guess she good still have gout - they don't really know. She does not currently have and S&S for gout. She was going for some type of gyne stuff to see if there were fibroids. She did not complain of any symptoms, has not had any S&S either but they are trying to rule everything out. Vitals, all within normal ranges. Don't really know where to go with this....

hi daytonite, I had a pt today who had gbp surgery 7 years ago. she was hospitalized b/c her primary care physician requested she get blood. her h&h levels were low. do you think I could use #2 or #3 from you list above ? I am having trouble because I have no s & s except her lab values for h& h. by the time I met her she already received blood and said she felt great. not sure how to go about a care plan for someone who does not seem to have any trouble. they wanted to run some more test on her for fibroids . she also had some gouty issues which is why she went to see he pcp in the first place. she says she eats well and has not had any problems since her gastric bypass. can I do a care plan for imbalanced nutrition even though I am not sure why she is anemic? anemia apparently "runs in her family" ?????? help thanks chicagrl

THanks ..funny how my instructor did not mention any of these..perhaps too advanced for first semester...probably not?

And the "competition" will never end -just don't play into it....Think about it....don't *some* people always want the "best car" or have the "most gifted child" etc....It happens in every facet of life. Just b/c someone aces a test does not mean they have good clinical skills, I would talk to an instructor, confide in someone who you feel will listen and work with you on this. Perhaps you are being to hard on yourself. Awesome for you that you are almost done with a BSN :) congrats

I don't know how to do a care plan for someone who seemed to be in pretty bad shape. 80 yr old female who had been in CCU for 2 weeks (came in coherent and had been gardening and mobile days earlier) she was transferred to med/surg and the family was trying to decide on hospice care. I am not sure how to write a care plan for this pt. She obviously had ineffective breathing (15/ml O2 with mask) tissue perfusion problems (gangrene on all fingers and toes) she was on antibiotics and morpheine with rectal acetominophen (but she had a colostomy) this was all very confusing to me. I mostly just felt horrible for the family and am having a hard time trying to digest my experience today. Please be gentle , i am a first year student and trying to do my "homework". I almost feel disrespectful to my pt. but I learned a lot today, just have not really processed it yet. thanks for any insight- i wanted to go with comfort dx but the NANDA list options don't seem right either. she was obviously in pain d/t the gangrene, therefore the morphine...etc. but i am not sure i want to focus on chronic vs acute pain. I wanted to write one along the idea of "comfort care" /end stage. I know I can't make those choices - i am just confused !

How wonderful! I hope I feel the same way when I am a new RN, no matter what dept I work in. I think it is great that you are surrounded by people who want to share information/educate!

as someone who recently had a baby and is also a nursing student i say . ewww it is too bad you have to documuent all this crap ...ewww mom having baby ...let her be ...nursing dx...not trying to be smart

OMG I am glad you can document and understand that you were treated poorly, not by the book etc. As a nurse , you have so much knowledge regarding your treatment. As a new student, I already know that my text book sounds great but real world healthcare does not follow all the lovely ideas my text book describes. I have been having a really hard time at clinical b/c I know one thing is supposedly right, but I have never experienced any of this so called health care system espoused in texts. If we are questioning our care, how does the typical patient deal with this? All I ever hear are bad , horror stories. I have many questions............but hopefully you are well. I mean really well! I don't want to go OT

I am sure it varies by program :) This first semester we only have clinicals 1x per week, in addition to our skills sessions on campus.

okay so therein lies the problem? i am just really confused . i am the person you just described but we are all so green . start clinicals from the beginning. this is our 3rd week in school and in clinical. maybe our school is doing it all wrong. that is what one pct told us. she has seen other students from other colleges who are more on their game...well they are probably not 1st year 1st semester students....duh ...so how do i deal with this ? thanks for your reply btw :) i totally understand not wanting to deal with the slacker type newbie acting student.....but these days i wonder how many of those types are allowed into nursing school??????????????? my program is asn/adn but it is hard to get into.....all of us seem to really have our stuff together. we are wondering if maybe we made the wrong choice by choosing an adn program ...i feel it is probably like this a lot of places ...

oh my ...stop what your are doing.... where are you? i have some experience with this. as a caucasian girl .... I had to go to college and be "smart" b/c i was first born and that is "just what we did" i bet i can kind of empathize. not trying to stereotype..but that is all my nursing texts do... i did not realize how big healthcare was in the filipino community until i took acna class in my city. wow. i bet I know some of what you are feeling.. anyway . if you are living in america you need to DO what is best for YOU ...i hope i am not flamed for saying that but that is what most of our filipino friends have done..... it will be hard but maybe you should come back to nursing take some time off if possible .. find a secure place. do you have any older siblings who may be more open minded? if not then a: suck it up , do it ..get your credentials and then go do something else ...what many of my friends did (all ethnicities) or b) do what you want/need to do and expect some other types of hardship..i only recommend this if you have a good support group ..friends . other relatives etc who are open to you doing something besides "what you are supposed to do" blah blah blah

Clinical site RNs don't want us around.... permalink ETA: It is not just one nurse ..it is all of them. Granted, this is a 5 nurse floor and there are 9 students. we have been doubled up so far ..... Hi I am a first year student. We have clinical once per week and have just started interacting with patients. Today we gave or helped with bed baths. The problem I see so far is that the nurses are definitely not friendly...in fact none of them seem to want us around. We are mostly in the way. I feel that this is an issue my school should deal with, at least our instructor. She finally admitted today that none of the nurses are very friendly. I am not sure what type of relationship she has with them but it does not seem like much of one. Has this happened to you and how did you deal with it. We were supposed to sit in on report this morning and got "shooed away" literally. "shoo" We ended up talking with the PCT and eventually gave a bed bath . Our clinical instructor came to check up on us and then later told us all the things we "should" have done etc. It just seems like we need to shadow more but our instructor says we will only learn from "DOING" I agree but i had never even seen a heart monitor or leg compression boots until today ...as i was helping a pt get clean. Any insight would be great . every one in my group is already counting down the clinical days.....we only go once per week ...until DECEMBER . It is obviously our instructors job to teach us - plus we have a skills check off session each week before clinical. It just seems to be very "incongruent".... x posted . i am not bashing any instructors . I fell like mine may not have the support she needs either ....

thanks for your replies. It almost seems as if the system is broken and I was not sure if it was just my school, this hospital or what? I really like and even admire my instructor. I feel bad for her ..she seems very qualified and so far is GREAT . I have had professors in other areas who know the material but don't know how to teach it. I don't get that vibe from her. She is still practicing in the ER - registry but not at this hospital. She does not seem to have any kind of "in" with these nurses and they are definitely not helping her out. She has maintained a professional presence but I think maybe she is annoyed as well. This is her first year as a full time instructor. HELP how do we fix a broken system ? I wonder if i can xpost this in nursing instructor forum???? any ideas I will kill them with kindness but i can't really show off my skills...I just got checked off on bed baths. Many of us have taken CNA course in the past but not necessarily utilized the skills we learned . It is not a requirement to have a CNA license for our 2 year program as I know it is for some . We are a very "willing to learn" group. A lot of adult learners and not too many with the attitude of "i am already THIS so I am sure i can be a nurse" . most people are generally in this program for a reason (it is so hard to get into as i think all are ) I will continue to be kind but when i really don't *know* anything it is hard to have that mentality. I would have loved to have really chatted with my pt today therefore probably gleaning LOTS of info but i was so worried about THERAPEUTIC conversation and HIPPA that i was so STERILE ..like i needed to say the right thing...i think if i had just been myself i would have gotten a lot more info. UGH

Hi I am a first year student. We have clinical once per week and have just started interacting with patients. Today we gave or helped with bed baths. The problem I see so far is that the nurses are definitely not friendly...in fact none of them seem to want us around. We are mostly in the way. I feel that this is an issue my school should deal with, at least our instructor. She finally admitted today that none of the nurses are very friendly. I am not sure what type of relationship she has with them but it does not seem like much of one. Has this happened to you and how did you deal with it. We were supposed to sit in on report this morning and got "shooed away" literally. "shoo" We ended up talking with the PCT and eventually gave a bed bath . Our clinical instructor came to check up on us and then later told us all the things we "should" have done etc. It just seems like we need to shadow more but our instructor says we will only learn from "DOING" I agree but i had never even seen a heart monitor or leg compression boots until today ...as i was helping a pt get clean. Any insight would be great . every one in my group is already counting down the clinical days.....we only go once per week ...until DECEMBER . It is obviously our instructors job to teach us - plus we have a skills check off session each week before clinical. It just seems to be very "incongruent"....