CanuckStudent

Just wondering how you guys keep your 'scopes clean. For example, do you just use the antimicrobial wipes? Can you even use alcohol on the bell/diaphragm of a stethoscope? If you were going to examine a patient, would you wash your hands/use a wipe on your hands, wipe the scope (bell/diaphragm) with a clean wipe, and then warm it with your now sanitised hand? Is this how you guys normally do it? Note: I'm talking about general infection control, not in areas where disposable nursing scopes would be used, etc.

Just be sure that you know what you are getting into. Nursing schools often love to showcase propaganda about a 'caring profession' that often appeals to the business/IT sect who are looking for a change and 'want to make a difference'. Just be prepared that when you hit the floor running, it's not the same as nursing school. This field has a lot of politics and other issues unique to it. While we need good nurses, we also can't pull people into the field without giving people a heads up first. They will leave anyway. I highly suggest that you job shadow a few nurses. Learn what nursing is really like *in the real world*. Do this on your own to prevent bias. Going to school open houses will not give you a real perspective. Talk to nurses that work in the hospitals and clinics in your area. You'll either love the environment and job duties, or you won't. If you are still 100% sure that you want to be a nurse. Go for it. You likely would make the perfect nurse. You have the skills and the right realistic attitude combined with the desire. You should have little problems getting through nursing school based on the info you provided. If you walk away undecided, all is not lost. There are many more healthcare jobs that 'help people' besides nursing. Nursing does not have a monopoly on that. What kind of 'math and sciences' are you 'good at'? If you are talking about university classes (calculus, biochem, physics, etc), why not focus more on that route? Pharmacy is a great choice. It's a stable career where you can make a large income and work with people. Respiratory Therapy is another option. Physical Therapists can open their own clinics. The list goes on and on.. I have known a few people who 'jumped ship' and now regret it. My key points are not to rush in to anything, and don't leave a stable decent paying job unless you are 100% sure that it is something that you want to do. That said, you are still relatively young and have time on your side, and you've already had your kids. So really, in the end, it's up to you if you want to explore. Just know exactly what nursing is before you jump in. Going on your description, you may be disappointed that you will likely have little time to sit and chat with patients, little time to 'make a difference', and you may even find nursing not enough of a challenge. For most people with a strong math and advanced science background at a university level, nursing is a lot of material, but it's not hard. Sure you can work your way to ICU/ER nursing, or another extremely challenging role, but are you prepared to deal with the politics and floor nursing duties that you will have to put up with in order to get there? Nursing can be a great career, and many people love being a nurse. But if you are unsure at all about nursing, you risk becoming one of those nurses who are very unhappy, frustrated, and want to leave. It's because of this constant turnover that people like you can now enter nursing and have a job. Just do some research first. You can also try working as an aide for awhile to gain some 'insider' experience. I don't want to discourage you, but rather enlighten you.

That may be so but this role is not the same as CRNAs in the US as far as I can infer. It will be primarily an 'assistant' role under an MD. Until there is a licensing body for CRNAs in Canada and the role is accepted (if ever), I would be hesitant to suggest this route for someone who wants the scope of a CRNA. http://www.georgebrown.ca/alumni/profiles/Natalie-Campbell.aspx http://www.news.utoronto.ca/lead-stories/u-of-ts-bloomberg-faculty-advances-nurses-unique-role-on-anesthesia-care-te.html I don't see anything here that says that these nurses will be functioning the role that you think they will. "Care" does not meant administering in the same independent capacity as CRNAs do in the US. At least from what I can tell. No offense, but I wouldn't let anyone touch me to put me under with that kind of limited training. Nowadays, patients are sicker than ever and often have multiple comorbidities. There is no way someone with the education listed here should be allowed to independently handle cases. http://bloomberg.nursing.utoronto.ca/CASPP/Anaesthesia_Care_for_Nurse_Practitioners.htm

Fiona59 said it best. 1.) Canada doesn't use CRNAs. Some people are not aware of this. We don't have them. Our standards are different in healthcare. Only MDs can be anesthetists. MacMaster (I believe) has started a 'anesthesiology assistant' program that accepts nurses, but it is not the same scope (not even close) as a CRNA. If you want to be a CRNA, you need to get the documentation to move to the States, get accepted to a school in the States, and take the long hard road as Fiona59 pointed out. Also, you need a BSN (not any other degree) to apply to the CRNA programs, and experience working in critical care. They only want the brightest and best. 2.) Which leads me to...your grades. A GPA of 3.6 is not competitive for Canadian med or dental schools with few exceptions (I.e. your MCAT or DAT score is extremely high and your ECs are stellar). In most cases, you simply won't make the cutoff. I suppose I can only really speak for Canadian med schools (you need typically AT LEAST a 3.7), but dentistry can be just as tough. I know people who have applied to both with GPAs from 3.9-4.0. I'm not kidding. I'm not saying this to discourage you by any means, just letting you know what you need to improve if you are serious about dentistry. Also, if you only have a 3.6 GPA with primarily arts courses, you may find it tough to get a 3.7 when you are taking Organic Chem, physics, calculus, etc. the classes typically needed for dentistry. Pre-med and pre-dental pre-reqs are generally the same. I know because I had pre-dents in many classes and have looked up the pre-reqs out of curiosity. Usually pre-professional (Dentistry, Meds, Vet Med, etc.) classes are the same. What science classes did you take as part of your degree? Many general bio and chem courses for arts majors are not acceptable for dentistry. Also, medicine requires that you have a full course load, and dentistry usually does as well. So if at any point your classes dropped beyond a full load, your grades for that semester will (likely) not count. You will need an additional semester of FT classes. Not saying that you did, but some people don't realize this. For example, nursing pre-reqs can be often completed part time, no one cares. Not so with medicine or dentistry. It's not hard to get a GPA of 3.5 taking a few classes at a time. It's something else to balance full pre-med/dent classes (including 'GPA killers' like O Chem) and still pull out a 3.7 or greater. 3.) I often come off as abrasive, so please don't think I'm attacking you. I'm definitely not. I'm simply just trying to give you a heads up. Since it seems like you didn't know what you wanted to do until now, it's not like you would know this. I HIGHLY suggest that you meet with an admissions/academic advisor at your school (or the school you wish to apply to) who can advise how to proceed. If you are looking at the US for CRNA, you'll need to figure out if it will be best to do your BSN here (perhaps with an accelerated program as you are a degree holder), or in the US. I don't know which works out better when you factor in relocation, if the school only admits Americans, etc. Also, while you can come back and work as a dentist in Canada, you will likely pay much more in tuition. And some professional schools may not admit anyone other than Americans. Call around. Only you can decide which you would prefer, the two practices are completely different. Also, Canada doesn't have the 'malpractice' issues that the US does. Feel free to PM if you require further info. I do also agree that you need to check out pre-med/pre-dental forums.

Daytonite has it correct. You are a nurse. Not an MD. Your main concern is how to provide care for the client and the risk factors that may affect or change that care. You are not diagnosing or treating any disease. Also, think about your wording and what you are saying (aside from NANDA). Since you are not an MD, it would be incorrect to infer that your patient has 'vascular resistance secondary to Hypertensive Crisis'. How can you determine that? Are you assuming that he has hyperthyroidism and is in a thyroid storm/toxicosis and thus his increased (not decreased) cardiac output thus triggered reflex resistance? Vascular resistance is a cause of HTN, but it doesn't make any sense to say that the vascular resistance was *caused by the HTN crisis*. If you were making a medical inference, you could reason that your patient has increased cardiac output/stroke volume due to Grave's toxicosis (hormone triggered HTN that can cause sinus tachy), which caused vascular resistance, which combined started a cycle that lead to a Hypertensive Crisis. I'm simplifying of course. And I'm just a stupid Practical Nursing student. But my point is that I agree with Daytonite and that you need to focus on what *nurses* diagnose (nurses are not junior MDs), and the NANDA list and format. Good luck! P.S. Daytonite gave you a good link. From what I have seen, this isn't really a homework question forum (assuming this is what your question is), so your best bet is to talk with your instructor if you are really stuck with the NANDA system. It is confusing to many people, especially if you are coming to nursing from another healthcare background. Nursing is its own entity with its own rules. :)

Genetic predisposition to HTN in AA are being investigated. Genetic disposition doesn't mean defect per se, but rather mutations in SNPs. It *may* be proven correct that a subgroup of AA have a higher risk of developing HTN either independently or as a result on interaction with lifestyle factors (this is my speculation, this is not in the Abstract). Interesting work. http://www.ncbi.nlm.nih.gov/pubmed/19341158? ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

If you want to take this one step further in the nursing realm of socioeconomic factors, (and I HATE generalizing about this), some African Americans and some other minority groups *often* lack proper education in order to learn how to avoid HTN. For example, most will have never heard of the DASH diet as a way to prevent/treat HTN. Some may have poor reading skills that impact their ability to read health literature. So these people may be at an even higher risk (generalizing here) because of their lack of education on a healthy lifestyle. The white woman with a family history may already be very aware of which lifestyle factors affect BP for obviously more than one reason. If you want to get technical, you could reason that since she has a strong family history, she is well educated in positive health behaviours for avoiding HTN.

So what did your instructor say is the right answer? :) I see what you're saying but I'm not sure if I agree. Remember, you're contradicting yourself a bit here. You're saying in one breath that genetics WILL make the 35 year old develop HTN (or be at high risk), but that being AA WON'T (a genetic/racial disposition to certain conditions is often found in AA people). I know many AA, Aboriginal, and East Indian people for example that have HTN and/or Type 2 diabetes, which is usually associated with being overweight and lifestyle. But these people are thin, eat healthy, and are active. It is well known that some (non-white) races have a higher genetic disposition to certain diseases. HTN is one of them. Also, if the person who is 35 has a very strong history, her familial HTN may have nothing to do with lifestyle and there is no way for her to prevent it no matter what you do. While many are, not all cases of HTN are lifestyle related, as I mentioned earlier. Especially if she has a very strong family history and none had related risk factors. These are cases for the MD to solve and not for nurse teaching. In the case of the AA man, he has a total of 4 risk factors Vs. the woman's 1, and 1 of them can be modified by current nurse intervention. So I still think A is a better answer. :) I know some people have assumed the the AA man already HAS HTN, which may or may not be correct. But I don't think an LPN instructor is trying to make a question more complicated then it has to be. If you aren't going to assume that being AA puts the man at a higher risk for HTN, then it's almost ironic (IMHO) to assume that he already HAS HTN for the purpose of this question. All in all, I don't know who's right. For the purposes of nurse education, I used the numbers game (I'm a numbers person :)) If you were looking at this from a medical standpoint, sure, you'd want to know more about the genetic background of C, and if A LACKED any history of HTN in his family (genetic protection or lack of disposition). For example, while we all know that smoking damages DNA, not many people know that the people who tend to get lung cancer often have a gene variant than makes them predisposed to it. Hence why some people will live to 90 and smoke like a chimney. They don't have the gene variant. But this is all not something that your typical nurse would need to know. Your job is patient education for the majority of people who have lifestyle related and modifiable risks, and general assumptions are made about those risks. When you look at this generally, I can see how some pick either A or C. I'm really curious to know though. Will you please tell us who in the end is right? Did you get the question right and everyone else picked A and got it wrong. I'm willing to admit that I'm wrong, but I want to know more.

A.) These types of questions are terrible, but there is usually one clear(er) answer. In this case, it's a numbers game. A male African American, older age, and overweight. Here are 4 reasons that will increase the risk of HTN. 4 risk factors tops the rest. Male AAs are very high risk. This may be due to a genetic susceptibility to be sodium sensitive or to HTN itself, proneness to obesity, or other lifestyle factors common in this group, such as diet or smoking. AAs also tend to have a higher rate of Type 2 diabetes and its complications, another risk factor. They also tend to respond to anti-hypertensive drugs differently, which can make treatment more of a challenge. While the 35 year old likely has a strong genetic risk for example, that is only 1 factor, unless she has other risk factors or a co-morbid condition such as kidney disease for example. Some cases of HTN are secondary to other diseases or disorders (Cushing's, Hyperthyroidism, blood vessel disorders and defects) and can occur in young, thin, fit, active, etc. people, but generally speaking, many cases are linked to ageing (primarily isolated systolic), excess weight, and lifestyle factors. In theory, all of these people are at a higher risk, but using numbers, A is the MOST likely solely based on the stats given. The idea for this is to be able to recognize when a patient has multiple risk factors, and which factors can be modified.

Nightingale (either on her own accord or via propaganda) promotes everything bad and sexist about nursing. Why is she idolized into modern nursing curriculum? The subservient role of nurses, nursing as a female calling, nurses putting their patients ahead of their own needs, the later anti-male propaganda and MD backlash that plagues nursing today.... I know I'm going to offend someone (as per usual ). It is a disservice to both women (and men) and the nursing profession to continue to promote Nightingale. It is oppressive propaganda. And people wonder why nursing has the issues that plague it to this day....FN doesn't apply to modern nursing. I propose that FN simply used nursing as a means to further her own recognition in an attempt to gain autonomy. I suppose being a teacher just wasn't as radical. There is growing evidence that she also did not accomplish what many think she did. http://www.bbc.co.uk/history/british/victorians/nightingale_05.shtml http://www.york.ac.uk/depts/maths/histstat/small.htm This is scathing, but an interesting read: http://www.bmj.com/cgi/content/full/337/dec16_1/a2889

Just to clarify, I am a student, NOT a 'seasoned nurse'. But I have to agree that the uniforms of yesteryear were very regal and professional looking. I like the caps as well. With those, you either love them or hate them. Dresses, while rare, are not dead. In fact, some nurses still wear dresses and 'old school' style uniforms as long as their workplace doesn't have uniform restrictions or requirements. In fact, I knew of a care aide who only wore the dresses. I also heard of a nursing student who wore a vintage nursing gown for all of her clinicals (no, I don't know how she was able to not wear the school scrubs). She said that her older patients really liked it. You can still buy dresses and older styles of uniforms, but they do tend to look dated. However, if there are no restrictions on what you can wear, it's up to you. All of that said, there are many good reasons for scrubs. Some people care, some people don't. There are valid reasons for each side, and it's not all about the appearance. The fact is, nursing is not what it was. Old nursing has gone out with the cap and gown. Before nurses would have 1 or two patients, and have time to give backrubs. A dress would be fine. Nowadays nurses are used to a higher scope to care for sicker patients. While the nurses in the 50s likely stood back and watched the MDs perform lifesaving measures, it's nurses now who would be jumping in. A white gown is simply not practical for many/most acute situations, where you will be bending, jumping, etc. That said, if you work in LTC for example, there is no reason why you can't still wear a more traditional uniform. Search online or have some custom made. I know Avida Healthware (in Canada) still offers some of the 'old school' uniforms.

All I can say is that Minnedosa is beautiful...and they used to have an AMAZING classic rock festival around August long weekend. 'Rockin the Fields of Minnedosa' (Essentially a 'classic rock weekend', sometimes the name would change due to different promoters.). I went in 2002 and saw Pat Benatar, Billy Idol, Trooper, etc. Easily the best concert of my life. Now the performers aren't usually quite as big, but I would think that it's still worth checking out if you love classic rock. Just do some research on the headliners...I hear that nowadays it's more hit or miss each year...

That is a situation that has 'no good' written all over it. Are you saying that they are asking you to put in central venous catheters?! First of all, I definitely would refuse to perform all skills that I felt I wasn't properly trained for or wasn't comfortable with. While I'd like to gain as much hands on experience as possible, I know my limits and where I'd draw the line with my current training. Compensation, a whole other *important* issue. But I would not actually do something that I felt would be unsafe or outside my scope. It's not worth it for 'less than $22/hr'. Speak out. This is not fair. And most importantly, potentially not safe. There is a huge amount of risk here. Like you said, it's not worth stressing over, killing yourself, or killing someone else over for 22 bucks an hour. I have to thank you though for being so honest. As much as I hate to hear your working conditions, at least you are speaking out. I unfortunately am in the same boat as you (not sure what to make of this), and don't have any direct advice other than to refuse and speak with your supervisor. If what you are being asked to perform is restricted for the LPN scope of practice (and I was sure it was?), then that is a whole other ballgame...I would assume the union would be involved, among others. Hopefully Fiona59 can be of more help. I'm thinking of you.

What do you think of CLPNAs new advertising campaign to (supposedly) attract (younger) people to practical nursing? They're trying to promote PN as a preferred career choice with benefits. To give them credit, they don't put down RNs while doing it (), but it doesn't seem right to attract more people to the profession until they sort some of the alleged issues either. Public education regarding LPNs as professional nurses and wages are more important at this time I would think. I agree that LPNs should not be cheap labour in place of RNs. It's fine to promote LPNs, but if your goal is attracting more LPNs, be sure that the dues you collect from them is money that they can afford to give. Also, if there are still issues with LPNs finding FT or even PT positions, I would think that this is a nonsensical move. All of that said, I will freely admit that I know very little and am simply wanting to open the dialogue to hear opinions from you, the people who really know what's going on because you have been through it all. I do think with my limited speculation that it's silly if CLNPA keeps passing the buck. I didn't realize that Stanger was an RN...interesting. Why are they not utilizing an LPN in that role?

While I didn't mention this, good point at the end. I definitely agree with the latter part of your post. True, I can't stand it when people class LPNs in with toilet cleaners and dietary aides (no offense to support staff, they work hard too and I greatly respect them), or even nursing/care aides. LPNs are professional nurses. Period. However, when you get unions that think RNs are the be all and end all of nursing, that is just as upsetting. That RN promotion campaign is disgusting and unprofessional. I can see why many LPNs would never want to join UNA. Assuming they have the same mindset and people at the top, that only makes sense. BC also seems to have a big split in this issue with their LPNs and their current union vs. merging. It's truly sad, as I can't see why we can't all respect each other for our scopes and be paid accordingly. While I don't want to price myself out of a job (like many RNs are figuring out since they can now be replaced in some cases with LPNs), I agree that LPNs need fair pay for the new skill set and education. I find it interesting that an older RN with a diploma could be making more than twice as much as me and yet have a smaller skill set. All of this said, in some cases a unified union (is that redundant? ) can work great for LPNs. MNU in Manitoba is an example. The question is, does everyone think AUPE will deliver for LPNs? What is the future for LPNs in AB with the 'new' standard?