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?

Apparently both. Here's a link from my friend Google : http://www.rosemed.com/CPM/RM%20Condition%20H%20-%20Room%20Flyer%20a.pdf Sadly, medical errors are not uncommon. This is a terrible story. While medical errors happen at all scopes of practice, I do believe that the nurse should have gotten the MD at the parent's request. In peds cases, I would think that parents know their child best. Also, it's very possible for a nurse to miss a developing complication or a risk for a complication that a specialist MD will not. It's obvious that there were a lot of mistakes made here. It is a patient's right (in this case the parents) to speak to their doctor. If it's not a medical emergency, let them decide and talk to the family. A nurse will not get in 'trouble' for requesting the doctor to look at the patient at the family's insistence. I know some of our nursing texts seem to dictate that nurses are the be all and end all of a patient's care, but it's not a bad thing to contact the MD. I think this article should be required reading for all healthcare students (meds, nursing, RT, etc.). There is no room for error in this business. Everything must be attended to and double checked. Thanks for posting.

Hey, don't be assuming that 'pretty' equals stupid or incompetent. That stereotype actually drives some people more insane that the inane comment made by your patient. I get your comment, though. Rather annoying when a client makes ANY reference to your or another staff member's appearance. You are there to care for them, not get an evaluation. Male Client: What do you look like without all of that war-paint? Me: A man. It hides the whiskers nicely. Are you still going to try and kiss me every shift?

Neither. So far, the same. I didn't gain weight when I started university either. I also eat healthy and am rather accountable for my actions. Weight gain should not be 'accepted' as a 'normal' part of the nursing school process. Even if you work shift work. I see nurses who eat crap all day/night. They wonder why they are so tired, overweight, etc. and can barely get through a shift. It always drives me bonkers (I don't understand) how nurses and nursing students are completely clueless about how bad their diets can be. Especially when a part of nursing is health promotion education. If you can take the extra 20 minutes to make some baked lemon salmon, brown rice (actually they have instant brown rice now), and some veggies with olive oil, it will pay off tenfold when you have that extra energy for your shift. For most people, if you eat healthy (and I'm not talking those processed 'Lean Cuisine' meals that the lay public have been brainwashed to see as 'healthy'...shudder), exercise, and sleep well, this should help you avoid major weight gain. Take the time to take care of yourself first. P.S. I'm not a 'stress eater', but I've heard it's a 'woman thing' As a female who tends to think more like a male (for better or for worse), I have to admit that I have no idea what this entails. That said, if you have a food addiction/stress induced eating, it would make sense to address the issue, much like an alcoholic, smoker, or drug user would seek counselling.

In your head? "How about a nice cup of shut the f... up!" That said, let's attack this in a more level-headed manner. As some on here may know (and perhaps dislike me for), I have a Type A personality. :) I can only imagine how upsetting this must have been for you. As you know, some people simply do not handle illness well. And that is to be expected. However, that can only be an excuse for so much. Assuming this man doesn't not have dementia or a psych dx, this is abuse by a cognitively competent person. You wouldn't tolerate this outside of your work. It is not part of the nurse's code of ethics to accept abuse either. It's shameful how some patients treat the very people who care for them. In this case, I simply would have asked the patient if they preferred another nurse to care for them. It's also entirely possible that they had some personal irrational issue with you (you look like their mother whom they hate, they hate minorities, you look too young to be a nurse, etc.) and nothing will remedy the situation other than another staff member. Sometimes it's best to bow out if you can. I'm not one of those people who thinks of trying to win over a tough patient as a 'challenge' that you can feel good about later. If they are going to be downright abusive, know that you do not have to take that. Honestly, I'd rather be fired then lose my integrity. See my other post on being abused by cognitively aware patients. I've dealt with a few, and I say no more. Joking with them can help, but it's a touch and go situation. If they're grumpy because they're nervous and embarrassed about their care, it often breaks barriers. If not, it can backfire. Tread with caution. So I generally don't recommend this, but some nurses just have that 'gift', in which they always know what to say. Aside from finding them a new nurse (trade patients if possible), or having a supervisor deal with them, you can also just stop feeding the troll and say nothing to them other than the basics (i.e. "this medicine is for your pain"). Don't try to 'be nice', don't try to go out of your way. They could also be one of those strange people who needs to be put in their place and then they suddenly become nice. We all have heard of someone like that. While you can't tell him off mid-shift, simply remaining distant may do the trick. There comes a point where you have to step back and say that nurses do not deserve to be treated like punching bags by rude patients. Normally I tend to side with the patients, as most are sick, scared, lonely, embarrassed, etc. But in this case, it appears to be blatant abuse. No one should put up with that, period. P.S. He could also just be one of those 'complainer' types who whine about everything and and anything no matter what. While you'd like to tell them that you'd send them to Africa and GIVE them something to complain about, realize that this is common. Many of us on here complain about nurses who complain, for example... Please, do not take this personally, even though that is your first reaction.

In some cases, it can be better to actually go out of your way to separate yourself from well, people with problems. You have enough to worry about dealing with patients, you don't need the unprofessionalism of said coworkers. If you can't look for another job, make the most of it until you can. Perhaps this is a broad statement, but it seems like most of the 'gossipy whiny types' tend to work on the floors and in LTC. You may want to consider a career in the ICU/ER or other highly specialized and perhaps more autonomic areas, where people are just too busy to whine and complain. Plus, they usually seem to LOVE their job. Please, I know there are some FABULOUS nurses who work on the floors and in LTC, but I'm simply trying to give this person some direction. So please don't murder me. Anyway, my advice is to walk away. Don't waste your time and energy trying to engage or enlighten them. If they have any hope of being saved from their negativity, they'll come around on their own. Sure, some people may not like you, but who cares? With people like this, you can do everything 'right' and they will still find a reason to complain. Might as well focus on making yourself happy first. Normally I'm all for teamwork (rah, rah) but we've all heard of some toxic nurses where it's best to just remove yourself from them. Remember, you work for your clients/patients. If some of these nurses actually got off their....and did more for their patients and communities (who has that much time to complain on the job when they work in healthcare!?), healthcare would be a much better place to work. Set the example by being productive. There's a small chance that they'll draw correlations.

I feel horrible to even mention this (poor lady), but one time a Resident vomited and her teeth came flying out and landed on the floor beside her bed. It was rather shocking. Double whammy. Good thing she had a great sense of humour.

Oh God, colostomy bag changes, without a doubt. I have almost yacked more times than I can count. Of course, the client never sees me react (thank God for my local theatre school scholarship in junior high), but inside, I am asking myself "how did I wind up doing THIS"?! As a student, guess who always 'gets' to do ostomy care? :wink2: I have no idea how I am able to retain composure and be completely professional when clients are farting, oozing smelly bodily fluids (and well, 'solids' ), have gangrene, lady partsl discharge, and haven't washed in a week. One Resident in LTC had a lady partsl infection with discharge and a VERY strong odor (BV?) for sure, but the regular staff kept saying "that smell is normal for her". Uh, what?! You guys have been holding your breath when you walk into the room and yet think that is 'normal'? I'd almost pass right out and vomit from the smell. Seriously. I have a really sensitive sense of smell and gag reflex. All of that said, I suppose I can hold it together because I try to provide the most professional, respectful, and compassionate understanding care that I can. That's a no-brainer, as I like to say. But inside, I'm not going to lie, BM makes me feel like crap. As for everything 'medical' (surgery, blood, open/compound fractures, pulsating umbilical cords (hehe), etc.) none of that remotely bothers me to look at or touch. At least in theory. But I have heard of the odd student nurse or med student who has supposedly passed out in the OR....

Wow. I am so sorry to hear of what you have been through. I have heard some interesting 'nursing tales' but nothing that blatantly unprofessional and well, rude. All I can say is this, you deserve better. If someone cannot treat you with respect and in a professional manner, simply walk away. You don't get paid enough in nursing to lose your dignity and sanity. Abuse from coworkers (whom you would HOPE wouldn't have dementia or a Psych Dx ) should never be tolerated. If nursing wants to be seen as a profession, nurses must act professional. All nurses are nurses and should work as a team with other healthcare providers. It doesn't matter where you came from, what color your skin is, or what ethnic foods you brought for lunch (on that note, if it's Indian, call me). If someone verbally harasses you, and no one seems to be coming to your aid, consider pressing charges. I know that some in your situation seem to have little support from management, unions, licensing bodies, etc. If this is the case, look outside of the circle. I am still a student, so my advice may be a little green. But my point first and foremost is that you (nurses in general) do NOT deserve to be abused, and especially not by coworkers. Do not ever let yourself be disrespected.

Lifestyle AND previous conditions (e.g. diabetes), or lifestyle OR previous conditions? Let's not forget that not all 'diabetics' are obese/overweight Type 2s with multiple cardio risk factors related to lifestyle. Type 1 (autoimmune) diabetes, MODY, LADA, neonatal mongeneic mutations (such as KIR6.2), etc. are all diabetes forms not related to lifestyle nor preventable. Sorry, this is just a research interest for me, so I have to always rant about people lumping all forms of 'diabetes' together. I also tend to come off as abrasive, please excuse that. My main focus of interest is autoimmune diseases, including Type 1 diabetes. :) So please forgive me. I'm a little touchy. A patient with one of these less common forms of diabetes may thank you (the OP) one day for actually knowing the difference. Sadly, many general nurses receive little education beyond knowing if the patient " does/does not take insulin". I've known at least one Type 1 diabetic patient who went into DKA due to a viral infection. The RN in the ER told him that "he must have lost a lot of weight" as he was thin. Completely not realizing that almost all Type 1 diabetics ARE thin and fit, because the disease has nothing to do with weight. Ouch. Anyway, on the diabetes note, one thing you may notice is what's called "Long Q-T" syndrome. It can happen during periods of hypo and hyperglycemia (NOT just during DKA, which I believe is a relatively new discovery). Also interesting is that some studies seem to indicate that a percentage of Type 1 diabetics (I believe all studies were in peds populations) also have a congenital/familial form of Long Q-T that is always present, upping their risk for sudden cardiac death (particularly during nocturnal hypoglycemia). I personally don't know much, but the assumption may be that there may be a genetic link to both diseases in a subset of families. But don't quote me on that, or anything, for that matter. This is meant to inspire you to do your own investigating. Please note that persistent Long Q-T syndrome in general is rare, but in the diabetic population, seemingly not as rare. Of course, Long Q-T syndrome can occur in all patients with diabetes (primarily due to diabetic autonomic neuropathy). There are other things that you will discover such as LVH, which also is seen more frequently in the diabetic population (including Type 1s). You may also want to research which meds should not be given to a patient experiencing Long Q-T for example, such as (certain?) anti-histamines (have to double check that, I believe that I'm correct). Anyway, I'm just a lowly student too (everyone here could eat me alive with their knowledge), but I thought I'd post simply because I can relate to the OP. I think it's great when students are eager to learn as much as they can. I like that! To the OP, Good luck and enjoy yourself! To the poster I replied to, this was just a general response not direct at you personally, I simply used what you said as a stepping stone.

Awesome! Thanks so much! You sound like a wealth of knowledge as an LPN from Calgary with ER experience! I may just be PM-ing you with questions, so be prepared. This is great! I like that Calgary uses LPNs full scope, and in acute care (as more than just bed pan pushers). LPN diploma programs nowadays cover a large range of clinical skills and critical thinking/health assessment skills. In fact, with the exception of advanced skills, LPNs can do most clinical nursing skills, as you know. Also, many older LPNs have years of experience. It's nice to see these skills being utilized. I have also heard that some employers will allow LPNs to do IV starts (peripheral). Is this true? Also, I always thought that IV push meds were restricted to RNs, but something tells me that at least one Health Region allows LPNs to admin. them. Is this Calgary? It's not critical (did I make an ER nursing joke? :wink2:), but it is a skill that I would like to have. Thanks for all of the answers.